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Sample records for medicine services gestao

  1. Radioactive waste management of the nuclear medicine services; Gestao de rejeitos radioativos em servicos de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Barboza, Alex

    2009-07-01

    Radioisotope applications in nuclear medicine services, for diagnosis and therapy, generate radioactive wastes. The general characteristics and the amount of wastes that are generated in each facility are function of the number of patients treated, the procedures adopted, and the radioisotopes used. The management of these wastes embraces every technical and administrative activity necessary to handle the wastes, from the moment of their generation, till their final disposal, must be planned before the nuclear medicine facility is commissioned, and aims at assuring people safety and environmental protection. The regulatory framework was established in 1985, when the National Commission on Nuclear Energy issued the regulation CNEN-NE-6.05 'Radioactive waste management in radioactive facilities'. Although the objective of that regulation was to set up the rules for the operation of a radioactive waste management system, many requirements were broadly or vaguely defined making it difficult to ascertain compliance in specific facilities. The objective of the present dissertation is to describe the radioactive waste management system in a nuclear medicine facility and provide guidance on how to comply with regulatory requirements. (author)

  2. Radioactive waste management of the nuclear medicine services; Gestao de rejeitos radioativos em servicos de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Barboza, Alex

    2009-07-01

    Radioisotope applications in nuclear medicine services, for diagnosis and therapy, generate radioactive wastes. The general characteristics and the amount of wastes that are generated in each facility are function of the number of patients treated, the procedures adopted, and the radioisotopes used. The management of these wastes embraces every technical and administrative activity necessary to handle the wastes, from the moment of their generation, till their final disposal, must be planned before the nuclear medicine facility is commissioned, and aims at assuring people safety and environmental protection. The regulatory framework was established in 1985, when the National Commission on Nuclear Energy issued the regulation CNEN-NE-6.05 'Radioactive waste management in radioactive facilities'. Although the objective of that regulation was to set up the rules for the operation of a radioactive waste management system, many requirements were broadly or vaguely defined making it difficult to ascertain compliance in specific facilities. The objective of the present dissertation is to describe the radioactive waste management system in a nuclear medicine facility and provide guidance on how to comply with regulatory requirements. (author)

  3. Quality policy at nuclear medicine services

    International Nuclear Information System (INIS)

    Gil Martinez, Eduardo Manuel; Jimenez, Tomas

    2007-01-01

    In the present text we comment about a Quality Policy model to establish in a Nuclear Medicine Service. The need for a strict control in every process that take place in a Nuclear Medicine Service, requires of an exact planification in terms of Quality Policy, specific to the real needs of every Service. Quality Policy must be a live Policy, with capability of changes and must be known for every workers in a Nuclear Medicine Service. Although the 'model' showed in this text is concret for a specific Service type, it must be extrapolated to any Nuclear Medicine Service with the necessary changes (au)

  4. Customer service in equine veterinary medicine.

    Science.gov (United States)

    Blach, Edward L

    2009-12-01

    This article explores customer service in equine veterinary medicine. It begins with a discussion about the differences between customers and clients in veterinary medicine. An overview of the nature of the veterinary-client-patient relationship and its effects on the veterinarian's services sheds light on how to evaluate your customer service. The author reviews a study performed in 2007 that evaluated 24 attributes of customer service and their importance to clients of equine veterinarians in their decision to select a specific veterinarian or hospital. The article concludes with an overview of how to evaluate your customer service in an effort to optimize your service to achieve customer loyalty.

  5. Research data services in veterinary medicine libraries.

    Science.gov (United States)

    Kerby, Erin E

    2016-10-01

    The study investigated veterinary medicine librarians' experience with and perceptions of research data services. Many academic libraries have begun to offer research data services in response to researchers' increased need for data management support. To date, such services have typically been generic, rather than discipline-specific, to appeal to a wide variety of researchers. An online survey was deployed to identify trends regarding research data services in veterinary medicine libraries. Participants were identified from a list of contacts from the MLA Veterinary Medical Libraries Section. Although many respondents indicated that they have a professional interest in research data services, the majority of veterinary medicine librarians only rarely or occasionally provide data management support as part of their regular job responsibilities. There was little consensus as to whether research data services should be core to a library's mission despite their perceived importance to the advancement of veterinary research. Furthermore, most respondents stated that research data services are just as or somewhat less important than the other services that they provide and feel only slightly or somewhat prepared to offer such services. Lacking a standard definition of "research data" and a common understanding of precisely what research data services encompass, it is difficult for veterinary medicine librarians and libraries to define and understand their roles in research data services. Nonetheless, they appear to have an interest in learning more about and providing research data services.

  6. Research data services in veterinary medicine libraries

    Directory of Open Access Journals (Sweden)

    Erin E. Kerby, MSI

    2017-01-01

    Conclusions: Lacking a standard definition of ‘‘research data’’ and a common understanding of precisely what research data services encompass, it is difficult for veterinary medicine librarians and libraries to define and understand their roles in research data services. Nonetheless, they appear to have an interest in learning more about and providing research data services.

  7. Distribution of nuclear medicine service in Brazil

    International Nuclear Information System (INIS)

    Silva, Ana Carolina Costa da; Duarte, Alessandro; Santos, Bianca Maciel dos

    2011-01-01

    The Brazil does not posses a good distribution of nuclear medicine service por all his territory. This paper shows the difference among country regions as far the number of clinics of nuclear medicine as is concerning, and also doctors licensed in the area and radioprotection supervisors, both licensed by the Brazilian Nuclear Energy Commission (CNEN)

  8. Interpreter services in emergency medicine.

    Science.gov (United States)

    Chan, Yu-Feng; Alagappan, Kumar; Rella, Joseph; Bentley, Suzanne; Soto-Greene, Marie; Martin, Marcus

    2010-02-01

    Emergency physicians are routinely confronted with problems associated with language barriers. It is important for emergency health care providers and the health system to strive for cultural competency when communicating with members of an increasingly diverse society. Possible solutions that can be implemented include appropriate staffing, use of new technology, and efforts to develop new kinds of ties to the community served. Linguistically specific solutions include professional interpretation, telephone interpretation, the use of multilingual staff members, the use of ad hoc interpreters, and, more recently, the use of mobile computer technology at the bedside. Each of these methods carries a specific set of advantages and disadvantages. Although professionally trained medical interpreters offer improved communication, improved patient satisfaction, and overall cost savings, they are often underutilized due to their perceived inefficiency and the inconclusive results of their effect on patient care outcomes. Ultimately, the best solution for each emergency department will vary depending on the population served and available resources. Access to the multiple interpretation options outlined above and solid support and commitment from hospital institutions are necessary to provide proper and culturally competent care for patients. Appropriate communications inclusive of interpreter services are essential for culturally and linguistically competent provider/health systems and overall improved patient care and satisfaction. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  9. Areas control of a nuclear medicine service

    International Nuclear Information System (INIS)

    Silva, Islane C.S.; Silva, Iasmim M.S.; Júnior, Cláudio L.R.; Silva, Isvânia S.; Gonzalez, Kethyllém M.; Melo, Francisca A.; Lima, Fernando R.A.

    2017-01-01

    The measurement of the exposure rate of the sectors of a nuclear medicine service (NMS), with the purpose of establishing safety to the service workers and the public, classifying the areas according to the monitoring is presented. Following the studies on the classifications of the areas of a Nuclear Medicine service provided by the category regulatory standard, 3.05 CNEN-NN, measures were taken in all sectors of the NMS in order to classify the areas in: Free, controlled and supervised according to with the exposure level. As a measurement instrument, a Geiger-Muller counter of the digital type was used. The results obtained show a correlation with the Brazilian norm satisfactorily, referring to the exposure rate of the studied SMN sectors

  10. Basic requirements of nuclear medicine services

    International Nuclear Information System (INIS)

    Belcher, E.H.

    1992-01-01

    Technological progress in nuclear medicine continues, not always to the immediate advantage of the developing world. The capital expense, operational demands and maintenance requirements of ever more complex equipment, the consequent need for highly trained staff, the necessity to assure regular supplies of costly radioactive materials, all present problems to which compromise or alternative solutions must often be sought. This chapter constitutes an attempt to define the basic requirements for thr practice of nuclear medicine with respect to staff, equipment, accommodation, supplies and supporting services with particular reference to the needs of institutions in developing countries

  11. Basic requirements of nuclear medicine services

    Energy Technology Data Exchange (ETDEWEB)

    Belcher, E H

    1993-12-31

    Technological progress in nuclear medicine continues, not always to the immediate advantage of the developing world. The capital expense, operational demands and maintenance requirements of ever more complex equipment, the consequent need for highly trained staff, the necessity to assure regular supplies of costly radioactive materials, all present problems to which compromise or alternative solutions must often be sought. This chapter constitutes an attempt to define the basic requirements for thr practice of nuclear medicine with respect to staff, equipment, accommodation, supplies and supporting services with particular reference to the needs of institutions in developing countries

  12. Feast day service honoring pioneers in medicine.

    Science.gov (United States)

    Menninger, W Walter

    2013-01-01

    The Standing Liturgical Commission of the Anglican Church in the United States has identified persons whom they consider Holy men or Holy women, and who are celebrated in Lesser Feast and Fast day services. In 2009, the triennial General Convention of the Anglican Church, USA, ratified the recommendation of the Commission that Dr. William W. Mayo and Dr. Charles Menninger and their sons, as pioneers in medicine, were worthy of such a designation. The author was approached to deliver the following homily at a service at the Palmer Memorial Episcopal Church in Houston, Texas, March 6, 2013.

  13. Contracting of services companies management and the outsourcing paradox: a study of success case under the prism of the HSE management systems; Gestao de empresas prestadoras de servico e o paradoxo da terceirizacao: um estudo de caso de sucesso sob o prisma do sistema de gestao de SMS

    Energy Technology Data Exchange (ETDEWEB)

    Robalinho da Silva, Agostinho da Mota [PETROBRAS, Salvador, BA (Brazil). Unidade de Negocio da Bacia de Campos. Gerencia de Seguranca, Meio Ambiente e Saude]. E-mail: amrs@petrobras.com.br; Lima, Gilson Brito Alves [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Curso de Pos-graduacao em Engenharia de Seguranca do Trabalho]. E-mail: Gilson@civil.uff.br

    2003-07-01

    Outsourcing, sometimes called 'terceirizacao', evoques polemic. In one hand by arguments that becomes precarious the work conditions, seeking only to reduce costs, increasing as consequence the number of accidents. In other hand for arguments that companies can not be excellent in all competence areas, needing to associate more and more to strategic partners. Ideological arguments defends the non-outsourcing of work force as form of socializing the rights and strengthening the workers' representation in defense of its interests. On the other hand there are mega enterprises mobilizing a varied and intense range of professional competencies that would hinder personnel's administration in a non-outsourcing context. The outsourcing, here denominated Contracting of Services that best express the practice in study, it is the reality of Exploration and Production of Petroleum Industry. This work wants to demonstrate through Study of Case of Campos' Basin, that is possible to reconcile the industrial growth with elevated number of contracted workers, without committing SMS indicators. We do not enter in the merit of the outsourcing or non-outsourcing for understanding that is theme for specific work. Also wants to stimulate HSE Management Systems and regulatory instruments for selection and control like requirements to ability and qualify companies in the sector. (author)

  14. Sleep medicine services in Saudi Arabia: The 2013 national survey

    Directory of Open Access Journals (Sweden)

    Ahmed S Bahammam

    2014-01-01

    Conclusion: The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA.

  15. 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)

  16. Requirements of radiation protection and safety for nuclear medicine services

    International Nuclear Information System (INIS)

    1989-01-01

    The requirements of radiation protection and safety for nuclear medicine services are established. The norms is applied to activities related to the radiopharmaceuticals for therapeutics and 'in vivo' diagnostics purposes. (M.C.K.) [pt

  17. Professionalism, responsibility, and service in academic medicine.

    Science.gov (United States)

    Souba, W W

    1996-01-01

    Academic medical centers have responded to health care reform initiatives by launching a series of strategic plans designed to maintain patient flow and reduce hospital expenditures. Thought is also being given to processes by which the faculty can individually and collectively adjust to these changes and maintain morale at a time when reductions in the labor force and pay cuts are virtually certain. Physicians are concerned because managed care threatens their autonomy and jeopardizes the traditional ways in which they have carried out their multiple missions. Some doctors believe that it will become increasingly difficult to obtain genuine satisfaction from their job. The strategies that academic medical centers have begun to use to address the numerous challenges posed by a system of health care based on managed competition are reviewed. Potential mechanisms by which academic departments can continue to find fulfillment in an environment that threatens their traditional missions and values are discussed. A study of the social and historical origins of medicine in the United States reveals that the introduction of corporate medicine in the United States was destined to happen. Strategies implemented by academic medical centers in response to managed care include building an integrated delivery network, the acquisition of primary care practices, increasing cost-effectiveness, and creating physician-hospital organizations. Emphasis must be placed on integrating traditional core values (excellence, leadership, and innovation) with newer values such as patient focus, accountability, and diversity. A shift from rugged individualism to entrepreneurial teamwork is crucial. These reforms, although frightening at the onset, can serve to reaffirm our commitment to academic medicine and preserve our mission. The evolving managed care environment offers unique opportunities for academic medical centers to shape and positively impact health care delivery in the twenty

  18. Access to medicines: relations with the institutionalization of pharmaceutical services

    Directory of Open Access Journals (Sweden)

    Rafael Damasceno de Barros

    2017-11-01

    Full Text Available ABSTRACT OBJETIVE To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of MedicinesServices 2015, a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3; there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1; there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0; those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5; there is computerized system for pharmaceutical services management, OR

  19. Specific filters applied in nuclear medicine services

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, Vitor S.; Crispim, Verginia R., E-mail: verginia@con.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Nuclear; Brandao, Luis E.B. [Instituto de Engenharia Nuclear (IEN/CNEN-RJ) Rio de Janeiro, RJ (Brazil)

    2011-07-01

    In Nuclear Medicine, radioiodine, in various chemical forms, is a key tracer used in diagnostic practices and/or therapy. Due to its high volatility, medical professionals may incorporate radioactive iodine during the preparation of the dose to be administered to the patient. In radioactive iodine therapy doses ranging from 3.7 to 7.4 GBq per patient are employed. Thus, aiming at reducing the risk of occupational contamination, we developed a low cost filter to be installed at the exit of the exhaust system where doses of radioactive iodine are fractionated, using domestic technology. The effectiveness of radioactive iodine retention by silver impregnated silica [10%] crystals and natural activated carbon was verified using radiotracer techniques. The results showed that natural activated carbon is effective for I{sub 2} capture for a large or small amount of substrate but its use is restricted due to its low flash point (150 deg C). Besides, when poisoned by organic solvents, this flash point may become lower, causing explosions if absorbing large amounts of nitrates. To hold the CH{sub 3}I gas, it was necessary to increase the volume of natural activated carbon since it was not absorbed by SiO{sub 2} + Ag crystals. We concluded that, for an exhaust flow range of (306 {+-} 4) m{sup 3}/h, a double stage filter using SiO{sub 2} + Ag in the first stage and natural activated carbon in the second is sufficient to meet radiological safety requirements. (author)

  20. PACS in the nuclear medicine service

    International Nuclear Information System (INIS)

    Bitter, F.; Hellwig, D.; Weller, R.; Almasi, L.; Adam, W.E.

    1988-01-01

    A Picture Archiving and Communication System (PACS) is to be understood as a central system in a hospital spanning all services, interconnecting all imaging stations and allowing digital picture archivation. All data of a patient are prepared for direct access. A PAC system is made up of the following components: imaging equipment and data systems, viewing stations (image display), picture communication, storage, archive, connection to hospital information system. The authors explain the requirements to be met by a PACS, its set-up and mode of function, and they system the use. (orig./MG) [de

  1. 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

  2. The Defence Medical Library Service and military medicine.

    Science.gov (United States)

    Walker, S B

    2005-01-01

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

  3. Integrating personal medicine into service delivery: empowering people in recovery.

    Science.gov (United States)

    MacDonald-Wilson, Kim L; Deegan, Patricia E; Hutchison, Shari L; Parrotta, Nancy; Schuster, James M

    2013-12-01

    Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  4. Establishing a nuclear medicine service within the turnkey contract system

    International Nuclear Information System (INIS)

    Horton, P.W.

    1986-01-01

    The turnkey method of developing hospitals and its effect on the provision of nuclear medicine services are described. Accommodation provided is often limited to an imaging suite and a 'hot' laboratory and additional space may be required. Alterations may also be necessary, especially for radiopharmacies to meet current standards. Major items of capital equipment are provided but these may be out of date since they were purchased when hospital building commenced. A 'shortfall' of smaller items will need to be purchased and regular supplies of radiopharmaceuticals established. Radiation protection requirements for a new service in a developing country are listed. Some suggestions for improving the value of the turnkey method are made. (author)

  5. [Monitoring medication errors in an internal medicine service].

    Science.gov (United States)

    Smith, Ann-Loren M; Ruiz, Inés A; Jirón, Marcela A

    2014-01-01

    Patients admitted to internal medicine services receive multiple drugs and thus are at risk of medication errors. To determine the frequency of medication errors (ME) among patients admitted to an internal medicine service of a high complexity hospital. A prospective observational study conducted in 225 patients admitted to an internal medicine service. Each stage of drug utilization system (prescription, transcription, dispensing, preparation and administration) was directly observed by trained pharmacists not related to hospital staff during three months. ME were described and categorized according to the National Coordinating Council for Medication Error Reporting and Prevention. In each stage of medication use, the frequency of ME and their characteristics were determined. A total of 454 drugs were prescribed to the studied patients. In 138 (30,4%) indications, at least one ME occurred, involving 67 (29,8%) patients. Twenty four percent of detected ME occurred during administration, mainly due to wrong time schedules. Anticoagulants were the therapeutic group with the highest occurrence of ME. At least one ME occurred in approximately one third of patients studied, especially during the administration stage. These errors could affect the medication safety and avoid achieving therapeutic goals. Strategies to improve the quality and safe use of medications can be implemented using this information.

  6. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers.

    Science.gov (United States)

    Singer, Judy; Adams, Jon

    2014-05-22

    Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person

  7. Passive Dosimetry Of Nuclear Medicine Service Staff, Ibn Sina Hospital

    International Nuclear Information System (INIS)

    Sebihi, R.; Talsmat, K.; Cherkaoui, R.; Ben Rais, N.

    2010-01-01

    Full text: Since the implementation of Law No. 00571 of 21 Chaabane 1391 on protection against ionizing radiation and its decrees 2: 2-97-30 and 2-97-132 28 October 1997, surveillance of workers has the subject of major regulatory developments in Morocco, including individual registration delayed for dosimetry. As part of optimizing the protection of medical personnel, a dosimetric study was performed for the first time at the national level, the Nuclear Medicine Service of the Ibn Sina hospital in collaboration with the National Center for Energy Sciences and Nuclear Techniques (CNESTEN). Dosimetric monitoring was conducted for 2 weeks with the use of passive thermoluminescent dosimeters, (GR200A), covering all categories of staff. The administration of samarium (β emitter with energy substantially higher than the energies encountered in conventional nuclear medicine) has been studied, given his first service. Other cases of people concerned our study: a pregnant woman doctor, whose exposure of the unborn child must be reduced as much as possible, and a woman from a private company, working without dosimeter, handles maintenance of premises. To control the conditions imposed on all activities requiring exposure to ionizing radiation, we evaluated the dose at the extremities of operators with the use of ring dosimeters (GR200A) and the dose on the ambient environment of staff (dosimeters ALNOR). This experiment has shown exposure levels below legal limits, without been negligible for certain post. The evaluation results equivalent doses manipulators justify the wearing of dosimeter rings as a complementary dosimeter in Nuclear Medicine service and a way of controlling the normal working conditions. Finally Monitoring ambient dosimetry showed that the environment is low radiation doses. Lessons learned from this study, for the protection of personnel are as follows: from the simple awareness of staff and means of optimizing radiation can maintain a dosimetry annual

  8. Complementary and Alternative Medicine Services in the Military Health System.

    Science.gov (United States)

    Herman, Patricia M; Sorbero, Melony E; Sims-Columbia, Ann C

    2017-11-01

    Surveys of military personnel indicate substantial use of complementary and alternative medicine (CAM) that possibly exceeds use in the general U.S. Although military treatment facilities (MTFs) are known to offer CAM, surveys do not indicate where service members receive this care. This study offers a comprehensive system-wide accounting of the types of CAM offered across the military health system (MHS), the conditions for which it is used, and its level of use. These data will help MHS policymakers better support their population's healthcare needs. A census survey of MTFs across the MHS on all CAM use, supplemented where possible by MHS utilization data. Types of CAM offered by each MTF, reasons given for offering CAM, health conditions for which CAM is used, and number of patient visits for each CAM type. Of the 142 MTFs in the MHS, 133 (94%) responded. Of these, 110 (83%) offer at least one type of CAM and 5 more plan to offer CAM services in the future. Larger MTFs (those reporting ≥25,000 beneficiaries enrolled) are both more likely to offer CAM services (p 10) of different types of CAM (p = 0.010) than smaller MTFs. Three-fourths of MTFs offering CAM provide stress management/relaxation therapy, two-thirds provide acupuncture, and at least half provide progressive muscle relaxation, guided imagery, chiropractic, and mindfulness meditation. MTFs most commonly report CAM use for pain and mental health conditions. Acupuncture and chiropractic are most commonly used for pain, and stress management/relaxation therapy and mind-body medicine combinations are most often used for mental health-related conditions. We estimate 76,000 CAM patient encounters per month across the MHS. The availability of CAM services in the MHS is widespread and is being used to address a range of challenging pain and mental health conditions.

  9. Hospitalist Perspective of Interactions with Medicine Subspecialty Consult Services.

    Science.gov (United States)

    Adams, Traci N; Bonsall, Joanna; Hunt, Daniel; Puig, Alberto; Richards, Jeremy B; Yu, Liyang; McSparron, Jakob I; Shah, Nainesh; Weissler, Jonathan; Miloslavsky, Eli M

    2018-05-01

    Medicine subspecialty consultation is becoming increasingly important in inpatient medicine. We conducted a survey study in which we examined hospitalist practices and attitudes regarding medicine subspecialty consultation. The survey instrument was developed by the authors based on prior literature and administered online anonymously to hospitalists at 4 academic medical centers in the United States. The survey evaluated 4 domains: (1) current consultation practices, (2) preferences regarding consultation, (3) barriers to and facilitating factors of effective consultation, and (4) a comparison between hospitalist-fellow and hospitalist-subspecialty attending interactions. One hundred twenty-two of 261 hospitalists (46.7%) responded. The majority of hospitalists interacted with fellows during consultation. Of those, 90.9% reported that in-person communication occurred during less than half of consultations, and 64.4% perceived pushback at least "sometimes " in their consult interactions. Participants viewed consultation as an important learning experience, preferred direct communication with the consulting service, and were interested in more teaching during consultation. The survey identified a number of barriers to and facilitating factors of an effective hospitalist-consultant interaction, which impacted both hospitalist learning and patient care. Hospitalists reported more positive experiences when interacting with subspecialty attendings compared to fellows with regard to multiple aspects of the consultation. The hospitalist-consultant interaction is viewed as important for both hospitalist learning and patient care. Multiple barriers and facilitating factors impact the interaction, many of which are amenable to intervention.

  10. Radioactive waste management of the nuclear medicine services

    International Nuclear Information System (INIS)

    Barboza, Alex

    2009-01-01

    Radioisotope applications in nuclear medicine services, for diagnosis and therapy, generate radioactive wastes. The general characteristics and the amount of wastes that are generated in each facility are function of the number of patients treated, the procedures adopted, and the radioisotopes used. The management of these wastes embraces every technical and administrative activity necessary to handle the wastes, from the moment of their generation, till their final disposal, must be planned before the nuclear medicine facility is commissioned, and aims at assuring people safety and environmental protection. The regulatory framework was established in 1985, when the National Commission on Nuclear Energy issued the regulation CNEN-NE-6.05 'Radioactive waste management in radioactive facilities'. Although the objective of that regulation was to set up the rules for the operation of a radioactive waste management system, many requirements were broadly or vaguely defined making it difficult to ascertain compliance in specific facilities. The objective of the present dissertation is to describe the radioactive waste management system in a nuclear medicine facility and provide guidance on how to comply with regulatory requirements. (author)

  11. Optimization of the radioprotection for nuclear medicine services

    International Nuclear Information System (INIS)

    Lira, Renata F. de; Filho, Joao A.; Santos, Luiz A.P.; Lima, Fernando Roberto de Andrade; Vieira, Jose W.

    2013-01-01

    Nuclear medicine (NM) is a medical specialty which uses small amounts of radioactive material combined with drugs, to make either therapeutic treatments or form diagnostic images of the organ and tissue. Follow the nuclear regulations any activity involving ionizing radiation should be justified and it must have their procedures of work to be optimized. Thus, the aim of the study is to determine the need and the importance of optimization of radiation protection in NM services and reduce occupationally exposed individuals (OEI) doses in order to avoid possible contamination or accidents and reduce the costs of protection. Optimization for a NM service that makes use of ionizing radiation can be performed using different techniques such as the expanded cost-benefit analysis. Such technique introduces one or two attributes associated to the detriment cost, Y, and the protection costs, X. This work was conducted in the year 2011, where it was analyzed data of 56 employees from 2002 to 2010. The value of the cost of protection was R$ 147.645,95, including accessories, courses, training and maintenance costs. On the other hand, the cost of the expense ranged from R$ 1.065.750, 00 up to R$ 28.890.351, 00 and the parameter responsible for this variation is the collective dose. The increasing of these dose values causes the increasing of the total costs, and one can conclude that there really is an importance of applying the optimization technique to improve the safety of OEI at the nuclear medicine service and reducing costs of protection. (author)

  12. Evaluation of quality control of radiopharmaceuticals in Nuclear Medicine service

    International Nuclear Information System (INIS)

    Tavares, Jamille A. Lopes; Lira, Renata F. de; Santos, Marcus Aurelio P. dos

    2014-01-01

    Radiopharmaceuticals are a type of pharmaceutical preparation associated with radionuclides with purpose of diagnosis and therapy. Nuclear Medicine Services (NMS) should perform quality control of radiopharmaceuticals according to the recommendations of the manufacturer and scientific evidences accepted by the National Agency Sanitary Surveillance ( Brazilian ANVISA). This study evaluated the quality of the main radiopharmaceuticals in a NMS of the state of Pernambuco in relation to pH and radiochemical purity. The results showed that 96.8% of the radiopharmaceuticals showed radiochemical purity and all pH values were within the range recommended by the American pharmacopoeia. The study found that the quality control when inserted into the NMS, provides important data that allows exclusion of radiopharmaceuticals with low radiochemistry purity, favoring a reliable diagnosis and ensuring good radiation protection practices and biosecurity for patient and occupationally exposed individuals

  13. Improving Injectable Medicines Prescription in Outpatient Services: A Path Towards Rational Use of Medicines in Iran

    Science.gov (United States)

    Bairami, Firoozeh; Soleymani, Fatemeh; Rashidian, Arash

    2016-01-01

    Injection is one of the most common medical procedures in the health sector. Annually up to 16 billion injections are prescribed in low- and middle-income countries (LMICs), many of them are not necessary for the patients, increase the healthcare costs and may result in side effects. Currently over 40% of outpatient prescriptions in Iran contain at least one injectable medicine. To address the issue, a working group was established (August 2014 to April 2015) to provide a comprehensive policy brief to be used by national decision-makers. This report is the extract of methods that were followed and the main policy options for improving injectable medicines prescribing in outpatient services. Thirty-three potential policy options were developed focusing on different stakeholders. The panel reached consensus on seven policy options, noting effectiveness, cost, durability, and feasibility of each policy. The recommended policy options are targeted at patients and public (2 policies), insurers (2), physicians (1), pharmacies (1), and the Ministry of Health and Medical Education (MoHME) (1). PMID:27239881

  14. Improving Injectable Medicines Prescription in Outpatient Services: A Path Towards Rational Use of Medicines in Iran

    Directory of Open Access Journals (Sweden)

    Firoozeh Bairami

    2016-05-01

    Full Text Available Injection is one of the most common medical procedures in the health sector. Annually up to 16 billion injections are prescribed in low- and middle-income countries (LMICs, many of them are not necessary for the patients, increase the healthcare costs and may result in side effects. Currently over 40% of outpatient prescriptions in Iran contain at least one injectable medicine. To address the issue, a working group was established (August 2014 to April 2015 to provide a comprehensive policy brief to be used by national decision-makers. This report is the extract of methods that were followed and the main policy options for improving injectable medicines prescribing in outpatient services. Thirty-three potential policy options were developed focusing on different stakeholders. The panel reached consensus on seven policy options, noting effectiveness, cost, durability, and feasibility of each policy. The recommended policy options are targeted at patients and public (2 policies, insurers (2, physicians (1, pharmacies (1, and the Ministry of Health and Medical Education (MoHME (1.

  15. 31 CFR 594.515 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine....515 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine...

  16. 31 CFR 595.513 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine...-kind donations of medicine, medical devices, and medical services. (a) Effective July 6, 2006, nongovernmental organizations that are U.S. persons are authorized to provide in-kind donations of medicine...

  17. 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

  18. An E-mail Service in a Military Adolescent Medicine Clinic: will teens ...

    African Journals Online (AJOL)

    The goal of this study was to determine utilization patterns of an Adolescent Medicine Clinic e-mail service. An e-mail service was offered to 6134 patients presenting for care to a military Adolescent Medicine Clinic in San Antonio, Texas over a 6-month period. Families had to complete an authorization form acknowledging ...

  19. Extremity dosimetry in nuclear medicine services using thermoluminescent detectors

    International Nuclear Information System (INIS)

    Mebhah, D.; Djeffal, S.; Badreddine, A.; Medjahed, M.

    1993-01-01

    The Radiation Protection and Safety Centre in Algiers provides two types of dosemeters, one for monitoring doses to the whole body and skin and the other one for monitoring doses to the extremities of the body. In nuclear medicine services and radiopharmaceutical laboratories, hands and arms are often closer to a given radiation source than the main part of the body and therefore receive greater doses. In this context, extremity doses have been measured by a ring dosemeter and by a fingertip ultra-thin dosemeter. The ring dosemeter consists of a metallic ring with a circular indentation to hold a LiF chip which is covered with a 10 mg.cm -2 shrinkable black polyamide layer. The ultra-thin dosemeter contains a 5 mg.cm -2 LiF element for measuring doses at a depth of 7 mg.cm -2 . These extremity dosemeters have been characterised before their use in the field. They have also been tested using radioisotopes of various energies. The doses received by the monitored workers were correlated with the amount of the handled activity. The doses obtained using the fingertip and the ring dosemeters are presented and discussed from a radiological point of view. (author)

  20. [Patient-centered medicine for tuberculosis medical services].

    Science.gov (United States)

    Fujita, Akira; Narita, Tomoyo

    2012-12-01

    The 2011 edition of Specific Guiding Principles for Tuberculosis Prevention calls for a streamlined medical services system capable of providing medical care that is customized to the patient's needs. The new 21st Century Japanese version of the Directly Observed Treatment Short Course (DOTS) expands the indication of DOTS to all tuberculosis (TB) patients in need of treatment. Hospital DOTS consists of comprehensive, patient-centered support provided by a DOTS care team. For DOTS in the field, health care providers should select optimal administration support based on patient profiles and local circumstances. In accordance with medical fee revisions for 2012, basic inpatient fees have been raised and new standards for TB hospitals have been established, the result of efforts made by the Japanese Society for Tuberculosis and other associated groups. It is important that the medical care system be improved so that patients can actively engage themselves as a member of the team, for the ultimate goal of practicing patient-centered medicine. We have organized this symposium to explore the best ways for practicing patient-centered medicine in treating TB. It is our sincere hope that this symposium will lead to improved medical treatment for TB patients. 1. Providing patient-centered TB service via utilization of collaborative care pathway: Akiko MATSUOKA (Hiroshima Prefectural Tobu Public Health Center) We have been using two types of collaborative care pathway as one of the means of providing patient-centered TB services since 2008. The first is the clinical pathway, which is mainly used by TB specialist doctors to communicate with local practitioners on future treatment plan (e.g. medication and treatment duration) of patients. The clinical pathway was first piloted in Onomichi district and its use was later expanded to the whole of Hiroshima prefecture. The second is the regional care pathway, which is used to share treatment progress, test results and other

  1. Medicinal plants used with Thai Traditional Medicine in modern healthcare services: a case study in Kabchoeng Hospital, Surin Province, Thailand.

    Science.gov (United States)

    Chotchoungchatchai, Somtanuek; Saralamp, Promchit; Jenjittikul, Thaya; Pornsiripongse, Saowapa; Prathanturarug, Sompop

    2012-05-07

    Thai Traditional Medicine (TTM) is available in many modern hospitals in Thailand. However, there have been difficulties in integrating TTM, particularly the practices of the use of herbal medicines, into modern healthcare services. Kabchoeng Hospital is one hospital that has been able to overcome these difficulties. Thus, this study aimed to document the successful utilization of herbal medicine at Kabchoeng Hospital. The documentation focused on both the knowledge of medicinal plants and the success factors that facilitated the utilization of herbal medicine in the context of a modern hospital in Thailand. Kabchoeng Hospital was intentionally selected for this case study. Participatory observation was used for the data collection. There were six groups of key informants: three applied Thai Traditional Medicine practitioners (ATTMPs), a pharmacist, two physicians, two folk healers, the head of an herbal cultivation and collection group, and 190 patients. The plant specimens were collected and identified based on the botanical literature and a comparison with authentic specimens; these identifications were assisted by microscopic and thin layer chromatography (TLC) techniques. Eighty-nine medicinal plants were used for the herbal preparations. The ATTMPs used these plants to prepare 29 standard herbal preparations and occasional extemporaneous preparations. Moreover, in this hospital, seven herbal preparations were purchased from herbal medicine manufacturers. In total, 36 preparations were used for 10 groups of symptoms, such as the treatment of respiratory system disorders, musculo-skeletal system disorders, and digestive system disorders. Four success factors that facilitated the utilization of herbal medicine at Kabchoeng Hospital were determined. These factors included a proper understanding of the uses of herbal medicines, the successful integration of the modern and TTM healthcare teams, the support of an herbal cultivation and collection group, and the

  2. 31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine... Licensing Policy § 597.511 In-kind donations of medicine, medical devices, and medical services. (a... incident to the provision by nongovernmental organizations that are U.S. persons of in-kind donations of...

  3. Quality approach in hygiene in a nuclear medicine service

    International Nuclear Information System (INIS)

    Plogin, J.

    1998-01-01

    The activities of nuclear medicine, by their constraints of radiation protection, present difficulties for rules of hygiene protocols. Considering the particular risks of certain techniques, the approach brings to the fore the compromise between radiation protection and hygiene and to adapt the recommendations to local specificities. (N.C.)

  4. Facilitating and securing offline e-medicine service through image steganography.

    Science.gov (United States)

    Kamal, A H M; Islam, M Mahfuzul

    2014-06-01

    E-medicine is a process to provide health care services to people using the Internet or any networking technology. In this Letter, a new idea is proposed to model the physical structure of the e-medicine system to better provide offline health care services. Smart cards are used to authenticate the user singly. A very unique technique is also suggested to verify the card owner's identity and to embed secret data to the card while providing patients' reports either at booths or at the e-medicine server system. The simulation results of card authentication and embedding procedure justify the proposed implementation.

  5. Facilitating and securing offline e-medicine service through image steganography

    Science.gov (United States)

    Islam, M. Mahfuzul

    2014-01-01

    E-medicine is a process to provide health care services to people using the Internet or any networking technology. In this Letter, a new idea is proposed to model the physical structure of the e-medicine system to better provide offline health care services. Smart cards are used to authenticate the user singly. A very unique technique is also suggested to verify the card owner's identity and to embed secret data to the card while providing patients' reports either at booths or at the e-medicine server system. The simulation results of card authentication and embedding procedure justify the proposed implementation. PMID:26609382

  6. Impact of waiting on the perception of service quality in nuclear medicine

    NARCIS (Netherlands)

    De Man, S; Vlerick, P; Gemmel, P; De Bondt, P; Matthys, D; Dierckx, RA

    Background This is the first study examining the link between waiting and various dimensions of perceived service quality in nuclear medicine. Methods We tested the impact of selected waiting experience variables on the evaluation of service quality, measured using the Servqual tool, of 406 patients

  7. The National Library of Medicine Programs and Services, Fiscal Year 1974.

    Science.gov (United States)

    National Library of Medicine (DHEW), Bethesda, MD.

    The activities and projects of the National Library of Medicine are described. New and continuing programs in library services and operations, on-line computer retrieval services, grants for library assistance, audiovisual programs, and health communications research are included. International activities of the Library are outlined. Summary…

  8. Provision of a Medicines Information Service to Consumers on Facebook: An Australian Case Study.

    Science.gov (United States)

    Benetoli, Arcelio; Chen, Timothy F; Spagnardi, Sarah; Beer, Troy; Aslani, Parisa

    2015-11-23

    Social networking sites (SNSs) have changed the way people communicate. They may also change the way people seek health advice. This study describes the provision of a medicines information service on Facebook to individual consumers. It aimed to discuss the pros and cons, and inform health and pharmacy stakeholders and researchers about the opportunities and challenges of providing such a service. We adopted an exploratory approach using a case study method. NPS MedicineWise, an independent, not-for-profit Australian organization, runs a public question-and-answer service on Facebook, dubbed Pharmacist Hour. Consumers following the organization's Facebook page are invited to post medication-related questions often with a suggested health topic. A wide range of questions and comments are posted related to medication usage. The pharmacist answers the queries, providing evidence-based medicines information and using consumer-friendly language, during the specific 1-hour period. The most popular questions in the past 12 months were related to adverse effects, treatment options for conditions, and drug interactions. The service had a mean number of engagements (defined as a like or share of the Pharmacy Hour post) of 38 (SD 19) people and a mean 5 (SD 3) questions per session. The Pharmacist Hour Facebook service addresses the medicines information needs of consumers and indirectly promotes other appropriate and relevant NPS MedicineWise products and services to further assist consumers. The service offers a new medium for a quality use of medicines organization committed to promoting awareness about the correct and safe use of medicines in Australia.

  9. Medicines

    Science.gov (United States)

    Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to ...

  10. Effects of the regulatory inspections on nuclear medicine services executed by the Radioprotection and Dosimetry Services, Brazil

    International Nuclear Information System (INIS)

    Alves, C.E.G.R.; Farias, C.; Azevedo, E.M.; Nanni, G.J.; Vasconcellos, L.; Mendes, L.C.G.; Souza, L.A.C.; Franca, W.F.L.; Goncalves, M.

    2005-01-01

    The advances in the Nuclear Medicine auditing field performed by Nuclear Medicine Group of the Radiotherapy and Nuclear Medicine Division of the Institute of Radiation Protection and Dosimetry are shown. The main aspects observed during the auditing are presented as well as the evolution of the non-conformities. Its is also shown that the occurrence of these non-conformities decreases year by year, primarily as a function of the severity of the auditing and the consciousness of the personal of Nuclear Medicine Services. Results point clearly to the importance of the coercion actions to guarantee a radiation protection level in compliance with the standards established by the Brazilian Nuclear Energy Commission. (author)

  11. Evaluating Efficiencies in Preventive Medicine: Comparing Approaches Between the Services

    Science.gov (United States)

    2016-02-29

    of the military, or was this just a company line that we just accept as true? The writing of this paper was a labor of love, but it was a labor none...of food service facilities and storage areas, berthing spaces, childcare facilities, recreational facilities, potable water and wastewater disposal

  12. Working styles of medicine professionals in emergency medical service

    Directory of Open Access Journals (Sweden)

    Lazarević Marija

    2015-01-01

    Full Text Available Introduction: Transactional analysis is a personality and communication theory established by psychiatrist Eric Berne, at the end of the fifties. Counter script is the way of life in accordance with parental imperative. The person with a counter-script has a compulsion to fulfill the required task in order to avoid the disaster of ban. There are five drivers that are considered essential, and these are: 'Be perfect!', 'Be strong!', 'Hurry up!', 'Please others!' and 'Work hard!' Objective: a Determination of the most dominant driver in this medical service. b Because of the specifics of this job which requires speed and humanity, the emphasis will be on doublet: 'Hurry up!' and 'Please others!' Method: The study was conducted on a group of subjects employed in a general service with medical emergency. The instrument used in the study was Julie Hay's questionnaire for diagnosing the working styles. Results: Statistical research was conducted on a sample of 30 subjects employed in the emergency medical service. Availability of all afore mentioned drivers was tested. The research hypotheses were formulated as follows: H0: The driver is not present among the employees in this service; H1: The driver is present among the employees in this service. Calculated value of the t-statistics for the driver 'Hurry up!' is 1.398; for the driver 'Be perfect!' 3.616; for the driver 'Please others!' 11.693; for the driver 'Work hard!' -0.673; and for the driver 'Be strong!' 3.880. Since the realizable value of the t-statistics for the drivers: 'Be perfect!' and 'Please others!' and 'Be strong!' is bigger than the critical value 1.699, and p<0.05 we reject the null hypothesis and we accept the alternative hypothesis on the significance level of 95%. For the drivers 'Hurry up!' and 'Work hard!' the values of t-statistics are lower than the critical value 1.699 for significance level of 95%, so the alternative hypothesis are not acceptable. Conclusion: The results of

  13. Analysis of the feasibility of applying the theory of the supply chain nanagement for the electric energy chain services of the Bahia state, Brazil; Analise da viabilidade de aplicacao da teoria da gestao da cadeia de suprimentos para a cadeia de servicos de energia eletrica do estado da Bahia

    Energy Technology Data Exchange (ETDEWEB)

    Leal, Lydiane Abdon [Universidade Federal da Bahia (UFBA), Salvador, BA (Brazil)], e-mail: lydianeleal@yahoo.com.br; Carvalho, Claudio Bezerra de [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil). Petroleo e Gas], e-mail: claudiobcarvalho@yahoo.com.br

    2008-07-01

    This article aims to analyze the potential application of integrated management, through concepts of SCM (Supply Chain Management), in the chain of the energy industry, which is characterized by a chain of services. The prospect of incorporating new integrated management practices, through the selection of concepts and tools for supply chain management took the possibility of promoting systemic approach that includes the major components (physical, regulatory and commercial) the market of electric energy, investigating possibilities of reorganization of this important segment of the industry production chain. The proposal aims to provide a tool for planning indicative of great potential, to identify a theoretical reference in this important productive sector. The work includes qualitative analyses, which aim to map, understand and systematize the changes undertaken, with emphasis on Brazilian electric sector. It is described, in general, the characterization of the energy industry in Bahia state as a possible case study in implementing the proposed methodology. Thus, the work seeks to help the staff decision to purchase a minimum of integrated vision of possible decisions, including the dynamic interactions between market supply and demand. (author)

  14. Application impact of internal monitoring criteria in radiological protection programs of nuclear medicine services

    International Nuclear Information System (INIS)

    Dantas, Bernardo M.; Dantas, Ana Leticia A.; Juliao, Ligia Q.C.; Lourenco, Maria Cristina; Melo, Dunstana R.

    2005-01-01

    This work presents the simulation of the internal monitoring criteria application for the most used radionuclides by the area of nuclear medicine, taking into consideration the usual conditions of usual source handling and the activity bands authorized by the CNEN. It is concluded that the handling of Iodine 131 for therapeutical purposes is the practice which presents the most risk of internal exposure for the works, requiring the adoption of a program for internal monitoring by the nuclear medicine services

  15. Concerning nuclear medicine services. Notes on the practical situation in 1977

    International Nuclear Information System (INIS)

    Ducassou, Dominique.

    1977-01-01

    Nuclear medicine presents a certain number of teething problems, which are analysed here. An attempt is made first to estimate the worthwhileness or utility/cost ratio of a nuclear medicine service by determining firstly the expenses involved and secondly the services rendered. Problems connected with the running of nuclear medicine services are then discussed: civil and penal responsibility of the nuclear practitioner in relation to the human administration of radioactive preparations for diagnostic or therapeutic purposes; limited availability of scintillation cameras (1 for 500,000 inhabitants, a number considered hopelessly inadequate at the present time); organisation of premises; training of personnel (nuclear doctors, radiopharmacists, paramedical staff, technical staff). Finally the problems encountered in applying the nomenclature are dealt with [fr

  16. Quality control of radionuclide calibrators used in nuclear medicine services in the Brazilian northeast region

    International Nuclear Information System (INIS)

    Fragoso, Maria C.F.; Albuquerque, Antonio M.S.; Oliveira, Mercia L.; Lima, Ricardo A.; Lima, Fabiana F.

    2011-01-01

    The radionuclide calibrators are essential instruments in nuclear medicine services in order to activity determination of radiopharmaceuticals which will be administered to the patients. Inappropriate performance of these equipment could provide underestimation or overestimation of the activity, compromising the success of diagnosis or therapeutic procedures. To ensure the satisfactory performance of the radionuclide calibrators, quality control tests are recommended by national and international guides. The aim of this work was evaluate the establishment of the quality control program in the radionuclide calibrators at medicine nuclear services in the Brazilian northeast region, highlighting the tests and their frequencies. (author)

  17. Enhancing student perspectives of humanism in medicine: reflections from the Kalaupapa service learning project.

    Science.gov (United States)

    Lee, Winona K; Harris, Chessa C D; Mortensen, Kawika A; Long, Linsey M; Sugimoto-Matsuda, Jeanelle

    2016-05-09

    Service learning is endorsed by the Liaison Committee on Medical Education (LCME) as an integral part of U.S. medical school curricula for future physicians. Service learning has been shown to help physicians in training rediscover the altruistic reasons for pursuing medicine and has the potential to enhance students' perspectives of humanism in medicine. The Kalaupapa service learning project is a unique collaboration between disadvantaged post-baccalaureate students with an underserved rural community. This study was conducted to determine whether the Kalaupapa service learning curricula enhanced student perspectives of humanism in medicine at an early stage of their medical training. Program participants between 2008 and 2014 (n = 41) completed written reflections following the conclusion of the service learning project. Four prompts guided student responses. Reflections were thematically analyzed. Once all essays were read, team members compared their findings to condense or expand themes and assess levels of agreement. Emerging themes of resilience and unity were prominent throughout the student reflections. Students expressed respect and empathy for the patients' struggles and strengths, as well as those of their peers. The experience also reinforced students' commitment to service, particularly to populations in rural and underserved communities. Students also gained a deeper understanding of the patient experience and also of themselves as future physicians. To identify and address underserved and rural patients' health care needs, training programs must prepare an altruistic health care workforce that embraces the humanistic element of medicine. The Kalaupapa service learning project is a potential curricular model that can be used to enhance students' awareness and perspectives of humanism in medicine.

  18. [The Teratology Information Service: medicines during pregnancy and lactation].

    Science.gov (United States)

    de Vries, Loes C; de Swart, Irene W; van Puijenbroek, Eugène P

    2016-01-01

    Many women use medication during pregnancy. Both the healthcare professional and the pregnant woman often have many questions about the possible adverse effects of the medication that are not always answered in the product information. The Teratology Information Service (TIS), a part of the Netherlands Pharmacovigilance Centre Lareb, is a centre of expertise in the field of the safety of medication use and other external influences during spermatogenesis, pregnancy and lactation. The TIS collects, interprets, and disseminates information that can contribute to patient care. Healthcare professionals can contact the TIS for information and individual risk assessments. In this article we discuss the background and positioning of the TIS, the characteristics of telephone consultations, the collection of data and the considerations that are important for the use of medication during pregnancy and lactation.

  19. Place of the indigenous and the western systems of medicine in the health services of India.

    Science.gov (United States)

    Banerji, D

    1979-01-01

    The interrelationships of the indigenous (traditional and western (modern) systems of medicine are a function of the interplay of social, economic, and political forces in the community. In India, western medicine was used as a political weapon by the colonialists to strengthen the oppressing classes and to weaken the oppressed. Not only were the masses denied access to the western system of medicine, but this system contributed to the decay and degeneration of the preexisting indigenous systems. This western and privileged-class orientation of the health services has been actively perpetuated and promoted by the postcolonial leadership of India. The issue in formulating an alternative health care system for India is essentially that of rectifying the distortions which have been brought about by various forces. The basic premise for such an alternative will be to start with the people. Action in this field will lead to a more harmonious mix between the indigenous and western systems of medicine.

  20. Home Care Services as Teaching Sites for Geriatrics in Family Medicine Residencies.

    Science.gov (United States)

    Laguillo, Edgardo

    1988-01-01

    A national survey of family medicine programs and residency training in geriatrics found almost half using home care services as teaching sites. In the program design preferred by residents, the resident followed the patient long-term and discussed management with a multidisciplinary team. An alternative combined rotation is discussed. (Author/MSE)

  1. Clinical preventive services in Guatemala: a cross-sectional survey of internal medicine physicians.

    Directory of Open Access Journals (Sweden)

    Juan E Corral

    Full Text Available Guatemala is currently undergoing an epidemiologic transition. Preventive services are key to reducing the burden of non-communicable diseases, and smoking counseling and cessation are among the most cost-effective and wide-reaching strategies. Internal medicine physicians are fundamental to providing such services, and their knowledge is a cornerstone of non-communicable disease control.A national cross-sectional survey was conducted in 2011 to evaluate knowledge of clinical preventive services for non-communicable diseases. Interns, residents, and attending physicians of the internal medicine departments of all teaching hospitals in Guatemala completed a self-administered questionnaire. Participants' responses were contrasted with the Guatemalan Ministry of Health (MoH prevention guidelines and the US Preventive Services Task Force (USPSTF recommendations. Analysis compared knowledge of recommendations within and between hospitals.In response to simulated patient scenarios, all services were recommended by more than half of physicians regardless of MoH or USPSTF recommendations. Prioritization was adequate according to the MoH guidelines but not including other potentially effective services (e.g. colorectal cancer and lipid disorder screenings. With the exception of colorectal and prostate cancer screening, less frequently recommended by interns, there was no difference in recommendation rates by level.Guatemalan internal medicine physicians' knowledge on preventive services recommendations for non-communicable diseases is limited, and prioritization did not reflect cost-effectiveness. Based on these data we recommend that preventive medicine training be strengthened and development of evidence-based guidelines for low-middle income countries be a priority.

  2. Assessing Patients' Preference for Integrating Herbal Medicine Within Primary Care Services in Saudi Arabia.

    Science.gov (United States)

    Allam, Safaa; Moharam, Maha; Alarfaj, Gada

    2014-07-01

    Family physician advice and follow-up may be important to reduce the negative aspects of locally marketed herbal remedies and improve the patient outcome. There is a lack of studies assessing the preference of Saudi patients for the integration of herbal medicine into primary care services. To examine the knowledge, attitudes, and practice of Saudi patients toward herbal medicine and its integration into primary care services. A cross-sectional study was conducted between February and March 2013 among adult patients attending the family medicine clinics at a primary care center in Riyadh, Saudi Arabia. A self-administered questionnaire (27 items) was developed and administered to all patients. A total of 240 patients were included in the current analysis. The average age was 33.5 ± 9.9 years, and 61% of the patients were women. Approximately 60% of the patients were aware of herbal medicine use and its possible side effects. More than 85% of the patients believed that herbal containers should be labeled with safety information. Approximately 71% of the patients had a favorable attitude toward integrated services. Approximately 65% of the patients used herbal remedies for themselves, and 42% used them for their children. Preference for integrated services was significantly associated with female sex, better knowledge, positive attitudes toward safety and regulations, and higher level of practice. A good knowledge and a very favorable attitude toward integrating herbal medicine into primary care services were found among a group of patients attending a primary care center in Saudi Arabia. © The Author(s) 2014.

  3. Characterization of Complementary and Alternative Medicine-Related Consultations in an Academic Drug Information Service.

    Science.gov (United States)

    Gregory, Philip J; Jalloh, Mohamed A; Abe, Andrew M; Hu, James; Hein, Darren J

    2016-12-01

    To characterize requests received through an academic drug information consultation service related to complementary and alternative medicines. A retrospective review and descriptive analysis of drug information consultations was conducted. A total of 195 consultations related to complementary and alternative medicine were evaluated. All consultation requests involved questions about dietary supplements. The most common request types were related to safety and tolerability (39%), effectiveness (38%), and therapeutic use (34%). Sixty-eight percent of the requests were from pharmacists. The most frequent consultation requests from pharmacists were questions related to drug interactions (37%), therapeutic use (37%), or stability/compatibility/storage (34%). Nearly 60% of complementary and alternative medicine-related consultation requests were able to be completely addressed using available resources. Among review sources, Natural Medicines Comprehensive Database, Clinical Pharmacology, Micromedex, and Pharmacist's Letter were the most common resources used to address consultations. Utilization of a drug information service may be a viable option for health care professionals to help answer a complementary and alternative medicine-related question. Additionally, pharmacists and other health care professionals may consider acquiring resources identified to consistently answering these questions. © The Author(s) 2015.

  4. Seven years of teenage pregnancy in an inner London genitourinary medicine service - a retrospective cohort study.

    Science.gov (United States)

    Hegazi, Aseel; Daley, Natalie; Williams, Elizabeth; McLeod, Felicity; Rafiezadeh, Saba; Prime, Katia

    2014-12-01

    Young people attending genitourinary medicine services are at high risk of unplanned pregnancy. We performed a retrospective cohort study to identify characteristics of pregnant teenagers accessing an inner London genitourinary medicine service. There were 481 pregnancies in 458 teenagers with 54 previous pregnancies and 46 previous terminations of pregnancy. The under-18 and under-16 teenage pregnancy rates were 92.1 and 85.8 per 1000 age-matched clinic attendees, respectively. Median age was 17.1 years. 'Black Other' teenagers ('Black British', 'Mixed White-Black Caribbean' and 'Mixed White-Black African') were over-represented, compared to our clinic population, while those of White ethnicity were under-represented. Few pregnancies (1.5%) were planned with the majority (64%) intending terminations of pregnancy. Most teenagers did not use consistent contraception. Two-thirds of patients had attended genitourinary medicine services in the past and sexually transmitted infection prevalence at presentation was high. Effectively targeting the sexual and reproductive health needs of teenage genitourinary medicine clinic attendees may have a significant impact on reducing sexually transmitted infections, unplanned pregnancy and terminations of pregnancy in this group. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. 42 CFR 410.24 - Limitations on services of a doctor of dental surgery or dental medicine.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Limitations on services of a doctor of dental surgery or dental medicine. 410.24 Section 410.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Medical and Other Health Services § 410.24 Limitations on services of a doctor of dental surgery or dental...

  6. Breast cancer patients' satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service.

    Science.gov (United States)

    Hack, Carolin C; Antoniadis, Sophia; Hackl, Janina; Langemann, Hanna; Schwitulla, Judith; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

    2018-04-27

    Complementary medicine services are nowadays usually quite heterogeneous, and little information is available on standards for running an integrative medicine consultancy service. This study aimed to assess patients' satisfaction with a standardized treatment service on integrative medicine. Using a cross-sectional design, 75 breast cancer patients from the integrative medicine consultancy service at the University Breast Center for Franconia were evaluated between January 2016 and March 2017. At primary consultation, patients answered a standardized questionnaire on their medical history and treatment goals regarding integrative medicine. In a subsequent interview, patients evaluated their satisfaction with the treatment service and individual treatment goals. 72% of the patients (n = 54) reported high satisfaction with the overall approach of the treatment service. 76% of the patients (n = 57) were very satisfied or satisfied with their individual treatment plans. The most frequently reported goals were to slow tumor progression (n = 64, 85.3%), reducing the side effects of conventional cancer treatments (n = 60, 80%), and a desire to participate actively in the treatment of breast cancer (n = 64, 85.3%). Using a standardized procedure in integrative medicine allows a high quality level to be offered to patients. Overall, breast cancer patients report very high satisfaction with the integrative medicine consultancy service and state long-term treatment goals. Hence, long-term treatment with integrative medicine methods should be taken into consideration.

  7. 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.

  8. Effective collective dose imparted by a medicine nuclear service to Cordoba and Jaen populations

    International Nuclear Information System (INIS)

    Arias, M.C.; Galvez, M.; Torres, M.

    1997-01-01

    The application of diagnostic techniques in nuclear medicine is ever growing as part of clinical daily routine. Although the diagnostic procedures carry a negligible clinical risk, the introduction of radioactive substances into the patient makes it imperative to determine the effective dose to minimize the stochastic effects to the patient thus establishing the collective dose to the community. The aim of our work is to study the collective effective dose imparted by Nuclear Medicine Service during 1997 to Cordoba and Jaen inhabitants (1 448 988). The nuclear medicine techniques of bone exploration with 11 454 mSv-person (4,6 mSv/exploration) and thyroid scintigraphy with 6181 mSv-person (7,0 mSv /exploration) are the main techniques implicated in the relative contribution to the total annual effective collective dose of 35 901.2 mSv-person

  9. Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

    Science.gov (United States)

    Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

  10. [A physician profile--specialists in social medicine and health services administration].

    Science.gov (United States)

    Elterlein, E

    1989-04-01

    Specialists in social medicine and the organization of health services, in particular those in leading functions, are the most important persons who master the argumentation and justification of optimal relations of proposed innovations from the aspect of improving the health status of the population and from the aspect of national economy, ensuring expedient investment into the system of health services and early return of these investments. These leading workers must have exceptional abilities as regards management and organization and moreover be able to stimulate collaborators to creative work, ensure their effective cooperation, team work and consequential integration at the level of different health and economic facilities entrusted to them.

  11. All-Russian service of disaster medicine organizes response of radiative accidents

    International Nuclear Information System (INIS)

    Avetisov, G.M.; Goncharov, S.F.; Grachev, M.I.

    1996-01-01

    Theoretical base to establish the All-Russian service for disaster medicine (ARSDM) is elaborated. The arrangement system for medical aid for the population of the Chernobyl NPP (including the aspects of planning and management) is proved in action. COnclusion is made about the necessity to introduce special structure of measures aimed at provision of medical aid of accident victims, of their evacuation and treatment under elimination of radiation accidents. This structure requires to unify all abilities and means of health service into the single system for Medical Provision of population under the emergencies. 4 figs., 2 tabs

  12. Emergence of a rehabilitation medicine model for low vision service delivery, policy, and funding.

    Science.gov (United States)

    Stelmack, Joan

    2005-05-01

    A rehabilitation medicine model for low vision rehabilitation is emerging. There have been many challenges to reaching consensus on the roles of each discipline (optometry, ophthalmology, occupational therapy, and vision rehabilitation professionals) in the service delivery model and finding a place in the reimbursement system for all the providers. The history of low vision, legislation associated with Centers for Medicare and Medicaid Services coverage for vision rehabilitation, and research on the effectiveness of low vision service delivery are reviewed. Vision rehabilitation is now covered by Medicare under Physical Medicine and Rehabilitation codes by some Medicare carriers, yet reimbursement is not available for low vision devices or refraction. Also, the role of vision rehabilitation professionals (rehabilitation teachers, orientation and mobility specialists, and low vision therapists) in the model needs to be determined. In a recent systematic review of the scientific literature on the effectiveness of low vision services contracted by the Agency for Health Care Quality Research, no clinical trials were found. The literature consists primarily of longitudinal case studies, which provide weak support for third-party funding for vision rehabilitative services. Providers need to reach consensus on medical necessity, treatment plans, and protocols. Research on low vision outcomes is needed to develop an evidence base to guide clinical practice, policy, and funding decisions.

  13. An evaluation system for financial compensation in traditional Chinese medicine services.

    Science.gov (United States)

    Dou, Lei; Yin, Ai-Tian; Hao, Mo; Lu, Jun

    2015-10-01

    To describe the major factors influencing financial compensation in traditional Chinese medicine (TCM) and prioritize what TCM services should be compensated for. Two structured questionnaires-a TCM service baseline questionnaire and a service cost questionnaire-were used to collect information from TCM public hospitals on TCM services provided in certain situations and service cost accounting. The cross-sectional study examined 110 TCM services provided in four county TCM public hospitals in Shandong province. From the questionnaire data, a screening index system was established via expert consultation and brainstorming. Comprehensive evaluation of TCM services was performed using the analytic hierarchy process method. Weighted coefficients were used to measure the importance of each criterion, after which comprehensive evaluation scores for each service were ranked to indicate what services should receive priority for financial compensation. Economy value, social value, and efficacy value were the three main criteria for screening for what TCM services should be compensated for. The economy value local weight had the highest value (0.588), of which the profit sub-criterion (0.278) was the most important for TCM financial compensation. Moxibustion was tied for the highest comprehensive evaluation scores, at 0.65 while Acupuncture and Massage Therapy were tied for the second and third highest, with 0.63 and 0.58, respectively. Government and policymakers should consider offer financial compensation to Moxibustion, Acupuncture, Massage Therapy, and TCM Orthopedics as priority services. In the meanwhile, it is essential to correct the unreasonable pricing, explore compensation methods, objects and payment, and revise and improve the accounting system for the costs of TCM services. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Establishment of the Auditing National Service of quality to the instrumentation of Nuclear medicine in Cuba

    International Nuclear Information System (INIS)

    Varela C, C.; Diaz B, M.; Lopez B, G.M.; Torres A, L.A.; Coca P, M.A.

    2006-01-01

    Next to the vertiginous development of the technology in the Nuclear Medicine field, the possibility of early diagnosis of pathological processes without anatomical alterations, as well as its application with therapeutic purposes in the cancer treatment has grown. To assure a diagnosis and adapted therapy, it is vital to establish quality guarantee programs to the instrumentation. The State Medical Equipment Control Center (CCEEM), as regulator organ attributed to the Public Health Ministry of Cuba, it has licensed the Service of Quality Audits to the Nuclear medicine services, fulfilling all the technical and legal requirements to such effect. As base of these, the National Protocol for the Quality Control of the Instrumentation in Nuclear Medicine has been implemented, put out in vigour 2 national regulations, and an inter-institutional and multidisciplinary auditor equipment has been licensed. The different followed steps, as well as the realization of the first quality audits, its show not only a better execution of the tests and bigger professionalism of the involved specialists, but an increment in the taking of conscience to apply adequately the quality concepts for achieving a better service to the patient. On the other hand, the necessity of incorporating the clinical aspects to the audits, fomenting an integral harmonized advance of the quality guarantee programs is evidenced. (Author)

  15. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2017-01-01

    Full Text Available Background This paper aims to investigate the development trend of traditional Chinese medicine (TCM hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM at TCM hospitals. Methods Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field.

  16. Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

    Science.gov (United States)

    Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

    2009-02-01

    The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

  17. Perspectives of resettled African refugees on accessing medicines and pharmacy services in Queensland, Australia.

    Science.gov (United States)

    Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

    2017-10-01

    The aim of this study was to explore the barriers to accessing medicines and pharmacy services among refugees in Queensland, Australia, from the perspectives of resettled African refugees. A generic qualitative approach was used in this study. Resettled African refugees were recruited via a purposive snowball sampling method. The researcher collected data from different African refugee communities, specifically those from Sudanese, Congolese and Somalian communities. Participants were invited by a community health leader to participate in the study; a community health leader is a trained member of the refugee community who acts as a 'health information conduit' between refugees and the health system. Invitations were done either face-to-face, telephonically or by email. The focus groups were digitally recorded in English and transcribed verbatim by the researcher. Transcripts were entered into NVIVO© 11 and the data were analysed using inductive thematic analysis. Four focus groups were conducted between October and November 2014 in the city of Brisbane with African refugees, one with five Somali refugees, one with five Congolese refugees, one with three refugee community health leaders from South Sudan, Liberia and Eritrea and one with three refugee community health leaders from Uganda, Burundi and South Sudan. Eleven sub-themes emerged through the coding process, which resulted in four overarching themes: health system differences, navigating the Australian health system, communication barriers and health care-seeking behaviour. With regard to accessing medicines and pharmacy services, this study has shown that there is a gap between resettled refugees' expectations of health services and the reality of the Australian health system. Access barriers identified included language barriers, issues with the Translating and Interpreter Service, a lack of professional communication and cultural beliefs affecting health care-seeking behaviour. This exploratory study has

  18. Designing better medicines delivery in the UK National Health Services (NHS

    Directory of Open Access Journals (Sweden)

    P. John Clarkson

    2009-11-01

    Full Text Available Background: Prescribed medicines are delivered through a variety ofroutes to patients in the UK National Health Service (NHSand are regulated by a host of health and trade related policy and law. These ensure the efficient and safe supply of medicines of appropriate quality from the pharmaceutical manufacturer through to the end-user, the patient. However, persisting medication errors and therecent discovery of counter feit medicines in the bona fide supply chain have meant there are growing concerns aboutthe timely, accurate and safe supply of medicines in the NHS. Methods: This study undertakes a systems design approach to processmodelling and understanding three key supply routes fromthe manufacturer through to the patient, across bothprimary and secondary care. A systems design approachwas deployed to investigate complex interactions betweenprofessionals, products and processes to improve patient safety in collaboration with twenty five clinical and non-linical stakeholders across the supply chain and six enduser patients.Results: Several system process models were developed from the literature, field observations and alongside the interviewees. The results reveal that risk to medication safety is perceived as occurring most at the patient-end ofthe medicines supply chain: the pharmacy and the ward.There are differences observed in the responses ofinterviewees when they engage with system models.Conclusions: This paper reflects on the use of a systems design, a mainly engineering approach, to understanding a health care domain problem of medication errors. The approach provided an enhanced insight into the complex set of system factors and interactions involved in generating medication errors. This study is among the first to develop asystems-wide view of the medicines supply process ‘as-is’and identify opportunities for re-design to improve patient safety.

  19. Mobile satellite services for public safety, disaster mitigation and disaster medicine

    Science.gov (United States)

    Freibaum, Jerry

    1990-01-01

    Between 1967 and 1987 nearly three million lives were lost and property damage of $25 to $100 billion resulted form natural disasters that adversely affected more than 829 million people. The social and economic impacts have been staggering and are expected to grow more serious as a result of changing demographic factors. The role that the Mobile Satellite Service can play in the International Decade is discussed. MSS was not available for disaster relief operations during the recent Loma Prieta/San Francisco earthquake. However, the results of a review of the performance of seven other communication services with respect to public sector operations during and shortly after the earthquake are described. The services surveyed were: public and private telephone, mobile radio telephone, noncellular mobile radio, broadcast media, CB radio, ham radio, and government and nongovernment satellite systems. The application of MSS to disaster medicine, particularly with respect to the Armenian earthquake is also discussed.

  20. Teaching wound care to family medicine residents on a wound care service

    Directory of Open Access Journals (Sweden)

    Little SH

    2013-08-01

    Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

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

    Science.gov (United States)

    2008-06-06

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

  2. Comparison of activity measurements of the 67Ga and 123I at Brazilian nuclear medicine services

    International Nuclear Information System (INIS)

    Santos, J.A. dos; Silva, M.A.L. da; Lopes, R.T.; Iwahara, A.; Oliveira, A.E. de; Tauhata, L.

    2003-01-01

    Since 1998, the National Laboratory for Ionizing Radiations (LNMRI), of Institute for Radioprotection and Dosimetry, belonging to the Brazilian Commission for Nuclear Energy (IRD/CNEN), is conducting a comparison program for the measurements of radiopharmaceutical activities applied to to patients at the nuclear medicine sector, viewing to assessment the quality of that measurements. This work presents the results of three comparison rounds using the 67 Ga and 123 I, establishing the metrological tracking of the calibrators used by the participants. The results were analysed under the the viewpoint of the conformal with the regulatory authority and show that those comparisons are necessary to improve the quality of radiopharmaceutical measurement activities, identify failures on the equipment and technical procedures used by the nuclear medicine services all over the country

  3. [Environmental medicine in public health service--a social responsibility and its consequences].

    Science.gov (United States)

    Thriene, B

    2001-02-01

    The special committee for "Environmental Medicine" established by the Federal Association of Doctors in the German Public Health Service presents its paper entitled "Environmental Medicine in the Public Health Service--A Social Responsibility and its Consequences: Propositions with regard to the situation, aims, strategies, and opportunities for action". The paper includes core ideas and responsibilities in the public health service. It aims at providing a number of guidelines for implementing "Environment and Health" ("Umwelt und Gesundheit"), an action programme by the Federal Ministry of Environmental Protection and the Ministry of Health, as well as "Health 21" ("Gesundheit 21"), the framework concept "Health for all" for the WHO's European Region. The paper also aims at initiating and facilitating steps for joint action by the Public Health Service. These theses were passed on to Mrs. Andrea Fischer, the Federal Minister of Health, during a meeting with the Board of the Association. In Germany, environment-related public health protection is well established in the Public Health Departments and state institutes/departments within the scope of public health provision and disease prevention. Typical responsibilities include environmental hygiene and environment-related medical services which have increased in importance. The range of responsibilities and its current political importance are a result of environment-related public health risks, the social situation of the population, also with regard to health issues, and the scope of responsibilities and competencies by doctors and staff in the public health departments. With the people's demands for health, quality of life and life expectancy, this need for action increases. In this paper, judicial, professional, and personal consequence are presented which arise as public health authorities assume these responsibilities.

  4. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation.

    Science.gov (United States)

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2016-06-07

    This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  5. Evaluation of radiochemistry purity and p H of radiopharmaceuticals in nuclear medicine services at Pernambuco, Brazil

    International Nuclear Information System (INIS)

    Andrade, Wellington; Lima, Fabiana Farias de; Santos, Poliane A.L.; Lima, Fernando Roberto de Andrade; Lima, Fabiana Farias de

    2011-01-01

    Radiopharmaceuticals are cellular or molecular structures that have a radionuclide in its composition and they are used for diagnosing or treating diseases. The evaluation of the radiochemical purity of radiopharmaceuticals is essential to produce images with artifacts free, as well as avoid unnecessary absorbed dose to the patient. Since they are administered in humans is important and necessary that they undergo rigorous quality control. Due to this fact, the norm in ANVISA RDC 38/2008 declaring the mandatory completion of a minimum of tests in routine nuclear medicine services before human administration. (author)

  6. Organisation arrangements of nuclear medicine services. Planning of installations. Laboratory monitoring

    International Nuclear Information System (INIS)

    Chanteur, J.

    1977-01-01

    Apart from safety and quality requirements, the organisation of nuclear medicine services, or more generally of installations where nonsealed radioactive sources are used, is governed by profitability and efficiency criteria. In view of the high price of products and apparatus, the equipment must be based on a rationalisation of options guiding the organisation arrangements as a whole. The following items are dealt with in succession: various categories of installations; general planning of equipment; equipment regulations based on a major requirement, the confinement of contamination sources; practical observations concerning administrative and technical questions

  7. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    Science.gov (United States)

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.

  8. First, keep it safe: Integration of a complementary medicine service within a hospital.

    Science.gov (United States)

    Schiff, Elad; Levy, Ilana; Arnon, Zahi; Ben-Arye, Eran; Attias, Samuel

    2018-05-01

    This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety-related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment-associated adverse effects, which were documented in an obligatory field on treatment reports. After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice-director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety-related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty-nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety-related incidents and continuous adaptation of the CM service safety protocols. © 2018 John Wiley & Sons Ltd.

  9. Cost of Treatment of Hospitalized Patients with Diabetes in Prenda Hospital Medicine Service, Angola

    Directory of Open Access Journals (Sweden)

    António Zangulo

    2017-07-01

    Full Text Available Introduction: Diabetes has a major impact on morbidity and mortality today. It is estimated that by 2040, about 642 million people are affected worldwide, of which, 34.2 million are from sub-Saharan countries. The direct annual cost of diabetes health care worldwide is estimated at about 153 billion dollars. These patients represent 30% to 40% of all admissions to emergency services, leading to high values of hospital expenditure. We aim to evaluate the cost of treatment of patients with diabetes admitted to Prenda Hospital Medicine Service in 2012. Methods: Retrospective analytical observational study, with data collected from the clinical processes of medical service (age and gender, length of hospitalization, resources consumed, cost of treatment per patient and discharge. Results: Out of 121 patients, the majority was female (n = 70, 57.9%. The age group of 36 to 45 years old was the most frequent among these patients (n = 26, 21.5%. November was the month that recorded the largest number of admissions (n = 17, 14%. About 45.5% were hospitalized during five to eight days, on average for nine days. The majority (76.9% was discharged due to health condition improvement. The price of materials used for treatment of the disease had high variation, and 31 550.15 kwanzas was spent to acquire them. The direct cost per patient per day was 4170.11 kwanzas and the estimated annual cost of care of diabetic patients admitted to Prenda Hospital was 45 525 490.9 kwanzas in 2012. Discussion and Conclusion: These results are in accordance with other studies, indicating a relevant cost of treatment of diabetic patients admitted to Prenda Hospital Medicine Service in 2012.

  10. A Model Curriculum for an Emergency Medical Services (EMS Rotation for Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Michael Mancera

    2018-01-01

    Full Text Available Audience: This EMS curriculum is designed for Emergency Medicine residents at all levels of training. Introduction: Emergency Medicine (EM physicians have routine interaction with Emergency Medical Services (EMS in their clinical practice. Additionally, the American College of Graduate Medical Education (ACGME mandates that all Emergency Medicine resident physicians receive specific training in the area of EMS.1 Historically, EMS training for EM residents has been conducted in the absence of a standardized didactic curriculum. Despite advancements in the area of prehospital training, there remains wide inconsistency in EMS training experiences among EM residency training programs.2 To our knowledge a standardized and reproducible EMS curriculum for EM residents does not exist. Objectives: The aim of this curriculum is to provide a robust learning experience for EM residents around prehospital care and EMS that fulfills the ACGME requirements and which can be easily replicated and implemented in a variety of EM residency training programs. Method: The educational strategies used in this curriculum include didactics, asynchronous learning through online modules and a focused reading list, experiential learning through ride-alongs, structured small group discussion, supervised medical command shifts, and mentored practice in organizing and delivering didactics to EMS providers.

  11. European Council of Legal Medicine (ECLM) accreditation of forensic pathology services in Europe.

    Science.gov (United States)

    Mangin, P; Bonbled, F; Väli, M; Luna, A; Bajanowski, T; Hougen, H P; Ludes, B; Ferrara, D; Cusack, D; Keller, E; Vieira, N

    2015-03-01

    Forensic experts play a major role in the legal process as they offer professional expert opinion and evidence within the criminal justice system adjudicating on the innocence or alleged guilt of an accused person. In this respect, medico-legal examination is an essential part of the investigation process, determining in a scientific way the cause(s) and manner of unexpected and/or unnatural death or bringing clinical evidence in case of physical, psychological, or sexual abuse in living people. From a legal perspective, these types of investigation must meet international standards, i.e., it should be independent, effective, and prompt. Ideally, the investigations should be conducted by board-certified experts in forensic medicine, endowed with a solid experience in this field, without any hierarchical relationship with the prosecuting authorities and having access to appropriate facilities in order to provide forensic reports of high quality. In this respect, there is a need for any private or public national or international authority including non-governmental organizations seeking experts qualified in forensic medicine to have at disposal a list of specialists working in accordance with high standards of professional performance within forensic pathology services that have been successfully submitted to an official accreditation/certification process using valid and acceptable criteria. To reach this goal, the National Association of Medical Examiners (NAME) has elaborated an accreditation/certification checklist which should be served as decision-making support to assist inspectors appointed to evaluate applicants. In the same spirit than NAME Accreditation Standards, European Council of Legal Medicine (ECLM) board decided to set up an ad hoc working group with the mission to elaborate an accreditation/certification procedure similar to the NAME's one but taking into account the realities of forensic medicine practices in Europe and restricted to post

  12. Development of youth friendly family medicine services in Bosnia and Herzegovina: protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Haller, Dagmar M; Narring, Françoise; Chondros, Patty; Pejic, Daliborka; Sredic, Ana; Huseinagic, Senad; Perone, Nicolas; Sanci, Lena A; Meynard, Anne

    2014-01-01

    Young people face many barriers in accessing health services that are responsive to their needs. The World Health Organization has led a call to develop services that address these barriers, i.e. youth-friendly health services. Addressing the needs of young people is one of the priorities of Foundation fami, an organisation working in collaboration with the Swiss Federal Department of Development and Cooperation and Geneva University Hospitals to develop quality family medicine services in Bosnia and Herzegovina. This paper describes the design of a trial to assess the effectiveness of a multifaceted intervention involving family medicine teams (primary care doctors and nurses) to improve the youth-friendliness of family medicine services in Bosnia and Herzegovina. This is a stratified cluster randomised trial with a repeated cross-sectional design involving 59 health services in 10 municipalities of the canton of Zenica in Bosnia and Herzegovina. Municipalities were the unit of randomisation: five municipalities were randomised to the intervention arm and five to a wait-list control arm. Family medicine teams in the intervention arm were invited to participate in an interactive training program about youth-friendly service principles and change processes within their service. The primary outcome was the youth-friendliness of the primary care service measured using the YFHS-WHO + questionnaire, a validated tool which young people aged 15 to 24 years complete following a family medicine consultation. A total of 600 young people aged 15 to 24 years were invited to participate and complete the YFHS-WHO + questionnaire: 300 (30 per municipality) at baseline, and 300 at follow-up, three to five months after the training program. The results of this trial should provide much awaited evidence about the development of youth-friendly primary care services and inform their further development both in Bosnia and Herzegovina and worldwide. Australian New Zealand

  13. A cloud system for mobile medical services of traditional Chinese medicine.

    Science.gov (United States)

    Hu, Nian-Ze; Lee, Chia-Ying; Hou, Mark C; Chen, Ying-Ling

    2013-12-01

    Many medical centers in Taiwan have started to provide Traditional Chinese Medicine (TCM) services for hospitalized patients. Due to the complexity of TCM modality and the increasing need for providing TCM services for patients in different wards at distantly separate locations within the hospital, it is getting difficult to manage the situation in the traditional way. A computerized system with mobile ability can therefore provide a practical solution to the challenge presented. The study tries to develop a cloud system equipped with mobile devices to integrate electronic medical records, facilitate communication between medical workers, and improve the quality of TCM services for the hospitalized patients in a medical center. The system developed in the study includes mobile devices carrying Android operation system and a PC as a cloud server. All the devices use the same TCM management system developed by the study. A website of database is set up for information sharing. The cloud system allows users to access and update patients' medical information, which is of great help to medical workers for verifying patients' identification and giving proper treatments to patients. The information then can be wirelessly transmitted between medical personnel through the cloud system. Several quantitative and qualitative evaluation indexes are developed to measure the effectiveness of the cloud system on the quality of the TCM service. The cloud system is tested and verified based on a sample of hospitalized patients receiving the acupuncture treatment at the Lukang Branch of Changhua Christian Hospital (CCH) in Taiwan. The result shows a great improvement in operating efficiency of the TCM service in that a significant saving in labor time can be attributable to the cloud system. In addition, the cloud system makes it easy to confirm patients' identity through taking a picture of the patient upon receiving any medical treatment. The result also shows that the cloud system

  14. Genetic gatekeepers: regulating direct-to-consumer genomic services in an era of participatory medicine.

    Science.gov (United States)

    Palmer, Jessica Elizabeth

    2012-01-01

    Should consumers be able to obtain information about their own bodies, even if it has no proven medical value? Direct-to-consumer ("DTC") genomic companies offer consumers two services: generation of the consumer's personal genetic sequence, and interpretation of that sequence in light of current research. Concerned that consumers will misunderstand genomic information and make ill-advised health decisions, regulators, legislators and scholars have advocated restricted access to DTC genomic services. The Food and Drug Administration, which has historically refrained from regulating most genetic tests, has announced its intent to treat DTC genomic services as medical devices because they make "medical claims." This Article argues that FDA regulation of genomic services as medical devices would be counterproductive. Clinical laboratories conducting genetic tests are already overseen by a federal regime administered by the Centers for Medicare and Medicaid Services. While consumers and clinicians would benefit from clearer communication of test results and their health implications, FDA's gatekeeping framework is ill-suited to weigh the safety and efficacy of genomic information that is not medically actionable in traditional ways. Playing gatekeeper would burden FDA's resources, conflict with the patient-empowering policies promoted by personalized medicine initiatives, impair individuals' access to information in which they have powerful autonomy interests, weaken novel participatory research infrastructures, and set a poor precedent for the future regulation of medical information. Rather than applying its risk-based regulatory framework to genetic information, FDA should ameliorate regulatory uncertainty by working with the Federal Trade Commission and Centers for Medicare and Medicaid Services to ensure that DTC genomic services deliver analytically valid data, market and implement their services in a truthful manner, and fully disclose the limitations of their

  15. The Evolving Role of Open Source Software in Medicine and Health Services

    Directory of Open Access Journals (Sweden)

    Sevket Seref Arikan

    2013-01-01

    Full Text Available The past five decades have witnessed immense coevolution of methods and tools of information technology, and their practical and experimental application within the medical and healthcare domain. Healthcare itself continues to evolve in response to change in healthcare needs, progress in the scientific foundations of treatments, and in professional and managerial organization of affordable and effective services, in which patients and their families and carers increasingly participate. Taken together, these trends impose highly complex underlying challenges for the design, development, and sustainability of the quality of supporting information services and software infrastructure that are needed. The challenges are multidisciplinary and multiprofessional in scope, and they require deeper study and learning to inform policy and promote public awareness of the problems health services have faced in this area for many years. The repeating pattern of failure to live up to expectations of policy-driven national health IT initiatives has proved very costly and remains frustrating and unproductive for all involved. In this article, we highlight the barriers to progress and discuss the dangers of pursuing a standardization framework devoid of empirical testing and iterative development. We give the example of the openEHR Foundation, which was established at University College London (UCL in London, England, with members in 80 countries. The Foundation is a not-for-profit company providing open specifications and working for generic standards for electronic records, informed directly by a wide range of implementation experience. We also introduce the Opereffa open source framework, which was developed at UCL based on these specifications and which has been downloaded in some 70 countries. We argue that such an approach is now essential to support good discipline, innovation, and governance at the heart of medicine and health services, in line with the

  16. General practitioners' attitude to sport and exercise medicine services: a questionnaire-based survey.

    Science.gov (United States)

    Kassam, H; Tzortziou Brown, V; O'Halloran, P; Wheeler, P; Fairclough, J; Maffulli, N; Morrissey, D

    2014-12-01

    Sport and exercise medicine (SEM) aims to manage sporting injuries and promote physical activity. This study explores general practitioners' (GPs) awareness, understanding and utilisation of their local SEM services. A questionnaire survey, including patient case scenarios, was administered between February and May 2011. 693 GPs working in Cardiff and Vale, Leicester and Tower Hamlets were invited to participate. 244 GPs responded to the questionnaire (35.2% response rate). Less than half (46%; 112/244) were aware of their nearest SEM service and only 38% (92/244) had a clear understanding on referral indications. The majority (82%; 199/244) felt confident advising less active patients about exercise. There were divergent management opinions about the case scenarios of patients who were SEM referral candidates. Overall, GPs were significantly more likely to refer younger patients and patients with sport-related problems rather than patients who would benefit from increasing their activity levels in order to prevent or manage chronic conditions (pHealth Service which may be resulting in suboptimal utilisation especially for patients who could benefit from increasing their activity levels. 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.

  17. Quality assessment of radiopharmaceuticals in nuclear medicine services at Northeast states, Brazil

    International Nuclear Information System (INIS)

    Andrade, Wellington Gomes de

    2012-01-01

    The radiopharmaceuticals are used in the field nuclear medicine services (NMS) as tracer in the diagnoses and treatment of many diseases. Radiopharmaceuticals used in nuclear medicine and usually have a minimum of pharmacological effect. The procedures for labelling Radiopharmaceuticals should be observed in order to minimize risks to patients, employees and individuals from the public, and to be administered in humans, must be sterile and free of pyrogens and possess elements all measures of quality controls required a conventional drug. The 'Agencia Nacional de Vigilancia Sanitaria (ANVISA)' in its 'Resolucao de Diretoria Colegiada' (RDC) No. 38 of June 4 th 2008, decided that the NMS must perform quality control in the generators eluate and radiopharmaceuticals according to recommendations of manufacturers and scientific evidence accepted by ANVISA. Thus, this study proposes to evaluate the quality of the generator 99M o- 99m Tc eluate and radiopharmaceuticals labeled with 99m Tc used in most NMS of some states in the Northeast, in relation to radionuclide, chemical, radiochemical purity and pH and promote the inclusion of procedure for quality control of radiopharmaceuticals in routine NMS. The results show that 90% radionuclidic purity, 98.2% purity chemical and radiochemical purity of 46% and 100% of the eluates are in agreement with international pharmacopoeias; already radiopharmaceuticals showed 82.6% purity and all radiochemical pH values are also in accordance with international pharmacopoeias. Even with so many positive results, staff the majority of MNS was not able to perform the quality control of the eluates and radiopharmaceuticals. Showing the importance of implementing of quality control programs of the eluates and radiopharmaceuticals in nuclear medicine. (author)

  18. The myeloid splenomegaly in a service of nuclear medicine; La splenomegalie myeloide dans un service de Medecine Nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Rain, J-D.; Najean, Y.; Billoty, C. [Service de Medecine Nucleaire, Hopital Saint-Louis, Paris (France)

    1997-12-31

    The existence in a Nuclear Medicine service of several in-vivo (scintigraphy and kinetic) and in-vitro (dosages) sections can contribute into a better knowledge of diseases due to the complementarity of the provided information. Exploration, since 1990, of 183 primary and secondary myeloid splenomegalies (MS) is a good example. These 183 patients have had a medullary scintigraphy with Technetium colloids and Indium Transferrin, 98, a measurement of the sanguine mass, 60, a kinetic study of Iron-Chromium erythropoiesis and 180, a dosage of pro-collagen III. These four examinations allowed confirming the MS diagnosis and orienting the prognostic. The medullary scintigraphy is able to show the poverty of marrow-sustaining tissues and allows measuring the splenomegaly. It helps evaluating the wealth of myelopoietic tissue and its extensions and confirming the spleenic erythropoiesis. The measure of sanguine mass specifies the existence and importance of true anaemia and hemodilution due to the splenomegaly. The kinetic study by Iron-Chromium indicates the medullary spleenic production, degree of dys-erythropoiesis, the presence of hemolysis and its location. It brings about important prognostic arguments and is a precious aid in making the difficult decision of indication of splenectomy. The pro-collagen III dosage is of a certain prognostic interest. The patients with less than 0.70 U/ml have a slow evolutivity of their disease, those with values within 0.70 to 1 U/ml have a more severe evolution, while for those having values higher than 1 U/ml the prognostic is bad on short terms. In conclusion, the diagnosis and prognostic of these examinations in MS justify maintenance of a plurality of in-vivo and in-vitro techniques in our services

  19. Organisation of nuclear medicine services. Health physics. Technical and administrative arrangement

    International Nuclear Information System (INIS)

    Chanteur, J.; Pellerin, P.

    1975-01-01

    Apart from safety and quality requirements the organisation of nuclear medicine services, or more generally of installations where non-sealed radioactive sources are used, is governed by profitability and efficiency criteria. In view of the high price of products and apparatus the equipment must be based on a rationalisation of options guiding the organisation arrangements as a whole. The following items are dealt with in succession: various categories of installations; general planning of equipment; equipment regulations based on a major requirement, the confinement of contamination sources; working rules examined with respect to the systematics adopted by the International Health Physics Commission and referred in turn to the protection of the patient and that of the surroundings practical observations concerning administrative and technical questions [fr

  20. The use of Skype in a community hospital inpatient palliative medicine consultation service.

    Science.gov (United States)

    Brecher, David B

    2013-01-01

    Skype™, an Internet-based communication tool, has enhanced communication under numerous circumstances. As telemedicine continues to be an increasing part of medical practice, there will be more opportunities to use Skype and similar tools. Numerous scenarios in the lay literature have helped to highlight the potential uses. Although most commonly used to enhance physician-to-patient communication, there has been limited reported use of Skype for patient-to-family communication, especially in end of life and palliative care. Our inpatient Palliative Medicine Consultation Service has offered and used this technology to enhance our patients' quality of life. The objective was to provide another tool for our patients to use to communicate with family and/or friends, especially under circumstances in which clinical symptoms, functional status, financial concerns, or geographic limitations preclude in-person face-to face communication.

  1. Training veterinary students in shelter medicine: a service-learning community-classroom technique.

    Science.gov (United States)

    Stevens, Brenda J; Gruen, Margaret E

    2014-01-01

    Shelter medicine is a rapidly developing field of great importance, and shelters themselves provide abundant training opportunities for veterinary medical students. Students trained in shelter medicine have opportunities to practice zoonotic and species-specific infectious disease control, behavioral evaluation and management, primary care, animal welfare, ethics, and public policy issues. A range of sheltering systems now exists, from brick-and-mortar facilities to networks of foster homes with no centralized facility. Exposure to a single shelter setting may not allow students to understand the full range of sheltering systems that exist; a community-classroom approach introduces students to a diverse array of sheltering systems while providing practical experience. This article presents the details and results of a series of 2-week elective clinical rotations with a focus on field and service learning in animal shelters. The overall aim was to provide opportunities that familiarized students with sheltering systems and delivered primary-care training. Other priorities included increasing awareness of public health concerns and equipping students to evaluate shelters on design, operating protocols, infectious disease control, animal enrichment, and community outreach. Students were required to participate in rounds and complete a project that addressed a need recognized by them during the rotation. This article includes costs associated with the rotation, a blueprint for how the rotation was carried out at our institution, and details of shelters visited and animals treated, including a breakdown of treatments provided. Also discussed are the student projects and student feedback on this valuable clinical experience.

  2. Use of medical services and medicines attributable to diabetes in Sub-Saharan Africa.

    Science.gov (United States)

    Brown, Jonathan Betz; Ramaiya, Kaushik; Besançon, Stéphane; Rheeder, Paul; Tassou, Clarisse Mapa; Mbanya, Jean-Claude; Kissimova-Skarbek, Katarzyna; Njenga, Eva Wangechi; Muchemi, Eva Wangui; Wanjiru, Harrison Kiambuthi; Schneider, Erin

    2014-01-01

    Although the large majority of persons with diabetes and other non-communicable diseases (NCDs) lives and dies in low- and middle-income countries, the prevention and treatment of diabetes and other NCDs is widely neglected in these areas. A contributing reason may be that, unlike the impacts of acute and communicable diseases, the demands on resources imposed by diabetes is not superficially obvious, and studies capable of detecting these impacts have not be done. To ascertain recent use of medical services and medicines and other information about the impact of ill-health, we in 2008-2009 conducted structured, personal interviews with 1,780 persons with diagnosed diabetes (DMs) and 1,770 matched comparison subjects (MCs) without diabetes in Cameroon, Mali, Tanzania and South Africa. We sampled DMs from diabetes registries and, in Cameroon and South Africa, from attendees at outpatient diabetes clinics. To recruit MCs, we asked subjects with diabetes to identify five persons living nearest to them who were of the same sex and approximate age. We estimated diabetes impact on medical services use by calculating ratios and differences between DMs and MCs, testing for statistical significance using two-stage multivariable hurdle models. DMs consumed 12.95 times more days of inpatient treatment, 7.54 times more outpatient visits, and 5.61 times more medications than MCs (all pSub-Saharan Africa, the relative incremental use of medical care and medicines associated with diagnosed diabetes is much greater than in industrialized countries and in China. Published calculations of the health-system impact of diabetes in Africa are dramatic underestimates. Although non-communicable diseases like diabetes are commonly thought to be minor problems for health systems and patients in Africa, our data demonstrate the opposite.

  3. Use of medical services and medicines attributable to diabetes in Sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Jonathan Betz Brown

    Full Text Available Although the large majority of persons with diabetes and other non-communicable diseases (NCDs lives and dies in low- and middle-income countries, the prevention and treatment of diabetes and other NCDs is widely neglected in these areas. A contributing reason may be that, unlike the impacts of acute and communicable diseases, the demands on resources imposed by diabetes is not superficially obvious, and studies capable of detecting these impacts have not be done.To ascertain recent use of medical services and medicines and other information about the impact of ill-health, we in 2008-2009 conducted structured, personal interviews with 1,780 persons with diagnosed diabetes (DMs and 1,770 matched comparison subjects (MCs without diabetes in Cameroon, Mali, Tanzania and South Africa. We sampled DMs from diabetes registries and, in Cameroon and South Africa, from attendees at outpatient diabetes clinics. To recruit MCs, we asked subjects with diabetes to identify five persons living nearest to them who were of the same sex and approximate age. We estimated diabetes impact on medical services use by calculating ratios and differences between DMs and MCs, testing for statistical significance using two-stage multivariable hurdle models.DMs consumed 12.95 times more days of inpatient treatment, 7.54 times more outpatient visits, and 5.61 times more medications than MCs (all p<0.001. DMs used an estimated 3.44 inpatient days per person per year, made 10.72 outpatient visits per person per year (excluding traditional healers, and were taking an average of 2.49 prescribed medicines when interviewed.In Sub-Saharan Africa, the relative incremental use of medical care and medicines associated with diagnosed diabetes is much greater than in industrialized countries and in China. Published calculations of the health-system impact of diabetes in Africa are dramatic underestimates. Although non-communicable diseases like diabetes are commonly thought to be minor

  4. [Assessment of the Polish occupational medicine service (oms) system made by OMS nurses].

    Science.gov (United States)

    Sakowski, Piotr

    2012-01-01

    This paper presents the results of an assessment of the Polish occupational medicine service (OMS) system made by OMS nurses. The survey was carried out on a random group of OMS nurses. OMS nurses form a professional group comprised of rather experienced personnel. In the opinion of almost 70% of respondents the system guarantees good occupational heath care, whereas 20% took the opposite view. The great majority of respondents think that all employees have to undergo mandatory prophylactic examinations. The nurses have rather critical opinion about the legal regulations pertaining to occupational health care--their number and complexity, and also express negative opinion about the quality of cooperation with employers (who are contractors for OMS units). OMS nurses believe that prophylactic examinations are the strongest point of the system. They are often the only opportunity for establishing contact between an employee and a physician and learning about diseases he or she was previously unaware of. Although the general assessment of the OMS system is rather positive, it is not free of shortcomings. Improvements in such fields as legislation, financing of service, professional attitude towards responsibilities of the OMS staff, cooperation with employers (contractors) and primary health care units would undoubtedly result in even better assessment, and what is more important in better functioning of the Polish OMS system.

  5. Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center.

    Science.gov (United States)

    Manzano, Joanna-Grace M; Gadiraju, Sahitya; Hiremath, Adarsh; Lin, Heather Yan; Farroni, Jeff; Halm, Josiah

    2015-09-01

    Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values quality measures in cancer hospitals. Copyright © 2015 by American Society of Clinical Oncology.

  6. Use of health services and medicines amongst Australian war veterans: a comparison of young elderly, near centenarians and centenarians

    Directory of Open Access Journals (Sweden)

    Ryan Philip

    2010-11-01

    Full Text Available Abstract Background Age and life expectancy of residents in many developed countries, including Australia, is increasing. Health resource and medicine use in the very old is not well studied. The purpose of this study was to identify annual use of health services and medicines by very old Australian veterans; those aged 95 to 99 years (near centenarians and those aged 100 years and over (centenarians. Methods The study population included veterans eligible for all health services subsidised by the Department of Veterans' Affairs (DVA aged 95 years and over at August 1st 2006. A cohort of veterans aged 65 to 74 years was identified for comparison. Data were sourced from DVA claims databases. We identified all claims between August 1st 2006 and July 31st 2007 for medical consultations, pathology, diagnostic imaging and allied health services, hospital admissions, number of prescriptions and unique medicines. Chi squared tests were used to compare the proportion of centenarians (those aged 100 years and over and near centenarians (those aged 95 to 99 years who accessed medicines and health services with the 65 to 74 year age group. For those who accessed health services during follow up, Poisson regression was used to compare differences in the number of times centenarians and near centenarians accessed each health service compared to 65 to 74 year olds. Results A similar proportion (98% of centenarians and near centenarians compared to those aged 65 to 74 consulted a GP and received prescription medicine during follow up. A lower proportion of centenarians and near centenarians had claims for specialist visits (36% and 57% respectively, hospitalisation (19% and 24%, dental (12% and 18%, physiotherapy (13% and 15%, pathology(68% and 78% and diagnostic imaging services (51% and 68% (p Conclusions Medical consultations and medicines are the health services most frequently accessed by Australian veteran centenarians and near centenarians. For most

  7. A review of issues of nomenclature and taxonomy of Hypericum perforatum L. and Kew's Medicinal Plant Names Services.

    Science.gov (United States)

    Dauncey, Elizabeth Anne; Irving, Jason Thomas Whitley; Allkin, Robert

    2017-10-16

    To review which names are used to refer to Hypericum perforatum L. in health regulation and medicinal plant references, and the potential for ambiguity or imprecision. Structured searches of Kew's Medicinal Plant Names Services Resource, supplemented with other online bibliographic resources, found that the scientific name Hypericum perforatum L. is used consistently in the literature, but variation between subspecies is rarely considered by researchers. Research is still published using only the common name 'St John's wort' despite it being imprecise; at least 80 other common names are also used for this plant in multiple languages. Ambiguous and alternative plant names can lead to ineffective regulation, misinterpretation of literature, substitution of raw material or the failure to locate all published research. Kew's Medicinal Plant Names Services (MPNS) maps all names used for each plant in medicinal plant references onto current taxonomy, thereby providing for disambiguation and comprehensive access to the regulations and references that cite that plant, regardless of the name used. MPNS also supplies the controlled vocabulary for plant names now required for compliance with a new standard (Identification of Medicinal Products, IDMP) adopted by medicines regulators worldwide. © 2017 Royal Pharmaceutical Society.

  8. What proportion of prescription items dispensed in community pharmacies are eligible for the New Medicine Service?

    Science.gov (United States)

    Wells, Katharine M; Boyd, Matthew J; Thornley, Tracey; Boardman, Helen F

    2014-03-07

    The payment structure for the New Medicine Service (NMS) in England is based on the assumption that 0.5% of prescription items dispensed in community pharmacies are eligible for the service. This assumption is based on a theoretical calculation. This study aimed to find out the actual proportion of prescription items eligible for the NMS dispensed in community pharmacies in order to compare this with the theoretical assumption. The study also aimed to investigate whether the proportion of prescription items eligible for the NMS is affected by pharmacies' proximity to GP practices. The study collected data from eight pharmacies in Nottingham belonging to the same large chain of pharmacies. Pharmacies were grouped by distance from the nearest GP practice and sampled to reflect the distribution by distance of all pharmacies in Nottingham. Data on one thousand consecutive prescription items were collected from each pharmacy and the number of NMS eligible items recorded. All NHS prescriptions were included in the sample. Data were analysed and proportions calculated with 95% confidence intervals used to compare the study results against the theoretical figure of 0.5% of prescription items being eligible for the NMS. A total of 8005 prescription items were collected (a minimum of 1000 items per pharmacy) of which 17 items were eligible to receive the service. The study found that 0.25% (95% confidence intervals: 0.14% to 0.36%) of prescription items were eligible for the NMS which differs significantly from the theoretical assumption of 0.5%. The opportunity rate for the service was lower, 0.21% (95% confidence intervals: 0.10% to 0.32%) of items, as some items eligible for the NMS did not translate into opportunities to offer the service. Of all the prescription items collected in the pharmacies, 28% were collected by patient representatives. The results of this study show that the proportion of items eligible for the NMS dispensed in community pharmacies is lower than

  9. Prevalence and Predictors of Complementary and Alternative Medicine (CAM) Use among Ivy League College Students: Implications for Student Health Services

    Science.gov (United States)

    Versnik Nowak, Amy L.; DeGise, Joe; Daugherty, Amanda; O'Keefe, Richard; Seward, Samuel, Jr.; Setty, Suma; Tang, Fanny

    2015-01-01

    Objective: Determine prevalence and types of complementary and alternative medicine (CAM) therapies used and test the significance of demographics and social cognitive constructs as predictors of CAM use in a college sample. Secondary purpose was to guide the integration of CAM therapies into college health services. Participants: Random,…

  10. Solid radioactive waste: evaluation of residual activity in nuclear medicine services

    International Nuclear Information System (INIS)

    Alabarse, Frederico G.; Xavier, Ana M.; Magalhaes, Maisa H.; Guerrero, Jesus S.P.

    2009-01-01

    An experimental programme to estimate, with a better degree of accuracy, the activity that remains adsorbed in flasks and syringes used in Nuclear Medicine Services for the administration of radionuclides to patients submitted to diagnostic or therapy is been conducted under the coordination of the Radioactive Waste Division of the Brazilian Nuclear Energy Commission, CNEN. The adopted recommendation in Brazil to allow an expedite solid waste management in nuclear medicine facilities, up to the present, is to consider that 2% of the initial activity remains adsorbed in the solid waste, which easily allows the calculation of the storage time to achieve regulatory clearance levels by decay. This research evaluates 17 different kinds of radiopharmaceuticals and three radioisotopes: 99m Tc, 67 Ga and 201 Tl. Results obtained by means of a weighting method to estimate the residual mass in flasks show that the ratio of the mass of the liquid that remains in the solid waste to the mass of the empty flask is constant. This suggests that the residual activity depends on the initial activity concentration of radiopharmaceutical contained in each flask, as assumed by the regulatory body. Additionally, results obtained by determining the remaining activity in flasks, shortly after the injection of its radionuclide contents in patients, indicate that an average value for the residual activity of the order of 10% of the initial activity contained in the flasks or syringes should be adopted to determine the decay storage time before the release of solid waste in the urban conventional land fill disposal system. The 'rule of thumb' of 10 half-lives for storage before clearance is also discussed in the present work. (author)

  11. Evaluation of residual activity of solid waste generated in nuclear medicine services of Porto Alegre - Brazil

    International Nuclear Information System (INIS)

    Xavier, Ana M.; Alabarse, Frederico Gil; Magalhaes, Maisa Haiidamus; Guerrero, Jesus Salvador Perez

    2008-01-01

    An experimental programme to estimate, with a better degree of accuracy, the activity that remains adsorbed in flasks and syringes used in Nuclear Medicine Services for the administration of radionuclides to patients submitted to diagnostic or therapy was conducted under the coordination of the Radioactive Waste Division of the Brazilian Nuclear Energy Commission. The adopted recommendation in Brazil to allow an expedite solid waste management in nuclear medicine facilities, up to the present, is to consider that 2% of the initial activity remains adsorbed in the solid waste, which easily allows the calculation of the storage time to achieve regulatory clearance levels by decay. This research evaluates 17 different kinds of radio pharmaceuticals and three radioisotopes: 99m Tc, 67 Ga and 201 Tl. Results obtained by means of a weighting method to estimate the residual mass in flasks show that the ratio of the mass of the liquid that remains in the solid waste to the mass of the empty flask is constant. This suggests that the residual activity depends on the initial activity concentration of radiopharmaceutical contained in each flask, as assumed by the regulatory body. Additionally, results obtained by determining the remaining activity in flasks, shortly after the injection of its radionuclides contents in patients, indicate that an average value for the residual activity of the order of 10% of the initial activity contained in the flasks or syringes can be adopted instead of the previously assumed 2%. It is suggested that the more conservative average value obtained in the present work for the activity that remains in flasks and syringes, that is, 10% of the initial activity, could be adopted to determine the decay storage time before the release of solid waste in the urban conventional land fill disposal system. (author)

  12. Residents examine factors associated with 30-day, same-cause hospital readmissions on an internal medicine service.

    Science.gov (United States)

    Moran, Jennifer; Colbert, Colleen Y; Song, Juhee; Hull, Joshua; Rajan, Sabitha; Varghees, Sunita; Arroliga, Alejandro C; Reddy, Santosh P

    2013-01-01

    In recent years, there has been increased interest in stemming the tide of hospital readmissions in an attempt to improve quality of care. This study presents the Phase I results of a resident-led quality improvement initiative to determine the percentage of and risk factors for same-cause readmissions (SCRs; defined as hospital readmission within 30 days of hospital discharge for treatment of the same condition) to the internal medicine service of a multispecialty teaching hospital in central Texas. Results indicate that patients diagnosed with chronic obstructive pulmonary disease/asthma or anemia may be at increased risk for SCRs. Those patients who are insured by Medicaid and those who require assistance from social services also demonstrated an increased risk for SCRs. This study appears to be the first resident-led initiative in the field to examine 30-day SCRs to an internal medicine service for demographic and clinical risk factors.

  13. Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

    Science.gov (United States)

    Salata, Brian M; Sterling, Madeline R; Beecy, Ashley N; Ullal, Ajayram V; Jones, Erica C; Horn, Evelyn M; Goyal, Parag

    2018-05-01

    Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Shifting boundaries: religion, medicine, nursing and domestic service in mid-nineteenth-century Britain.

    Science.gov (United States)

    Helmstadter, Carol

    2009-06-01

    The boundaries between medicine, religion, nursing and domestic service were fluid in mid-nineteenth-century England. The traditional religious understanding of illness conflicted with the newer understanding of anatomically based disease, the Anglican sisters were drawing a line between professional nursing and the traditional role of nurses as domestic servants who looked after sick people as one of their many duties, and doctors were looking for more knowledgeable nurses who could carry out their orders competently. This prosopographical study of the over 200 women who served as government nurses during the Crimean War 1854-56 describes the status of nursing and provides a picture of the religious and social structure of Britain in the 1850s. It also illustrates how religious, political and social factors affected the development of the new nursing. The Crimean War nurses can be divided into four major groups: volunteer secular ladies, Roman Catholic nuns, Anglican sisters and working-class hospital nurses. Of these four groups I conclude that it was the experienced working-class nurses who had the greatest influence on the organization of the new nursing.

  15. Determination of radiochemistry purity and pH of radiopharmaceutical in Northeast nuclear medicine services

    International Nuclear Information System (INIS)

    Andrade, Wellington; Santos, Poliane; Lima, Fernando de Andrade; Lima, Fabiana Farias de

    2013-01-01

    The radiopharmaceutical is a chemical compound associated with a radionuclide, which is selected so that meets the need cf diagnosis and capable of producing quality images. Drugs labeled with 99m Tc radionuclide kits consist of lyophilized, and be handled by the nuclear medicine services (NMS) must pass tests as the resolution of ANVISA (RDC 38) published in 2008. Among these tests are those of radiochemical purity and pH determination. This study evaluated the radiochemical purity of radiopharmaceuticals and pH SMN manipulated in the Northeast. The radiochemical purity (RCP) was determined by thin layer chromatography, which were used Whatman ® and silica gel, with dimensions of 1 x 10 cm, as stationary phase, and solvents indicated in the inserts of manufacturers. The chromatographic strips were placed in sealed containers so as not to touch the walls thereof. After the chromatographic run, the tape was cut every centimeter and the activities determined in doses of each calibrator NMS. The pH of the radiopharmaceutical was assessed through the use of universal pH paper (Merck®) and obtained staining compared with its color scale. The results showed (hat 82.6% and 100% of the radiopharmaceuticals of the samples were within the limits recommended by international pharmacopoeias for radiochemical purity and pl-l, respectively. There is then the need to include in routine tests indicated SMN by ANVISA. Well, they can detect possible problems in the marking of radiopharmaceuticals administered to the patient and avoid inappropriate material. (author)

  16. Intercomparison of 131I and 99mTc activity measurements in Brazilian nuclear medicine services

    International Nuclear Information System (INIS)

    Iwahara, Akira; De Oliveira, Antonio E.; Tauhata, Luiz; Silva, Carlos J. da; Lopes, Ricardo T.

    2001-01-01

    This work outlines the quality assurance program for the activity measurements of the most used radionuclides at Brazilian Nuclear Medicine Services (NMS). The program aims to guarantee that the patient is given the correct prescribed amount of activity in diagnostic or therapeutic applications. This accurate administration depends upon proper use and calibration of the activity meters by the NMS. Underestimation of administered activity in diagnostic practices could delay correct diagnosis disturbing the value of the investigation. On the other hand, the overestimation would be worse, mainly in therapeutic applications, because an unnecessarily high absorbed dose would be delivered to the patient. The preliminary results of intercomparison for 131 I and 99m Tc showed that many activity meters used at NMS's present problems giving results up to 41% greater than the reference values determined at the National Metrology Laboratory for Ionizing Radiation (LNMRI) which is recognized as the Brazilian authorized metrology laboratory for ionizing radiation. These results have demonstrated that the NMS should improve the accuracy of the activity measurements of the radionuclides administered to the patients and establish the traceability to the national standards of measurements. These standards are based on a pressurized well-type ionization chamber installed at LNMRI and calibrated with reference sources standardized by absolute methods. The protocol of the intercomparison and recommendations made in order to minimize errors in measuring procedures are described and results are discussed

  17. Evaluating the fundamental qualities of a nuclear medicine radiographer for the provision of an optimal clinical service

    International Nuclear Information System (INIS)

    Griffiths, Marc; King, Simon; Stewart, Rob; Dawson, Gary

    2010-01-01

    The developing nature of nuclear medicine practice highlights the need for an evaluation of the fundamental qualities of a Radiographer working within this discipline. Existing guidelines appear to be in place for clinical technologists working within nuclear medicine. However, limited guidance has been provided for Radiographers practicing within this discipline. This article aims to discuss the fundamental qualities that are considered essential for optimal service delivery, following consultation with various stakeholders. Areas such as technical expertise and knowledge, appropriate use of imaging equipment and current models of safe working practice will be discussed. Patient care and ethical considerations will also be evaluated, along with some core recommendations for future advanced practice.

  18. Control flow of radiopharmaceuticals in nuclear medicine by means of an E-service; Control flujo de radiofarmacos en medicine nuclear por medio de un E-servicio

    Energy Technology Data Exchange (ETDEWEB)

    Nunez Martin, L.; Gonzalez de Mingo, M. A.; Fragua Redondo, J. A.; Martinez Ortega, J.; Gutierrez Camunas, S.; Redondo Miguel, A. B.

    2013-07-01

    The almost generalized use of single-dose Nuclear Medicine for performing diagnostic tests or treatments, and the consequent complexity that accompanies its management, has resulted in the need to control the flow of material radioisotopic tools. An e-service is designed to manage the flow of radiopharmaceuticals and control its use and spending. This control does not only affect the efficiency in the use and cost of material, but in the radioactive waste associated with the non-use and waste reduction and a more effective organization of the Department. (Author)

  19. Critical evaluation of the external occupational exposure in nuclear medicine services in Brazil

    International Nuclear Information System (INIS)

    Kubo, Ana Luiza Silva Lima

    2016-01-01

    Currently in Brazil (2016), there are 421 Nuclear Medicine Services (NMS). In nuclear medicine, the possibility of occupational internal contamination and external exposure is unavoidable. The chest individual monitoring, to estimate the effective dose, is mandatory, but the extremity monitoring is not always made. The aim of this study was to conduct a survey of data for external exposure of NMS professionals in Brazil from 1987 to 2010, analysing them in terms of trends and comparing them with measurements carried out in this work and in other countries. Although most of the NMS is still located in large urban centres (54% in the Southeast region), there is no state without any NMS. The increasing number of NMS has generated the need for more professionals. In the year 1987, they were 755 workers and, in 2010, 4134, with the following distribution of specialties: 29% of Nuclear Medicine Technicians (NMT), 23% of Nursing professionals, 29% of Physicians and 3% of Physicists. The average annual effective dose reached more than 3.0 mSv in some regions of the country, from 1987 to 2010, but tends to 1.0 mSv in 2010. The highest doses, as expected, are received by NMT and Nursing. The professionals who handle radiopharmaceuticals have their hands much more exposed than the chest. During 2010, only 31% of NMT and 16% of Nursing used extremity dosimeters as compared to chest dosimeters. The data from the measurements indicate that not all individual dosimeters are used properly. Generally, both in the measurements as in national registries, the hand doses were higher for professionals who prepared the radiopharmaceutical (NMT) than those who injected (Nursing). The value measured by chest dosimeters can be used to estimate the equivalent dose to the eye lenses, except for NMT at preparation practices at conventional NMS, where the equivalent dose of the lens is about 2 times higher than the dose at the chest. The most exposed areas of the hands are the tips of the index

  20. Quality evaluation of radiopharmaceuticals in nuclear medicine services in the states of Alagoas and Sergipe - Brazil

    International Nuclear Information System (INIS)

    Santos, Poliane Angelo de Lucena; Andrade, Wellington Gomes de; Lima, Fernando Roberto de Andrade; Lima, Fabiana Farias de

    2011-01-01

    Radiopharmaceuticals are compounds associated with a radionuclide. They can be considered as vectors that have some specificity for an organ or a physiological or pathophysiological function. Assessing the radiopharmaceutical's quality is essential to obtain adequate images, avoiding repetition of examinations and unnecessary absorbed dose to the patient. Resolution no. 8 (RCD 38) of 06/04/2008 by Agencia Nacional de Vigilancia Sanitaria (ANVISA) states the obligation of performing a minimum of tests in the routines of nuclear medicine services (NMS). The aim of this work was to evaluate the radiochemical purity and pH of radiopharmaceuticals used in NMS in states of Alagoas and Sergipe - Brazil. Radiochemical purity was determined by thin layer chromatography where a paper Whatman and TLC were used as steady state and the solvents were used related to the appropriate radiopharmaceutical, both as recommended by the manufacturer's directions. The chromatographic strips were placed in closed containers to avoid contact with the walls. After, the strips were cut in 1cm pieces and the activity was determined in each NMS's activity calibrators. The radiopharmaceuticals pH was evaluated by using universal pH paper (Merck) and the obtained color was compared with its range of colors. It was observed that 33.34% and 2.3% of the tested radiopharmaceuticals showed PRQ (radiochemical purity) and pH values, respectively, are outside of the limits described by the manufacturers. The results show that the radiochemical purity assessment in the NMS's routine can indicate problems with a radioisotope tagging, allowing their exclusion before administration. (author)

  1. Limb-body wall defect: experience of a reference service of fetal medicine from Southern Brazil.

    Science.gov (United States)

    Gazolla, Ana C; da Cunha, André C; Telles, Jorge A B; Betat, Rosilene da S; Romano, Mayara A; Marshall, Isabel; Gobatto, Amanda M; de H Bicca, Anna M; Arcolini, Camila P; Dal Pai, Thaís K V; Vieira, Luciane R; Targa, Luciano V; Betineli, Ildo; Zen, Paulo R G; Rosa, Rafael F M

    2014-10-01

    Limb-body wall defect is a rare condition characterized by a combination of large and complex defects of the ventral thorax and abdominal wall with craniofacial and limb anomalies. The aim of this study was to describe the experience of our fetal medicine service, a reference from Southern Brazil, with prenatally diagnosed patients with a limb-body wall defect in a 3 years period. Only patients who fulfilled the criteria suggested by Hunter et al. (2011) were included in the study. Clinical data and results of radiological and cytogenetic evaluation were collected from their medical records. Our sample was composed of 8 patients. Many of their mothers were younger than 25 years (50%) and in their first pregnancy (62.5%). It is noteworthy that one patient was referred due to suspected anencephaly and another due to a twin pregnancy with an embryonic sac. Craniofacial defects were verified in three patients (37.5%), thoracic/abdominal abnormalities in 6 (75%) and limb defects in eight (100%). Congenital heart defects were observed in five patients (62.5%). One of them presented a previously undescribed complex heart defect. The results disclosed that complementary exams, such as MRI and echocardiography, are important to better define the observed defects. Some of them, such as congenital heart defects, may be more common than previously reported. This definition is essential for the proper management of the pregnancy and genetic counseling of the family. The birth of these children must be planned with caution and for the prognosis a long survival possibility, despite unlikely and rare, must be considered. © 2014 Wiley Periodicals, Inc.

  2. Risk estimation in association with diagnostic techniques in the nuclear medicine service of the Camaguey Ciego de Avila Territory

    International Nuclear Information System (INIS)

    Barrerras, C.A.; Brigido, F.O.; Naranjo, L.A.; Lasserra, S.O.; Hernandez Garcia, J.

    1999-01-01

    The nuclear medicine service at the Maria Curie Oncological Hospital, Camaguey, has experience of over three decades in using radiofarmaceutical imaging agents for diagnosis. Although the clinical risk associated with these techniques is negligible, it is necessary to evaluate the effective dose administered to the patient due to the introduction of radioactive substances into the body. The study of the dose administered to the patient provides useful data for evaluating the detriment associated with this medical practice, its subsequently optimization and consequently, for minimizing the stochastic effects on the patient. The aim of our paper is to study the collective effective dose administered by nuclear medicine service to Camaguey and Ciego de Avila population from 1995 to 1998 and the relative contribution to the total annual effective collective dose of the different diagnostic examinations. The studies were conducted on the basis of statistics from nuclear medicine examinations given to a population of 1102353 inhabitants since 1995. The results show that the nuclear medicine techniques of neck examinations with 1168.8 Sv man (1.11 Sv/expl), thyroid explorations with 119.6 Sv man (55.5 mSv/expl) and iodide uptake with 113.7 Sv man (14.0 mSv/expl) are the main techniques implicated in the relative contribution to the total annual effective collective dose of 1419.5 Sv man. The risk estimation in association with diagnostic techniques in the nuclear medicine service studied is globally low (total detriment: 103.6 as a result of 16232 explorations), similar to other published data

  3. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    Science.gov (United States)

    2010-10-01

    ... offered. (1) There must be a director who is a doctor of medicine or osteopathy qualified in nuclear... accordance with acceptable standards of practice. (1) In-house preparation of radiopharmaceuticals is by, or under, the direct supervision of an appropriately trained registered pharmacist or a doctor of medicine...

  4. [Undesirable effects of medicine in the Internal Medicine Service of the University Hospital Center du Point G].

    Science.gov (United States)

    Soukho-Kaya, A; Minta, D K; Diarra, M T; Konaté, A; Diallo, B; Sidibé, A T; Dembélé, M; Bah, M; Doumbia, A A; Dao, K; Tolo, N; Camara, B D; Sy, D; Maiga, M Y; Traoré, H A

    2010-01-01

    The aim of this study was to determine the frequency of adverse reactions to drugs, the WHO grade, describe the clinical features and identify the drug responsible. This was a descriptive cross-sectional study which took place from February 2005 to January 2006 in the Internal Medicine Department at the hospital point G. Were included in this study, all patients hospitalized during the study period, which presented adverse drug reactions (ADRs) that the relation of cause and effect was certain or likely. Thus, 47 ADRs were identified in 39 patients of 426 admitted during the same period a frequency of 9.2%. The average age of our patients was 48.5 ± 16.5 years. The sex-ratio was 1.6 for women. Eighty-two percent of our patients had an ADR and 18% more than one. The WHO grade 1 was the most met or 36.2%, followed by grades 4 and 2 respectively 27.7% and 25.5%. Antidiabetics were responsible for adverse reactions in 46.8% and 21.3% in TB. Adverse events were neurological in 53.2% and type of manifestations of hypoglycemia 46.8% (22/47 cases), polyneuritis 6.4% (3 / 47 cases) and 29.8% in digestive cases dominated by vomiting 12.8% (6 / 47 cases), the epigastria pain 6.4% (3 / 47 cases). The outcome was favorable in 87.2% of cases, however, 3 cases of death among those over 60 years all grade 4 WHO. ADRs deserve special attention to this high death rate (6.4% 3/47 cases) where the interest to search systematically for all patients under medical treatment with a good clinical examination and questioning some thoroughly.

  5. Quality approach in hygiene in a nuclear medicine service; Demarche qualite en hygiene dans un service de medecine nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Plogin, J

    1998-10-29

    The activities of nuclear medicine, by their constraints of radiation protection, present difficulties for rules of hygiene protocols. Considering the particular risks of certain techniques, the approach brings to the fore the compromise between radiation protection and hygiene and to adapt the recommendations to local specificities. (N.C.)

  6. Automation as a strategic toll for service stations management; Automacao como ferramenta aliada a gestao de postos de servicos

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Marcello Cyrino [GILBARCO do Brasil, Sao Paulo, SP (Brazil). Div. de Automacao

    2004-07-01

    The use of automation systems will be approached as fundamental tool in the control of sales in the pumps as well electronic management of stock in the tanks on a consolidated and integrated way, offering reliability and total control in the administration of fuel resale, no matter if the user be a one station owner, a group of dozens stations, or oil companies in general. These systems allow the local control in the gas station as well remotely through internet access or other kind of communication interface which be Also available. We will give some examples, as the possibility of remote stock management through a communication link between the oil company and gas station, in order to setup in the system a minimum stock level in each tank, that when being reached sends an automatic alarm for the oil company and another alarm for the station operator, so that the replenishment is programmed immediately without the need of sending purchase order by fax, e mail or telephone. This process brings a huge reduction of costs in the delivery logistics as well in the operational costs, reverting directly on a growth of the gas station and dealer's profit. Through this control, is also possible the remote management of fuel leak alarms in attendance to CONAMA 273, making possible a shared control and offering higher safety for both parts involved, considering the concept of environmental co-responsibility between gas station and oil company (dealer). (author)

  7. Experiences of the Nuclear Medicine Service at the University Hospital Surgical Clinic Dr. Salvador Allende 2013-2015

    International Nuclear Information System (INIS)

    Suárez Iznaga, Rodolfo; Pozo Almaguer, Armando del; Gil Valdés, Doris; Fleitas Anaya, Ricardo

    2016-01-01

    The Nuclear Medicine Service of the University Hospital Surgical Clinic D r. Salvador Allende , located in the municipality of Cerro, began the provision of scintigraphic services in May 2013. A retrospective descriptive and analytical study was carried out from May 2013 to December 2015 from the archived scintigraphic reports. The objective of the study was to present the results of the Nuclear Medicine Service during this period. The data were reflected in percentages, using tables and graphs. To determine the existence of a statistically significant relationship between the variables were used: Chi square test with a level of significance α = 0.05 being positive if p <0.05. Until December 2015, 798 cases had been reported, which included Bone scans (88.34%), renal (10.65%) and thyroid scans for follow-up of cancer patients (1%); (76.82%) and the female sex was the most attended with 446 (55.89%) patients, there were no statistically significant differences between the scintigraphic studies and the sex of the patients. There were statistically significant differences between the scintigraphic studies and the age of the patients. The most frequent diagnoses were: bone scintigraphy, metastasis in 86.52% of patients, renal cyst scintigraphy (48.78%) and dynamic scintigraphy of the kidneys with obstructive functional involvement (63.64%) It was recommended to create the necessary technical and human resources conditions to be able to introduce other scintigraphy studies in the Nuclear Medicine Service such as: breast scintigraphy and lymph node scans, high demand in the medical center. In addition, to use scientifically the criteria of approval of patients in the consultation of classification of the service, with the aim of achieving a better selection of the applicants for scintigraphic studies, which would favor a more rational and efficient use of these studies.

  8. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    Directory of Open Access Journals (Sweden)

    Rebecca Levy

    2010-01-01

    Full Text Available Background: Electronic medical records (EMRs provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution′s initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting strategy within the EMR. Methods: A focus group of our hospital′s transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater real-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encountered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also

  9. An E-mail Service in a Military Adolescent Medicine Clinic: will teens ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    *Adolescent Medicine Physician, Brooke Army Medical Center, San Antonio, TX,. USA. **Assistant ... into the patient's electronic medical record. At the end of the .... our patients or parents, and privacy concerns were easily addressed.

  10. 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

  11. Response of monitors of surface contamination to internal exposition control from 131I in the 'nuclear medicine services'

    International Nuclear Information System (INIS)

    Puerta, Nancy; Rojo, Ana M.; Villella, Adrian; Gossio, Sebastian; Parada, Ines Gomez; Acosta, Norma; Arenas, German

    2013-01-01

    The IAEA, in its publication RS-G-1.2, proposes individual control of workers occupationally exposed with risk of internal exposure when the potential exposure provided by incorporation leads to a value of annual committed effective dose equal to or greater than 1 mSv. Because the radionuclide 131 I is the most important to control internal exposure in Nuclear Medicine Services, it is evaluated if the surface contamination monitors, commonly used in nuclear medicine centers of Argentina, would implement individual control of internal exposure to 131 I. Selected detectors were calibrated with a dummy neck and thyroid with calibrated sources of 131 I and 133 Ba reference. For each detector is was estimated the detection efficiency for 131 I and its detection limit. Each instrument was evaluated for the lowest effective dose possible to detect compromised by individual routine monitoring with different measurement intervals . We analyzed the response of each team for determining conditions that may be effective for the control of internal exposure of 131 I. Finally , we conclude that the daily individual monitoring surface contamination detectors available in the Nuclear Medicine Services is feasible to implement and ensures detection of significant additions of 131 I

  12. Impact of the application of criteria of internal monitoring in radiological protection programmes in nuclear medicine services

    International Nuclear Information System (INIS)

    Dantas, B.M.; Dantas, A.L.A.; Juliao, L.Q.C.; Lourenco, M.C.; Melo, D.R.

    2005-01-01

    The manipulation of open sources in Nuclear Medicine services involves risks of external exposure and internal contamination. The radiological protection plan of facilities licensed by CNEN - Brazilian Nuclear Energy Commission - must include the evaluation of such risks and propose a programme of individual monitoring to control exposure and ensure the maintenance of conditions of radiation safety. The IAEA - International Atomic Energy Agency - recommendations presented in the Safety Guide RS-G-1.2 suggest that an internal worker monitoring program be implemented where there is a possibility of internal contamination lead to effective dose committed annual values equal to or greater than 1 mSv. This paper presents the application of such criteria to the radionuclides most frequently used in the field of Nuclear Medicine, taking into account the normal conditions of handling and the ranges of activity authorized by CNEN. It is concluded that iodine 131 manipulation for therapeutic purposes is the practice that presented the greatest risk of internal exposure of workers, requiring the adoption of a programme of internal monitoring of Nuclear Medicine services

  13. The perceived value of clinical pharmacy service provision by pharmacists and physicians: an initial assessment of family medicine and internal medicine providers.

    Science.gov (United States)

    Wietholter, Jon P; Ponte, Charles D; Long, Dustin M

    2017-10-01

    Few publications have addressed the perceptions of pharmacists and physicians regarding the value of clinical pharmacist services. A survey-based study was conducted to determine whether Internal Medicine (IM) and Family Medicine (FM) pharmacists and physicians differed in their attitudes regarding the benefits of collaboration in an acute care setting. The primary objective was to evaluate perceived differences regarding self-assessment of value between IM and FM pharmacists. The secondary objective was to evaluate perceived differences of clinical pharmacist benefit between IM and FM physicians. An eight-item questionnaire assessed the attitudes and beliefs of pharmacists and physicians regarding the value of clinical pharmacy services. Surveys were emailed and participants marked their responses using a 7-point Likert scale for each item. Demographic data and overall comments were collected from each participant. Overall, 167 surveys were completed. When comparing cumulative physician and pharmacist responses, none of the eight questions showed significant differences. Statistically significant differences were noted when comparing IM and FM clinical pharmacists on five of the eight survey items; for each of these items, FM pharmacists had more favourable perceptions than their IM counterparts. No statistically significant differences were noted when comparing responses of IM and FM physicians. This study found that FM pharmacists perceived a greater benefit regarding participation in inpatient acute care rounds when compared to their IM pharmacist counterparts. Future studies are necessary to determine if other medical specialties' perceptions of clinical pharmacy provision differ from our findings and to evaluate the rationale behind specific attitudes and behaviours. © 2016 Royal Pharmaceutical Society.

  14. Avaliacao da gestao ambiental dos hoteis de selva na Amazonia, Brasil

    Directory of Open Access Journals (Sweden)

    Gomes de Moraes, Adriana

    2008-10-01

    Full Text Available In the challenge of desvelar of that it forms the hoteleiros enterprises they manage its ambient action without causing great impacts in one of biggest ecosystems of the world, the Amazonian forest, was tried to know in this research the forms of ambient management of the located hotels of forest in the legal Amazônia. The norteadora question of the research was to know that type of ambient management is made by the hotels of selva?Foi used as instrument of collection of data the questionnaire, that if subdividiui in four great subjects to be searched. The first one was relative questions to the planning of the place, according to to the profile of the customer, third to the room and the relative questions architecture the building subject relative questions to the energy resources and infrastructure of the public services. As result of this analysis was concluded that two of three hotels searched are practising management ambient of form less impactante, since type of construction adopted until services offered to guests, or either shows objective that its hotel is coadjuvante for customer that visits this type of place, that stops it does not import luxury, comfort and amenities, more yes contact with the fauna and flora and way of life of the natives.

  15. International Journal of Occupational Medicine and Environmental Health in world documentation services: the SCOPUS based analysis of citation.

    Science.gov (United States)

    Przyłuska, Jolanta

    2006-01-01

    A high classification of scientific journals in the ranking of international transfer of knowledge is reflected by other researchers' citations. The International Journal of Occupational Medicine and Environmental Health (IJOMEH) is an international professional quarterly focused on such areas as occupational medicine, toxicology and environmental health edited in Poland. IJOMEH, published in English, is indexed in numerous world information services (MEDLINE, EMBASE, EBSCO, SCOPUS). This paper presents the contribution of IJOMEH publications to the world circulation of scientific information based on the citation analysis. The analysis, grounded on the SCOPUS database, assessed the frequency of citations in the years 1996-2005. Journals in which they have been cited were retrieved and their list is also included.

  16. Effect of a Community-Based Service Learning Experience in Geriatrics on Internal Medicine Residents and Community Participants.

    Science.gov (United States)

    Miller, Rachel K; Michener, Jennifer; Yang, Phyllis; Goldstein, Karen; Groce-Martin, Jennine; True, Gala; Johnson, Jerry

    2017-09-01

    Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources. Residents evaluated the experience. Postgraduate Year 3 internal medicine residents (n = 71) delivered 64 sessions. Residents felt that the experience increased their ability to communicate effectively with older adults (mean 3.91 ± 0.73 on a Likert scale with 5 = strongly agree), increased their knowledge of resources (4.09 ± 1.01), expanded their knowledge of a health topic pertinent to aging (3.48 ± 1.09), and contributed to their capacity to evaluate and care for older adults (3.84 ± 0.67). Free-text responses demonstrated that residents thought that this program would change their practice. Of 815 older adults surveyed from 36 discrete teaching sessions, 461 (56%) thought that the medical residents delivered health information clearly (4.55 ± 0.88) and that the health topics were relevant (4.26 ± 0.92). Free-text responses showed that the program helped them understand their health concerns. This CBSL program is a feasible and effective tool for teaching internal medicine residents and older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  17. Monetary Value of a Prescription Assistance Program Service in a Rural Family Medicine Clinic

    Science.gov (United States)

    Whitley, Heather P.

    2011-01-01

    Purpose: To quantify the monetary value of medications provided to rural Alabamians through provision of pharmaceutical manufacturer-sponsored prescription assistance programs (PAPs) provided by a clinical pharmacist in a private Black Belt family medicine clinic during 2007 and 2008. Methods: Patients struggling to afford prescription medications…

  18. Individual monitoring of internal exposure of 131I of workers from the nuclear medicine service FUESMEN, Argentina

    International Nuclear Information System (INIS)

    Arenas, G.; Acosta, N.; Venier, V.; Bedoya Toboo, C.

    2013-01-01

    It is presented the FUESMEN experience in routine monitoring of thyroid internal doses due to inhalation of 131 I in workers of the Nuclear Medicine Service in normal operation or accidental exposure. It is used a surface contamination monitor, type Geiger Mueller, calibrated with a acrylic phantom based on specifications of the simulator of thyroid of ICRU 48 with 131 I reference activity. Through the obtained measurements is achieved to validate the use of Portable Monitor to carry out preliminary exploration on the monitoring scenarios of incidental situations

  19. Performance evaluation of the activity meters of the Brazilian Nuclear Medicine Services in the country during 16 years

    International Nuclear Information System (INIS)

    Toledo, B.C. de; Oliveira, A.E. de; Iwahara, A.; Tauhata, L.; Delgado, J.U.

    2017-01-01

    Measurements of radionuclide activity are a very intense routine in the Nuclear Medicine Services (NMS) of Brazil. In order to guarantee the quality of these measurements, the Institute of Radioprotection and Dosimetry (IRD) has developed an activity measurement comparison program aiming at the improvement of these services. The evaluation methodology was the criterion of accuracy of the CNEN NN 3.05 standard. The reference value was established by the National Laboratory of Ionizing Radiation Metrology (LNMR) of the IRD, RJ, Brazil. The results showed that 77% of the NMS reached a performance within the range of acceptance, whereas values obtained for the activity in the activity meters with Geiger-Müller (GM) type detectors, presented insufficient performance, supporting the prohibition of these calibrators

  20. The paradox of non-evidence based, publicly funded complementary alternative medicine in the English National Health Service: An explanation.

    Science.gov (United States)

    Sheppard, Maria K

    2015-10-01

    Despite the unproven effectiveness of many practices that are under the umbrella term 'complementary alternative medicine' (CAM), there is provision of CAM within the English National Health Service (NHS). Moreover, although the National Institute for Health and Care Excellence was established to promote scientifically validated medicine in the NHS, the paradox of publicly funded, non-evidence based CAM can be explained as linked with government policy of patient choice and specifically patient treatment choice. Patient choice is useful in the political and policy discourse as it is open to different interpretations and can be justified by policy-makers who rely on the traditional NHS values of equity and universality. Treatment choice finds expression in the policy of personalised healthcare linked with patient responsibilisation which finds resonance in the emphasis CAM places on self-care and self-management. More importantly, however, policy-makers also use patient choice and treatment choice as a policy initiative with the objective of encouraging destabilisation of the entrenched healthcare institutions and practices considered resistant to change. This political strategy of system reform has the unintended, paradoxical consequence of allowing for the emergence of non-evidence based, publicly funded CAM in the NHS. The political and policy discourse of patient choice thus trumps evidence based medicine, with patients that demand access to CAM becoming the unwitting beneficiaries. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Integrating Traditional Chinese Medicine Services in Community Health Centers: Insights into Utilization Patterns in the Pearl River Region of China

    Directory of Open Access Journals (Sweden)

    Vincent C. H. Chung

    2013-01-01

    Full Text Available In China's healthcare reform, community health centers (CHCs are designed to take a pivotal role in providing primary care. Whilst about 20% of all outpatient care in China is delivered by the traditional Chinese medicine (TCM sector, hospitals, instead of CHCs, are major providers. Using current patterns of patient utilization this study aims to inform CHCs on how they may strengthen access to TCM services. Three thousand three hundred and sixty CHC patients from six cities within the urban Pearl Delta Region were enumerated using multistage cluster sampling. Fifty-two percent had visited herbalists within three months with a mean visit frequency of 1.50 times. Herbal treatments, which are cheaper than western medicines, were more popular amongst those who needed to pay out of pocket including the uninsured. Herbal medicines appeared to be an alternative for those who are underinsured. Acupuncturists and massage therapists were visited by smaller proportions, 6.58% and 5.98%, respectively, with a mean three-month visit of 0.27 and 0.26 times. Access was restricted by lack of social insurance coverage. Whilst increasing provision of TCM in CHCs might respond to patient demand, increasing insurance coverage for TCM needs to be evaluated using current evidence on safety and effectiveness.

  2. Medical and administrative management by computing devices in the service of nuclear medicine of Nancy

    International Nuclear Information System (INIS)

    Legras, B.; Chau, N.; Lambert, J.-P.; Martin, J.; Bertrand, A.

    1977-01-01

    The results of the processing of the administrative and medical data collected in a Department of Nuclear medicine are presented. For a moderate increase in the secretaries' work (limited by the use of carbon copies) and for minor efforts of the doctors, the resulting dvantages are tremendous. A detailed balance of the Department activity can be obtained monthly. From the medical files, the computer provides statistical data and listings in clear form (with or without sort) of the selected records [fr

  3. Evaluation of internal occupational exposure of workers from nuclear medicine services by aerosol analysis containing 131I

    International Nuclear Information System (INIS)

    Carneiro, Luana Gomes; Sampaio, Camilla da Silva; Dantas, Ana Leticia Almeida; Lucena, Eder Augusto; Santos, Maristela Souza; Dantas, Bernardo Maranhao; Paula, Gustavo Affonso de

    2014-01-01

    This study evaluated the risk of internal occupational exposure associated with the incorporation of 131 I via inhalation, in Nuclear Medicine Services, using aerosol analysis techniques. Occupationally Exposed Individuals (IOE) involved in handling this radionuclide are subject to chronic exposure, which can lead to an increase in the committed effective dose. Results obtained in preliminary studies indicate the occurrence of incorporation of 131 I by workers involved in handling solutions for radioiodine therapy procedures. The evaluation was carried out in radiopharmacy lab (nuclear medicine service) of a public hospital located in the city of Rio de Janeiro. After confirmed the presence of the radioisotope, by a qualitative assessment, it was determined an experimental arrangement for sample collection and were detected and quantitated the presence of steam 131 I during routine work. The average concentration of activity obtained in this study was 3 Bq / m 3 . This value is below of Derived Concentration in Air (DCA) of 8.4 x 10 3 Bq of 131 I / m 3 corresponding to a committed effective dose of 1.76 x 10 -4 mSv. These results demonstrate that the studied area is safe in terms of internal exposure of workers. However, the presence of 131 I should be periodically reevaluated, since this type of exposure contributes to the increase of the individual effective doses. Based on the data obtained improvements were suggested in the exhaust system and the use of good work practices in order to optimize the exposures

  4. Customers' perceptions of and satisfaction with medicine retail outlet services in Addis Ababa, Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Gebregeorgise, Dawit T; Mohammed, Tofik A; Redi, Zebiba S; Sporrong, Sofia Kälvemark

    2018-06-01

    The aim of this study was to assess customers' perceptions of and satisfaction with MRO services in Addis Ababa and to explore factors associated with their satisfaction and reasons for visits. A cross-sectional survey was conducted among customers selected from 28 MROs in Addis Ababa, using multi-stage sampling techniques. Simple descriptive statistics and multivariable logistic regression at 95% confidence interval were used for the analysis. Of 396 respondents, 324 (81.8%) visited MROs to purchase prescription medicines. A majority (338/396; 85.4%) of them perceived that pharmacists and druggists (pharmacy professionals) play a major role in healthcare delivery. A third (140/396; 35.4%) of the respondents agreed with the statement that pharmacy professionals are more concerned about patient care than about their business. Regarding reasons for visiting, being married was positively associated with buying over-the-counter, higher educational status was linked with more satisfaction. Overall, 56.8% (225/396) of the respondents reported that they were satisfied with the service provided by MROs. Customers of MROs had mixed perceptions of and satisfaction with the current service. Marital status and age were associated with the reason for visiting, while the educational level was associated with the level of satisfaction. The overall positive perceptions and satisfaction about MROs should be taken as an opportunity to promote and improve pharmaceutical services rendered in MROs, to ensure that the public is receiving maximum benefit. © 2017 Royal Pharmaceutical Society.

  5. Age, chronic non-communicable disease and choice of traditional Chinese and western medicine outpatient services in a Chinese population

    Directory of Open Access Journals (Sweden)

    Yeoh Eng

    2009-11-01

    Full Text Available Abstract Background In 1997 Hong Kong reunified with China and the development of traditional Chinese medicine (TCM started with this change in national identity. However, the two latest discussion papers on Hong Kong's healthcare reform have failed to mention the role of TCM in primary healthcare, despite TCM's public popularity and its potential in tackling the chronic non-communicable disease (NCD challenge in the ageing population. This study aims to describe the interrelationship between age, non-communicable disease (NCD status, and the choice of TCM and western medicine (WM services in the Hong Kong population. Methods This study is a secondary analysis of the Thematic Household Survey (THS 2005 dataset. The THS is a Hong Kong population representative face to face survey was conducted by the Hong Kong Administrative Region Government of China. A random sample of respondents aged >15 years were invited to report their use of TCM and WM in the past year, together with other health and demographic information. A total of 33,263 persons were interviewed (response rate 79.2%. Results Amongst those who received outpatient services in the past year (n = 18,087, 80.23% only visited WM doctors, 3.17% consulted TCM practitioners solely, and 16.60% used both type of services (double consulters. Compared to those who only consulted WM doctor, multinomial logistic regression showed that double consulters were more likely to be older, female, NCD patients, and have higher socioeconomic backgrounds. Further analysis showed that the association between age and double consulting was curvilinear (inverted U shaped regardless of NCD status. Middle aged (45-60 years NCD patients, and the NCD free "young old" group (60-75 years were most likely to double consult. On the other hand, the relationship between age and use of TCM as an alternative to WM was linear regardless of NCD status. The NCD free segment of the population was more inclined to use TCM alone

  6. European Council of Legal Medicine (ECLM) accreditation of forensic pathology services in Europe

    DEFF Research Database (Denmark)

    Mangin, P; Bonbled, F; Väli, M

    2015-01-01

    in order to provide forensic reports of high quality. In this respect, there is a need for any private or public national or international authority including non-governmental organizations seeking experts qualified in forensic medicine to have at disposal a list of specialists working in accordance...... process, determining in a scientific way the cause(s) and manner of unexpected and/or unnatural death or bringing clinical evidence in case of physical, psychological, or sexual abuse in living people. From a legal perspective, these types of investigation must meet international standards, i...

  7. Customers' perceptions of and satisfaction with medicine retail outlet services in Addis Ababa, Ethiopia

    DEFF Research Database (Denmark)

    Gebregeorgise, Dawit T; Mohammed, Tofik A; Redi, Zebiba S

    2018-01-01

    OBJECTIVES: The aim of this study was to assess customers' perceptions of and satisfaction with MRO services in Addis Ababa and to explore factors associated with their satisfaction and reasons for visits. METHODS: A cross-sectional survey was conducted among customers selected from 28 MROs...... for visiting, being married was positively associated with buying over-the-counter, higher educational status was linked with more satisfaction. Overall, 56.8% (225/396) of the respondents reported that they were satisfied with the service provided by MROs. CONCLUSION: Customers of MROs had mixed perceptions...... of and satisfaction with the current service. Marital status and age were associated with the reason for visiting, while the educational level was associated with the level of satisfaction. The overall positive perceptions and satisfaction about MROs should be taken as an opportunity to promote and improve...

  8. Implementation of a quality control program of the equipment of the nuclear medicine services in Chile

    International Nuclear Information System (INIS)

    Astudillo, R.; Diaz, G.; Ferreira, A.; Garcia, M.; Hermosilla, A.; Pacheco, F.; Vasquez, M.; Coca, M.

    2014-08-01

    Now days in Chile there are more of 43 Nuclear Medicine centers; most of them have gamma cameras in order to study physiological process in diagnostic and treatment of patients pathologies. This requires having the equipment in optimal operating condition and it is ensured with quality control programs that are based on a series of tests relating to protocols, such as TECDOC-602 y AAPM No.6. Planar test often applied in gamma cameras including: spatial resolution, spatial linearity, sensitivity and uniformity. SPECT tests consider: tomography uniformity, rotation center tomography resolution and total performance. The tests in dose calibrator are: background measurement, accuracy, precision, linearity and reproducibility. The tests above require the use of radioactive sources and specific simulators patterns or phantom based on international standards such as The National Electrical Manufacturers Association (Nema), International Atomic Energy Agency (IAEA) and The American Association of Medical Physics (AAPM). In this work we carried out several tests of quality control in a Nuclear Medicine Center of Temuco and we propose to implement the applied methodology in others similar Chilean centers. (author)

  9. Monitoring of the internal contamination of occupationally exposure personnel in services of nuclear medicine through the use of gamma cameras

    International Nuclear Information System (INIS)

    Teran, M.; Paolino, A.; Savio, E.; Hermida, J.C.; Dantas, B.M.

    2006-01-01

    time: 15 minutes; Detector- source distance: 20 cm. Under the determined conditions is possible to maintain the monitoring service of workers using gamma cameras like alternative method before the lack of an equipment of thyroid caption, allowing a work continuity without stopping the monitoring and the possibility opens up of implementing this methodology in nuclear medicine clinics far from the university center. (Author)

  10. Evaluation of diagnostic procedures in nuclear medicine services of Pernambuco and Alagoas states - Brazil

    International Nuclear Information System (INIS)

    Silva, Ricardo Braz F. da; Hazin, Clovis A.

    2011-01-01

    The medical use of ionizing radiation contributes significantly to population exposure to radiation. This study aimed to evaluate the diagnostic procedures carried out in nuclear medicine (SMN) in Pernambuco and Alagoas in order to gather data to subsidize the proposal of reference levels for nuclear medicine in Brazil. Data were collected of the SMN in Pernambuco and Alagoas in the period of 2005 to 2009, according by UNSCEAR. The study used data from IBGE. The results showed that the total number of examinations in the period 2005 to 2009 was 34.828 in Pernambuco and 27.700 in Alagoas, corresponding to 6.966 and 5.540 average annual examinations in Pernambuco and Alagoas, respectively. The total number of examinations performed in both states in 2009 was twice the number carried out in 2005. Scintigraphy is the cardiovascular examination most performed in both states, followed by bone scintigraphy. Tc-99m is the radionuclide used most often, followed by I-131. The number of tests using Tc-99m in 2009 doubled when compared with the examinations performed in 2005. The results indicate that there has been a significant increase in the number of examinations in MN, and that females outnumber males, as far as the use of this diagnostic resource is concerned. The study of the activities of the radionuclides administered to patients in the states of Pernambuco and Alagoas showed that they are high when compared to the values recommended by the IAEA in its Safety Report Series Document No. 40. (author)

  11. Common Health Risks, Required Precautions of Travelers and their Customs Towards the Use of Travel Medicine Services.

    Science.gov (United States)

    Roupa, Zoe; Zikos, Dimitrios; Vasilopoulos, Aristides; Diomidous, Marianna

    2012-01-01

    There is an increasing number of people who travel around the world. Every traveler is exposed to nearly all infectious risks which may occur during his travel time. Some of the main risk factors can be water quality, temperature and high humidity and the exposure to multi-resistant microorganisms. To tackle the upcoming problem there is an imperative need to develop a new branch of medicine with the name of travel medicine. A consultation prior to departure for an upcoming trip is required, focusing to a personalized healthcare plan, based on international scientific protocols and epidemiological studies.Travelers must acquire essential information about the prevailing hygiene conditions and climatic differentiations that occur in the region. Additionally there are several health risks upon the arrival at destination. A scheduled visit to a health professional is necessary, especially in the case of travelers suffering from chronic diseases or those taking medication, while vaccination is considered essential for specific destination countries. Healthcare professionals should be able to inform travelers and evaluate their needs. According to research studies on notion and attitudes travelers' specific risks, only few of them are well-informed during a trip. While most studies indicate that travelers have some kind of pre travel medical consultation, not all of them proceed to the required vaccinations and medications. Travelling for business or leisure around the world may be unhealthy. The importance of proper preparation prior to the travel requires to be adequately informed by specialized healthcare professionals, and to receive appropriate vaccinations and medications, when required. The results of the review of notions and attitudes of travelers during the trip indicate not only the need for further development of the branch of travel medicine but especially the need for the expansion and the availability of health services.

  12. Determination of the presence of molybdenum-99 in the technetium-99m solutions used at the nuclear medicine services of Recife, Pernambuco, Brazil

    International Nuclear Information System (INIS)

    Sena, Thiago G. de; Souza, Fernanda R. de L.; Lopes Filho, Ferdinand de J.; Vieira, Jose W.; Lima, Fernando R. de A.

    2009-01-01

    The main objective of this work is to calculate the percentage of 99 Mo in the eluates of the 99 mTc used at the nuclear medicine services localized at the Recife city, Pernambuco, Brazil. At the present moment three nuclear medicine services were evaluated verifying the 99 Mo in the eluates of 99 mTc, and in two services, the contamination were superior to the limits stipulated by the international organism adopted as reference in this work. The work follows in other nuclear medicine institutions evaluating and orienting the professionals on these quality control not only for the optimization of the patient dose, but also for the improvement of the image to be used for the diagnostic

  13. Contribution of the operational dosimetry in the radiation protection optimization in a nuclear medicine service

    International Nuclear Information System (INIS)

    Herit, S.; Cosculluela, S.; Lambert, B.; Gras, H.

    2007-01-01

    Beyond its contribution in the personnel dosimetric surveillance, the operational dosimetry is a very efficient educational tool, of easy use. This study is lengthened by the setting up in 2007 of a job study in order to redefine the service zoning and by an evaluation of the extremities dosimetry with the help of thermoluminescent rings, in order to optimize the practices during the phase of preparation and injection. (N.C.)

  14. [Supply medicinal products improvement in outpatient care in a hospital pharmacy service].

    Science.gov (United States)

    Santiago Pérez, A; Peña Pedrosa, J A; Alguacil Pau, A I; Pérez Morales, A; Molina Muñoz, P; Benítez Giménez, M T

    Pharmaceutical care to outpatients is currently one of the main occupations of hospital pharmacy services (PEX). There are several questionnaires to measure the satisfaction of the PEX of a pharmacy service, and the results of these questionnaires can generate improvement actions that result in satisfaction. To verify if a satisfaction questionnaire for outpatients is valid for the generation of improvements in the care provided, and if after its implementation, the same questionnaire is able to detect changes in satisfaction. Prospective study of a single center carried out in a tertiary hospital in 2015 and 2016. A questionnaire previously validated with 16 Likert-type items was used. Demographic and classification data were collected. A descriptive analysis was performed and the internal consistency was calculated using the Cronbach's α value. A total of 258 questionnaires were collected in 2015 and 493 in 2016. There were no differences in the baseline characteristics of the patients and users of the service. The items with the lowest satisfaction scores in 2015 (comfort of the waiting room, dispensing privacy, drug pick-up time and medication pick-up time) guided the improvement actions to be implemented. In 2016 there was an improvement in the waiting time until collection in 12.3% (p = 0.002); in the comfort of the waiting room 4.9% (p = 0.304); business hours for medication collection, 10.7% (p = 0.013); and in the confidentiality of the dispensation 4% (p = 0.292). The remaining scores fluctuated minimally, with no statistical significance at all. A 5.1% improvement in overall satisfaction was found (p improve the care received in an outpatient unit of a pharmacy service. This same questionnaire is a tool to monitor the changes implemented to improve the care received. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. National phantoms bank for the service of nuclear medicine in Cuba. Utility for the quality control of the instrumentation

    International Nuclear Information System (INIS)

    Varela C, C.; Diaz B, M.; Lopez B, G.M.

    2006-01-01

    Although, most of the applications in Nuclear Medicine have diagnostic ends, its going enlarging considerably the therapeutic applications. So that the diagnostic accuracy or the therapy effectiveness have not been affected, it becomes indispensable the quality control of the instrumentation, independently of its technological complexity and/or its exploitation period. Before the real lack of phantoms in the institutions, it was created a bank that puts to disposition of all the institutions, the existent phantoms in the country, and those that are going acquired, centralized by the State Control of Medical Equipment Center (CCEEM) and with Web access in its place www.eqmed.sld.cu. Having like base the elaboration of the National Protocol for the Quality Control of the Instrumentation in Nuclear Medicine that keeps in mind the international normative and the own existent conditions, were dictated and established two national regulations and its are being carried out the first audits to the instrumentation quality. These have evidenced the partial realization of the established quality controls in the services, the necessity to make aware as for the fulfillment of the criteria and quality concepts for the instrumentation, as well as the necessity to increase the phantoms number to the bank to guarantee the fulfillment of the Quality Control Programs. (Author)

  16. Quality of Interhospital Transfer Communication Practices and Association With Adverse Events on an Internal Medicine Hospitalist Service.

    Science.gov (United States)

    Borofsky, Jennifer S; Bartsch, Jason C; Howard, Alan B; Repp, Allen B

    Communication practices around interhospital transfer have not been rigorously assessed in adult medicine patients. Furthermore, the clinical implications of such practices have not been reported. This case-control study was designed to assess the quality of communication between clinicians during interhospital transfer and to determine if posttransfer adverse events (PTAEs) are associated with suboptimal communication. Cases included patients transferred to a Medicine Hospitalist Service from an outside hospital who subsequently experienced a PTAE, defined as unplanned transfer to an intensive care unit or death within 24 hours of transfer. Control patients also underwent interhospital transfer but did not experience a PTAE. A blinded investigator retrospectively reviewed the recorded pretransfer phone conversations between sending and receiving clinicians for adherence to a set of 13 empiric best practice communication elements. The primary outcome was the mean communication score, on a scale of 0-13. Mean scores between PTAE (8.3; 95% confidence interval [CI], 7.6-8.9) and control groups (7.9; 95% CI, 7.1-8.8) did not differ significantly (p = .50), although suboptimal communication on a subset of these elements was associated with increased PTAEs. Communication around interhospital transfer appears suboptimal compared with an empiric set of standard communication elements. Posttransfer adverse events were not associated with aggregate adherence to these standards.

  17. An observational pre-post study of re-structuring Medicine inpatient teaching service: Improved continuity of care within constraint of 2011 duty hours.

    Science.gov (United States)

    Cheung, Joseph Y; Mueller, Daniel; Blum, Marissa; Ravreby, Hannah; Williams, Paul; Moyer, Darilyn; Caroline, Malka; Zack, Chad; Fisher, Susan G; Feldman, Arthur M

    2015-09-01

    Implementation of more stringent regulations on duty hours and supervision by the Accreditation Council for Graduate Medical Education in July 2011 makes it challenging to design inpatient Medicine teaching service that complies with the duty hour restrictions while optimizing continuity of patient care. To prospectively compare two inpatient Medicine teaching service structures with respect to residents' impression of continuity of patient care (primary outcome), time available for teaching, resident satisfaction and length-of-stay (secondary endpoints). Observational pre-post study. Surveys were conducted both before and after Conventional Medicine teaching service was changed to a novel model (MegaTeam). Academic General Medicine inpatient teaching service. Surveys before and after MegaTeam implementation were completed by 68.5% and 72.2% of internal medicine residents, respectively. Comparing conventional with MegaTeam, the % of residents who agreed or strongly agreed that the (i) ability to care for majority of patients from admission to discharge increased from 29.7% to 86.6% (pcare, decreases number of handoffs, provides adequate supervision and teaching of interns and medical students, increases resident overall satisfaction and decreases length-of-stay. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Availability and affordability of essential medicines: exploring the health seeking behaviours and health service utilisation for children under-5 years living in squatter settlement of Karachi, Pakistan.

    Science.gov (United States)

    Shafiq, Yasir; Shaikh, Babar Tasneem; Kumar, Ramesh

    2011-01-01

    Child health outcomes in the poor communities are largely affected by the non-availability of essential medicines at government health facilities and non-affordability of prescribed medicines at private retail pharmacies. This phenomenon largely defines health seeking behaviours and health service utilisation patterns of the families of the children. Using observational visits, we examined the shelf-availability of medicines for children less than 5 years of age at a rural health centre and conducted focus group discussions with the mothers to explore the effects of non-availability and non-affordability of medicines. We also validated all information by interviewing the health care providers of the area. We found that erratic and insufficient supply of essential medicines at the government health facility and a limited purchasing power to buy medicines from a retail pharmacy, led to considerable 'financial burden' on the poor people, non-compliance with the treatment, health care seeking from informal health providers and healer shopping. This trend has a serious repercussion on the health seeking behaviours and of course the health outcomes, especially among children. On the users' side, health education and health promotion campaign must be instituted to explain the adverse effects on child health ensure appropriate health care seeking behaviours. For the supply side, the health care authorities must ensure the availability of essential medicines for the children at the government facilities. Local community representatives must be involved in the matters related to medicines stock management at the facility.

  19. Implementation of internal monitoring programs for workers occupationally exposed by 131I in nuclear medicine services in Brazil

    International Nuclear Information System (INIS)

    Oliveira, S.M.; Dantas, A.L.A.; Dantas, B.M.

    2017-01-01

    In nuclear medicine services (NMS), workers routinely handle radionuclides for diagnostic and therapy. This practice represents a risk of incorporation by these radionuclides. The International Atomic Energy Agency (IAEA) recommends the implementation of an internal monitoring program on workers exposed to annual effective doses greater than 1 mSv, as for example, those who handle 131 I for therapy in NMS. Currently, in Brazil, there are not enough available laboratories qualified to provide internal monitoring services to attend all possible demand of internal monitoring if it such regulation were applied by the Brazilian Nuclear Regulatory Board (CNEN). The objective of this work is to disseminate simple and inexpensive methods for in vivo routine thyroid monitoring of 131 I using equipment available in the NMS. Devices available in two public hospitals located in the city of Rio de Janeiro were calibrated for use in occupational internal monitoring. The equipment evaluated in this work presented enough sensitivity for such application, being suitable to access intakes of 131 I in the thyroid and able to estimate doses below 1 mSv. (author)

  20. Implementation of internal monitoring programs for workers occupationally exposed by {sup 131}I in nuclear medicine services in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, S.M.; Dantas, A.L.A.; Dantas, B.M., E-mail: salomao.marques@ymail.com [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Div. de Dosimetria

    2017-07-01

    In nuclear medicine services (NMS), workers routinely handle radionuclides for diagnostic and therapy. This practice represents a risk of incorporation by these radionuclides. The International Atomic Energy Agency (IAEA) recommends the implementation of an internal monitoring program on workers exposed to annual effective doses greater than 1 mSv, as for example, those who handle {sup 131}I for therapy in NMS. Currently, in Brazil, there are not enough available laboratories qualified to provide internal monitoring services to attend all possible demand of internal monitoring if it such regulation were applied by the Brazilian Nuclear Regulatory Board (CNEN). The objective of this work is to disseminate simple and inexpensive methods for in vivo routine thyroid monitoring of {sup 131}I using equipment available in the NMS. Devices available in two public hospitals located in the city of Rio de Janeiro were calibrated for use in occupational internal monitoring. The equipment evaluated in this work presented enough sensitivity for such application, being suitable to access intakes of {sup 131}I in the thyroid and able to estimate doses below 1 mSv. (author)

  1. [User's perceived quality in an internal medicine service after a five-year period application of a user's satisfaction survey].

    Science.gov (United States)

    García-Aparicio, J; Herrero-Herrero, J; Corral-Gudino, L; Jorge-Sánchez, R

    2010-01-01

    To evaluate the quality perceived by users of the 'Los Montalvos' Internal Medicine Service (Salamanca, Spain), over its first five years of operation. A cross-sectional study was carried out from February 2004 to January 2009. All in-patients (6,997) were given a survey model SERVQHOS at the time of discharge, which was anonymous and voluntary. We collected 2,435 surveys. Participation was 34.8%. Except for the item regarding accessibility, the other questions of the survey were perceived "as expected" or above expectations by over 85% of the users. A total of 90.6% of patients who completed the survey were satisfied with the care received, and 83.9% would recommend the hospital to others. The variables with higher predictive capability, in relation to overall satisfaction, were "personalised care', and the interests of staff to solve problems. The easy access to the hospital' was seen by 33.6% as below expectations. After introducing several improvement measures, the percentage of dissatisfaction regarding accessibility was 24.8% (p=0.02). Nine out of ten patients surveyed were satisfied or very satisfied with the care received, and would recommend the hospital to others. The variables more strongly associated with overall satisfaction were those related to service personnel. After identifying deficiencies and implementing measures to improve, the survey detected an increase in the level of satisfaction. Copyright 2009 SECA. Published by Elsevier Espana. All rights reserved.

  2. Divine service, music, sport, and recreation as medicinal in Australian asylums 1860s-1945.

    Science.gov (United States)

    MacKinnon, Dolly

    2009-01-01

    Australian asylum records (circa 1860 to circa 1945) demonstrate that medical staff went to great lengths to provide recreation to suitable patients. This article examines how the demarcation of Australian institutional spaces along gender divisions was also mirrored by the gender-specific recreational activities provided in purpose-built facilities. Using Australian examples I demonstrate how the main forms of recreation-that is divine service, music and dance, and sport-were justified to governments on medical grounds. Some designated recreational spaces even offered select female and male patients the opportunity to mix under medical supervision. Recreation was therapeutic because of its psychological, physical, social, and moral benefits, and government authorities funded the construction of costly chapels, recreation halls, and sports grounds expressly for this medical purpose.

  3. Health service utilization and access to medicines among Syrian refugee children in Jordan.

    Science.gov (United States)

    Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Weiss, William

    2016-01-01

    With over one million Syrian refugee children in the region, we undertook this study to characterize care-seeking behaviors and health service utilization for child refugees with the aim of informing humanitarian programming for non-camp settings in Jordan. A survey of Syrian refugees living outside of camps in Jordan was conducted using a 125 × 12 cluster design with probability proportional to size sampling to obtain a representative sample. The questionnaire focused on access to health services, including a module on care seeking for children. Care seeking was high with 90.9% of households with a child less than 18 years seeking medical care the last time it was needed. Households most often sought care for children in the public sector (54.6%), followed by private (36.5%) and charity sectors (8.9%). Among child care seekers, 88.6% were prescribed medication during the most recent visit, 90.6% of which obtained the medication. Overall, 49.4% of households reported out-of-pocket expenditures for either the consultation or prescribed medications at the most recent visit (mean $US21.1 and median $US0). Syrian refugees had good access to care for their sick children at the time of the survey; however, this has likely deteriorated since the survey because of the withdrawal of free access for refugees. The number of refugees in Jordan and relative accessibility of care has resulted in a large burden on the health system; the Jordanian government will require additional support if current levels of health access are to be maintained for Syrian refugees. © 2016 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

  4. Management report 2003 CNEN - Brazilian Nuclear Energy Commission; Relatorio de gestao 2003 CNEN - Comissao Nacional de Energia Nuclear

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-03-15

    This document reports the general activity management of the Comissao Nacional de Energia Nuclear - CNEN - Brazil during the year of 2003, involving the government programs in the areas of nuclear safety, medicine application, technological development, administration and miscellaneous.

  5. 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

  6. Report on Health Manpower and Programs in Ohio: Part Two. Allied Health, Area Health Education Centers, Dentistry, Emergency Medical Services, Nursing, Optometry, Pharmacy, Podiatry, and Veterinary Medicine.

    Science.gov (United States)

    Ohio Board of Regents, Columbus.

    Information on health occupations educational programs in Ohio and current and projected employment needs for health professionals are presented. The following health fields are examined: allied health, dentistry, emergency medical service, nursing, optometry, pharmacy, podiatry, and veterinary medicine. Issues and trends affecting each field are…

  7. Proposal of a monitoring program of occupational exposure by incorporation of radioactive material for nuclear medicine services in the Caja Costarricense del Seguro Social

    International Nuclear Information System (INIS)

    Badilla Segura, Mirta

    2013-01-01

    A monitoring program of the occupational exposure by incorporation of radioactive material is proposed. Nuclear medicine services of the Caja Costarricense del Seguro Social (CCSS) are evaluated. The monitoring program is based on the provisions of the International Atomic Energy Agency and of study of nuclear medicine services of the CCSS. Radionuclides are determined for monitoring of the occupational exposure, according to the radioactive material that is worked in nuclear medicine services of the CCSS. The appropriate and alternative techniques are established for the monitoring of the occupational exposure by incorporation of radioactive material, depending on the type of radionuclide that is worked in nuclear medicine services. The worker occupationally exposed (TOE) should be subject of monitoring and how often should be realized the monitoring of the occupational exposure. The monitoring of the radiation by radioactive material must be applied to personnel working in radiopharmacies and the worker has carried out therapeutic procedures for handling of significant amounts of 13 1 I. The calculation of the committed effective dose is proposed by incorporation of radioactive material with the TOE [es

  8. Integrative Medicine in Preventive Medicine Education

    OpenAIRE

    Jani, Asim A.; Trask, Jennifer; Ali, Ather

    2015-01-01

    During 2012, the USDHHS?s Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center esta...

  9. Evaluation of the implementation of a clinical pharmacy service on an acute internal medicine ward in Italy.

    Science.gov (United States)

    Lombardi, Nicola; Wei, Li; Ghaleb, Maisoon; Pasut, Enrico; Leschiutta, Silvia; Rossi, Paolo; Troncon, Maria Grazia

    2018-04-10

    Successful implementation of clinical pharmacy services is associated with improvement of appropriateness of prescribing. Both high clinical significance of pharmacist interventions and their high acceptance rate mean that potential harm to patients could be avoided. Evidence shows that low acceptance rate of pharmacist interventions can be associated with lack of communication between pharmacists and the rest of the healthcare team. The objective of this study was to evaluate the effect of a structured communication strategy on acceptance rate of interventions made by a clinical pharmacist implementing a ward-based clinical pharmacy service targeting elderly patients at high risk of drug-related problems. Characteristics of interventions made to improve appropriateness of prescribing, their clinical significance and intervention acceptance rate by doctors were recorded. A clinical pharmacy intervention study was conducted between September 2013 and December 2013 in an internal medicine ward of a teaching hospital. A trained clinical pharmacist provided pharmaceutical care to 94 patients aged over 70 years. The clinical pharmacist used the following communication and marketing tools to implement the service described: Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis; Specific, Measurable, Achievable, Realistic and Timely (SMART) goals; Awareness, Interest, Desire, Action (AIDA) model. A total of 740 interventions were made by the clinical pharmacist. The most common drug classes involved in interventions were: antibacterials for systemic use (11.1%) and anti-parkinson drugs (10.8%). The main drug-related problem categories triggering interventions were: no specific problem (15.9%) and prescription writing error (12.0%). A total of 93.2% of interventions were fully accepted by physicians. After assessment by an external panel 63.2% of interventions (96 interventions/ per month) were considered of moderate clinical significance and 23.4% (36

  10. Out of the Universities, into the Fields: New Community Service for Medicine Students in the Autonomous University of Mexico (1934-1940

    Directory of Open Access Journals (Sweden)

    Ivonne Meza Huacuja

    2014-10-01

    Full Text Available The creation of a community service for Medicine students can be understood as an important part of Cardenas' social policies seeking to expand basic services throughout the country. It also represents a struggle to strengthen the power of the president and of the National Revolutionary Party (PNR, specially regarding a group distinguished since the beginning of the Revolution for its conservatism: the University of Mexico students. This work goes through the history of how this medical community service was created and organized, including documents such as students' reports and results obtained by these young doctors in factories, mines, and rural areas.

  11. Giving Voice to the Medically Under-Served: A Qualitative Co-Production Approach to Explore Patient Medicine Experiences and Improve Services to Marginalized Communities.

    Science.gov (United States)

    Latif, Asam; Tariq, Sana; Abbasi, Nasa; Mandane, Baguiasri

    2018-01-27

    With an aging population, the appropriate, effective and safe use of medicines is a global health priority. However, "'medically under-served" patients continue to experience significant inequalities around access to healthcare services. This study forms part of a wider project to co-develop and evaluate a digital educational intervention for community pharmacy. The aim of this paper is to explore the medicine needs of patients from marginalized communities and suggest practical way on how services could be better tailored to their requirements. Following ethical approval, qualitative data was gathered from: (1) workshops with patients and professionals ( n = 57 attendees); and (2) qualitative semi-structured interviews (10 patients and 10 pharmacists). Our findings revealed that patients from marginalized communities reported poor management of their medical conditions and significant problems with adherence to prescribed medicines. Their experience of pharmacy services was found to be variable with many experiencing discrimination or disadvantage as a result of their status. This study highlights the plight of medically under-served communities and the need for policy makers to tailor services to an individual's needs and circumstances. Furthermore, patients and professionals can work in collaboration using a co-production approach to develop educational interventions for pharmacy service improvements.

  12. Areas control of a nuclear medicine service; Controle de áreas de um serviço de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Islane C.S.; Silva, Iasmim M.S.; Júnior, Cláudio L.R.; Silva, Isvânia S.; Gonzalez, Kethyllém M.; Melo, Francisca A. [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. de Energia Nuclear; Vieira, Wilson J.; Lopes Filho, Ferdinand de J. [Instituto Federal de Educação, Ciência e Tecnologia de Pernambuco (IFPE), Recife, PE (Brazil); Lima, Fernando R.A. [Centro Regional de Ciências Nucleares do Nordeste (CRCN-NE/CNEN), Recife, PE (Brazil)

    2017-07-01

    The measurement of the exposure rate of the sectors of a nuclear medicine service (NMS), with the purpose of establishing safety to the service workers and the public, classifying the areas according to the monitoring is presented. Following the studies on the classifications of the areas of a Nuclear Medicine service provided by the category regulatory standard, 3.05 CNEN-NN, measures were taken in all sectors of the NMS in order to classify the areas in: Free, controlled and supervised according to with the exposure level. As a measurement instrument, a Geiger-Muller counter of the digital type was used. The results obtained show a correlation with the Brazilian norm satisfactorily, referring to the exposure rate of the studied SMN sectors.

  13. The impact of team-based primary care on health care services utilization and costs: Quebec's family medicine groups.

    Science.gov (United States)

    Strumpf, Erin; Ammi, Mehdi; Diop, Mamadou; Fiset-Laniel, Julie; Tousignant, Pierre

    2017-09-01

    We investigate the effects on health care costs and utilization of team-based primary care delivery: Quebec's Family Medicine Groups (FMGs). FMGs include extended hours, patient enrolment and multidisciplinary teams, but they maintain the same remuneration scheme (fee-for-service) as outside FMGs. In contrast to previous studies, we examine the impacts of organizational changes in primary care settings in the absence of changes to provider payment and outside integrated care systems. We built a panel of administrative data of the population of elderly and chronically ill patients, characterizing all individuals as FMG enrollees or not. Participation in FMGs is voluntary and we address potential selection bias by matching on GP propensity scores, using inverse probability of treatment weights at the patient level, and then estimating difference-in-differences models. We also use appropriate modelling strategies to account for the distributions of health care cost and utilization data. We find that FMGs significantly decrease patients' health care services utilization and costs in outpatient settings relative to patients not in FMGs. The number of primary care visits decreased by 11% per patient per year among FMG enrolees and specialist visits declined by 6%. The declines in costs were of roughly equal magnitude. We found no evidence of an effect on hospitalizations, their associated costs, or the costs of ED visits. These results provide support for the idea that primary care organizational reforms can have impacts on the health care system in the absence of changes to physician payment mechanisms. The extent to which the decline in GP visits represents substitution with other primary care providers warrants further investigation. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  14. A selective review of the first 20 years of instrumental variables models in health-services research and medicine.

    Science.gov (United States)

    Cawley, John

    2015-01-01

    The method of instrumental variables (IV) is useful for estimating causal effects. Intuitively, it exploits exogenous variation in the treatment, sometimes called natural experiments or instruments. This study reviews the literature in health-services research and medical research that applies the method of instrumental variables, documents trends in its use, and offers examples of various types of instruments. A literature search of the PubMed and EconLit research databases for English-language journal articles published after 1990 yielded a total of 522 original research articles. Citations counts for each article were derived from the Web of Science. A selective review was conducted, with articles prioritized based on number of citations, validity and power of the instrument, and type of instrument. The average annual number of papers in health services research and medical research that apply the method of instrumental variables rose from 1.2 in 1991-1995 to 41.8 in 2006-2010. Commonly-used instruments (natural experiments) in health and medicine are relative distance to a medical care provider offering the treatment and the medical care provider's historic tendency to administer the treatment. Less common but still noteworthy instruments include randomization of treatment for reasons other than research, randomized encouragement to undertake the treatment, day of week of admission as an instrument for waiting time for surgery, and genes as an instrument for whether the respondent has a heritable condition. The use of the method of IV has increased dramatically in the past 20 years, and a wide range of instruments have been used. Applications of the method of IV have in several cases upended conventional wisdom that was based on correlations and led to important insights about health and healthcare. Future research should pursue new applications of existing instruments and search for new instruments that are powerful and valid.

  15. Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.

    Science.gov (United States)

    Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk

    2017-03-28

    Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and

  16. Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014.

    Directory of Open Access Journals (Sweden)

    Shalini Rudra

    Full Text Available AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy represents the alternative systems of medicine recognized by the Government of India. Understanding the patterns of utilization of AYUSH care has been important for various reasons including an increased focus on its mainstreaming and integration with biomedicine-based health care system. Based on a nationally representative health survey 2014, we present an analysis to understand utilization of AYUSH care across socioeconomic and demographic groups in India. Overall, 6.9% of all patients seeking outpatient care in the reference period of last two weeks have used AYUSH services without any significant differentials across rural and urban India. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care.

  17. Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014

    Science.gov (United States)

    2017-01-01

    AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy represents the alternative systems of medicine recognized by the Government of India. Understanding the patterns of utilization of AYUSH care has been important for various reasons including an increased focus on its mainstreaming and integration with biomedicine-based health care system. Based on a nationally representative health survey 2014, we present an analysis to understand utilization of AYUSH care across socioeconomic and demographic groups in India. Overall, 6.9% of all patients seeking outpatient care in the reference period of last two weeks have used AYUSH services without any significant differentials across rural and urban India. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care. PMID:28472197

  18. Seeking to understand: using generic qualitative research to explore access to medicines and pharmacy services among resettled refugees.

    Science.gov (United States)

    Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

    2016-06-01

    Introduction There are challenges associated with selecting a qualitative research approach. In a field abundant with terminology and theories, it may be difficult for a pharmacist to know where and how to begin a qualitative research journey. The purpose of this paper is to provide insight into generic qualitative research and to describe the journey of data collection of a novice qualitative researcher in the quest to answer her research question: 'What are the barriers to accessing medicines and pharmacy services for resettled refugees in Queensland, Australia?' Methodology Generic qualitative research draws on the strengths of one or more qualitative approaches. The aim is to draw out participants' ideas about things that are 'outside themselves'; rather than focussing on their inner feelings the research seeks to understand a phenomenon, a process, or the perspectives of participants. Sampling is designed to obtain a broad range of opinions about events and experiences and data collection includes interviews, questionnaires or surveys; thematic analysis is often used to analyse data. When to use Generic qualitative research provides an opportunity to develop research designs that fit researchers' epistemological stance and discipline, with research choices, including methodology and methods, being informed by the research question. Limitations Generic qualitative research is one of many methodologies that may be used to answer a research question and there is a paucity of literature about how to do it well. There is also debate about its validity as a qualitative methodology.

  19. The role of traditional healers in the provision of health care and family planning services: Malay traditional and indigenous medicine.

    Science.gov (United States)

    Raden Sanusi, H R; Werner, R

    1985-01-01

    The practitioners of traditional and indigenous medicine rely mainly upon medicinal plants and herbs for the preparation of therapeutic substances. The therapeutic properties of several medicinal plants and popular traditional medicine remedies are being investigated and validated. Present health care systems place people from developing countries in a dilemma. Countries can either continue providing a type of health care which cannot be extended to all in need or rethink and offer more inclusive types of medical care and delivery systems. Traditional medicine has a clear role to play in society, and even the World Health Organization supports the practice of traditional medicine to complement modern medicine. Traditional Malay medicine is the distillation of vast historical experience dating back more than 1000 years. It is often based upon observation, clinical trials, and experiments. The promotion and development of Malay traditional medicine can both foster dignity and self-confidence in communities through self-reliance, while considerably reducing the country's drug costs. The integrity and dignity of a people stems from self-respect and self-reliance. The practice of traditional medicine practitioners can help promote such conditions in many ways. It serves as an important focus for international technical cooperation and offers the potential for major breakthroughs in therapeutics and health care delivery. Effort should be taken to keep the practice of traditional medicine alive in Malaysia.

  20. Proposal of a methodology to be applied for the characterization of external exposure risk of employees in nuclear medicine services

    International Nuclear Information System (INIS)

    Simoes, Rafael Figueiredo Pohlmann

    2010-01-01

    Nuclear medicine procedure requires the administration of radioactive material by injection, ingestion or inhalation. After incorporation, the patient becomes a mobile source of radiation and, after their examination; they can irradiate everyone on their way out of the Nuclear Medicine Service (NMS). A group of workers in this path is considered a critical group, but there are no conviction on this classification, because there are not measurements available. Thus, workers claiming for occupationally exposed individual's (OEI) rights are common. Employers are always in a complex situation, because if they decided to undertake the individual external monitoring of the critical working groups, the Court considers all as OEI and employers are taxed. On the other hand, if they do not provide monitoring, it is impossible to prove that these workers were not exposed to effective doses higher than individual annual public's limit and they lose the actions, too. This work proposes a methodology to evaluate, using TLD environmental monitors, air kerma rate at critical staff points in a NMS. This method provides relevant information about critical groups' exposure. From these results, the clinic or hospital may prove technically, without individual monitoring of employees, the classification of areas and can estimate the maximum flow of patients in the free areas which guarantees exposures below the public individual dose limit. This methodology has been applied successfully to a private clinic in Rio de Janeiro, which operates a NMS. The only critical group that received exposure statistically different from clinic background radiation was that on the antechamber of the NMS. This is a site that should be characterized as a supervised area and the group of workers in this environment as OEI, as the estimated extrapolated annual effective dose in this position was 1.2 +- 0.7 mSv/year, above the public annual limit (1,0 mSv/year). Normalizing by the number of patients, it can

  1. Retrospective analysis of the role and performance of family medicine versus emergency medical services in the pre-hospital management of patients with AMI in Banja Luka.

    Science.gov (United States)

    Lakić, Biljana; Račić, Maja; Vulić, Duško

    2016-05-01

    The aim of this study was to investigate the differences in pre-hospital care of patients with acute myocardial infarction between emergency medical services and family medicine. This retrospective descriptive study included patients treated for acute myocardial infarction at the University Clinical Centre of Banja Luka, in the period from 1st January to 31st December 2011. The patients were divided into two groups: patients who received a hospital referral from the family medicine service and those who received one from the emergency medical service. The majority of patients (54.8%) received pre-hospital care from emergency medical services, while in 24.8% of cases the care was provided by family medicine physicians. The analysis showed that the time that passed from the onset of symptoms to the visit to the health institution of first medical contact was shorter in the emergency medical service (pfamily practice was 24 hours, and to the emergency service 2 hours. The patients who established their first medical contact with the emergency service reported more severe symptoms than the ones who visited a family practice over the same period of time. The severity of symptoms affected the patients' decisions to seek help in a timely manner and to choose the facility of first medical contact. Interventions to decrease delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge of the benefits of early medical contact and treatment. Continuing education of family practitioners in this field is required. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  2. Scaling up family medicine training in Gezira, Sudan - a 2-year in-service master programme using modern information and communication technology: a survey study.

    Science.gov (United States)

    Mohamed, Khalid G; Hunskaar, Steinar; Abdelrahman, Samira Hamid; Malik, Elfatih M

    2014-01-21

    In 2010 the Gezira Family Medicine Project (GFMP) was initiated in Gezira state, Sudan, designed as an in-service training model. The project is a collaboration project between the University of Gezira, which aims to provide a 2-year master's programme in family medicine for practicing doctors, and the Ministry of Health, which facilitates service provision and funds the training programme. This paper presents the programme, the teaching environment, and the first batch of candidates enrolled. In this study a self-administered questionnaire was used to collect baseline data at the start of the project from doctors who joined the programme. A checklist was also used to assess the health centres where they work. A total of 188 out of 207 doctors responded (91%), while data were gathered from all 158 health centres (100%) staffed by the programme candidates. The Gezira model of in-service family medicine training has succeeded in recruiting 207 candidates in its first batch, providing health services in 158 centres, of which 84 had never been served by a doctor before. The curriculum is community oriented. The mean age of doctors was 32.5 years, 57% were males, and 32% were graduates from the University of Gezira. Respondents stated high confidence in practicing some skills such as asthma management and post-abortion uterine evacuation. They were least confident in other skills such as managing depression or inserting an intrauterine device. The majority of health centres was poorly equipped for management of noncommunicable diseases, as only 10% had an electrocardiography machine (ECG), 5% had spirometer, and 1% had a defibrillator. The Gezira model has responded to local health system needs. Use of modern information and communication technology is used to facilitate both health service provision and training. The GFMP represents an example of a large-volume scaling-up programme of family medicine in Africa.

  3. Scaling up family medicine training in Gezira, Sudan – a 2-year in-service master programme using modern information and communication technology: a survey study

    Science.gov (United States)

    2014-01-01

    Background In 2010 the Gezira Family Medicine Project (GFMP) was initiated in Gezira state, Sudan, designed as an in-service training model. The project is a collaboration project between the University of Gezira, which aims to provide a 2-year master’s programme in family medicine for practicing doctors, and the Ministry of Health, which facilitates service provision and funds the training programme. This paper presents the programme, the teaching environment, and the first batch of candidates enrolled. Methods In this study a self-administered questionnaire was used to collect baseline data at the start of the project from doctors who joined the programme. A checklist was also used to assess the health centres where they work. A total of 188 out of 207 doctors responded (91%), while data were gathered from all 158 health centres (100%) staffed by the programme candidates. Results The Gezira model of in-service family medicine training has succeeded in recruiting 207 candidates in its first batch, providing health services in 158 centres, of which 84 had never been served by a doctor before. The curriculum is community oriented. The mean age of doctors was 32.5 years, 57% were males, and 32% were graduates from the University of Gezira. Respondents stated high confidence in practicing some skills such as asthma management and post-abortion uterine evacuation. They were least confident in other skills such as managing depression or inserting an intrauterine device. The majority of health centres was poorly equipped for management of noncommunicable diseases, as only 10% had an electrocardiography machine (ECG), 5% had spirometer, and 1% had a defibrillator. Conclusions The Gezira model has responded to local health system needs. Use of modern information and communication technology is used to facilitate both health service provision and training. The GFMP represents an example of a large-volume scaling-up programme of family medicine in Africa. PMID:24443978

  4. Medical Services: Preventive Medicine

    Science.gov (United States)

    1990-10-15

    those at risk. Isoniazid (INH)administered orally is normally used for preventive therapy (300 mg daily for adults and 10 to 14 mg/kg body weight not to...netting, and insecticide aerosols; by taking approved chemoprophylaxis; and by wearing the uniform properly. d. Enteric disease by using iodine tablets ...National stock number: 6850–00–985–7166 Description: Water purification tablet , iodine, 50’s Unit/Issue: BT Allowance: 400 Authority: CTA 8–100 Notes: 1

  5. Medicine, market and communication: ethical considerations in regard to persuasive communication in direct-to-consumer genetic testing services.

    Science.gov (United States)

    Schaper, Manuel; Schicktanz, Silke

    2018-06-05

    Commercial genetic testing offered over the internet, known as direct-to-consumer genetic testing (DTC GT), currently is under ethical attack. A common critique aims at the limited validation of the tests as well as the risk of psycho-social stress or adaption of incorrect behavior by users triggered by misleading health information. Here, we examine in detail the specific role of advertising communication of DTC GT companies from a medical ethical perspective. Our argumentative analysis departs from the starting point that DTC GT operates at the intersection of two different contexts: medicine on the one hand and the market on the other. Both fields differ strongly with regard to their standards of communication practices and the underlying normative assumptions regarding autonomy and responsibility. Following a short review of the ethical contexts of medical and commercial communication, we provide case examples for persuasive messages of DTC GT websites and briefly analyze their design with a multi-modal approach to illustrate some of their problematic implications. We observe three main aspects in DTC GT advertising communication: (1) the use of material suggesting medical professional legitimacy as a trust-establishing tool, (2) the suggestion of empowerment as a benefit of using DTC GT services and (3) the narrative of responsibility as a persuasive appeal to a moral self-conception. While strengthening and respecting the autonomy of a patient is the focus in medical communication, specifically genetic counselling, persuasive communication is the normal mode in marketing of consumer goods, presuming an autonomous, rational, independent consumer. This creates tension in the context of DTC GT regarding the expectation and normative assessment of communication strategies. Our analysis can even the ground for a better understanding of ethical problems associated with intersections of medical and commercial communication and point to perspectives of analysis of

  6. Introducing routine HIV screening for patients on an internal medicine residency inpatient service: a quality improvement project.

    Science.gov (United States)

    Padrnos, Leslie J; Barr, Patrick J; Klassen, Christine L; Fields, Heather E; Azadeh, Natalya; Mendoza, Neil; Saadiq, Rayya A; Pauwels, Emanuel M; King, Christopher S; Chung, Andrew A; Sakata, Kenneth K; Blair, Janis E

    2016-01-01

    The US Centers for Disease Control and Prevention (CDC) recommend human immunodeficiency virus (HIV) screening for all persons aged 13 to 64 years who present to a health care provider. We sought to improve adherence to the CDC guidelines on the Internal Medicine Resident Hospital Service. We surveyed residents about the CDC guidelines, sent email reminders, provided education, and engaged them in friendly competition. Credit for guideline adherence was awarded if an offer of HIV screening was documented at admission, if a screening test was performed, or if a notation in the resident sign out sheet indicated why screening was not performed. We examined HIV screening of a postintervention group of patients admitted between August 8, 2012, and June 30, 2013, and compared them to a preintervention group admitted between August 1, 2011, and June 30, 2012. Postintervention offers of HIV screening increased significantly (7.9% [44/559] vs 55.5% [300/541]; P<.001), as did documentation of residents' contemplation of screening (8.9% [50/559] vs 67.5% [365/541]; P<.001). A significantly higher proportion of HIV screening tests was ordered postintervention (7.7% [43/559] vs 44.4% [240/541]; P<.001). Monthly HIV screening documentation ranged from 0% (0/53) to 17% (9/53) preintervention, whereas it ranged from 30.6% (11/36) to 100% (62/62) postintervention. HIV screening adherence can be improved through resident education, friendly competition, and system reminders. Barriers to achieving sustained adherence to the CDC guidelines include a heterogeneous patient population and provider discomfort with the subject.

  7. Development and evaluation of Standard Operating Procedures (SOPs) for quality control tests and radiological protection activities in a Nuclear Medicine Service

    Energy Technology Data Exchange (ETDEWEB)

    Krempser, Alexandre R., E-mail: krempser@peb.ufrj.br [Universidade Federal do Rio de Janeiro (PEB/COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Biomedica; Soares, Alexandre B. [Universidade Federal do Rio de Janeiro (IF/UFRJ), Rio de Janeiro, RJ (Brazil). Inst. de Fisica; Corbo, Rossana [Universidade Federal do Rio de Janeiro (FM/UFRJ), Rio de Janeiro, RJ (Brazil). Dept. de Radiologia

    2011-07-01

    The quality management in Nuclear Medicine Services is a requirement of national and international standards. The Brazilian regulatory agency in health surveillance, the Agencia Nacional de Vigilancia Sanitaria (ANVISA), in its Resolucao de Diretoria Colegiada (Collegiate Directory Resolution) no. 38, requires the elaboration of documents describing the technical and clinical routine activities. This study aimed to elaborate, implement and evaluate Standard Operating Procedures (SOPs) for quality control tests and radiological protection activities in the Nuclear Medicine Service of a university hospital. Eighteen SOPs were developed, involving tasks related to dose calibrator, gamma camera, Geiger-Muller detectors and radiological protection activities. The performance of its application was evaluated for a period of six months. It was observed a reduction in 75% of reported operational errors and 42% of the number of reported incidents with contamination by radioactive material. The SOPs were adequate and successful in its application. New procedures involving clinical activities will also be developed and evaluated. (author)

  8. Comparison of activity measurements of 131I and 99mTc radionuclides administered in nuclear medicine services of Porto Alegre

    International Nuclear Information System (INIS)

    Alabarse, Frederico Gil.; Santos, Carlos Eduardo Lima dos

    2005-01-01

    A programme for the comparison of activity measurements of radionuclides administered to patients in Nuclear Medicine Services, for the purpose of diagnosis or therapy, is being conducted under the coordination of the Radioprotection and Dosimetry Institute of the Brazilian Nuclear Energy Commission, IRD/CNEN. In the present work, measurements of the activity of samples of 131 I and 99 mTc were conducted in the dose calibrators of the Nuclear Medicine Services of the city of Porto Alegre, in the period from June to September 2004. The results were analysed to evaluate the compliance with the Brazilian regulation and were also compared to data available in the literature for the cities of Rio de Janeiro and Brasilia. The performance of the activity meters in Porto Alegre is shown to be very good, which contributes to the radiological protection of patients submitted to diagnosis or therapy with radiopharmaceuticals. (author)

  9. Risks and opportunities for plastic surgeons in a widening cosmetic medicine market: future demand, consumer preferences, and trends in practitioners' services.

    Science.gov (United States)

    D'Amico, Richard A; Saltz, Renato; Rohrich, Rod J; Kinney, Brian; Haeck, Phillip; Gold, Alan H; Singer, Robert; Jewell, Mark L; Eaves, Felmont

    2008-05-01

    The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery launched a joint Cosmetic Medicine Task Force to address the growing trend of non-plastic surgeons entering the cosmetic medicine field. The task force commissioned two surveys in 2007 to determine consumer attitudes about choosing cosmetic medicine providers and to learn about the cosmetic services that plastic surgeons offer. The first survey obtained responses from 1015 women who had undergone a cosmetic procedure or were considering having one within 2 years. The second survey obtained responses from 260 members of the two societies. Compared with other practitioners, plastic surgeons enjoy higher rates of satisfaction among their patients who undergo noninvasive procedures. Injectables present a particularly promising market for plastic surgeons. Half of consumers surveyed said they were very concerned about complications associated with injectables, and generally, the higher the perceived risk of the procedure, the higher the likelihood that a patient would choose a plastic surgeon to perform it. In addition, injectables were among the noninvasive treatments most frequently being considered by consumers. However, almost half of consumers said that if they had a positive experience with a non-plastic surgeon core provider for a noninvasive procedure, that physician would likely be their first choice for a surgical procedure. These findings suggest that plastic surgeons, and especially those who are building young practices, must expand their offerings of nonsurgical cosmetic services to remain at the core of the cosmetic medicine field.

  10. Electric energy management - basis for a municipal public politics; Gestao da energia eletrica - bases para uma politica publica municipal

    Energy Technology Data Exchange (ETDEWEB)

    Kurahassi, Luiz Fernando

    2006-07-01

    Electricity is an input whose impact on the costs of the municipal public services varies according to the manner it is used and to the way it is obtained from the supplying company. The management of its use results in savings and in greater efficiency and quality of the delivered services - including the public lighting - besides, it softens environmental impacts and develops actions to orientate society towards energy-efficient consumption habits. The public sector has a significant share in the electricity final consumption in Brazil, trending to increase, but a room for consumption reduction and increase in energy efficiency can be seen in the municipalities. The purpose of this thesis is to identify concepts and set parameters that can be the basis of a public policy on electrical power management at the ambit of municipality. This paper reports a series of theoretical studies and empirical researches concerning the efficient use of electrical power in public services in cities of different countries and analyses the results reached from the application of models that successively work in the reality of cities from the Sao Paulo metropolitan area. It concludes that the municipality must play a role much more relevant than being a simple institutional electricity consumer, by proposing the basis for an intervention in the municipal reality. (author)

  11. Calculation of dose due to exposure internal in the services of nuclear medicine of Peru; Calculo de dosis debida a la exposicion interna en los servicios de medicina nuclear del Peru

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, S.; Zapata, L.; Cardenas, A.; Velasquez, M.

    2013-07-01

    The objective of this work is to improve the radiation protection of workers occupationally exposed to open source of nuclear medicine services and train those responsible for radiation protection of such installations to carry a comprehensive record of doses. (Author)

  12. Documentary System for Process of Radiopharmacy of the Nuclear Medicine Service of the Institute of Nephrology 'Dr. Abelardo Buch Lopez'

    International Nuclear Information System (INIS)

    Mesa Dueñas, Niurka; Zayas Crespo, Francisco; Peña Tornet, Adela; Serra Águila, Rolando

    2016-01-01

    Radiopharmacy is one of the key processes within a Nuclear Medicine Service and its adequate management, therefore, contributes to improve the quality of diagnostics and therapies provided by these departments. In the paper the documentary system developed for the radiopharmacy process of the Department of Nuclear Medicine of the Institute of Nephrology D r. Abelardo Buch Lopez , as part of the Quality Management System, which has been implemented since 2015. Also described are the tools developed in Excel to guarantee the operation, monitoring and measurement of control variables and indicators of this process. The information of the reception activities of the generators, freeze-dried kit and materials; Elution and quality control of the 99 Mo- 99m Tc generator; Marking and quality control of radiopharmaceuticals; Dispensing and delivery of the dose for administration are those managed by these tools.

  13. Percecao da cultura organizacional em instituicoes publicas de saude com diferentes modelos de gestao Percepcion de la cultura organizacional en las instituciones de salud publica con diferentes modelos de gestion Perception of organizational culture in public health facilities with different management models

    Directory of Open Access Journals (Sweden)

    Sofia Gaspar Cruz

    2012-03-01

    Full Text Available Contexto: o sistema de saude portugues tem vindo a ser palco de reformas constantes sem que se tenham obtido os resultados esperados. Considerada enquanto variavel organizacional, que pode ditar o sucesso de determinada mudanca/reforma, e partindo-se do pressuposto que e gerivel, conhecer a cultura organizacional que predomina nas instituicoes de saude parece ser importante para quem as gere, principalmente perante processos de mudanca, como seja a implementacao de novos modelos de gestao. Objetivo: identificar o tipo de cultura organizacional que predomina em instituicoes publicas de saude com diferentes modelos de gestao. Metodo: estudo de tipo quantitativo e transversal, realizado numa amostra de 671 colaboradores de dez instituicoes de saude com diferentes modelos de gestao: modelo Sector Publico Administrativo (SPA, modelo Entidade Publica Empresarial (EPE e modelo Unidade de Saude Familiar (USF. Para identificar a percecao da cultura organizacional recorreu-se ao Organizational Culture Assessment Instrument (OCAI, que foi por nos traduzido, adaptado e validado. Resultados: nos modelos SPA e EPE verifica-se um predominio da cultura hierarquica, enquanto no modelo USF sobressai a cultura de cla. Conclusao: a cultura organizacional que prevalece nas instituicoes de saude, nomeadamente a nivel hospitalar (cultura hierarquica, nao parece ser a mais adequada a filosofia subjacente aos novos modelos de gestao e seu funcionamento. Considera-se pertinente alargar o estudo da percecao da cultura organizacional em cada modelo de gestao das instituicoes de saude e relacionar com variaveis de contexto.Contexto: el sistema de salud portugues ha sido el escenario de constantes reformas sin que por ello se hayan obtenido los resultados esperados. Considerada como una variable organizacional, que puede dictar el exito de un determinado cambio o reforma, y partiendo de la suposicion de que es gestionable, conocer la cultura organizacional que predomina en

  14. Guide to integrated management systems for industrial maintenance contractors; Guia de sistemas de gestao integrada para contratadas de manutencao industrial

    Energy Technology Data Exchange (ETDEWEB)

    Ruella, Nildemar Correa [PETROBRAS, Rio de Janeiro, RJ (Brazil); Lima, Gilson Brito Alves [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)

    2004-07-01

    Presentation of an integrated management systems guide to hired of services of industrial maintenance with base in the management systems normative requisites and guides of the quality (ISO 9001, ISO 9004, ISO TS 29001 e API SPEC Q1), of environmental management systems (ISO 14001 and ISO 14004), of safety and occupational health management systems (BSI BS 8800, BSI OHSAS 18001, BSI OHSAS 18002 and ILO OSH 2001), of social accountability (SA 8000 and Implementation Guide of the SA 8000), publications and recommended practices (API RP 76, API RP 2220, API RP 2221, API Publ 9100 Publ A/B, API RP 760, API RP 761, AS/NZS 4581, CCS OAUPE009, ARPEL Guide N. 1, OGP Report No. 6.36/210, OGP Report No. 6.64/291, etc) and success experiences in the Brazil petroleum and gas industry. (author)

  15. Communication in the Service of American Health...A Bicentennial Report from the National Library of Medicine.

    Science.gov (United States)

    National Library of Medicine (DHEW), Bethesda, MD.

    Programs of the National Library of Medicine over almost a century and a half are described, ranging from a history of American medical literature and the development of medical indexing to modern technological developments. Activities covered include the development of the Toxicology Information Program and the online data base TOXLINE; the…

  16. Intercomparison measurements of activity of 99mTc and 131I in nuclear medicine services at Recife city, Pernambuco state, Brazil

    International Nuclear Information System (INIS)

    Barreto, F.C.P.; Santos, M.A.P dos; Oliveira, M.L.; Lima, F.F. de

    2007-01-01

    The aim of this work is to present the results of the first round of intercomparison measurements of activity of 99m Tc and 131 I. This round was carried out in Recife/PE. Six nuclear medicine services (NMS), public and private, participated in this intercomparison. Additionally to the activity measurement, some information about equipment (calibration and quality control program) and human resources was obtained. All NMS participants complied with the limit established by CNEN for the accuracy of measurement (+- 10%) for 99m Tc and 131 I. Measurements will be repeated for 99m Tc and 131 I, and additional rounds will be performed including different radionuclides. (author)

  17. Oiling the gate: a mobile application to improve the admissions process from the emergency department to an academic community hospital inpatient medicine service.

    Science.gov (United States)

    Fung, Russell; Hyde, Jensen Hart; Davis, Mike

    2018-01-01

    The process of admitting patients from the emergency department (ED) to an academic internal medicine (AIM) service in a community teaching hospital is one fraught with variability and disorder. This results in an inconsistent volume of patients admitted to academic versus private hospitalist services and results in frustration of both ED and AIM clinicians. We postulated that implementation of a mobile application (app) would improve provider satisfaction and increase admissions to the academic service. The app was designed and implemented to be easily accessible to ED physicians, regularly updated by academic residents on call, and a real-time source of the number of open AIM admission spots. We found a significant improvement in ED and AIM provider satisfaction with the admission process. There was also a significant increase in admissions to the AIM service after implementation of the app. We submit that the implementation of a mobile app is a viable, cost-efficient, and effective method to streamline the admission process from the ED to AIM services at community-based hospitals.

  18. Genitourinary medicine/HIV services for persons with insecure immigration or seeking asylum in the United Kingdom: a British Co-operative Clinical Group survey.

    Science.gov (United States)

    Rajamanoharan, Sasikala; Monteiro, Eric F; Maw, Raymond; Carne, Christopher A; Robinson, Angela

    2004-08-01

    Over the past three years many genitourinary medicine (GUM) clinics have anecdotally reported large numbers of persons with insecure immigration or seeking asylum (PIISA) attending their facilities. We conducted a national survey to assess the prevalence and demographic background of PIISA who were attending GUM clinics in the UK during 2001 and 2002 and the effect on service provision. A questionnaire was circulated in April 2003 to 182 consultants in the UK of whom 128 (70%) responded. Amongst those centres that responded, 89 (69%) had provided GUM/HIV services for PIISA in 2002. One-third of clinics had accurate data collection systems and less than a quarter used computerized databases in order to identify the associated workload. Of the HIV-positive patients attending these clinics during 2002, 1140 (42%) were identified as PIISA. Eighty-two (95.3%) and 62 (48.8%) clinics had cared for PIISA from Africa and Europe respectively. Co-infection with HIV and tuberculosis was higher in patients from the PIISA group compared with the non-PIISA group (85% vs 15%, P = 0.001) for both 2001 and 2002. Clinics reported many problems associated with the service for PIISA. Forty-five percent of the clinics reported difficulties with funding for the increased workload associated with PIISA. The survey shows that GUM services have an important role in the management of PIISA and that the programme of dispersal is having a significant impact on the workload of clinics outside London. Services report that they are significantly overstretched and underfunded. An immediate investment in GUM services is necessary to improve the health of this client group. Any delay in diagnosis of sexually transmitted infections and HIV will have implications for public health and acute services.

  19. Association of apneic oxygenation with decreased desaturation rates during rapid sequence intubation by a Chinese emergency medicine service.

    Science.gov (United States)

    Mao, Yong; Qin, Zong-He

    2015-01-01

    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The achievement rate of emergency medicine inhabitants in airway management improved enhanced essentially subsequent to finishing anaesthesiology turn. There was a slightly higher rate of quick sequence intubation in the postapneic oxygenation groups (preapneic oxygenation 6.4%; postapneic oxygenation 9.1%). The majority of patients intubated in both groups were men (preapneic oxygenation 72.3%; postapneic oxygenation 63.5%). A higher percentage of patients in the preapneic oxygenation group had a Cormack-Lehane grade III or worse view (23.2% versus 11.8%). Anaesthesiology turns should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

  20. Survey or quality for radiopharmaceuticals and activimeters available in services of nuclear medicine from Recife, Pernambuco State, Brazil

    International Nuclear Information System (INIS)

    Nogueira, Fernanda Maria Dornellas Camara

    2001-08-01

    The radiopharmaceutical used in Nuclear Medicine must present high chemical and radiochemical purities in order to obtain images with contrast and clearness adequate for the diagnosis. Test should be made by the Nuclear Medicine institutes to evaluate the presence of molybdenum, aluminium and the free Tc O 4 - /TC-HR in the radiopharmaceutical before they use it. On the other hand, the activity to be administered to the patient is determined by the activimeters available in the Nuclear Medicine institutions. So it is necessary to perform tests to verify operating conditions of the activimeter to guarantee that the dose received by patient is the prescribed by the physician. In Brazil, few clinics of Nuclear Medicine are implanting the tests of the radiopharmaceutical and of the activimeters. The objective of this work is to establish the procedures for the radiopharmaceutical tests and to evaluate the quality of the radiopharmaceutical used at the clinics of Recife, as well as the operation conditions of the activemeters in these institutions. The results show that all the activimeters analyzed present a good performance and that the equipment with Geiger-Muller detectors present larger instability than the ones that use ionization chamber. Concerning the Mo/Tc generators, it was observed that only one presented Mo in the generator eluate with concentration over the acceptable limits and that the concentration of Al found in the samples analyzed were below the limits. On the other hand, in 73% of the MIBI analyzed samples were observed problems with its preparation that were caused by the procedures adopted at the clinics, which do not follow the manufacturers recommendations. (author)

  1. Social medicalization and alternative and complementary medicine: the pluralization of health services in the Brazilian Unified Health System.

    Science.gov (United States)

    Tesser, Charles Dalcanale; Barros, Nelson Filice de

    2008-10-01

    Social medicalization transforms people's habits, discourages them from finding their own solutions to certain health problems and places an excess demand on the Unified Health System. With regard to healthcare provision, an alternative to social medicalization is the pluralization of treatment provided by health institutions namely through the recognition and provision of alternative and complementary practices and medicines. The objective of the article was to analyze the potentials and difficulties of alternative and complementary practices and medicines based on clinical and institutional experiences and on the specialist literature. The research concludes that the potential of such a strategy to "demedicalize" is limited and should be included in the remit of the Unified Health System. The article highlights that the Biosciences retain a political and epistemiological hegemony over medicine and that the area of healthcare is dominated by market principles, whereby there is a trend towards the transformation of any kind of knowledge or structured practice related to health-illness processes into goods or procedures to be consumed, and this only reinforces heteronomy and medicalization.

  2. Exploring challenges in the patient's discharge process from the internal medicine service: A qualitative study of patients' and providers' perceptions.

    Science.gov (United States)

    Pinelli, Vincent; Stuckey, Heather L; Gonzalo, Jed D

    2017-09-01

    In hospital-based medicine units, patients have a wide range of complex medical conditions, requiring timely and accurate communication between multiple interprofessional providers at the time of discharge. Limited work has investigated the challenges in interprofessional collaboration and communication during the patient discharge process. In this study, authors qualitatively assessed the experiences of internal medicine providers and patients about roles, challenges, and potential solutions in the discharge process, with a phenomenological focus on the process of collaboration. Authors conducted interviews with 87 providers and patients-41 providers in eight focus-groups, 39 providers in individual interviews, and seven individual patient interviews. Provider roles included physicians, nurses, therapists, pharmacists, care coordinators, and social workers. Interviews were audio-recorded and transcribed verbatim, followed by iterative review of transcripts using qualitative coding and content analysis. Participants identified several barriers related to interprofessional collaboration during the discharge process, including systems insufficiencies (e.g., medication reconciliation process, staffing challenges); lack of understanding others' roles (e.g., unclear which provider should be completing the discharge summary); information-communication breakdowns (e.g., inaccurate information communicated to the primary medical team); patient issues (e.g., patient preferences misaligned with recommendations); and poor collaboration processes (e.g., lack of structured interprofessional rounds). These results provide context for targeting improvement in interprofessional collaboration in medicine units during patient discharges. Implementing changes in care delivery processes may increase potential for accurate and timely coordination, thereby improving the quality of care transitions.

  3. Quick-Reaction Report on the Audit of ReCoupment Actions on Medicine Payments to Uniformed Services Treatment Facilities.

    Science.gov (United States)

    1993-07-21

    OFFICE OF THE INSPECTOR GENERAL QUICK-REACTION REPORT ON THE AUDIT OF RECOUPMENT ACTIONS ON MEDICARE PAYMENTS TO UNIFORMED SERVICES TREATMENT...Quick-Reaction Report on the Audit of Recoupment Actions on Medicare Payments to Uniformed Services Treatment Facilities (Report No. 93-150) We are...Inspectors General will provide a joint report to the congressional committees that requested the audit . The courtesies extended to the audit staff

  4. A Decade of Counseling Services in One College of Veterinary Medicine: Veterinary Medical Students' Psychological Distress and Help-Seeking Trends.

    Science.gov (United States)

    Drake, Adryanna A S; Hafen, McArthur; Rush, Bonnie R

    Much has been discussed about the high prevalence of psychological distress among veterinary medical students. Studies investigating general samples of veterinary medical students indicate that, on average, depression and anxiety symptoms are present at higher rates than in comparison samples. However, little is known about veterinary medical students who seek counseling. This study intends to expand the literature on veterinary student well-being, as the first to examine a sample of veterinary medical students seeking counseling services. It offers an overview of student distress and help-seeking trends from a decade of counseling services provided in one College of Veterinary Medicine (CVM) in the US. The sample includes data from 279 participants. Results indicate a steady increase in students seeking counseling over the last decade. First-year students sought services at higher rates but second-year students experienced the greatest distress when compared to other cohorts. Students seeking counseling services experienced levels of overall distress, symptoms of anxiety and depression, and social role concerns that were, on average, above cut-off scores. Physical health was significantly associated with student distress, suggesting opportunities for intervention.

  5. How effective is the integration of Sport and Exercise Medicine in the English National Health Service for sport related injury treatment and health management?

    Science.gov (United States)

    Pullen, Emma; Malcolm, Dominic; Wheeler, Patrick

    2018-06-07

    Regular participation in sport, exercise and physical activity is associated with positive health outcomes and form a mainstay of British public health policies. However, regular participation in sport and exercise can result in sport related injury (SRI) which, in turn, is a key cause of exercise cessation. The integration of Sport and Exercise Medicine (SEM) in the English National Health Service (NHS) aims to provide a specialist service for public populations and thus reduce the impact of SRI on exercise cessation and associated negative health outcomes. More broadly it aims to both support physical activity health promotion policies and improve healthcare organisations efficiencies through providing the most condition-appropriate treatment. This qualitative interview study examines patients' (n=19) experiences of accessing and receiving SEM treatment within the English NHS. The research demonstrates that referral pathways into SEM were often prolonged, characterised by multiple General Practitioner (GP) visits and referrals into other musculoskeletal services, demonstrating an inefficient use of healthcare resources. Prolonged pathways fostered only limited recovery back to previous physical activity levels and other negative health behaviours, yet on accessing the SEM clinic, patients experienced progressive rehabilitation back into sport and exercise participation. This study highlights the importance of more fully integrating SEM services into public healthcare as a way of improving the organisational capacity of healthcare in treating SRI and ensuring that citizens comply with state interventions which orchestrate health management through raising physical activity levels across the population.

  6. Perspectives on medicine adherence in service users and carers with experience of legally sanctioned detention and medication: a qualitative study.

    Science.gov (United States)

    Gault, Iris; Gallagher, Ann; Chambers, Mary

    2013-01-01

    To explore and analyze perceptions of service users and caregivers on adherence and nonadherence to medication in a mental health care context. Mental health medication adherence is considered problematic and legal coercion exists in many countries. This was a qualitative study aiming to explore perceptions of medication adherence from the perspective of the service user (and their caregiver, where possible). Eighteen mental health service users (and six caregivers) with histories of medication nonadherence and repeated compulsory admission were recruited from voluntary sector support groups in England. Data were collected between 2008 and 2010. Using qualitative coding techniques, the study analyzed interview and focus group data from service users, previously subjected to compulsory medication under mental health law, or their caregivers. The process of medication adherence or nonadherence is encapsulated in an explanatory narrative. This narrative constitutes participants' struggle to negotiate acceptable and effective routes through variable quality of care. Results indicated that service users and caregivers eventually accepted the reality of their own mental illness and their need for safety and treatment. They perceived the behavior of professionals as key in their recovery process. Professionals could be enabling or disabling with regard to adherence to medication. This study investigated service user and caregiver perceptions of medication adherence and compulsory treatment. Participants described a process perceived as variable and potentially doubly faceted. The behavior of professionals was seen as crucial in collaborative decision making on medication adherence.

  7. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  8. Nuclear Medicine

    Science.gov (United States)

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  9. Studies for calculations of the thicknesses of shielding necessary for implementation of a nuclear medicine service with PET-CT

    International Nuclear Information System (INIS)

    Nascimento, Erika M.; Lopes Filho, Ferdinand J.; Souza, Milena Thays B. de; Aragao Filho, Geraldo L.

    2013-01-01

    The thickness of shielding for controlled and surrounding areas must be considered in terms of the PET-CT equipment installation. However, for a project to install a PET-CT requires the participation of technologists, engineers and architects so that together we can meet the requirements of radiological protection at low cost, enabling its installation and maintenance in nuclear medical centers and hospitals. The objective of this paper is to describe the calculations needed to shield a nuclear medicine center that will install a PET-CT equipment and describe how the participation of other professionals can contribute to a lower cost

  10. Factors Associated With Medical School Entrants' Interest in Military Financial Assistance in Exchange for a Service Obligation: The Michigan State University College of Human Medicine Cohort.

    Science.gov (United States)

    Sienko, Dean G; Oberst, Kathleen

    2017-07-01

    The U.S. military offers comprehensive scholarships to medical students to help offset costs in exchange for either reserve or active duty service commitments. Our goal was to describe to what degree newly admitted students to Michigan State University's College of Human Medicine were aware of and interested in these opportunities. We surveyed 176 newly admitted students at the beginning and immediately following a presentation on military medicine opportunities. We collected anonymous paper surveys from program attendees and entered the data into Stata v13.1. The project was submitted for institutional review board review and deemed to not involve human subjects. Tests of association were performed using Chi-square test of independence and Fisher's exact test where needed. Our cohort was 49% female, 51% male, and over 90% were less than 30 years of age. Only 14% reported having family involved in the military. Our results indicated that over 90% of students were aware of these programs but less than 3% took advantage of the offerings. Despite 65% reporting somewhat or significant concerns over debt, financial concerns were not statistically associated with scholarship interest level. Instead, having a family member in the military was the most significant positive predictor of interest (47% compared with 17%, p benefits of military service aside from financial support. Career vignettes and summaries may offer better insight into the service experience for those lacking familiarity thereby potentially increasing interest and applications. Focus groups with current scholarship awardees may inform recruitment strategies. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  11. Perspectives on medicine adherence in service users and carers with experience of legally sanctioned detention and medication: a qualitative study

    Directory of Open Access Journals (Sweden)

    Chambers M

    2013-08-01

    Full Text Available Iris Gault,1 Ann Gallagher,2 Mary Chambers31Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, Kingston, Surrey, UK; 2International Centre for Nursing Ethics, School of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK; 3Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, St George's University of London, Tooting, London, UKAim: To explore and analyze perceptions of service users and caregivers on adherence and nonadherence to medication in a mental health care context.Background: Mental health medication adherence is considered problematic and legal coercion exists in many countries.Design: This was a qualitative study aiming to explore perceptions of medication adherence from the perspective of the service user (and their caregiver, where possible.Participants: Eighteen mental health service users (and six caregivers with histories of medication nonadherence and repeated compulsory admission were recruited from voluntary sector support groups in England.Methods: Data were collected between 2008 and 2010. Using qualitative coding techniques, the study analyzed interview and focus group data from service users, previously subjected to compulsory medication under mental health law, or their caregivers.Results: The process of medication adherence or nonadherence is encapsulated in an explanatory narrative. This narrative constitutes participants' struggle to negotiate acceptable and effective routes through variable quality of care. Results indicated that service users and caregivers eventually accepted the reality of their own mental illness and their need for safety and treatment. They perceived the behavior of professionals as key in their recovery process. Professionals could be enabling or disabling with regard to adherence to medication.Conclusion: This study investigated service user

  12. Supporting 'medicine at a distance' for delivery of hospital services in war-torn Somalia: how well are we doing?

    Science.gov (United States)

    Maalim, Abdisalan M; Zachariah, Rony; Khogali, Mohamed; Van Griensven, Johan; Van den Bergh, Rafael; Tayler-Smith, Katherine; Kizito, Walter; Baruani, Bienvenu; Osoble, Abdirahman; Abdirahman, Faiza; Ayada, Latifa; Mohamed, Abdinoor H

    2014-03-01

    We describe an innovative strategy implemented to support national staff at Istarlin Hospital in the conflict setting of Somalia; and report on inpatient morbidities, mortality and adverse hospital exit outcomes. This was a retrospective analysis of hospital data for 2011. Of 8584 admitted patients, the largest numbers were for lower respiratory tract infections (LRTI) (2114; 25%), normal deliveries (1355; 16%) and diarrhoeal diseases (715; 8%). The highest contributors to mortality were gunshot wounds in surgery (18/30; 60%), LRTIs in internal medicine (6/32; 19%) and malnutrition in paediatrics (30/81; 37%). Adverse hospital exit outcomes (deaths and absconded) were well within thresholds set by Médecins Sans Frontières. With a support package, satisfactory standards of care were met for hospital care in Somalia.

  13. Perceived impacts of the national essential medicines system: a cross-sectional survey of health workers in urban community health services in China.

    Science.gov (United States)

    Zhang, Tao; Liu, Chaojie; Ren, Jianping; Wang, Sheng; Huang, Xianhong; Guo, Qing

    2017-07-10

    This study aimed to investigate the perceptions of primary care workers about the impacts of the national essential medicines policy (NEMP). A cross-sectional questionnaire survey was undertaken in 42 urban community health centres randomly selected from four provinces in China. 791 primary care workers rated the impacts of the NEMP on a 5-point Likert scale. An average score for the impacts of the NEMP on four aspects (the practice of health workers, interactions of patients with health workers, operations of health centres and provision of medicines) was calculated, each ranging from 0 to 100. A higher score indicates a more positive rating. Linear regression models were established to determine the sociodemographic characteristics (region, age, gender, profession, training, income) that were associated with the ratings. The respondents gave an average rating score of 65.61±11.76, 63.17±13.62, 66.35±13.02 and 67.26±11.60 for the impacts of the NEMP on health workers, patients, health centres and provision of medicines, respectively. Respondents from the central region rated the NEMP higher than those from the eastern and western regions. The pharmacists (β=5.457~7.558, pimpacts (as perceived by the health workers) on health services delivery in primary care settings. However, the impacts of the NEMP vary by region, professional practice and the income level of health workers. It is important to maintain support from physicians through income subsidies (to compensate for potential loss) and training. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Quality assessment of radiopharmaceuticals in nuclear medicine services at Northeast states, Brazil; Avaliacao da qualidade de radiofarmacos em servicos de medicina nuclear de estados da regiao nordeste

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Wellington Gomes de

    2012-07-01

    The radiopharmaceuticals are used in the field nuclear medicine services (NMS) as tracer in the diagnoses and treatment of many diseases. Radiopharmaceuticals used in nuclear medicine and usually have a minimum of pharmacological effect. The procedures for labelling Radiopharmaceuticals should be observed in order to minimize risks to patients, employees and individuals from the public, and to be administered in humans, must be sterile and free of pyrogens and possess elements all measures of quality controls required a conventional drug. The 'Agencia Nacional de Vigilancia Sanitaria (ANVISA)' in its 'Resolucao de Diretoria Colegiada' (RDC) No. 38 of June 4{sup th} 2008, decided that the NMS must perform quality control in the generators eluate and radiopharmaceuticals according to recommendations of manufacturers and scientific evidence accepted by ANVISA. Thus, this study proposes to evaluate the quality of the generator {sup 99M}o-{sup 99m}Tc eluate and radiopharmaceuticals labeled with {sup 99m}Tc used in most NMS of some states in the Northeast, in relation to radionuclide, chemical, radiochemical purity and pH and promote the inclusion of procedure for quality control of radiopharmaceuticals in routine NMS. The results show that 90% radionuclidic purity, 98.2% purity chemical and radiochemical purity of 46% and 100% of the eluates are in agreement with international pharmacopoeias; already radiopharmaceuticals showed 82.6% purity and all radiochemical pH values are also in accordance with international pharmacopoeias. Even with so many positive results, staff the majority of MNS was not able to perform the quality control of the eluates and radiopharmaceuticals. Showing the importance of implementing of quality control programs of the eluates and radiopharmaceuticals in nuclear medicine. (author)

  15. Does providing more services increase the primary hospitals' revenue? An assessment of national essential medicine policy based on 2,675 counties in China.

    Directory of Open Access Journals (Sweden)

    Fei Chen

    Full Text Available To understand whether the increased outpatient service provision (OSP brings in enough additional income (excluding income from essential medicine for primary hospitals (INCOME to compensate for reduced costs of medicine.The two outcomes, annual OSP and INCOME for the period of 2008-2012, were collected from 34,506 primary hospitals in 2,675 counties in 31 provinces in China by the national surveillance system. The data had a four-level hierarchical structure; time points were nested within primary hospital, hospitals within county, and counties within province. We fitted bivariate five-level random effects regression models to examine correlations between OSP and INCOME in terms of their mean values and dose-response effects of the essential medicine policy (EMP. We adjusted for the effects of time period and selected hospital resources.The estimated correlation coefficients between the two outcomes' mean values were strongly positive among provinces (r = 0.910, moderately positive among counties (r = 0.380, and none among hospitals (r = 0.002 and time (r = 0.007. The correlation between their policy effects was weakly positive among provinces (r = 0.234, but none at the county and hospital levels. However, there were markedly negative correlation coefficients between the mean and policy effects at -0.328 for OSP and -0.541 for INCOME at the hospital level.There was no evidence to suggest an association between the two outcomes in terms of their mean values and dose-response effects of EMP at the hospital level. This indicated that increased OSP did not bring enough additional INCOME. Sustainable mechanisms to compensate primary hospitals are needed.

  16. Quality assessment of radiopharmaceuticals in nuclear medicine services at Northeast states, Brazil; Avaliacao da qualidade de radiofarmacos em servicos de medicina nuclear de estados da regiao nordeste

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Wellington Gomes de

    2012-07-01

    The radiopharmaceuticals are used in the field nuclear medicine services (NMS) as tracer in the diagnoses and treatment of many diseases. Radiopharmaceuticals used in nuclear medicine and usually have a minimum of pharmacological effect. The procedures for labelling Radiopharmaceuticals should be observed in order to minimize risks to patients, employees and individuals from the public, and to be administered in humans, must be sterile and free of pyrogens and possess elements all measures of quality controls required a conventional drug. The 'Agencia Nacional de Vigilancia Sanitaria (ANVISA)' in its 'Resolucao de Diretoria Colegiada' (RDC) No. 38 of June 4{sup th} 2008, decided that the NMS must perform quality control in the generators eluate and radiopharmaceuticals according to recommendations of manufacturers and scientific evidence accepted by ANVISA. Thus, this study proposes to evaluate the quality of the generator {sup 99M}o-{sup 99m}Tc eluate and radiopharmaceuticals labeled with {sup 99m}Tc used in most NMS of some states in the Northeast, in relation to radionuclide, chemical, radiochemical purity and pH and promote the inclusion of procedure for quality control of radiopharmaceuticals in routine NMS. The results show that 90% radionuclidic purity, 98.2% purity chemical and radiochemical purity of 46% and 100% of the eluates are in agreement with international pharmacopoeias; already radiopharmaceuticals showed 82.6% purity and all radiochemical pH values are also in accordance with international pharmacopoeias. Even with so many positive results, staff the majority of MNS was not able to perform the quality control of the eluates and radiopharmaceuticals. Showing the importance of implementing of quality control programs of the eluates and radiopharmaceuticals in nuclear medicine. (author)

  17. Evaluation of quality control of radiopharmaceuticals in Nuclear Medicine service; Avaliacao do controle de qualidade de radiofarmacos em servico de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Tavares, Jamille A. Lopes; Lira, Renata F. de, E-mail: jam_alt@hotmail.com, E-mail: renatafariasdelira@hotmail.com [Universidade Federal de Pernambuco (UFPE), Recife (Brazil); Santos, Marcus Aurelio P. dos, E-mail: masantos@cnen.gov.br [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil)

    2014-07-01

    Radiopharmaceuticals are a type of pharmaceutical preparation associated with radionuclides with purpose of diagnosis and therapy. Nuclear Medicine Services (NMS) should perform quality control of radiopharmaceuticals according to the recommendations of the manufacturer and scientific evidences accepted by the National Agency Sanitary Surveillance ( Brazilian ANVISA). This study evaluated the quality of the main radiopharmaceuticals in a NMS of the state of Pernambuco in relation to pH and radiochemical purity. The results showed that 96.8% of the radiopharmaceuticals showed radiochemical purity and all pH values were within the range recommended by the American pharmacopoeia. The study found that the quality control when inserted into the NMS, provides important data that allows exclusion of radiopharmaceuticals with low radiochemistry purity, favoring a reliable diagnosis and ensuring good radiation protection practices and biosecurity for patient and occupationally exposed individuals.

  18. A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Justin Shmalberg

    2015-01-01

    Full Text Available Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital demonstrated that patients most commonly received a combination of therapeutic modalities (39% of all treatment sessions. The 274 patients receiving multiple modalities were most frequently treated for neurologic and orthopedic disease (50.7% versus 49.6% of all presenting complaints, resp.. Older neutered or spayed dogs (mean age = 9.0 years and Dachshunds were treated more often than expected based on general population statistics. Acupuncture, laser therapy, electroacupuncture, and hydrotherapy were frequently administered (>50% patients. Neurologic patients were more likely to receive acupuncture, electroacupuncture, and therapeutic exercises but less likely than orthopedic patients to receive laser, hydrotherapy, or therapeutic ultrasound treatments (P<0.05. The results suggest that the application of these specific modalities to orthopedic and neurologic diseases should be subjected to increased evidence-based investigations. A review of current knowledge in core areas is presented.

  19. Preventable Admissions on a General Medicine Service: Prevalence, Causes and Comparison with AHRQ Prevention Quality Indicators-A Cross-Sectional Analysis.

    Science.gov (United States)

    Patel, Krishna K; Vakharia, Nirav; Pile, James; Howell, Erik H; Rothberg, Michael B

    2016-06-01

    Rates of preventable admissions will soon be publicly reported and used in calculating performance-based payments. The current method of assessing preventable admissions, the Agency of Healthcare Research and Quality (AHRQ) Preventable Quality Indicators (PQI) rate, is drawn from claims data and was originally designed to assess population-level access to care. To identify the prevalence and causes of preventable admissions by attending physician review and to compare its performance with the PQI tool in identifying preventable admissions. Cross-sectional survey. General medicine service at an academic medical center. Consecutive inpatient admissions from December 1-15, 2013. Survey of inpatient attending physicians regarding the preventability of the admissions, primary contributing factors and feasibility of prevention. For the same patients, the PQI tool was applied to determine the claims-derived preventable admission rate. Physicians rated all 322 admissions and classified 122 (38 %) as preventable, of which 31 (25 %) were readmissions. Readmissions were more likely to be rated preventable than other admissions (49 % vs. 35 %, p = 0.04). Application of the AHRQ PQI methodology identified 75 (23 %) preventable admissions. Thirty-one admissions (10 %) were classified as preventable by both methods, and the majority of admissions considered preventable by the AHRQ PQI method (44/78) were not considered preventable by physician assessment (K = 0.04). Of the preventable admissions, physicians assigned patient factors in 54 (44 %), clinician factors in 36 (30 %) and system factors in 32 (26 %). A large proportion of admissions to a general medicine service appeared preventable, but AHRQ's PQI tool was unable to identify these admissions. Before initiation of the PQI rate for use in pay-for-performance programs, further study is warranted.

  20. Disparities in availability of essential medicines to treat non-communicable diseases in Uganda: A Poisson analysis using the Service Availability and Readiness Assessment.

    Science.gov (United States)

    Armstrong-Hough, Mari; Kishore, Sandeep P; Byakika, Sarah; Mutungi, Gerald; Nunez-Smith, Marcella; Schwartz, Jeremy I

    2018-01-01

    Although the WHO-developed Service Availability and Readiness Assessment (SARA) tool is a comprehensive and widely applied survey of health facility preparedness, SARA data have not previously been used to model predictors of readiness. We sought to demonstrate that SARA data can be used to model availability of essential medicines for treating non-communicable diseases (EM-NCD). We fit a Poisson regression model using 2013 SARA data from 196 Ugandan health facilities. The outcome was total number of different EM-NCD available. Basic amenities, equipment, region, health facility type, managing authority, NCD diagnostic capacity, and range of HIV services were tested as predictor variables. In multivariate models, we found significant associations between EM-NCD availability and region, managing authority, facility type, and range of HIV services. For-profit facilities' EM-NCD counts were 98% higher than public facilities (p < .001). General hospitals and referral health centers had 98% (p = .004) and 105% (p = .002) higher counts compared to primary health centers. Facilities in the North and East had significantly lower counts than those in the capital region (p = 0.015; p = 0.003). Offering HIV care was associated with 35% lower EM-NCD counts (p = 0.006). Offering HIV counseling and testing was associated with 57% higher counts (p = 0.048). We identified multiple within-country disparities in availability of EM-NCD in Uganda. Our findings can be used to identify gaps and guide distribution of limited resources. While the primary purpose of SARA is to assess and monitor health services readiness, we show that it can also be an important resource for answering complex research and policy questions requiring multivariate analysis.

  1. Radiological safety analysis of the nuclear medicine service at the 'Hospital Nacional Dos de Mayo'/Peru

    International Nuclear Information System (INIS)

    Acosta R, N.; Ramirez Q, R.

    1996-01-01

    For the purpose of applying for installation licenses for nuclear medicine, as it is required by the peruvian Law, it is necessary to make an analysis of safety and protection of the installation and its procedures, so that the technical criteria can be satisfied. Previous information includes a description of activities that employs I 131 and Tc 99m in the diagnosis and treatment. A description of the installations, surrounding areas and construction details is performed, especially in hot zones. The safety analysis takes into account the normal operation risk in terms of doses for each process or operation that is executed (for example: division, fraction, extraction, dilution, etc),the operation time and the frequency. The annual doses are not more than 5,88 mSv for diagnostics and 5 mSv in therapy. In accidental situations, events of individual contamination, spills, fire and explosion, which are the most likely to happen, have been taken into account. Due to these events, the doses are between 5.5 mSv and 0.53 mSv under reasonable assumptions. In view of the possibility of these normal and potential doses, it is necessary the implementation of procedures and specifications to complete the protection in the practice. The documents were evaluated and the installation license was granted. (authors). 7 refs., 1 fig

  2. [Health services research: subject matter and objectives of a field at the intersection of economics, medicine and ethics].

    Science.gov (United States)

    Arnold, M

    2003-07-01

    In analogy to the famous saying that war is too serious to leave it to the generals, one could say that the provision of medical care is too serious and too costly to leave it to doctors. This, however.would give the impression of an incongruity which does not exist as an actual factor or as a standpoint in research on the healthcare system. Having said that, there are differences in the methods of observation used: doctors always base their observations on their experiences at the doctor/patient level. In these situations, they are influenced by the therapeutic imperative of wanting to help and their convictions do not allow them to take into account competing requirements or to feel dependent on the higher-level conditions; and the realm of research on the health care system bases its observations more or less on findings derived by means of analysing what is often highly aggregated data, be it of a medical, economic or epidemiological nature. Even though the insights gained at the macrolevel ultimately have to be applied at the microlevel of the doctor/patient relationship, there remains an internal distance from the problems of care which is conducive to proper judgement. From this distant vantage point, researchers attempt to prove the relationship between effort and yield, to indicate weak spots which individual doctors cannot recognise and to define capacity, structure and incentive conditions which guarantee maxi-mum medical care quality. There is, for instance, evidence of astonishing dependence between the medical care provided and incentives for the number of doctor/patient contacts, use of medicines, surgery rates and number of diagnoses. This evidence can be used to draw up recommendations for self-governing bodies in the health care sector and for the political sphere as to how the health care system could be enhanced to achieve a high level of efficiency and quality.

  3. The business of medicine: how to overcome financial obstacles and secure financing for your private practice and ancillary services business.

    Science.gov (United States)

    Nayor, David

    2012-01-01

    Doctors across the country who operate private medical practices are facing increasing financial obstacles, namely shrinking income as a result of rising costs and lower reimbursements. In addition, as hospitals have become overburdened many physicians have opened up private surgical centers; magnetic resonance imaging and computed tomography and positron emission tomography scanning facilities; pathology labs; colonoscopy/endoscopy suites; lithotripsy centers; and other medical businesses typically performed within the hospital. Moreover, many doctors seek loans to purchase existing practices or for their capital contribution in medical partnerships. The past decade has thus seen a significant increase in the number of doctors taking out small business loans. Indeed, banks view the healthcare industry as a large growth market. This article includes practical information, advice, and resources to help doctors to secure bank financing for their practices, ancillary services business, real estate, and equipment on the best possible market terms.

  4. Integrative Medicine in Preventive Medicine Education

    Science.gov (United States)

    Jani, Asim A.; Trask, Jennifer; Ali, Ather

    2016-01-01

    During 2012, the USDHHS’s Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center established a multidisciplinary steering committee, versed in integrative medicine, whose primary aim was to develop integrative medicine core competencies for incorporation into preventive medicine graduate medical education training. The competency development process was informed by central integrative medicine definitions and principles, preventive medicine’s dual role in clinical and population-based prevention, and the burgeoning evidence base of integrative medicine. The steering committee considered an interdisciplinary integrative medicine contextual framework guided by several themes related to workforce development and population health. A list of nine competencies, mapped to the six general domains of competence approved by the Accreditation Council of Graduate Medical Education, was operationalized through an iterative exercise with the 12 grantees in a process that included mapping each site’s competency and curriculum products to the core competencies. The competencies, along with central curricular components informed by grantees’ work presented elsewhere in this supplement, are outlined as a roadmap for residency programs aiming to incorporate integrative medicine content into their curricula. This set of competencies adds to the larger efforts of the IMPriME initiative to facilitate and enhance further curriculum development and implementation by not only the current grantees but other stakeholders in graduate medical education around integrative medicine

  5. The formation of human resources in the area of imaging diagnosed and therapeutic of the Universidad de Costa Rica and its contribution to the services of radiology, radiotherapy and nuclear medicine: period 1969 - 2007

    International Nuclear Information System (INIS)

    Mendez Avila, Maria Catalina

    2009-01-01

    The formation of human resources in the area of imaging diagnosed and therapeutic at the Universidad de Costa Rica, was carried out during the last 38 years and has been necessary to realize an assessment of that trajectory and value the impact it has had, the race today, in radiodiagnostic services, radiotherapy and nuclear medicine. The present work was carried out in order of providing to the Escuela de Tecnologias en Salud, the Universidad de Costa Rica, radiology services, radiotherapy, nuclear medicine and all those involved and interested in the area, a documented and rigorous analysis regarding the trajectory and characterization of the different stages of historical development of human resources training in imaging diagnosed and therapeutic. Also, suffered changes in the curriculum are considered in accordance with historical events and service needs. The analysis of each curriculum was performed and used for training of technicians and graduates in nuclear medicine and ionizing radiation, as well as the curriculum for the training of bachelors and degrees in imaging diagnosed and therapeutics, as part of the curriculum evolution in the formation of human resources. The strengths, deficiencies and challenge in each curriculum were presented, determining in this way how the changes made to the curriculum meet the needs and demands of radiology services, nuclear medicine and radiotherapy. (author) [es

  6. Linkage between the Danish National Health Service Prescription Database, the Danish Fetal Medicine Database, and other Danish registries as a tool for the study of drug safety in pregnancy

    DEFF Research Database (Denmark)

    Pedersen, Lars Henning; Petersen, Olav Bjørn; Nørgaard, Mette

    2016-01-01

    A linked population-based database is being created in Denmark for research on drug safety during pregnancy. It combines information from the Danish National Health Service Prescription Database (with information on all prescriptions reimbursed in Denmark since 2004), the Danish Fetal Medicine...

  7. The relationship between internal medicine residency graduate performance on the ABIM certifying examination, yearly in-service training examinations, and the USMLE Step 1 examination.

    Science.gov (United States)

    Kay, Cynthia; Jackson, Jeffrey L; Frank, Michael

    2015-01-01

    To explore the relationship between United States Medical Licensing Examination (USMLE) Step 1 scores, yearly in-service training exam (ITE) scores, and passing the American Board of Internal Medicine certifying examination (ABIM-CE). The authors conducted a retrospective database review of internal medicine residents from the Medical College of Wisconsin from 2004 through 2012. Residents' USMLE Step 1, ITE, and ABIM-CE scores were extracted. Pearson rho, chi-square, and logistic regression were used to determine whether relationships existed between the scores and if Step 1 and ITE scores correlate with passing the ABIM-CE. There were 241 residents, who participated in 728 annual ITEs. There were Step 1 scores for 195 (81%) residents and ABIM-CE scores for 183 (76%). Step 1 and ABIM-CE scores had a modest correlation (rho: 0.59), as did ITE and ABIM-CE scores (rho: 0.48-0.67). Failing Step 1 or being in the bottom ITE quartile during any year of testing markedly increased likelihood of failing the boards (Step 1: relative risk [RR]: 2.4; 95% CI: 1.0-5.9; first-year residents' RR: 1.3; 95% CI: 1.0-1.6; second-year residents' RR: 1.3; 95% CI: 1.1-1.5; third-year residents' RR: 1.3; 95% CI: 1.1-1.5). USMLE Step 1 and ITE scores have a modest correlation with board scores. Failing Step 1 or scoring in the bottom quartile of the ITE increased the risk of failing the boards. What effective intervention, if any, program directors may use with at-risk residents is a question deserving further research.

  8. Impact of consumer copayments for subsidised medicines on health services use and outcomes: a protocol using linked administrative data from Western Australia.

    Science.gov (United States)

    Seaman, Karla L; Sanfilippo, Frank M; Roughead, Elizabeth E; Bulsara, Max K; Kemp-Casey, Anna; Bulsara, Caroline; Watts, Gerald F; Preen, David

    2017-06-21

    Across the world, health systems are adopting approaches to manage rising healthcare costs. One common strategy is a medication copayments scheme where consumers make a contribution (copayment) towards the cost of their dispensed medicines, with remaining costs subsidised by the health insurance service, which in Australia is the Federal Government.In Australia, copayments have tended to increase in proportion to inflation, but in January 2005, the copayment increased substantially more than inflation. Results from aggregated dispensing data showed that this increase led to a significant decrease in the use of several medicines. The aim of this study is to determine the demographic and clinical characteristics of individuals ceasing or reducing statin medication use following the January 2005 Pharmaceutical Benefit Scheme (PBS) copayment increase and the effects on their health outcomes. This whole-of-population study comprises a series of retrospective, observational investigations using linked administrative health data on a cohort of West Australians (WA) who had at least one statin dispensed between 1 May 2002 and 30 June 2010. Individual-level data on the use of pharmaceuticals, general practitioner (GP) visits, hospitalisations and death are used.This study will identify patients who were stable users of statin medication in 2004 with follow-up commencing from 2005 onwards. Subgroups determined by change in adherence levels of statin medication from 2004 to 2005 will be classified as continuation, reduction or cessation of statin therapy and explored for differences in health outcomes and health service utilisation after the 2005 copayment change. Ethics approvals have been obtained from the Western Australian Department of Health (#2007/33), University of Western Australia (RA/4/1/1775) and University of Notre Dame (0 14 167F). Outputs from the findings will be published in peer reviewed journals designed for a policy audience and presented at state

  9. [Self-assessment of tasks and roles of occupational medicine service (OMS) nurses in the Polish system of workers' health protection].

    Science.gov (United States)

    Sakowski, Piotr

    2010-01-01

    This paper presents the results of survey performed to find out how occupational medicine service (OMS) nurses assess their tasks and roles in the Polish system of workers' health protection. The survey was carried out in a random group of 200 OMS nurses. The survey showed that OMS nurses form-an experienced professional group. According to self-assessment they have an opportunity to use their competence in its full scope. Almost half of respondents agreed that in Poland the skills of OMS nurses are properly used. There are two reasons why certain tasks are not performed by OMS nurses, first, certain tasks are assigned to other persons in the unit; second, employers are sometimes not interested in those tasks or find them not necessary. The majority of nurses assess their knowledge and preparation to perform tasks relatively well, however they want to broaden their knowledge and improve their skills. OMS nurses play an important role in the Polish system of workers' health protection. They perform many tasks, which fall within the scope of OMS activities being currently implemented. Their competences are usually properly used. There is a need to convince employers that the scope of services provided by OMS units should be extended and adequately financed. This should result in the better use of OMS nurses' competences. Nurses are well educated and skilled to perform their jobs. Nevertheless, they feel the need to broaden their knowledge. Although the programs of specialization and qualification courses are rather comprehensive, nurses declare that some areas should be enriched with additional information.

  10. Society of Behavioral Medicine (SBM) position statement: SBM urges Congress to preserve and increase the financing of federally funded nutrition assistance programs and services.

    Science.gov (United States)

    Behrman, Pamela; Demirci, Jill; Yanez, Betina; Beharie, Nisha; Laroche, Helena

    2018-05-03

    Deep cuts have been proposed to federally funded nutrition assistance programs, including the Supplemental Nutrition Assistance Program (SNAP); the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and federally subsidized school breakfast and lunch programs. Yet, these programs help parents afford healthy meals for their families, pregnant and postpartum mothers access supplemental foods and health services for themselves and their infants and young children, and children obtain the nutrition necessary for optimal school performance. Participation in these programs is linked with reductions in perinatal morbidity and mortality, improved childhood growth trajectories, enhanced school performance, and reductions in food insecurity and poverty. Given these compelling health and economic benefits, the Society of Behavioral Medicine urges Congress to protect and increase funding for federally funded nutrition assistance programs, specifically SNAP, WIC, and school breakfast and lunch programs. Per the recent (2017) recommendations of the School Nutrition Association, Congress should also resist any attempts to "block-grant" subsidized school breakfast and lunch programs, which could reduce access to these programs. It is further recommended that Congress improve the scope of implementation- and outcomes-based assessments of these programs. Finally, we recommend efforts to increase awareness of and participation in SNAP, WIC, and federally funded school meal programs for eligible individuals, children, and families.

  11. Cooperation within physician-nurse team in occupational medicine service in Poland - Knowledge about professional activities performed by the team-partner.

    Science.gov (United States)

    Sakowski, Piotr

    2015-01-01

    The goal of the study has been to learn about physicians' and nurses' awareness of the professional activities that are being performed by their colleague in the physician-nurse team. Postal questionnaires were sent out to occupational physicians and nurses in Poland. The analysis includes responses from 232 pairs of physician-nurse teams. The knowledge among occupational professionals about tasks performed by their colleagues in the physician-nurse team seems to be poor. Respondents were asked about who performs tasks from each of 21 groups mentioned in the Occupational Medicine Service Act. In the case of only 3 out of 21 groups of tasks, the rate of non-consistence in answers was lower than 30%. A specified number of professionals performed their tasks on the individual basis. Although in many cases their team colleagues knew about those activities, there was a major proportion of those who had no awareness of such actions. Polish occupational physicians and nurses perform a variety of tasks. Occupational nurses, besides medical role, also play important organizational roles in their units. The cooperation between the two professional groups is, however, slightly disturbed by the deficits in communication. This issue needs to be improved for the betterment of operations within the whole system. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  12. Tele-facilities for medicine, imaging, quality controls and maintenance services in the health sector for the developing countries and its present and future scope in Bangladesh

    International Nuclear Information System (INIS)

    Jahangir, Saleh Mahmud; Xie, Y.; Uddin, Rokon Md.; Haque, Mohammod Abu Sayid; Hoq, Mahbubul; Mawla, Yasmeen; Morium, Tasnim

    2002-01-01

    The information revolution is transforming health technology itself. With the development of international fiberoptic networks, satellite communications and the ever expanding Internet, technology is now going from revolutionary to routine, from unimaginable to indispensable. There has been little practical experience with telemedicine of a direct clinical kind in the developing world which contains 80% of the world's population. In the 45 poorest countries, it is estimated that only 50% of the population have access to health services. Arguably, it is those same countries that stand to gain most from a simple and cheap telemedicine system, on the principle that it could improve access to health care specialists and enhance research and the education of local health care workers. The work of the Swinfen Charitable trust demonstrates, useful clinical and educational results can be achieved using low cost telemedicine methods. As with the rest of telemedicine, the guiding principle seems to be that it is important to be clear about what problem we are trying to solve. Bangladesh has already entered the age of telemedicine. Under the umbrella of the IAEA TC Project on tele-nuclear medicine and tele-maintenance of nuclear medical equipment it will gradually step forward to reach its desired goal. What role telemedicine will play in the developing countries is yet to be determined. In terms of global health care the relevancy of telemedicine can only be ascertained after successful implementation of these projects

  13. Aerospace Medicine

    Science.gov (United States)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  14. [Cross-sectional analysis of heart failure among patients in the Internal Medicine Service at a third-level hospital. Part I: epidemiologic analysis].

    Science.gov (United States)

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

    2007-06-01

    To observe the epidemiologic characteristics of the patients intake during five years in a internal medicine department, with heart failure. A cross-sectional study of the intake patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intake by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with qualitative and quantitative measures, chi-cuadrado and t-student, and multivariant analyses. 248 patients were accepted for the study. We observed more women than men (55.2%) and bigger median age (79 years old vs. 73 years old in men, p < 0.001). The mean income was 13.61 days and a median of 11 days. The 41,8% of the patients had hypertension, 30.9% diabetes mellitus and 81,9% had someone heart disease. The aetiologies of heart failure most frequent were ischemic cardiopathy (27.2%) and hypertension (24.2%). The most frequent symptom was the dyspnea (68.9%). It made echocardiography in 20.9% of patients and 45.1% showed systolic disfunction. The only factor related with this small percentage of echocardiographies was the incoming time. The most frequent etiology was respiratory infections (39.5%). The 8.6% of patients was deceased. The pharmacologic treatment more prescribed were the diuretics (86.9%) and transcutaneous nitrates (49.5%). It was indicated ECAI or AAR-II in the 86.9% of patients and beta-blockers in 0.9%. The number of echocardiograms practiced to the patients is smaller that the number advised by international associations and smaller to the cardiologist registers. The beta-blockers and ECAI use is smaller too.

  15. Critical evaluation of the external occupational exposure in nuclear medicine services in Brazil; Avaliacao critica da exposicao ocupacional externa nos servicos de medicina nuclear no Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Ana Luiza Silva Lima

    2016-07-01

    Currently in Brazil (2016), there are 421 Nuclear Medicine Services (NMS). In nuclear medicine, the possibility of occupational internal contamination and external exposure is unavoidable. The chest individual monitoring, to estimate the effective dose, is mandatory, but the extremity monitoring is not always made. The aim of this study was to conduct a survey of data for external exposure of NMS professionals in Brazil from 1987 to 2010, analysing them in terms of trends and comparing them with measurements carried out in this work and in other countries. Although most of the NMS is still located in large urban centres (54% in the Southeast region), there is no state without any NMS. The increasing number of NMS has generated the need for more professionals. In the year 1987, they were 755 workers and, in 2010, 4134, with the following distribution of specialties: 29% of Nuclear Medicine Technicians (NMT), 23% of Nursing professionals, 29% of Physicians and 3% of Physicists. The average annual effective dose reached more than 3.0 mSv in some regions of the country, from 1987 to 2010, but tends to 1.0 mSv in 2010. The highest doses, as expected, are received by NMT and Nursing. The professionals who handle radiopharmaceuticals have their hands much more exposed than the chest. During 2010, only 31% of NMT and 16% of Nursing used extremity dosimeters as compared to chest dosimeters. The data from the measurements indicate that not all individual dosimeters are used properly. Generally, both in the measurements as in national registries, the hand doses were higher for professionals who prepared the radiopharmaceutical (NMT) than those who injected (Nursing). The value measured by chest dosimeters can be used to estimate the equivalent dose to the eye lenses, except for NMT at preparation practices at conventional NMS, where the equivalent dose of the lens is about 2 times higher than the dose at the chest. The most exposed areas of the hands are the tips of the index

  16. Nuclear medicine

    International Nuclear Information System (INIS)

    Lentle, B.C.

    1986-01-01

    Several growth areas for nuclear medicine were defined. Among them were: cardiac nuclear medicine, neuro-psychiatric nuclear medicine, and cancer diagnosis through direct tumor imaging. A powerful new tool, Positron Emission Tomography (PET) was lauded as the impetus for new developments in nuclear medicine. The political environment (funding, degree of autonomy) was discussed, as were the economic and scientific environments

  17. [Cross-sectional study of heart failure of patients intaked in an Internal Medicine Service in the third level hospital in mixed area. Part III: mortality analysis].

    Science.gov (United States)

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

    2007-08-01

    To establish the characteristics of the deceased in intaked patients by heart failure. A cross-sectional study of the intaked patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intaked by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with cualitative and cuantitative measures, chi-cuadrado and t-student. 248 patients were accepted for the study, with the mortality rate rising 8.6% (21 patients). We did not observed differences between sexes, but the median age in death patients was greater than other patients. The median income was 5 days, letter than study population. The hypertension prevalence (30 vs. 42.6%, p = 0.27) and ischemic cardiopathy (30 vs. 27.7%, p = 0.82) did not showed differences with the population. The hypertension prevalence in women (16.7 vs. 35.7%, p = 0.21) and the ischemic cardiopathy prevalence in men (50 vs. 21.4%, p = 0.20) did not showed differences. It made echocardiography in 21.0% of death patients, p = 0.76. The systolic disfunction prevalence was bigger in death patients (80 vs. 41.3%), this difference was not significant statistically. The older patients showed letter survival. We did not observe any influence of sex or left ventricular systolic function on mortality in patients with heart failure.

  18. Heart failure - medicines

    Science.gov (United States)

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  19. Navy Medicine - World Class Care... Anytime, Anywhere

    Science.gov (United States)

    Search Saturday, May 26th, 2018 Home About Disclaimer Search Navy Medicine Navy Medicine World Class Care... Anytime, Anywhere Home Disclaimer Navy Medicine WebSite About Leadership Readiness Health Partnerships Inside Navy Medicine Dental Corps Hospital Corps Medical Corps Medical Service Corps Nurse Corps

  20. Establishment of the Auditing National Service of quality to the instrumentation of Nuclear medicine in Cuba; Establecimiento del Servicio Nacional de Auditorias de calidad a la instrumentacion de medicina nuclear en Cuba

    Energy Technology Data Exchange (ETDEWEB)

    Varela C, C; Diaz B, M [Centro de Control Estatal de Equipos Medicos (CCEEM), Calle 4 No. 455 (altos) e/ 19 y 21 Vedado, Ciudad Habana (Cuba); Lopez B, G M [CPHR, Calle 20 No. 4113 e/ 41 y 47, Playa, Ciudad Habana (Cuba); Torres A, L A; Coca P, M A [Centro de Investigaciones Clinicas, Calle 34 No. 4501, e/ 45 y 47, Roto Kohly, Playa, Ciudad Habana (Cuba)

    2006-07-01

    Next to the vertiginous development of the technology in the Nuclear Medicine field, the possibility of early diagnosis of pathological processes without anatomical alterations, as well as its application with therapeutic purposes in the cancer treatment has grown. To assure a diagnosis and adapted therapy, it is vital to establish quality guarantee programs to the instrumentation. The State Medical Equipment Control Center (CCEEM), as regulator organ attributed to the Public Health Ministry of Cuba, it has licensed the Service of Quality Audits to the Nuclear medicine services, fulfilling all the technical and legal requirements to such effect. As base of these, the National Protocol for the Quality Control of the Instrumentation in Nuclear Medicine has been implemented, put out in vigour 2 national regulations, and an inter-institutional and multidisciplinary auditor equipment has been licensed. The different followed steps, as well as the realization of the first quality audits, its show not only a better execution of the tests and bigger professionalism of the involved specialists, but an increment in the taking of conscience to apply adequately the quality concepts for achieving a better service to the patient. On the other hand, the necessity of incorporating the clinical aspects to the audits, fomenting an integral harmonized advance of the quality guarantee programs is evidenced. (Author)

  1. Nuclear Medicine and Application of Nuclear Techniques in Medicine

    International Nuclear Information System (INIS)

    Wiharto, Kunto

    1996-01-01

    The use of nuclear techniques medicine covers not only nuclear medicine and radiology in strict sense but also determination of body mineral content by neutron activation analysis and x-ray fluorescence technique either in vitro or in vivo, application of radioisotopes as tracers in pharmacology and biochemistry, etc. This paper describes the ideal tracer in nuclear medicine, functional and morphological imaging, clinical aspect and radiation protection in nuclear medicine. Nuclear technique offers facilities and chances related to research activities and services in medicine. The development of diagnostic as well as therapeutic methods using monoclonal antibodies labeled with radioisotope will undoubtedly play an important role in the disease control

  2. Diabetes Medicines

    Science.gov (United States)

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  3. Herbal Medicine

    Science.gov (United States)

    ... used for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are ... extracts, and fresh or dried plants. People use herbal medicines to try to maintain or improve their health. ...

  4. [Ambulance in emergency medicine].

    Science.gov (United States)

    Aksoy, Fikret; Ergun, Alper

    2002-07-01

    The ambulance service is very important in emergency medicine. The aim of this study was to investigate the new governing statuate of private ambulance service and to propose some new ideas. We examinated the new governing statuate of private ambulance service, rules of patient transporte between the hospitals and reports written by SSK Goztepe Educational Hospital ambulance drivers. We concluded that SSK Goztepe Educational Hospital ambulance drivers have a iot of problems especially at the rules of patient transport between the hospitals and there are some defiencies at the new governing statuate of private ambulance service. We concluded that it is necesssary to manage all the ambulance services in one center; all the private ambulance services have to have a specialist and all these must be determinated by the special rules. Key words: Regulation ofprivate ambulance, emergency head maintanence, ambulance services

  5. Folk Medicine

    Science.gov (United States)

    ... lead’s effects on health. How to tell if herbal medicines or folk medicines contain lead You only can ... as high as 90%. Ghasard, an Indian folk medicine, has also been found to contain lead. It is a brown powder used as a tonic. Ba-baw-san is a Chinese herbal remedy that contains lead. It is used to ...

  6. [Evaluating health effects--a preventive medicine responsibility of public health offices. Summary of a workshop presentation by the public health services at the Travemünde federal congress 1989].

    Science.gov (United States)

    Wodarg, W

    1989-11-01

    It appears that Federal Public Health services are getting increasingly engaged in curative activities both in individual medicine and in medicine concerned with the general population. Public Health services are expected to draw attention to this fact and to demand that suitable methods be employed to ensure that all the people live in healthy conditions. Such environmental health protection should not be just a safety valve to "let off steam" if planning had been based on miscalculations and false appraisals--it should function in advance to prevent such social and political mishaps. A method is presented utilising the systematic scrutiny of the effects of projects on healthy as an interactive process. Since Public Health offices possess multidisciplinary competence, they are likely to cope with the multifarious problems of environmental medicine. They should act as though they were the attorneys of the population in respect of popular health demands, and must enlist competent staff capable of handling the pertinent problems. It has become apparent that the average citizen is most inclined to comply with the demands made on him by the environment if he becomes aware of the ecological linkups via his own experience. This is precisely where Public Health offices have important educational chances to accomplish their mission.

  7. Quality management system for petroleum and natural gas suppliers; Sistema de gestao da qualidade para os fornecedores da industria do petroleo e gas natural

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Oscar Felizzola [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Escola de Engenharia. Lab. de Tecnologia, Gestao de Negocios e Meio Ambiente (LATEC)]|[PETROBRAS, Rio de Janeiro, RJ (Brazil); Costa, Stella Regina R. da [Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropedica, RJ (Brazil)]|[Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)

    2004-07-01

    The subject of this paper is the implementation of a quality management system for suppliers of products and services for the petroleum and natural gas industry that meet the ISO TS 29001:2003 Standard requirements. This technical specification establishes supplementary requirements to ISO 9001:2000 Standard for the product and service suppliers of the petroleum and natural gas industries. It was the result of a partnership between API and ISO TC 67. It intends to become the common and unique reference for the quality management systems requirements for the industry in the world. Therefore, it helps to avoid multiple systems that ask multiple audits for the certification. The generality of the ISO 9001:2000 Standard, reference for the quality management system for any organization , independent of its size, activity and location, not always satisfies all requirements of the specific sectors. (author)

  8. Comparison of activity measurements of the {sup 67}Ga and {sup 123}I at Brazilian nuclear medicine services; Comparacao das medicoes de atividade do {sup 67}Ga e {sup 123}I em servicos de medicina nuclear brasileiros

    Energy Technology Data Exchange (ETDEWEB)

    Santos, J.A. dos; Silva, M.A.L. da; Lopes, R.T. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-Graduacao de Engenharia (COPPE)], e-mail: joyra@ird.gov.br, e-mail: leobino@ird.gov.br, e-mail: ricardo@lin.ufrj.br; Iwahara, A.; Oliveira, A.E. de; Tauhata, L. [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Lab. Nacional de Metrologia das Radiacoes Ionizantes (LNMRI)], e-mail: iwahara@ird.gov.br, e-mail: aedu@ird.gov.br, e-mail: tauhata@ird.gov.br

    2003-07-01

    Since 1998, the National Laboratory for Ionizing Radiations (LNMRI), of Institute for Radioprotection and Dosimetry, belonging to the Brazilian Commission for Nuclear Energy (IRD/CNEN), is conducting a comparison program for the measurements of radiopharmaceutical activities applied to to patients at the nuclear medicine sector, viewing to assessment the quality of that measurements. This work presents the results of three comparison rounds using the {sup 67}Ga and {sup 123}I, establishing the metrological tracking of the calibrators used by the participants. The results were analysed under the the viewpoint of the conformal with the regulatory authority and show that those comparisons are necessary to improve the quality of radiopharmaceutical measurement activities, identify failures on the equipment and technical procedures used by the nuclear medicine services all over the country.

  9. 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)

  10. Use Medicines Safely

    Science.gov (United States)

    ... Prescription Medicines 1 of 7 sections The Basics: Prescription Medicines There are different types of medicine. The 2 ... medicine are prescription and over-the-counter (OTC). Prescription medicines Prescription medicines are medicines you can get only ...

  11. Center for Disaster & Humanitarian Assistance Medicine

    Data.gov (United States)

    Federal Laboratory Consortium — The Center for Disaster and Humanitarian Assistance Medicine (CDHAM) was formally established at the Uniformed Services University of the Health Sciences (USUHS) by...

  12. Management of radioactive waste from {sup 99}Mo production by nuclear fission; Gestao dos rejeitos radioativos gerados na producao do {sup 99}Mo por fissao nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Rego, Maria Eugenia de Melo

    2013-07-01

    Brazil intends to build a facility for the {sup 99}Mo production through {sup 235}U fission, once this radioisotope is largely used in nuclear medicine. This study aimed at estimating the physical, chemical and radiological characteristics of radioactive waste expected to be generated in that facility, and to provide theoretical subsides that can be used on the definition of a proper waste management system. Two production scenarios were established and the radioisotope inventories of the wastes were calculated by Scale®. From the chemical processing of the uranium targets the wastes were characterized on their chemical and radiological features. MicroShield® was used to determine the activity concentrations up to three months of {sup 99}Mo production. In addition, this work presents dose rate calculation for several sizes of shielding and different amount of wastes, collected in a proper package for in-site transportation. Radionuclides responsible for higher doses were identified in order to facilitate choosing the most appropriate method for managing the wastes after their chemical separation and before their storage. These results are part of what is expected on radioactive wastes at a {sup 99}Mo production facility and might help on the development of the waste management planning for that facility. (author)

  13. Evaluation of radiochemistry purity and p H of radiopharmaceuticals in nuclear medicine services at Pernambuco, Brazil; Avaliacao da pureza radioquimica e pH de radiofarmacos em servicos de medicina nuclear de Pernambuco, Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Wellington; Lima, Fabiana Farias de, E-mail: falima@cnen.gov.b [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil); Santos, Poliane A.L.; Lima, Fernando Roberto de Andrade; Lima, Fabiana Farias de, E-mail: fflima@cnen.gov.b [Centro Regional de Ciencias Nucleares (CRCN-NE/CNEN-PE), Recife, PE (Brazil)

    2011-07-01

    Radiopharmaceuticals are cellular or molecular structures that have a radionuclide in its composition and they are used for diagnosing or treating diseases. The evaluation of the radiochemical purity of radiopharmaceuticals is essential to produce images with artifacts free, as well as avoid unnecessary absorbed dose to the patient. Since they are administered in humans is important and necessary that they undergo rigorous quality control. Due to this fact, the norm in ANVISA RDC 38/2008 declaring the mandatory completion of a minimum of tests in routine nuclear medicine services before human administration. (author)

  14. Individual monitoring of internal exposure of {sup 131}I of workers from the nuclear medicine service FUESMEN, Argentina; Monitoraje individual debido a exposicion interna por {sup 131I} de los trabajadores del servicio de medicina nuclear de FUESMEN

    Energy Technology Data Exchange (ETDEWEB)

    Arenas, G.; Acosta, N.; Venier, V.; Bedoya Toboo, C. [Comision Nacional de Energia Atomica (FUESMEN/CNEA), Buenos Aires (Argentina). Fundacion Escuela de Medicina Nuclear

    2013-07-01

    It is presented the FUESMEN experience in routine monitoring of thyroid internal doses due to inhalation of {sup 131}I in workers of the Nuclear Medicine Service in normal operation or accidental exposure. It is used a surface contamination monitor, type Geiger Mueller, calibrated with a acrylic phantom based on specifications of the simulator of thyroid of ICRU 48 with {sup 131}I reference activity. Through the obtained measurements is achieved to validate the use of Portable Monitor to carry out preliminary exploration on the monitoring scenarios of incidental situations.

  15. Spatial map dose of nuclear medicine service of the Clinical Hospital of Botucatu, SP, Brazil; Mapa espacial de dose do servico de medicina nuclear do Hospital das Clinicas de Botucatu

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Caio V.; Mendonca, Caroline; Silva, Eduardo T.; Moriguchi, Sonia M.; Koga, Katia H., E-mail: caiov_oliveira@yahoo.com.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina

    2013-12-15

    This study was conducted to describe levels of occupational and environmental exposure of the Nuclear Medicine Service of the Clinical Hospital of Botucatu. To this end, measurements were made of the radiometric levels of points strategically defined, in all the environments, for a period of six months, sampling different days and times, during operation normal routine of the sector. The results allow to estimate the expected dose for each environment, comparing them to the dose limitation established by the National Commission of Nuclear Energy (CNEN), allowing better targeting of occupationally exposed individuals, indicating the points where the occupation should be the minimum required, enabling the reduction of risks to potential exposures. (author)

  16. Nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, S M [Bhabha Atomic Research Centre, Bombay (India). Radiation Medicine Centre

    1967-01-01

    The article deals with the growth of nuclear medicine in India. Radiopharmaceuticals both in elemental form and radiolabelled compounds became commercially available in India in 1961. Objectives and educational efforts of the Radiation Medicine Centre setup in Bombay are mentioned. In vivo tests of nuclear medicine such as imaging procedures, dynamic studies, dilution studies, thyroid function studies, renal function studies, linear function studies, blood flow, and absorption studies are reported. Techniques of radioimmunoassay are also mentioned.

  17. Nuclear medicine

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The area of nuclear medicine, the development of artificially produced radioactive isotopes for medical applications, is relatively recent. Among the subjects covered in a lengthy discussion are the following: history of development; impact of nuclear medicine; understanding the most effective use of radioisotopes; most significant uses of nuclear medicine radioimmunoassays; description of equipment designed for use in the field of nuclear medicine (counters, scanning system, display systems, gamma camera); description of radioisotopes used and their purposes; quality control. Numerous historical photographs are included. 52 refs

  18. Environmental management systems methodology for pipeline systems implementation; Metodologia para implantacao de sistemas de gestao ambiental na implementacao de empreendimentos dutoviarios

    Energy Technology Data Exchange (ETDEWEB)

    Paz, Claudio Marques [JPTE Engenharia Ltda., Barueri, SP (Brazil); Pinaud, Rodrigo Zambrotti [AJR Engenharia - Seguranca, Meio Ambiente e Saude Ltda. (Brazil)

    2004-07-01

    The implementation of oil and gas pipeline systems are commonly made in a own or shared with power transmission, rail and crossroads right-of-way. Pipelines are a 'linear' structure, such as power transmission lines, which are established on landscapes with several conformations (accent slopes, swamp and rocky soils), including sites with high environmental sensibility. The services involved on pipeline implementation are very dynamic, involving several number of employees, vehicles, heavy equipment of excavation and welding that results in a high potential to cause environmental and social impacts. This article, based on the Brazilian and foreign experience on pipeline construction, proposes a methodology to prevent and minimize social and environmental impacts during the construction stage of a pipeline system. (author)

  19. Linkage between the Danish National Health Service Prescription Database, the Danish Fetal Medicine Database, and other Danish registries as a tool for the study of drug safety in pregnancy

    Directory of Open Access Journals (Sweden)

    Pedersen LH

    2016-05-01

    Full Text Available Lars H Pedersen,1,2 Olav B Petersen,1,2 Mette Nørgaard,3 Charlotte Ekelund,4 Lars Pedersen,3 Ann Tabor,4 Henrik T Sørensen3 1Department of Clinical Medicine, Aarhus University, 2Department of Obstetrics and Gynecology, 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 4Department of Fetal Medicine, Rigshospitalet, Copenhagen, Denmark Abstract: A linked population-based database is being created in Denmark for research on drug safety during pregnancy. It combines information from the Danish National Health Service Prescription Database (with information on all prescriptions reimbursed in Denmark since 2004, the Danish Fetal Medicine Database, the Danish National Registry of Patients, and the Medical Birth Registry. The new linked database will provide validated information on malformations diagnosed both prenatally and postnatally. The cohort from 2008 to 2014 will comprise 589,000 pregnancies with information on 424,000 pregnancies resulting in live-born children, ~420,000 pregnancies undergoing prenatal ultrasound scans, 65,000 miscarriages, and 92,000 terminations. It will be updated yearly with information on ~80,000 pregnancies. The cohort will enable identification of drug exposures associated with severe malformations, not only based on malformations diagnosed after birth but also including those having led to termination of pregnancy or miscarriage. Such combined data will provide a unique source of information for research on the safety of medications used during pregnancy. Keywords: malformations, teratology, therapeutic drug monitoring, epidemiological methods, registries

  20. Vulnerable Medicine

    Science.gov (United States)

    Bochner, Arthur P.

    2009-01-01

    In "Narrative Medicine: Honoring the Stories of Illness," Rita Charon paints an original and humane portrait of what it can mean to be a doctor, to live a life immersed in sickness and dedicated to wellness. Charon drops the veil, inviting readers to look at the secret, subjective, emotional face of medicine, a zone of self-censored feelings and…

  1. Medicinal claims

    NARCIS (Netherlands)

    Meulen, van der Bernd

    2017-01-01

    Under EU medicinal law, substances presented as having properties for treating or preventing disease are medicinal products by virtue of their presentation. EU food law prohibits attributing to any food the property of preventing, treating or curing a disease. However, if certain conditions are

  2. Newspaper reports from the Coroners Court in Ireland are used to reveal the potential complexity and need for reform in forensic toxicology and medicine services.

    Science.gov (United States)

    Tormey, William P

    2015-05-01

    Newspapers devote regular space to inquests in the public interest. Accuracy in determining the causes of death is important for public health. Expert opinion features prominently in press reports and is an important channel of public education. How expert are the experts and how complex are apparently simple cases? Toxicology cases involving cannabis and stroke, 'junk food' diet, unexplained sudden death, potential drug interactions, allergy during caesarean section, and ecstacy-type drugs are used to illustrate the complexities. A template for reform is suggested to reform the Coroners Laws in Ireland to recognise the complexity of forensic toxicology and medicine. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  3. [Evolutionary medicine].

    Science.gov (United States)

    Wjst, M

    2013-12-01

    Evolutionary medicine allows new insights into long standing medical problems. Are we "really stoneagers on the fast lane"? This insight might have enormous consequences and will allow new answers that could never been provided by traditional anthropology. Only now this is made possible using data from molecular medicine and systems biology. Thereby evolutionary medicine takes a leap from a merely theoretical discipline to practical fields - reproductive, nutritional and preventive medicine, as well as microbiology, immunology and psychiatry. Evolutionary medicine is not another "just so story" but a serious candidate for the medical curriculum providing a universal understanding of health and disease based on our biological origin. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Nuclear medicine

    International Nuclear Information System (INIS)

    Kand, Purushottam

    2012-01-01

    Nuclear medicine is a specialized area of radiology that uses very small amounts of radioactive materials to examine organ function and structure. Nuclear medicine is older than CT, ultrasound and MRI. It was first used in patients over 60-70 years ago. Today it is an established medical specialty and offers procedures that are essential in many medical specialities like nephrology, pediatrics, cardiology, psychiatry, endocrinology and oncology. Nuclear medicine refers to medicine (a pharmaceutical) that is attached to a small quantity of radioactive material (a radioisotope). This combination is called a radiopharmaceutical. There are many radiopharmaceuticals like DTPA, DMSA, HIDA, MIBI and MDP available to study different parts of the body like kidneys, heart and bones etc. Nuclear medicine uses radiation coming from inside a patient's body where as conventional radiology exposes patients to radiation from outside the body. Thus nuclear imaging study is a physiological imaging, whereas diagnostic radiology is anatomical imaging. It combines many different disciplines like chemistry, physics mathematics, computer technology, and medicine. It helps in diagnosis and to treat abnormalities very early in the progression of a disease. The information provides a quick and accurate diagnosis of wide range of conditions and diseases in a person of any age. These tests are painless and most scans expose patients to only minimal and safe amounts of radiation. The amount of radiation received from a nuclear medicine procedure is comparable to, or often many times less than, that of a diagnostic X-ray. Nuclear medicine provides an effective means of examining whether some tissues/organs are functioning properly. Therapy using nuclear medicine in an effective, safe and relatively inexpensive way of controlling and in some cases eliminating, conditions such as overactive thyroid, thyroid cancer and arthritis. Nuclear medicine imaging is unique because it provides doctors with

  5. Environmental management of the OSBAT 24'' oil pipeline: reached practical results; Gestao ambiental do Oleoduto OSBAT 24{sup :} resultados praticos alcancados

    Energy Technology Data Exchange (ETDEWEB)

    Serra, Ricardo N.; Garibaldi, Celia M.; Kagawa, Adriana; Serra, Maira B.; Oliveira, Flavio M. de; Perim, Leandro A. [LENC - Laboratorio de Engenharia e Consultoria Ltda., Cotia, SP (Brazil); Baptista, Sidney L. [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The main objective of this article is to present considerations about the practical results obtained over the implementation of specialized technical services for environmental monitoring and control of the work of maintenance of OSBAT 24'' pipeline, located in a stretch of about 32 km from the Aquatic Terminal of Sao Sebastiao - SP (TASSE) to the district Camburi. This area is characterized by intense environmental complexity by the presence of the Serra do Mar State Park, under enormous natural diversity of preserved Mata Atlantica forest, contrasting with a considerable pole of urban sprawl whose population growth rates (4.66% pa) and economic they are above the average for the Sao Paulo State. The presentation of results considers the practical implementation of the package of environmental management tools used and seek verification of the scope and quality of the following items: general Review of care as environmental registers occurred at different periods (eg monthly, bimonthly, half, etc.); survey of the nature of environmental registers; environmental registers recovered; cases of non-compliance and the main control measures implemented; evaluation of environmental performance; recommendations and learning. (author)

  6. Assessing the impact of bibliographical support on the quality of medical care in patients admitted to an internal medicine service: a prospective clinical, open, randomised two-arm parallel study.

    Science.gov (United States)

    Pastori, Matteo Mario; Sarti, Manuela; Pons, Marco; Barazzoni, Fabrizio

    2014-10-01

    To assess and quantify the impact of the literature in diagnostic decisions and treatment of patients admitted to an internal medicine service using the methodology of evidence-based medicine. From November 2012 to February 2013, patients who were hospitalised in the internal medicine service of Regional Hospital of Lugano (Switzerland) and generated questions on medical care were randomly assigned to two groups: an 'intervention group' (supported by the literature research) and a 'control group' (not supported by the literature research). The information obtained from the literature was submitted by email to all members of the medical team within 12 h after asking the question. Two hundred and one participants, from 866 patients hospitalised in the analysed period, divided into intervention (n=101) and control (n=100) groups, generated questions. In the intervention group, bibliographical research was possible for 98 participants. The medical team accepted the results and implemented the research for 90.8% of these participants (89/98). Statistical analyses were carried out on the intention-to-treat and on the per-protocol populations. Bibliographical research had a significant protective effect on transfer to an intensive care unit (relative risk (RR)=0.30; 95% CI 0.10 to 0.90; χ²=5.3, p=0.02) and hospital readmissions were also influenced by bibliographical research (RR=0.42; 95% CI 0.17 to 1.0; χ²=3.36, p=0.05) in the intention-to-treat population. Our results point out the importance of bibliographical support on the quality of medical care. In particular, they show its possible impact on clinical outcome. EOC Registry (registration number: 14-055).

  7. From vision to reality--managing change in the provision of library and information services to nurses, midwives, health visitors and PAMs: (professions allied to medicine) a case study of the North Thames experience with the Inner London Consortium.

    Science.gov (United States)

    Godbolt, S; Williamson, J; Wilson, A

    1997-06-01

    One of the North Thames' pioneering consortia, the Inner London Consortium (ILC) is a complex body which includes NHS Trusts with teaching hospital university connections, community-based Trusts and general hospital acute Trusts. Within the consortium there are 12,000 trained nurses, midwives, health visitors and other professional staff working in the professions allied to medicine (PAMs), all of whom require access to and provision of appropriate library information services. In 1994, taking into account experiences elsewhere in the Region and nationally, it became clear that library issues were complex and would become acute with the move of nursing libraries from ILC Trust sites over a very short timescale. A report on the issues commissioned by the Consortium recommended that a library project, which built on existing NHS Trust PGMDE funded library resources and moved these to a multidisciplinary base to serve the consortium membership, be implemented. The objective of providing access to library information services for nurses and PAMs was achieved. Successes that emerged from the implementation included: The registration in Trust libraries of almost 12 000 new members within the initial 6-month monitoring period. The development of service level agreements and standards for the delivery of services to these new user groups. This paper describes the processes behind these significant and complex changes.

  8. The main trends of interaction of sanitary-epidemiological teams in the system of the Russian service of disaster medicine in emergency situations

    International Nuclear Information System (INIS)

    Zaichenko, A.I.; Zhuravleva, V.E.; Varenikov, I.I.; Komarova, V.V.; Borisov, B.K.; Pozhidaev, A.E.; Pozhidaeva, N.V.

    1995-01-01

    For improvement of the system of prevention of emergency situations (ES) and for rendering emergency therapeutic-prophylactic and sanitary-epidemiological aid to population in case of ES the paper has determined and proved the first and foremost tasks which are to be settled by joint efforts of the Russian Centre on Disaster Medicine Zashchita and Scientific-practical Center of hygienic expert survey for practical perfection of the efficient forms of interaction of medical-sanitary forces engaged in work in ES. 4 refs

  9. 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.)

  10. Ayurvedic Medicine

    Science.gov (United States)

    ... to the biologic humors of the ancient Greek system. Using these concepts, Ayurvedic physicians prescribe individualized treatments, including compounds of herbs or proprietary ingredients, and diet, exercise, and lifestyle recommendations. The majority of India’s population uses Ayurvedic medicine ...

  11. COPD Medicine

    Science.gov (United States)

    ... Education & Training Home Treatment & Programs Medications COPD Medications COPD Medications Make an Appointment Ask a Question Refer ... control the symptoms of chronic obstructive pulmonary disease (COPD). Most people with COPD take long-acting medicine ...

  12. Nuclear medicine

    International Nuclear Information System (INIS)

    Blanquet, Paul; Blanc, Daniel.

    1976-01-01

    The applications of radioisotopes in medical diagnostics are briefly reviewed. Each organ system is considered and the Nuclear medicine procedures pertinent to that system are discussed. This includes, the principle of the test, the detector and the radiopharmaceutical used, the procedure followed and the clinical results obtained. The various types of radiation detectors presently employed in Nuclear Medicine are surveyed, including scanners, gamma cameras, positron cameras and procedures for obtaining tomographic presentation of radionuclide distributions [fr

  13. 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'

  14. Monitoring of the internal contamination of occupationally exposure personnel in services of nuclear medicine through the use of gamma cameras; Monitoreo de la contaminacion interna de personal ocupacionalmente expuesto en servicios de medicina nuclear mediante el uso de gamma camaras

    Energy Technology Data Exchange (ETDEWEB)

    Teran, M.; Paolino, A.; Savio, E. [Catedra de Radioquimica, Facultad de Quimica, Montevideo (Uruguay); Hermida, J.C. [Centro de Medicina Nuclear, Hospital de Clinicas, Facultad de Medicina, Montevideo (Uruguay); Dantas, B.M. [Laboratorio de Medidas In vivo, Instituto da Radioprotecao e Dosimetria, Rio de Janeiro (Brazil)

    2006-07-01

    time: 15 minutes; Detector- source distance: 20 cm. Under the determined conditions is possible to maintain the monitoring service of workers using gamma cameras like alternative method before the lack of an equipment of thyroid caption, allowing a work continuity without stopping the monitoring and the possibility opens up of implementing this methodology in nuclear medicine clinics far from the university center. (Author)

  15. Nuclear medicine resources manual

    International Nuclear Information System (INIS)

    2006-02-01

    Over the past decade many IAEA programmes have significantly enhanced the capabilities of numerous Member States in the field of nuclear medicine. Functional imaging using nuclear medicine procedures has become an indispensable tool for the diagnosis, treatment planning and management of patients. However, due to the heterogeneous growth and development of nuclear medicine in the IAEA's Member States, the operating standards of practice vary considerably from country to country and region to region. This publication is the result of the work of over 30 international professionals who have assisted the IAEA in the process of standardization and harmonization. This manual sets out the prerequisites for the establishment of a nuclear medicine service, including basic infrastructure, suitable premises, reliable supply of electricity, maintenance of a steady temperature, dust exclusion for gamma cameras and radiopharmacy dispensaries. It offers clear guidance on human resources and training needs for medical doctors, technologists, radiopharmaceutical scientists, physicists and specialist nurses in the practice of nuclear medicine. The manual describes the requirements for safe preparation and quality control of radiopharmaceuticals. In addition, it contains essential requirements for maintenance of facilities and instruments, for radiation hygiene and for optimization of nuclear medicine operational performance with the use of working clinical protocols. The result is a comprehensive guide at an international level that contains practical suggestions based on the experience of professionals around the globe. This publication will be of interest to nuclear medicine physicians, radiologists, medical educationalists, diagnostic centre managers, medical physicists, medical technologists, radiopharmacists, specialist nurses, clinical scientists and those engaged in quality assurance and control systems in public health in both developed and developing countries

  16. The association between the use of biomedical services and the holistic use of traditional East Asian medicine: a national survey of outpatients in South Korea.

    Science.gov (United States)

    Shim, Jae-Mahn; Lee, Yun-Suk

    2017-12-06

    The holistic use of a system of complementary and alternative medicine (CAM) is potentially linked to its treatment outcomes. This paper examines how the use of biomedicine is associated with the holistic use of CAM, focusing on traditional East Asian medicine (EM) that is uniquely integrated in the medical system in South Korea. A representative national sample of EM outpatients in South Korea. 3861 survey respondents. By using the 2011 Korean National Survey of EM patients, ordered logistic regression models specify the relationship between EM outpatients' use of biomedicine and their holistic use of EM modalities. Among EM outpatients who used at least one EM modality in the past 3 months, people who used two (33.3%) or three (29.4%) modalities together are the two highest proportions, followed by users of four (18.1%), five (7.2%), six (2.1%) and seven (0.6%) modalities. The odds for EM users to use EM holistically are 17% greater among EM users who used biomedicine as well, compared with EM users who did not use biomedicine. The healthcare community should recognise that CAM use likely becomes holistic as people use biomedicine concomitantly, when the practice rights over a CAM system are comprehensively and exclusively entitled to a group of CAM professionals who are independent from practitioners of biomedicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Travel medicine

    Science.gov (United States)

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

  18. Mesopotamian medicine.

    Science.gov (United States)

    Retief, F P; Cilliers, L

    2007-01-01

    Although the Mesopotamian civilisation is as old as that of Egypt and might even have predated it, we know much less about Mesopotamian medicine, mainly because the cuneiform source material is less well researched. Medical healers existed from the middle of the 3rd millennium. In line with the strong theocratic state culture, healers were closely integrated with the powerful priestly fraternity, and were essentially of three main kinds: barû (seers) who were experts in divination, âshipu (exorcists), and asû (healing priests) who tended directly to the sick. All illness was accepted as sent by gods, demons and other evil spirits, either as retribution for sins or as malevolent visitations. Treatment revolved around identification of the offending supernatural power, appeasement of the angry gods, for example by offering amulets or incantations, exorcism of evil spirits, as well as a measure of empirical therapy aimed against certain recognised symptom complexes. Medical practice was rigidly codified, starting with Hammurabi's Code in the 18th century BC and persisting to the late 1st millennium BC. Works like the so-called Diagnostic Handbook, the Assyrian Herbal and Prescription Texts describe the rationale of Mesopotamian medicine, based predominantly on supernatural concepts, although rudimentary traces of empirical medicine are discernible. There is evidence that Egyptian medicine might have been influenced by Mesopotamian practices, but Greek rational medicine as it evolved in the 5th/4th centuries BC almost certainly had no significant Mesopotamian roots.

  19. National phantoms bank for the service of nuclear medicine in Cuba. Utility for the quality control of the instrumentation; Banco de fantomas nacional para los servicios de medicina nuclear en Cuba. Utilidad para el control de calidad de la instrumentacion

    Energy Technology Data Exchange (ETDEWEB)

    Varela C, C.; Diaz B, M. [CCEEM, Calle 4 No. 455 (altos) e/19 y 21, Vedado, Ciudad Habana (Cuba); Lopez B, G.M. [CPHR, Calle 20 No. 4113 e/41 y 47, Playa Ciudad Habana (Cuba)]. e-mail: consuelo.varela@infomed.sld.cu

    2006-07-01

    Although, most of the applications in Nuclear Medicine have diagnostic ends, its going enlarging considerably the therapeutic applications. So that the diagnostic accuracy or the therapy effectiveness have not been affected, it becomes indispensable the quality control of the instrumentation, independently of its technological complexity and/or its exploitation period. Before the real lack of phantoms in the institutions, it was created a bank that puts to disposition of all the institutions, the existent phantoms in the country, and those that are going acquired, centralized by the State Control of Medical Equipment Center (CCEEM) and with Web access in its place www.eqmed.sld.cu. Having like base the elaboration of the National Protocol for the Quality Control of the Instrumentation in Nuclear Medicine that keeps in mind the international normative and the own existent conditions, were dictated and established two national regulations and its are being carried out the first audits to the instrumentation quality. These have evidenced the partial realization of the established quality controls in the services, the necessity to make aware as for the fulfillment of the criteria and quality concepts for the instrumentation, as well as the necessity to increase the phantoms number to the bank to guarantee the fulfillment of the Quality Control Programs. (Author)

  20. Medicines by Design

    Science.gov (United States)

    ... Home > Science Education > Medicines By Design Medicines By Design Spotlight Nature's Medicine Cabinet A Medicine's Life Inside ... hunt for drugs of the future. Medicines By Design in PDF | E-PUB Tell Us What You ...

  1. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  3. General Nuclear Medicine

    Science.gov (United States)

    ... Resources Professions Site Index A-Z General Nuclear Medicine Nuclear medicine imaging uses small amounts of radioactive ... of General Nuclear Medicine? What is General Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  4. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  6. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  7. Evaluation of internal occupational exposure of workers from nuclear medicine services by aerosol analysis containing {sup 131}I; Avaliacao da exposicao interna de trabalhadores em servicos de medicina nuclear atraves da analise de aerossois contendo {sup 131}I

    Energy Technology Data Exchange (ETDEWEB)

    Carneiro, Luana Gomes; Sampaio, Camilla da Silva; Dantas, Ana Leticia Almeida; Lucena, Eder Augusto; Santos, Maristela Souza; Dantas, Bernardo Maranhao, E-mail: carneiro@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ),Rio de Janeiro, RJ (Brazil); Paula, Gustavo Affonso de [Escola SESC de Ensino Medio, Rio de Janeiro, RJ (Brazil)

    2014-07-01

    This study evaluated the risk of internal occupational exposure associated with the incorporation of {sup 131}I via inhalation, in Nuclear Medicine Services, using aerosol analysis techniques. Occupationally Exposed Individuals (IOE) involved in handling this radionuclide are subject to chronic exposure, which can lead to an increase in the committed effective dose. Results obtained in preliminary studies indicate the occurrence of incorporation of {sup 131}I by workers involved in handling solutions for radioiodine therapy procedures. The evaluation was carried out in radiopharmacy lab (nuclear medicine service) of a public hospital located in the city of Rio de Janeiro. After confirmed the presence of the radioisotope, by a qualitative assessment, it was determined an experimental arrangement for sample collection and were detected and quantitated the presence of steam {sup 131}I during routine work. The average concentration of activity obtained in this study was 3 Bq / m{sup 3}. This value is below of Derived Concentration in Air (DCA) of 8.4 x 10{sup 3} Bq of {sup 131}I / m{sup 3} corresponding to a committed effective dose of 1.76 x 10{sup -4} mSv. These results demonstrate that the studied area is safe in terms of internal exposure of workers. However, the presence of {sup 131}I should be periodically reevaluated, since this type of exposure contributes to the increase of the individual effective doses. Based on the data obtained improvements were suggested in the exhaust system and the use of good work practices in order to optimize the exposures.

  8. [Medicinal cannabis].

    Science.gov (United States)

    Van der Meersch, H; Verschuere, A P; Bottriaux, F

    2006-01-01

    Pharmaceutical grade cannabis is available to Dutch patients from public pharmacies in the Netherlands. The first part of this paper reviews the pharmaceutical and pharmacological properties of medicinal cannabis. Detailed information about its composition and quality, potential applications, methods of administration, adverse reactions, drug interactions and safety during pregnancy or breastfeeding are given. The second part deals with the legal aspects of dispensing medicinal cannabis through pharmacies in view of the Belgian and Dutch legislation. The last part discusses the present Belgian regulation about the possession of cannabis.

  9. Nuclear medicine

    International Nuclear Information System (INIS)

    Reichelt, H.G.

    1980-01-01

    Nuclear medicine as a complex diagnostical method is used mainly to detect functional organic disorders, to locate disorders and for radioimmunologic assays (RIA) in vitro. In surgery, its indication range comprises the thyroid (in vivo and in vitro), liver and bile ducts, skeletal and joint diseases, disorders of the cerebro-spinal liquor system and the urologic disorders. In the early detection of tumors, the search for metastases and tumor after-care, scintiscanning and the tumor marcher method (CEA) can be of great practical advantage, but the value of myocardial sciritiscanning in cardiac respectively coronary disorders is restricted. The paper is also concerned with the radiation doses in nuclear medicine. (orig.) [de

  10. Operational reliability management; Gestao da confiabilidade operacional

    Energy Technology Data Exchange (ETDEWEB)

    Bressan, Edemir [Refinaria Alberto Pasqualini (REFAP), Canoas, RS (Brazil). Setor de Tecnologia de Equipamentos

    2000-07-01

    It is described the PETROBRAS Alberto Pasqualini Refinery process plant reliability management, strategies, maintenance organizational structure, management processes, predictive and preventive maintenance, condition monitoring techniques, reliability metrics, pointing out a need for close work relationship between production, maintenance and project engineering functions with highly qualified and committed proper teams, in order to reach one of the highest mechanical availability among Latin America refineries. (author)

  11. Implications of healing power and positioning for collaboration between formal mental health services and traditional/alternative medicine: the case of Ghana.

    Science.gov (United States)

    Kpobi, Lily; Swartz, Leslie

    2018-01-01

    Many current debates about global mental health have increasingly called for collaboration between biomedical and traditional medical health systems. Despite these calls, not much has been written about the variables that would influence such collaboration. To a large extent, collaboration dialogues have considered biomedicine on the one hand, and a wide range of traditional and faith-based treatments on the other hand. However, this dualistic bifurcation does not reflect the plurality of healing systems in operation in many contexts, and the diverse investments that different non-biomedical healing approaches may have in their own power to heal. We set out to explore the diversity of different healers' perceptions of power, and the relationship between that power and the perceived power of biomedical approaches. Through a qualitative design, and using the case of medical pluralism in urban Ghana as an example, we conducted interviews among different categories of traditional and alternative medicine (TAM) practitioners living and/or working in the Greater Accra Region of Ghana. Through thematic analyses, differences in the notions about collaboration between the different categories of healers were identified. Their perceptions of whether collaboration would be beneficial seemed, from this study, to co-occur with their perceptions of their own power. We suggest that an important way to move debates forward about collaboration amongst different sectors is to examine the notions of power and positioning of different categories of TAM healers in relation to biomedicine, and the attendant implications of those notions for integrative mental healthcare.

  12. [Monitoring of a protocol for the adequacy of the pharmaceutical form of the oral medication to the degree of dysphagia in patients hospitalized in an internal medicine service].

    Science.gov (United States)

    García Aparicio, J; Herrero Herrero, J I; Moreno Gómez, A Ma; Martínez Sotelo, J; González del Valle, E; Fernández de la Fuente, Ma A

    2011-01-01

    The oral route is the most convenient way of administering medication, although it may not be safe. Dysphagia is one of the factors rendering difficult a proper feeding and administration of medication. to improve the administration of oral medication in patients with dysphagia by changing the pharmaceutical formulation of the principles prescribed to tolerable textures. Pilot project for the application of a dysphagia protocol that included the patients admitted to the Internal Medicine Unit at Los Montalvos Center for 4 months. After detecting the suspicion of dysphagia, a dysphagia-viscosity test was applied to know the tolerated textures. Then, the pharmaceutical formulations were adapted and the manipulation instructions for the drugs were indicated for their proper administration. 23 out of 627 admitted patients were included, with a mean age of 85 years (σ±7.4). The pathologies implicated in dysphagia were: dementia (65.2%); cerebrovascular disease (30.4%), and Parkinson's disease (4.4%). The best texture for drug intake was a "pudding" in 48.0%. 43 active ingredients were reviewed and 134 interventions were performed: in 41% of the cases, swallowing was made easier by mixing the drug with the food and in 59% water and a thickener were used. 94% of the recommendations were considered to be appropriate. the adaptation of the pharmaceutical formulations to the degree of dysphagia impacts on the improvement of healthcare quality by implementing safety in drug prescription and administration processes.

  13. Performance evaluation of the activity meters of nuclear medicine services of the hospitals Rafael Angel Calderon, San Juan de Dios and Mexico during the period from July 1, 2008 to December 31, 2008

    International Nuclear Information System (INIS)

    Barahona Navarro, Alvaro; Binns Quiros, Natalia

    2009-01-01

    Nuclear medicine has used radioisotopes associated to drugs in order to get them to an organ of interest. The radioisotope has the quality to emit radiation, which passes through the body, after being admitted to it, and this is perceived by equipment such as a gamma camera to study the behavior of the organ under study. The radiation is a energy emission able to boot electrons from atoms and produce ions, thus the chemical composition may be altered, resulting in alterations in the cells. Conditions such as: a onreproductive of the cells, causing a tumor; or alterations in geminal cells, causing genetic alterations, which may occur in the offspring of an individual. For the above reason is that the use of radiopharmaceuticals should be as careful as possible, doing as little radiation exposure, without compromising the quality of the study, these should be applied with more important in more radiosensitive population such as children and older adults. The doses used in nuclear medicine are quantified using a device called activity meters and the proper functioning of the overexposures shall impose or low-quality studies doses outside the range of usefulness. The operation of these machines based on the quality control logs have been studied to discover if there are alterations in dosages of nuclear medicine departments of hospitals Calderon Guardia, San Juan de Dios and Mexico. Tests of zero settings, display, physical monitoring, high voltage, linearity test, stability, background radiation, precision, accuracy and consistency have been performed as quality control. This research is classified as non-experimental longitudinal quantitative. The study population was the record set and the realization of quality control tests made to the hospital activity meters above. The collection of data was performed by two steps, the first taking records concerning quality control of the different hospitals, completed tabulation, gratification and analysis of the same. The

  14. Mountain medicin

    DEFF Research Database (Denmark)

    Bay, Bjørn; Hjuler, Kasper Fjellhaugen

    2016-01-01

    medicine. The first part covered high-altitude physiology and medical aspects of objective alpine dangers and the increased exposure to ultraviolet radiation. This part covers altitude sickness, fluid balance, nutrition, and precautions for patients with pre-existing medical conditions, pregnant women...

  15. Personalized medicine

    DEFF Research Database (Denmark)

    Bendtzen, Klaus

    2013-01-01

    engineered anti-TNF-alpha antibody constructs now constitute one of the heaviest medicinal expenditures in many countries. All currently used TNF antagonists may dramatically lower disease activity and, in some patients, induce remission. Unfortunately, however, not all patients respond favorably, and safety...

  16. Predictive medicine

    NARCIS (Netherlands)

    Boenink, Marianne; ten Have, Henk

    2015-01-01

    In the last part of the twentieth century, predictive medicine has gained currency as an important ideal in biomedical research and health care. Research in the genetic and molecular basis of disease suggested that the insights gained might be used to develop tests that predict the future health

  17. Medicinal Mushrooms

    NARCIS (Netherlands)

    Lindequist, U.; Won Kim, H.; Tiralongo, E.; Griensven, van L.J.L.D.

    2014-01-01

    Since beginning of mankind nature is the most important source of medicines. Bioactive compounds produced by living organisms can be used directly as drugs or as lead compounds for drug development. Besides, the natural material can be used as crude drug for preparation of powder or extracts. Plants

  18. Medicinal Plants.

    Science.gov (United States)

    Phillipson, J. David

    1997-01-01

    Highlights the demand for medicinal plants as pharmaceuticals and the demand for health care treatments worldwide and the issues that arise from this. Discusses new drugs from plants, anticancer drugs, antiviral drugs, antimalarial drugs, herbal remedies, quality, safety, efficacy, and conservation of plants. Contains 30 references. (JRH)

  19. Nuclear medicine in Ghana

    International Nuclear Information System (INIS)

    Affram, R.K.; Kyere, K.; Amuasi, J.

    1991-01-01

    The background to the introduction and application of radioisotopes in medicine culminating in the establishment of the nuclear Medicine Unit at the Korle Bu Teaching Hospital, Ghana, has been examined. The Unit has been involved in important clinical researches since early 1970s but routine application in patient management has not always been possible because of cost per test and lack of continuous availability of convertible currency for the purchase of radioisotopes which are not presently produced by the National Nuclear Research Institute at Kwabenya. The capabilities and potentials of the Unit are highlighted and a comparison of Nuclear Medicine techniques to other medical diagnostic and imaging methods have been made. There is no organised instruction in the principles of medical imaging and diagnostic methods at both undergraduate and postgraduate levels in Korle Bu Teaching Hospital which has not promoted the use of Nuclear Medicine techniques. The development of a comprehensive medical diagnostic and imaging services is urgently needed. (author). 18 refs., 3 tabs

  20. How and when to get rid of unused medicines

    Science.gov (United States)

    ... location for disposal. Contact your local trash and recycling service to find out when the next event ... if: Someone consumes expired medicines accidentally or on purpose You have an allergic reaction to a medicine

  1. Environmental medicine

    International Nuclear Information System (INIS)

    Steneberg, A.

    1996-01-01

    'Environmental medicine' deals with the manifold health problems from environmental factors of chemical, physical and psychosocial origin that are possible or have been observed. The book gives insight into the current state of knowledge of environmental medicine institutions, possibilities of diagnosis and therapeutic methods. It offers a systematic overview of pollutant sources and pollutant effects and points out, inter alia, syndromes that are discussed in connection with environmental factors: not only allergies and carcinogenous diseases but also symptom complexes that are hard to diagnose by ordinary methods such as the sick-building syndrome, multiple sensitivity to chemicals, electrosensitivity, amalgam intoxications, disorders due to wood preservatives and fungal diseases. The lingering course of a disease and a set of symptoms varying from one patient to another are the rule, not the exception, because environmental diseases are due above all to the chronic uptake of low pollutant doses (orig./MG) [de

  2. Nuclear medicine

    International Nuclear Information System (INIS)

    Sibille, L.; Nalda, E.; Collombier, L.; Kotzki, P.O.; Boudousq, V.

    2011-01-01

    Nuclear medicine is a medical specialty using the properties of radioactivity. Radioactive markers associated with vectors are used as a tracer or radiopharmaceutical for diagnostic purposes and/or therapy. Since its birth more than half a century ago, it has become essential in the care of many patients, particularly in oncology. After some definitions, this paper presents the main nuclear techniques - imaging for diagnostic, radiopharmaceuticals as therapeutic agents, intra-operative detection, technique of radioimmunoassay - and the future of this field. (authors)

  3. Transfusion Medicine

    Directory of Open Access Journals (Sweden)

    Smit Sibinga CT

    2013-07-01

    Full Text Available Cees Th. Smit Sibinga ID Consulting, Zuidhorn, The NetherlandsTransfusion Medicine is a bridging science, spanning the evidence-based practice at the bedside with the social sciences in the community.     Transfusion Medicine starts at the bedside. Surprisingly, only recently that has become rediscovered with the development of ‘patient blood management’ and ‘patient centered’ approaches to allow the growth of an optimal and rational patient care through supportive hemotherapy – safe and effective, affordable and accessible.1    Where transfusion of blood found its origin in the need of a patient, it has drifted away for a long period of time from the bedside and has been dominated for almost a century by laboratory sciences. At least the first ten editions of the famous and well reputed textbook Mollison’s Blood Transfusion in Clinical Medicine contained only a fraction on the actual bedside practice of transfusion medicine and did not focus at all on patient blood management.2    This journal will focus on all aspects of the transfusion chain that immediately relate to the bedside practice and clinical use of blood and its components, and plasma derivatives as integral elements of a human transplant tissue. That includes legal and regulatory aspects, medical, ethical and cultural aspects, pure science and pathophysiology of disease and the impact of transfusion of blood, as well as aspects of the epidemiology of blood transfusion and clinical indications, and cost-effectiveness. Education through timely and continued transfer of up to date knowledge and the application of knowledge in clinical practice to develop and maintain clinical skills and competence, with the extension of current educational approaches through e-learning and accessible ‘apps’ will be given a prominent place.

  4. ENERGY MEDICINE

    OpenAIRE

    Srinivasan, T. M.

    1987-01-01

    Energy medicine is the most comprehensive concept introduced in medical diagnostics and therapy to account for a whole range of phenomena and methods available to help an individual proceed from sickness to health. The modern medical theories do not account for, much less accept many traditional therapies due to deep suspicion that the older methods are not scientific. However, the Holistic Health groups around the world have now created an environment for therapies which work at subtle energ...

  5. Transfusion medicine

    International Nuclear Information System (INIS)

    Murawski, K.; Peetoom, F.

    1986-01-01

    These proceedings contain 24 selections, including papers presented at the conference of American Red Cross held in May 1985, on the Subject of transfusion medicine. Some of the titles are: Fluosol/sup R/-DA in Radiation Therapy; Expression of Cloned Human Factor VIII and the Molecular Basis of Gene Defects that Cause Hemophilia; DNA-Probing Assay in the Detection of Hepatitis B Virus Genome in Human Peripheral Blood Cells; and Monoclonal Antibodies: Convergence of Technology and Application

  6. 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.

  7. Place and achieving a magistral preparation in a service of nuclear medicine: example of the IBZM; Place et realisation d`une preparation magistrale dans un service de medecine nucleaire: exemple de l`IBZM

    Energy Technology Data Exchange (ETDEWEB)

    Zimmer, L.; Baulieu, J.L.; Bugeon, S.; Besnard, J.C.; Guilloteau, D. [CHU Tours (France)

    1997-12-31

    The radio-pharmacist is competent and a legal licensee to realizing magistral preparations, defined in the book V of public health Code. We present here the case of a radiopharmaceutical drug prepared extemporary on a medical prescription, the labelling of BZM by iodine 123. The choice of this molecule is made after obtaining the indispensable pre-requisites (lack of noxiousness, teratogenicity, validation by pre-clinic studies, etc). The IBZM allows achieving the etiologic diagnosis of extra-pyramidal syndromes by scintigraphic visualisation of central D2 dopaminergic receptors. The magistral preparation of a radiopharmaceutical implies: (1). Identification of the row materials indispensable in warranting the labelling quality and innocuity of the final injected product. This is done by means of routine chemical reactions, described by France Pharmacopoeia or specifically established. Thus, all the row materials are tested and referenced prior to utilization. (2). The radio-labelling is effected in the day of the examination following a validated procedure: labelling of BZM by sodium iodate in buffer acid medium, extraction of formed IBZM by an organic solvent, purification of IBZM by HPCL, brought in injectable form by chromatographic passage (Sep Pack) and sterilizing filtration. (3). The test of final product is done prior to its injection by measuring the pH and co-elution by HPLC with the cool standard product. The IBZM is delivered providing its radiochemical purity is higher than 90%. A sterility test of preparation is effected a posteriori. The magistral preparation of IBZM allows neurological scintigraphic examinations, still unique in nuclear medicine. Other radiopharmaceuticals with cerebral use will be proposed to clinicians by radio-pharmacists. In all the these cases, the quality of injected labeller will be warranted by the same pharmaceutic approach

  8. Regenerative Medicine Build-Out

    Science.gov (United States)

    Pfenning, Michael A.; Gores, Gregory J.; Harper, C. Michel

    2015-01-01

    Summary Regenerative technologies strive to boost innate repair processes and restitute normative impact. Deployment of regenerative principles into practice is poised to usher in a new era in health care, driving radical innovation in patient management to address the needs of an aging population challenged by escalating chronic diseases. There is urgency to design, execute, and validate viable paradigms for translating and implementing the science of regenerative medicine into tangible health benefits that provide value to stakeholders. A regenerative medicine model of care would entail scalable production and standardized application of clinical grade biotherapies supported by comprehensive supply chain capabilities that integrate sourcing and manufacturing with care delivery. Mayo Clinic has rolled out a blueprint for discovery, translation, and application of regenerative medicine therapies for accelerated adoption into the standard of care. To establish regenerative medical and surgical service lines, the Mayo Clinic model incorporates patient access, enabling platforms and delivery. Access is coordinated through a designated portal, the Regenerative Medicine Consult Service, serving to facilitate patient/provider education, procurement of biomaterials, referral to specialty services, and/or regenerative interventions, often in clinical trials. Platforms include the Regenerative Medicine Biotrust and Good Manufacturing Practice facilities for manufacture of clinical grade products for cell-based, acellular, and/or biomaterial applications. Care delivery leverages dedicated interventional suites for provision of regenerative services. Performance is tracked using a scorecard system to inform decision making. The Mayo Clinic roadmap exemplifies an integrated organization in the discovery, development, and delivery of regenerative medicine within a growing community of practice at the core of modern health care. Significance Regenerative medicine is at the

  9. Regenerative Medicine Build-Out.

    Science.gov (United States)

    Terzic, Andre; Pfenning, Michael A; Gores, Gregory J; Harper, C Michel

    2015-12-01

    Regenerative technologies strive to boost innate repair processes and restitute normative impact. Deployment of regenerative principles into practice is poised to usher in a new era in health care, driving radical innovation in patient management to address the needs of an aging population challenged by escalating chronic diseases. There is urgency to design, execute, and validate viable paradigms for translating and implementing the science of regenerative medicine into tangible health benefits that provide value to stakeholders. A regenerative medicine model of care would entail scalable production and standardized application of clinical grade biotherapies supported by comprehensive supply chain capabilities that integrate sourcing and manufacturing with care delivery. Mayo Clinic has rolled out a blueprint for discovery, translation, and application of regenerative medicine therapies for accelerated adoption into the standard of care. To establish regenerative medical and surgical service lines, the Mayo Clinic model incorporates patient access, enabling platforms and delivery. Access is coordinated through a designated portal, the Regenerative Medicine Consult Service, serving to facilitate patient/provider education, procurement of biomaterials, referral to specialty services, and/or regenerative interventions, often in clinical trials. Platforms include the Regenerative Medicine Biotrust and Good Manufacturing Practice facilities for manufacture of clinical grade products for cell-based, acellular, and/or biomaterial applications. Care delivery leverages dedicated interventional suites for provision of regenerative services. Performance is tracked using a scorecard system to inform decision making. The Mayo Clinic roadmap exemplifies an integrated organization in the discovery, development, and delivery of regenerative medicine within a growing community of practice at the core of modern health care. Regenerative medicine is at the vanguard of health care

  10. Complementary and Alternative Medicine

    Science.gov (United States)

    ... for Educators Search English Español Complementary and Alternative Medicine KidsHealth / For Teens / Complementary and Alternative Medicine What's ... a replacement. How Is CAM Different From Conventional Medicine? Conventional medicine is based on scientific knowledge of ...

  11. Regulatory problems in nuclear medicine

    International Nuclear Information System (INIS)

    Vandergrift, J.F.

    1987-01-01

    Governmental involvement in the practice of medicine has increased sharply within the past few years. The impact on health care has, for the most part, been in terms of financial interactions between health care facilities and federally funded health services programs. One might say that this type of governmental involvement has indirect impact on the medical and/or technical decisions in the practice of nuclear medicine. In other areas, however, governmental policies and regulations have had a more direct and fundamental impact on nuclear medicine than on any other medical specialty. Without an understanding and acceptance of this situation, the practice of nuclear medicine can be very frustrating. This chapter is thus written in the hope that potential frustration can be reduced or eliminated

  12. Practical occupational medicine in "practice"

    DEFF Research Database (Denmark)

    Ingemann Larsen, Anders; Schmidt, Jan; Jepsen, Jørgen Riis

    2016-01-01

    with few occupational health resources. This Editorial argues that family physicians are indeed in a position where they can make a major positive difference for their working patients and for the enterprises where they work. Without specialist knowledge in occupational medicine, the family physician......’s empiric knowledge in combination with a narrative approach to the patient permits the contribution from family medicine not only with regard to diagnosis and treatment, but also relating to actions targeted to optimize the patient’s future accommodation at work as well as to protect other similarly......In Denmark, the practice of occupational medicine tends to be carried out by specialists in occupational medicine and less so by family physicians. The provision of health service to workers is therefore limited. This constraint may also apply in other developed countries and even more in countries...

  13. [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.

  14. Arizona TeleMedicine Project.

    Science.gov (United States)

    Arizona Univ., Tucson. Coll. of Medicine.

    Designed to provide health services for American Indians living on rurally isolated reservations, the Arizona TeleMedicine Project proposes to link Phoenix and Tucson medical centers, via a statewide telecommunications system, with the Hopi, San Carlos Apache, Papago, Navajo, and White Mountain Apache reservations. Advisory boards are being…

  15. Nuclear medicine

    International Nuclear Information System (INIS)

    Casier, Ph.; Lepage, B.

    1998-01-01

    Except for dedicated devices for mobile nuclear cardiology for instance, the market is set on variable angulation dual heads cameras. These cameras are suited for all general applications and their cost effectiveness is optimized. Now, all major companies have such a camera in their of products. But, the big question in nuclear medicine is about the future of coincidence imaging for the monitoring of treatments in oncology. Many companies are focused on WIP assessments to find out the right crustal thickness to perform both high energy FDG procedures and low energy Tc procedures, with the same SPECT camera. The classic thickness is 3/8''. Assessments are made with 1/2'', 5/8'' or 3/4'' crystals. If FDG procedures proved to be of great interest in oncology, it may lead to the design of a dedicated SPECT camera with a 1'' crustal. Due to the short half of FDG, it may be the dawning of slip ring technology. (e.g. Varicam from Elscint). The three small heads camera market seems to be depressed. Will the new three large heads camera unveiled by Picker, reverse that trend? The last important topic in nuclear medicine is the emergence of new flat digital detectors to get rid of the old bulky ones. Digirad is the first company to manufacture a commercial product based on that technology. Bichron, Siemens and General Electric are working on that development, too. But that technology is very expensive and the market for digital detection in nuclear medicine is not as large as the market in digital detection in radiology. (author)

  16. Building emergency medicine in Ethiopia | IDRC - International ...

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

    2014-09-05

    Sep 5, 2014 ... Ethiopia faces a critical gap in emergency medical care. ... Dr Biruk Germa, Senior Emergency Medicine Resident at Addis Ababa University, also ... The issue Inaccessibility to veterinary services in Ethiopia's livestock sector.

  17. Postgraduate education in internal medicine in Europe.

    Science.gov (United States)

    Cranston, Mark; Slee-Valentijn, Monique; Davidson, Christopher; Lindgren, Stefan; Semple, Colin; Palsson, Runolfur

    2013-10-01

    Limited information exists on the framework and content of postgraduate education in internal medicine in Europe. This report describes the results of a survey of postgraduate training in internal medicine in the European countries. Two online questionnaire-based surveys were carried out by the European Board of Internal Medicine, one on the practice of internists and the other on postgraduate training in internal medicine. The national internal medicine societies of all 30 member countries of the European Federation of Internal Medicine were invited to participate. The responses were reviewed by internal medicine residents from the respective countries and summaries of the data were sent to the national societies for approval. Descriptive analysis of the data on postgraduate training in internal medicine was performed. Twenty-seven countries (90%) completed the questionnaire and approved their datasets. The length of training ranged from four to six years and was commonly five years. The majority of countries offered training in internal medicine and a subspecialty. A common trunk of internal medicine was frequently a component of subspecialty training programmes. Hospital inpatient service was the predominant setting used for training. A final certifying examination was in place in 14 countries. Although some similarities exists, there appear to be significant differences in the organisation, content and governance of postgraduate training in internal medicine between the European countries. Our findings will prove invaluable for harmonisation of training and qualification in internal medicine in Europe. © 2013.

  18. Nuclear medicine

    International Nuclear Information System (INIS)

    James, A.E. Jr.; Squire, L.F.

    1977-01-01

    The book presents a number of fundamental imaging principles in nuclear medicine. The fact that low radiation doses are sufficient for the study of normal and changed physiological functions of the body is an important advancement brought about by nuclear medicine. The possibility of quantitative investigations of organs and organ regions and of an assessment of their function as compared to normal values is a fascinating new diagnostic dimension. The possibility of comparing the findings with other pathological findings and of course control in the same patient lead to a dynamic continuity with many research possibilities not even recognized until now. The limits of nuclear scanning methods are presented by the imprecise structural information of the images. When scintiscans are compared with X-ray images or contrast angiography, the great difference in the imaging of anatomical details is clearly seen. But although the present pictures are not optimal, they are a great improvement on the pictures that were considered clinically valuable a few years ago. (orig./AJ) [de

  19. [Challenges of Digital Medicine].

    Science.gov (United States)

    Blaser, Jürg

    2018-06-01

    Challenges of Digital Medicine Abstract. Digitization is increasingly covering more and more sectors, including medicine. To ensure medical operation 365 × 24 hours, progressively more human and financial resources are necessary. The transformation of patient histories from paper into electronic patient records focused initially on documentation. Today, hospital information systems are increasingly used as a platform for the communication of all professionals involved in the patient process - in Switzerland, however, so far without providing patients direct access to their data. Digititizing processes intend to increase efficiency, but also to enhance clinical and administrative decision support and quality assurance. The introduction of the electronic patient record in Switzerland in 2020 is expected to provide cross-company, more complete documentation of patient care. Multimorbid patients, often treated in different institutions and by different specialists, should benefit from this in particular. Advances in artificial intelligence offer new opportunities in medicine. Challenges include ensuring reliable data protection, and better interoperability of the systems involved. Semantically structured, machine-readable data exchange is a necessity for both networked services and internationally competitive research.

  20. Interpretive Medicine

    Science.gov (United States)

    Reeve, Joanne

    2010-01-01

    Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the

  1. Service availability and readiness for diabetes care at health ...

    African Journals Online (AJOL)

    EPHA USER33

    2Addis Ababa University, College of Health Science, School of Medicine, Department of Internal Medicine, ... Results: Among all health facilities, 59% of health facilities offer services for .... provide good-quality client services for diabetes,.

  2. Medicinal cannabis.

    Science.gov (United States)

    Murnion, Bridin

    2015-12-01

    A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations. Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy. However, evidence is limited, may reflect subjective rather than objective outcomes, and is not conclusive. Controversies lie in how to produce, supply and administer cannabinoid products. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community. The Regulator of Medicinal Cannabis Bill 2014 is under consideration in Australia to address this. Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion in Schedule 4.

  3. Narrativ medicin

    DEFF Research Database (Denmark)

    Hvas, Lotte; Getz, Linn

    2015-01-01

    Dagens allmänmedicin påverkas av ett växande managementtänkandetillsammans med fragmenterande ekonomiska incitament.Vårdens kvaliteter evalueras med nya metoder som ”värdebaseradvård” där värde räknas i kronor och ören. Produktion går före etik,och det intersubjektiva mötet mellan patient och läk...... läkare håller påatt nedvärderas. Perspektiven från narrativ medicin kan bidra tillatt visa vad som står på spel. Vilken blir annars berättelsen omallmänmedicinen?...

  4. Proposal of a methodology to be applied for the characterization of external exposure risk of employees in nuclear medicine services; Proposta de uma metodologia para caracterizacao de risco de exposicao externa de funcionarios de servicos de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Simoes, Rafael Figueiredo Pohlmann

    2010-07-01

    Nuclear medicine procedure requires the administration of radioactive material by injection, ingestion or inhalation. After incorporation, the patient becomes a mobile source of radiation and, after their examination; they can irradiate everyone on their way out of the Nuclear Medicine Service (NMS). A group of workers in this path is considered a critical group, but there are no conviction on this classification, because there are not measurements available. Thus, workers claiming for occupationally exposed individual's (OEI) rights are common. Employers are always in a complex situation, because if they decided to undertake the individual external monitoring of the critical working groups, the Court considers all as OEI and employers are taxed. On the other hand, if they do not provide monitoring, it is impossible to prove that these workers were not exposed to effective doses higher than individual annual public's limit and they lose the actions, too. This work proposes a methodology to evaluate, using TLD environmental monitors, air kerma rate at critical staff points in a NMS. This method provides relevant information about critical groups' exposure. From these results, the clinic or hospital may prove technically, without individual monitoring of employees, the classification of areas and can estimate the maximum flow of patients in the free areas which guarantees exposures below the public individual dose limit. This methodology has been applied successfully to a private clinic in Rio de Janeiro, which operates a NMS. The only critical group that received exposure statistically different from clinic background radiation was that on the antechamber of the NMS. This is a site that should be characterized as a supervised area and the group of workers in this environment as OEI, as the estimated extrapolated annual effective dose in this position was 1.2 +- 0.7 mSv/year, above the public annual limit (1,0 mSv/year). Normalizing by the number of

  5. Medicine safety and children

    Science.gov (United States)

    ... it is candy. What to Do If Your Child Takes Medicine If you think your child has taken medicine, call the poison control center ... blood pressure monitored. Preventing Medicine Mistakes When giving medicine to your young child, follow these safety tips: Use medicine made only ...

  6. 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...

  7. 21 CFR 868.5640 - Medicinal nonventilatory nebulizer (atomizer).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medicinal nonventilatory nebulizer (atomizer). 868... SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5640 Medicinal nonventilatory nebulizer (atomizer). (a) Identification. A medicinal nonventilatory nebulizer (atomizer) is a...

  8. 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...

  9. [80 years of soial service in medicine].

    Science.gov (United States)

    Hace 80 años, la Escuela de Medicina de la Universidad Nacional, en voz de su director, Gustavo Baz Prada, hizo una propuesta que pronto se convirtió en realidad y finalmente en norma, la que desde entonces se conoce como SS. Esta iniciativa se vio como una manera para que los estudiantes de medicina del último año retribuyeran a la sociedad una parte de lo que esta invirtió en su educación, consolidaran su formación mediante la exposición a las realidades de todos los días en los medios más necesitados, se pusieran a prueba sobre sus verdaderas capacidades para atender pacientes y participaran en la solución de un problema de atención sanitaria que en ese entonces era mucho más apremiante que ahora. Unos años después, los recién egresados de otras licenciaturas (pasantes) también fueron incorporados a esta estrategia y, al fin, se reconoció formalmente como una responsabilidad de las instituciones educativas. Las aportaciones del SS a la salud de las personas y a la formación de los médicos han sido incuestionables, y la experiencia humana que ha representado para quienes lo han vivido ha dejado marcas indelebles.

  10. CERN technology in the service of medicine

    CERN Multimedia

    2001-01-01

    The prototype of the first module of the LInac BOster (LIBO) has been constructed and tested at CERN. This new medical accelerator offers new perspectives in deep-seated tumour treatment.   Accelerator technology developed at CERN is set to bring about important advances in cancer therapy. The linac booster - LIBO - project aims to build a 3GHz proton linear accelerator to boost to 200 MeV the energy of the beam from 50-70 MeV cyclotrons, existing in several hospitals and laboratories. This will allow deep-seated tumours to be treated (see box). The prototype of the first LIBO module has just passed high power RF tests at CERN. Two members of the LIBO collaboration, Riccardo Zennaro and Paolo Berra, with the first LIBO module installed in the LIL tunnel. The LIBO idea goes back to 1993 when it was conceived by CERN's Ugo Amaldi, founder of Italy's TERA foundation. From the beginning, Mario Weiss, a former CERN staff member has led the project. A decisive step was taken in 1998 when a collaboration...

  11. Expiry of medicines in supply outlets in Uganda.

    Science.gov (United States)

    Nakyanzi, Josephine Katabaazi; Kitutu, Freddy Eric; Oria, Hussein; Kamba, Pakoyo Fadhiru

    2010-02-01

    The expiry of medicines in the supply chain is a serious threat to the already constrained access to medicines in developing countries. We investigated the extent of, and the main contributing factors to, expiry of medicines in medicine supply outlets in Kampala and Entebbe, Uganda. A cross-sectional survey of six public and 32 private medicine outlets was done using semi-structured questionnaires. The study area has 19 public medicine outlets (three non-profit wholesalers, 16 hospital stores/pharmacies), 123 private wholesale pharmacies and 173 retail pharmacies, equivalent to about 70% of the country's pharmaceutical businesses. Our findings indicate that medicines prone to expiry include those used for vertical programmes, donated medicines and those with a slow turnover. Awareness about the threat of expiry of medicines to the delivery of health services has increased. We have adapted training modules to emphasize management of medicine expiry for pharmacy students, pharmacists and other persons handling medicines. Our work has also generated more research interest on medicine expiry in Uganda. Even essential medicines expire in the supply chain in Uganda. Sound coordination is needed between public medicine wholesalers and their clients to harmonize procurement and consumption as well as with vertical programmes to prevent duplicate procurement. Additionally, national medicine regulatory authorities should enforce existing international guidelines to prevent dumping of donated medicine. Medicine selection and quantification should be matched with consumer tastes and prescribing habits. Lean supply and stock rotation should be considered.

  12. Knowledge Management in Nuclear Medicine

    International Nuclear Information System (INIS)

    Abaza, A.

    2017-01-01

    The last two decades have seen a significant increase in the demand for medical radiation services following the introduction of new techniques and technologies that has led to major improvements in the diagnosis and treatment of human diseases. The diagnostic and therapeutic applications of nuclear medicine techniques play a pivotal role in the management of these diseases, improving the quality of life of patients by means of an early diagnosis allowing opportune and proper therapy. On the other hand, inappropriate or unskilled use of these technologies can result in potential health hazards for patients and staff. So, there is a need to control and minimize these health risks and to maximize the benefits of radiation in medicine. The present study aims to discuss the role of nuclear medicine technology knowledge and scales in improving the management of patients, and raising the awareness and knowledge of nuclear medicine staff regarding the use of nuclear medicine facilities. The practical experience knowledge of nuclear medicine staff in 50 medical centers was reviewed through normal visiting and compared with the IAEA Published documents information. This review shows that the nuclear medicine staff has good technology knowledge and scales during managing patients as compared to IAEA Published information regarding the radiation protection measures and regulation. The outcome of the study reveals that competent authority can improve radiation safety in medical settings by developing and facilitating the implementation of scientific evidence-based policies and recommendations covering nuclear medicine technology focusing in the public health aspects and considering the risks and benefits of the use of radiation in health care. It could be concluded that concerted and coordinated efforts are required to improve radiation safety, quality and sustain ability of health systems

  13. Medicine organizer

    Science.gov (United States)

    Martins, Ricardo; Belchior, Ismael

    2015-04-01

    In the last year of secondary school, students studying physics and chemistry are incentivized to do a project where they must put in practice their improvement of scientific knowledge and skills, like observation of phenomena and analysis of data with scientific knowledge. In this project a group of students, tutored by the teacher, wanted to build an instrument that helps people to take their medical drugs at the right time. This instrument must have some compartments with an alarm and an LED light where the people can put their medical drugs. The instrument must be easily programed using an android program that also registers if the medicine has been taken. The students needed to simulate the hardware and software, draw the electronic system and build the final product. At the end of the school year, a public oral presentation was prepared by each group of students and presented to the school community. They are also encouraged to participate in national and international scientific shows and competitions.

  14. Research medicine

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    In Section I of this annual report, a brief summary of work is presented by the Research Medicine Group. The major emphasis has been the study of the blood system in man with a special emphasis on the examination of platelet abnormalities in human disease. New programs of major importance include the study of aging or dementia of the Alzheimer's type. A differential diagnosis technique has been perfected using positron emission tomography. Studies on the biochemical basis of schizophrenia have proceeded using radioisotope studies which image physiological and biochemical processes. In the investigation of atherosclerosis, techniques have been developed to measure blood perfusion of the heart muscle by labelling platelets and lipoproteins. Progress is reported in a new program which uses NMR for both imaging and spectroscopic studies in humans. The group has determined through an epidemiological study that bubble chamber and cyclotron workers who have been exposed to high electromagnetic fields for two decades have no significant increases in the prevalence of 21 diseases as compared with controls

  15. Determination of radiochemistry purity and pH of radiopharmaceutical in Northeast nuclear medicine services; Determinacao da pureza radioquimica e pH de radiofarmacos em servicos de medicina nuclear do Nordeste

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Wellington; Santos, Poliane, E-mail: wellington.gandrade@gmail.com, E-mail: polianeangelo@gmail.com [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil); Lima, Fernando de Andrade; Lima, Fabiana Farias de, E-mail: falima@cnen.gov.br, E-mail: ffmima@cnen.gov.br [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil)

    2013-07-01

    The radiopharmaceutical is a chemical compound associated with a radionuclide, which is selected so that meets the need cf diagnosis and capable of producing quality images. Drugs labeled with {sup 99m}Tc radionuclide kits consist of lyophilized, and be handled by the nuclear medicine services (NMS) must pass tests as the resolution of ANVISA (RDC 38) published in 2008. Among these tests are those of radiochemical purity and pH determination. This study evaluated the radiochemical purity of radiopharmaceuticals and pH SMN manipulated in the Northeast. The radiochemical purity (RCP) was determined by thin layer chromatography, which were used Whatman Registered-Sign and silica gel, with dimensions of 1 x 10 cm, as stationary phase, and solvents indicated in the inserts of manufacturers. The chromatographic strips were placed in sealed containers so as not to touch the walls thereof. After the chromatographic run, the tape was cut every centimeter and the activities determined in doses of each calibrator NMS. The pH of the radiopharmaceutical was assessed through the use of universal pH paper (Merck Registered-Sign ) and obtained staining compared with its color scale. The results showed (hat 82.6% and 100% of the radiopharmaceuticals of the samples were within the limits recommended by international pharmacopoeias for radiochemical purity and pl-l, respectively. There is then the need to include in routine tests indicated SMN by ANVISA. Well, they can detect possible problems in the marking of radiopharmaceuticals administered to the patient and avoid inappropriate material. (author)

  16. NEUMOCISTOSIS EN EL SERVICIO DE MEDICINA INTERNA, COMPLEJO HOSPITALARIO UNIVERSITARIO “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012 I PNEUMOCYSTOSIS IN THE INTERNAL MEDICINE SERVICE, UNIVERSITY HOSPITAL COMPLEX “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012

    Directory of Open Access Journals (Sweden)

    Fadi Wahab-El-Fatairi

    2015-07-01

    Full Text Available In Venezuela and in the state Anzoátegui, the pneumocystosis, is little studied. To weigh that it is an infection opportunist caused by Pneumocystis jirovecii, it causes pneumonia of high morbility and mortality. The inmunocompromised patient is those that present bigger risks of acquiring this infection. The objectives of this investigation were to determine the infection frequency for P. jirovecii in patient with breathing symptoms and immunocompromised hospitalized in the Service of Internal Medicine of the Complex Hospital University “Dr. Luis Razetti", and to describe the clinical parameters, of laboratory, radiological and epidemic. To increase the sensibility of the diagnosis etiologic of the pneumocystosis you employment the combination of microscopic methods (Giemsa and direct immunofluorescence technique. 52 samples of spontaneous sputum were studied, which were processed by fluidification -concentration. Results: 8 patients (15.38% they were positive. The most frequent clinical manifestations among the patients with pneumocystosis were the dyspnea (75%, cough (62% and bullous (50% they were the most common signs among those infected, the one infiltrated alveolar (62.5% and the spill pleural (37.5% they prevailed as radiological signs. Was the LDH presented in values 300 UI/L in 5 of the positive patients. Other common discoveries were: moderate anemia and breathing alkalosis. The evaluated epidemic aspects were the gender, occupation, smoking, accumulation and comorbidities, in this last aspect, the diabetes, hypertension and infection for the VIH was opposing comorbidities among these patients. The confirmation of the infection in the state Anzoátegui, demonstrates that in this hospital the agent exists and probably you this underdiagnosticated the pneumocystosis.

  17. Cough & Cold Medicine Abuse

    Science.gov (United States)

    ... Videos for Educators Search English Español Cough & Cold Medicine Abuse KidsHealth / For Teens / Cough & Cold Medicine Abuse ... resfriado Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  18. Complementary and Integrative Medicine

    Science.gov (United States)

    ... medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine. Complementary medicine is used together with mainstream medical ...

  19. Depression - stopping your medicines

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000570.htm Depression - stopping your medicines To use the sharing features ... prescription medicines you may take to help with depression, anxiety, or pain. Like any medicine, there are ...

  20. Cold medicines and children

    Science.gov (United States)

    ... ingredient. Avoid giving more than one OTC cold medicine to your child. It may cause an overdose with severe side ... the dosage instructions strictly while giving an OTC medicine to your child. When giving OTC cold medicines to your child: ...

  1. Traveling Safely with Medicines

    Science.gov (United States)

    ... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...

  2. Blood banking and transfusion medicine for the nephrologist.

    Science.gov (United States)

    Wehrli, Gay

    2012-01-01

    Therapeutic Apheresis Medicine Services work closely with Blood Banking and Transfusion Medicine Services (BBTMS). The BBTMS performs patient testing and provides blood components for patients undergoing therapeutic apheresis procedures. This article will provide an overview of blood component descriptions, patient testing, and blood component options and preparations for therapeutic apheresis procedures. © 2012 Wiley Periodicals, Inc.

  3. Ethnoveterinary Medicine: The prospects of integrating medicinal ...

    African Journals Online (AJOL)

    Medicinal plants products are part of the natural products that have been in use in traditional medicine and also a source of novel drugs. Therefore, the use of medicinal plant products would be a rational alternative to synthetic drugs. Ethnobotanical surveys carried out in many parts of Kenya have revealed a lot of plants ...

  4. The future of general medicine.

    Science.gov (United States)

    Firth, John

    2014-08-01

    It is a truth universally acknowledged that there is a problem with general medicine. Physicians have become increasingly specialised over the past 30 years or so, and specialist care has produced increasingly better outcomes for some patients. The patients left behind are looked after by general medicine, where demand is increasing, operational priority within hospitals is low, there is little professional kudos and recruitment is suffering. Three recent reports - Hospitals on the Edge?, the Future Hospital Commission report, and the Shape of Training report - have described the problems, but not articulated compelling solutions. Here, I discuss what is good about general medicine, what is bad and make suggestions for improvement. These involve getting specialities to take responsibility for care of appropriate admissions automatically and without delay, giving general physicians control over the service that they provide, and using well-chosen financial drivers to support movement in the right direction. © 2014 Royal College of Physicians.

  5. Medicines, excipients and dietary intolerances.

    Science.gov (United States)

    2016-08-01

    Medicinal products contain not only active drugs but also other ingredients included for a variety of purposes and collectively known as excipients.(1) People who wish to avoid a specific substance because of an allergy or intolerance may ask a healthcare professional about the constituents of a medicine and whether an alternative is available. In a previous article we discussed the issues facing people who wish to avoid certain substances for religious or cultural reasons.(2) Here, we provide an overview of several dietary conditions and the pharmaceutical issues that need to be considered by healthcare professionals advising on the suitability of a medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Obstetric medicine

    Directory of Open Access Journals (Sweden)

    L. Balbi

    2013-05-01

    Full Text Available BACKGROUND Obstetric assistance made major advances in the last 20 years: improved surgical technique allows quicker caesarean sections, anaesthesiology procedures such as peripheral anaesthesia and epidural analgesia made safer operative assistance, remarkably reducing perioperative morbidity and mortality, neonatology greatly improved the results of assistance to low birth weight newborns. A new branch of medicine called “obstetric medicine” gained interest and experience after the lessons of distinguished physicians like Michael De Swiet in England. All together these advances are making successful pregnancies that 20 years ago would have been discouraged or even interrupted: that’s what we call high risk pregnancy. High risk of what? Either complications of pregnancy on pre-existing disease or complications of pre-existing disease on pregnancy. Nowadays, mortality in pregnancy has a medical cause in 80% of cases in Western countries (Confidential Enquiry on Maternal Deaths, UK, 2004. DISCUSSION The background is always changing and we have to take in account of: increase of maternal age; widespread use of assisted fertilization techniques for treatment of infertility; social feelings about maternity desire with increasing expectations from medical assistance; immigration of medically “naive” patients who don’t know to have a chronic disease, but apt and ready to conceive; limited knowledge of feasibility of drug use in pregnancy which may induce both patients and doctors to stopping appropriate drug therapy in condition of severe disease. Preconception counseling, planning the pregnancy, wise use of drugs, regular follow-up throughout the pregnancy and, in selected cases, preterm elective termination of pregnancy may result in excellent outcome both for mother and foetus. CONCLUSIONS Highly committed and specifically trained physicians are required to counsel these patients and to plan their treatment before and during pregnancy.

  7. Medicines for sleep

    Science.gov (United States)

    Benzodiazepines; Sedatives; Hypnotics; Sleeping pills; Insomnia - medicines; Sleep disorder - medicines ... are commonly used to treat allergies. While these sleep aids are not addictive, your body becomes used ...

  8. Translational research in medicine

    Directory of Open Access Journals (Sweden)

    Bakir Mehić

    2011-05-01

    Full Text Available Translational medicine is a medical practice based on interventional epidemiology. It is regarded by its proponents as a natural progression from Evidence-Based Medicine. It integrates research from the basic sciences, social sciences and political sciences with the aim of optimizing patient care and preventive measures which may extend beyond healthcare services. In short, it is the process of turning appropriate biological discoveries into drugs and medical devices that can be used in the treatment of patients.[1]Scientific research and the development of modern powerful techniques are crucial for improving patient care in a society that is increasingly demanding the highest quality health services.[2] Indeed, effective patient care requires the continuous improvement of knowledge on the pathophysiology of the diseases, diagnostic procedures and therapeutic tools available. To this end, development of both clinical and basic research in health sciences is required. However, what is most effective in improving medical knowledge, and hence patient care, is the cross-fertilization between basic and clinical science. This has been specifically highlighted in recent years with the coining of the term “translational research”.[3] Translational research is of great importance in all medical specialties.Translational Research is the basis for Translational Medicine. It is the process which leads from evidence based medicine to sustainable solutions for public health problems.[4] It aims to improve the health and longevity of the world’s populations and depends on developing broad-based teams of scientists and scholars who are able to focus their efforts to link basic scientific discoveries with the arena of clinical investigation, and translating the results of clinical trials into changes in clinical practice, informed by evidence from the social and political sciences. Clinical science and ecological support from effective policies can

  9. Use of thin layer chromatography for the determination of radiochemical purity of radiopharmaceuticals in nuclear medicine services of Paraiba and Rio Grande do Norte, Brazil; Utilizacao da cromatografia em camada delgada para determinacao da pureza radioquimica de radiofarmacos em servicos de medicina nuclear da Paraiba e Rio Grande do Norte, Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, W.G.; Santos, P.A.L.; Lima, F.R.A. [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Programa de Pos-Graduacao em Tecnologia Energetica; Lima, F.F., E-mail: wellington.gandrade@gmail.com [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil)

    2012-07-01

    The paper chromatography and the thin layer chromatography are separation techniques in which the radioactive components migrate because of their affinity with the eluent (mobile phase) or stationary phase, respectively. In radiopharmaceuticals labeled with {sup 99m}Tc, besides its own radiopharmaceutical, {sup 99m}TcO{sup 4-} free and TcO{sub 2} can be identified and quantified. The evaluation of radiochemical purity of radiopharmaceuticals is essential to produce images free of artifacts as well as avoid unnecessary absorbed dose to the patient. Once they are managed in humans it is important and necessary that they undergo to strict quality control. Because of this, ANVISA in its 'Resolucao da Diretoria Colegiada (RDC) 38 of June 4th, 2008 states the obligation of performing a minimum of tests in nuclear medicine services routine prior to human administration. This work evaluated, by the method of thin layer chromatography (TLC), radiochemical purity, determined the pH of the radiopharmaceutical DEXTRAN- 500, DMSA, DTPA, PHYTATE, MDP, MIBI and Sn-Col used in nuclear medicine services in the states of Paraiba and Rio Grande do Norte - Brazil. The results show that the use of thin layer chromatography (TLC) as a standard method in routine of nuclear medicine services is possible, because it provides important data for the evaluation of radiochemical purity, allowing the exclusion of a radiopharmaceutical poorly marked. (author)

  10. A Practice of Social Medicine

    Directory of Open Access Journals (Sweden)

    Sidney Kark

    2006-08-01

    Full Text Available SOCIAL MEDICINE may be regarded as a practice of medicine concerned with health and disease as a function of group living. It is interested in the health of people in relation to their behaviour in social groups and as such is concerned with care of the individual patient as a member of a family and of other significant groups in his daily life. It is also concerned with the health of these groups as such and with that of the whole community as a community. Concern with the health needs of larger communities and territorial groups such as cities, regions and nations is also an important area of social medicine in which the public health physician is involved. Special interest groups have been the focus of attention of yet other practitioners of social medicine. Children at school, university students and occupational groups are among the more important of these groups for whom special health services, oriented to their specific needs, have been developed. Less formal groupings are now receiving increasing attention by those concerned with community health services, such as the family, in which the relationships between the members have intimate and enduring qualities. Other significant informal groups, in which face-to-face relationships are characteristic, are friendship groups, play groups of children and the neighbourhood community, in rural village or urban neighbourhood.

  11. Moral imperatives for academic medicine.

    Science.gov (United States)

    Thompson, J N

    1997-12-01

    As the health care system becomes dominated by managed care, academic medicine must do more than simply learn how to continue to offer the same level of care with ever-tightening resources and in new practice environments. Three moral imperatives must guide how medicine is practiced and taught: (1) patients' health and well-being must always be foremost, centered in quality of care and respect for life; (2) the emotional and spiritual needs of patients must be considered, not just the physical needs; (3) academic medicine must instill in its trainees discipline, passion, and skills to meet their obligation to be lifelong learners. These imperatives make it more important than ever for medical educators to tackle two crucial questions: What kind of person makes the best possible physician? And what constitutes the best possible training for that person? Taking these questions seriously in the new era of health care may mean that medical educators need to rethink the teaching of medicine. One example of how this might be done is the Curriculum for 2002 Committee recently formed at the Wake Forest University School of Medicine. It is becoming clear that medical educators can do a better and more comprehensive job of helping future physicians uncover and strengthen their own morality and, in the face of managed care's pressures, renew their loyalty to medicine as a service rather than a business. Morally sensitized physicians can better deal with the hard issues of medicine, such as euthanasia and abortion, and can help their students examine these issues. Most important, they can show their students that physicians are members of a moral community dedicated to something other than its own self-interest.

  12. Nuclear Medicine Practice in Kenya

    International Nuclear Information System (INIS)

    Ndrirangu, T.T.

    2017-01-01

    Nuclear medicine is a medical specialty that relies on the use of nuclear technology in the diagnosis and treatment (therapy) of diseases. Nuclear medicine uses the principle that a certain radiopharmaceutical (tracer) will at a certain point in time have a preferential uptake by a particular body, tissue or cell. Unlike other radiation applications for medical use, nuclear medicine uses open (unsealed) sources of radiation. The tracer is introduced into the body of the patient through several routes (oral, intravenous, percutaneous, intradermally, inhalation, intracapsular etc) and s/he becomes the source of radiation. Early diagnosis of diseases coupled with associated timely therapeutic intervention will lead to better prognosis. In a country with an estimated population of 42 million in 2017, Kenya has only two (2) nuclear medicine facilities (units) that is Kenyatta National Hospital - Public facility and Aga Khan University Hospital which is a Private facility. Being a relatively new medical discipline in Kenya, several measures have been taken by the clinical nuclear medicine team to create awareness at various levels. Kenya does not manufacture radiopharmaceuticals. We therefore have to import them from abroad and this makes them quite expensive, and the process demanding. There is no local training in nuclear medicine and staff have to be sent abroad for training, making this quite expensive and cumbersome and the IAEA has been complimenting in this area. With concerted effort by all stakeholders at the individual, national and international level, it is possible for Kenya to effectively sustain clinical nuclear medicine service not only as a diagnostic tool in many disease entities, but also play an increasingly important role in therapy

  13. Multimedia services in intelligent environments recommendation services

    CERN Document Server

    Virvou, Maria; Jain, Lakhmi

    2013-01-01

    Multimedia services are now commonly used in various activities in the daily lives of humans. Related application areas include services that allow access to large depositories of information, digital libraries, e-learning and e-education, e-government and e-governance, e-commerce and e-auctions, e-entertainment, e-health and e-medicine, and e-legal services, as well as their mobile counterparts (i.e., m-services). Despite the tremendous growth of multimedia services over the recent years, there is an increasing demand for their further development. This demand is driven by the ever-increasing desire of society for easy accessibility to information in friendly, personalized and adaptive environments. In this book at hand, we examine recent Recommendation Services. Recommendation services appear in the mobile environment, medicine/biology, tourism, education, and so on. The book includes ten chapters, which present various recently developed recommendation services. This research book is directed to professors...

  14. TRADITIONAL CHINESE HERBAL MEDICINE

    NARCIS (Netherlands)

    ZHU, YP; WOERDENBAG, HJ

    1995-01-01

    Herbal medicine, acupuncture and moxibustion, and massage and the three major constituent parts of traditional Chinese medicine. Although acupuncture is well known in many Western countries, Chinese herbal medicine, the mos important part of traditional Chinese medicine, is less well known in the

  15. [Structure of pain management facilities in Germany : Classification of medical and psychological pain treatment services-Consensus of the Joint Commission of the Professional Societies and Organizations for Quality in Pain Medicine].

    Science.gov (United States)

    Müller-Schwefe, G H H; Nadstawek, J; Tölle, T; Nilges, P; Überall, M A; Laubenthal, H J; Bock, F; Arnold, B; Casser, H R; Cegla, T H; Emrich, O M D; Graf-Baumann, T; Henning, J; Horlemann, J; Kayser, H; Kletzko, H; Koppert, W; Längler, K H; Locher, H; Ludwig, J; Maurer, S; Pfingsten, M; Schäfer, M; Schenk, M; Willweber-Strumpf, A

    2016-06-01

    On behalf of the Medical/Psychological Pain Associations, Pain Patients Alliance and the Professional Association of Pain Physicians and Psychologists, the Joint Commission of Professional Societies and Organizations for Quality in Pain Medicine, working in close collaboration with the respective presidents, has developed verifiable structural and process-related criteria for the classification of medical and psychological pain treatment facilities in Germany. Based on the established system of graded care in Germany and on existing qualifications, these criteria also argue for the introduction of a basic qualification in pain medicine. In addition to the first-ever comprehensive description of psychological pain facilities, the criteria presented can be used to classify five different levels of pain facilities, from basic pain management facilities, to specialized institutions, to the Centre for Interdisciplinary Pain Medicine. The recommendations offer binding and verifiable criteria for quality assurance in pain medicine and improved pain treatment.

  16. [Cross-sectional study of heart failure of patients intaked in an internal medicine service in the third level hospital in mixed area. Part II: prevalence and hypertension control].

    Science.gov (United States)

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

    2007-07-01

    To know the arterial hypertension prevalencia and hypertension control in the patients income by heart failure. A cross-sectional study of the intaked patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analysed were: sex, age, days of hospital stay, number of intaked by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with qualitative and quantitative measures, chi-cuadrado and t-student, and multivariant analyses. 248 patients were accepted for the study, and 100 were hypertensive patients (41.8%). We observed more women than men in hypertensive group (63.0%) and in non hypertensive group (51.1%). The median age was 77 years old in both groups. The median income was 11 days. The number of patients with diabetes mellitus and ischemic cardiopathy was bigger in hypertension group (43.0 vs. 22.3%), p < 0.001; (38 vs. 21.6%), p = 0.005. The most frequent symptom was the dyspnea (66,9%), in both groups, p = 0.62. The 62.6% of the patients were bad control of blood pressures. The prevalence of bad control in hypertensive patients was bigger tha non-hypertensive patients (76.9 vs. 59.4%, p = 0.01). The pharmacologic treatment more prescribed in hypertensive patients ECAI or AAR-II (62.6 vs. 26.8%, p < 0.001). And the diuretics wee more prescribed in non-hypertensive patients (91.1 vs. 81.1%, p = 0.03). The prevalence of diabetes mellitus is associated with hypertension in the patients. The ECAI prescription was acceptable. The number of echocardiograms practiced to the patients is smaller that the number advised by international associations and smaller to the cardiologist registers. The beta

  17. Alternative Medicine and the Ethics Of Commerce.

    Science.gov (United States)

    Macdonald, Chris; Gavura, Scott

    2016-02-01

    Is it ethical to market complementary and alternative medicines? Complementary and alternative medicines (CAM) are medical products and services outside the mainstream of medical practice. But they are not just medicines (or supposed medicines) offered and provided for the prevention and treatment of illness. They are also products and services - things offered for sale in the marketplace. Most discussion of the ethics of CAM has focused on bioethical issues - issues having to do with therapeutic value, and the relationship between patients and those purveyors of CAM. This article aims instead to consider CAM from the perspective of commercial ethics. That is, we consider the ethics not of prescribing or administering CAM (activities most closely associated with health professionals) but the ethics of selling CAM. © 2016 John Wiley & Sons Ltd.

  18. Value and Payment in Sleep Medicine.

    Science.gov (United States)

    Wickwire, Emerson M; Verma, Tilak

    2018-05-15

    Value, like beauty, exists in the eye of the beholder. This article places the value of clinical sleep medicine services in historical context and presents a vision for the value-based sleep of the future. First, the history of value and payment in sleep medicine is reviewed from the early days of the field, to innovative disruption, to the widespread adoption of home sleep apnea testing. Next, the importance of economic perspective is discussed, with emphasis on cost containment and cost-shifting between payers, employers, providers, and patients. Specific recommendations are made for sleep medicine providers and the field at large to maximize the perceived value of sleep. Finally, alternate payment models and value-based care are presented, with an eye toward the future for clinical service providers as well as integrated health delivery networks. © 2018 American Academy of Sleep Medicine.

  19. Conscientious Objection and Reproductive Health Service Delivery ...

    African Journals Online (AJOL)

    HP

    Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in ... such services to clients/patients on moral and/or religious grounds. While the ..... The internal morality of medicine:.

  20. 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)

  1. Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records

    Directory of Open Access Journals (Sweden)

    Hee Seung Choi

    2014-01-01

    Full Text Available Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patients, 62% were male and the average age was 50.20 years. Ninety percent of patients presented with LBP and 67% with sciatica. Eighty-four percent were diagnosed with herniated nucleus pulposus at time of surgery. Of these patients, 70% had pain recurrence 6 months or later, but 19% experienced no relief or immediate aggravation of pain after surgery. Many patients selected traditional Korean medicine treatment as primary means of postsurgery care (47%. When time to pain recurrence was short or pain persisted after surgery, return of symptoms at the same disc level and side was frequent. Conclusion. An integrative treatment model focusing on Korean medicine and used in conjunction with radiological diagnostics and conventional medicine is currently used as a treatment option for patients with pain after lumbar spine surgery.

  2. Hospital Intranet and Extranet in nuclear medicine

    International Nuclear Information System (INIS)

    Gambini, D.J.; Baum, T.P.; Spector, M.; Dumas, F.; Elgard, M.C.; Collington, M.A.; Barritault, L.

    1997-01-01

    Since two years ago nuclear medicine service of Laennec Hospital has implemented transmission and distribution networks of scintigraphic images. A new stage was reached at present by developing an Intranet and Extranet system for nursing units and other services of nuclear medicine. The Intranet link to the services of Laennec Hospital and AP HP is based on a image server connected to the service gamma camera and, after a possible post-processing, the images are transmitted in PCX format by e-mail, attached to the medical record. For communication between nuclear medicine services, a heavier procedure making use of a program for image processing under inter-file standards has been implemented. To achieve the Extranet link with services and physicians of town, exterior to AP HP, a procedure was installed which allows reaching any nursing unit or town physicians having at their disposal e-mail on a secured network. This procedure will be generalized when the Health secured network, linking the medical bodies to Health insurance institutions, will be operational. The interactive tele-medicine will be achieved by means of a procedure based on Internet cooperative tools (wild cards, video- and vision-conferences) which will permits in all situations an interactive work on all the transmitted patient files

  3. Quality Management Audits in Nuclear Medicine Practices. 2. Ed

    International Nuclear Information System (INIS)

    2015-01-01

    Quality management systems are essential and should be maintained with the intent to continuously improve effectiveness and efficiency, enabling nuclear medicine to achieve the expectations of its quality policy, satisfy its customers and improve professionalism. The quality management (QM) audit methodology in nuclear medicine practice, introduced in this publication, is designed to be applied to a variety of economic circumstances. A key outcome is a culture of reviewing all processes of the clinical service for continuous improvement in nuclear medicine practice. Regular quality audits and assessments are vital for modern nuclear medicine services. 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, medical physics and radiation safety procedures

  4. Response of monitors of surface contamination to internal exposition control from {sup 131}I in the 'nuclear medicine services'; Respuesta de monitores de contaminacion superficial para el control de la exposicion interna a {sup 131}I en servicios de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Puerta, Nancy; Rojo, Ana M.; Villella, Adrian; Gossio, Sebastian; Parada, Ines Gomez, E-mail: info@arn.gov.br [Autoridad Regulatoria Nuclear (ARN), Buenos Aires (Argentina); Acosta, Norma; Arenas, German, E-mail: nacosta@fuesmen.edu.ar [Fundacion Escuela de Medina Nuclear (FUESMEN), Mendoza (Argentina)

    2013-11-01

    The IAEA, in its publication RS-G-1.2, proposes individual control of workers occupationally exposed with risk of internal exposure when the potential exposure provided by incorporation leads to a value of annual committed effective dose equal to or greater than 1 mSv. Because the radionuclide {sup 131}I is the most important to control internal exposure in Nuclear Medicine Services, it is evaluated if the surface contamination monitors, commonly used in nuclear medicine centers of Argentina, would implement individual control of internal exposure to {sup 131}I. Selected detectors were calibrated with a dummy neck and thyroid with calibrated sources of {sup 131}I and {sup 133}Ba reference. For each detector is was estimated the detection efficiency for {sup 131}I and its detection limit. Each instrument was evaluated for the lowest effective dose possible to detect compromised by individual routine monitoring with different measurement intervals . We analyzed the response of each team for determining conditions that may be effective for the control of internal exposure of {sup 131}I. Finally , we conclude that the daily individual monitoring surface contamination detectors available in the Nuclear Medicine Services is feasible to implement and ensures detection of significant additions of {sup 131}I.

  5. Reflections on preventive medicine.

    Science.gov (United States)

    Miettinen, Olli S

    2014-10-01

    Having thought much about medicine in my career-long effort to understand it and the research for its advancement, I have come to views rather different form the now-prevailing ones in respect to what preventive medicine is about; what epidemiology is in relation to preventive medicine; what distinguishes preventive medicine in preventive healthcare at large; the relation of preventive medicine to public health; the concept of health promotion; and also the core principles of preventive medicine. All of these views I set forth in this article, for the readers' critical reflection. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Rational use of medicines - Indian perspective!

    Science.gov (United States)

    Mohanta, G P; Manna, P K

    2015-01-01

    India, the largest democracy in the world, is with a federal structure of 29 states and 7 union territories. With a population of more than 1.2 billion, resource is always a constraint and so is in the health system too. In the federal structure, providing healthcare is largely the responsibility of state governments. Medicines are important component of health care delivery system and quality care is dependent on the availability and proper use of quality medicines. In spite of being known as pharmacy of the third world, poor access to medicines in the country is always a serious concern. Realizing the need of quality use of medicines, several initiatives have been initiated. As early as 1994, seeds of rational use of medicines were sown in the country with two initiatives: establishment of a civil society, Delhi Society for Promoting Rational Use of Drugs (DSPURD) and establishment of government agency in Tamil Nadu, a southern state, called Tamil Medical Services Corporation Limited (TNMSCL). DSPUD was in official association with World Health Organization Country Office for implementing essential medicine programme in the country for two biennia. In addition to organizing sensitising and training programme for healthcare professionals throughout the country, it looked after the procurement and appropriate use of medicines in Delhi government health facilities. TNMSCL has made innovations in medicine management including procurement directly from manufacturers as a part of pooled procurement, establishing warehouses with modern storage facilities and Information Technology enabled management of whole process. TNMSCL Model is now replicated in almost the entire country and even in some small other countries as it is successful in improving access to medicines.The National Government and the State Governments have developed strategies to promote rational use of medicines as a part of improving access and quality care in public health facilities. National

  7. Traditional Chinese and Thai medicine in a comparative perspective.

    Science.gov (United States)

    He, Ke

    2015-12-01

    The work presented in this paper compares traditional Chinese medicine and traditional Thai medicine, expounding on origins, academic thinking, theoretical system, diagnostic method and modern development. Based on a secondary analysis of available literature, the paper concentrates on two crucial historical developments: (1) the response to, and consequences of, the impact of the Western medicine; and (2) the revival of traditional medicine in these two countries and its prospects. From a comparative perspective, the analysis has led to the conclusion that the rise and fall of traditional medicine is an issue closely related with social and political issues; and the development of traditional medicines requires national policy and financial support from governments, human resource development, the improvement of service quality, and the dissemination of traditional medicine knowledge to the public. In addition, this paper also suggests deepening exchanges and cooperation between China and Thailand, strengthening cooperation between traditional medicine and medical tourism. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Österreichischer Muster-Leistungskatalog Physikalische Medizin – empirische Grundlagen zur Wirksamkeit der Inhalte [Austrian catalogue of services of physical medicine – empirical basis of the effectiveness of the contents

    Directory of Open Access Journals (Sweden)

    Wilbacher, Ingrid

    2013-07-01

    Full Text Available [english] Background: An existing catalogue of services of physical medicine as a basic guideline for contracts with physicians and institutes in the Austrian Social Health Insurance Setting was checked for the evidence of the services. The main focus for this is the outpatient setting.Method: Based on the level of services (not indications nine systematic literature reviews were done using the databases Pubmed, PEDRO and Cochrane and were concluded in this overview-report. Results: More than 180 studies were included in the several literature reviews. There is good evidence for active exercises like aerobic, strengthening, stretching, graded activity, training of the back muscles and coordination training. Positive results are reported for pain decrease and functional increase especially for chronic musculoskeletal disorders. However, exercise is not a universal remedy: there are negative results for the effectiveness of exercise for indications like asthma, dysmenorrheal, epilepsy and psychiatric disorders.Limited evidence was found for exercise supported by mechanical devices, the studies found mainly focus on traction. Manual therapies and mobilization do not show clear evidence for a recommendation, and they have an unclear potential of harm. There is fair positive evidence for electro physical therapy (TENS for indications connected with pain and conflicting evidence for middle- and high frequent electro therapy modalities. Thermotherapy does not show clear advantages over placebo.Conclusion: There is positive evidence for the effectiveness of active exercises and conflicting evidence for passive treatment modalities for musculoskeletal conditions. There are methodical limitations due to the comparability in many of the studies using different outcomes, different scores for outcome measurement, subjective outcome indicators and a huge range of different indications where physical therapy modalities are done. Additional therapies, like pain

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... are small, diagnostic nuclear medicine procedures result in low radiation exposure, acceptable for diagnostic exams. Thus, the radiation risk is very low compared with the potential benefits. Nuclear medicine diagnostic ...

  10. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed to help diagnose childhood disorders that are congenital (present at birth) or that develop during childhood. Physicians use nuclear medicine imaging to ...

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts of radioactive materials called radiotracers, a special ... is a branch of medical imaging that uses small amounts of radioactive material to diagnose and determine ...

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Tell your doctor about your child’s recent illnesses, medical conditions, medications and allergies. Depending on the type ... Nuclear Medicine? Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material ...

  13. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Because nuclear medicine procedures are able to pinpoint molecular activity within the body, they offer the potential ... or imaging device that produces pictures and provides molecular information. In many centers, nuclear medicine images can ...

  14. Is Marijuana Medicine?

    Science.gov (United States)

    ... Alcohol Club Drugs Cocaine Fentanyl Hallucinogens Inhalants Heroin Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Over-the-Counter Medicines Prescription Medicines Steroids (Anabolic) Synthetic Cannabinoids (K2/Spice) Synthetic Cathinones (Bath Salts) Tobacco/ ...

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... interventions. Children's (pediatric) nuclear medicine refers to imaging examinations done in babies, young children and teenagers. Nuclear ... nuclear medicine procedure work? With ordinary x-ray examinations, an image is made by passing x-rays ...

  16. 30 days in medicine

    African Journals Online (AJOL)

    Of the 58 men who tested positive for oral gonorrhoea, 33 were randomly ... Medicine suggests that compressing this amount of physical activity into a weekend ... practise medicine differently; for example, women are more likely to adhere to ...

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ... at birth) or that develop during childhood. Physicians use nuclear medicine imaging to evaluate organ systems, including ...

  18. Herbal Medicine - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Herbal Medicine URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Herbal Medicine - Multiple Languages To use the sharing features on ...

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... child is taking as well as vitamins and herbal supplements and if he or she has any ... What are the limitations of Children's (Pediatric) Nuclear Medicine? Nuclear medicine procedures can be time consuming. It ...

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Children's (Pediatric) Nuclear Medicine? What are some common uses of the procedure? How does the nuclear medicine procedure work? What does the equipment look like? How is ...

  1. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... that are congenital (present at birth) or that develop during childhood. Physicians use nuclear medicine imaging to evaluate organ ... Nuclear medicine scans are typically used to ...

  2. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... referring physician. top of page What are the benefits vs. risks? Benefits The information provided by nuclear medicine examinations is ... risk is very low compared with the potential benefits. Nuclear medicine diagnostic procedures have been used for ...

  3. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Nuclear Medicine? Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to ... a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you ...

  4. Personalized laboratory medicine

    DEFF Research Database (Denmark)

    Pazzagli, M.; Malentacchi, F.; Mancini, I.

    2015-01-01

    diagnostic tools and expertise and commands proper state-of-the-art knowledge about Personalized Medicine and Laboratory Medicine in Europe, the joint Working Group "Personalized Laboratory Medicine" of the EFLM and ESPT societies compiled and conducted the Questionnaire "Is Laboratory Medicine ready...... in "omics"; 2. Additional training for the current personnel focused on the new methodologies; 3. Incorporation in the Laboratory of new competencies in data interpretation and counselling; 4. Improving cooperation and collaboration between professionals of different disciplines to integrate information...

  5. Arizona TeleMedicine Network: Engineering Master Plan.

    Science.gov (United States)

    Atlantic Research Corp., Alexandria, VA.

    As the planning document for establishing a statewide health communications system initially servicing the Papago, San Carlos and White Mountain Apache, Navajo, and Hopi reservations, this document prescribes the communications services to be provided by the Arizona TeleMedicine Network. Specifications include: (1) communications services for each…

  6. Annals of African Medicine

    African Journals Online (AJOL)

    The Annals of African Medicine is published by the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria and the Annals of African Medicine Society. The Journal is intended to serve as a medium for the publication of research findings in the broad field of Medicine in Africa and other developing countries, and ...

  7. 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...

  8. Mind-Body Medicine Practices in Complementary and Alternative Medicine

    Science.gov (United States)

    ... Visitor Information RePORT NIH Fact Sheets Home > Mind-Body Medicine Practices in Complementary and Alternative Medicine Small Text Medium Text Large Text Mind-Body Medicine Practices in Complementary and Alternative Medicine YESTERDAY ...

  9. Nuclear medicine physics

    CERN Document Server

    De Lima, Joao Jose

    2011-01-01

    Edited by a renowned international expert in the field, Nuclear Medicine Physics offers an up-to-date, state-of-the-art account of the physics behind the theoretical foundation and applications of nuclear medicine. It covers important physical aspects of the methods and instruments involved in modern nuclear medicine, along with related biological topics. The book first discusses the physics of and machines for producing radioisotopes suitable for use in conventional nuclear medicine and PET. After focusing on positron physics and the applications of positrons in medicine and biology, it descr

  10. Nuclear medicine in emergency

    International Nuclear Information System (INIS)

    Mansi, L.; Rambaldi, P.F.; Cuccurullo, V.; Varetto, T.

    2005-01-01

    The role of a procedure depends not only on its own capabilities but also on a cost/effective comparison with alternative technique giving similar information. Starting from the definition of emergency as a sudden unexpected occurrence demanding immediate action, the role of nuclear medicine (NM) is difficult to identify if it is not possible to respond 24h a day, 365 days a year, to clinical demands. To justify a 24 h NM service it is necessary to reaffirm the role in diagnosis of pulmonary embolism in the spiral CT era, to spread knowledge of the capabilities of nuclear cardiology in reliability diagnosis myocardial infraction (better defining admission and discharge to/from the emergency department), to increase the number of indications. Radionuclide technique could be used as first line, alternative, complementary procedures in a diagnostic tree taking into account not only the diagnosis but also the connections with prognosis and therapy in evaluating cerebral pathologies, acute inflammation/infection, transplants, bleeding, trauma, skeletal, hepatobiliary, renal and endocrine emergencies, acute scrotal pain

  11. [Design and implementation of supply security monitoring and analysis system for Chinese patent medicines supply in national essential medicines].

    Science.gov (United States)

    Wang, Hui; Zhang, Xiao-Bo; Huang, Lu-Qi; Guo, Lan-Ping; Wang, Ling; Zhao, Yu-Ping; Yang, Guang

    2017-11-01

    The supply of Chinese patent medicine is influenced by the price of raw materials (Chinese herbal medicines) and the stock of resources. On the one hand, raw material prices show cyclical volatility or even irreversible soaring, making the price of Chinese patent medicine is not stable or even the highest cost of hanging upside down. On the other hand, due to lack of resources or disable some of the proprietary Chinese medicine was forced to stop production. Based on the micro-service architecture and Redis cluster deployment Based on the micro-service architecture and Redis cluster deployment, the supply security monitoring and analysis system for Chinese patent medicines in national essential medicines has realized the dynamic monitoring and intelligence warning of herbs and Chinese patent medicine by connecting and integrating the database of Chinese medicine resources, the dynamic monitoring system of traditional Chinese medicine resources and the basic medicine database of Chinese patent medicine. Copyright© by the Chinese Pharmaceutical Association.

  12. Psychiatric Services • In Matabeleland

    African Journals Online (AJOL)

    1974-05-04

    May 4, 1974 ... To provide some basis for planning psychiatric services in Matabeleland, a ... medicine. and at the same time up-grade mental health services.' Tn the .... We present a survey of some of the changes in a population of African ...

  13. National directory of nuclear services

    International Nuclear Information System (INIS)

    1974-09-01

    This directory contains information on nuclear services which can be provided in South Africa. These services have to do with the application of nuclear materials and techniques in medicine, industry, agriculture, research, etc. A list of locally manufactured radioisotopes is given

  14. Essential travel medicine

    CERN Document Server

    Zuckerman, Jane N; Leggat, Peter

    2015-01-01

    This 1st edition of Essential Travel Medicine provides an excellent concise introduction to the specialty of Travel Medicine. This core text will enable health care practitioners particularly those new to the clinical practice of Travel Medicine, to gain a fundamental understanding of the diverse and complex issues which can potentially affect the health of the many millions of people who undertake international travel. Jane N Zuckerman is joined by Gary W Brunette from CDC and Peter A Leggat from Australia as Editors. Leading international specialists in their fields have contributed authoritative chapters reflecting current knowledge to facilitate best clinical practice in the different aspects of travel medicine. The aim of Essential Travel Medicine is to provide a comprehensive guide to Travel Medicine as well as a fundamental knowledge base to support international undergraduate and postgraduate specialty training programmes in the discipline of Travel Medicine. The 1st edition of Essential Travel ...

  15. 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.

  16. Over-the-Counter Medicines

    Science.gov (United States)

    Over-the-counter (OTC) medicines are drugs you can buy without a prescription. Some OTC medicines relieve aches, pains and itches. ... medicine is safe enough to sell over-the-counter. Taking OTC medicines still has risks. Some interact ...

  17. 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

  18. Performance evaluation of the activity meters of the Brazilian Nuclear Medicine Services in the country during 16 years; Avaliação do desempenho dos ativímetros dos Serviços de Medicina Nuclear no país no período de 16 anos

    Energy Technology Data Exchange (ETDEWEB)

    Toledo, B.C. de; Oliveira, A.E. de; Iwahara, A.; Tauhata, L.; Delgado, J.U., E-mail: bruce.de.toledo@gmail.com [Instituto de Radioproteção e Dosimetria (LNMRI/IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Lab. Nacional de Metrologia das Radiações Ionizantes

    2017-07-01

    Measurements of radionuclide activity are a very intense routine in the Nuclear Medicine Services (NMS) of Brazil. In order to guarantee the quality of these measurements, the Institute of Radioprotection and Dosimetry (IRD) has developed an activity measurement comparison program aiming at the improvement of these services. The evaluation methodology was the criterion of accuracy of the CNEN NN 3.05 standard. The reference value was established by the National Laboratory of Ionizing Radiation Metrology (LNMR) of the IRD, RJ, Brazil. The results showed that 77% of the NMS reached a performance within the range of acceptance, whereas values obtained for the activity in the activity meters with Geiger-Müller (GM) type detectors, presented insufficient performance, supporting the prohibition of these calibrators.

  19. 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...

  20. Regenerative medicine applications in combat casualty care.

    Science.gov (United States)

    Fleming, Mark E; Bharmal, Husain; Valerio, Ian

    2014-03-01

    The purpose of this report is to describe regenerative medicine applications in the management of complex injuries sustained by service members injured in support of the wars in Afghanistan and Iraq. Improvements in body armor, resuscitative techniques and faster transport have translated into increased patient survivability and more complex wounds. Combat-related blast injuries have resulted in multiple extremity injuries, significant tissue loss and amputations. Due to the limited availability and morbidity associated with autologous tissue donor sites, the introduction of regenerative medicine has been critical in managing war extremity injuries with composite massive tissue loss. Through case reports and clinical images, this report reviews the application of regenerative medicine modalities employed to manage combat-related injuries. It illustrates that the novel use of hybrid reconstructions combining traditional and regenerative medicine approaches are an effective tool in managing wounds. Lessons learned can be adapted to civilian care.

  1. 75 FR 65404 - Rehabilitation Research and Development Service Scientific Merit Review Board; Notice of Meeting

    Science.gov (United States)

    2010-10-22

    ... DEPARTMENT OF VETERANS AFFAIRS Rehabilitation Research and Development Service Scientific Merit... & Regenerative Medicine Subcommittee of the Rehabilitation Research and Development Service Scientific Merit..., examination, reference to, [[Page 65405

  2. rural medicine as a sub-specialty

    African Journals Online (AJOL)

    hospital for a year can be regarded as a rural medical specialist. Most often they realise ... of them, that they leave the public service for ever, for a situation that is ... So for rural medicine, it is an extremely wide set of skills that best describes ...

  3. Bringing Precision Medicine to Community Oncologists.

    Science.gov (United States)

    2017-01-01

    Quest Diagnostics has teamed up with Memorial Sloan Kettering Cancer Center and IBM Watson Health to offer IBM Watson Genomics to its network of community cancer centers and hospitals. This new service aims to advance precision medicine by combining genomic tumor sequencing with the power of cognitive computing. ©2017 American Association for Cancer Research.

  4. Financial operation and management concepts in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Bennington, J.L.; Handmaker, H.; Freedman, G.S. (eds.)

    1977-01-01

    Separate abstracts were prepared on two of the 19 chapters in this book that discuss current concepts of management, accounting, and systems techniques of nuclear medicine facilities to insure that the services are used intelligently and frugally.

  5. From hospitals to herbalists: Rx herbal medicines | IDRC ...

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

    2011-02-03

    Feb 3, 2011 ... "Equally important, their services are inexpensive — in fact, herbal medicines ... There's also a strong cultural attachment to this form of health care. ... "People and associations of traditional healers now have home gardens of ...

  6. Survey or quality for radiopharmaceuticals and activimeters available in services of nuclear medicine from Recife, Pernambuco State, Brazil; Estudo da qualidade dos radiofarmacos e dos activimetros utilizados nos servicos de medicina nuclear do Recife

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Fernanda Maria Dornellas Camara

    2001-08-01

    The radiopharmaceutical used in Nuclear Medicine must present high chemical and radiochemical purities in order to obtain images with contrast and clearness adequate for the diagnosis. Test should be made by the Nuclear Medicine institutes to evaluate the presence of molybdenum, aluminium and the free Tc O{sub 4}{sup -}/TC-HR in the radiopharmaceutical before they use it. On the other hand, the activity to be administered to the patient is determined by the activimeters available in the Nuclear Medicine institutions. So it is necessary to perform tests to verify operating conditions of the activimeter to guarantee that the dose received by patient is the prescribed by the physician. In Brazil, few clinics of Nuclear Medicine are implanting the tests of the radiopharmaceutical and of the activimeters. The objective of this work is to establish the procedures for the radiopharmaceutical tests and to evaluate the quality of the radiopharmaceutical used at the clinics of Recife, as well as the operation conditions of the activemeters in these institutions. The results show that all the activimeters analyzed present a good performance and that the equipment with Geiger-Muller detectors present larger instability than the ones that use ionization chamber. Concerning the Mo/Tc generators, it was observed that only one presented Mo in the generator eluate with concentration over the acceptable limits and that the concentration of Al found in the samples analyzed were below the limits. On the other hand, in 73% of the MIBI analyzed samples were observed problems with its preparation that were caused by the procedures adopted at the clinics, which do not follow the manufacturers recommendations. (author)

  7. 76 FR 78672 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2011-12-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  8. 75 FR 13136 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2010-03-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App.), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  9. 78 FR 36555 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2013-06-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  10. 77 FR 72364 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2012-12-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  11. 77 FR 39715 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    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...

  12. 76 FR 51994 - National Library of Medicine Notice of Meeting

    Science.gov (United States)

    2011-08-19

    ... 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...

  13. 76 FR 80953 - National Library of Medicine Notice of Meeting

    Science.gov (United States)

    2011-12-27

    ... 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...

  14. 78 FR 18358 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2013-03-26

    ... 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.... Agenda: Review and Analysis of Systems. Place: National Library of Medicine, Building 38, 2nd Floor...

  15. 78 FR 76848 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2013-12-19

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App.), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  16. 78 FR 36552 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2013-06-18

    ... 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... National Library of Medicine will be closed to the public in accordance with the provisions set forth in...

  17. 77 FR 72363 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2012-12-05

    ... 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... National Library of Medicine will be closed to the public in accordance with the provisions set forth in...

  18. 76 FR 16431 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2011-03-23

    ... 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... titles to be indexed by the National Library of Medicine and the discussions would likely to...

  19. 75 FR 42101 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2010-07-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  20. 75 FR 62549 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    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...

  1. 75 FR 78720 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2010-12-16

    ... 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...

  2. 78 FR 18356 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2013-03-26

    ... 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... National Library of Medicine will be closed to the public in accordance with the provisions set forth in...

  3. 75 FR 14173 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2010-03-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... indicated below, with attendance limited to space available. Individuals who plan to attend and need special... and evaluation of journals for potential indexing by the National Library of Medicine will be closed...

  4. 76 FR 45842 - National Library of Medicine Notice of Meetings

    Science.gov (United States)

    2011-08-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  5. 75 FR 78718 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2010-12-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  6. 78 FR 13362 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2013-02-27

    ... 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...

  7. 77 FR 17490 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2012-03-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  8. 77 FR 39715 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2012-07-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  9. 78 FR 76846 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2013-12-19

    ... 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...

  10. 77 FR 17488 - National Library of Medicine Notice of Meetings

    Science.gov (United States)

    2012-03-26

    ... 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... potential titles to be indexed by the National Library of Medicine and the discussions would likely to...

  11. 75 FR 44800 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2010-07-29

    ... 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... National Library of Medicine will be closed to the public in accordance with the provisions set forth in...

  12. 76 FR 14677 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2011-03-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  13. 77 FR 37684 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    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...

  14. 75 FR 80831 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2010-12-23

    ... 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... titles to be indexed by the National Library of Medicine and the discussions would likely significantly...

  15. 75 FR 42102 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2010-07-20

    ... 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...

  16. 76 FR 54778 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2011-09-02

    ... 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... titles to be indexed by the National Library of Medicine and the discussions would likely to...

  17. 77 FR 17488 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    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...

  18. 78 FR 76845 - National Library of Medicine; Notice of Meeting

    Science.gov (United States)

    2013-12-19

    ... 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... potential indexing by the National Library of Medicine will be closed to the public in accordance with the...

  19. 78 FR 18356 - National Library of Medicine; Notice of Meetings

    Science.gov (United States)

    2013-03-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... App), notice is hereby given of meetings of the Board of Regents of the National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...

  20. EDITORIAL Traditional medicine: Reawakening a “pending agendum”.

    African Journals Online (AJOL)

    admin

    that show the workforce represented by practitioners of traditional medicine ... sector to health, wellness and people-centered health care; and ... J. Health Dev. and supervised use of traditional medicine practitioners in strengthening and expanding primary health care services. Furthermore, both the Health Policy (13) and ...

  1. Extended family medicine training

    Science.gov (United States)

    Slade, Steve; Ross, Shelley; Lawrence, Kathrine; Archibald, Douglas; Mackay, Maria Palacios; Oandasan, Ivy F.

    2016-01-01

    Abstract Objective To examine trends in family medicine training at a time when substantial pedagogic change is under way, focusing on factors that relate to extended family medicine training. Design Aggregate-level secondary data analysis based on the Canadian Post-MD Education Registry. Setting Canada. Participants All Canadian citizens and permanent residents who were registered in postgraduate family medicine training programs within Canadian faculties of medicine from 1995 to 2013. Main outcome measures Number and proportion of family medicine residents exiting 2-year and extended (third-year and above) family medicine training programs, as well as the types and numbers of extended training programs offered in 2015. Results The proportion of family medicine trainees pursuing extended training almost doubled during the study period, going from 10.9% in 1995 to 21.1% in 2013. Men and Canadian medical graduates were more likely to take extended family medicine training. Among the 5 most recent family medicine exit cohorts (from 2009 to 2013), 25.9% of men completed extended training programs compared with 18.3% of women, and 23.1% of Canadian medical graduates completed extended training compared with 13.6% of international medical graduates. Family medicine programs vary substantially with respect to the proportion of their trainees who undertake extended training, ranging from a low of 12.3% to a high of 35.1% among trainees exiting from 2011 to 2013. Conclusion New initiatives, such as the Triple C Competency-based Curriculum, CanMEDS–Family Medicine, and Certificates of Added Competence, have emerged as part of family medicine education and credentialing. In acknowledgment of the potential effect of these initiatives, it is important that future research examine how pedagogic change and, in particular, extended training shapes the care family physicians offer their patients. As part of that research it will be important to measure the breadth and uptake of

  2. The future of emergency medicine.

    Science.gov (United States)

    Schneider, Sandra M; Gardner, Angela F; Weiss, Larry D; Wood, Joseph P; Ybarra, Michael; Beck, Dennis M; Stauffer, Arlen R; Wilkerson, Dean; Brabson, Thomas; Jennings, Anthony; Mitchell, Mark; McGrath, Roland B; Christopher, Theodore A; King, Brent; Muelleman, Robert L; Wagner, Mary J; Char, Douglas M; McGee, Douglas L; Pilgrim, Randy L; Moskovitz, Joshua B; Zinkel, Andrew R; Byers, Michelle; Briggs, William T; Hobgood, Cherri D; Kupas, Douglas F; Krueger, Jennifer; Stratford, Cary J; Jouriles, Nicholas J

    2010-08-01

    The specialty of emergency medicine (EM) continues to experience a significant workforce shortage in the face of increasing demand for emergency care. In July 2009, representatives of the leading EM organizations met in Dallas for the Future of Emergency Medicine Summit. Attendees at the Future of Emergency Medicine Summit agreed on the following: 1) Emergency medical care is an essential community service that should be available to all; 2) An insufficient emergency physician workforce also represents a potential threat to patient safety; 3) Accreditation Council for Graduate Medical Education/American Osteopathic Association (AOA)-accredited EM residency training and American Board of Medical Specialties/AOA EM board certification is the recognized standard for physician providers currently entering a career in emergency care; 4) Physician supply shortages in all fields contribute to-and will continue to contribute to-a situation in which providers with other levels of training may be a necessary part of the workforce for the foreseeable future; 5) A maldistribution of EM residency-trained physicians persists, with few pursuing practice in small hospital or rural settings; 6) Assuring that the public receives high quality emergency care while continuing to produce highly skilled EM specialists through EM training programs is the challenge for EM's future; 7) It is important that all providers of emergency care receive continuing postgraduate education. Copyright 2010. Published by Elsevier Inc.

  3. Maimonides? Appreciation for Medicine

    OpenAIRE

    Gesundheit, Benjamin

    2011-01-01

    Moses Maimonides, the illustrious medieval rabbi and philosopher, dedicated the last decade of his life primarily to medicine. His strong interest in medicine was an integral component of his religious-philosophical teachings and world view. In this paper various sources from his rabbinic writings are presented that explain Maimonides’ motivation regarding and deep appreciation for medicine: (A) The physician fulfills the basic biblical obligation to return lost objects to their owner, for wi...

  4. Fundamentals of nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-01-01

    The book begins with basic science and statistics relevant to nuclear medicine, and specific organ systems are addressed in separate chapters. A section of the text also covers imaging of groups of disease processes (eg, trauma, cancer). The authors present a comparison between nuclear medicine techniques and other diagnostic imaging studies. A table is given which comments on sensitivities and specificities of common nuclear medicine studies. The sensitivities and specificities are categorized as very high, high, moderate, and so forth.

  5. Fundamentals of nuclear medicine

    International Nuclear Information System (INIS)

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

    1988-01-01

    The book begins with basic science and statistics relevant to nuclear medicine, and specific organ systems are addressed in separate chapters. A section of the text also covers imaging of groups of disease processes (eg, trauma, cancer). The authors present a comparison between nuclear medicine techniques and other diagnostic imaging studies. A table is given which comments on sensitivities and specificities of common nuclear medicine studies. The sensitivities and specificities are categorized as very high, high, moderate, and so forth

  6. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... variety of diseases, including many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders and other abnormalities within the body. Because nuclear medicine procedures are ...

  7. Traditional medicine and genomics

    Directory of Open Access Journals (Sweden)

    Kalpana Joshi

    2010-01-01

    Full Text Available ′Omics′ developments in the form of genomics, proteomics and metabolomics have increased the impetus of traditional medicine research. Studies exploring the genomic, proteomic and metabolomic basis of human constitutional types based on Ayurveda and other systems of oriental medicine are becoming popular. Such studies remain important to developing better understanding of human variations and individual differences. Countries like India, Korea, China and Japan are investing in research on evidence-based traditional medicines and scientific validation of fundamental principles. This review provides an account of studies addressing relationships between traditional medicine and genomics.

  8. Traditional medicine and genomics.

    Science.gov (United States)

    Joshi, Kalpana; Ghodke, Yogita; Shintre, Pooja

    2010-01-01

    'Omics' developments in the form of genomics, proteomics and metabolomics have increased the impetus of traditional medicine research. Studies exploring the genomic, proteomic and metabolomic basis of human constitutional types based on Ayurveda and other systems of oriental medicine are becoming popular. Such studies remain important to developing better understanding of human variations and individual differences. Countries like India, Korea, China and Japan are investing in research on evidence-based traditional medicines and scientific validation of fundamental principles. This review provides an account of studies addressing relationships between traditional medicine and genomics.

  9. [Precision and personalized medicine].

    Science.gov (United States)

    Sipka, Sándor

    2016-10-01

    The author describes the concept of "personalized medicine" and the newly introduced "precision medicine". "Precision medicine" applies the terms of "phenotype", "endotype" and "biomarker" in order to characterize more precisely the various diseases. Using "biomarkers" the homogeneous type of a disease (a "phenotype") can be divided into subgroups called "endotypes" requiring different forms of treatment and financing. The good results of "precision medicine" have become especially apparent in relation with allergic and autoimmune diseases. The application of this new way of thinking is going to be necessary in Hungary, too, in the near future for participants, controllers and financing boards of healthcare. Orv. Hetil., 2016, 157(44), 1739-1741.

  10. Personalized medicine in psychiatry

    DEFF Research Database (Denmark)

    Wium-Andersen, Ida Kim; Vinberg, Maj; Kessing, Lars Vedel

    2017-01-01

    Background: Personalized medicine is a model in which a patient’s unique clinical, genetic, and environmental characteristics are the basis for treatment and prevention.  Aim, method, and results: This review aims to describe the current tools, phenomenological features, clinical risk factors......, and biomarkers used to provide personalized medicine. Furthermore, this study describes the target areas in which they can be applied including diagnostics, treatment selection and response, assessment of risk of side-effects, and prevention.  Discussion and conclusion: Personalized medicine in psychiatry....... The discussion proposes possible solutions to narrow this gap and to move psychiatric research forward towards personalized medicine....

  11. 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

  12. Veterinary nuclear medicine

    International Nuclear Information System (INIS)

    Kallfelz, F.A.; Comar, C.L.; Wentworth, R.A.

    1974-01-01

    A brief review is presented of the expanding horizons of nuclear medicine, the equipment necessary for a nuclear medicine laboratory is listed, and the value of this relatively new field to the veterinary clinician is indicated. Although clinical applications to veterinary medicine have not kept pace with those of human medicine, many advances have been made, particularly in the use of in vitro techniques. Areas for expanded applications should include competitive protein binding and other in vitro procedures, particularly in connection with metabolic profile studies. Indicated also is more intensive application by the veterinarian of imaging procedures, which have been found to be of such great value to the physician. (U.S.)

  13. Teaching evidence based medicine in family medicine

    Directory of Open Access Journals (Sweden)

    Davorka Vrdoljak

    2012-05-01

    Full Text Available The concept of evidence based medicine (EBM as the integrationof clinical expertise, patient values and the best evidence was introduced by David Sackett in the 1980’s. Scientific literature in medicine is often marked by expansion, acummulation and quick expiration. Reading all important articles to keep in touch with relevant information is impossible. Finding the best evidence that answers a clinical question in general practice (GP in a short time is not easy. Five useful steps are described –represented by the acronym “5A+E”: assess, ask, acquire, appraise, apply and evaluate.The habit of conducting an evidence search “on the spot’’ is proposed. Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses, their experience of evidence-searching and critical appraisal of the evidence, in real time with real patient is inadequate. Teaching the final-year students the practical use of EBM in a GP’s office is different and can have an important role in their professional development. It can positively impact on quality of their future work in family practice (or some other medical specialty by acquiring this habit of constant evidence-checking to ensure that best practice becomes a mechanism for life-long learning. Conclusion. EBM is a foundation stone of every branch of medicine and important part of Family Medicine as scientific and professional discipline. To have an EB answer resulting from GP’s everyday work is becoming a part of everyday practice.

  14. The Danish Fetal Medicine Database

    Directory of Open Access Journals (Sweden)

    Ekelund CK

    2016-10-01

    Full Text Available Charlotte Kvist Ekelund,1 Tine Iskov Kopp,2 Ann Tabor,1 Olav Bjørn Petersen3 1Department of Obstetrics, Center of Fetal Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 2Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Glostrup, Denmark; 3Fetal Medicine Unit, Aarhus University Hospital, Aarhus Nord, Denmark Aim: The aim of this study is to set up a database in order to monitor the detection rates and false-positive rates of first-trimester screening for chromosomal abnormalities and prenatal detection rates of fetal malformations in Denmark. Study population: Pregnant women with a first or second trimester ultrasound scan performed at all public hospitals in Denmark are registered in the database. Main variables/descriptive data: Data on maternal characteristics, ultrasonic, and biochemical variables are continuously sent from the fetal medicine units' Astraia databases to the central database via web service. Information about outcome of pregnancy (miscarriage, termination, live birth, or stillbirth is received from the National Patient Register and National Birth Register and linked via the Danish unique personal registration number. Furthermore, results of all pre- and postnatal chromosome analyses are sent to the database. Conclusion: It has been possible to establish a fetal medicine database, which monitors first-trimester screening for chromosomal abnormalities and second-trimester screening for major fetal malformations with the input from already collected data. The database is valuable to assess the performance at a regional level and to compare Danish performance with international results at a national level. Keywords: prenatal screening, nuchal translucency, fetal malformations, chromosomal abnormalities

  15. Complementary alternative medicine and nuclear medicine

    International Nuclear Information System (INIS)

    Werneke, Ursula; McCready, V.Ralph

    2004-01-01

    Complementary alternative medicines (CAMs), including food supplements, are taken widely by patients, especially those with cancer. Others take CAMs hoping to improve fitness or prevent disease. Physicians (and patients) may not be aware of the potential side-effects and interactions of CAMs with conventional treatment. Likewise, their known physiological effects could interfere with radiopharmaceutical kinetics, producing abnormal treatment responses and diagnostic results. Nuclear medicine physicians are encouraged to question patients on their intake of CAMs when taking their history prior to radionuclide therapy or diagnosis. The potential effect of CAMs should be considered when unexpected therapeutic or diagnostic results are found. (orig.)

  16. Ethical quandaries in spiritual healing and herbal medicine: A critical analysis of the morality of traditional medicine advertising in southern African urban societies

    OpenAIRE

    Mawere Munyaradzi

    2011-01-01

    This paper critically examines the morality of advertising by practitioners in spiritual healing and herbal medicine heretofore referred to as traditional medicine, in southern African urban societies. While the subject of traditional medicine has been heavily contested in medical studies in the last few decades, the monumental studies on the subject have emphasised the place of traditional medicine in basic health services. Insignificant attention has been devoted to examine the ethical prob...

  17. 42 CFR 482.51 - Condition of participation: Surgical services.

    Science.gov (United States)

    2010-10-01

    ... of medicine or osteopathy. (2) Licensed practical nurses (LPNs) and surgical technologists (operating... performing surgery in accordance with the competencies of each practitioner. The surgical service must...

  18. Computers in nuclear medicine

    International Nuclear Information System (INIS)

    Cradduck, T.D.; Knowles, L.G.

    1977-01-01

    The decision to buy a computer is difficult. The wide variety of computing systems available makes that decision even harder because each of the systems has unique advantages and disadvantages. The following list contains many of the essentials any computer system for nuclear medicine should embody: (1) sophisticated and reliable hardware with sufficient memory capacity to acquire or display at least 128 x 128 static images or 64 x 64 dynamic studies and with the facility for adding extra hardware and peripheral equipment at a later date; (2) a well-proved, general-purpose, real-time operating system to which the programs specific to the gamma camera have been interfaced and which will allow expansion or modification of both hardware and software in the future; (3) a display exhibiting at least 128 x 128 resolution, a monochrome mode with extended gray scale, and perhaps color; a varied set of programmed image formats and hardware system that includes local refresher capabilities; (4) a high-level language, such as FORTRAN or BASIC, with the ability to directly access all data files and interact with system programs as well as a macroprogramming capability so the user may write his own programs for data manipulation and analysis; (5) a comprehensive yet generally applicable set of system programs to enable data acquisition, storage, analysis, and display. In addition to the above, one should expect the services of a team of well-trained maintenance technicians and engineers. The manufacturer should offer software support and exhibit a plan for continued development and upgrading of the software initially provided

  19. 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

  20. Episodes of care: is emergency medicine ready?

    Science.gov (United States)

    Wiler, Jennifer L; Beck, Dennis; Asplin, Brent R; Granovsky, Michael; Moorhead, John; Pilgrim, Randy; Schuur, Jeremiah D

    2012-05-01

    Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting. Copyright © 2011. Published by Mosby, Inc.

  1. National and international agencies demands and the implementation of an integrated management system: advantages of certification; As demandas dos orgaos nacionais e internacionais e a implementacao do Sistema de Gestao Integrado - SGI: vantagens da certificacao

    Energy Technology Data Exchange (ETDEWEB)

    Pessoa, Maria Eduarda C. [Queiroz Galvao Perfuracoes S.A., Rio de Janeiro, RJ (Brazil). Coordenacao de Meio Ambiente

    2004-07-01

    During the 80's, companies started to be concerned with more than their production processes. Due to the demands for products and services quality, in 1987, ISO 9000 (International Standards Organization) was established. Ten years later, ISO 14000 was established, regarding environmental management system, and in the same period BS 8800 (British Standards) and OHSAS 18001 (Occupational Health and Safety Assessment Series) were also published, regarding occupational health and safety in the working environment. With the increasing demands for companies that participate with the country's economical and social development, SA 8000 was elaborated. In the present days, companies that do not incorporate these factors (quality, environment, occupational health, safety, and social responsibility), has its markets diminished. For several countries, especially European countries, environmental and social aspects are essential for companies and products to gain entry into their markets. The implementation of such systems therefore aids companies to manage their aspects, leading to continuous process improval and the opening of new markets. A company's success depends more of the demands of national and international agencies (financing or licensing agencies, for example). Financing agencies have to assure themselves that they are investing in environmentally and socially friendly projects. Licensing agencies require that specific projects take place with the smallest possible environmental impact. The existence of a management system in the company that incorporates environmental management facilitates the licensing process, as well as financing by multilateral national and international agencies. Certification therefore acts as an important tool to help companies as well as financing and licensing agencies, demonstrating the company's global commitment with such aspects. (author)

  2. Nuclear medicine and related radionuclide applications in developing countries

    International Nuclear Information System (INIS)

    1986-01-01

    The Symposium presentations were divided into sessions devoted to the following topics: Radioimmunoassay and related techniques (4 papers and 4 poster presentations); Radionuclide applications in the diagnosis of parasitic diseases (7 papers and 2 posters); Instrumentation (6 papers and 4 posters); Clinical nuclear medicine: liver, bones, thyroid, cardiovascular system, lungs, kidneys, brain (23 papers and 15 posters); Organization of nuclear medicine services in the developing countries (9 papers and 5 posters); Training in nuclear medicine (4 papers) and the panel discussion. Future of Nuclear Medicine in the developing countries. A separate abstract was prepared for each of these papers and posters

  3. Implementation of a quality control program of the equipment of the nuclear medicine services in Chile; Implementacion de un programa de control de calidad del equipamiento de los servicios de medicina nuclear de Chile

    Energy Technology Data Exchange (ETDEWEB)

    Astudillo, R.; Diaz, G.; Ferreira, A.; Garcia, M.; Hermosilla, A.; Pacheco, F.; Vasquez, M. [Universidad de la Frontera, Departamento de Ciencias Fisicas, Av. Francisco Salazar 1145, Temuco 4811230, Araucania (Chile); Coca, M., E-mail: ferreira.sdgr@gmail.com [MedScan Concepcion, Paicavi 270, Concepcion (Chile)

    2014-08-15

    Now days in Chile there are more of 43 Nuclear Medicine centers; most of them have gamma cameras in order to study physiological process in diagnostic and treatment of patients pathologies. This requires having the equipment in optimal operating condition and it is ensured with quality control programs that are based on a series of tests relating to protocols, such as TECDOC-602 y AAPM No.6. Planar test often applied in gamma cameras including: spatial resolution, spatial linearity, sensitivity and uniformity. SPECT tests consider: tomography uniformity, rotation center tomography resolution and total performance. The tests in dose calibrator are: background measurement, accuracy, precision, linearity and reproducibility. The tests above require the use of radioactive sources and specific simulators patterns or phantom based on international standards such as The National Electrical Manufacturers Association (Nema), International Atomic Energy Agency (IAEA) and The American Association of Medical Physics (AAPM). In this work we carried out several tests of quality control in a Nuclear Medicine Center of Temuco and we propose to implement the applied methodology in others similar Chilean centers. (author)

  4. Public health medicine: the constant dilemma.

    Science.gov (United States)

    Eskin, Frada

    2002-03-01

    There is a well-known quotation by the nineteenth-century sociologist Virchow (quoted in Ref. 1) that aptly captures the dilemma that has confronted public health medicine since the specialty was created as a discrete entity in 1848. Virchow said: 'Medicine is politics and social medicine is politics writ large!' What does this mean in relation to effective public health medicine practice and how is it likely to affect its future? There is increasingly limited freedom of expression within the current context of political correctness, central control and a rapidly burgeoning litigious climate. The purpose of this paper is to explore these issues and to propose a means of maintaining public health medicine integrity within a working environment where action is becoming rapidly constrained by political rigidity. An additional factor to be included in the dialogue is the current context within which public health physicians work. Because the majority of public health doctors are employed within the National Health Service (NHS), they are finding themselves being expected to take on tasks and responsibilities marginal to their essential purpose and function. For example, public health physicians spend a great deal of time involved in detailed deliberations about health service provision. Although there is a great deal of evidence to show that good quality health care provision positively affects the health of the individual, there is no evidence to show that this activity has any effect on the population's health status. The essence of public health medicine practice is the prevention of ill-health and the promotion of the health of the population and, consequently, attention needs to be focused on the root causes of disease. However, as these are outside the aegis of the NHS, public health medicine involvement in such issues as education, nutrition, housing, transport and poverty is regarded as marginal to the NHS corporate agenda.

  5. Medicinal plants of Lorestan

    Directory of Open Access Journals (Sweden)

    shahla ahmadi

    2010-03-01

    Full Text Available Collection and determination of medicinal plants in Lorestan province have been carried out for 6 years in the agriculture and natural resources research of center of Lorestan. The aims of this study were collection and identification the medicinal plans that grow in Loretta province, their distribution, habitat, traditional uses, utilized organ, manner of usage, botany specification, local name, Persian name and scientific name. Material and methods: Medicinal plants were collected from different regions by using field and library study for these goals we prepared a list of recorded medicinal plants from Lorestan, identified the local herbal experts. Results: Finally we collected 151 medicinal plant identified that related to 63 families and 90 genuses. The Lamiaceae, Compositae, Legominosae , Liliaceae, Umbelliferae and . Rosaceae are the greatest family in the Lorestan province. Diction: According to the literature 96 medicinal plans were recorded from Lorestan, but during this study we collected and identified 151 medicinal plants in Lorestan province. Comparing with those that recorded from Bushehr 70 sp.(9, Hormozgan 113 sp.(10, Markazi 144 sp. And Kordestan 144 sp(11. We have more diversity but comparing with Zanjan 163 sp.(13, Hamedan 315 sp.(14 And Qazvin 250 sp.(15 We have less diversity in medicinal plants.

  6. Immoral behaviour in medicine.

    Science.gov (United States)

    Carmon, P; Tabak, N

    1997-03-01

    The purpose of this paper is to emphasize a social phenomenon that exists in Israel: immoral medicine. In recent years, nurses have been exposed to many instances of immoral medicine in hospitals. We want to protest about the demands for money from patients who are waiting for surgical intervention, arouse the medical community's conscience concerning these immoral activities, and improve professional and moral behaviour.

  7. Medicines from Marine Invertebrates

    Science.gov (United States)

    Davies-Coleman, Mike

    2011-01-01

    Few of us realise that the oceans of the world are a relatively untapped reservoir of new natural product-derived medicines to combat the many diseases that plague humanity. We explore the role that an unremarkable sea snail and sea squirt are playing in providing us with new medicines for the alleviation of chronic pain and cancer respectively.…

  8. OTC Medicines and Pregnancy

    Science.gov (United States)

    ... need to take medicine regularly because of a health problem, talk with your doctor before you try to get pregnant. There may ... I currently take an OTC medicine for a health problem. Is there another ... Family Physicians, Over-the-Counter Medications in Pregnancy Centers for ...

  9. Radioisotopes in nuclear medicine

    International Nuclear Information System (INIS)

    Samuel, A.M.

    2002-01-01

    Full text: A number of advances in diverse fields of science and technology and the fruitful synchronization of many a new development to address the issues related to health care in terms of prognosis and diagnosis resulted in the availability of host of modern diagnostic tools in medicine. Nuclear medicine, a unique discipline in medicine is one such development, which during the last four decades has seen exponential growth. The unique contribution of this specialty is the ability to examine the dynamic state of every organ of the body with the help of radioactive tracers. This tracer application in nuclear medicine to monitor the biological molecules that participate in the dynamic state of body constituents has led to a whole new approach to biology and medicine. No other technique has the same level of sensitivity and specificity as obtained in radiotracer technique in the study of in-situ chemistry of body organs. As modem medicine becomes oriented towards molecules rather than organs, nuclear medicine will be in the forefront and will become an integral part of a curative process for regular and routine application. Advances in nuclear medicine will proceed along two principal lines: (i) the development of improved sensitive detectors of radiation, powerful and interpretable data processing, image analysis and display techniques, and (ii) the production of exotic and new but useful radiopharmaceuticals. All these aspects are dealt with in detail in this talk

  10. Radiation and medicine: introduction

    International Nuclear Information System (INIS)

    Lentle, B.; Singh, H.

    1984-01-01

    A brief historical review is given of the development of the various nuclear medicine techniques which have been evolved since the discovery of X-rays and radioactivity. The role of various disciplines, such as radiobiology, radiation chemistry, radiation physics and computers in the application of radiation in medicine is discussed. (U.K.)

  11. Nuclear energy and medicine

    International Nuclear Information System (INIS)

    1988-01-01

    The applications of nuclear energy on medicine, as well as the basic principles of these applications, are presented. The radiological diagnosis, the radiotherapy, the nuclear medicine, the radiological protection and the production of radioisotopes are studied. (M.A.C.) [pt

  12. Personalized physiological medicine

    NARCIS (Netherlands)

    Ince, Can

    2017-01-01

    This paper introduces the concept of personalized physiological medicine that is specifically directed at the needs of the critically ill patient. This differs from the conventional view of personalized medicine, characterized by biomarkers and gene profiling, instead focusing on time-variant

  13. Digital Nuclear Medicine

    International Nuclear Information System (INIS)

    Erickson, J.J.; Rollo, F.D.

    1982-01-01

    This book is meant ''to provide the most comprehensive presentation of the technical as well as clincial aspects of computerized nuclear medicine''. It covers basic applications, and advice on acquisition and quality control of nuclear medicine computer systems. The book evolved from a series of lectures given by the contributors during the computer preceptorship program at their institution, Vanderbilt University in Nashville

  14. Textbook of respiratory medicine

    International Nuclear Information System (INIS)

    Murray, J.F.; Nadel, J.

    1987-01-01

    This book presents a clinical reference of respiratory medicine. It also details basic science aspects of pulmonary physiology and describes recently developed, sophisticated diagnostic tools and therapeutic methods. It also covers anatomy, physiology, pharmacology, and pathology; microbiologic, radiologic, nuclear medicine, and biopsy methods for diagnosis

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... resume his/her normal activities after the nuclear medicine scan. If the child has been sedated, you will receive specific instructions ... usually mild. Nevertheless, you should inform the nuclear medicine personnel of any allergies your child may have or other problems that may have ...

  16. Medicines and Children

    Science.gov (United States)

    ... child. Here are some other tips for giving medicine safely to your child: Read and follow the label directions every time. ... new symptoms or unexpected side effects in your child The medicine doesn't appear to be working when you ...

  17. PACS in nuclear medicine

    International Nuclear Information System (INIS)

    Kang, Keon Wook

    2000-01-01

    PACS (Picture Archiving and Communication System) is being rapidly spread and installed in many hospitals, but most of the system do not include nuclear medicine field. Although additional costs of hardware for nuclear medicine PACS is low, the complexity in developing viewing software and little market have made the nuclear medicine PACS not popular. Most PACS utilize DICOM 3.0 as standard format, but standard format in nuclear medicine has been Interfile. Interfile should be converted into DICOM format if nuclear images are to be stored and visualized in most PACS. Nowadays, many vendors supply the DICOM option in gamma camera and PET. Several hospitals in Korea have already installed nucler PACS with DICOM, but only the screen captured images are supplied. Software for visualizing pseudo-color with color lookup tables and expressing with volume view should be developed to fulfill the demand of referring physicians and nuclear medicine physicians. PACS is going to integrate not only radiologic images but also endoscopic and pathologic images. Web and PC based PACS is now a trend and is much compatible with nuclear medicine PACS. Most important barrier for nuclear medicine PACS that we encounter is not a technical problem, but indifference of investor such as administrator of hospital or PACS. Now it is time to support and invest for the development of nuclear medicine PACS

  18. Obstetric medicine: Interlinking obstetrics and internal medicine

    African Journals Online (AJOL)

    1 Mayo Clinic Hospitals, Division of Hospital Internal Medicine, Rochester, Minn, USA ... Obstetric physicians have a specific role in managing pregnant and postpartum women with ... problems may also affect pregnancy outcomes, with increased risk of ... greatly benefited from good control of her diabetes and hypertension.

  19. [Medicine in sports or sport medicine?] ].

    Science.gov (United States)

    Heimer, S; Tonković-Lojović, M

    2001-01-01

    Sports medicine is a profession pertaining to primary health care of sport population (competitors, coaches, referees, participants in sports recreation). It embraces the physical and mental health protection and promotion of participants in relation to a particular sport activity and sport environment, directing athletes to a sport and adapting them to sport and the sport to them. Sports medicine takes part in selection procedure, training process planning and programming, and cares for epidemiological, hygienic, nutritional and other problems in sport. The Republic of Croatia belongs to those world states in which the field of sports medicine is regulated neither by a law or by profession. A consequence is that wide circle of physicians and paramedics work in clubs and various medical units without any legal or/and professional control not being adequately educated nor having licence for it. This review is an appeal to the Croatian Medical Chamber and the Ministry of Health to make efforts to promote the education and medical profession in sports medicine.

  20. Integrative medicine is a future medicine

    International Nuclear Information System (INIS)

    Samosyuk, I.Z.; Chukhraev, N.V.

    2001-01-01

    An analysis is given of the modern integrative medicine basis which is the synthesis of: 1. Theology, philosophy and sociology; 2. Physico-mathematical sciences, cybernetics, chemistry and astrology; 3. Medico-biological and clinical experience; 4. Traditional and scientific medicine; 5. Use of traditional and new medical technologies. Problems of 'holistic' medicine which considers Man as a unity of biological, emotional, psychological and social phenomena are exposed. Advantages in combining the drug therapy with modern physiotherapy and physioacupuncture methods seem to be obvious. All visible effects of a disease can de represented in the following forms of changes: information-energy - biochemical - ultrastructure - tissue - clinical diseases. Self-regulation of functional systems has a multilevel structure and needs application of different methods for body recovery. Short-wave irradiation (lasers, magnetotherapy) can be used for energy restoration in functional systems or meridians, and acupuncture plays the role of a 'trigger' which activises the body recovery. Integration of Western and Oriental medicines is the way for achieving the qualitative new level of health protection

  1. Information for nuclear medicine researchers and practitioners

    International Nuclear Information System (INIS)

    Bartlett, W.

    1987-01-01

    The Australian Nuclear Science and Technology Organisation (ANSTO) has a major research program in nuclear medicine; this article describes the information support given to the program by the Lucas Heights Research Laboratories (LHRL) Library. The INIS database is a prime indicator of the information held at LHRL Library, however, other databases also cover nuclear medicine. As part of the Australian library system the ANSTO Library's resources are accessed by subscription. The ANSTO Library staff can also search INIS for a fee for external enquiries but the other databases can presently only be searched for LHRL staff and affiliates. Even so, most major library and information services can provide access to these databases

  2. 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)

  3. Tapping the potential of alternative medicine.

    Science.gov (United States)

    La Puma, J; Eiler, G

    1998-04-01

    Interest in alternative medicine is growing among healthcare consumers. Health plans and healthcare organizations may be able to improve clinical outcomes and benefit financially by providing patients with access to alternative services. Organizations that can assess their communities' particular needs, draw on interested professional staff to help develop alternative medicine programs and protocols, and study quality outcomes will stand a better chance of making such programs successful. Educating medical staff, designing a credible program, and forging strategic alliances with respected partners can help organizations create a sharply focused brand identity in the community.

  4. Ethical Issues Surrounding Personalized Medicine: A Literature Review

    Directory of Open Access Journals (Sweden)

    Pooneh Salari

    2017-03-01

    Full Text Available More than a decade ago, personalized medicine was presented in modern medicine. Personalized medicine means that the right drug should be prescribed for the right patient based on genetic data. No doubt is developing medical sciences, and its shift into personalized medicine complicates ethical challenges more than before. In this review, we categorized all probable ethical considerations of personalized medicine in research and development and service provision. Based on our review, extensive changes in healthcare system including ethical changes are needed to overcome the ethical obstacles including knowledge gap and informed consent, privacy and confidentiality and availability of healthcare services. Furthermore social benefit versus science development and individual benefit should be balanced. Therefore guidelines and regulations should be compiled to represent the ethical framework; also ethical decision making should be day-to-day and individualized.

  5. Ethical Issues Surrounding Personalized Medicine: A Literature Review.

    Science.gov (United States)

    Salari, Pooneh; Larijani, Bagher

    2017-03-01

    More than a decade ago, personalized medicine was presented in modern medicine. Personalized medicine means that the right drug should be prescribed for the right patient based on genetic data. No doubt is developing medical sciences, and its shift into personalized medicine complicates ethical challenges more than before. In this review, we categorized all probable ethical considerations of personalized medicine in research and development and service provision. Based on our review, extensive changes in healthcare system including ethical changes are needed to overcome the ethical obstacles including knowledge gap and informed consent, privacy and confidentiality and availability of healthcare services. Furthermore social benefit versus science development and individual benefit should be balanced. Therefore guidelines and regulations should be compiled to represent the ethical framework; also ethical decision making should be day-to-day and individualized.

  6. Japan's advanced medicine.

    Science.gov (United States)

    Sho, Ri; Narimatsu, Hiroto; Murakami, Masayasu

    2013-10-01

    Like health care systems in other developed countries, Japan's health care system faces significant challenges due to aging of the population and economic stagnation. Advanced medicine (Senshin Iryou) is a unique system of medical care in Japan offering highly technology-driven medical care that is not covered by public health insurance. Advanced medicine has recently developed and expanded as part of health care reform. Will it work? To answer this question, we briefly trace the historical development of advanced medicine and describe the characteristics and current state of advanced medical care in Japan. We then offer our opinions on the future of advanced medicine with careful consideration of its pros and cons. We believe that developing advanced medicine is an attempt to bring health care reform in line rather than the goal of health care reform.

  7. Evolutionary molecular medicine.

    Science.gov (United States)

    Nesse, Randolph M; Ganten, Detlev; Gregory, T Ryan; Omenn, Gilbert S

    2012-05-01

    Evolution has long provided a foundation for population genetics, but some major advances in evolutionary biology from the twentieth century that provide foundations for evolutionary medicine are only now being applied in molecular medicine. They include the need for both proximate and evolutionary explanations, kin selection, evolutionary models for cooperation, competition between alleles, co-evolution, and new strategies for tracing phylogenies and identifying signals of selection. Recent advances in genomics are transforming evolutionary biology in ways that create even more opportunities for progress at its interfaces with genetics, medicine, and public health. This article reviews 15 evolutionary principles and their applications in molecular medicine in hopes that readers will use them and related principles to speed the development of evolutionary molecular medicine.

  8. Maimonides’ Appreciation for Medicine

    Science.gov (United States)

    Gesundheit, Benjamin

    2011-01-01

    Moses Maimonides, the illustrious medieval rabbi and philosopher, dedicated the last decade of his life primarily to medicine. His strong interest in medicine was an integral component of his religious-philosophical teachings and world view. In this paper various sources from his rabbinic writings are presented that explain Maimonides’ motivation regarding and deep appreciation for medicine: (A) The physician fulfills the basic biblical obligation to return lost objects to their owner, for with his knowledge and experience the physician can restore good health to his sick fellow human being; (B) medicine provides a unique opportunity to practice imitatio dei, as it reflects the religious duty to maintain a healthy life-style; (C) as an important natural science, medicine offers tools to recognize, love, and fear God. These three aspects address man’s relationship and obligation towards his fellow-man, himself and God. Biographical insights supported by additional sources from Maimonides’ writings are discussed. PMID:23908790

  9. Maimonides’ Appreciation for Medicine

    Directory of Open Access Journals (Sweden)

    Benjamin Gesundheit

    2011-01-01

    Full Text Available Moses Maimonides, the illustrious medieval rabbi and philosopher, dedicated the last decade of his life primarily to medicine. His strong interest in medicine was an integral component of his religious-philosophical teachings and world view. In this paper various sources from his rabbinic writings are presented that explain Maimonides’ motivation regarding and deep appreciation for medicine: (A The physician fulfills the basic biblical obligation to return lost objects to their owner, for with his knowledge and experience the physician can restore good health to his sick fellow human being; (B medicine provides a unique opportunity to practice imitatio dei, as it reflects the religious duty to maintain a healthy life-style; (C as an important natural science, medicine offers tools to recognize, love, and fear God. These three aspects address man’s relationship and obligation towards his fellow-man, himself and God. Biographical insights supported by additional sources from Maimonides’ writings are discussed.

  10. Personalized medicine in dentistry

    Directory of Open Access Journals (Sweden)

    Pushpa S Pudakalkatti

    2017-01-01

    Full Text Available Personalized medicine is a branch of medicine that proposes customization of healthcare in which decisions and treatment are tailored according to individual patient needs. The field of personalized medicine relies on genetic information, proteomic information and clinical patient characteristics to individualize treatment. With advances in genetics, proteomics, pharmacogenetics and knowledgeable patient population, the opportunity exists to deliver never before levels of personalized care. Although general dentists may consider personalized medicine a concept for the future, the reality is that its direct application to everyday dentistry is closer than one might think. Use of personalized medicine in dentistry, especially in periodontology is progressing rapidly, and dentist should consider this approach while treating patients. Google and PubMed search was done to select articles for present review. Total 17 articles were used to compile information.

  11. Medicine use of elderly Chinese and Vietnamese immigrants and attitudes to home medicines review.

    Science.gov (United States)

    White, Lesley; Klinner, Christiane

    2012-01-01

    There is a paucity of research into the perceptions of elderly Australian ethnic minorities towards public health services related to quality use of medicines. Among the six fastest growing ethnic groups in Australia, the Mandarin-speaking Chinese and Vietnamese constitute the largest elderly populations with poor English skills. This paper investigates the relationships of elderly Chinese and Vietnamese migrants with medicines, general practitioners and pharmacists, and how these relationships influence their awareness and attitudes of the home medicines review (HMR) program. Two semi-structured focus groups were held with a total of 17 HMR-eligible patients who have never received a HMR, one with Chinese and one with Vietnamese respondents, each in the respective community language. Confusion about medications and an intention to have a HMR were pronounced among all participants although none of them had heard of the program before participating in the focus groups. Respondents reported difficulties locating a pharmacist who spoke their native language, which contributed to an increased unmet need for medicine information. The Chinese group additionally complained about a lack of support from their general practitioners in relation to their medicine concerns and was adamant that they would prefer to have a HMR without the involvement of their general practitioner. Our results indicate a distinct HMR need but not use among elderly Chinese and Vietnamese eligible patients with poor English skills. Home medicines review service use and perceived medication problems are likely to improve with an increasing availability of bilingual and culturally sensitive health care providers.

  12. 78 FR 77475 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    2013-12-23

    ... personal privacy. Name of Committee: National Library of Medicine Special Emphasis Panel Conflicts R01R21... 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...

  13. 76 FR 31621 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    2011-06-01

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

  14. 75 FR 54157 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    2010-09-03

    ... personal privacy. Name of Committee: National Library of Medicine Special Emphasis Panel; G08. Date... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... Library of Medicine, 6705 Rockledge Drive, Suite 301, Bethesda, MD 20892-7968, 301-496-4253, [email protected

  15. 76 FR 17660 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    2011-03-30

    ... personal privacy. Name of Committee: National Library of Medicine Special Emphasis Panel; Conflicteds. Date... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine...: National Library of Medicine, 6705 Rockledge Drive, Suite 301, Bethesda, MD 20817 (Telephone Conference...

  16. 76 FR 77242 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    2011-12-12

    ... personal privacy. Name of Committee: National Library of Medicine Special Emphasis Panel, Conflict R01/K99... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... Place: National Library of Medicine, 6705 Rockledge Drive, Suite 301, Bethesda, MD 20817, (Telephone...

  17. 78 FR 55265 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    2013-09-10

    ... personal privacy. Name of Committee: National Library of Medicine Special Emphasis Panel; Conflicts R01/K22... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... Place: National Library of Medicine, 6705 Rockledge Drive, Suite 301, Bethesda, MD 20817 (Telephone...

  18. 75 FR 45647 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    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...

  19. 76 FR 9031 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    2011-02-16

    ... personal privacy. Name of Committee: National Library of Medicine Special Emphasis Panel R25. Date: March... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... Library of Medicine, 6705 Rockledge Drive, Suite 301, Bethesda, MD 20817 (Telephone Conference Call...

  20. 77 FR 72365 - National Library of Medicine; Notice of Closed Meeting

    Science.gov (United States)

    2012-12-05

    ... personal privacy. Name of Committee: National Library of Medicine Special Emphasis Panel; Conflict R01/K99... 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...