Consensus Document of the Spanish Society of Cardiology and the Spanish Society of Internal Medicine on the diagnosis and treatment of iron deficiency in heart failure.

Science.gov (United States)

Manito, N; Cerqueiro, J M; Comín-Colet, J; García-Pinilla, J M; González-Franco, A; Grau-Amorós, J; Peraira, J R; Manzano, L

Iron deficiency in patients with heart failure is a medical problem of recent particular interest. This interest has resulted from the publication of several clinical trials that demonstrated that the administration of intravenous iron to such patients improved their functional capacity and even reduced the number of hospitalisations for heart failure decompensation. However, applying the evidence from these studies in clinical practice is still controversial, both in terms of the diagnostic criteria for iron deficiency (absolute and functional) and the optimal method for iron replenishment. This article is a consensus document that integrates the recommendations of the Spanish Society of Internal Medicine and the Spanish Society of Cardiology. The article reviews the scientific evidence and proposes a diagnostic and therapeutic performance protocol for iron deficiency in heart failure. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Society for Maternal-Fetal Medicine

Science.gov (United States)

... checklists in obstetrics Coding update of the SMFM definition of low risk for cesarean delivery from ICD- ... DC 20024 Email: smfm@smfm.org © 2000-2017, Society for Maternal-Fetal Medicine. All rights reserved The ...

International Society of Radiographers and Radiological Technologists and radiation protection

International Nuclear Information System (INIS)

Yule, A.

2001-01-01

The ISRRT was formed in 1962 with 15 national societies and by the year 2000 has grown to comprise more than 70 member societies. The main objects of the organization are to: Improve the education of radiographers; Support the development of medical radiation technology worldwide; Promote a better understanding and implementation of radiation protection standards. The ISRRT has been a non-governmental organization in official relations with the World Health Organization (WHO) since 1967. It is the only international radiographic organization that represents radiation medicine technology and has more than 200 000 members within its 70 member countries. Representatives of the ISRRT have addressed a number of assemblies of WHO regional committees on matters relating to radiation protection and radiation medicine technology. In this way, the expertise of radiographers worldwide contributes to the establishment of international standards in vital areas, such as: Quality control; Legislation for radiation protection; Good practice in radiographic procedures; Basic radiological services. The ISRRT believes that good and consistent standards of practice throughout the world are essential

[A history of internal medicine: medical specialization: as old as antiquity].

Science.gov (United States)

Echenberg, Donald

2007-11-28

This article presents a short review of the history of medical specialization and the evolution of internal medicine within the last two centuries. Medical specialization, far from being a recent phenomenon, existed in the Hellenistic world and in Rome. The development of specialization during the latter part of the 19th century and early 20th century is credited to the rapid expansion of medical knowledge which made it impossible for a single doctor to encompass all the different spheres of the profession. The term innere medizin or internal medicine was adopted from German terminology in the 1880's. The Canadian society of internal medicine was formed in 1983 and its main goal is to promote a broad perspective of medical care and to master the complexity in medicine through a generalist approach.

3rd International Arab Forensic Sciences & Forensic Medicine Conference, ASFSFM 2017: Conference Report

Directory of Open Access Journals (Sweden)

Abdulsallam A. Bakdash

2017-12-01

Full Text Available The Arab Society for Forensic Sciences and Forensic Medicine (ASFSFM at Naif Arab University for Security Sciences seeks to present the latest developments in all fields of forensic sciences through holding specialized scientific events and academic activities. This is also achieved through its periodic scientific peer-reviewed journal, the Arab Journal of Forensic Sciences and Forensic Medicine. It also seeks to promote scientific research in all fields of forensic science and forensic medicine, and seeks actively to contribute in holding scientific meetings in accordance with advanced scientific standards, including the 3rd International Arab Forensic Sciences & Forensic Medicine Conference. This important event was attended by scientists and experts from various fields of criminal and forensic sciences from both Arab and non-Arab countries. This conference was a significant scientific accomplishment that contributed to the advancement of forensic sciences and forensic medicine in the Arab world. The conference aimed, in accordance with the vision of Naif Arab University for Security Sciences, to enhance peace, security and justice in Arab societies.  Naif Arab University for Security Sciences, represented by the Arab Society for Forensic Sciences and Forensic Medicine, held the 3rd International Arab Forensic Sciences & Forensic Medicine Conference on the University's campus during the period from 21st to 23rd November 2017. The event included the participation of more than 720 experts in forensic sciences and forensic medicine from 33 countries all over the world. Experts discussed and presented the latest developments in their fields. The conference provided a creative environment for students from both local and international universities to benefit from experts and specialists, and to access the most recent research.  On behalf of His Excellency the president of Naif Arab University for Security Sciences, and the Arab Society for

The Bockus International Society of Gastroenterology: Historical review

Science.gov (United States)

Chaun, Hugh

2012-01-01

The Bockus International Society of Gastroenterology was founded in 1958 in honour of Dr Henry L Bockus (1894–1982) by his former students, residents and fellows at the Graduate School of Medicine of the University of Pennsylvania, Philadelphia, USA. It was a celebrated tribute to Dr Bockus’ outstanding leadership in the development and teaching of clinical gastroenterology as a subspecialty, which was in its infancy in the post-World War II era. He established the first formal training course in clinical gastroenterology in America. His department of gastroenterology became the leading graduate school of clinical gastroenterology in the world, training many clinical gastroenterologists in America and from many regions around the world. For many years, Dr Bockus was the most prominent American in world gastroenterology. The Bockus Society holds biennial scientific congresses in different continents, thus continuing to foster Dr Bockus’ lifelong interest and vision to promote international medical friendship, and excellence in education and research collaboration. PMID:22506261

An evidence-based unified definition of lifelong and acquired premature ejaculation : report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation

NARCIS (Netherlands)

Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D|info:eu-repo/dai/nl/163958564; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne J G; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

INTRODUCTION: The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that

An evidence-based unified definition of lifelong and acquired premature ejaculation : report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation

NARCIS (Netherlands)

Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D|info:eu-repo/dai/nl/163958564; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne Jg; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

INTRODUCTION: The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that

Society for Academic Emergency Medicine Statement on Plagiarism.

Science.gov (United States)

Asher, Shellie L; Iserson, Kenneth V; Merck, Lisa H

2017-10-01

The integrity of the research enterprise is of the utmost importance for the advancement of safe and effective medical practice for patients and for maintaining the public trust in health care. Academic societies and editors of journals are key participants in guarding scientific integrity. Avoiding and preventing plagiarism helps to preserve the scientific integrity of professional presentations and publications. The Society for Academic Emergency Medicine (SAEM) Ethics Committee discusses current issues in scientific publishing integrity and provides a guideline to avoid plagiarism in SAEM presentations and publications. © 2017 by the Society for Academic Emergency Medicine.

The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures.

Science.gov (United States)

Narouze, Samer N; Provenzano, David; Peng, Philip; Eichenberger, Urs; Lee, Sang Chul; Nicholls, Barry; Moriggl, Bernhard

2012-01-01

The use of ultrasound in pain medicine for interventional axial, nonaxial, and musculoskeletal pain procedures is rapidly evolving and growing. Because of the lack of specialty-specific guidelines for ultrasonography in pain medicine, an international collaborative effort consisting of members of the Special Interest Group on Ultrasonography in Pain Medicine from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies developed the following recommendations for education and training in ultrasound-guided interventional pain procedures. The purpose of these recommendations is to define the required skills for performing ultrasound-guided pain procedures, the processes for appropriate education, and training and quality improvement. Training algorithms are outlined for practice- and fellowship-based pathways. The previously published American Society of Regional Anesthesia and Pain Medicine and European Society of Regional Anaesthesia and Pain Therapy education and teaching recommendations for ultrasound-guided regional anesthesia served as a foundation for the pain medicine recommendations. Although the decision to grant ultrasound privileges occurs at the institutional level, the committee recommends that the training guidelines outlined in this document serve as the foundation for educational training and the advancement of the practice of ultrasonography in pain medicine.

The International Certification of Addiction Medicine: Validating Clinical Knowledge across Borders

Science.gov (United States)

el-Guebaly, Nady; Violato, Claudio

2011-01-01

The experience of the International Society of Addiction Medicine in setting up the first international certification of clinical knowledge is reported. The steps followed and the results of a psychometric analysis of the tests from the first 65 candidates are reported. Lessons learned in the first 5 years and challenges for the future are…

[What is Internal Medicine?].

Science.gov (United States)

Reyes, Humberto

2006-10-01

Internal Medicine can be defined as a medical specialty devoted to the comprehensive care of adult patients, focused in the diagnosis and non surgical treatment of diseases affecting internal organs and systems (excluding gyneco-obstetrical problems) and the prevention of those diseases. This position paper reviews the history of Internal Medicine, the birth of its subspecialties and the difficulties faced by young physicians when they decide whether to practice as internist or in a subspecialty. In Chile as in most occidental countries formal training in a subspecialty of internal medicine requires previous certification in internal medicine but the proportion of young physicians who remain in practice as general internists appears to be considerably lower than those who choose a subspecialty. The main reasons for this unbalance can be related to financial advantages (by the practice of specialized technologies) and the patients' tendency to request direct assistance by a professional thought to be better qualified to take care of their specific problems. Training programs in internal medicine should consider a greater emphasis in comprehensive outpatient care instead of the traditional emphasis for training in hospital wards.

International Youth Justice Systems: Promoting Youth Development and Alternative Approaches: A Position Paper of the Society for Adolescent Health and Medicine.

Science.gov (United States)

2016-10-01

Youth incarceration is an international public health concern among developed and developing countries. Worldwide, youth are held in incarceration, detention, and other secure settings that are inappropriate for their age and developmental stages, jeopardizing their prosocial development, and reintegration into society. Youth incarceration lacks evidence and cost-effectiveness. The well-being of youth is a key indicator of the welfare of families, communities, and society at large; therefore, the Society for Adolescent Health and Medicine (SAHM) supports a paradigm shift in the role of the justice system as it relates to treatment of youth. SAHM recommends justice systems focus greater attention and resources on identifying and reducing the antecedents of high-risk and criminal behaviors, recognizing the rights and freedom of young persons, and prioritizing the well-being of youth over punitive measures that may harm and disrupt healthy adolescent development. SAHM supports the following positions: (1) incarceration is a last option for selected offenders who have committed the most serious violent crimes and are unable to remain safely in the community; (2) youth justice policies, programs, and practices affecting youth be evidence based and trauma informed; (3) youth justice policies, programs, and practices must incorporate research and ongoing program evaluation; (4) youth justice policies shall protect the privacy and dignity of children younger than 18 years; and (5) health care professionals and media will promote positive portrayals of youth in healthy relationships within their communities and reduce representations and images of youth that are negative, violent, deviant, and threatening. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Italian intersociety consensus on DOAC use in internal medicine.

Science.gov (United States)

Prisco, Domenico; Ageno, Walter; Becattini, Cecilia; D'Angelo, Armando; Davì, Giovanni; De Cristofaro, Raimondo; Dentali, Francesco; Di Minno, Giovanni; Falanga, Anna; Gussoni, Gualberto; Masotti, Luca; Palareti, Gualtiero; Pignatelli, Pasquale; Santi, Roberto M; Santilli, Francesca; Silingardi, Mauro; Tufano, Antonella; Violi, Francesco

2017-04-01

The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events. This document represents a consensus paper on the use of DOACs by representatives of three Italian scientific societies: the Italian Society of Internal Medicine (SIMI), the Federation of the Associations of Hospital Managers (FADOI), and the Society for the Study of Haemostasis and Thrombosis (SISET). This document formulates expert opinion guidance for pragmatic managing, monitoring and reversing the anticoagulant effect of DOACs in both chronic and emergency settings. This practical guidance may help the internist to create adequate protocols for patients hospitalized ion internal medicine wards, where patients are often elderly subjects affected by poly-morbidities and renal insufficiency, and, thus, require particular attention to drug-drug interactions and peri-procedural protocols.

The history of the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction.

Science.gov (United States)

Weissbart, Steven J; Zimmern, Philippe E; Nitti, Victor W; Lemack, Gary E; Kobashi, Kathleen C; Vasavada, Sandip P; Wein, Alan J

2018-03-25

To review the history of the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU). We reviewed Society meeting minutes, contacted all living former Society presidents, searched the William P. Didusch Center for Urology History records, and asked Society members to share their important Society experiences in order to gather important historical information about the Society. The Society initially formed as the Urodynamics Society in 1969 in the backdrop of a growing passion for scientific research in the country after World War II ended. Since then, Society meetings have provided a pivotal forum for the advancement of science in lower urinary tract dysfunction. Meetings occurred annually until 2004, when the meeting schedule increased to biannual. The journal, Neurourology and Urodynamics, became the official journal of the Society in 2005. SUFU has authored important guidelines on urodynamics (2012), non-neurogenic overactive bladder (2012), and stress urinary incontinence (2017) and has shared important collaborations with other societies, including the American Urological Association (AUA), the International Continence Society (ICS), and the International Society of Pelvic Neuromodulation (ISPiN). SUFU has also been instrumental in trainee education and helped to establish formal fellowship training in the field in addition to holding a yearly educational meeting for urology residents. The Society has been led by 21 presidents throughout its history. Throughout the Society's near half-century long existence, the Society has fostered research, published guidelines, and educated trainees in order to improve the care of individuals suffering from lower urinary tract dysfunction. © 2018 Wiley Periodicals, Inc.

Guidelines for Percutaneous Dilatational Tracheostomy (PDT) from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM)

DEFF Research Database (Denmark)

Madsen, Kristian Rørbæk; Guldager, Henrik; Rewers, Mikael

2011-01-01

Percutaneous dilatational tracheostomy is a common procedure in intensive care. This guideline from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM) describes indications and contraindications, timing, complications...

Medicinal Meditations on Korean History and Society

Directory of Open Access Journals (Sweden)

Laura C. Nelson

2018-03-01

Full Text Available Soyoung Suh. Naming the Local: Medicine, Language, and Identity in Korea since the Fifteenth Century. Cambridge, MA: Harvard University Press, 2017. 244 pp. $40 (cloth. Eunjung Kim. Curative Violence: Rehabilitating Disability, Gender, and Sexuality in Modern Korea. Durham, NC: Duke University Press, 2017. 312 pp. $100 (cloth; $26 (paper. Taken together, and particularly situated in the context of related studies of science and medicine in Korea and the East Asian region, Naming the Local and Curative Violence illustrate the productive power of ideas of health and wellness in the formation of Korean culture, society, and institutions. Medicine and medical care obviously are central elements of biopolitics, but the reach and complexity of their effects are often overlooked. Given the massive social and financial investments in health, it is no wonder that looking at South Korea through these lenses illuminates whole aspects of Korean society with new light...

Self-reported hypertension, dyslipidemia and hyperuricemia management by Italian Internal Medicine Units: a national survey of the FADOI Study Group in Cardiovascular Medicine

Directory of Open Access Journals (Sweden)

Alberto Mazza

2017-11-01

Full Text Available The aim of this study was to evaluate the management practices of internal medicine clinicians for patients with cardiovascular risk factors, with particular respect to treatment thresholds, medication choices and target goals. A sample of internists - representatives of Internal Medicine Units (IMUs from all the regions in Italy - were identified by the cardiovascular medicine study group of the Italian Internal Medicine FADOI (Federazione delle Associazioni dei Dirigenti Ospedalieri Internisti Society and invited to fill out a questionnaire about hypertension, dyslipidemia and hyperuricemia. From the 101 questionnaires collected, it was found that despite large heterogeneity between IMUs in terms of patient management and adherence to guidelines, internists were experts in the management of patients with multiple cardiovascular risk factors and associated comorbidities. We hope that these data prompt the internal medicine community to consider the value of producing shared, real-world guidelines on the management of cardiovascular disease.

An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE

Directory of Open Access Journals (Sweden)

Stanley E. Althof, PhD

2014-06-01

Conclusion: Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, Becher E, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE. Sex Med 2014;2:60–90.

General medicine vs subspecialty career plans among internal medicine residents.

Science.gov (United States)

West, Colin P; Dupras, Denise M

2012-12-05

Current medical training models in the United States are unlikely to produce sufficient numbers of general internists and primary care physicians. Differences in general internal medicine (GIM) career plans between internal medicine residency program types and across resident demographics are not well understood. To evaluate the general medicine career plans of internal medicine residents and how career plans evolve during training. A study of US internal medicine residents using an annual survey linked to the Internal Medicine In-Training Examination taken in October of 2009-2011 to evaluate career plans by training program, sex, and medical school location. Of 67,207 US eligible categorical and primary care internal medicine residents, 57,087 (84.9%) completed and returned the survey. Demographic data provided by the National Board of Medical Examiners were available for 52,035 (77.4%) of these residents, of whom 51,390 (76.5%) responded to all survey items and an additional 645 (1.0%) responded to at least 1 survey item. Data were analyzed from the 16,781 third-year residents (32.2%) in this sample. Self-reported ultimate career plans of internal medicine residents. A GIM career plan was reported by 3605 graduating residents (21.5%). A total of 562 primary care program (39.6%) and 3043 categorical (19.9%) residents reported GIM as their ultimate career plan (adjusted odds ratio [AOR], 2.76; 99% CI, 2.35-3.23; P international medical graduates (22.0% vs 21.1%, respectively; AOR, 1.76; 99% CI, 1.50-2.06; P international medical graduates (57.3% vs 27.3%, respectively; AOR, 3.48; 99% CI, 2.58-4.70; P internal medicine residents, including those in primary care training programs, and differed according to resident sex, medical school location, and program type.

Expectations and obligations: professionalism and medicine's social contract with society.

Science.gov (United States)

Cruess, Richard L; Cruess, Sylvia R

2008-01-01

As health care has become of great importance to both individual citizens and to society, it has become more important to understand medicine's relationship to the society it serves in order to have a basis for meaningful dialogue. During the past decade, individuals in the medical, legal, social sciences, and health policy fields have suggested that professionalism serves as the basis of medicine's relationship with society, and many have termed this relationship a social contract. However, the concept of medicine's social contract remains vague, and the implications of its existence have not been fully explored. This paper endorses the use of the term social contract, examines the origin of the concept and its relationship to professionalism, traces its evolution and application to medicine, describes the expectations of the various parties to the contract, and explores some of the implications of its use.

[Congress of the German Society of Internal Medicine 2009: evaluation of the poster exhibition].

Science.gov (United States)

Siebig, Sylvia; Schacherer, Doris; Schölmerich, Jürgen; Klebl, Frank

2009-09-15

The presentation of scientific posters gives young scientists the opportunity to present their data in the setting of a medical congress. In preparation of the organization of the 116th Congress of the German Society of Internal Medicine (DGIM) 2010, the authors evaluated the poster rounds at the 115th Congress of the DGIM 2009 by using a questionnaire that was given to poster presenters, poster chairmen, and visitors. The authors sought to receive an instructive criticism for the organization in 2010. Distribution of questionnaires containing ten questions with preformulated response options and an additional field for further comments to all presenters, chairmen, and visitors of the poster rounds during the 115th Congress of the DGIM (April 2009). 159 questionnaires were returned and evaluated. Almost all respondents quoted the poster presentation as being important for their scientific work (98%). In general, they were satisfied with the discussion at the poster rounds (83%). The amount of posters within one round was criticized by 41%, as was the inadequate adherence to time constraints and time frame and room conditions themselves. The poster exhibition of the 115th Congress of the DGIM 2009 was evaluated positively by most of the respondents to the survey. Nevertheless, helpful hints were retrieved as how to further improve poster rounds. They should be respected when planning the exhibition at the congress in 2010.

[100 years with certificates: Danish Society of Insurance Medicine 1902-2002].

Science.gov (United States)

Permin, Henrik

2002-01-01

Danish Society of Insurance Medicine was formed in 1902 as an association between the Danish Society of Accident Insurance and the Danish Society of Life Insurance Medicine, both founded a year before. The purpose of the society is to apply and to further the scientific basis of insurance medicine. The meetings also play a role as a forum for discussions. The members of the society are all working part-time in an insurance company in Denmark (in contrast to many other countries where it is a full-time job). The members are mainly specialists in medicine and surgery. During the first half life of the society nearly all members were high-qualified doctors, i.e. professors and consultants at a university hospital in Copenhagen usually with a doctoral degree. These prominent doctors had a significant influence on insurance medicine in Denmark. The managing directors of the Insurance Companies were invited to the meetings. Many scientific works and textbooks were written on the subject. The society arranges two meetings yearly - one concerning with life insurance and one with accident-insurance medicine. Previously, the question put to the medical adviser was always "Which impairments can still be insured?", but today the question is the opposite "Which impairments are not insurable?" The members have increased to currently 112, still only men, but today the members are younger, comprise fewer professors and fewer with a doctoral degree. During the last 6 years, all interested members in the insurance companies have been invited to the meetings, providing a broader input for the discussions. The topic of the meeting is of current interest: new laws or a new treatment of a disease (medication, surgery) which has been introduced. One to three speakers open the meeting, followed by a discussion. The meetings are always concluded with a light meal and a glass of wine, in earlier days also with cigars and Danish schnaps. 190 meetings have been held during the last 100 years

Philanthropic endowments in general internal medicine.

Science.gov (United States)

Murden, R A; Lamb, J F

1999-04-01

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

History of the World Federation of Societies for Laser Medicine and Surgery (WFSLMS) and its Non-Profit Organization (NPO-WFSLMS): Part 1: Origins to Inaugural Meeting, 2005.

Science.gov (United States)

Ohshiro, Toshio

2014-07-01

The first society formed to represent the "new" field of laser applications in medicine and surgery was the late Professor Kaplan's International Society for Laser Surgery and Medicine, held in Israel in 1975. Following the ISLSM lead, a large number of national and international societies were very swiftly formed. As the number grew, it became obvious that some sort of linking forum would help all these separate societies to pool the knowledge of their members for the good of the clinicians and their patients. The World Federation of Societies for Laser Medicine and Surgery was formed to attempt to fill this role. The History: At the 1996 meeting of the Greek Medical Laser Association, the first international forum of representatives from 17 international and national laser societies was convened by Professor Nick Nicolopoulos, and the seed of an idea for a centralized forum to help separate laser societies coordinate efforts and knowledge was planted. This seed was nurtured by the ISLSM as the first medical laser society, and forums were called together at each meeting of the ISLSM and the other related societies from 1997 to 2003. At the 2004 Chinese Medical Laser Society meeting, the idea of worldwide federation of laser societies crystallized into a more tangible form The Inaugural WFSLMS Congress: The convening of the first WFSLMS congress took place in Tokyo in 2005, under the leadership of Professor Kazuhiko Atsumi. At this meeting, Professor Kaplan proposed that a Medical Laser Foundation should be established and donated the first seed money for its formation. Because of the Japanese legal requirements, a foundation was impossible and so a Non-profit Organization (NPO-WFSLMS) was started, based in Japan, to oversee the work and fund the tasks of promoting laser surgery and medicine worldwide, for the good of mankind: the financing, running and holding WFSLMS congresses became one of the tasks of NPO-WFSLMS. Both the WFSLMS and NPO-WFSLMS were therefore on

Addressing the nation's physician workforce needs: The Society of General Internal Medicine (SGIM) recommendations on graduate medical education reform.

Science.gov (United States)

Jackson, Angela; Baron, Robert B; Jaeger, Jeffrey; Liebow, Mark; Plews-Ogan, Margaret; Schwartz, Mark D

2014-11-01

The Graduate Medical Education (GME) system in the United States (US) has garnered worldwide respect, graduating over 25,000 new physicians from over 8,000 residency and fellowship programs annually. GME is the portal of entry to medical practice and licensure in the US, and the pathway through which resident physicians develop the competence to practice independently and further develop their career plans. The number and specialty distribution of available GME positions shapes the overall composition of our national workforce; however, GME is failing to provide appropriate programs that support the delivery of our society's system of healthcare. This paper, prepared by the Health Policy Education Subcommittee of the Society of General Internal Medicine (SGIM) and unanimously endorsed by SGIM's Council, outlines a set of recommendations on how to reform the GME system to best prepare a physician workforce that can provide high quality, high value, population-based, and patient-centered health care, aligned with the dynamic needs of our nation's healthcare delivery system. These recommendations include: accurate workforce needs assessment, broadened GME funding sources, increased transparency of the use of GME dollars, and implementation of incentives to increase the accountability of GME-funded programs for the preparation and specialty selection of their program graduates.

Proceedings of the Korean Society Nuclear Medicine Autumn Meeting 2002

International Nuclear Information System (INIS)

2002-01-01

This proceedings contains articles of 2002 autumn meeting of the Korean Society Nuclear Medicine. It was held on November 15-16, 2002 in Seoul, Korea. This proceedings is comprised of 5 sessions. The subject titles of session are as follows: Cancer, Physics of nuclear medicine, Neurology, Radiopharmacy and biology, General nuclear medicine. (Yi, J. H.)

Update of the ERS international Adult Respiratory Medicine syllabus for postgraduate training.

Science.gov (United States)

Tabin, Nathalie; Mitchell, Sharon; O'Connell, Elaine; Stolz, Daiana; Rohde, Gernot

2018-03-01

First published in 2006, the first European core syllabus in Adult Respiratory Medicine was developed with the intention of harmonising education and training throughout Europe. Internationally recognised by the European Union of Medical Specialists and identified as the first document of its kind in respiratory medicine, it has provided a comprehensive guide for both local and national institutions in the development of adult respiratory training programmes. Like all fields in education, respiratory medicine is an ever-changing area and as such, respective syllabi, curricula and training programmes must adapt and diversify in line with the evolution of core medical concepts. Given the proven importance of the Adult Respiratory Medicine syllabus from both a national and international standpoint, it is of equal importance that said syllabus remains abreast of emerging trends so as to sustain the synchronisation of respiratory medicine in Europe. In order to develop an updated programme, a comprehensive review process of the current syllabus is a necessary endeavour and a step that the European Respiratory Society (ERS) has undertaken through the process of a needs assessment.

Proceedings of the Korean Society Nuclear Medicine Autumn Meeting 2001

International Nuclear Information System (INIS)

2001-01-01

This proceedings contains articles of 2001 autumn meeting of the Korean Society Nuclear Medicine. It was held on November 16-17, 2001 in Seoul, Korea. This proceedings is comprised of 6 sessions. The subject titles of session are as follows: Cancer, Physics of nuclear medicine, Neurology, Radiopharmacy and biology, Nuclear cardiology, General nuclear medicine. (Yi, J. H.)

What skills should new internal medicine interns have in july? A national survey of internal medicine residency program directors.

Science.gov (United States)

Angus, Steven; Vu, T Robert; Halvorsen, Andrew J; Aiyer, Meenakshy; McKown, Kevin; Chmielewski, Amy F; McDonald, Furman S

2014-03-01

The transition from medical student to intern may cause stress and burnout in new interns and the delivery of suboptimal patient care. Despite a formal set of subinternship curriculum guidelines, program directors have expressed concern regarding the skill set of new interns and the lack of standardization in that skill set among interns from different medical schools. To address these issues, the Accreditation Council for Graduate Medical Education's Next Accreditation System focuses on the development of a competency-based education continuum spanning undergraduate, graduate, and continuing medical education. In 2010, the Clerkship Directors in Internal Medicine subinternship task force, in collaboration with the Association of Program Directors in Internal Medicine survey committee, surveyed internal medicine residency program directors to determine which competencies or skills they expected from new medical school graduates. The authors summarized the results using categories of interest. In both an item rank list and free-text responses, program directors were nearly uniform in ranking the skills they deemed most important for new interns-organization and time management and prioritization skills; effective communication skills; basic clinical skills; and knowing when to ask for assistance. Stakeholders should use the results of this survey as they develop a milestone-based curriculum for the fourth year of medical school and for the internal medicine subinternship. By doing so, they should develop a standardized set of skills that meet program directors' expectations, reduce the stress of transitions across the educational continuum, and improve the quality of patient care.

Transition to international classification of disease version 10, clinical modification: the impact on internal medicine and internal medicine subspecialties.

Science.gov (United States)

Caskey, Rachel N; Abutahoun, Angelos; Polick, Anne; Barnes, Michelle; Srivastava, Pavan; Boyd, Andrew D

2018-05-04

The US health care system uses diagnostic codes for billing and reimbursement as well as quality assessment and measuring clinical outcomes. The US transitioned to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) on October, 2015. Little is known about the impact of ICD-10-CM on internal medicine and medicine subspecialists. We used a state-wide data set from Illinois Medicaid specified for Internal Medicine providers and subspecialists. A total of 3191 ICD-9-CM codes were used for 51,078 patient encounters, for a total cost of US $26,022,022 for all internal medicine. We categorized all of the ICD-9-CM codes based on the complexity of mapping to ICD-10-CM as codes with complex mapping could result in billing or administrative errors during the transition. Codes found to have complex mapping and frequently used codes (n = 295) were analyzed for clinical accuracy of mapping to ICD-10-CM. Each subspecialty was analyzed for complexity of codes used and proportion of reimbursement associated with complex codes. Twenty-five percent of internal medicine codes have convoluted mapping to ICD-10-CM, which represent 22% of Illinois Medicaid patients, and 30% of reimbursements. Rheumatology and Endocrinology had the greatest proportion of visits and reimbursement associated with complex codes. We found 14.5% of ICD-9-CM codes used by internists, when mapped to ICD-10-CM, resulted in potential clinical inaccuracies. We identified that 43% of diagnostic codes evaluated and used by internists and that account for 14% of internal medicine reimbursements are associated with codes which could result in administrative errors.

Palliative Care Exposure in Internal Medicine Residency Education: A Survey of ACGME Internal Medicine Program Directors.

Science.gov (United States)

Edwards, Asher; Nam, Samuel

2018-01-01

As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training. In this study, we surveyed 338 Accreditation Council for Graduate Medical Education-accredited internal medicine program directors. We queried how palliative care was integrated into their training programs. The vast majority of respondents felt that palliative care training was "very important" (87.5%) and 75.9% of respondents offered some kind of palliative care rotation, often with a multidisciplinary approach. Moving forward, we are hopeful that the data provided from our survey will act as a launching point for more formal investigations into palliative care education for internal medicine residents. Concurrently, policy makers should aid in palliative care instruction by formalizing required palliative care training for internal medicine residents.

Education in sexual medicine: proceedings from the international consultation in sexual medicine, 2009.

Science.gov (United States)

Parish, Sharon J; Rubio-Aurioles, Eusebio

2010-10-01

Sexual problems in men and women are common; and physicians endorse many barriers to addressing these issues, including lack of knowledge about the diagnosis and management of sexual problems and inadequate training in sexual health communication and counseling. To update the recommendations published in 2004, from the International Consultation on Sexual Medicine (ICSM) relevant to the educational aspects of sexual health in undergraduate, graduate, and postgraducate medical education. A third international consultation in collaboration with the major sexual health organizations assembled over 186 multidisciplinary experts from 33 countries into 25 committees. Three experts from three countries contributed to this committee's review of Education in Sexual Medicine. Expert opinion was based on a comprehensive review of the medical literature, committee discussion, public presentation, and debate. A comprehensive review about the current state of undergraduate, graduate, and postgraduate sexual health education worldwide is provided. Recommendations about ideal sexual health curricula across training levels are provided. Best methods for achieving optimal training approaches to sexual health communication and interviewing, clinical skills and management, and counseling are described. Current sexual health education for undergraduate and practicing physicians is inadequate to meet the advancing science and technology and increasing patient demand for high-quality sexual health care. There is a need for enhanced training in medical institutions responsible for physician sexual health training worldwide. Future training programs at all levels of medical education should incorporate standardized measures of sexual health clinical skills acquisition and assessments of the impact on patient outcomes into the design of educational initiatives. © 2010 International Society for Sexual Medicine.

Developing post-disaster physical rehabilitation: role of the World Health Organization Liaison Sub-Committee on Rehabilitation Disaster Relief of the International Society of Physical and Rehabilitation Medicine.

Science.gov (United States)

Gosney, James; Reinhardt, Jan Dietrich; Haig, Andrew J; Li, Jianan

2011-11-01

This special report presents the role of the World Health Organization (WHO) Liaison Sub-Committee on Rehabilitation Disaster Relief (CRDR) of the International Society of Physical and Rehabilitation Medicine (ISPRM) in developing an enhanced physical rehabilitation relief response to large-scale natural disasters. The CRDR has stated that disaster rehabilitation is an emerging subspecialty within physical and rehabilitation medicine (PRM). In reviewing the existing literature it was found that large natural disasters result in many survivors with disabling impairments, that these survivors may have better clinical outcomes when they are treated by PRM physicians and teams of rehabilitation professionals, that the delivery of these rehabilitation services to disaster sites is complicated, and that their absence can result in significant negative consequences for individuals, communities and society. To advance its agenda, the CRDR sponsored an inaugural Symposium on Rehabilitation Disaster Relief as a concurrent scientific session at the 2011 ISPRM 6th World Congress in San Juan, Puerto Rico. The symposium included oral and poster presentations on a range of relevant topics and concluded with an international non-governmental organization panel discussion that addressed the critical question "How can rehabilitation actors coordinate better in disaster?" Building upon the symposium, the CRDR is developing a disaster rehabilitation evidence-base, which will inform and educate the global professional rehabilitation community about needs and best practices in disaster rehabilitation. The Journal of Rehabilitation Medicine (JRM) has commissioned this special report to announce a series of papers on disaster rehabilitation from the symposium's scientific programme. Authors are invited to submit papers on the topic for inclusion in this special series. JRM also encourages expert commentary in the form of Letters to the Editor.

Chapter 3: International non-governmental organizations in the emerging world society: the example of ISPRM.

Science.gov (United States)

Reinhardt, Jan D; von Groote, Per M; DeLisa, Joel A; Melvin, John L; Bickenbach, Jerome E; Li, Leonard S W; Stucki, Gerold

2009-09-01

Using the International Society of Physical and Rehabilitation Medicine (ISPRM) as a case in point, the paper describes the complex world societal situation within which non-governmental organizations that address health issues have to operate.This paper describes the complex world societal situation within which non-governmental organizations (NGOs), that are addressing health issues have to operate. In particular, as an international organization in official relation with the World Health Organization (WHO), ISPRM is confronted with a variety of responsibilities and a true world health political mandate. The accompanying rights need to be played out in relation to its own internal member organization and external allies. The theory of the world society and the current situation are briefly reviewed. The role of international NGOs within the world health polity, rehabilitation and Physical and Rehabilitation Medicine (PRM) is highlighted, whilst special emphasis is placed on NGOs in official relation with WHO. Functions, dysfunctions and challenges of international NGOs operating in the health sector are discussed. Against this background, key approaches to enhance ISPRM's political role are analysed. These include transparent and accountable development of the organization, the differentiation between internal and external policy relations, the harmonization of organizational structures and procedures, the consequential use of political structures available to influence WHO's agenda, and the identification of other policy players of major relevance to PRM in order to build strategic alliances with external partners and to enhance ISPRM's membership base.

[International reference prices and cost minimization analysis for the regulation of medicine prices in Colombia].

Science.gov (United States)

Vacca, Caludia; Acosta, Angela; Rodriguez, Ivan

2011-01-01

To suggest a scheme of decision making on pricing for medicines that are part of Free Regulated Regime, a regulation way of the pharmaceutical pricing policy in Colombia. It includes two regulation tools: international reference prices and a cost minimization analysis methodology. Following the current pricing policy, international reference prices were built with data from five countries for selected medicines, which are under Free Regulated Regime. The cost minimization analysis methodology includes selection of those medicines under Free Regulated Regime with possible comparable medicines, selection of comparable medicines, and treatment costs evaluation. As a result of the estimate of International Reference Prices, four medicines showed in the domestic pharmaceutical market a bigger price than the Reference Price. A scheme of decision-making was design containing two possible regulation tools for medicines that are part of Free Regulated Regime: estimate of international reference prices and cost minimization analysis methodology. This diagram would be useful to assist the pricing regulation of Free Regulated Regime in Colombia. As present results shows, international reference prices make clear when domestic prices are higher than those of reference countries. In the current regulation of pharmaceutical prices in Colombia, the international reference price has been applied for four medicines. Would be suitable to extend this methodology to other medicines of high impact on the pharmaceutical expenditure, in particular those covered by public funding. The availability of primary sources about treatment costs in Colombia needs to be improved as a requirement to develop pharmaco-economic evidence. SISMED is an official database that represents an important primary source of medicines prices in Colombia. Nevertheless, having into account that SISMED represents an important advantage of transparency in medicines prices, it needs to be improved in quality and data

Birth of a Neurogastronomy Nation: The Inaugural Symposium of the International Society of Neurogastronomy.

Science.gov (United States)

Herz, Rachel S

2016-02-01

A review of the neuroscientific, clinical medicine, culinary, and food technology and agriculture presentations and demonstrations that were featured at the inaugural symposium of the International Society of Neurogastronomy, held at the University of Kentucky on November 7, 2015. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[ETHICS, MORALS AND SOCIETY IN PERSONALIZED MEDICINE].

Science.gov (United States)

Flugelman, Anath

2015-09-01

Following the completion of the human genome project, genomic medicine including personalized medicine, widely based on pharmacogenetics and pharmacogenomics, is rapidly developing. This breakthrough should benefit humankind thanks to tailoring the most appropriate prevention, interventions and therapies to each individual, minimizing adverse side effects, based on inter-personal genetic variety and polymorphism. Yet wide spectrum ethical, legal and social issues carry significant implications regarding individuals, families, society and public health. The main issues concern genomic information and autonomy, justice and equity, resources allocation and solidarity, challenging the traditional role of medicine and dealing with unlimited boundaries of knowledge. Those issues are not new nor exceptional to genomic medicine, yet their wide unlimited scope and implications on many aspects of life renders them crucial. These aspects will be discussed in light of Beauchamp and Childress' four principles: non-maleficence, beneficence, autonomy and justice, and main moral philosophies, Kant's autonomy, Utilitarianism which promotes the common good, and Rawls' Theory of Justice.

Clinical decisions in patients with diabetes and other cardiovascular risk factors. A statement of the Spanish Society of Internal Medicine.

Science.gov (United States)

Gómez-Huelgas, R; Pérez-Jiménez, F; Serrano-Ríos, M; González-Santos, P; Román, P; Camafort, M; Conthe, P; García-Alegría, J; Guijarro, R; López-Miranda, J; Tirado-Miranda, R; Valdivielso, P

2014-05-01

Although the mortality associated to cardiovascular diseases (CVD) has been reduced in the last decades, CVD remains the main cause of mortality in Spain and they are associated with an important morbidity and a huge economic burden. The increasing prevalence of obesity and diabetes could be slowing down the mortality reduction in Spain. Clinicians have often difficulty making clinical decisions due to the multiple clinical guidelines available. Moreover, in the current context of economic crisis it is critical to promote an efficient use of diagnostic and therapeutic proceedings to ensure the viability of public health care systems. The Spanish Society of Internal Medicine (SEMI) has coordinated a consensus document to answer questions of daily practice with the aim of facilitating physicians' decision-making in the management of diabetes and cardiovascular risk factors from a cost-efficiency point of view. Copyright © 2013 Elsevier España, S.L. All rights reserved.

The internal medicine clerkship and ambulatory learning experiences: results of the 2010 clerkship directors in internal medicine survey.

Science.gov (United States)

Shaheen, Amy; Papp, Klara K; Torre, Dario

2013-01-01

Education in the ambulatory setting should be an integral part of undergraduate medical education. However, previous studies have shown education in this setting has been lacking in medical school. Ambulatory education occurs on some internal medicine clerkships. The extent of this education is unclear. The purpose of this survey was to assess the structure, curriculum, assessment methods, and barriers to implementation of ambulatory education on the internal medicine clerkship. An annual survey of institutional members of the Clerkship Directors in Internal Medicine (CDIM) was done in April 2010. The data were anonymous and descriptive statistics were used to summarize responses. Free text results were analyzed using qualitative techniques. The response rate was 75%. The majority of respondents had a required ambulatory component to the clerkship. Ambulatory experiences distinct from the inpatient internal medicine experience were common (46%). Integration with either the inpatient experiences or other departmental clerkships also occurred. The majority of ambulatory educational experiences were with generalists (74%) and/or subspecialists (45%). The most common assessment tool was the National Board of Medical Examiners (NBME) ambulatory shelf exam. Thematic analysis of the question about how practice based learning was taught elicited four major themes: Not taught; taught in the context of learning evidence based medicine; taught while learning chronic disease management with quality improvement; taught while learning about health care finance. Barriers to implementation included lack of faculty and financial resources. There have been significant increases in the amount of time dedicated to ambulatory internal medicine. The numbers of medical schools with ambulatory internal medicine education has increased. Integration of the ambulatory experiences with other clerkships such as family medicine occurs. Curriculum was varied but difficulties with dissemination

American Internal Medicine in the 21st Century

Science.gov (United States)

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

2003-01-01

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

Hospitalist career decisions among internal medicine residents.

Science.gov (United States)

Ratelle, John T; Dupras, Denise M; Alguire, Patrick; Masters, Philip; Weissman, Arlene; West, Colin P

2014-07-01

Hospital medicine is a rapidly growing field of internal medicine. However, little is known about internal medicine residents' decisions to pursue careers in hospital medicine (HM). To identify which internal medicine residents choose a career in HM, and describe changes in this career choice over the course of their residency education. Observational cohort using data collected from the annual Internal Medicine In-Training Examination (IM-ITE) survey. 16,781 postgraduate year 3 (PGY-3) North American internal medicine residents who completed the annual IM-ITE survey in 2009-2011, 9,501 of whom completed the survey in all 3 years of residency. Self-reported career plans for individual residents during their postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2) and PGY-3. Of the 16,781 graduating PGY-3 residents, 1,552 (9.3 %) reported HM as their ultimate career choice. Of the 951 PGY-3 residents planning a HM career among the 9,501 residents responding in all 3 years, 128 (13.5 %) originally made this decision in PGY-1, 192 (20.2 %) in PGY-2, and 631 (66.4 %) in PGY-3. Only 87 (9.1 %) of these 951 residents maintained a career decision of HM during all three years of residency education. Hospital medicine is a reported career choice for an important proportion of graduating internal medicine residents. However, the majority of residents do not finalize this decision until their final year.

An official American Thoracic Society/International Society for Heart and Lung Transplantation/Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: ethical and policy considerations in organ donation after circulatory determination of death.

Science.gov (United States)

Gries, Cynthia J; White, Douglas B; Truog, Robert D; Dubois, James; Cosio, Carmen C; Dhanani, Sonny; Chan, Kevin M; Corris, Paul; Dark, John; Fulda, Gerald; Glazier, Alexandra K; Higgins, Robert; Love, Robert; Mason, David P; Nakagawa, Thomas A; Shapiro, Ron; Shemie, Sam; Tracy, Mary Fran; Travaline, John M; Valapour, Maryam; West, Lori; Zaas, David; Halpern, Scott D

2013-07-01

Donation after circulatory determination of death (DCDD) has the potential to increase the number of organs available for transplantation. Because consent and management of potential donors must occur before death, DCDD raises unique ethical and policy issues. To develop an ethics and health policy statement on adult and pediatric DCDD relevant to critical care and transplantation stakeholders. A multidisciplinary panel of stakeholders was convened to develop an ethics and health policy statement. The panel consisted of representatives from the American Thoracic Society, Society of Critical Care Medicine, International Society for Heart and Lung Transplantation, Association of Organ Procurement Organizations, and the United Network of Organ Sharing. The panel reviewed the literature, discussed important ethics and health policy considerations, and developed a guiding framework for decision making by stakeholders. A framework to guide ethics and health policy statement was established, which addressed the consent process, pre- and post mortem interventions, the determination of death, provisions of end-of-life care, and pediatric DCDD. The information presented in this Statement is based on the current evidence, experience, and clinical rationale. New clinical research and the development and dissemination of new technologies will eventually necessitate an update of this Statement.

History of the international societies in health technology assessment: International Society for Technology Assessment in Health Care and Health Technology Assessment International.

Science.gov (United States)

Banta, David; Jonsson, Egon; Childs, Paul

2009-07-01

The International Society for Technology Assessment in Health Care (ISTAHC) was formed in 1985. It grew out of the increasing awareness of the international dimensions of health technology assessment (HTA) and the need for new communication methods at the international level. The main function of ISTAHC was to present an annual conference, which gradually grew in size, and also to generally improve in quality from to year. ISTAHC overextended itself financially early in the first decade of the 2000s and had to cease its existence. A new society, Health Technology Assessment international (HTAi), based on many of the same ideas and people, grew up beginning in the year 2003. The two societies have played a large role in making the field of HTA visible to people around the world and providing a forum for discussion on the methods and role of HTA.

[Work and Training Conditions of Young German Physicians in Internal Medicine - Results of a Second Nationwide Survey by Young Internists from the German Society of Internal Medicine and the German Professional Association of Internists.

Science.gov (United States)

Raspe, Matthias; Vogelgesang, Anja; Fendel, Johannes; Weiß, Cornelius; Schulte, Kevin; Rolling, Thierry

2018-04-01

 Medical specialty training is the basis for career development of young internists and it is vital for the delivery of high-quality medical care. In 2014 the young internists of two professional bodies in Germany conducted a survey among their young members and described major factors influencing training and working conditions. We present the results of a follow-up survey to describe changes of these factors over time. An additional focus is set on the difficulties of balancing medical career and family.  In the end of 2016 we conducted an online-based survey of all members in training of the German Society of Internal Medicine (DGIM) and the Professional Association of German Internists (BDI). The questionnaire used in the 2014 survey was modified and items investigating the balance between career and family were added.  A total of 1587 questionnaires were returned and analysed. Mayor findings did not change over time. Psychosocial strain remains very high among medical trainees in internal medicine. A structured training curriculum and meaningful feedback are associated with lower psychosocial strain and higher work satisfaction. Internists - and here especially women - with children experience the daily balance of medical career and family as extremely challenging.  These results demonstrate that there is still a serious need for adjusting training and working conditions of young internists in Germany. Especially the role and increasing importance of female physicians has to be recognized by enabling a successful integration of medical career and family. © Georg Thieme Verlag KG Stuttgart · New York.

General internal medicine at the crossroads of prosperity and despair: caring for patients with chronic diseases in an aging society.

Science.gov (United States)

Larson, E B

2001-05-15

During the past quarter century, general internal medicine has emerged as a vital discipline. In the realm of patient care, it is the integrating discipline par excellence. Ironically, as general internists face the challenge of integrating advances of dizzying speed and complexity, and as their clinical practice becomes increasingly effective, it has become much more difficult for them to earn a living. General internists find themselves at the crossroads of prosperity and despair. Although general medicine research leads the research agenda in many departments of medicine, it is particularly vulnerable. The necessary multidisciplinary "programmatic" infrastructure is expensive, and results often take many years to obtain, particularly in the study of chronic disease. The educational environment in many institutions is particularly difficult for general medicine, both because the current emphasis on technical skills obscures patients' and learners' real needs and because complex patients on general medicine services are now so ill and their turnover so rapid. General internal medicine and geriatrics are synergistic, especially in today's marketplace. A focus on geriatric medicine could help general medicine continue to flourish. General internists are ideally suited to the integrated care of elderly patients with multiple problems, research opportunities are enormous in the geriatric population, and the teaching of geriatrics requires a high level of generalist skills. Problems that plague current generalist practice have unique significance to older patients. Organizations that represent general internists would do well to join forces with many other advocacy groups, especially those representing the interests of elderly patients and geriatric medicine.

Proceedings of the Korean Society Nuclear Medicine Spring Meeting 2002

International Nuclear Information System (INIS)

2002-01-01

This proceedings contains articles of 2002 Spring meeting of the Korean Society Nuclear Medicine. It was held on May 17, 2002 in Suwon, Korea. This proceedings is comprised of 3 sessions. The subject titles of session are as follows: Gynecological and Colorectal cancer, Lung cancer and Lymphoma, and general nuclear medicine. (Yi, J. H.)

Proceedings of the Korean Society Nuclear Medicine Autumn Meeting 1998

International Nuclear Information System (INIS)

1998-01-01

This proceedings contains articles of 1998 Autumn meeting of the Korean Society Nuclear Medicine. It was held on November 13-14, 1998 in Seoul, Korea. This proceedings is comprised of 5 sessions. The subject titles of session are as follows: general nuclear medicine, neurology, radiopharmacy and biology, nuclear cardiology, physics and instrumentation. (Yi, J. H.)

Proceedings of the Korean Society Nuclear Medicine Autumn Meeting 1997

International Nuclear Information System (INIS)

1997-01-01

This proceedings contains articles of 1997 autumn meeting of the Korean Society Nuclear Medicine. It was held on November 21, 1997 in Kwangju, Korea. This proceedings is comprised of 5 sessions. The subject titles of session are as follows: general nuclear medicine, neurology, radiopharmacy and biology, nuclear cardiology, physics and instrumentation. (Yi, J. H.)

Management of patients with type 2 diabetes and multiple chronic conditions: A Delphi consensus of the Spanish Society of Internal Medicine.

Science.gov (United States)

Ena, Javier; Gómez-Huelgas, Ricardo; Sánchez-Fuentes, Demetrio; Camafort-Babkowsk, Miguel; Formiga, Francesc; Michán-Doña, Alfredo; Casariego, Emilio

2016-01-01

To develop consensus-based recommendations for the management of chronic complex patients with type 2 diabetes mellitus using a two round Delphi technique. Experts from the Diabetes and Obesity Working Group (DOWG) of the Spanish Society of Internal Medicine (SEMI) reviewed MEDLINE, PubMed, SCOPUS and Cochrane Library databases up to September 2014 to gather information on organization and health care management, stratification of therapeutic targets and therapeutic approach for glucose control in chronic complex patients with type 2 diabetes mellitus. A list of 6 recommendations was created and rated by a panel of 75 experts from the DOWG by email (first round) and by open discussion (second round). A written document was produced and sent back to DOWG experts for clarification purposes. A high degree of consensus was achieved for all recommendations summarized as 1) there is a need to redesign and test new health care programs for chronic complex patients with type 2 diabetes mellitus; 2) therapeutic targets in patients with short life expectancy should be individualized in accordance to their personal, clinical and social characteristics; 3) patients with chronic complex conditions and type 2 diabetes mellitus should be stratified by hypoglycemia risk; 4) age and specific comorbidities should guide the objectives for glucose control; 5) the risk of hypoglycemia should be a key factor when choosing a treatment; and 6) basal insulin analogs compared to human insulin are cost-effective options. The assessment and recommendations provided herein represent our best professional judgment based on current data and clinical experience. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Proceedings of the signature series event of the international society for cellular therapy: "Advancements in cellular therapies and regenerative medicine in digestive diseases," London, United Kingdom, May 3, 2017.

Science.gov (United States)

Ciccocioppo, Rachele; Dos Santos, Claudia C; Baumgart, Daniel C; Cangemi, Giuseppina C; Cardinale, Vincenzo; Ciacci, Carolina; De Coppi, Paolo; Haldar, Debashis; Klersy, Catherine; Nostro, M Cristina; Ott, Michael; Piemonti, Lorenzo; Tomei, Alice A; Uygun, Basak; Vetrano, Stefania; Orlando, Giuseppe

2018-03-01

A summary of the First Signature Series Event, "Advancements in Cellular Therapies and Regenerative Medicine for Digestive Diseases," held on May 3, 2017, in London, United Kingdom, is presented. Twelve speakers from three continents covered major topics in the areas of cellular therapy and regenerative medicine applied to liver and gastrointestinal medicine as well as to diabetes mellitus. Highlights from their presentations, together with an overview of the global impact of digestive diseases and a proposal for a shared online collection and data-monitoring platform tool, are included in this proceedings. Although growing evidence demonstrate the feasibility and safety of exploiting cell-based technologies for the treatment of digestive diseases, regulatory and methodological obstacles will need to be overcome before the successful implementation in the clinic of these novel attractive therapeutic strategies. Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Internal medicine. An illustrated radiological guide

International Nuclear Information System (INIS)

Al-Tubaikh, Jarrah Ali; Sabah Hospital, Kuwait

2010-01-01

This book explains how radiology can be a powerful tool for establishing the diagnosis of many internal medicine diseases that are usually diagnosed on the basis of their laboratory or clinical presentation. It is organized in the classic fashion for internal medicine books, with eleven chapters covering the different internal medicine specialties. Within these chapters, more than 450 diseases are considered, some of which are rarely encountered but are nonetheless significant. For each disease, radiological and clinical features are displayed in images and high-quality digital medical illustrations, and those differential diagnoses are identified that can be ruled out by imaging alone. In addition, the pathophysiology underlying the radiological features is described, enabling the reader to understand why a particular sign is seen on MR images, CT scans, or plain radiographs. The book will serve as an excellent radiological atlas for internal medicine practitioners and family physicians, showing disease presentations that may be hard to find in standard medical textbooks and explaining which imaging modalities are likely to be most informative in particular patients. (orig.)

[Internal Medicine in the curriculum of General Medicine at Universities of Mexico, 2014].

Science.gov (United States)

Maldonado, Jesús Adrián; Peinado, José María

2017-01-01

The aim of this study was to analyze Internal Medicine as a subject and its requirement in each of the Universities curriculum in Mexico that offers a degree in General Medicine. By the end of the first quarter of 2014, the research was closed and 81 campuses were studied. This research was quantitative, using an analytical technique, written discourse, exploratory and purposive sampling not random and homogeneous type. The Likert questionnaire was used in this study to analyse the following variables: the record of Internal Medicine as a subject, the burden of credit, and the location of the program. The procedure consisted of three phases. First obtaining an official list of all the Universities in the Mexican Association of Colleges and Schools of Medicine. Second, obtaining an analysis of each of the Universities' curriculums, and lastly gathering each variable of the study. The results of the Universities were 63% were public and 37% private. Internal Medicine as a subject in the curriculum was 37.1%, and 20% of the universities include it for six months and 9% offer it the whole year. However, the undergraduate internship in Internal Medicine offers it 100%. In conclusion, Internal Medicine as a subject could disappear from the curriculum in General Medicine before coming to the undergraduate internship, even though the latter is declared required in hospital shifts.

Thieme Textbook Internal Medicine - TIM

International Nuclear Information System (INIS)

Flasnoecker, M.

1999-01-01

The textbook and reference work covers the entire field of internal medicine arranged in 15 chapters, each covering a particular branch of internal medicine. This subject arrangement corresponds to the subject clusters of the regime of post-graduate education. Every branch, i. e. every chapter, has its own responsible editor. This selection of editors and authors,- all in all 180 experts in general and clinical practice -, guarantees a maximum of competence and compliance with the frontiers of research and clinical experience. (orig./CB) [de

[What's new in internal medicine?

Science.gov (United States)

Fardet, L

2017-12-01

As it is practiced in France, internal medicine meets the Anglo-Saxon definition of the specialty, ie doctors "equipped to handle the broad and comprehensive spectrum of illnesses that affect adults, and are recognized as experts in diagnosis, in treatment of chronic illness, and in health promotion and disease prevention - they are not limited to one type of medical problem or organ system". This 2017 "What's new in internal medicine" will consist of 2 parts, a first part on significant publications in the field of systemic and autoimmune diseases and a second part on more diverse publications (HIV, cancer, pregnancy, well-being...) important for medicine in general and its different specialties. © 2017 Elsevier Masson SAS. Tous droits réservés.

Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group.

Science.gov (United States)

Ma, Irene W Y; Arishenkoff, Shane; Wiseman, Jeffrey; Desy, Janeve; Ailon, Jonathan; Martin, Leslie; Otremba, Mirek; Halman, Samantha; Willemot, Patrick; Blouw, Marcus

2017-09-01

Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs. We recommend four POCUS applications for the core PGY 1-3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4-5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.

The European Society for Medical Oncology (ESMO) Precision Medicine Glossary.

Science.gov (United States)

Yates, L R; Seoane, J; Le Tourneau, C; Siu, L L; Marais, R; Michiels, S; Soria, J C; Campbell, P; Normanno, N; Scarpa, A; Reis-Filho, J S; Rodon, J; Swanton, C; Andre, F

2018-01-01

Precision medicine is rapidly evolving within the field of oncology and has brought many new concepts and terminologies that are often poorly defined when first introduced, which may subsequently lead to miscommunication within the oncology community. The European Society for Medical Oncology (ESMO) recognises these challenges and is committed to support the adoption of precision medicine in oncology. To add clarity to the language used by oncologists and basic scientists within the context of precision medicine, the ESMO Translational Research and Personalised Medicine Working Group has developed a standardised glossary of relevant terms. Relevant terms for inclusion in the glossary were identified via an ESMO member survey conducted in Autumn 2016, and by the ESMO Translational Research and Personalised Medicine Working Group members. Each term was defined by experts in the field, discussed and, if necessary, modified by the Working Group before reaching consensus approval. A literature search was carried out to determine which of the terms, 'precision medicine' and 'personalised medicine', is most appropriate to describe this field. A total of 43 terms are included in the glossary, grouped into five main themes-(i) mechanisms of decision, (ii) characteristics of molecular alterations, (iii) tumour characteristics, (iv) clinical trials and statistics and (v) new research tools. The glossary classes 'precision medicine' or 'personalised medicine' as technically interchangeable but the term 'precision medicine' is favoured as it more accurately reflects the highly precise nature of new technologies that permit base pair resolution dissection of cancer genomes and is less likely to be misinterpreted. The ESMO Precision Medicine Glossary provides a resource to facilitate consistent communication in this field by clarifying and raising awareness of the language employed in cancer research and oncology practice. The glossary will be a dynamic entity, undergoing

Teaching Prevention in Internal Medicine Clerkships.

Science.gov (United States)

Kinsinger, Linda

2000-01-01

Reviews the rationale for including prevention in the clinical medicine clerkship. Summarizes current guidelines, presents examples of curricula in several medical schools, and proposes a future direction that stresses integrating teaching preventive medicine into internal medicine clerkships and across the entire four-year medical curriculum. (DB)

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine (QUANUM) Program. Part 1: the QUANUM Program and Methodology.

Science.gov (United States)

Dondi, Maurizio; Torres, Leonel; Marengo, Mario; Massardo, Teresa; Mishani, Eyal; Van Zyl Ellmann, Annare; Solanki, Kishor; Bischof Delaloye, Angelika; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Paez, Diana; Pascual, Thomas

2017-11-01

An effective management system that integrates quality management is essential for a modern nuclear medicine practice. The Nuclear Medicine and Diagnostic Imaging Section of the International Atomic Energy Agency (IAEA) has the mission of supporting nuclear medicine practice in low- and middle-income countries and of helping them introduce it in their health-care system, when not yet present. The experience gathered over several years has shown diversified levels of development and varying degrees of quality of practice, among others because of limited professional networking and limited or no opportunities for exchange of experiences. Those findings triggered the development of a program named Quality Management Audits in Nuclear Medicine (QUANUM), aimed at improving the standards of NM practice in low- and middle-income countries to internationally accepted standards through the introduction of a culture of quality management and systematic auditing programs. QUANUM takes into account the diversity of nuclear medicine services around the world and multidisciplinary contributions to the practice. Those contributions include clinical, technical, radiopharmaceutical, and medical physics procedures. Aspects of radiation safety and patient protection are also integral to the process. Such an approach ensures consistency in providing safe services of superior quality to patients. The level of conformance is assessed using standards based on publications of the IAEA and the International Commission on Radiological Protection, and guidelines from scientific societies such as Society of Nuclear Medicine and Molecular Imaging (SNMMI) and European Association of Nuclear Medicine (EANM). Following QUANUM guidelines and by means of a specific assessment tool developed by the IAEA, auditors, both internal and external, will be able to evaluate the level of conformance. Nonconformances will then be prioritized and recommendations will be provided during an exit briefing. The

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.

The Concept of Law and International Society

DEFF Research Database (Denmark)

Schaumburg-Müller, Sten

Hedley Bull, one of the founders of the School of International Society (English School) relies heavily on H.L.A. Hart in his understanding of law, including international law. The contribution seeks to explore 1) how Bull has creatively made use of Hart's Concept of Law, 2) on which points Hart'......'s theory has short comings, 3) on which additional points Bull's use of the concept of law has short comings, and 4) sketch of ideas how to improve the various short comings.......Hedley Bull, one of the founders of the School of International Society (English School) relies heavily on H.L.A. Hart in his understanding of law, including international law. The contribution seeks to explore 1) how Bull has creatively made use of Hart's Concept of Law, 2) on which points Hart...

The integration of acupuncture within medicine in the UK--the British Medical Acupuncture Society's 25th anniversary.

Science.gov (United States)

Baldry, Peter

2005-03-01

Acupuncture was first used in China, probable about 2000 years ago. When acupuncture first arrived in the West in the 17th century, the principles which the Chinese had used to explain its actions were at variance with current scientific knowledge of the body's structure and function. This led to the rejection of acupuncture by the medical profession in the UK, although individual practitioners adopted it with enthusiasm, usually needling the point of maximal tenderness to treat musculoskeletal pain. Acupuncture was more generally accepted in France and Germany, where the pioneering British physician Felix Mann encountered it in the 1950s. He then taught acupuncture to other medical practitioners and organised regular meetings in London, from which the British Medical Acupuncture Society, BMAS, emerged in 1980. The tradition of biannual scientific meetings has continued since then. The Society has many connections with prominent acupuncturists internationally and is a founder member of the International Council of Medical Acupuncture and Related Techniques (ICMART), and has hosted two world congresses. The Society was involved in standardisation of the meridian nomenclature published in 1990. The Society's scientific journal, Acupuncture in Medicine, was founded in 1981 and has gained international recognition, being indexed on several databases. The Society has established regular teaching courses at different levels, which lead to professional qualifications of Certificate and Diploma. The membership is now open to different health professionals, has grown steadily and now stands at nearly 2500. The Society is administered from offices in Cheshire and London. Many individual members have contributed to the Society's characteristic Western 'medical' approach to acupuncture in which needling is seen as a form of neuromuscular stimulation that owes little to traditional meridians or points. The Society has shown a particular interest in acupuncture for myofascial

Delphi-RAND consensus of the Spanish Society of Internal Medicine on the controversies in anticoagulant therapy and prophylaxis in medical diseases. INTROMBIN Project (Uncertainty in thromboprophylaxis in internal medicine).

Science.gov (United States)

Ruiz-Ruiz, F; Medrano, F J; Navarro-Puerto, M A; Rodríguez-Torres, P; Romero-Alonso, A; Santos-Lozano, J M; Alonso-Ortiz Del Rio, C; Varela-Aguilar, J M; Calderón, E J; Marín-León, I

2018-05-21

The aim of this study was to determine the opinion of internists on the management of anticoagulation and thromboembolism prophylaxis in complex clinical scenarios in which the risk-benefit ratio of surgery is narrow and to develop a consensus document on the use of drugs anticoagulant therapy in this patient group. To this end, we identified by consensus the clinical areas of greatest uncertainty, a survey was created with 20 scenarios laid out in 40 clinical questions, and we reviewed the specific literature. The survey was distributed among the internists of the Spanish Society of Internal Medicine (SEMI) and was completed by 290 of its members. The consensus process was implemented by changing the Delphi-RAND appropriateness method in an anonymous, double-round process that enabled an expert panel to identify the areas of agreement and uncertainty. In our case, we also added the survey results to the panel, a methodological innovation that helps provide additional information on the standard clinical practice. The result of the process is a set of 19 recommendations formulated by SEMI experts, which helps establish guidelines for action on anticoagulant therapy in complex scenarios (high risk or active haemorrhage, short life expectancy, coexistence of antiplatelet therapy or comorbidities such as kidney disease and liver disease), which are not uncommon in standard clinical practice. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Core addiction medicine competencies for doctors: An international consultation on training.

Science.gov (United States)

Ayu, Astri Parawita; El-Guebaly, Nady; Schellekens, Arnt; De Jong, Cor; Welle-Strand, Gabrielle; Small, William; Wood, Evan; Cullen, Walter; Klimas, Jan

2017-01-01

Despite the high prevalence of substance use disorders, associated comorbidities, and the evidence base upon which to base clinical practice, most health systems have not invested in standardized training of health care providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, this study was undertaken to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education. A total of 13 members of the International Society of 20 Addiction Medicine (ISAM), from 12 different countries (37% response rate), were interviewed over Skype, e-mail survey, or in person at the annual conference. Content analysis was used to analyze interview transcripts, using constant comparison methodology. We identified recommendations related to the core set of the addiction medicine competencies at 3 educational levels: (i) undergraduate, (ii) postgraduate, and (iii) continued medical education (CME). The participants described broad ideas, such as knowledge/skills/attitudes towards addiction to be obtained at undergraduate level, or knowledge of addiction treatment to be acquired at graduate level, as well as specific recommendations, including the need to tailor curriculum to national settings and different specialties. Although it is unclear whether a global curriculum is needed, a consensus on a core set of principles for progression of knowledge, attitudes, and skills in addiction medicine to be developed at each educational level amongst medical graduates would likely have substantial value.

[Medicine and society. Schools of thought in the health field].

Science.gov (United States)

García, J C

1983-01-01

The article considers the answers given by different schools of thought to the fundamental questions about the degree of autonomy of medicine and the kind of articulation between medicine and society as a whole and in its "parts." The answers vary with the thinking in the different social sciences and the philosophic schools associated with them. The author divides his presentation in two broad chapters: The first covers schools of thought in the health field, and attempts to delineate the philosophical foundations underlying the principal current schools of thought in this field, without attempting a history of the philosophical schools or analyzing each of them in detail. Thus, two idealist currents are studied which have exerted great influence in the health field--neopositivism and neo-Kantianism--and marxism as the materialist school, which recognizes the primary of matter, nature, and objective reality, and views consciousness as a property of matter. The second chapter considers the theoretical contest now going on among the schools of thought discussed in the first chapter, which try to explain the relationship between medicine and the social structure; the effectiveness of medical action, and the social determinants of disease. Prior to the seventies, the author says, the dominant view of the autonomy of medicine, its effectiveness, the potential for social change of the medical institutions, and the benefits to health of economic development, was endorsed by the predominance of positivism among these schools of medical thought. The view that medicine was broadly autonomous and at the same level with other subsystems such as the economic, the political and the educational subsystems, assumed the possibility of changing society by an effort begun through any of these "sectors." The enormous growth of productive forces that took place in the developed capitalist countries during the fifties, and even more during the sixties, collided at the end of the latter

Course on internal dosimetry in nuclear medicine

International Nuclear Information System (INIS)

2004-01-01

This documentation was distributed to the participants in the Course of Internal Dosimetry in Nuclear Medicine organised by the Nuclear Regulatory Authority (ARN) of Argentina and held in Buenos Aires, Argentina, August 9-13, 2004. The course was intended for people from IAEA Member States in the Latin American and Caribbean region, and for professionals and workers in medicine, related with the radiation protection. Spanish and English were the languages of the course. The following subjects were covered: radioprotection of the patient in nuclear medicine; injuries by ionizing radiations; MIRD methodology; radiation dose assessment in nuclear medicine; small scale and microdosimetry; bone and marrow dose modelling; medical internal dose calculations; SPECT and image reconstruction; principles of the gamma camera; scattering and attenuation correction in SPECT; tomography in nuclear medicine

Role of Scientific Societies in International Collaboration

Science.gov (United States)

Fucugauchi, J. U.

2007-12-01

Geophysical research increasingly requires global multidisciplinary approaches. Understanding how deeply interrelated are Earth components and processes, population growth, increased needs of mineral and energy resources, global impact of human activities, and view of our planet as an interconnected system emphasizes the need of international cooperation. International research collaboration has an immense potential and is needed for further development of Earth science research and education. The Union Session is planned to provide a forum for analysis and discussion of the status of research and education of geosciences in developing countries, international collaboration programs and new initiatives for promoting and strengthening scientific cooperation. A theme of particular relevance in the analyses and discussions is the role of scientific societies in international collaboration. Societies organize meetings, publish journals and books and promote cooperation through academic exchange activities. They may further assist communities in developing countries in providing and facilitating access to scientific literature, attendance to international meetings, short and long-term stays and student and young researcher mobility. What else can be done? This is a complex subject and scientific societies may not be seen independently from the many factors involved in research and education. Developing countries present additional challenges resulting from limited economic resources and social and political problems, while urgently requiring improved educational and research programs. Needed are in-depth analyses of infrastructure and human resources, and identification of major problems and needs. What are the major limitations and needs in research and postgraduate education in developing countries? What and how should international collaboration do? What are the roles of individuals, academic institutions, funding agencies, scientific societies? Here we attempt to

International Social Medicine between the Wars : Positioning a Volatile Concept

Directory of Open Access Journals (Sweden)

Borowy, Iris

2007-12-01

Full Text Available International health work during the 1930s was influenced by several inter-acting developments which caused general attention to turn away from pathogens and individual diseases to social conditions and their impact on the status of public health. Internationally, the League of Nations Health Organisation became the centre of initiatives in social medicine. After 1932, the search for the health implications of the depression invigorated ongoing social studies. Thus, nutrition, housing and rural hygiene became major issues, followed by discussions on sports. All these topics had important political connotations because they touched sensitive questions of welfare, status and the distribution of wealth and poverty within societies. In the process, they opened discussions on abstract issues like social and moral justice and on tangible questions of political systems.

[Infectious diseases - a specialty of internal medicine].

Science.gov (United States)

Fätkenheuer, G; Jung, N; Kern, W V; Fölsch, U R; Salzberger, B

2018-04-01

Infectious diseases have recently gained wide public interest. Emerging infections and rising rates of antibiotic resistance are determining this trend. Both challenges will need to be addressed in international and local collaborations between different specialties in medicine and basic science. Infectious diseases as a clinical specialty in this scenario is directly responsible for the care of patients with infectious diseases. Its involvement in the care of patients with complicated infections has proved to be highly effective. Antibiotic stewardship programmes are effective measures in slowing the development of antibiotic resistance and have been widely implemented. But antibiotic stewardship specialists should not be confused with or taken as an alternative to infectious disease experts. Infectious diseases requires appropriate and specific training. It mainly uses the instrumentarium of internal medicine. With the current challenges in modern medicine, infectious diseases in Germany should thus be upgraded from a subspecialty to a clinical specialty, ideally within Internal Medicine.

Sir Ronald A. Fisher and the International Biometric Society.

Science.gov (United States)

Billard, Lynne

2014-06-01

The year 2012 marks the 50th anniversary of the death of Sir Ronald A. Fisher, one of the two Fathers of Statistics and a Founder of the International Biometric Society (the "Society"). To celebrate the extraordinary genius of Fisher and the far-sighted vision of Fisher and Chester Bliss in organizing and promoting the formation of the Society, this article looks at the origins and growth of the Society, some of the key players and events, and especially the roles played by Fisher himself as the First President. A fresh look at Fisher, the man rather than the scientific genius is also presented. © 2014, The International Biometric Society.

International assistance and cooperation for access to essential medicines.

Science.gov (United States)

Mok, Emily A

2010-06-15

Access to essential medicines is a critical problem that plagues many developing countries. With a daunting number of domestic constraints - technologically, economically, and otherwise - developing countries are faced with a steep uphill battle to meet the human rights obligation of providing essential medicines immediately. To meet these challenges, the international human rights obligations of international assistance and cooperation can play a key role to help developing countries fulfill the need for access to essential medicines. This article seeks to highlight and expand upon the current understanding of international assistance and cooperation for access to essential medicines through a review of obligations identified in international human rights law and a synthesis of official guidance provided on the matter.

Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.

Science.gov (United States)

Williams, Brent C; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg Mpa, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G; Leipzig, Rosanne M

2010-09-01

Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory

Proceedings of 2nd Korea-China Congress of Nuclear Medicine and the Korean Society Nuclear Medicine Spring Meeting 2000

International Nuclear Information System (INIS)

2000-01-01

This proceedings contains articles of 2nd Korea-China Congress of Nuclear Medicine and 2000 spring meeting of the Korean Society Nuclear Medicine. It was held on May 17-19, 2000 in Seoul, Korean. This proceedings is comprised of 6 sessions. The subject titles of session are as follows: general nuclear medicine, neurology, oncology, radiopharmacy and biology, nuclear cardiology, nuclear cardiology: physics and instrumentation and so on. (Yi, J. H.)

Curricula and Organization of Primary Care Residencies in Internal Medicine.

Science.gov (United States)

Eisenberg, John M.

1980-01-01

The organization and curricula of internal medicine residencies programs that emphasize primary care are described and compared with traditional residencies in internal medicine. It is noted that primary care residents spend more time in ambulatory care and are allowed more electives in specialties outside of internal medicine. Out-of-hospital…

Proceedings of the forty third annual conference of Society of Nuclear Medicine India: empowering modern medicine with molecular nuclear medicine

International Nuclear Information System (INIS)

2011-01-01

Theme of the 43rd Annual Conference of the Society of Nuclear Medicine India is 'empowering modem medicine with molecular nuclear medicine'. Keeping the theme in mind, the scientific committee has arranged an attractive and comprehensive program for both physicians and scientists reflecting the multimodality background of Nuclear Medicine and Metabolic Imaging. During this meeting the present status and future prospects of Nuclear medicine are discussed at length by esteemed faculty in dedicated symposia and interesting featured sessions which are immensely facilitate in educating the participants. Nuclear Medicine has come a long way since the first applications of radioiodine in the diagnosis of thyroid disease. The specialty of nuclear medicine in India is growing very rapidly. Technology continues to push the field in new directions and open new pathways for providing optimal care to patients. It is indeed an exciting time in the world of imaging and in the field of nuclear medicine. Innovative techniques in hardware and software offer advantages for enhanced accuracy. New imaging agents, equipment, and software will provide us with new opportunities to improve current practices and to introduce new technology into the clinical protocols. Papers relevant to INIS are indexed separately

The Evolution of General Internal Medicine (GIM)in Canada: International Implications.

Science.gov (United States)

Card, Sharon E; Clark, Heather D; Elizov, Michelle; Kassam, Narmin

2017-05-01

General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition. However, interest amongst trainees in GIM was declining, and the GIM workforce in Canada, like that in many other countries, was in danger of serious shortfalls. After much deliberation and consultation, in 2010, the RCPSC recognized GIM as a distinct subspecialty of internal medicine. Since this time, despite the challenges in the educational implementation of GIM as a distinct discipline, there has been a resurgence of interest in this field of medicine. This paper outlines the journey of the Canadian GIM to educational implementation as a distinct discipline, the impact on the discipline, and the implications for the international GIM community.

The human dimension: esthetics in society and in medicine.

Science.gov (United States)

Talarico, Giorgio; Morgante, Ezio

2013-01-01

This research has been carried out to transmit a multidisciplinary knowledge of esthetics in society and in the field of science (psychology, sociology, philosophy, medicine, art, ethics). This knowledge is necessary to ensure that esthetic doctors who deal with esthetic medicine may, through their intervention - which is not only analytical, but also creative - respecting human nature, people's esthetic expectations and the rules of social ethics. This is the only way we can best respond to the overall concept referred to as the human dimension. This may be carried out in different ways and contexts that are current and are an expression of the age we are living in.

Does clerkship experience influence interest In internal medicine ...

African Journals Online (AJOL)

BACKGROUND:The career intention of undergraduate medical students may be influenced by the clerkship experience in the various specialties. AIM:This study was undertaken to assess the medical student's perception of the internal medicine clerkship and determine its influence in the choice of internal medicine as a ...

International Journal of Medicine and Health Development

African Journals Online (AJOL)

International Journal of Medicine and Health Development ... This is the official publication of College of Medicine, University of Nigeria under the ... Health related quality of life and sociodemographic characteristics among Iranian students ...

Proceedings of the Joint Conference of Australasian College of Physical Scientists and Engineers in Medicine and IEAust College of Biomedical Engineers; Asia/Pacific Region of the IEEE Engineering in Medicine and Biology Society

International Nuclear Information System (INIS)

1996-01-01

This is a celebration of the centenary of Rontgen''s discovery of Xrays. It is also the 50th anniversary of the first hospital physicist appointment in New Zealand. The historical element of the programme will complement the emphasis on current applications of the physical and engineering sciences to medicine and an anticipation of future developments. For the first time the Australasian College of Physical Scientists and Engineers in Medicine, together with the IEAust College of Biomedical Engineers, are joined by the Asia/Pacific Region of the IEEE Engineering in Medicine and Biology Society to make this a truly international conference. The proceedings include many papers on radiology and radiotherapy

Presidential addresses of the Royal Society of Tropical Medicine and Hygiene: 1907–2013

Science.gov (United States)

Hay, Simon I.; McHugh, Gerri M.

2013-01-01

Presidents have been required to give an inaugural address on commencing office at the Royal Society of Tropical Medicine and Hygiene (RSTMH) since its foundation in 1907. All presidential addresses were identified, sourced and assembled into an annotated bibliography. The majority of presidential addresses have been published in Transactions of the Royal Society of Tropical Medicine and Hygiene. Unpublished and in some cases ‘lost’ contributions have now been sourced where possible and archived at the RSTMH. This unique, rich and rewarding archive provides a vista into the development of the RSTMH and the discipline of tropical medicine. The archive is freely available to all. PMID:24026462

International co-operation through scientific and technical nuclear societies

International Nuclear Information System (INIS)

Manning Muntzing, L.

1983-01-01

As an international organization the American Nuclear Society (ANS) has played an active role in international co-operation of nuclear technology exchange since its establishment in 1954. The ANS has a membership of over 13,000 individuals, of whom approximately 1200 live overseas in forty countries. To carry out the goals of the Society, local sections have been established. Currently the ANS maintains 48 local sections in the United States of America and 8 overseas local sections in Africa, Asia, Europe and South America. The ANS also has formal agreements for co-operation with The Asociacion Argentina de Tecnologia Nuclear (AATN), the Israel Nuclear Society (INS), and the Chinese Nuclear Society (CNS). In 1977 the Japan Atomic Energy Society (JAES), the European Nuclear Society (ENS), and the ANS co-operation in sponsoring the First International Conference on Transfer of Nuclear Technology (ICONTT I) in Tehran, Iran. In 1982, the Second International Conference on Transfer of Nuclear Technology (ICONTT II), Buenos Aires, Argentina, was sponsored through the co-operation of the AATN, the ENS and the ANS. The ANS and its overseas sections sponsor the Pacific Basin Conference approximately every three years to discuss nuclear matters of concern to the countries around the Pacific Ocean. In 1981 the ANS held a Nuclear Technology Exhibit in Beijing, the People's Republic of China. In addition to meetings, the ANS is extensively involved in the co-operative exchange of applied nuclear research information through its publications. Nuclear Technology, a technical journal, is published monthly under joint ownership of the ENS and the ANS. The ANS has been a leader in voluntary standards development since 1958. In its dedication to the co-operation of international nuclear technology the ANS maintains a comprehensive international exchange of nuclear standards

Predictors of yoga use among internal medicine patients.

Science.gov (United States)

Cramer, Holger; Lauche, Romy; Langhorst, Jost; Paul, Anna; Michalsen, Andreas; Dobos, Gustav

2013-07-13

Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50-64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically

Impact of Behavior Genetics on Medicine and Society

OpenAIRE

Dean Hamer

2008-01-01

Understanding the role of genes in human behavior will impact both medicine and society, but not always in the manner expected. Knowledge about behavioral genes can be used for the good, for example by improving psychiatric diagnoses, developing new drugs to treat mental illnesses, and dispelling harmful myths about certain types of human variation. However, the same sort of information could be used to discriminate against people, to provide quick fixes for social problems, or to support eug...

Choosing wisely in headache medicine: the American Headache Society's list of five things physicians and patients should question.

Science.gov (United States)

Loder, Elizabeth; Weizenbaum, Emma; Frishberg, Benjamin; Silberstein, Stephen

2013-01-01

In an effort to draw attention to tests and procedures associated with low-value care in headache medicine, the American Headache Society (AHS) joined the Choosing Wisely initiative of the American Board of Internal Medicine Foundation. The AHS president appointed an ad hoc "Choosing Wisely" task force of the AHS. The committee surveyed AHS members to develop a candidate list of items for the AHS "Top 5" list of low-value care in headache medicine. Through a process of literature review and consensus, the final list of five items was chosen. Draft recommendations went through several rounds of revision and a process of outside review. The AHS Board of Directors approved the final list of "Five Things." The five recommendations approved by the AHS Board of Directors are: (1) don't perform neuroimaging studies in patients with stable headaches that meet criteria for migraine; (2) don't perform computed tomography imaging for headache when magnetic resonance imaging is available, except in emergency settings; (3) don't recommend surgical deactivation of migraine trigger points outside of a clinical trial; (4) don't prescribe opioid- or butalbital-containing medications as a first-line treatment for recurrent headache disorders; and (5) don't recommend prolonged or frequent use of over-the-counter pain medications for headache. We recommend that headache medicine specialists and other physicians who evaluate and treat headache disorders should use this list when discussing care with patients. © 2013 American Headache Society.

2nd Anglo-Croatian Medicinal Symposium on Macrocycles Medicinal Chemistry and Beyond-the-Rule-of-Five

Directory of Open Access Journals (Sweden)

Vitomir Šunjić

2016-09-01

Full Text Available Second international symposium was jointly organized by the Biological and Medicinal Sector of the Royal Society of Chemistry (RSC and by the Croatian Chemical Society (CCS on October 17–18, 2016, in Zagreb, Croatia. This work is licensed under a Creative Commons Attribution 4.0 International License.

Introducing the International Confederation of Plastic Surgery Societies: ICOPLAST.

Science.gov (United States)

Rakhorst, Hinne A; Badran, Hassan; Clarke, Howard M; Cooter, Rodney; Evans, Gregory R D; Kirschbaum, Julio Daniel; Koh, Kyung Suk; Lazier, Carol; Murphy, Robert X; Nakatsuka, Takashi; Piccolo, Nelson Sarto; Perks, Graeme

2017-09-01

This article describes the formation of the International Confederation of Plastic Surgery Societies (ICOPLAST) as a novel, transparent, dynamic, and proactive confederation of national plastic surgery societies. ICOPLAST aspires to provide a voice for the entire international community of plastic surgeons. ICOPLAST has been designed to benefit the patient, plastic surgery as a profession, and each individual plastic surgeon. Its principal objective is to enhance international communication, education, and advocacy processes to ultimately improve patient outcomes for plastic surgery patients globally. The new ICOPLAST's focus is to add true value for patients. ICOPLAST's evolution, philosophy, governance, and bylaws are explained and all societies worldwide are encouraged and cordially invited to join. An open and warm invitation is provided. Additional information is found at www.ICOPLAST.org.

Topics of internal medicine for undergraduate dental education: a qualitative study.

Science.gov (United States)

Kunde, A; Harendza, S

2015-08-01

Due to the ageing population, internal medicine has become increasingly important for dental education. Although several studies have reported dentists' dissatisfaction with their internal medicine training, no guidelines exist for internal medicine learning objectives in dental education. The aim of this study was to identify topics of internal medicine considered to be relevant for dental education by dentists and internists. Eight dentists from private dental practices in Hamburg and eight experienced internal medicine consultants from Hamburg University Hospital were recruited for semi-structured interviews about internal medicine topics relevant for dentists. Internal diseases were clustered into representative subspecialties. Dentists and internists were also asked to rate medical diseases or emergencies compiled from the literature by their relevance to dental education. Coagulopathy and endocarditis were rated highest by dentists, whilst anaphylaxis was rated highest by internists. Dentists rated hepatitis, HIV, organ transplantation and head/neck neoplasm significantly higher than internists. The largest number of different internal diseases mentioned by dentists or internists could be clustered under cardiovascular diseases. The number of specific diseases dentists considered to be relevant for dental education was higher in the subspecialties cardiovascular diseases, haematology/oncology and infectiology. We identified the internal medicine topics most relevant for dental education by surveying practising dentists and internists. The relevance of these topics should be confirmed by larger quantitative studies to develop guidelines how to design specific learning objectives for internal medicine in the dental curriculum. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Historical Roots of International Biomedical and Health Informatics: The Road to IFIP-TC4 and IMIA through Cybernetic Medicine and the Elsinore Meetings.

Science.gov (United States)

Kulikowski, C A

2017-08-01

Background: It is 50 years since the International Federation of Information Processing (IFIP) Societies approved the formation of a new Technical Committee (TC) 4 on Medical Information Processing under the leadership of Professor Francois Grémy, which was the direct precursor of the International Medical Informatics Association (IMIA). Objectives: The goals of this paper are to give a very brief overview of early international developments leading to informatics in medicine, with the origins of the applications of computers to medicine in the USA and Europe, and two meetings - of the International Society of Cybernetic Medicine, and the Elsinore Meetings on Hospital Information Systems-that took place in 1966. These set the stage for the formation of IFIP-TC4 the following year, with later sponsorship of the first MEDINFO in 1974, setting the path for the evolution to IMIA. Methods: This paper reviews and analyzes some of the earliest research and publications, together with two critical contrasting meetings in 1966 involving international activities in what evolved into biomedical and health informatics in terms of their probable influence on the formation of IFIP-TC4. Conclusion: The formation of IFIP-TC 4 in 1967 by Francois Grémy arose out of his concerns for merging, at an international level, the diverse strands from the more abstract work on cybernetic medicine and its basis in biophysical and neural modeling, with the more concrete and health-oriented medical information processing that was developing at the time for hospitals and clinical decision-making. Georg Thieme Verlag KG Stuttgart.

An Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation: Report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation

Directory of Open Access Journals (Sweden)

Ege Can Serefoglu, MD

2014-06-01

Conclusion: The ISSM unified definition of lifelong and acquired PE represents the first evidence-based definition for these conditions. This definition will enable researchers to design methodologically rigorous studies to improve our understanding of acquired PE. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, Becher EF, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An evidence-based unified definition of lifelong and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. Sex Med 2014;2:41–59.

International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.

Science.gov (United States)

Kreider, Richard B; Kalman, Douglas S; Antonio, Jose; Ziegenfuss, Tim N; Wildman, Robert; Collins, Rick; Candow, Darren G; Kleiner, Susan M; Almada, Anthony L; Lopez, Hector L

2017-01-01

Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. Additionally, a number of clinical applications of creatine supplementation have been studied involving neurodegenerative diseases (e.g., muscular dystrophy, Parkinson's, Huntington's disease), diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia, adolescent depression, and pregnancy. These studies provide a large body of evidence that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads. Additionally, researchers have identified a number of potentially beneficial clinical uses of creatine supplementation. These studies show that short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly. Moreover, significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan. The purpose of this review is to provide an update to the current literature regarding the role and safety of creatine supplementation in exercise, sport, and medicine and to update the position stand of International Society of Sports Nutrition (ISSN).

Performance of International Medical Students In psychosocial medicine.

Science.gov (United States)

Huhn, D; Lauter, J; Roesch Ely, D; Koch, E; Möltner, A; Herzog, W; Resch, F; Herpertz, S C; Nikendei, C

2017-07-10

Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students. All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making. International medical students scored significantly poorer than their local peers (p International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship.

Update in outpatient general internal medicine: practice-changing evidence published in 2014.

Science.gov (United States)

Sundsted, Karna K; Wieland, Mark L; Szostek, Jason H; Post, Jason A; Mauck, Karen F

2015-10-01

The practice of outpatient general internal medicine requires a diverse and evolving knowledge base. General internists must identify practice-changing shifts in the literature and reflect on their impact. Accordingly, we conducted a review of practice-changing articles published in outpatient general internal medicine in 2014. To identify high-quality, clinically relevant publications, we reviewed all titles and abstracts published in the following primary data sources in 2014: New England Journal of Medicine, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, JAMA Internal Medicine, and the Cochrane Database of Systematic Reviews. All 2014 primary data summaries from Journal Watch-General Internal Medicine and ACP JournalWise also were reviewed. The authors used a modified Delphi method to reach consensus on inclusion of 8 articles using the following criteria: clinical relevance to outpatient internal medicine, potential for practice change, and strength of evidence. Clusters of important articles around one clinical question were considered as a single-candidate series. The article merits were debated until consensus was reached on the final 8, spanning a variety of topics commonly encountered in outpatient general internal medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

[Diagnosis and treatment in general internal medicine. Curriculum selection].

Science.gov (United States)

Casal, E R; Vázquez, E N; Husni, C

1994-01-01

In our country general internists are the providers of adult medical care in urban areas. In the past twenty years, with the increasing subspecialization within internal medicine and the development of advances in technology, the role of the general internist seems to be endangered. Recently much attention has been focused on this area and Divisions and Programs of General Internal Medicine have been established in most medical schools in the USA. The University of Buenos Aires instituted a Program of General Internal Medicine in its major teaching hospital in 1987. One of its purposes was to offer an educational experience to residents in the field of internal medicine primary care. This paper summarizes how this program was carried out and the subjects proposed in the area of Diagnosis and Treatment. The Program of General Internal Medicine is performed in the Outpatient Division and it is staffed by 3 faculty members and 4 fellows. Residents in Internal Medicine have a three month, full-time block rotation in the Program. A young, city dwelling, lower middle class population participates in the Program, with almost 10000 visits a year. The Program offers an experience that includes supervised patient care, an average of 100 office visits a month, and seminars and/or workshops covering topics of "Diagnosis and Treatment", "Case Presentations", "Clinical Epidemiology", "Prevention", and "Doctor-Patient Interview". In the area of Diagnosis and Treatment, the criteria used were: 1-frequency of diagnosis as determined by previous investigations, 2-relevant clinical conditions absent from the frequency list as determined by a consensus process by faculty members.(ABSTRACT TRUNCATED AT 250 WORDS)

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.

[Representation of Internal Medicine in G-DRG System - Analysis of Reasons for Prolonged Length of Stay].

Science.gov (United States)

Siam, Kristina; Roeder, Norbert; Fölsch, Ulrich R; Spies, Hans-Friedrich

2017-08-01

Background  There is an ongoing discussion within the German Society of Internal Medicine (DGIM) and the Professional Association of German Internists (BDI) about the appropriate depiction and remuneration of internal medicine in the G-DRG. Method  Therefore, cases with a significantly prolonged length of stay were analyzed in a multicenter study. 124 cases from 6 hospitals were collected for evaluation. Results  The results show that the observed prolongation of hospitalization was mainly due to medical reasons. Discussion  Thus, patients with unclear symptoms and consequently need for a thorough workup could not be identified to cause longer inpatient stay. Instead, treatment complications and comorbidities led to extended hospitalization. The results also reveal prolonged hospitalization as a consequence of unsettled or delayed postdischarge care e. g. in rehabilitation facilities. © Georg Thieme Verlag KG Stuttgart · New York.

5th Conference of the International Federation of Classification Societies

CERN Document Server

Yajima, Keiji; Bock, Hans-Hermann; Ohsumi, Noboru; Tanaka, Yutaka; Baba, Yasumasa

1998-01-01

This volume, Data Science, Classification, and Related Methods, contains a selection of papers presented at the Fifth Conference of the International Federation of Oassification Societies (IFCS-96), which was held in Kobe, Japan, from March 27 to 30,1996. The volume covers a wide range of topics and perspectives in the growing field of data science, including theoretical and methodological advances in domains relating to data gathering, classification and clustering, exploratory and multivariate data analysis, and knowledge discovery and seeking. It gives a broad view of the state of the art and is intended for those in the scientific community who either develop new data analysis methods or gather data and use search tools for analyzing and interpreting large and complex data sets. Presenting a wide field of applications, this book is of interest not only to data analysts, mathematicians, and statisticians but also to scientists from many areas and disciplines concerned with complex data: medicine, biology, ...

Factors influencing career decisions in internal medicine.

Science.gov (United States)

Macdonald, C; Cawood, T

2012-08-01

Numerous factors influence career decisions for internal medicine trainees and Fellows. There is a perception that a greater emphasis is placed on work-family balance by younger physicians. To determine the characteristics of the modern internal medicine workforce and ascertain whether job flexibility is important to career decision-making. We hypothesised that factors which reflect flexibility would be highly influential in decision-making, especially for women and those with young children. A questionnaire was mailed to 250 New Zealand internal medicine trainees and Fellows. It focused on factors, including job flexibility, interest and collegial support, and included demographic details which were primarily aimed at ascertaining family responsibilities. Response rate was 54%. The majority of female physicians are the main person responsible for their children (62%), and the majority of their partners work full-time (80%). This contrasts with male physicians, of whom only 4% are the main person responsible for their children. Flexibility was found to be more influential in women, those with young children, trainees and those working in outpatient-based subspecialties. However, contrary to our original hypothesis, flexibility was not reported to be highly influential in any group, with career choice being most influenced by interest and enjoyment, intellectual challenge and variety within the job. It is hoped that results will inform employers and those involved with training to enable them to better cater for the needs of the workforce and also encourage trainees to consider future family commitments when making career decisions. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

The internal medicine specialist and neurosurgery

Directory of Open Access Journals (Sweden)

A. Pizzini

2013-05-01

Full Text Available BACKGROUND The neurosurgical patient is often a real challenge for the physicians, because of a frequent multimorbidity and a higher risk for severe complications. Cooperation between internal medicine specialist and neurosurgeon is essential to prevent the fatal effects of cranial and spinal injuries. The topic issues of medical interest in neurosurgery are the disorders of sodium balance, the glycemic control, the thromboembolic risk, the intracerebral bleeding management and the infective problems. The neurosurgeons could be worried by treating these complications that are mostly of internal medicine interest and that could unfortunately rise the risk of death or irreversible insults. AIM OF THE REVIEW This review summarizes the modality of diagnosis and therapy of the foremost concerns in neurosurgical field.

Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination.

Science.gov (United States)

Sisson, Stephen D; Bertram, Amanda; Yeh, Hsin-Chieh

2015-03-01

A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P ITE total and percentile rank scores (P ITE percentile rank. Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE.

Publication rate of abstracts presented at the emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012.

Science.gov (United States)

Kalkan, Asim; Kose, Ozkan; Bilir, Ozlem; Ersunan, Gokhan; Ozel, Deniz; Guler, Ferhat

2015-09-01

The purpose of this study was to assess the publication rate of the abstracts presented at the 6th Mediterranean Emergency Medicine Congress, 2011 and the 7th European Congress on Emergency Medicine, 2012. All abstracts, both posters and oral presentations, from the international emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012 were identified. To establish whether these abstracts were subsequently published in peer-reviewed medical journals, the names of all the authors and the title of the abstracts were searched for in the databases of Clinical Key/Elsevier, EBSCO Discovery Service, MD Consult, Science Direct, Scopus, EMBASE, Medscape, Google Scholar and local ULAKBIM. The year of publication, consistency of author names and titles, the type of study, the journals in which papers were published and countries from which reports were submitted were all recorded. A total of 1721 abstracts were examined; 626 from 2011 (307 oral presentations and 319 posters) and 1095 from 2012 (154 oral presentations and 941 posters). Of all abstracts in 2011, 172 (27.5%) and of all abstracts in 2012, 265 (24.2%) were subsequently published as full-text reports in peer-reviewed journals. Of the 172 papers published in 2011, 152 (88.4%) were accepted by Science Citation Index (SCI) and/or SCI Expanded (SCI-E) journals and 155 (58.5%) of 265 papers were accepted by SCI and/or SCI-E journals in 2012 (p=0.0001). The publication rate of abstracts submitted to international emergency medicine congresses held by EUSEM over those 2 years was low compared with that of abstracts presented in other emergency medicine congresses. Presenters should be encouraged to send their studies to peer-reviewed journals. During the selection process by the scientific panel, constructive critics should be notified to the presenters instead of simply accepting or rejecting the studies that submitted to the congress, which may increase the

Academic general internal medicine: a mission for the future.

Science.gov (United States)

Armstrong, Katrina; Keating, Nancy L; Landry, Michael; Crotty, Bradley H; Phillips, Russell S; Selker, Harry P

2013-06-01

After five decades of growth that has included advances in medical education and health care delivery, value cohesion, and integration of diversity, we propose an overarching mission for academic general internal medicine to lead excellence, change, and innovation in clinical care, education, and research. General internal medicine aims to achieve health care delivery that is comprehensive, technologically advanced and individualized; instills trust within a culture of respect; is efficient in the use of time, people, and resources; is organized and financed to achieve optimal health outcomes; maximizes equity; and continually learns and adapts. This mission of health care transformation has implications for the clinical, educational, and research activities of divisions of general internal medicine over the next several decades.

[The Computer Book of the Internal Medicine resident: validity and reliability of a questionnaire for self-assessment of competences in internal medicine residents].

Science.gov (United States)

Oristrell, J; Casanovas, A; Jordana, R; Comet, R; Gil, M; Oliva, J C

2012-12-01

There are no simple and validated instruments for evaluating the training of specialists. To analyze the reliability and validity of a computerized self-assessment method to quantify the acquisition of medical competences during the Internal Medicine residency program. All residents of our department participated in the study during a period of 28 months. Twenty-two questionnaires specific for each rotation (the Computer-Book of the Internal Medicine Resident) were constructed with items (questions) corresponding to three competence domains: clinical skills competence, communication skills and teamwork. Reliability was analyzed by measuring the internal consistency of items in each competence domain using Cronbach's alpha index. Validation was performed by comparing mean scores in each competence domain between senior and junior residents. Cut-off levels of competence scores were established in order to identify the strengths and weaknesses of our training program. Finally, self-assessment values were correlated with the evaluations of the medical staff. There was a high internal consistency of the items of clinical skills competences, communication skills and teamwork. Higher scores of clinical skills competence and communication skills, but not in those of teamwork were observed in senior residents than in junior residents. The Computer-Book of the Internal Medicine Resident identified the strengths and weaknesses of our training program. We did not observe any correlation between the results of the self- evaluations and the evaluations made by staff physicians. The items of Computer-Book of the Internal Medicine Resident showed high internal consistency and made it possible to measure the acquisition of medical competences in a team of Internal Medicine residents. This self-assessment method should be complemented with other evaluation methods in order to assess the acquisition of medical competences by an individual resident. Copyright © 2012 Elsevier Espa

Second International Congress on Chocolate and Cocoa in Medicine Held in Barcelona, Spain, 25–26th September 2015

OpenAIRE

Margarida Castell; Sandra Saldaña-Ruíz; Maria José Rodríguez-Lagunas; Àngels Franch; Francisco J. Pérez-Cano

2015-01-01

In order to further our understanding of, and disseminate the latest findings on the healthy properties of cocoa and chocolate, the International Society of Chocolate and Cocoa in Medicine (ISCHOM) was founded in 2010 in Florence (http://ischom.com/ischom/). This Society aims to gather information and become a forum of discussion and debate on cocoa and chocolate, not only among researchers from around the world, but also to introduce the science involved and the latest findings to the public...

Effects of internal and external environment on health and well-being: from cell to society.

Science.gov (United States)

Tomljenović, Andrea

2014-03-01

Stem cell fate in cell culture depends on the composition of the culturing media. Every single cell in an organism is influenced by its microenvironment and surrounding cells. Biology, psychology, emotions, spirit, energy, lifestyle, culture, economic and political influences, social interactions in family, work, living area and the possibilities to expresses oneself and live full life with a sense of well-being have influence on people appearances. Disease is as much social as biological. It is a reaction of an organism to unbalancing changes in the internal environment caused by the changes in the external environment and/or by the structural and functional failures or unfortunate legacies. Health gradient in the society depends on the every day circumstances in which people live and work. The health of the population is an insight into the society. The problem facing medicine in the complex society of today cannot be resolved without the aid of social sciences, as cultural, social, ecological and mental processes affect physiological responses and health outcomes. Anthropology could be a bridge between biomedicine and social sciences and influence strategies in public health to prevent rather than cure and in education for fulfillment in life and improvement of society.

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...

A Learning-Curve Approach to the Self-Assessment of Internal Medicine Training.

Science.gov (United States)

Day, Susan C.; And Others

1984-01-01

In response to the perceived need for primary care physicians, two major changes in internal medicine training have occurred: (1) a third year of general training was required for internal medicine board certification and (2) many hospitals developed primary care internal medicine residencies with an increased emphasis on ambulatory training.…

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...

Study of Potential Extension For Improving Knowledge Society in Ngadas Village about Medicinal plants

Directory of Open Access Journals (Sweden)

hajmia guswika

2017-09-01

Full Text Available Society knowledge in Ngadas village about medicinal plants began to fade, as people do not know the plants that can be consume as a drug around them. However, the treatment by plant utilizing is a traditional medicine that has become a cultural heritage that should be conserved and has been recommended by the WHO as the effort back to nature for the maintenance of public health, prevention and treatment of disease. Wild plant that has potential as a drug in the village Ngadas big enough examples adas, ajeran, akasia duri, anting-anting, alang-alang, patikan kebo, pegagan, semanggi gunung, kersen, krisan, kecubung gunung, tempuyung, etc. The purpose of writing this article is to examine the potential of extension as a efforts on improving knowledge of society. The method used is to review literature of some journal that examines the educational efforts to improve public knowledge. Based on data obtained from reviewing the literature, extension activities proved potentially in increasing knowledge of society. Thus it is needed to do extension in an effort to provide information on the potential of medicinal plants in the Ngadas villages.

International Telemedicine/Disaster Medicine Conference: Papers and Presentations

Science.gov (United States)

1991-01-01

The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.

Professional radiation protection societies and the international organizations – exploiting the synergies

Energy Technology Data Exchange (ETDEWEB)

Metcalf, Phil

2013-07-01

Radiation protection covers many disciplines from science through philosophy to law, and interacts with many human activities and endeavors. Professional societies for radiation protection were established and evolved throughout the second half of the twentieth century in many countries, and presently represent more than twenty thousand professionals working in more than fifty countries. During the same period a number of international organizations were established, some devoted to radiation safety, others with a role to play in radiation safety; such organizations being either independent non-governmental organizations or intergovernmental organizations of both regional and international dimensions. The national, regional and international radiation protection societies and associations have become the vehicle to provide this conduit from the profession to the international organizations. This is achieved by IRPA having representation within the relevant committees of the various international bodies, such as the Radiation Safety Standards Committee (RASSC) of the IAEA. At a national level radiation protection professionals can gain access to all international developments in radiation protection through the national societies and their interactions with IRPA and also as individual members of IRPA. The possibility to provide consolidated comment and feedback to the international organizations through national societies provides excellent opportunities for societies to organize national workshops and discussion platforms on all important areas of radiation protection.

Eleventh congress of the South African Society of Nuclear Medicine : programme and abstracts

International Nuclear Information System (INIS)

2004-10-01

The volume contains the abstracts of papers and poster sessions presented at the eleventh biennial congress of the South African Society of Nuclear Medicine that was held at the CSIR Conference Centre in Pretoria from 1-4 October 2004, and was preceded by a workshop on nuclear medicine in endocrinology and molecular imaging. The workshop papers are not included. Forty-nine presentations are indexed. One presentation was excluded.

Recent trends in internal medicine education: a brief update.

Science.gov (United States)

Flannery, Michael T

2014-03-01

This perspective attempts to bring graduate medical offices, residency programs and medical students interested in categorical internal medicine (CIM) a brief update on the American Board of Internal Medicine (ABIM), Accreditation Council for Graduate Medical Education (ACGME) and the National Registry for Medical Programs (NRMP) changes for the past 3-5 years in the United States (US). The US model for certification and recertification may serve as a homogenous example for other countries. This model will be described so that there is an understanding of the importance of such changes in the American system and its effect on resident education. This is critical knowledge for both teachers and learners in internal medicine in preparation for a lifetime career and requirements for certification/credentialing for both programs and their residents/fellows. Data from the review indicate a small increase in the number of applicants but a concordant decrease in ABIM initial certification exams. Programs should well be aware of the new focus on outcomes via the Next Accreditation System (NAS) being put forth by the ACGME. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Hospitalist workload influences faculty evaluations by internal medicine clerkship students

Directory of Open Access Journals (Sweden)

Robinson RL

2015-02-01

Full Text Available 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 relationship between clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students. Design: A retrospective correlation analysis of clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students during the 2009 to 2013 academic years at Southern Illinois University School of Medicine was conducted. Participants: Internal medicine hospitalists who supervise the third-year inpatient experience for medical students during the 2009 to 2013 academic years participated in the study. Measures: Clinical service intensity data in terms of work relative value units (RVUs, patient encounters, and days of inpatient duty were collected for all members of the hospitalist service. Medical students rated hospitalists in the areas of patient rapport, enthusiasm about the profession, clinical skills, sharing knowledge and skills, encouraging the students, probing student knowledge, stimulating independent learning, providing timely feedback, providing constructive criticism, and observing patient encounters with students. Results: Significant negative correlations between higher work RVU production, total patient encounters, duty days, and learner evaluation scores for enthusiasm about the profession, clinical skills, probing the student for knowledge and judgment, and observing a patient encounter with the student were identified. Higher duty days had a significant negative correlation

[The library of the Society of the Dutch Journal of Medicine].

Science.gov (United States)

Molenaar, J C

2004-11-20

This year the library of the Vereniging Nederlands Tijdschrift voor Geneeskunde (Society of the Dutch Journal of Medicine) has reached the age of go. The idea was born in 1900 when the editor-in-chief M.Straub proposed starting a library for the Journal. This was rejected by the members of the Society, but fourteen years later, in 1914, when the new editor-in-chief G.A. van Rijnberk made a similar proposal, it was accepted. His long-term as editor (1913-1946) would prove to be a guarantee for the acquisition of a large collection of books, both antique and contemporary. The collection reflects the history of medicine, notably in The Netherlands, but also in a wider sense. Over the years, several catalogues of the collection have been published, and this year has seen the completion of an electronic catalogue which is available on the Internet (www.ntvg.nl). The acquisition and restoration of books have been re-started in the past five years and a fellowship for the study of the existing collection of books has been instituted.

Evaluation of a Substance Use Disorder Curriculum for Internal Medicine Residents

Science.gov (United States)

Stein, Melissa R.; Arnsten, Julia H.; Parish, Sharon J.; Kunins, Hillary V.

2011-01-01

Teaching about diagnosis, treatment, and sequelae of substance use disorders (SUDs) is insufficient in most Internal Medicine residency programs. To address this, the authors developed, implemented, and evaluated a novel and comprehensive SUD curriculum for first year residents (interns) in Internal Medicine, which anchors the ensuing 3-year…

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2017.

Science.gov (United States)

Wieland, Mark L; Szostek, Jason H; Wingo, Majken T; Post, Jason A; Mauck, Karen F

2018-02-26

Clinicians are challenged to identify new practice-changing articles in the medical literature. To identify the practice-changing articles published in 2017 most relevant to outpatient general internal medicine, 5 internists reviewed the following sources: 1) titles and abstracts from internal medicine journals with the 7 highest impact factors, including New England Journal of Medicine, Lancet, Journal of the American Medical Association, British Medical Journal, Public Library of Science Medicine, Annals of Internal Medicine, and JAMA Internal Medicine; 2) synopses and syntheses of individual studies, including collections in the American College of Physicians Journal Club, Journal Watch, and Evidence-Based Medicine; 3) databases of synthesis, including Evidence Updates and the Cochrane Library. Inclusion criteria were perceived clinical relevance to outpatient general medicine, potential for practice change, and strength of evidence. This process yielded 140 articles. Clusters of important articles around one topic were considered as a single-candidate series. A modified Delphi method was utilized by the 5 authors to reach consensus on 7 topics to highlight and appraise from the 2017 literature. Copyright © 2018 Elsevier Inc. All rights reserved.

The anticoagulation choices of internal medicine residents for stroke prevention in non-valvular atrial fibrillation.

Science.gov (United States)

Moulson, Nathaniel; McIntyre, William F; Oqab, Zardasht; Yazdan-Ashoori, Payam; Quinn, Kieran L; van Oosten, Erik; Hopman, Wilma M; Baranchuk, Adrian

2017-06-01

To explore the oral anticoagulation (OAC) prescribing choices of Canadian internal medicine residents, at different training levels, in comparison with the Canadian Cardiovascular Society (CCS) guidelines for non-valvular atrial fibrillation (NVAF). Cross-sectional, web-based survey, involving clinical scenarios designed to favour the use of non-vitamin K antagonists (NOACs) as per the 2014 CCS NVAF guidelines. Additional questions were also designed to determine resident attitudes towards OAC prescribing. A total of 518 internal medicine responses were analysed, with 196 postgraduate year (PGY)-1s, 169 PGY-2s and 153 PGY-3s. The majority of residents (81%) reported feeling comfortable choosing OAC, with 95% having started OAC in the past 3 months. In the initial clinical scenario involving an uncomplicated patient with a CHADS2 score of 3, warfarin was favoured over any of the NOACs by PGY-1s (81.6% vs 73.9%), but NOACs were favoured by PGY-3s (88.3% vs 83.7%). This was the only scenario where OAC choices varied by PGY year, as each of the subsequent clinical scenarios residents generally favoured warfarin over NOACs irrespective of level of training. The majority of residents stated that they would no longer prescribe warfarin once NOAC reversal agents are available, and residents felt risk of adverse events was the most important factor when choosing OAC. Canadian internal medicine residents favoured warfarin over NOACs for patients with NVAF, which is in discordance with the evidence-based CCS guidelines. This finding persisted throughout the 3 years of core internal medicine training. 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/.

Six decades of the chair of Internal Medicine at the Medical Faculty in Skopje.

Science.gov (United States)

Chakalaroski, K

2013-01-01

The chair of internal medicine in Republic of Macedonia was created in 1947. The Department of Internal Medicine (CIM) is the most numerous at Skopje's medical faculty (currently 56 members). According to the archive material from the first session of the Scientific Teaching Council of the Faculty of Medicine (17.03.1947), Mr Mario Krmpotic (Professor of Internal Medicine) was proposed as the first Director of the Internal Clinic (1947). For reasons unknown, Mr Krmpotic never came to Skopje to accept the post. As a consequence of this fact, the real founder of the CIM was the Russian Professor Alexandar Ignjatovski (1875-1955). Mr Ignjatovski was elected as the first Director of the Clinic for Internal Medicine in 1948 for a period of 4 years (1948-1952). At the same time, he was the first Chief of the CIM in Skopje (Macedonia). Dr D. Arsov was elected as the first Assistant Professor of Medicine in 1947, and second (and last) Director of the Clinic for Internal Medicine (1952-1974). For the same period (22 years) he was Head of the CIM. Dr D. Arsov sequentially and successively became first associated and then ordinary professor of medicine in the years 1951 and 1958. The regular activities of the CIM are as follows: 1) Undergraduate education for students (Clinical Investigation, Internal Medicine, Clinical Pharmacy) in general medicine, dentistry, geriatrics, urgent and family medicine (ECKTS); Undergraduate educationfor nurses, speech therapists, physiotherapists, radiologists (high /three year/ nurses School, ECKTS); 2) Postgraduate education (candidates for specialisation in internal medicine, infectology, anaesthesiology, neurology and surgery; 3) Continual medical education (a traditional morning scientific meeting on Thursdays, 08 h; weekly meetings of all internal medicine subspecialists); Scientific meetings, symposiums, congresses of former internal medicine associations (cardiology, pulmoallergology, gastroenterology, nephrology, haematology

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

Science.gov (United States)

Pereg, David; Gronich, Naomi; Lishner, Michael

2006-08-01

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

Incidence of refeeding syndrome in internal medicine patients.

Science.gov (United States)

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

2016-03-01

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

Symposium of the International Society of Dynamic Games

CERN Document Server

Haurie, Alain; Annals of the International Society of Dynamic Games

1994-01-01

Recent years have witnessed a surge of activity in the field of dynamic both theory and applications. Theoretical as well as practical games, in problems in zero-sum and nonzero-sum games, continuous time differential and discrete time multistage games, and deterministic and stochastic games games are currently being investigated by researchers in diverse disciplines, such as engineering, mathematics, biology, economics, management science, and political science. This surge of interest has led to the formation of the International Society of Dynamic Games (ISDG) in 1990, whose primary goal is to foster the development of advanced research and applications in the field of game theory. One important activity of the Society is to organize biannually an international symposium which aims at bringing together all those who contribute to the development of this active field of applied science. In 1992 the symposium was organized in Grimentz, Switzerland, under the supervision of an international scientific committe...

Principles to Consider in Defining New Directions in Internal Medicine Training and Certification

Science.gov (United States)

Turner, Barbara J; Centor, Robert M; Rosenthal, Gary E

2006-01-01

SGIM endoreses seven principles related to current thinking about internal medicine training: 1) internal medicine requires a full three years of residency training before subspecialization; 2) internal medicine residency programs must dramatically increase support for training in the ambulatory setting and offer equivalent opportunities for training in both inpatient and outpatient medicine; 3) in settings where adequate support and time are devoted to ambulatory training, the third year of residency could offer an opportunity to develop further expertise or mastery in a specific type or setting of care; 4) further certification in specific specialties within internal medicine requires the completion of an approved fellowship program; 5) areas of mastery in internal medicine can be demonstrated through modified board certification and recertification examinations; 6) certification processes throughout internal medicine should focus increasingly on demonstration of clinical competence through adherence to validated standards of care within and across practice settings; and 7) regardless of the setting in which General Internists practice, we should unite to promote the critical role that this specialty serves in patient care. PMID:16637826

DNA commission of the International Society for Forensic Genetics

DEFF Research Database (Denmark)

Gill, P; Brenner, C H; Buckleton, J S

2006-01-01

The DNA commission of the International Society of Forensic Genetics (ISFG) was convened at the 21st congress of the International Society for Forensic Genetics held between 13 and 17 September in the Azores, Portugal. The purpose of the group was to agree on guidelines to encourage best practice...... a consensus from experts but to be practical we do not claim to have conveyed a clear vision in every respect in this difficult subject. For this reason, we propose to allow a period of time for feedback and reflection by the scientific community. Then the DNA commission will meet again to consider further...

Internal Contamination by 131I in nuclear medicine department

International Nuclear Information System (INIS)

Chahed, N.; Mtimet, S.; Hammami, H.; Mhiri, A.

1998-01-01

Therapeutic applications in nuclear medicine use high activities of 131 I in sodium iodine liquid from which is volatile at ambient temperature. Besides external exposure there is, for the nuclear medicine personnel, an internal exposure risk induced by 131 iodine inhalation. So we tried to assess this risk among the personnel in a nuclear medicine department. We used direct method for measuring 131 radioactivity in vivo by external counting. Gamma ray detector with a Nal ( TI ) probe positioned near the thyroid gland allows investigation of 131 radioactivity. We realised 34 measurements among the personnel, two times at an interval of one month. The results indicate that an 131 iodine internal contamination is found. Estimated thyroid activities were ranging from 35 to 132 Bq. The highest activities has been found in the thyroid of the technicians involved in the administration of 131 iodine therapy. Therefore this values are lower than norms. This study must lead to the implementation control of the 131 iodine internal contamination in order to optimise the personnel protection in nuclear medicine departments (author)

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

Directory of Open Access Journals (Sweden)

Francesco Ventrella

2014-09-01

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

Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery)

Science.gov (United States)

2014-01-01

Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients

International terrorism, a new challenge to modern Western society

International Nuclear Information System (INIS)

Hochleitner, E.

2002-01-01

Full text: The attacks of 9/11 against the WTC and the Pentagon have made western society aware of the threat potential, which international terrorism presents to the open and democratic societies of the West. The new international terrorism is substantially different from the traditional form terrorism, which our societies has experienced in the past. The arms of traditional terrorism were bombs and guns and the victims were mostly clearly defined targets and its political and ideological motives were known. The terrorists assumed responsibility and there was an interest and scope for political negotiation. Terrorist groups had a vertical structure with a hierarchy. The new international terrorism is organized in a horizontal way and its structure is amorphous. Terrorist groups act in an autonomous way and linked by a rather loose network. International terrorism makes full use of modern communication systems and seek to equip themselves with the best armament available including WMDs, provided they can get hold of them. Their target are no longer individuals, but the modern western society. They aim at a maximum number of victims in order to get maximum media attention and to destabilize the targeted society. The motives of terrorist groups are religious or ideological. A terrorist attack represents for those terrorists a religious, nearly sacral act, including self sacrifice. Today, the main challenge for the open, democratic and modern society represents the network of Islamic Fundamentalists. Islamic terrorism has been active mainly in Islamic countries with the aim to overthrow westernized forms of government, mainly in Egypt and Algeria. In the early 1990's, the network of Islamic terror groups has been built up and the al-Qaida was formed. AI-Qaida is a network of Islamic terror groups and a platform for co-operation and support of Islamic cells. It provides training, arms, finances, etc.. AI-Qaida supported the Taliban regime, which provided it with a

Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital.

Science.gov (United States)

Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

2016-04-12

This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely.

Embryo transfer techniques: an American Society for Reproductive Medicine survey of current Society for Assisted Reproductive Technology practices.

Science.gov (United States)

Toth, Thomas L; Lee, Malinda S; Bendikson, Kristin A; Reindollar, Richard H

2017-04-01

To better understand practice patterns and opportunities for standardization of ET. Cross-sectional survey. Not applicable. Not applicable. An anonymous 82-question survey was emailed to the medical directors of 286 Society for Assisted Reproductive Technology member IVF practices. A follow-up survey composed of three questions specific to ET technique was emailed to the same medical directors. Descriptive statistics of the results were compiled. The survey assessed policies, protocols, restrictions, and specifics pertinent to the technique of ET. There were 117 (41%) responses; 32% practice in academic settings and 68% in private practice. Responders were experienced clinicians, half of whom had performed Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

From 'implications' to 'dimensions': science, medicine and ethics in society.

Science.gov (United States)

Pickersgill, Martyn D

2013-03-01

Much bioethical scholarship is concerned with the social, legal and philosophical implications of new and emerging science and medicine, as well as with the processes of research that under-gird these innovations. Science and technology studies (STS), and the related and interpenetrating disciplines of anthropology and sociology, have also explored what novel technoscience might imply for society, and how the social is constitutive of scientific knowledge and technological artefacts. More recently, social scientists have interrogated the emergence of ethical issues: they have documented how particular matters come to be regarded as in some way to do with 'ethics', and how this in turn enjoins particular types of social action. In this paper, I will discuss some of this and other STS (and STS-inflected) literature and reflect on how it might complement more 'traditional' modes of bioethical enquiry. I argue that STS might (1) cast new light on current bioethical issues, (2) direct the gaze of bioethicists towards matters that may previously have escaped their attention, and (3) indicate the import not only of the ethical implications of biomedical innovation, but also how these innovative and other processes feature ethics as a dimension of everyday laboratory and clinical work. In sum, engagements between STS and bioethics are increasingly important in order to understand and manage the complex dynamics between science, medicine and ethics in society.

International Journal of Medicine and Biomedical Research

African Journals Online (AJOL)

The International Journal of Medicine and Biomedical Research (IJMBR) is a peer-reviewed ... useful to researchers in all aspects of Clinical and Basic Medical Sciences including Anatomical Sciences, Biochemistry, Dentistry, Genetics, ...

Determining and prioritizing competencies in the undergraduate internal medicine curriculum in Saudi Arabia.

Science.gov (United States)

Almoallim, H

2011-08-01

To determine knowledge and skills competencies in internal medicine for the undergraduate curriculum in Saudi Arabia, competencies were identified based on group work utilizing common textbooks. The Delphi Technique was used as a consensus method to determine and prioritize competencies in internal medicine. A group of 20 clinicians rated the identified competencies from 0-3 (0: no need to know, 1: interesting to know, 2: should know and 3: must know). After formulating the results, a second Delphi round was conducted with 5 experts in internal medicine. A total of 1513 knowledge competencies and 189 skills competencies were determined and prioritized. The competencies corresponded to the 12 systems in internal medicine. All competencies rated 2.2-3.0 were produced separately and considered core competencies for the undergraduate internal medicine curriculum. Determining and prioritizing competencies should influence the curriculum reform process.

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2015.

Science.gov (United States)

Szostek, Jason H; Wieland, Mark L; Post, Jason A; Sundsted, Karna K; Mauck, Karen F

2016-08-01

Identifying new practice-changing articles is challenging. To determine the 2015 practice-changing articles most relevant to outpatient general internal medicine, 3 internists independently reviewed the titles and abstracts of original articles, synopses of single studies and syntheses, and databases of syntheses. For original articles, internal medicine journals with the 7 highest impact factors were reviewed: New England Journal of Medicine, Lancet, Journal of the American Medical Association (JAMA), British Medical Journal, Public Library of Science Medicine, Annals of Internal Medicine, and JAMA Internal Medicine. For synopses of single studies and syntheses, collections in American College of Physicians Journal Club, Journal Watch, and Evidence-Based Medicine were reviewed. For databases of synthesis, Evidence Updates and the Cochrane Library were reviewed. More than 100 articles were identified. Criteria for inclusion were as follows: clinical relevance, potential for practice change, and strength of evidence. Clusters of important articles around one topic were considered as a single-candidate series. The 5 authors used a modified Delphi method to reach consensus on inclusion of 7 topics for in-depth appraisal. Copyright © 2016 Elsevier Inc. All rights reserved.

Rise of radiation protection: science, medicine and technology in society, 1896--1935

International Nuclear Information System (INIS)

Serwer, D.P.

1976-12-01

The history of radiation protection before World War II is treated as a case study of interactions between science, medicine, and technology. The fundamental concerns include the following: are how medical and technical decisions with social impacts are made under conditions of uncertainty; how social pressures are brought to bear on the development of science, medicine, and technology; what it means for medicine or technology to be scientific; why professional groups seek international cooperation; and the roles various professionals and organizations play in controlling the harmful side effects of science, medicine, and technology. These questions are addressed in the specific context of protection from the biological effects of x-rays and radium in medical use

Rise of radiation protection: science, medicine and technology in society, 1896--1935

Energy Technology Data Exchange (ETDEWEB)

Serwer, D.P.

1976-12-01

The history of radiation protection before World War II is treated as a case study of interactions between science, medicine, and technology. The fundamental concerns include the following: are how medical and technical decisions with social impacts are made under conditions of uncertainty; how social pressures are brought to bear on the development of science, medicine, and technology; what it means for medicine or technology to be scientific; why professional groups seek international cooperation; and the roles various professionals and organizations play in controlling the harmful side effects of science, medicine, and technology. These questions are addressed in the specific context of protection from the biological effects of x-rays and radium in medical use.

Minority politics in the house of medicine: the physicians forum and the New York County Medical Society, 1938-1965.

Science.gov (United States)

Brickman, J P

1999-01-01

The late 1930s challenged laissez-faire medicine. Recognition of serious inadequacies in the distribution of medical services stirred activists who questioned fee-for-service delivery and posited a national health program, including health insurance. The AMA and its components--state and county medical societies--counterattacked, mobilizing money and their powerful political arsenal to fight government intrusion in private medicine. The Physicians Forum, initially under the leadership of Ernst P. Boas, emerged as a formidable element within the New York County Medical Society (the largest component of the AMA). The Forum provoked discussion of medical indigence and economics, upsetting the Society leadership with independent candidate slates and telling the public that doctors spoke with more than one voice. For 25 years, the Physicians Forum altered the dynamics of the Medical Society of the County of New York. While the Forum effort to institutionalize minority opinion in the councils of medicine failed, the interchange between County regulars and Forum insurgents broadened the medical reform agenda and moved the County Society in directions that historically it had avoided. Although medical economics formed an unbridgeable chasm between County regulars and rebels, Forum members demonstrated that medicine was not monolithic, that "majority opinion [was not] ... unanimous opinion," and that doctors must speak to issues of medical and social policy.

Review of the International Society for Heart and Lung Transplantation Practice guidelines for management of heart failure in children.

Science.gov (United States)

Colan, Steven D

2015-08-01

In 2004, practice guidelines for the management of heart failure in children by Rosenthal and colleagues were published in conjunction with the International Society for Heart and Lung Transplantation. These guidelines have not been updated or reviewed since that time. In general, there has been considerable controversy as to the utility and purpose of clinical practice guidelines, but there is general recognition that the relentless progress of medicine leads to the progressive irrelevance of clinical practice guidelines that do not undergo periodic review and updating. Paediatrics and paediatric cardiology, in particular, have had comparatively minimal participation in the clinical practice guidelines realm. As a result, most clinical practice guidelines either specifically exclude paediatrics from consideration, as has been the case for the guidelines related to cardiac failure in adults, or else involve clinical practice guidelines committees that include one or two paediatric cardiologists and produce guidelines that cannot reasonably be considered a consensus paediatric opinion. These circumstances raise a legitimate question as to whether the International Society for Heart and Lung Transplantation paediatric heart failure guidelines should be re-reviewed. The time, effort, and expense involved in producing clinical practice guidelines should be considered before recommending an update to the International Society for Heart and Lung Transplantation Paediatric Heart Failure guidelines. There are specific areas of rapid change in the evaluation and management of heart failure in children that are undoubtedly worthy of updating. These domains include areas such as use of serum and imaging biomarkers, wearable and implantable monitoring devices, and acute heart failure management and mechanical circulatory support. At the time the International Society for Heart and Lung Transplantation guidelines were published, echocardiographic tissue Doppler, 3 dimensional

Study of nuclear medicine practices in Portugal from an internal dosimetry perspective

International Nuclear Information System (INIS)

Bento, J.; Teles, P.; Neves, M.; Santos, A. I.; Cardoso, G.; Barreto, A.; Alves, F.; Guerreiro, C.; Rodrigues, A.; Santos, J. A. M.; Capelo, C.; Parafita, R.; Martins, B.

2012-01-01

Nuclear medicine practices involve the handling of a wide range of pharmaceuticals labelled with different radionuclides, for diagnostic and therapeutic purposes. This work intends to evaluate the potential risks of internal contamination of nuclear medicine staff in several Portuguese nuclear medicine services and to conclude about the requirement of a routine internal monitoring. A methodology proposed by the International Atomic Energy Agency (IAEA), providing a set of criteria to determine the need, or not, for an internal monitoring programme, was applied. The evaluation of the risk of internal contaminations in a given set of working conditions is based on the type and amount of radionuclides being handled, as well as the safety conditions with which they are manipulated. The application of the IAEA criteria showed that 73.1 % of all the workers included in this study should be integrated in a routine monitoring programme for internal contaminations; more specifically, 100 % of workers performing radioimmunoassay techniques should be monitored. This study suggests that a routine monitoring programme for internal exposures should be implemented in Portugal for most nuclear medicine workers. (authors)

Associations between subspecialty fellowship interest and knowledge of internal medicine: A hypothesis-generating study of internal medicine residents

Science.gov (United States)

2011-01-01

Background Little is known about whether and how medical knowledge relates to interest in subspecialty fellowship training. The purpose of this study was to examine the relationships between residents' interest in subspecialty fellowship training and their knowledge of internal medicine (IM). Methods A questionnaire was emailed to 48 categorical postgraduate-year (PGY) two and three residents at a New York university-affiliated IM residency program in 2007 using the Survey Monkey online survey instrument. Overall and content area-specific percentile scores from the IM in-training examination (IM-ITE) for the same year was used to determine objective knowledge. Results Forty-five of 48 residents (response rate was 93.8%) completed the survey. Twenty-two (49%) were PG2 residents and 23(51%) were PGY3 residents. Sixty percent of respondents were male. Six (13%) residents were graduates of U.S. medical schools. Eight (18%) reported formal clinical training prior to starting internal medicine residency in the U.S. Of this latter group, 6 (75%) had training in IM and 6 (75) % reported a training length of 3 years or less. Thirty-seven of 45 (82%) residents had a subspecialty fellowship interest. Residents with a fellowship interest had a greater mean overall objective knowledge percentile score (56.44 vs. 31.67; p = 0.04) as well as greater mean percentile scores in all content areas of IM. The adjusted mean difference was statistically significant (p internal medicine residents. PMID:21281500

Correlations Between Ratings on the Resident Annual Evaluation Summary and the Internal Medicine Milestones and Association With ABIM Certification Examination Scores Among US Internal Medicine Residents, 2013-2014.

Science.gov (United States)

Hauer, Karen E; Vandergrift, Jonathan; Hess, Brian; Lipner, Rebecca S; Holmboe, Eric S; Hood, Sarah; Iobst, William; Hamstra, Stanley J; McDonald, Furman S

2016-12-06

US internal medicine residency programs are now required to rate residents using milestones. Evidence of validity of milestone ratings is needed. To compare ratings of internal medicine residents using the pre-2015 resident annual evaluation summary (RAES), a nondevelopmental rating scale, with developmental milestone ratings. Cross-sectional study of US internal medicine residency programs in the 2013-2014 academic year, including 21 284 internal medicine residents (7048 postgraduate-year 1 [PGY-1], 7233 PGY-2, and 7003 PGY-3). Program director ratings on the RAES and milestone ratings. Correlations of RAES and milestone ratings by training year; correlations of medical knowledge ratings with American Board of Internal Medicine (ABIM) certification examination scores; rating of unprofessional behavior using the 2 systems. Corresponding RAES ratings and milestone ratings showed progressively higher correlations across training years, ranging among competencies from 0.31 (95% CI, 0.29 to 0.33) to 0.35 (95% CI, 0.33 to 0.37) for PGY-1 residents to 0.43 (95% CI, 0.41 to 0.45) to 0.52 (95% CI, 0.50 to 0.54) for PGY-3 residents (all P values internal medicine residents in the 2013-2014 academic year, milestone-based ratings correlated with RAES ratings but with a greater difference across training years. Both rating systems for medical knowledge correlated with ABIM certification examination scores. Milestone ratings may better detect problems with professionalism. These preliminary findings may inform establishment of the validity of milestone-based assessment.

Hospitalist workload influences faculty evaluations by internal medicine clerkship students.

Science.gov (United States)

Robinson, Robert L

2015-01-01

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. The study reported here was conducted to explore the relationship between clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students. A retrospective correlation analysis of clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students during the 2009 to 2013 academic years at Southern Illinois University School of Medicine was conducted. Internal medicine hospitalists who supervise the third-year inpatient experience for medical students during the 2009 to 2013 academic years participated in the study. Clinical service intensity data in terms of work relative value units (RVUs), patient encounters, and days of inpatient duty were collected for all members of the hospitalist service. Medical students rated hospitalists in the areas of patient rapport, enthusiasm about the profession, clinical skills, sharing knowledge and skills, encouraging the students, probing student knowledge, stimulating independent learning, providing timely feedback, providing constructive criticism, and observing patient encounters with students. Significant negative correlations between higher work RVU production, total patient encounters, duty days, and learner evaluation scores for enthusiasm about the profession, clinical skills, probing the student for knowledge and judgment, and observing a patient encounter with the student were identified. Higher duty days had a significant negative correlation with sharing knowledge/skills and encouraging student initiative. Higher work RVUs and total patient encounters were negatively correlated with timely feedback and constructive criticism. The results suggest that

VIIIth international symposium on nuclear medicine

International Nuclear Information System (INIS)

1986-01-01

The conference proceedings contain 92 abstracts of submitted papers dealing with various applications of radioisotopes in diagnosis and therapy. The papers were devoted to scintiscanning, radioimmunoassay, tomography, the applications of nuclear magnetic resonance and electron microscopy in different branches - oncology, cardiology, neurology, histology, gynecology, internal medicine, etc. (M.D.)

Advocating vaccination of adults aged 60 years and older in Western Europe: statement by the Joint Vaccine Working Group of the European Union Geriatric Medicine Society and the International Association of Gerontology and Geriatrics-European Region.

Science.gov (United States)

Michel, Jean-Pierre; Chidiac, Christian; Grubeck-Loebenstein, Beatrix; Johnson, Robert W; Lambert, Paul Henri; Maggi, Stefania; Moulias, Robert; Nicholson, Karl; Werner, Hans

2009-04-01

Vaccines are an underused public health strategy for healthy aging. Considering the risks of vaccine-preventable diseases and the current low vaccine coverage rates in older European citizens, the two European geriatric and gerontological societies (European Union Geriatric Medicine Society [EUGMS] and International Association of Gerontology and Geriatrics-European Region [IAGG-ER]) convened a Joint Vaccine Working Group to develop a consensus document advocating routine vaccination of aging populations. The mandate of this Working Group was to improve the uptake of routine vaccinations in adults aged 60 years and over. The consensus statement underlines the need to establish, strengthen, and harmonize European policies that continue routine vaccinations to adulthood and that will include older populations. Improved vaccination rates will promote healthy aging by reducing the burden of vaccine-preventable infectious diseases in older populations, a population that is rapidly increasing in Europe.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

Science.gov (United States)

Perez, Jose A., Jr.; Greer, Sharon

2009-01-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

[What is new in 2016 for the specialist in hospital internal medicine?

Science.gov (United States)

Mraihi, Hamza; Chevaux, Fabienne; Castoni, Julien; Aebischer, Oriane; Christou, Foetini; Jaccard, Evrim; Benmachiche, Malik; Tasheva, Plamena; Giroud, Sabine; Kraege, Vanessa; Lamy, Olivier

2017-01-18

The year 2016 was rich in significant advances in all areas of internal medicine. Many of them have an impact on our daily practice in general internal medicine. From the treatment of NSTEMI in population older than 80, to new sepsis and septic shock criteria to antidotes of new oral anticoagulants, this selection offers to the readers a brief overview of the major advances. The chief residents in the Service of internal medicine of the Lausanne University hospital are pleased to share their readings.

International congress on aromatic and medicinal plants

International Nuclear Information System (INIS)

2009-01-01

Full Text : In Morocco, medicinal and aromatic plants occupy an important place in the traditional care system of a large number of local people. They are also economically strong potential, but unfortunately they are not valued enough. Indeed, Morocco by its privileged geographical position in the Mediterranean basin and its floristic diversity (with a total of over 4,200 species and subspecies of which over 500 are recognized as medicinal and aromatic plants), is a leading provider of traditional global market. In this context and given the back label of the natural global, group research and studies on Aromatic and Medicinal Plants (GREPAM), the Faculty of Semlalia and University Cadi Ayyad, organize: the International Congress on Medicinal and Aromatic Plants CIPAM 2009. The organization of this conference is part of scientific research developed by the GREPAM. [fr

Optimizing the use of intravenous therapy in internal medicine.

Science.gov (United States)

Champion, Karine; Mouly, Stéphane; Lloret-Linares, Celia; Lopes, Amanda; Vicaut, Eric; Bergmann, Jean-François

2013-10-01

We aimed to evaluate the impact of physicians' educational programs in the reduction of inappropriate intravenous lines in internal medicine. Fifty-six French internal medicine units were enrolled in a nationwide, prospective, blinded, randomized controlled trial. Forms describing the patients with an intravenous line and internal medicine department characteristics were filled out on 2 separate days in January and April 2007. Following the first visit, all units were randomly assigned to either a specific education program on the appropriate indications of an intravenous line, during February and March 2007, or no training (control group). The Investigators' Committee then blindly evaluated the clinical relevance of the intravenous line according to pre-established criteria. The primary outcome was the percentage of inappropriate intravenous lines. During January 2007, intravenous lines were used in 475 (24.9%) of the 1910 hospitalized patients. Of these, 80 (16.8%) were considered inappropriate. In April 2007, 416 (22.8%) of the 1823 hospitalized patients received an intravenous line, which was considered in 10.2% (21/205) of patients managed by trained physicians, versus 16.6% (35/211) of patients in the control group (relative difference 39%; 95% confidence interval, -0.6-13.3; P = .05). Reduced intravenous administration of fluids, antibiotics, and analgesics accounted for the observed decrease. The use of a simple education program reduced the rate of inappropriate intravenous lines by almost 40% in an internal medicine setting (NCT01633307). Copyright © 2013 Elsevier Inc. All rights reserved.

International Combined Orthopaedic Research Societies: A model for international collaboration to promote orthopaedic and musculoskeletal research

Directory of Open Access Journals (Sweden)

Theodore Miclau

2014-10-01

Full Text Available In October 2013, the International Combined Orthopaedic Research Societies (ICORS; http://i-cors.org was founded with inaugural member organisations from the previous Combined Orthopaedic Research Society, which had sponsored combined meetings for more than 2 decades. The ICORS is dedicated to the stimulation of orthopaedic and musculoskeletal research in fields such as biomedical engineering, biology, chemistry, and veterinary and human clinical research. The ICORS seeks to facilitate communication with member organisations to enhance international research collaborations and to promote the development of new international orthopaedic and musculoskeletal research organisations. Through new categories of membership, the ICORS represents the broadest coalition of orthopaedic research organisations globally.

State and multilateralism, a theoretical approach. Transformations in a globalized international society

Directory of Open Access Journals (Sweden)

Paloma González del Miño

2013-11-01

Full Text Available The State, classical international actor, has had to readaption to the new dynamics in the International Society and has given prominence to other actors. In this logic, it´s relevant to analyze the role in the international system after the Cold War to evaluare whether it is still an actor capable of responding to the functional needs of the society. For this, reaffirms its commitment to multilateralism as a response to the main issue on the international agenda. Namely, is reactivated as an ideal tool to manage structural changes, despite the different interpretations of United States, the European Union or the BRICS. The object of this analysis contribute to the academic debate and focuses on studying the transformations of the State in the globalized international society where multilateralism has become a concept discussed and a common practice in the international discourse, despite its complexity and the different visions and interpretations by different actors. Multilateralism granted the State a path of cooperation and understanding as a guiding principle and foreign policy legitimizing discourse.

Official Program and Abstracts of the 15. Meeting of the Latin-American Association of Biology and Nuclear Medicine Societies (ALASBIMN 97); Iberoamerican Congress of Nuclear Medicine

International Nuclear Information System (INIS)

1997-01-01

This issue contains 117 abstracts of lectures and poster sessions of the 15th Meeting of the Latin-American Association of Biology and Nuclear Medicine Societies (ALASBIMN 97) and Iberoamerican Congress of Nuclear Medicine, held in Lima, Peru, from 26 to 30 October 1997. The key subjects addressed are nuclear medicine and diagnostic techniques on brain, liver, lungs, heart, osteo-articular, cardiology, oncology, endocrinology, radiopharmaceuticals, medical physics, SPECT and their applications in diagnostic medicine. (APC)

Standard operating procedures for female orgasmic disorder: consensus of the International Society for Sexual Medicine

NARCIS (Netherlands)

Laan, Ellen; Rellini, Alessandra H.; Barnes, Tricia

2013-01-01

As the field of sexual medicine evolves, it is important to continually improve patient care by developing contemporary "standard operating procedures" (SOPs), reflecting the consensus view of experts in sexual medicine. Few, if any, consensus SOPs have been developed for the diagnosis and treatment

Relationship between internal medicine program board examination pass rates, accreditation standards, and program size.

Science.gov (United States)

Falcone, John L; Gonzalo, Jed D

2014-01-19

To determine Internal Medicine residency program compliance with the Accreditation Council for Graduate Medical Education 80% pass-rate standard and the correlation between residency program size and performance on the American Board of Internal Medicine Certifying Examination. Using a cross-sectional study design from 2010-2012 American Board of Internal Medicine Certifying Examination data of all Internal Medicine residency pro-grams, comparisons were made between program pass rates to the Accreditation Council for Graduate Medical Education pass-rate standard. To assess the correlation between program size and performance, a Spearman's rho was calculated. To evaluate program size and its relationship to the pass-rate standard, receiver operative characteristic curves were calculated. Of 372 Internal Medicine residency programs, 276 programs (74%) achieved a pass rate of =80%, surpassing the Accreditation Council for Graduate Medical Education minimum standard. A weak correlation was found between residency program size and pass rate for the three-year period (p=0.19, pInternal Medicine residency programs complied with Accreditation Council for Graduate Medical Education pass-rate standards, a quarter of the programs failed to meet this requirement. Program size is positively but weakly associated with American Board of Internal Medicine Certifying Examination performance, suggesting other unidentified variables significantly contribute to program performance.

Internal radiation dosimetry using nuclear medicine imaging in radionuclide therapy

International Nuclear Information System (INIS)

Kim, Kyeong Min; Byun, Byun Hyun; Cheon, Gi Jeong; Lim, Sang Moo

2007-01-01

Radionuclide therapy has been an important field in nuclear medicine. In radionuclide therapy, relevant evaluation of internally absorbed dose is essential for the achievement of efficient and sufficient treatment of incurable disease, and can be accomplished by means of accurate measurement of radioactivity in body and its changes with time. Recently, the advances of nuclear medicine imaging and multi modality imaging processing techniques can provide chance of more accurate and easier measurement of the measures commented above, in cooperation of conventional imaging based approaches. In this review, basic concept for internal dosimetry using nuclear medicine imaging is summarized with several check points which should be considered in real practice

Meeting report of the first conference of the International Placenta Stem Cell Society (IPLASS)

Science.gov (United States)

Parolini, O.; Alviano, F.; Betz, A.G.; Bianchi, D.W.; Götherström, C.; Manuelpillai, U.; Mellor, A.L.; Ofir, R.; Ponsaerts, P.; Scherjon, S.A.; Weiss, M.L.; Wolbank, S.; Wood, K.J.; Borlongan, C.V.

2012-01-01

The International Placenta Stem Cell Society (IPLASS) was founded in June 2010. Its goal is to serve as a network for advancing research and clinical applications of stem/progenitor cells isolated from human term placental tissues, including the amnio-chorionic fetal membranes and Wharton's jelly. The commitment of the Society to champion placenta as a stem cell source was realized with the inaugural meeting of IPLASS held in Brescia, Italy, in October 2010. Officially designated as an EMBO-endorsed scientific activity, international experts in the field gathered for a 3-day meeting, which commenced with “Meet with the experts” sessions, IPLASS member and board meetings, and welcome remarks by Dr. Ornella Parolini, President of IPLASS. The evening's highlight was a keynote plenary lecture by Dr. Diana Bianchi. The subsequent scientific program consisted of morning and afternoon oral and poster presentations, followed by social events. Both provided many opportunities for intellectual exchange among the 120 multi-national participants. This allowed a methodical and deliberate evaluation of the status of placental cells in research in regenerative and reparative medicine. The meeting concluded with Dr. Parolini summarizing the meeting's highlights. This further prepared the fertile ground on which to build the promising potential of placental cell research. The second IPLASS meeting will take place in September 2012 in Vienna, Austria. This meeting report summarizes the thought-provoking lectures delivered at the first meeting of IPLASS. PMID:21575989

Trend and impact of international collaboration in clinical medicine papers published in Malaysia.

Science.gov (United States)

Low, Wah Yun; Ng, Kwan Hoong; Kabir, M A; Koh, Ai Peng; Sinnasamy, Janaki

2014-01-01

Research collaboration is the way forward in order to improve quality and impact of its research findings. International research collaboration has resulted in international co-authorship in scientific communications and publications. This study highlights the collaborating research and authorship trend in clinical medicine in Malaysia from 2001 to 2010. Malaysian-based author affiliation in the Web of Science (Science Citation Index Expanded) and clinical medicine journals ( n  = 999) and articles ( n  = 3951) as of 30th Oct 2011 were downloaded. Types of document analyzed were articles and reviews, and impact factors (IF) in the 2010 Journal Citation Report Science Edition were taken to access the quality of the articles. The number of publications in clinical medicine increased from 4.5 % ( n  = 178) in 2001 to 23.9 % ( n  = 944) in 2010. The top three contributors in the subject categories are Pharmacology and Pharmacy (13.9 %), General and Internal Medicine (13.6 %) and Tropical Medicine (7.3 %). By journal tier system: Tier 1 (18.7 %, n  = 738), Tier 2 (22.5 %, n  = 888), Tier 3 (29.6 %, n  = 1170), Tier 4 (27.2 %, n  = 1074), and journals without IF (2.1 %, n  = 81). University of Malaya was the most productive. Local collaborators accounted for 60.3 % and international collaborations 39.7 %. Articles with international collaborations appeared in journals with higher journal IFs than those without international collaboration. They were also cited more significantly than articles without international collaborations. Citations, impact factor and journal tiers were significantly associated with international collaboration in Malaysia's clinical medicine publications. Malaysia has achieved a significant number of ISI publications in clinical medicine participation in international collaboration.

Radiation safety in nuclear medicine procedures

International Nuclear Information System (INIS)

Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun

2017-01-01

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed

Radiation safety in nuclear medicine procedures

Energy Technology Data Exchange (ETDEWEB)

Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun [Dept. of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, Gwangju (Korea, Republic of)

2017-03-15

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

Competency-based education and training in internal medicine.

Science.gov (United States)

Weinberger, Steven E; Pereira, Anne G; Iobst, William F; Mechaber, Alex J; Bronze, Michael S

2010-12-07

Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program. Challenges to competency-based education include teaching and evaluating the competencies related to practice-based learning and improvement and systems-based practice, as well as implementing a flexible time frame to achieve competencies. However, the Alliance for Academic Internal Medicine Education Redesign Task Force II does not favor reducing internal medicine training to less than 36 months as part of competency-based education. Rather, the 36-month time frame should allow for remediation to address deficiencies in achieving competencies and for diverse enrichment experiences in such areas as quality of care and practice improvement for residents who have demonstrated skills in all required competencies.

[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.

Catalogue of learning goals for pregraduate education in geriatric medicine. A recommendation of the German Geriatric Society (DGG), the German Society of Gerontology and Geriatrics (DGGG), the Austrian Society of Geriatrics and Gerontology (OGGG) and the Swiss Society of Geriatric Medicine (SFGG) on the basis of recommendations of the European Union of Medical Specialists Geriatric Medicine Section (UEMS-GMS) 2013

DEFF Research Database (Denmark)

Singler, K.; Stuck, A. E.; Masud, T.

2014-01-01

using a modified Delphi technique in order to encourage education in this field. This catalogue of learning objectives for geriatric medicine focuses on the minimum requirements with specific learning goals in knowledge, skills and attitudes that medical students should have acquired by the end...... at German-speaking medical faculties and universities of Austria, Germany and Switzerland. This article contains the final German translation of the curriculum. The Geriatric Medicine Societies of Germany, Austria, and Switzerland formally endorse the present curriculum and recommend that medical faculties...

Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications: guidelines from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain.

Science.gov (United States)

Narouze, Samer; Benzon, Honorio T; Provenzano, David A; Buvanendran, Asokumar; De Andres, José; Deer, Timothy R; Rauck, Richard; Huntoon, Marc A

2015-01-01

Interventional spine and pain procedures cover a far broader spectrum than those for regional anesthesia, reflecting diverse targets and goals. When surveyed, interventional pain and spine physicians attending the American Society of Regional Anesthesia and Pain Medicine (ASRA) 11th Annual Pain Medicine Meeting exhorted that existing ASRA guidelines for regional anesthesia in patients on antiplatelet and anticoagulant medications were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors necessitated separate guidelines for pain and spine procedures. In response, ASRA formed a guidelines committee. After preliminary review of published complication reports and studies, committee members stratified interventional spine and pain procedures according to potential bleeding risk as low-, intermediate-, and high-risk procedures. The ASRA guidelines were deemed largely appropriate for the low- and intermediate-risk categories, but it was agreed that the high-risk targets required an intensive look at issues specific to patient safety and optimal outcomes in pain medicine. The latest evidence was sought through extensive database search strategies and the recommendations were evidence-based when available and pharmacology-driven otherwise. We could not provide strength and grading of these recommendations as there are not enough well-designed large studies concerning interventional pain procedures to support such grading. Although the guidelines could not always be based on randomized studies or on large numbers of patients from pooled databases, it is hoped that they will provide sound recommendations and the evidentiary basis for such recommendations.

Internal medicine board certification and career pathways in Japan.

Science.gov (United States)

Koike, Soichi; Matsumoto, Masatoshi; Ide, Hiroo; Kawaguchi, Hideaki; Shimpo, Masahisa; Yasunaga, Hideo

2017-05-08

Establishing and managing a board certification system is a common concern for many countries. In Japan, the board certification system is under revision. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice. We analyzed 2010 and 2012 data from the Survey of Physicians, Dentists and Pharmacists. We conducted logistic regression analysis to identify factors associated with the maintenance of board certification between 2010 and 2012. We also analyzed data on career transition from hospitals to clinics for hospital physicians with board certification. It was common for physicians seeking board certification to do so in their early career. The odds of maintaining board certification were lower in women and those working in locations other than academic hospitals, and higher in physicians with subspecialty practice areas. Among hospital physicians with board certification who moved to clinics between 2010 and 2012, 95.8% remained in internal medicine or its subspecialty areas and 87.7% maintained board certification but changed their practice from a subspecialty area to more general internal medicine. Revisions of the internal medicine board certification system must consider different physician career pathways including mid-career moves while maintaining certification quality. This will help to secure an adequate number and distribution of specialists. To meet the increasing demand for generalist physicians, it is important to design programs to train specialists in general practice.

Comparison of Patient Health History Questionnaires Used in General Internal and Family Medicine, Integrative Medicine, and Complementary and Alternative Medicine Clinics.

Science.gov (United States)

Laube, Justin G R; Shapiro, Martin F

2017-05-01

Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. HHQs were obtained from GIM/FM (n = 9), integrative medicine (n = 11), naturopathic medicine (n = 5), chiropractic (n = 4), and TCM (n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine (p medicine (p = 0.04), 2.0 (SD, 1.4) for chiropractic (p = 0.54), and 2.0 (SD, 1.5) for TCM (p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine (p = 0.01), 9.0 (SD, 0) for naturopathic medicine (p = 0.01), 7.1 (SD, 2.8) for chiropractic (p = 0.58), and 7.1 (SD, 1.7) for TCM (p = 0.41). Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to support the clinical and preventive

Women on professional society and journal editorial boards.

Science.gov (United States)

Morton, Melinda J; Sonnad, Seema S

2007-07-01

Membership on a professional medical society or journal editorial board is a marker of influence and prestige for those in academic medicine. This study presents the first comprehensive quantification of women on these boards and the implications for women in medicine. The numbers of women and men on professional society and journal editorial boards across 28 specialties (March 2004) were counted. The number of women holding multiple roles on these boards and the number of women holding top leadership positions on these boards were counted, and these proportions were compared. Three-thousand-four-hundred-seventy-three individuals on 39 professional medical society boards and 54 journal editorial boards were included. Eighty-three percent (2,884) of board members were male. Men occupied > 80% of top leadership positions on these boards. Thirty-five of the 589 women in the study held multiple roles. Anesthesiology (p women on boards in comparison to the total women in the specialty. Internal medicine, plastic surgery, cardiology and general surgery had nearly equivalent proportions; in otolaryngology and family medicine, female board members slightly exceeded the proportion of women in the field. Women's representation on society and editorial boards does not always reflect their presence in medical specialties, and it is critically lacking in certain specialties. Efforts should be made to attain parity of women leaders on these boards. Further efforts should be made to eliminate barriers to women's leadership in medicine.

Validation of the American Society for Reproductive Medicine guidelines/recommendations in white European men presenting for couple's infertility.

Science.gov (United States)

Ventimiglia, Eugenio; Capogrosso, Paolo; Boeri, Luca; Ippolito, Silvia; Scano, Roberta; Moschini, Marco; Gandaglia, Giorgio; Papaleo, Enrico; Montorsi, Francesco; Salonia, Andrea

2016-10-01

To retrospectively validate the American Society for Reproductive Medicine (ASRM) guidelines/recommendations concerning endocrine evaluation in a cohort of white European men presenting for couple's infertility. Retrospective study. Academic reproductive medicine outpatient clinic. Cohort of 1,056 consecutive infertile men (noninterracial infertile couples). Testicular volume was assessed with a Prader orchidometer. Serum hormones were measured (8-10 a.m.) in all cases. Hypogonadism was defined as total T Society definition. Semen analysis values were assessed based on the 2010 World Health Organisation reference criteria. ASRM indications for endocrine assessment in infertile men (sperm concentration Society classification criteria. Conversely, 37 (23.7%) out of 156 patients with biochemical hypogonadism would have been overlooked. The overall predictive accuracy, sensitivity, and specificity of the ASRM guidelines was 58%, 76%, and 39%, respectively. Our nomogram was not reliable enough to predict hypogonadism, despite demonstrating a significantly higher predictive accuracy (68%) than the ASRM guidelines. The current findings show that the ASRM guidelines/recommendations for male infertility workup may not be suitable for application in white European infertile men. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The American Society of Clinical Oncology's Efforts to Support Global Cancer Medicine

Science.gov (United States)

El-Saghir, Nagi S.; Cufer, Tanja; Cazap, Eduardo; de Guzman, Roselle; Othieno-Abinya, Nicholas Anthony; Sanchez, Jose Angel; Pyle, Doug

2016-01-01

Despite much progress in the management of malignant diseases, the number of new cases and cancer-related deaths continues to rise around the world. More than half of new cases occur in economically developing countries, where more than two thirds of cancer deaths are expected. However, implementation of all necessary steps to accomplish the dissemination of state-of-the-art prevention, diagnosis, and management will require increased allocation of resources, and, more importantly, harmonization of the efforts of hundreds of national and international public health agencies, policy-setting bodies, governments, pharmaceutical companies, and philanthropic organizations. More than 30% of the members of the American Society of Clinical Oncology (ASCO) reside and practice outside US borders, and more than half of attendees at all of the scientific congresses and symposia organized by ASCO are international. As cancer has become an increasingly global disease, ASCO has evolved as a global organization. The ASCO Board of Directors currently includes members from France, Brazil, and Canada. In 2013, the ASCO Board of Directors identified a number of strategic priorities for the future. Recognizing the importance of non-US members to the society, their first strategic priority was improving the society's service to non-US members and defining these members' identity in the international oncology community. This article reviews current ASCO activities in the international arena and its future plans in global oncology. PMID:26578614

International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT).

Science.gov (United States)

Torres, Antoni; Niederman, Michael S; Chastre, Jean; Ewig, Santiago; Fernandez-Vandellos, Patricia; Hanberger, Hakan; Kollef, Marin; Li Bassi, Gianluigi; Luna, Carlos M; Martin-Loeches, Ignacio; Paiva, J Artur; Read, Robert C; Rigau, David; Timsit, Jean François; Welte, Tobias; Wunderink, Richard

2017-09-01

The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent.The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited.A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink).Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population-intervention-comparison-outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention. Copyright ©ERS 2017.

Radiobiology 2000: advances in fundamental and clinical radiobiology. Programme and abstracts: 1st international congress of the South African Radiobiology Society (SARS) in conjunction with the South African Association of Physicists in Medicine and Biology (SAAPMB) and the University of Stellenbosch, 10-13 December 2000, Music Conservatoire, University of Stellenbosch

International Nuclear Information System (INIS)

2000-12-01

Programme and abstracts of the 1st international congress of the South African Radiobiology Society, held in conjunction with the South African Association of Physicists in Medicine and Biology and the University of Stellenbosch, from 10-13 December 2000. This publication contain the abstracts of the forty-four papers and posters that were presented

[The European network of transfusion medicine societies (EuroNet-TMS): The White Book 2005].

Science.gov (United States)

Rouger, P

2005-06-01

Europe is building up. It develops in a quite complex environment, in which health care represents an important field of activities. As for blood transfusion, it plays a major role especially in the development of medical activities as well as for the patients treatments. Today, blood components are still of human origin and there are no substitutes for them. As a medical discipline, Blood Transfusion represents a broad field in medicine which requests the involvement of numerous actors. It is up to professional medical/scientific societies to promote the discipline. This is why it has been considered necessary and relevant to build up a federation of transfusion medicine societies throughout the European Union (EU) ; it is called EuroNet-TMS, the European Network of Transfusion Medicine Societies. This network groups more than 7500 professionals of involved in blood transfusion activities. It has six major objectives: 1) To find coherent responses to issues at stake in transfusion; 2) To promote medical and scientific developments of blood transfusion in Europe; 3) To ensure the highest and most up-to-date scientific level to meet safety and quality standards; 4) To offer similar services to all EU citizens in the field of blood transfusion; 5) To share knowledge and date within Europe; 6) To develop interfaces with decision-makers among the diverse European countries. The first step is the writing of the "White Book 2005" which reports the state of the art of blood transfusion in Europe; a prospective plan is proposed to be discussed.

Ultrasound for internal medicine physicians: the future of the physical examination.

Science.gov (United States)

Dulohery, Megan M; Stoven, Samantha; Kurklinsky, Andrew K; Kurklinksy, Andrew; Halvorsen, Andrew; McDonald, Furman S; Bhagra, Anjali

2014-06-01

With the advent of compact ultrasound (US) devices, it is easier for physicians to enhance their physical examinations through the use of US. However, although this new tool is widely available, few internal medicine physicians have US training. This study sought to understand physicians' baseline knowledge and skill, provide education in US principles, and demonstrate that proper use of compact US devices is a skill that can be quickly learned. Training was performed at the Mayo Clinic in June 2010 and June 2011. The participants consisted of internal medicine residents. The workshop included didactics and hands-on US experiences with human and cadaver models in a simulation center. Pretests and posttests of residents' knowledge, attitudes, and skills with US were completed. We reassessed the 2010 group in the spring of 2012 with a long-term retention survey for knowledge and confidence in viewing images. A total of 136 interns completed the workshop. Thirty-nine residents completed the long-term retention survey. Posttest assessments showed a statistically significant improvement in the knowledge of US imaging, confidence in identifying structures, image identification, and image acquisition (P internal medicine training and practice. © 2014 by the American Institute of Ultrasound in Medicine.

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

OpenAIRE

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

2009-01-01

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

A Survey of Clinical Skills Evaluation Practices in Internal Medicine Residency Programs.

Science.gov (United States)

Blank, Linda L.; And Others

1984-01-01

The evaluation processes of 75 internal medicine residencies visited by the American Board of Internal Medicine (ABIM) in 1978-82 are reviewed. The methods of evaluation used by the residencies are described and compared with the findings from an earlier cycle of visits in 1972-75. (Author/MLW)

Mindfulness, burnout, and effects on performance evaluations in internal medicine residents

Directory of Open Access Journals (Sweden)

Braun SE

2017-08-01

Full Text Available Sarah E Braun,1 Stephen M Auerbach,1 Bruce Rybarczyk,1 Bennett Lee,2 Stephanie Call2 1Department of Psychology, School of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA; 2Department of Internal Medicine, Division of General Medicine, Virginia Commonwealth University, Richmond, VA, USA Purpose: Burnout has been documented at high levels in medical residents with negative effects on performance. Some dispositional qualities, like mindfulness, may protect against burnout. The purpose of the present study was to assess burnout prevalence among internal medicine residents at a single institution, examine the relationship between mindfulness and burnout, and provide preliminary findings on the relation between burnout and performance evaluations in internal medicine residents.Methods: Residents (n = 38 completed validated measures of burnout at three time points separated by 2 months and a validated measure of dispositional mindfulness at baseline. Program director end-of-year performance evaluations were also obtained on 22 milestones used to evaluate internal medicine resident performance; notably, these milestones have not yet been validated for research purposes; therefore, the investigation here is exploratory.Results: Overall, 71.1% (n = 27 of the residents met criteria for burnout during the study. Lower scores on the “acting with awareness” facet of dispositional mindfulness significantly predicted meeting burnout criteria χ2(5 = 11.88, p = 0.04. Lastly, meeting burnout criteria significantly predicted performance on three of the performance milestones, with positive effects on milestones from the “system-based practices” and “professionalism” domains and negative effects on a milestone from the “patient care” domain.Conclusion: Burnout rates were high in this sample of internal medicine residents and rates were consistent with other reports of burnout during medical residency. Dispositional

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

Science.gov (United States)

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

2011-02-02

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

Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

Science.gov (United States)

Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J

2008-08-01

The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.

Burnout, coping, and spirituality among internal medicine resident physicians.

Science.gov (United States)

Doolittle, Benjamin R; Windish, Donna M; Seelig, Charles B

2013-06-01

Burnout in physicians is common, and studies show a prevalence of 30% to 78%. Identifying constructive coping strategies and personal characteristics that protect residents against burnout may be helpful for reducing errors and improving physician satisfaction. We explored the complex relationships between burnout, behaviors, emotional coping, and spirituality among internal medicine and internal medicine-pediatrics residents. We anonymously surveyed 173 internal medicine and medicine-pediatrics residents to explore burnout, coping, and spiritual attitudes. We used 3 validated survey instruments: the Maslach Burnout Inventory, the Carver Coping Orientation to Problems Experienced (COPE) Inventory, and the Hatch Spiritual Involvement and Beliefs Scale (SIBS). A total of 108 (63%) residents participated, with 31 (28%) reporting burnout. Residents who employed strategies of acceptance, active coping, and positive reframing had lower emotional exhaustion and depersonalization (all, P < .03). Residents who reported denial or disengagement had higher emotional exhaustion and depersonalization scores. Personal accomplishment was positively correlated with the SIBS total score (r  =  +.28, P  =  .003), as well as the internal/fluid domain (r  =  +.32, P  =  .001), existential axes (r  =  +.32, P  =  .001), and humility/personal application domain (r  =  +.23, P  =  .02). The humility/personal application domain also was negatively correlated with emotional exhaustion (r  =  -.20, P  =  .04) and depersonalization (r  =  -.25, P  =  .009). No activity or demographic factor affected any burnout domain. Burnout is a heterogeneous syndrome that affects many residents. We identified a range of emotional and spiritual coping strategies that may have protective benefit.

International Comparisons of Behavioral and Emotional Problems in Preschool Children: Parents’ Reports From 24 Societies

Science.gov (United States)

Rescorla, Leslie A.; Achenbach, Thomas M.; Ivanova, Masha Y.; Harder, Valerie S.; Otten, Laura; Bilenberg, Niels; Bjarnadottir, Gudrun; Capron, Christiane; De Pauw, Sarah S. W.; Dias, Pedro; Dobrean, Anca; Döpfner, Manfred; Duyme, Michel; Eapen, Valsamma; Erol, Nese; Esmaeili, Elaheh Mohammad; Ezpeleta, Lourdes; Frigerio, Alessandra; Fung, Daniel S. S.; Gonçalves, Miguel; Guđmundsson, Halldór; Jeng, Suh-Fang; Jusiené, Roma; Kim, Young Ah; Kristensen, Solvejg; Liu, Jianghong; Lecannelier, Felipe; Leung, Patrick W. L.; Machado, Bárbara César; Montirosso, Rosario; Oh, Kyung Ja; Ooi, Yoon Phaik; Plück, Julia; Pomalima, Rolando; Pranvera, Jetishi; Schmeck, Klaus; Shahini, Mimoza; Silva, Jaime R.; Simsek, Zeynep; Sourander, Andre; Valverde, José; van der Ende, Jan; Van Leeuwen, Karla G.; Wu, Yen-Tzu; Yurdusen, Sema; Zubrick, Stephen R.; Verhulst, Frank C.

2014-01-01

International comparisons were conducted of preschool children’s behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½–5 by parents in 24 societies (N =19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental Disorders–oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3–12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0–198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes societies, correlations between mean item ratings averaged .78, and correlations between internal consistency alphas for the scales averaged .92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies. PMID:21534056

[Day hospital in internal medicine: A chance for ambulatory care].

Science.gov (United States)

Grasland, A; Mortier, E

2018-04-16

Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Ethical quandaries in spiritual healing and herbal medicine: a critical analysis of the morality of traditional medicine advertising in southern African urban societies.

Science.gov (United States)

Munyaradzi, Mawere

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 problems associated with traditional medicine advertising. Critical look at the worthiness of some advertising strategies used by practitioners in traditional medicine in launching their products and services on market thus has been largely ignored. Yet, though advertising is key to helping traditional medicine practitioners' products and services known by prospective customers, this research registers a number of morally negative effects that seem to outweigh the merits that the activity brings to prospective customers. The paper adopts southern African urban societies, and in particular Mozambique, South Africa and Zimbabwe as particular references. The choice of the trio is not accidental, but based on the fact that these countries have in the last few decades been flooded with traditional medicine practitioners/traditional healers from within the continent and from abroad. Most of these practitioners use immoral advertising strategies in communicating to the public the products and services they offer. It is against this background that this paper examines the morality of advertising strategies deployed by practitioners in launching their products and services. To examine the moral worthiness of the advertising strategies used by traditional medical practitioners, I used qualitative analysis of street adverts as well as electronic and print media. From the results obtained through thematic content analysis, the paper concludes that most of the practitioners in traditional

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

Science.gov (United States)

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

2017-08-01

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

Internal Medicine Resident Engagement with a Laboratory Utilization Dashboard: Mixed Methods Study.

Science.gov (United States)

Kurtzman, Gregory; Dine, Jessica; Epstein, Andrew; Gitelman, Yevgenly; Leri, Damien; Patel, Miltesh S; Ryskina, Kyra

2017-09-01

The objective of this study was to measure internal medicine resident engagement with an electronic medical record-based dashboard providing feedback on their use of routine laboratory tests relative to service averages. From January 2016 to June 2016, residents were e-mailed a snapshot of their personalized dashboard, a link to the online dashboard, and text summarizing the resident and service utilization averages. We measured resident engagement using e-mail read-receipts and web-based tracking. We also conducted 3 hour-long focus groups with residents. Using grounded theory approach, the transcripts were analyzed for common themes focusing on barriers and facilitators of dashboard use. Among 80 residents, 74% opened the e-mail containing a link to the dashboard and 21% accessed the dashboard itself. We did not observe a statistically significant difference in routine laboratory ordering by dashboard use, although residents who opened the link to the dashboard ordered 0.26 fewer labs per doctor-patient-day than those who did not (95% confidence interval, -0.77 to 0.25; = 0 .31). While they raised several concerns, focus group participants had positive attitudes toward receiving individualized feedback delivered in real time. © 2017 Society of Hospital Medicine.

The role of civil society organizations in the institutionalization of indigenous medicine in Bolivia.

Science.gov (United States)

Babis, Deby

2014-12-01

December 2013 marked a significant shift in Bolivia with the enactment of a law for the inclusion of indigenous doctors in the National Health System. This article traces the constellation of forces that led to the institutionalization of indigenous medicine in Bolivia. It identifies three factors contributing to this health policy change. The first factor is the crystallization of a strong indigenous movement fighting for the recognition of cultural rights through the foundation of civil society organizations. Second is the rise to power of Evo Morales, the first Latin American president of indigenous origin, who has promoted multicultural policies, formally supported through the promulgation of a new constitution. Lastly is the influence of the global acceptance of alternative medicine. Indigenous doctor organizations in Bolivia have been highly involved throughout the entire process of institutionalization and have played a crucial role in it. An analysis of the relationship between these civil society organizations and the Bolivian government reveals a strong partnership. This dynamic can be described in terms of Interdependence Theory, as each party relied on the other in the promotion and practice of the law to achieve the integration of indigenous medicine as part of the Bolivian Health System. Copyright © 2014 Elsevier Ltd. All rights reserved.

Documentation of quality improvement exposure by internal medicine residency applicants.

Science.gov (United States)

Kolade, Victor O; Sethi, Anuradha

2016-01-01

Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

Internal medicine point-of-care ultrasound assessment of left ventricular function correlates with formal echocardiography.

Science.gov (United States)

Johnson, Benjamin K; Tierney, David M; Rosborough, Terry K; Harris, Kevin M; Newell, Marc C

2016-02-01

Although focused cardiac ultrasonographic (FoCUS) examination has been evaluated in emergency departments and intensive care units with good correlation to formal echocardiography, accuracy for the assessment of left ventricular systolic function (LVSF) when performed by internal medicine physicians still needs independent evaluation. This prospective observational study in a 640-bed, academic, quaternary care center, included 178 inpatients examined by 10 internal medicine physicians who had completed our internal medicine bedside ultrasound training program. The ability to estimate LVSF with FoCUS as "normal," "mild to moderately decreased," or "severely decreased" was compared with left ventricular ejection fraction (>50%, 31-49%, and internal medicine physician-performed FoCUS and formal echocardiography for any LVSF impairment was "good/substantial" with κ = 0.77 (p Internal medicine physicians using FoCUS identify normal versus decreased LVSF with high sensitivity, specificity, and "good/substantial" interrater agreement when compared with formal echocardiography. These results support the role of cardiac FoCUS by properly trained internal medicine physicians for discriminating normal from reduced LVSF. © 2015 Wiley Periodicals, Inc.

The role of nuclear societies in the promotion of international cooperation

International Nuclear Information System (INIS)

Velez, C.

1992-01-01

International cooperation in the peaceful uses of atomic energy started with the Atoms for Peace initiative in 1955. The satisfaction of the foreseeable world demand for electricity requires a large increase in nuclear power. Such an increase will not be realized unless a number of current nuclear issues, both real and perceived, are resolved first. Most of the problems have acquired an international character and many of them are amenable only to international treatments. The nuclear societies can have an important role in this development. The last years of the present century will be decisive for the immediate future of nuclear power. The nuclear societies should coordinate efforts, join forces and speak out with one clear and distinct voice in all important issues

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey

OpenAIRE

Wilson Mark C; Mustafa Reem; Gunukula Sameer; Akl Elie A; Symons Andrew; Moheet Amir; Schünemann Holger J

2010-01-01

Abstract Background The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. Methods We conducted a survey of family medicine and internal medicine residency program directors in the United Stat...

Interview with Dr. Andre Davy, Honorary President, International Union of Phlebology; Honorary President, French Society of Phlebology; Honorary President, European Society of Phlebectomy. Interview by Jose Antonio Olivencia.

Science.gov (United States)

Davy, A

2000-06-01

Dr. Davy is the Honorary President International Union of Phlebology, Honorary President French Society of Phlebology, Honorary President European Society of Phlebectomy. Dr. Andre Davy was born in 1924 in Basse, Normandy. I met Dr. Davy in 1967 in a World Congress of Phlebology in Amsterdam. I was so impressed with his skills and knowledge that when he later on proposed to be associated in the practice of phlebology, I accepted immediately. That lead to a very long medical and surgical partnership. He was an expert in the Muller phlebectomy and was also interested in chronic venous insufficiency, chronic stasis ulcer and lymphedema. He promoted sclerotherapy as part of the overall treatment of venous disease. In the early seventies, he started a training program that included not only theoretical but also practical knowledge of phlebology. In 1974 he published a book entitled, "Les Varices." He organized the first Franco-British Symposium of Phlebology that was held in Touquet in May 1981. That symposium was a complete success. It was immediately followed by a second Franco-British symposium and later on by the creation of the Venous Forum of the Royal Society of Medicine, the birth of the English journal "Phlebology," the North American Society of Phlebology, and the American Venous Forum. Later, he became Editor in Chief of Phlebologie, the journal of the French Society of Phlebology. He was named President of the French Society of Phlebology in 1986 and in 1989 President of the International Union of Phlebology. This very well educated and calm gentleman with a very outward tranquil appearance and great strength of character has always held strong opinions. He is now retired at his family home in Pont L'Eveque, France and spends his time reading, listening to the music of his favorite composers Verdi and Mahler, continuously visiting old friends such as Jean Van der Stricht, Robert Muller, Claude Gillot, and still remaining very close to his family. PAUL OUVRY

Associations between subspecialty fellowship interest and knowledge of internal medicine: A hypothesis-generating study of internal medicine residents

Directory of Open Access Journals (Sweden)

Haidet Paul

2011-01-01

Full Text Available Abstract Background Little is known about whether and how medical knowledge relates to interest in subspecialty fellowship training. The purpose of this study was to examine the relationships between residents' interest in subspecialty fellowship training and their knowledge of internal medicine (IM. Methods A questionnaire was emailed to 48 categorical postgraduate-year (PGY two and three residents at a New York university-affiliated IM residency program in 2007 using the Survey Monkey online survey instrument. Overall and content area-specific percentile scores from the IM in-training examination (IM-ITE for the same year was used to determine objective knowledge. Results Forty-five of 48 residents (response rate was 93.8% completed the survey. Twenty-two (49% were PG2 residents and 23(51% were PGY3 residents. Sixty percent of respondents were male. Six (13% residents were graduates of U.S. medical schools. Eight (18% reported formal clinical training prior to starting internal medicine residency in the U.S. Of this latter group, 6 (75% had training in IM and 6 (75 % reported a training length of 3 years or less. Thirty-seven of 45 (82% residents had a subspecialty fellowship interest. Residents with a fellowship interest had a greater mean overall objective knowledge percentile score (56.44 vs. 31.67; p = 0.04 as well as greater mean percentile scores in all content areas of IM. The adjusted mean difference was statistically significant (p Conclusions More than half of surveyed residents indicated interest in pursuing a subspecialty fellowship. Fellowship interest appears positively associated with general medical knowledge in this study population. Further work is needed to explore motivation and study patterns among internal medicine residents.

[Practice of Internal Medicine in Latin America. Role of the internist].

Science.gov (United States)

Varela, Nacor

2002-01-01

This article explores the causes of the crisis in the role of internists. As in the United States, the progressive specialization of internists lead to a dehumanized, expensive and technical practice of medicine. Aiming to better incomes and prestige, more than 60% of internists practice as specialists. Primary care physicians, with a very low rate of problem solving, cover 75% of consultations. Specialists, with increasing costs, cover the rest of consultations. Patients, medical schools and health organizations are claiming the return of the general internal medicine specialist. To increase the interest for general internal medicine, several strategies are applicable. Medical students interested in general internal medicine could receive a focused training, provided by these specialists. A greater emphasis should be put on primary care. More independent, secondary care diagnostic and treatment centers, should be created. Continuous medical education should be done with periodical re certification of physicians. The public health system should increase its wages and the generalist view should be maintained by physicians when practicing at their private offices.

Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

Science.gov (United States)

Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

2017-12-11

The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017

Imperial Medicine in a Changing World: The Fourth International Congresses on Tropical Medicine and Malaria, 1948.

Science.gov (United States)

Wells, Julia

2016-01-01

The close connections between colonialism and tropical medicine have been widely discussed by historians over the last fifty years. However, few authors consider the relationship between tropical medicine and European and North American imperialism in the immediate post-World War II period. This article examines the Fourth International Congresses on Tropical Medicine and Malaria, held jointly in Washington in 1948. Using the research presented during the conference, it questions to what degree the specialisation had changed in the postwar period. It argues that although some changes are discernable, imperial traditions and relationships remained firmly embedded within the tropical medicine of the congress.

[Pharmacovigilance center --internal medicine interactions: A useful diagnostic tool].

Science.gov (United States)

Rochoy, M; Gautier, S; Bordet, R; Caron, J; Launay, D; Hachulla, E; Hatron, P-Y; Lambert, M

2015-08-01

Patients hospitalized in internal medicine often have unexplained clinical symptoms for which a drug origin can be considered. The prevalence of patients hospitalized for iatrogenic is estimated between 4-22%. We wanted to evaluate the diagnostic value of the regional center of pharmacovigilance to identify or confirm an iatrogenic disease in the department of internal medicine of Lille and characterize factors associated with drug-related side effect. This is a single-center prospective diagnostic study. We included all subsequent requests from the department of internal medicine with the Nord-Pas-de-Calais regional pharmacovigilance center between 2010 and 2012. The opinion of the regional pharmacovigilance centre was held on the record of the adverse drug reaction in the national pharmacovigilance database and analyzed according to the conclusion of iatrogenic used by clinicians in internal medicine (reference diagnosis) with a follow-up to June 2013. The variables relating to the patient, medication and adverse events were analyzed by binary logistic regression. We analyzed 160 contacts: 118 concordant cases, 38 false-positives (drug-related side effect retained by the regional pharmacovigilance center only), 4 false negatives. Registration in the national pharmacovigilance database had a sensitivity of 96% (95% CI [0.92 to 0.99]), a specificity of 46% (95% CI [0.38 to 0.53]), a value positive predictive of 69% (95% CI [0.62 to 0.76]), a negative predictive value of 89% (95% CI [0.84 to 0.94]) and a negative likelihood ratio of 0.1. False-positive had chronological and semiological accountabilities questionable (adjusted RR=2.1, 95% CI [1.2 to 2.8]). In our study, the regional pharmacovigilance center confirms the clinician's suspicion of drug-related side effects and helps to exclude drug-induced with a high negative predictive value. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

The Rise of the Welfare State in International Society

DEFF Research Database (Denmark)

Schouenborg, Laust

2015-01-01

In this article I seek to develop a case for viewing the welfare state as a primary institution in international society. This is with particular reference to Norden (Denmark, Finland, Iceland, Norway and Sweden), where in the course of the 1930s, and particularly in the post-1945 era, the welfare...... state was elevated to a core principle of legitimacy, largely defining the idea of nationhood for these countries. Furthermore, I will attempt to show how the adoption of this principle of legitimacy conditioned the Nordic countries’ interpretation of a number of other primary institutions...... in international society such as diplomacy, war and trade. A key contribution of this approach is that it aspires not only to examine the evolution of one institution in isolation, as has often been attempted in English School scholarship, but to actively explore how institutions interact with each other....

Between Nationalism and Internationalism: The German Chemical Society In Comparative Perspective, 1867-1945.

Science.gov (United States)

Johnson, Jeffrey Allan

2017-09-04

One-hundred fifty years ago, on the eve of German unification, about one-hundred people gathered in Berlin to found the German Chemical Society (DChG) under the charismatic leadership of August Wilhelm von Hofmann, who attracted a large international membership by promoting modern organic chemistry. By 1892, when Emil Fischer succeeded Hofmann, the DChG was the world's largest chemical society. Under Fischer the Society promoted international collaboration with foreign societies, and in 1900 it opened an impressive headquarters, the Hofmann House, where it centralized its greatly expanded literary activity including abstracts and reference publications. Yet a half-century later, after war and racial-national extremism, the house lay in ruins and the Society had ceased to exist. In remembering the Society, one may well ask why its auspicious beginning should have led to this ignominious end. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Globalization, Credence Goods and International Civil Society

OpenAIRE

Krautheim, Sebastian; Verdier, Thierry

2012-01-01

The process of globalization is characterized by an impressive growth in global value chains, as well as the proliferation of non-governmental organizations (NGOs) interacting with production and sourcing decisions of multinational firms. In this paper, we present a simple North-South model of international trade allowing for the joint emergence of firm offshoring to South and NGO activism financed by donations from the civil society. In our model northern consumers care about unobservable “c...

Implementing standardized, inter-unit communication in an international setting: handoff of patients from emergency medicine to internal medicine.

Science.gov (United States)

Balhara, Kamna S; Peterson, Susan M; Elabd, Mohamed Moheb; Regan, Linda; Anton, Xavier; Al-Natour, Basil Ali; Hsieh, Yu-Hsiang; Scheulen, James; Stewart de Ramirez, Sarah A

2018-04-01

Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs. EM and IM physicians collaboratively developed a written tool encouraging bedside handoff of admitted patients. After the intervention, surveys of EM physicians and 40 observations were subsequently repeated. 77.5% of initial observed handoffs occurred face-to-face, with 42.5% at bedside, and in four different languages. Most survey respondents considered face-to-face handoff ideal. Respondents noted 9-13 patients suffering harm due to handoff in the prior month. After handoff tool implementation, 97.5% of observed handoffs occurred face-to-face (versus 77.5%, p = 0.014), with 82.5% at bedside (versus 42.5%, p face-to-face and bedside handoff, positively impacted workflow, and increased perceptions of safety by EM physicians in an international, non-academic setting. Our three-step approach can be applied towards developing standardized, context-specific inter-specialty handoff in a variety of settings.

The State of Evaluation in Internal Medicine Residency

Science.gov (United States)

Holmboe, Eric; Beasley, Brent W.

2008-01-01

Background There are no nationwide data on the methods residency programs are using to assess trainee competence. The Accreditation Council for Graduate Medical Education (ACGME) has recommended tools that programs can use to evaluate their trainees. It is unknown if programs are adhering to these recommendations. Objective To describe evaluation methods used by our nation’s internal medicine residency programs and assess adherence to ACGME methodological recommendations for evaluation. Design Nationwide survey. Participants All internal medicine programs registered with the Association of Program Directors of Internal Medicine (APDIM). Measurements Descriptive statistics of programs and tools used to evaluate competence; compliance with ACGME recommended evaluative methods. Results The response rate was 70%. Programs were using an average of 4.2–6.0 tools to evaluate their trainees with heavy reliance on rating forms. Direct observation and practice and data-based tools were used much less frequently. Most programs were using at least 1 of the Accreditation Council for Graduate Medical Education (ACGME)’s “most desirable” methods of evaluation for all 6 measures of trainee competence. These programs had higher support staff to resident ratios than programs using less desirable evaluative methods. Conclusions Residency programs are using a large number and variety of tools for evaluating the competence of their trainees. Most are complying with ACGME recommended methods of evaluation especially if the support staff to resident ratio is high. PMID:18612734

Personal and professional profile of mountain medicine physicians.

Science.gov (United States)

Peters, Patrick

2003-01-01

The purpose of this study was to define and describe the personal and professional profile of mountain medicine physicians including general physical training information and to include a detailed overview of the practice of mountain sports. A group of physicians participating in a specialized mountain medicine education program filled out a standardized questionnaire. The data obtained from this questionnaire were first analyzed in a descriptive way and then by statistical methods (chi2 test, t test, and analysis of variance). Detailed results have been provided for gender, age, marital status, general training frequency and methods, professional status, additional medical qualifications, memberships in professional societies and alpine clubs, mountain sports practice, and injuries sustained during the practice of mountain sports. This study has provided a detailed overview concerning the personal and professional profile of mountain medicine physicians. Course organizers as well as official commissions regulating the education in mountain medicine will be able to use this information to adapt and optimize the courses and the recommendations/requirements as detailed by the UIAA-ICAR-ISMM (Union Internationale des Associations Alpinistes, International Commission for Alpine Rescue, International Society for Mountain Medicine).

Nailfold videocapillaroscopy in internal medicine

Directory of Open Access Journals (Sweden)

Paola Faggioli

2015-09-01

Full Text Available Capillaroscopy is an actual inexpensive imaging technique, used to examine, non-invasively and safely, the morphology of nailfold dermal papillary capillaries. Many studies agree in the statement that the capillaroscopy is one of the gold standard methods for non-invasive examination of the microcirculation and it plays an important role in screening in Raynaud’s phenomenon and in monitoring of systemic sclerosis and other rheumatologic diseases. There are also many reports on the possible use of nailfold capillaroscopy in the diagnosis and monitoring of many other diseases in internal medicine.

US Medical Student Performance on the NBME Subject Examination in Internal Medicine: Do Clerkship Sequence and Clerkship Length Matter?

Science.gov (United States)

Ouyang, Wenli; Cuddy, Monica M; Swanson, David B

2015-09-01

Prior to graduation, US medical students are required to complete clinical clerkship rotations, most commonly in the specialty areas of family medicine, internal medicine, obstetrics and gynecology (ob/gyn), pediatrics, psychiatry, and surgery. Within a school, the sequence in which students complete these clerkships varies. In addition, the length of these rotations varies, both within a school for different clerkships and between schools for the same clerkship. The present study investigated the effects of clerkship sequence and length on performance on the National Board of Medical Examiner's subject examination in internal medicine. The study sample included 16,091 students from 67 US Liaison Committee on Medical Education (LCME)-accredited medical schools who graduated in 2012 or 2013. Student-level measures included first-attempt internal medicine subject examination scores, first-attempt USMLE Step 1 scores, and five dichotomous variables capturing whether or not students completed rotations in family medicine, ob/gyn, pediatrics, psychiatry, and surgery prior to taking the internal medicine rotation. School-level measures included clerkship length and average Step 1 score. Multilevel models with students nested in schools were estimated with internal medicine subject examination scores as the dependent measure. Step 1 scores and the five dichotomous variables were treated as student-level predictors. Internal medicine clerkship length and average Step 1 score were used to predict school-to-school variation in average internal medicine subject examination scores. Completion of rotations in surgery, pediatrics and family medicine prior to taking the internal medicine examination significantly improved scores, with the largest benefit observed for surgery (coefficient = 1.58 points; p value internal medicine subject examination performance. At the school level, longer internal medicine clerkships were associated with higher scores on the internal medicine

[Inventory of training of internal medicine in France: Results of a national survey].

Science.gov (United States)

Samson, M; Terrier, B; Mangin, O; Mouthon, L

2017-05-01

To make an inventory of training of Internal Medicine in France. This study was conducted between May and September 2015 with coordinators (interviews of 45minutes) of local Internal Medicine training and fellows (online questionnaire). All coordinators (n=28) responded to the interviews. Local training of Internal Medicine exists in 86% of regions (3.1±3.1hours/month) and an interregional training in all interregions (34.7±13.9hours/year). When excluding Île-de-France, no correlation between the number of teachers and the amount of lessons was noted (P=0.61). Of the 550 fellows in Internal Medicine in 2014-2015, 223 (41%) responded to the online questionnaire. Mean level was 5.5±2.7 semesters. The rate of satisfaction (1=very dissatisfied and 5=very satisfied) was 3.0±1.0 and 3.8±0.8 for regional and interregional teaching, respectively (P<0.0001). Regional teaching satisfaction was correlated with the perceived expanse of diseases covered into the program (P<0.0001). In addition, 89% of fellows wish to evaluate themselves online, 66% wish to have a practical evaluation at the bedside and 70% in simulation centers. Finally, 91% of fellows support the establishment of a national program for the training of Internal Medicine. This survey states for the first time an inventory of training of Internal Medicine dedicated to fellows in France. This report highlights that fellows wish to have a national program, be further evaluated and have access to more interactive approach of teaching. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

The international distribution of authorship in the Nuclear Medicine literature: a bibliometric analysis

International Nuclear Information System (INIS)

Hannigan, G.G.; Bartold, S.P.

2002-01-01

Aim: This study profiles the increasingly diverse international contributions to the specialty of Nuclear Medicine as measured by publication in the European Journal of Nuclear Medicine (Springer) and the Journal of Nuclear Medicine (Society of Nuclear Medicine). These are the leading journals in the field, with 2001 impact factor scores of 3.617 and 3.772 respectively.1 Materials and Methods: We searched the MEDLINE database from 1988-2001, using the Limits (Journal) feature. 1988 is the first year that author affiliation information is reliably included on the MEDLINE record. The retrieved set of articles from the European Journal of Nuclear Medicine and the Journal of Nuclear Medicine was limited to articles with abstracts, the goal being to count only substantive articles and to eliminate editorials, letters, and other brief communications. Since author affiliation information is neither standardized nor can it be sorted in MEDLINE, we manually counted and categorized publications by country of the first author as listed in the article. Microsoft Excel was used to tabulate and analyze the data. Results: 2,634 articles were analyzed for six years (1988, 1991, 1992, 1993, 1996, 2001). Authors from 40 countries published in these two journals. In 1988, authors from seven countries (US, Japan, UK, France, Germany, the Netherlands, Canada) contributed ten or more articles, accounting for 80% of the articles . In 2001, authors from eleven countries contributed ten or more articles, accounting for 86% of the total (US, Germany, Japan, Netherlands, Italy, Belgium, Australia, France, UK, Spain, Finland); Conclusions: A previous study showed that, from 1980-97, seven countries accounted for 86% of the research articles in the Journal of Nuclear Medicine: US 60.2%, Japan 8.6%, and Canada, France, Germany, UK, Netherlands each 3.4%.2. In this study, for the six years included, authors from ten countries accounted for 86% of the research articles in the European Journal of

Associations between quality indicators of internal medicine residency training programs

Science.gov (United States)

2011-01-01

Background Several residency program characteristics have been suggested as measures of program quality, but associations between these measures are unknown. We set out to determine associations between these potential measures of program quality. Methods Survey of internal medicine residency programs that shared an online ambulatory curriculum on hospital type, faculty size, number of trainees, proportion of international medical graduate (IMG) trainees, Internal Medicine In-Training Examination (IM-ITE) scores, three-year American Board of Internal Medicine Certifying Examination (ABIM-CE) first-try pass rates, Residency Review Committee-Internal Medicine (RRC-IM) certification length, program director clinical duties, and use of pharmaceutical funding to support education. Associations assessed using Chi-square, Spearman rank correlation, univariate and multivariable linear regression. Results Fifty one of 67 programs responded (response rate 76.1%), including 29 (56.9%) community teaching and 17 (33.3%) university hospitals, with a mean of 68 trainees and 101 faculty. Forty four percent of trainees were IMGs. The average post-graduate year (PGY)-2 IM-ITE raw score was 63.1, which was 66.8 for PGY3s. Average 3-year ABIM-CE pass rate was 95.8%; average RRC-IM certification was 4.3 years. ABIM-CE results, IM-ITE results, and length of RRC-IM certification were strongly associated with each other (p ITE scores were higher in programs with more IMGs and in programs that accepted pharmaceutical support (p < 0.05). RRC-IM certification was shorter in programs with higher numbers of IMGs. In multivariable analysis, a higher proportion of IMGs was associated with 1.17 years shorter RRC accreditation. Conclusions Associations between quality indicators are complex, but suggest that the presence of IMGs is associated with better performance on standardized tests but decreased duration of RRC-IM certification. PMID:21651768

European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome

Science.gov (United States)

Baijens, Laura WJ; Clavé, Pere; Cras, Patrick; Ekberg, Olle; Forster, Alexandre; Kolb, Gerald F; Leners, Jean-Claude; Masiero, Stefano; Mateos-Nozal, Jesús; Ortega, Omar; Smithard, David G; Speyer, Renée; Walshe, Margaret

2016-01-01

This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization’s classification of diseases. It can cause severe complications such as malnutrition, dehydration, respiratory infections, aspiration pneumonia, and increased readmissions, institutionalization, and morbimortality. OD is a prevalent and serious problem among all phenotypes of older patients as oropharyngeal swallow response is impaired in older people and can cause aspiration. Despite its prevalence and severity, OD is still underdiagnosed and untreated in many medical centers. There are several validated clinical and instrumental methods (videofluoroscopy and fiberoptic endoscopic evaluation of swallowing) to diagnose OD, and treatment is mainly based on compensatory measures, although new treatments to stimulate the oropharyngeal swallow response are under research. OD matches the definition of a geriatric syndrome as it is highly prevalent among older people, is caused by multiple factors, is associated with several comorbidities and poor prognosis, and needs a multidimensional approach to be treated. OD should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications. More research is needed to develop and standardize new treatments and management protocols for older patients with OD, which is a challenging mission for our societies

Monitoring stress among internal medicine residents: an experience-driven, practical and short measure.

Science.gov (United States)

Myszkowski, Nils; Villoing, Barbara; Zenasni, Franck; Jaury, Philippe; Boujut, Emilie

2017-07-01

Residents experience severely high levels of stress, depression and burnout, leading to perceived medical errors, as well as to symptoms of impairment, such as chronic anger, cognitive impairment, suicidal behavior and substance abuse. Because research has not yet provided a psychometrically robust population-specific tool to measure the level of stress of medicine residents, we aimed at building and validating such a measure. Using an inductive scale development approach, a short, pragmatic measure was built, based on the interviews of 17 medicine residents. The Internal Medicine Residency Stress Scale (IMRSS) was then administered in a sample of 259 internal medicine residents (199 females, 60 males, M Age  = 25.6) along with the Hospital Anxiety and Depression Scale, Maslach Burnout Inventory, Satisfaction With Life Scale and Ways of Coping Checklist. The IMRSS showed satisfactory internal reliability (Cronbach's α = .86), adequate structural validity - studied through Confirmatory Factor Analysis (χ 2 /df = 2.51, CFI = .94; SRMR = .037, RMSEA = .076) - and good criterion validity - the IMRSS was notably strongly correlated with emotional exhaustion (r = .64; p is recommended to quickly and frequently assess and monitor stress among internal medicine residents.

DNA Commission of the International Society for Forensic Genetics

DEFF Research Database (Denmark)

Parson, W; Gusmão, L; Hares, D R

2014-01-01

The DNA Commission of the International Society of Forensic Genetics (ISFG) regularly publishes guidelines and recommendations concerning the application of DNA polymorphisms to the question of human identification. Previous recommendations published in 2000 addressed the analysis and interpretat......The DNA Commission of the International Society of Forensic Genetics (ISFG) regularly publishes guidelines and recommendations concerning the application of DNA polymorphisms to the question of human identification. Previous recommendations published in 2000 addressed the analysis...... and interpretation of mitochondrial DNA (mtDNA) in forensic casework. While the foundations set forth in the earlier recommendations still apply, new approaches to the quality control, alignment and nomenclature of mitochondrial sequences, as well as the establishment of mtDNA reference population databases, have...... been developed. Here, we describe these developments and discuss their application to both mtDNA casework and mtDNA reference population databasing applications. While the generation of mtDNA for forensic casework has always been guided by specific standards, it is now well-established that data...

American Orthopaedic Society for Sports Medicine

Science.gov (United States)

... Upcoming Meetings Online Education Archived Meetings Faculty Resources Sports Medicine Fellowships Traveling Fellowship Submit an Abstract Submit ... Support AOSSM Research Publications Toggle American Journal of Sports Medicine Sports Health: A Multidisciplinary Approach Orthopaedic Journal ...

Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now.

Science.gov (United States)

Sabath, Bruce F; Singh, Gurkeerat

2016-01-01

Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution - a community hospital - in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes. We also review the growing evidence of the application of ultrasound in the diagnosis of a myriad of conditions encountered in general internal medicine as well as the mounting data on the ability of internal medicine residents to apply this technology accurately at the bedside. We advocate that the literature has sufficiently established the role of POC ultrasonography in general internal medicine that there should no longer be any delay in giving this an official place in the development of internal medicine trainees. This may be particularly useful in the community hospital setting where 24-h echocardiography or other sonography may not be readily available.

Ethical quandaries in spiritual healing and herbal medicine: A critical analysis of the morality of traditional medicine advertising in southern African urban societies

Science.gov (United States)

Munyaradzi, Mawere

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 problems associated with traditional medicine advertising. Critical look at the worthiness of some advertising strategies used by practitioners in traditional medicine in launching their products and services on market thus has been largely ignored. Yet, though advertising is key to helping traditional medicine practitioners’ products and services known by prospective customers, this research registers a number of morally negative effects that seem to outweigh the merits that the activity brings to prospective customers. The paper adopts southern African urban societies, and in particular Mozambique, South Africa and Zimbabwe as particular references. The choice of the trio is not accidental, but based on the fact that these countries have in the last few decades been flooded with traditional medicine practitioners/traditional healers from within the continent and from abroad. Most of these practitioners use immoral advertising strategies in communicating to the public the products and services they offer. It is against this background that this paper examines the morality of advertising strategies deployed by practitioners in launching their products and services. To examine the moral worthiness of the advertising strategies used by traditional medical practitioners, I used qualitative analysis of street adverts as well as electronic and print media. From the results obtained through thematic content analysis, the paper concludes that most of the practitioners in traditional

Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training

Science.gov (United States)

Green, Michael L.; Aagaard, Eva M.; Caverzagie, Kelly J.; Chick, Davoren A.; Holmboe, Eric; Kane, Gregory; Smith, Cynthia D.; Iobst, William

2009-01-01

Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project requires that residency program directors objectively document that their residents achieve competence in 6 general dimensions of practice. Intervention In November 2007, the American Board of Internal Medicine (ABIM) and the ACGME initiated the development of milestones for internal medicine residency training. ABIM and ACGME convened a 33-member milestones task force made up of program directors, experts in evaluation and quality, and representatives of internal medicine stakeholder organizations. This article reports on the development process and the resulting list of proposed milestones for each ACGME competency. Outcomes The task force adopted the Dreyfus model of skill acquisition as a framework the internal medicine milestones, and calibrated the milestones with the expectation that residents achieve, at a minimum, the “competency” level in the 5-step progression by the completion of residency. The task force also developed general recommendations for strategies to evaluate the milestones. Discussion The milestones resulting from this effort will promote competency-based resident education in internal medicine, and will allow program directors to track the progress of residents and inform decisions regarding promotion and readiness for independent practice. In addition, the milestones may guide curriculum development, suggest specific assessment strategies, provide benchmarks for resident self-directed assessment-seeking, and assist remediation by facilitating identification of specific deficits. Finally, by making explicit the profession's expectations for graduates and providing a degree of national standardization in evaluation, the milestones may improve public accountability for residency training. PMID:21975701

PREFACE: International Conference on Image Optimisation in Nuclear Medicine (OptiNM)

Science.gov (United States)

Christofides, Stelios; Parpottas, Yiannis

2011-09-01

Conference logo The International Conference on Image Optimisation in Nuclear Medicine was held at the Atlantica Aeneas Resort in Ayia Napa, Cyprus between 23-26 March 2011. It was organised in the framework of the research project "Optimising Diagnostic Value in SPECT Myocardial Perfusion Imaging" (YΓΕΙΑ/ΔYΓΕΙΑ/0308/11), funded by the Cyprus Research Promotion Foundation and the European Regional Development Fund, to present the highlights of the project, discuss the progress and results, and define future related goals. The aim of this International Conference was to concentrate on image optimization approaches in Nuclear Medicine. Experts in the field of nuclear medicine presented their latest research results, exchanged experiences and set future goals for image optimisation while balancing patient dose and diagnostic value. The conference was jointly organized by the Frederick Research Centre in Cyprus, the Department of Medical and Public Health Services of the Cyprus Ministry of Health, the Biomedical Research Foundation in Cyprus and the AGH University of Science and Technology in Poland. It was supported by the Cyprus Association of Medical Physics and Biomedical Engineering, and the Cyprus Society of Nuclear Medicine. The conference was held under the auspices of the European Federation of Organisations for Medical Physics and the European Association of Nuclear Medicine. The conference scientific programme covered several important topics such as functional imaging; image optimization; quantification for diagnosis; justification; simulations; patient dosimetry, staff exposures and radiation risks; quality assurance and clinical audit; education, training and radiation protection culture; hybrid systems and image registration; and new and competing technologies. The programme consisted of 13 invited and keynote presentations as well as workshops, round table discussions and a number of scientific sessions. A total of 51 speakers presented their

Attitudes and preferences toward the provision of medication abortion in an urban academic internal medicine practice.

Science.gov (United States)

Page, Cameron; Stumbar, Sarah; Gold, Marji

2012-06-01

Mifepristone offers internal medicine doctors the opportunity to greatly expand access to abortion for their patients. Almost 70% of pregnancy terminations, however, still occur in specialized clinics. No studies have examined the preferences of Internal Medicine patients specifically. Determine whether patient preference is a reason for the limited uptake of medication abortion among internal medicine physicians. Women aged 18-45 recruited from the waiting room in an urban academic internal medicine clinic. A semi-structured questionnaire was used to determine risk of unintended pregnancy and attitudes toward abortion. Support for provision of medication abortion in the internal medicine clinic was assessed with a yes/no question, followed by the open-ended question, "Why do you think this clinic should or should not offer medication abortion?" Subjects were asked whether it was very important, somewhat important, or not important for the internal medicine clinic to provide medication abortion. Of 102 women who met inclusion criteria, 90 completed the survey, yielding a response rate of 88%. Twenty-two percent were at risk of unintended pregnancy. 46.7% had had at least one lifetime abortion. Among those who would consider having an abortion, 67.7% responded yes to the question, "Do you think this clinic should offer medication abortions?" and 83.9% stated that it was "very important" or "somewhat important" to offer this service. Of women open to having an abortion, 87.1% stated that they would be interested in receiving a medication abortion from their primary care doctor. A clinically significant proportion of women in this urban internal medicine clinic were at risk of unintended pregnancy. Among those open to having an abortion, a wide majority would consider receiving it from their internal medicine doctor. The provision of medication abortion by internal medicine physicians has the potential to greatly expand abortion access for women.

Predictors of Final Specialty Choice by Internal Medicine Residents

Science.gov (United States)

Diehl, Andrew K; Kumar, Vineeta; Gateley, Ann; Appleby, Jane L; O'Keefe, Mary E

2006-01-01

BACKGROUND Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. OBJECTIVE To identify factors that predict the clinical practice of residents following their training. DESIGN Prospective cohort study. PARTICIPANTS Two hundred and four categorical residents from 2 university-based residency programs. MEASUREMENTS Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. RESULTS International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, Pinternal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05medicine, with trends apparent for higher debt (P = .05) and greater comfort caring for patients with psychological problems (P = .07). CONCLUSION Recruitment of IMGs may not increase the supply of General Internists. Prospects of lower income, even in the face of large debt, may not discourage residents from becoming generalists. If increasing generalist manpower is a goal, residencies should consider weighing applicants' personal attributes during the selection process. PMID:16836624

Radioactive isotopes in clinical medicine and research. Abstracts

International Nuclear Information System (INIS)

2005-01-01

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

[Some epistemological outlines throughout the publications of the International Society for the History of Pharmacy].

Science.gov (United States)

Ledermann, Franeois

2014-10-01

The International Society, created in 1926 in Innsbruck, was originally strongly influ- enced by the German world, although it included some members from other nations, such as Eugène Humbert Guitard from France, and was designated only as the Society for the History of Pharmacy. Its international aspect, with a new name, was finally recognized officially after the Second World War. Early on, the Society published several documents dedicated to various subjects related to the history of pharmacy without a clear editorial orientation. This was changed post-war, in 1951, with the launch of "Publications of the Society" and of a journal. During these years the society was, however, still very focused on Germany, Austria and Switzerland, and the vast majority of works were written in German. In 1999, following new statutes, it was decided that the national societies would be the collective members of the Society and, at the same time, a newsletter appeared as an official organ and link between the International Society and members of the national societies. These publications as a whole have been the subject of an analytical treatment to examine the major orientations of history of pharmacy during a century. What were the subjects preferred by the authors, and what approach did they take to pharmaceutical history? What is the place of the social history of pharmacy and of drugs research? This conference tries to answer these questions by the analysis of the large corpus of publications of the International Society for the History of Pharmacy.

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

Science.gov (United States)

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

2018-04-01

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

Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: a multicenter study.

Science.gov (United States)

Tufan, Fatih; Yuruyen, Mehmet; Kizilarslanoglu, Muhammet Cemal; Akpinar, Timur; Emiksiye, Sirhan; Yesil, Yusuf; Ozturk, Zeynel Abidin; Bozbulut, Utku Burak; Bolayir, Basak; Tasar, Pinar Tosun; Yavuzer, Hakan; Sahin, Sevnaz; Ulger, Zekeriya; Ozturk, Gulistan Bahat; Halil, Meltem; Akcicek, Fehmi; Doventas, Alper; Kepekci, Yalcin; Ince, Nurhan; Karan, Mehmet Akif

2015-01-01

The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people. This cross-sectional multicenter study was undertaken in the internal medicine clinics of six university state hospitals that provide education in geriatric care. All internal medicine residents working in these hospitals were invited to participate in this questionnaire study between March 2013 and December 2013. We recorded the participants' age, sex, duration of internal medicine residency, existence of relatives older than 65 years, history of geriatrics course in medical school, geriatrics rotation in internal medicine residency, and nursing home visits. A total of 274 (82.3%) of the residents participated in this study, and 83.6% of them had positive attitudes toward older people. A geriatrics rotation during internal medicine residency was the only independent factor associated with positive attitudes toward the elderly in this multivariate analysis. A geriatrics course during medical school was associated with positive attitudes in the univariate analysis, but only tended to be so in the multivariate analysis. Geriatrics rotation during internal medicine residency was independently associated with positive attitudes toward older people. Generalization of geriatrics education in developing countries may translate into a better understanding and improved care for older patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome

Directory of Open Access Journals (Sweden)

Baijens LW

2016-10-01

Full Text Available Laura WJ Baijens,1 Pere Clavé,2,3 Patrick Cras,4 Olle Ekberg,5 Alexandre Forster,6 Gerald F Kolb,7 Jean-Claude Leners,8 Stefano Masiero,9 Jesús Mateos-Nozal,10 Omar Ortega,2,3 David G Smithard,11 Renée Speyer,12 Margaret Walshe13 1Department of Otorhinolaryngology – Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands; 2Gastrointestinal Physiology Laboratory, Department of Surgery, Hospital of Mataró, Autonomous University of Barcelona, Mataró, 3CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain; 4Department of Neurology, Antwerp University Hospital, University of Antwerp, Born Bunge Institute, Edegem, Belgium; 5Department of Translational Medicine, Division of Medical Radiology, Skåne University Hospital, Malmö, Sweden; 6Clinique Bois-Bougy, Nyon, Switzerland; 7Department of Geriatrics and Physical Medicine, Bonifatius Hospital, Lingen, Germany; 8Long Term Care and Hospice, Ettelbruck, Luxembourg; 9Rehabilitation Unit, Department of Neuroscience, University of Padua, Padova, Italy; 10Department of Geriatric Medicine, Hospital Ramón y Cajal, Madrid, Spain; 11Clinical Gerontology, Princess Royal University Hospital, King’s College Hospital Foundation Trust, London, UK; 12College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia; 13Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland Abstract: This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids

Incidence of refeeding syndrome in internal medicine patients

NARCIS (Netherlands)

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

2016-01-01

Refeeding syndrome is a potentially fatal shift of fluids and electrolytes that may occur after reintroducing nutrition in a malnourished patient. Its incidence in internal medicine patients is not known. We aimed at determining the incidence in a heterogeneous group of patients acutely admitted to

Role of PET/CT for precision medicine in lung cancer: perspective of the Society of Nuclear Medicine and Molecular Imaging.

Science.gov (United States)

Greenspan, Bennett S

2017-12-01

This article discusses the role of PET/CT in contributing to precision medicine in lung cancer, and provides the perspective of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) on this process. The mission and vision of SNMMI are listed, along with the guidance provided by SNMMI to promote best practice in precision medicine. Basic principles of PET/CT are presented. An overview of the use of PET/CT imaging in lung cancer is discussed. In lung cancer patients, PET/CT is vitally important for optimal patient management. PET/CT is essential in determining staging and re-staging of disease, detecting recurrent or residual disease, evaluating response to therapy, and providing prognostic information. PET/CT is also critically important in radiation therapy planning by determining the extent of active disease, including an assessment of functional tumor volume. The current approach in tumor imaging is a significant advance over conventional imaging. However, recent advances suggest that therapeutic response criteria in the near future will be based on metabolic characteristics and will include the evaluation of biologic characteristics of tumors to further enhance the effectiveness of precision medicine in lung cancer, producing improved patient outcomes with less morbidity.

Burnout and Physical Activity in Minnesota Internal Medicine Resident Physicians

Science.gov (United States)

Olson, Shawn M.; Odo, Nnaemeka U.; Duran, Alisa M.; Pereira, Anne G.; Mandel, Jeffrey H.

2014-01-01

Background Regular physical activity plays an important role in the amelioration of several mental health disorders; however, its relationship with burnout has not yet been clarified. Objective To determine the association between achievement of national physical activity guidelines and burnout in internal medicine resident physicians. Methods A Web-based survey of internal medicine resident physicians at the University of Minnesota and Hennepin County Medical Center was conducted from September to October 2012. Survey measures included the Maslach Burnout Inventory-Human Services Survey and the International Physical Activity Questionnaire. Results Of 149 eligible residents, 76 (51.0%) completed surveys, which were used in the analysis. Burnout prevalence, determined by the Maslach Burnout Inventory, was 53.9% (41 of 76). Prevalence of failure to achieve US Department of Health and Human Services physical activity guidelines was 40.8% (31 of 76), and 78.9% (60 of 76) of residents reported that their level of physical activity has decreased since they began medical training. Residents who were able to meet physical activity guidelines were less likely to be burned out than their fellow residents (OR, 0.38, 95% CI 0.147–0.99). Conclusions Among internal medicine resident physicians, achievement of national physical activity guidelines appears to be inversely associated with burnout. Given the high national prevalence of burnout and inactivity, additional investigation of this relationship appears warranted. PMID:26140116

[Catalogue of learning goals for pregraduate education in geriatric medicine. A recommendation of the German Geriatric Society (DGG), the German Society of Gerontology and Geriatrics (DGGG), the Austrian Society of Geriatrics and Gerontology (ÖGGG) and the Swiss Society of Geriatric Medicine (SFGG) on the basis of recommendations of the European Union of Medical Specialists Geriatric Medicine Section (UEMS-GMS) 2013].

Science.gov (United States)

Singler, K; Stuck, A E; Masud, T; Goeldlin, A; Roller, R E

2014-11-01

Sound knowledge in the care and management of geriatric patients is essential for doctors in almost all medical subspecialties. Therefore, it is important that pregraduate medical education adequately covers the field of geriatric medicine. However, in most medical faculties in Europe today, learning objectives in geriatric medicine are often substandard or not even explicitly addressed. As a first step to encourage undergraduate teaching in geriatric medicine, the European Union of Medical Specialists -Geriatric Medicine Section (UEMS-GMS) recently developed a catalogue of learning goals using a modified Delphi technique in order to encourage education in this field. This catalogue of learning objectives for geriatric medicine focuses on the minimum requirements with specific learning goals in knowledge, skills and attitudes that medical students should have acquired by the end of their studies.In order to ease the implementation of this new, competence-based curriculum among the medical faculties in universities teaching in the German language, the authors translated the published English language curriculum into German and adapted it according to medical language and terms used at German-speaking medical faculties and universities of Austria, Germany and Switzerland. This article contains the final German translation of the curriculum. The Geriatric Medicine Societies of Germany, Austria, and Switzerland formally endorse the present curriculum and recommend that medical faculties adapt their curricula for undergraduate teaching based on this catalogue.

Serving the medicinal chemistry community with Royal Society of Chemistry cheminformatics platforms

OpenAIRE

Williams, Antony

2015-01-01

The Royal Society of Chemistry (RSC) is a major participant in providing access to chemistry related data via the web. As an internationally renowned society for the chemical sciences, a scientific publisher and the host of the ChemSpider database for the community, RSC continues to make dramatic strides in providing online access to data. ChemSpider provides access to over 30 million chemicals sourced from over 500 data suppliers and linked out to related information on the web. The platform...

World Workshop on Oral Medicine VI: an international validation study of clinical competencies for advanced training in oral medicine.

Science.gov (United States)

Steele, John C; Clark, Hadleigh J; Hong, Catherine H L; Jurge, Sabine; Muthukrishnan, Arvind; Kerr, A Ross; Wray, David; Prescott-Clements, Linda; Felix, David H; Sollecito, Thomas P

2015-08-01

To explore international consensus for the validation of clinical competencies for advanced training in Oral Medicine. An electronic survey of clinical competencies was designed. The survey was sent to and completed by identified international stakeholders during a 10-week period. To be validated, an individual competency had to achieve 90% or greater consensus to keep it in its current format. Stakeholders from 31 countries responded. High consensus agreement was achieved with 93 of 101 (92%) competencies exceeding the benchmark for agreement. Only 8 warranted further attention and were reviewed by a focus group. No additional competencies were suggested. This is the first international validated study of clinical competencies for advanced training in Oral Medicine. These validated clinical competencies could provide a model for countries developing an advanced training curriculum for Oral Medicine and also inform review of existing curricula. Copyright © 2015 Elsevier Inc. All rights reserved.

The VIII International Congress on Stress Proteins in Biology and Medicine: täynnä henkeä.

Science.gov (United States)

Bonorino, Cristina; Sistonen, Lea; Eriksson, John; Mezger, Valérie; Santoro, Gabriella; Hightower, Lawrence E

2018-03-01

About 150 international scientists gathered in Turku, Finland, in August of 2017 for the eighth in a series of international congresses about the roles of stress proteins in biology and medicine. The scientific theme and title of the 2017 Congress was "Stress Management Mechanisms and Pathways." The meeting covered a broad range of topics, reflecting the wide scope of the Cell Stress Society International (CSSI) and highlighting the numerous recent breakthroughs in stress response biology and medicine. The keynote lecturers included Marja Jäättelä, Richard Morimoto, Anne Bertolotti, and Peter Walter. The Executive Council of the CSSI elected new Fellows and Senior Fellows. The Spirit of Budapest Award was presented to Peter Csermely, Wolfgang Schumann, and Subhash Lakhotia in recognition of pioneering service contributions to the CSSI. The CSSI Medallion for Career Achievement was awarded to Larry Hightower and CSSI president Gabriella Santoro proclaimed Tuesday, August 15, 2017, Robert M. Tanguay Day at the congress in recognition of Robert's many years of scientific accomplishment and work on behalf of the CSSI. Additional special events were the awarding of the Ferruccio Ritossa Early Career Award to Serena Carra and the Alfred Tissières Young Investigator Award to Ayesha Murshid. As is the tradition at CSSI congresses, there were social events that included an exciting piano performance by a trio of young Finnish pianists, at the Sibelius Museum.

Using patient-reported measurement to pave the path towards personalized medicine

NARCIS (Netherlands)

Sprangers, Mirjam A. G.; Hall, Per; Morisky, Donald E.; Narrow, William E.; Dapueto, Juan

2013-01-01

Given the potential and importance of personalized or individualized medicine for health care delivery and its effects on patients' quality of life, a plenary session was devoted to personalized medicine during the 19th Annual Conference of the International Society for Quality of Life Research held

Gender gap in medicine: only one woman councilor in the Japan Surgical Society.

Science.gov (United States)

Tomizawa, Yasuko

2015-02-01

Japan ranks low in the global gender gap index. Academic promotion is difficult for women doctors, and the leaky pipeline of women doctors is evident in academic medicine. The Japan Surgical Society (JSS) has 2,874 (7.2% of total membership) female members as of April 2014. The total number of councilors in JSS has increased, but there is still only one female member on the Council. The fact that there are so few women in decision-making positions makes it challenging to fight for equality. The Japanese Association of Medical Science (JAMS) is an association with exclusive institutional membership comprising the major medical societies in Japan, and currently has a membership of 122 specialist medical societies. It is essential to have at least one female committee member in each committee of the JAMS, which would provide opportunities to establish career paths for women doctors, to make rules that suit the lifestyle of women doctors, and to improve work-life balance.

Review of international radioactive waste management based on a report of the International Nuclear Societies Council (INSC)

International Nuclear Information System (INIS)

Hardy, C.

2003-01-01

The INSC is an international group of 42 nuclear societies with the aim of promoting the peaceful uses of nuclear science and technology. It has a number of working groups addressing important issues and publishes the reports of these groups. The latest report of the working group on radioactive waste management was published in August 2002. The main aim of the report is to provide the latest information on radioactive waste management among the member societies and particularly to provide access to internet resources on this topic including access to the radioactive waste management organisations in the several countries.The major topics addressed in the report are: what is radioactive waste management?; where does radioactive waste come from?; principles and objectives; management strategies - options and ethics; current worldwide status; international cooperation; and international instruments, including treaties and legislation

Evaluating M.D.-Level Competence in Internal Medicine.

Science.gov (United States)

Anderson, Alexander S.; Botticelli, Max G.

1981-01-01

The implementation of a clinical clerkship in internal medicine that was flexible in time required that a new evaluation program be developed to assess the progress of students. The progress of the classes of 1979 and 1980 toward achievement of predetermined levels of mastery is presented. (Author/MLW)

Interprofessional simulation training improves knowledge and teamwork in nursing and medical students during internal medicine clerkship.

Science.gov (United States)

Tofil, Nancy M; Morris, Jason L; Peterson, Dawn Taylor; Watts, Penni; Epps, Chad; Harrington, Kathy F; Leon, Kevin; Pierce, Caleb; White, Marjorie Lee

2014-03-01

Simulation is effective at improving healthcare students' knowledge and communication. Despite increasingly interprofessional approaches to medicine, most studies demonstrate these effects in isolation. We enhanced an existing internal medicine curriculum with immersive interprofessional simulations. For ten months, third-year medical students and senior nursing students were recruited for four, 1-hour simulations. Scenarios included myocardial infarction, pancreatitis/hyperkalemia, upper gastrointestinal bleed, and chronic obstructive pulmonary disease exacerbation. After each scenario, experts in medicine, nursing, simulation, and adult learning facilitated a debriefing. Study measures included pre- and post-tests assessing self-efficacy, communication skills, and understanding of each profession's role. Seventy-two medical students and 30 nursing students participated. Self-efficacy communication scores improved for both (medicine, 18.9 ± 3.3 pretest vs 23.7 ± 3.7 post-test; nursing, 19.6 ± 2.7 pretest vs 24.5 ± 2.5 post-test). Both groups showed improvement in "confidence to correct another healthcare provider in a collaborative manner" (Δ = .97 medicine, Δ = 1.2 nursing). Medical students showed the most improvement in "confidence to close the loop in patient care" (Δ = .93). Nursing students showed the most improvement in "confidence to figure out roles" (Δ = 1.1). This study supports the hypothesis that interdisciplinary simulation improves each discipline's self-efficacy communication skills and understanding of each profession's role. Despite many barriers to interprofessional simulation, this model is being sustained. © 2014 Society of Hospital Medicine.

A Qualitative Study of Work-Life Choices in Academic Internal Medicine

Science.gov (United States)

Isaac, Carol; Byars-Winston, Angela; McSorley, Rebecca; Schultz, Alexandra; Kaatz, Anna; Carnes, Mary L.

2014-01-01

The high attrition rate of female physicians pursuing an academic medicine research career has not been examined in the context of career development theory. We explored how internal medicine residents and faculty experience their work within the context of their broader life domain in order to identify strategies for facilitating career…

An Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation: Report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation

Science.gov (United States)

Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne JG; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

2014-01-01

Introduction The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE. Aim The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. Methods In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. Results The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the

An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation.

Science.gov (United States)

Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne Jg; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

2014-06-01

The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE. The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. The

Gender differences in salary of internal medicine residency directors: a national survey.

Science.gov (United States)

Willett, Lisa L; Halvorsen, Andrew J; McDonald, Furman S; Chaudhry, Saima I; Arora, Vineet M

2015-06-01

Whether salary disparities exist between men and women in medical education leadership roles is not known. The study objective was to determine whether salary disparities exist between male and female Internal Medicine residency program directors, and if so, to identify factors associated with the disparities and explore historical trends. The annual Association of Program Directors in Internal Medicine (APDIM) survey in August 2012 included items to assess the salary and demographic characteristics of program directors, which were merged with publically available program data. To assess historical trends, we used similarly obtained survey data from 2008 to 2011. The study included program directors of 370 APDIM member programs, representing 95.6% of the 387 accredited Internal Medicine training programs in the United States and Puerto Rico. Of the 370 APDIM member programs, 241 (65.1%) completed the survey, of whom 169 (70.1%) were men and 72 (29.9%) were women. Program directors' total annual salary, measured in $25,000 increments, ranged from $75,000 or less to more than $400,000. Historical trends of mode salary by gender from 2008 to 2012 were assessed. The mode salary was $200,000 to 225,000 for men and $175,000 to $200,000 for women (P = .0005). After controlling for academic rank, career in general internal medicine, and program director age, the distribution of salary remained different by gender (P = .004). Historical trends show that the difference in mode salary has persisted since 2008. Leaders in academic medical centers, residency and fellowship directors, and all faculty in medical education need to be aware that salary disparities cited decades ago persist in this sample of medical educators. Closing the gender gap will require continued advocacy for measuring and reporting salary gaps, and changing the culture of academic medical centers. Copyright © 2015 Alliance for Academic Internal Medicine. Published by Elsevier Inc. All rights reserved.

International Outreach: What Is the Responsibility of ASTRO and the Major International Radiation Oncology Societies?

International Nuclear Information System (INIS)

Mayr, Nina A.; Hu, Kenneth S.; Liao, Zhongxing; Viswanathan, Akila N.; Wall, Terry J.; Amendola, Beatriz E.; Calaguas, Miriam J.; Palta, Jatinder R.; Yue, Ning J.; Rengan, Ramesh; Williams, Timothy R.

2014-01-01

In this era of globalization and rapid advances in radiation oncology worldwide, the American Society for Radiation Oncology (ASTRO) is committed to help decrease profound regional disparities through the work of the International Education Subcommittee (IES). The IES has expanded its base, reach, and activities to foster educational advances through a variety of educational methods with broad scope, in addition to committing to the advancement of radiation oncology care for cancer patients around the world, through close collaboration with our sister radiation oncology societies and other educational, governmental, and organizational groups

International Outreach: What Is the Responsibility of ASTRO and the Major International Radiation Oncology Societies?

Energy Technology Data Exchange (ETDEWEB)

Mayr, Nina A., E-mail: ninamayr@uw.edu [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Hu, Kenneth S. [Department of Radiation Oncology, Beth Israel Medical Center, New York, New York (United States); Liao, Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Viswanathan, Akila N. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Wall, Terry J. [St. Luke' s Cancer Institute, Kansas City, Missouri (United States); Amendola, Beatriz E. [Innovative Cancer Institute, Miami, Florida (United States); Calaguas, Miriam J. [Department of Radiation Oncology, St. Luke' s Medical Center, Quezon City (Philippines); Palta, Jatinder R. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Yue, Ning J. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Rengan, Ramesh [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Williams, Timothy R. [Lynn Cancer Institute, Boca Raton Regional Hospital, Boca Raton, Florida (United States)

2014-07-01

In this era of globalization and rapid advances in radiation oncology worldwide, the American Society for Radiation Oncology (ASTRO) is committed to help decrease profound regional disparities through the work of the International Education Subcommittee (IES). The IES has expanded its base, reach, and activities to foster educational advances through a variety of educational methods with broad scope, in addition to committing to the advancement of radiation oncology care for cancer patients around the world, through close collaboration with our sister radiation oncology societies and other educational, governmental, and organizational groups.

Occupational medicine in a developing society: a case study of Venezuela.

Science.gov (United States)

Guidotti, T L; Goldsmith, D F

1980-01-01

Recent activities of the World Health Organization and other international agencies have placed new emphasis on occupational health in developing nations. Venezuela is a nation in transition from a developing society dominated economically by petroleum and agriculture to an economically-diversified industrialized urban society. It provides a case study which illuminates the problems of extending occupational health services in developing economies and questions of public policy regarding utilization of medical resources and the priority that occupational health should hold in such a society. Occupational health has become a serious problem in the developing world as new industries and accelerating ecnomic development occur without adequate resources for worker protection. The study of cases such as that of Venezuela may provide guidance for anticipating and preventing problems in other nations. This paper should be considered a pilot study to explore a social aspect of occupational health that has not received adequate attention.

Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes.

Science.gov (United States)

Nawaz, Haq; Petraro, Paul V; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M

2016-01-01

The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents' progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents' discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.

Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes

Science.gov (United States)

Nawaz, Haq; Petraro, Paul V.; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M.

2016-01-01

Background The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. Objective To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Methods Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents’ progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. Results A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents’ discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Conclusion Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits. PMID:27507540

Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes

Directory of Open Access Journals (Sweden)

Haq Nawaz

2016-08-01

Full Text Available Background: The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating. Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. Objective: To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Methods: Training included didactics (six sessions/year, distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents’ progress including Objective Structured Clinical Examinations (OSCEs, self-assessments, and logs of personal health habits. Results: A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents’ discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01. Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76% compared with plural for resident, preventive medicine residents (80%. However, this difference did not reach statistical significance (p=0.11. Conclusion: Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.

Problematic communications during 2016 fellowship recruitment in internal medicine.

Science.gov (United States)

Cornett, Patricia A; Williams, Chris; Alweis, Richard L; McConville, John; Frank, Michael; Dalal, Bhavin; Kopelman, Richard I; Luther, Vera P; O'connor, Alec B; Muchmore, Elaine A

2017-01-01

Some internal medicine residency program directors have expressed concerns that their third-year residents may have been subjected to inappropriate communication during the 2016 fellowship recruitment season. The authors sought to study applicants' interpersonal communication experiences with fellowship programs. Many respondents indicated that they had been asked questions that would constitute violations of the National Residency Matching Program (NRMP) Communications Code of Conduct agreement, including how they plan to rank specific programs. Moreover, female respondents were more likely to have been asked questions during interview experiences about other programs to which they applied, and about their family plans. Post-interview communication policies were not made clear to most applicants. These results suggest ongoing challenges for the internal medicine community to improve communication with applicants and uniform compliance with the NRMP communications code of conduct during the fellowship recruitment process.

Military Internal Medicine Resident Decision to Apply to Fellowship and Extend Military Commitment.

Science.gov (United States)

Barsoumian, Alice E; Hartzell, Joshua D; Bonura, Erin M; Ressner, Roseanne A; Whitman, Timothy J; Yun, Heather C

2018-02-06

Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations. Questions were developed after discussion with various military graduate medical education and internal medicine leaders, underwent external review, and were added to a larger question set. The survey link was distributed electronically to all U.S. military affiliated residencies' graduating internal medicine residents in December 2016-January 2017. Data were analyzed by decision to apply to fellowship and decision to extend military obligation using Fisher's exact test or Pearon's chi-square test. Sixty-eight residents from 10 of 11 military residency programs responded, for a response rate of 51%. The majority (62%) applied to fellowship to start after residency completion. Reasons cited for applying to fellowship included wanting to become a specialist as soon as possible (74%), wishing to avoid being a general internist (57%), and because they are unable to practice as a hospitalist in the military (52%). Fellowship applicants were more likely to plan to extend their military obligation than non-applicants, as did those with longer duration of military commitments. No other factors, including Uniformed Services University attendance or participation in undergraduate military experiences, were found to impact plan to extend active duty service commitment. The majority of graduating internal medicine residents apply for fellowship and report a desire to avoid being a

Society for Health Psychology (APA Division 38) and Society of Behavioral Medicine joint position statement on the Medicare Diabetes Prevention Program.

Science.gov (United States)

Fitzpatrick, Stephanie L; Wilson, Dawn K; Pagoto, Sherry L

2017-06-01

Beginning in January 2018, the Centers for Medicare and Medicaid Services (CMS) plans to cover the Diabetes Prevention Program (DPP), also referred to as Medicare DPP. The American Psychological Association Society for Health Psychology (SfHP) and the Society for Behavioral Medicine (SBM) reviewed the proposed plan. SfHP and SBM are in support of the CMS decision to cover DPP for Medicare beneficiaries but have a significant concern that aspects of the proposal will limit the public health impact. Concerns include the emphasis on weight outcomes to determine continued coverage and the lack of details regarding requirements for coaches. SfHP and SBM are in strong support of modifications to the proposal that would remove the minimum weight loss stipulation to determine coverage and to specify type and qualifications of "coaches."

Full text publication rates of studies presented at an international emergency medicine scientific meeting.

Science.gov (United States)

Chan, Jannet W M; Graham, Colin A

2011-09-01

The publication rate of full text papers following an abstract presentation at a medical conference is variable, and few studies have examined the situation with respect to international emergency medicine conferences. This retrospective study aimed to identify the publication rate of abstracts presented at the 2006 International Conference on Emergency Medicine (ICEM) held in Halifax, Canada. The full text publication rate was 33.2%, similar to previous emergency medicine meetings. English language barriers may play a role in the low publication rate seen.

Joint conference of the International Society of Environmental Medicine and the Gesellschaft fuer Hygiene und Umweltmedizin. Abstracts; Gemeinsame Konferenz der International Society of Environmental Medicine und der Gesellschaft fuer Hygiene und Umweltmedizin. Kurzfassungen

Energy Technology Data Exchange (ETDEWEB)

Anon.

2004-07-01

88 Papers and 48 posters were presented during the meeting. The headings were as follows: Water hygiene and infectiology, water hygiene in hospitals, clinical studies concerning environmental medicine, consumer protection, environmental toxicology, indoor hygiene and toxicology, sources of infections in hospitals, risks and prevention of infections due to minimum invasive surgery, disinfection and sterilization.

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey.

Science.gov (United States)

Akl, Elie A; Gunukula, Sameer; Mustafa, Reem; Wilson, Mark C; Symons, Andrew; Moheet, Amir; Schünemann, Holger J

2010-03-25

The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. We conducted a survey of family medicine and internal medicine residency program directors in the United States. The questionnaire asked the program directors whether they supported the use of educational games, their actual use of games, and the type of games being used and the purpose of that use. Of 434 responding program directors (52% response rate), 92% were in support of the use of games as an educational strategy, and 80% reported already using them in their programs. Jeopardy like games were the most frequently used games (78%). The use of games was equally popular in family medicine and internal medicine residency programs and popularity was inversely associated with more than 75% of residents in the program being International Medical Graduates. The percentage of program directors who reported using educational games as teaching tools, review tools, and evaluation tools were 62%, 47%, and 4% respectively. Given a widespread use of educational games in the training of medical residents, in spite of limited evidence for efficacy, further evaluation of the best approaches to education games should be explored.

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey

Directory of Open Access Journals (Sweden)

Wilson Mark C

2010-03-01

Full Text Available Abstract Background The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. Methods We conducted a survey of family medicine and internal medicine residency program directors in the United States. The questionnaire asked the program directors whether they supported the use of educational games, their actual use of games, and the type of games being used and the purpose of that use. Results Of 434 responding program directors (52% response rate, 92% were in support of the use of games as an educational strategy, and 80% reported already using them in their programs. Jeopardy like games were the most frequently used games (78%. The use of games was equally popular in family medicine and internal medicine residency programs and popularity was inversely associated with more than 75% of residents in the program being International Medical Graduates. The percentage of program directors who reported using educational games as teaching tools, review tools, and evaluation tools were 62%, 47%, and 4% respectively. Conclusions Given a widespread use of educational games in the training of medical residents, in spite of limited evidence for efficacy, further evaluation of the best approaches to education games should be explored.

Grading Practices and Distributions Across Internal Medicine Clerkships.

Science.gov (United States)

Fazio, Sara B; Torre, Dario M; DeFer, Thomas M

2016-01-01

Clerkship evaluation and grading practices vary widely between U.S. medical schools. Grade inflation continues to exist, and grade distribution is likely to be different among U.S. medical schools. Increasing the number of available grades curtails "grade inflation." A national survey of all Clerkship Directors in Internal Medicine members was administered in 2011. The authors assessed key aspects of grading. Response rate was 76%. Among clerkship directors (CDs), 61% of respondents agreed that grade inflation existed in the internal medicine clerkship at their school, and 43% believed that it helped students obtain better residency positions. With respect to grading practices, 79% of CDs define specific behaviors needed to achieve each grade, and 36% specify an ideal grade distribution. In addition, 44% have a trained core faculty responsible for evaluating students, 35% describe formal grading meetings, and 39% use the Reporter-Interpreter-Manager-Educator (RIME) scheme. Grading scales were described as follows: 4% utilize a pass/fail system, 13% a 3-tier (e.g., Honors/Pass/Fail), 45% 4-tier, 35% 5-tier, and 4% 6+-tier system. There was a trend to higher grades with more tiers available. Grade inflation continues in the internal medicine clerkship. Almost half of CDs feel that this practice assists students to obtain better residency positions. A minority of programs have a trained core faculty who are responsible for evaluation. About one third have formal grading meetings and use the RIME system; both have been associated with more robust and balanced grading practices. In particular, there is a wide variation between schools in the percentage of students who are awarded the highest grade, which has implications for residency applications. Downstream users of clinical clerkship grades must be fully aware of these variations in grading in order to appropriately judge medical student performance.

4th International Conference on Biomedical Engineering in Vietnam

CERN Document Server

Toan, Nguyen; Khoa, Truong; Phuong, Tran; Development of Biomedical Engineering

2013-01-01

This volume presents the proceedings of the Fourth International Conference on the Development of Biomedical Engineering in Vietnam which was held in Ho Chi Minh City as a Mega-conference. It is kicked off by the Regenerative Medicine Conference with the theme “BUILDING A FACE” USING A REGENERATIVE MEDICINE APPROACH”, endorsed mainly by the Tissue Engineering and Regenerative Medicine International Society (TERMIS). It is followed by the Computational Medicine Conference, endorsed mainly by the Computational Surgery International Network (COSINE) and the Computational Molecular Medicine of German National Funding Agency; and the General Biomedical Engineering Conference, endorsed mainly by the International Federation for Medical and Biological Engineering (IFMBE). It featured the contributions of 435 scientists from 30 countries, including: Australia, Austria, Belgium, Canada, China, Finland, France, Germany, Hungary, India, Iran, Italy, Japan, Jordan, Korea, Malaysia, Netherlands, Pakistan, Poland, Ru...

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement.

Science.gov (United States)

Griffin, D R; Dickenson, E J; O'Donnell, J; Agricola, R; Awan, T; Beck, M; Clohisy, J C; Dijkstra, H P; Falvey, E; Gimpel, M; Hinman, R S; Hölmich, P; Kassarjian, A; Martin, H D; Martin, R; Mather, R C; Philippon, M J; Reiman, M P; Takla, A; Thorborg, K; Walker, S; Weir, A; Bennell, K L

2016-10-01

The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27-29 June. Presentations were followed by open discussion. At the 1-day consensus meeting, panel members developed statements in response to each question through open discussion; members then scored their level of agreement with each response on a scale of 0-10. Substantial agreement (range 9.5-10) was reached for each of the 6 consensus questions, and the associated terminology was agreed on. The term 'femoroacetabular impingement syndrome' was introduced to reflect the central role of patients' symptoms in the disorder. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery. Current understanding of prognosis and topics for future research were discussed. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on the diagnosis, treatment principles and key terminology relating to FAI syndrome.Author note The Warwick Agreement on femoroacetabular impingement syndrome has been endorsed by the following 25 clinical societies: American Medical Society for Sports Medicine (AMSSM), Association of Chartered Physiotherapists in Sports and Exercise Medicine (ACPSEM), Australasian College of Sports and Exercise Physicians (ACSEP), Austian Sports Physiotherapists, British Association of Sports and Exercise

Proceedings of the 11th Congress of the International Society of Nutrigenetics and Nutrigenomics (ISNN 2017).

Science.gov (United States)

Barrington, William T; Salvador, Anna C; Hartiala, Jaana A; De Caterina, Raffaele; Kohlmeier, Martin; Martinez, J Alfredo; Kreutzer, Carin B; Heber, David; Lusis, Aldons J; Li, Zhaoping; Allayee, Hooman

2017-01-01

The International Society of Nutrigenetics and Nutrigenomics (ISNN) held its 11th annual Congress in Los Angeles, California, between September 16 and 19, 2017. In addition to 2 keynote lectures, 4 plenary sessions included presentations by internationally renowned speakers on cutting-edge areas of research and new discoveries in genetics/genomics, the microbiome, and nutrition. Scientific topics included multi-omics approaches; diet and the microbiome; cancer, longevity, and metabolism; moving the field forward; and translational/educational aspects and the future of medicine. There was also an accepted oral abstracts session designed specifically to provide young investigators and trainees with the opportunity to present their work, as well as a session focused on industry-academic partnerships, which included a roundtable discussion afterwards. Overall, the 11th ISNN Congress was an exciting and intellectually stimulating meeting focused on understanding the impact of biological interactions between genes and nutrients on health and disease. These efforts continued the decade-long tradition of the annual ISNN Congress to provide an interdisciplinary platform for scientists from various disciplines to discuss research ideas and advance the fields of nutrigenetics and nutrigenomics. © 2018 S. Karger AG, Basel.

Burnout syndrome during residency in internal medicine and pediatrics in a country without working time directive.

Science.gov (United States)

Aksoy, Duygu Yazgan; Durusu Tanriover, Mine; Unal, Sule; Dizdar, Omer; Kalyoncu, Umut; Karakaya, Jale; Unal, Serhat; Kale, Gulsev

2014-01-01

The purpose of this paper is to demonstrate burnout syndrome among internal medicine and pediatrics residents in a country that does not have the working time directive (WTD) and also to determine the risk factors and consequent impact on efficient functioning in clinical areas. A 57-item questionnaire was given to internal medicine and pediatrics residents. Responses from 22 pediatrics and 33 internal medicine residents were evaluated. Demographic findings, burnout scores, having hobbies, social activities and reading books unrelated to medicine were similar between the two groups. Six pediatrics residents (27.3 per cent) and 11 (33.3 per cent) internal medicine residents met the criteria for clinically significant burnout. Personal accomplishment scores and reading books unrelated to medicine were found to be related to burnout. Burnout is a syndrome characterized by depersonalization, emotional exhaustion and a low sense of personal accomplishment. It is important to document burnout in countries where WTDs are not implemented. Further studies might demonstrate burnout's effect on patient safety, service quality and physician's performance.

Basic Geriatrics Knowledge Among Internal Medicine Trainees in a Teaching Hospital in Saudi Arabia.

Science.gov (United States)

Al-Aama, Tareef

2016-06-01

To assess the basic knowledge of medical trainees, in the absence of a structured geriatrics curriculum, around a variety of geriatric medicine components that are considered essential for the care of the rapidly increasing elderly population. Eighty-three trainees at different levels of training in internal medicine were asked about a variety of common geriatric conditions. Those included: delirium, falls, geriatric syndromes, pain, cognitive impairment, and medications. The trainees' knowledge about common geriatric condition was overall poor. The most pronounced deficits included: the lack of familiarity in diagnosing geriatric syndromes (63 %) or managing them (67 %), the underestimation of the prevalence of delirium (49 %), and the tendency to undertreat pain (64 %). Poor familiarity with polypharmacy and its impact, as well as inappropriate prescription practices in the elderly were also observed. In the absence of a structured geriatric medicine curriculum, internal medicine trainees' knowledge about important geriatric conditions is poor, even if their internal medicine knowledge is overall adequate. This would translate into suboptimal care for this vulnerable and rapidly expanding segment of the population.

Mindfulness, burnout, and effects on performance evaluations in internal medicine residents.

Science.gov (United States)

Braun, Sarah E; Auerbach, Stephen M; Rybarczyk, Bruce; Lee, Bennett; Call, Stephanie

2017-01-01

Burnout has been documented at high levels in medical residents with negative effects on performance. Some dispositional qualities, like mindfulness, may protect against burnout. The purpose of the present study was to assess burnout prevalence among internal medicine residents at a single institution, examine the relationship between mindfulness and burnout, and provide preliminary findings on the relation between burnout and performance evaluations in internal medicine residents. Residents (n = 38) completed validated measures of burnout at three time points separated by 2 months and a validated measure of dispositional mindfulness at baseline. Program director end-of-year performance evaluations were also obtained on 22 milestones used to evaluate internal medicine resident performance; notably, these milestones have not yet been validated for research purposes; therefore, the investigation here is exploratory. Overall, 71.1% (n = 27) of the residents met criteria for burnout during the study. Lower scores on the "acting with awareness" facet of dispositional mindfulness significantly predicted meeting burnout criteria χ 2 (5) = 11.88, p = 0.04. Lastly, meeting burnout criteria significantly predicted performance on three of the performance milestones, with positive effects on milestones from the "system-based practices" and "professionalism" domains and negative effects on a milestone from the "patient care" domain. Burnout rates were high in this sample of internal medicine residents and rates were consistent with other reports of burnout during medical residency. Dispositional mindfulness was supported as a protective factor against burnout. Importantly, results from the exploratory investigation of the relationship between burnout and resident evaluations suggested that burnout may improve performance on some domains of resident evaluations while compromising performance on other domains. Implications and directions for future research are discussed.

Can we predict final outcome of internal medicine residents with in-training evaluation.

Science.gov (United States)

Chierakul, Nitipatana; Pongprasobchai, Supot; Boonyapisit, Kanokwan; Chinthammitr, Yingyong; Pithukpakorn, Manop; Maneesai, Adisak; Srivijitkamol, Apiradee; Koomanachai, Pornpan; Koolvisoot, Ajchara; Tanwandee, Tawesak; Shayakul, Chairat; Kachintorn, Udom

2011-02-01

To assess the predictive value of in-training evaluation for determining future success in the internal medicine board certifying examination. Ninety-seven internal medicine residents from Faculty of Medicine Siriraj Hospital who undertake the Thai Board examination during the academic year 2006-2008 were enrolled. Correlation between the scores during internal medicine rotation and final scores in board examination were then examined. Significant positive linear correlation was found between scores from both written and clinical parts of board certifying examination and scores from the first-year summative written and clinical examinations and also the second-year formative written examination (r = 0.43-0.68, p evaluation by attending staffs was less well correlated (r = 0.29-0.36) and the evaluation by nurses or medical students demonstrated inverse relationship (r = -0.2, p = 0.27 and r = -0.13, p = 0.48). Some methods of in-training evaluation can predict successful outcome of board certifying examination. Multisource assessments cannot well extrapolate some aspects of professional competences and qualities.

CHINA’S ROLE AND STATUS IN INTERNATIONAL SOCIETY: SHOULD ITS RISE BE PERCEIVED AS A ‘THREAT’?

Directory of Open Access Journals (Sweden)

Dahlia Patricia Sterling

2017-12-01

Full Text Available China has been making strides in numerous areas the entire world is still trying to grapple with and determine in what way China’s economic growth, active engagement and participation in the world system will affect nation states. Without a doubt, this has added increasing pressure and brought complications for China in continuously explaining its economic growth to a number of actors who perceive its growth and active participation in international society as a “threat”. In effect, China is still yet to define completely its new role in international society even today, and is still using its foreign policy principles and approaches in its participatory role in international society. Moreover, despite honoring its commitments to international society, it still plays a comparatively lesser role in the shaping and making of rules and regulations. Thus, rather than developing and creating new comprehensive policies geared towards shaping and making new rules and regulations to guide its action and roles in international society given that numerous changes have occurred in the world, such as more and more civil conflicts, humanitarian crisis and rogue leaders on the rise today, etc.; China needs to make changes to ensure that not only its voice is heard, but its rules and regulations are up-to-date, works and applicable along with its spoken voice. Based on these assumptions and debates, it is therefore reasonable to make an attempt to determine China’s role and status in its involvement in international society and its rise to become a global power, given its participation in international society which plays a significant part in the way the world perceives China’s rise. On this basis, the article intends to attempt to unravel China’s role and status in international society, the limitations and challenges China faces and the perception of its threat in becoming a “rising” global power.

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction

OpenAIRE

Sultan, A. H.; Monga, A.; Lee, J.; Emmanuel, A.; Norton, C.; Santoro, G.; Hull, T.; Berghmans, B.; Brody, S.; Haylen, B. T.

2017-01-01

INTRODUCTION AND HYPOTHESIS: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal...

An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the Terminology for Female Anorectal Dysfunction

OpenAIRE

Sultan, A. H.; Monga, A.; Lee, J.; Emmanuel, A.; Norton, C.; Santoro, G.; Hull, T.; Berghmans, B.; Brody, S.; Haylen, B. T.

2017-01-01

INTRODUCTION: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Termi...

Nuclear Medicine Technologists' Perception and Current Assessment of Quality: A Society of Nuclear Medicine and Molecular Imaging Technologist Section Survey.

Science.gov (United States)

Mann, April; Farrell, Mary Beth; Williams, Jessica; Basso, Danny

2017-06-01

In 2015, the Society of Nuclear Medicine and Molecular Imaging Technologist Section (SNMMI-TS) launched a multiyear quality initiative to help prepare the technologist workforce for an evidence-based health-care delivery system that focuses on quality. To best implement the quality strategy, the SNMMI-TS first surveyed technologists to ascertain their perception of quality and current measurement of quality indicators. Methods: An internet survey was sent to 27,989 e-mail contacts. Questions related to demographic data, perceptions of quality, quality measurement, and opinions on the minimum level of education are discussed in this article. Results: A total of 4,007 (14.3%) responses were received. When asked to list 3 words or phrases that represent quality, there were a plethora of different responses. The top 3 responses were image quality, quality control, and technologist education or competency. Surveying patient satisfaction was the most common quality measure (80.9%), followed by evaluation of image quality (78.2%). Evaluation of image quality (90.3%) and equipment functionality (89.4%) were considered the most effective measures. Technologists' differentiation between quality, quality improvement, quality control, quality assurance, and quality assessment seemed ambiguous. Respondents were confident in their ability to assess and improve quality at their workplace (91.9%) and agreed their colleagues were committed to delivering quality work. Of note, 70.7% of respondents believed that quality is directly related to the technologist's level of education. Correspondingly, respondents felt there should be a minimum level of education (99.5%) and that certification or registry should be required (74.4%). Most respondents (59.6%) felt that a Bachelor's degree should be the minimum level of education, followed by an Associate's degree (40.4%). Conclusion: To best help nuclear medicine technologists provide quality care, the SNMMI-TS queried technologists to

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination performance.

Science.gov (United States)

Perez, Jose A; Greer, Sharon

2009-12-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical Licensing Examination (USMLE) to make decisions in recruitment of potential applicants. This study was done to determine a correlation of USMLE Steps 1, 2 and 3 results with ITE scores in each level of Internal Medicine training. A retrospective review of all residents graduating from an Internal Medicine program from 1999 to 2006 was done. Subjects included had data for all USMLE Steps and ITE during all years of training. Thirty-one subjects were included in the study. Correlations of USMLE Steps 1, 2 and 3 were done with ITE scores (percent correct) in each year of training. Pearson's correlation coefficient (r) was determined for each pairing and a t test to determine statistical significance of the correlation was done. Statistical significance was defined as P value ITE percent correct in PGY I, II and III were 0.46, 0.55 and 0.51 respectively. Corresponding r values for USMLE Step 2 and ITE percent correct were 0.79, 0.70 and 0.72; for USMLE Step 3 these values were 0.51, 0.37 and 0.51 respectively for each training year. USMLE scores are correlated with ITE scores. This correlation was strongest for USMLE Step 2.

Year-End Clinic Handoffs: A National Survey of Academic Internal Medicine Programs.

Science.gov (United States)

Phillips, Erica; Harris, Christina; Lee, Wei Wei; Pincavage, Amber T; Ouchida, Karin; Miller, Rachel K; Chaudhry, Saima; Arora, Vineet M

2017-06-01

While there has been increasing emphasis and innovation nationwide in training residents in inpatient handoffs, very little is known about the practice and preparation for year-end clinic handoffs of residency outpatient continuity practices. Thus, the latter remains an identified, yet nationally unaddressed, patient safety concern. The 2014 annual Association of Program Directors in Internal Medicine (APDIM) survey included seven items for assessing the current year-end clinic handoff practices of internal medicine residency programs throughout the country. Nationwide survey. All internal medicine program directors registered with APDIM. Descriptive statistics of programs and tools used to formulate a year-end handoff in the ambulatory setting, methods for evaluating the process, patient safety and quality measures incorporated within the process, and barriers to conducting year-end handoffs. Of the 361 APDIM member programs, 214 (59%) completed the Transitions of Care Year-End Clinic Handoffs section of the survey. Only 34% of respondent programs reported having a year-end ambulatory handoff system, and 4% reported assessing residents for competency in this area. The top three barriers to developing a year-end handoff system were insufficient overlap between graduating and incoming residents, inability to schedule patients with new residents in advance, and time constraints for residents, attendings, and support staff. Most internal medicine programs do not have a year-end clinic handoff system in place. Greater attention to clinic handoffs and resident assessment of this care transition is needed.

International comparisons of behavioral and emotional problems in preschool children: parents' reports from 24 societies

DEFF Research Database (Denmark)

Rescorla, Leslie A; Achenbach, Thomas M; Ivanova, Masha Y

2011-01-01

International comparisons were conducted of preschool children's behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½-5 by parents in 24 societies (N = 19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental...... Disorders-oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3-12%). Although societies differed greatly in language, culture, and other characteristics, Total...

Metabolic syndrome in Internal Medicine patients: the pilot NIMEC study (National Internal Medicine Equivalent/Complex C-V-@Risk

Directory of Open Access Journals (Sweden)

R. Nardi

2013-05-01

Full Text Available BACKGROUND Metabolic Syndrome (MetS, currently defined as slight differences in the criteria of diagnosis – depending on which authority is quoted [i.e.: NCEP-ATP III (National Cholesterol Education Program/Adult Treatment Panel III; WHO (World Health Organization; IDF (International Diabetes Federation; AACE (American Association of Clinical Endocrinologists], designates a cluster of metabolic risk factors that come together in a single individual, leading to cardiovascular disease. MetS is quite common, approximately 20-30% of the population in industrialized countries being affected. However, most of epidemiological data regarding MetS are derived from populations consisting mostly of middle-aged and younger subjects. AIM OF THE STUDY To assess the prevalence of the MetS in Internal Medicine wards and to determine its related comorbidities, including other clinical forms of atherosclerotic disease such as CHD risk equivalents. METHODS Our study was performed in patients admitted in Internal Medicine wards and selected as a randomization list in 12 Emilia Romagna-Marche FADOI centers. 1.316 patients were registered. According to explicit inclusion/exclusion criteria, we studied overall 902 participants (50.6% men, mean of age: 71-73 years. RESULTS According to NCEP-ATP III and IDF criteria the prevalence of MetS was 45.3% (IC 95%: 41.6-49.1 and 38.6% (IC 95%: 34.9-42.3, respectively. Patients with MetS presented a higher significant rate of ALT increase, syncope, atrial fibrillation, COPD, unstable angina, chronic kidney disease, cancer, valvular heart disease, peripheral arterial disease and carotid plaques. A strong association between IDF-MetS and congestive heart failure was observed, suggesting a role of central obesity as an independent risk factor in the elderly. DISCUSSION World-wide populations are becoming older. Aging and MetS are two conditions that represent an important part of health-care spending. Trunkal fatness increases in

Promoting Success: A Professional Development Coaching Program for Interns in Medicine.

Science.gov (United States)

Palamara, Kerri; Kauffman, Carol; Stone, Valerie E; Bazari, Hasan; Donelan, Karen

2015-12-01

Residency is an intense period. Challenges, including burnout, arise as new physicians develop their professional identities. Residency programs provide remediation, but emotional support for interns is often limited. Professional development coaching of interns, regardless of their performance, has not been reported. Design, implement, and evaluate a program to support intern professional development through positive psychology coaching. We implemented a professional development coaching program in a large residency program. The program included curriculum development, coach-intern interactions, and evaluative metrics. A total of 72 internal medicine interns and 26 internal medicine faculty participated in the first year. Interns and coaches were expected to meet quarterly; expected time commitments per year were 9 hours (per individual coached) for coaches, 5 1/2 hours for each individual coachee, and 70 hours for the director of the coaching program. Coaches and interns were asked to complete 2 surveys in the first year and to participate in qualitative interviews. Eighty-two percent of interns met with their coaches 3 or more times. Coaches and their interns assessed the program in multiple dimensions (participation, program and professional activities, burnout, coping, and coach-intern communication). Most of the interns (94%) rated the coaching program as good or excellent, and 96% would recommend this program to other residency programs. The experience of burnout was lower in this cohort compared with a prior cohort. There is early evidence that a coaching program of interactions with faculty trained in positive psychology may advance intern development and partially address burnout.

Course on internal dosimetry in nuclear medicine; Curso de dosimetria interna en medicina nuclear

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-07-01

This documentation was distributed to the participants in the Course of Internal Dosimetry in Nuclear Medicine organised by the Nuclear Regulatory Authority (ARN) of Argentina and held in Buenos Aires, Argentina, August 9-13, 2004. The course was intended for people from IAEA Member States in the Latin American and Caribbean region, and for professionals and workers in medicine, related with the radiation protection. Spanish and English were the languages of the course. The following subjects were covered: radioprotection of the patient in nuclear medicine; injuries by ionizing radiations; MIRD methodology; radiation dose assessment in nuclear medicine; small scale and microdosimetry; bone and marrow dose modelling; medical internal dose calculations; SPECT and image reconstruction; principles of the gamma camera; scattering and attenuation correction in SPECT; tomography in nuclear medicine.

Minimal experimental requirements for definition of extracellular vesicles and their functions: a position statement from the International Society for Extracellular Vesicles.

Science.gov (United States)

Lötvall, Jan; Hill, Andrew F; Hochberg, Fred; Buzás, Edit I; Di Vizio, Dolores; Gardiner, Christopher; Gho, Yong Song; Kurochkin, Igor V; Mathivanan, Suresh; Quesenberry, Peter; Sahoo, Susmita; Tahara, Hidetoshi; Wauben, Marca H; Witwer, Kenneth W; Théry, Clotilde

2014-01-01

Secreted membrane-enclosed vesicles, collectively called extracellular vesicles (EVs), which include exosomes, ectosomes, microvesicles, microparticles, apoptotic bodies and other EV subsets, encompass a very rapidly growing scientific field in biology and medicine. Importantly, it is currently technically challenging to obtain a totally pure EV fraction free from non-vesicular components for functional studies, and therefore there is a need to establish guidelines for analyses of these vesicles and reporting of scientific studies on EV biology. Here, the International Society for Extracellular Vesicles (ISEV) provides researchers with a minimal set of biochemical, biophysical and functional standards that should be used to attribute any specific biological cargo or functions to EVs.

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

78 FR 26375 - Food and Drug Administration/International Society for Pharmaceutical Engineering Co-Sponsorship...

Science.gov (United States)

2013-05-06

...] Food and Drug Administration/International Society for Pharmaceutical Engineering Co-Sponsorship... Society of Pharmaceutical Engineering (ISPE), is announcing a conference entitled ``Redefining the `C' in CGMP: Creating, Implementing and Sustaining a Culture of Quality'' Pharmaceutical Quality System (ICH...

3. Congress of the SA Society of nuclear medicine: Technetium-99m technology

International Nuclear Information System (INIS)

Beyers, M.

1988-08-01

The Atomic Energy Corporation of SA Limited have been engaged in the manufacture of radioisotopes since 1967, shortly after the SAFARI-1 reactor at Pelindaba was commissioned. Since then the use of radioisotopes in South Africa has grown rapidly and at present 95% of the in vivo diagnostic radioisotopes (radiopharmaceuticals) utilized in nuclear medicine are manufactured locally. Because radioisotopes are applied mainly in sophisticated chemically or mechanically processed forms, production requires not only a skilled production team, but also the appropriate facilities for the manufacture of high-quality products which comply with the necessary safety standards. Compliance with such standards is especially important for the routine production of radiopharmaceuticals for use in nuclear medicine. Over the past 20 years technetium-99m has achieved a dominant position among the diagnostic tools in modern nuclear medicine.The scope of nuclear medicine is expanding continuously and its future lies primarily in the development of new organspecific technetium-99m radiodiagnostic agents. Many improvements and changes have been made to Tc-99m generators, the major source of Tc-99m, since they were introduced to nuclear medicine in the late 1950's. The new Peltek-F sterile Tc-99m generator developed by the Isotope Production Centre is a symbol of progress made. In order to commemorate the launching of the new Peltek-F technetium-99m generator during August 1988 it was decided to publish six papers that were presented at the Third Congress of the Society of Nuclear Medicine held at Bloemfontein during the period 15 - 17 August 1988 by members of the Isotope Production Centre. This will serve as a useful reference on various aspects of technetium-99m technology and will stimulate the use of this product as well as new research in this field

Cardiovascular nuclear medicine and MRI

International Nuclear Information System (INIS)

Reiber, J.H.C.; Wall, E.E. van der

1992-01-01

This book is based on a meeting of the Working Group on Nuclear Cardiology, which held March 22-23,1991 under the auspices of the European Society of Cardiology and the Interuniversity Cardiology Institute of the Netherlands, and on the Second International Symposium on Computer Applications in Nuclear Medicine and Cardiac Magnetic Resonance Imaging, which was held March 20-22,1991 in Rotterdam, the Netherlands. It covers almost every aspect of quantitative cardio-vascular nuclear medicine and magnetic resonance imaging. The main topics are: single photon emission computed tomography (technical aspects); new development in cardiovascular nuclear medicine; advances in cardiovascular imaging; cardiovascular clinical applications; and cardiac magnetic resonance imaging. (A.S.). refs.; figs.; tabs

Estimation of Internal Radiation Dose to Nuclear Medicine Workers at Siriraj Hospital

International Nuclear Information System (INIS)

Asawarattanapakdee, J.; Sritongkul, N.; Chaudakshetrin, P.; Kanchanaphiboon, P.; Tuntawiroon, M.

2012-01-01

Every type of work performed in a nuclear medicine department will make a contribution to both external and internal exposure of the worker. The purpose of this study is to evaluate the potential risks of internal contamination to staff members during nuclear medicine practices and to conclude about the requirement of a routine internal monitoring. Following the method describes in the ICRP Publication 78 and the IAEA Safety Standard Series No. RS- G-1.2, in vivo thyroid bioassays using NaI(Tl) thyroid probe were performed to determine the intake estimates on 7 groups of nuclear medicine personnel working with I-131 and Tc-99m, based on working conditions and amount of radionuclides being handled. Frequency of measurements was between 7 and 14 days. These include (1) physicians and physicists, (2) radiochemists (3) technologists, (4) nurses and assistant nurses, (5) imaging room assistants, (6) hot lab workers and (7) hospital ward housekeepers/cleaners. Among all workers, the intake estimates of I-131 in the thyroid ranged from 0 to 76.7 kBq and of the technetium-99m from 0 to 35.4 MBq. The mean committed effective dose equivalent (CEDE) from both I-131 and Tc-99m were 0.63, 1.44 0.53, 0.57, 0.73, 0.98, and 1.36, mSv, for group 1 through group 7 respectively. However, the highest mean CEDE of 1.44 (max. 1.75) and 1.36 (max. 2.11) mSv observed in groups of radiochemists and hospital ward housekeepers were within the permissible level. Our results showed that CEDE for internal exposure in this study were less than investigate level of 5 mSv according to the ICRP Publication 78 and the IAEA Basic Safety Standards. However, the mean CEDE for radiochemists and hospital ward housekeepers were considered in exceed of the limits of recording level (1 mSv).The increasing use of I-131 and Tc-99m in nuclear medicine poses significant risks of internal exposure to the staff. This study suggests that a routine monitoring program for internal exposures should be implemented for

Human genetics: international projects and personalized medicine.

Science.gov (United States)

Apellaniz-Ruiz, Maria; Gallego, Cristina; Ruiz-Pinto, Sara; Carracedo, Angel; Rodríguez-Antona, Cristina

2016-03-01

In this article, we present the progress driven by the recent technological advances and new revolutionary massive sequencing technologies in the field of human genetics. We discuss this knowledge in relation with drug response prediction, from the germline genetic variation compiled in the 1000 Genomes Project or in the Genotype-Tissue Expression project, to the phenome-genome archives, the international cancer projects, such as The Cancer Genome Atlas or the International Cancer Genome Consortium, and the epigenetic variation and its influence in gene expression, including the regulation of drug metabolism. This review is based on the lectures presented by the speakers of the Symposium "Human Genetics: International Projects & New Technologies" from the VII Conference of the Spanish Pharmacogenetics and Pharmacogenomics Society, held on the 20th and 21st of April 2015.

"Families" in International Context: Comparing Institutional Effects across Western Societies

Science.gov (United States)

Cooke, Lynn Prince; Baxter, Janeen

2010-01-01

We review comparative evidence of institutional effects on families in Western societies. We focus on 2 key aspects of family life: gendered divisions of labor and people's transitions into, within, and out of relationships. Many individual-level models assume the effects are robust across countries. The international evidence over the past decade…

Optimizing the Internal Medicine Clinic at Evans Army Community Hospital

National Research Council Canada - National Science Library

Bonilla, Jose

2003-01-01

...) 2002, the Internal Medicine (IM) clinic at Evans Army Community Hospital, Fort Carson, Colorado, failed to meet access to care standards for routine appointments, and was only marginally successful in meeting standards for urgent appointments...

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

Science.gov (United States)

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

2017-02-01

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

Divergent Fates of the Medical Humanities in Psychiatry and Internal Medicine: Should Psychiatry Be Rehumanized?

Science.gov (United States)

Rutherford, Bret R.; Hellerstein, David J.

2008-01-01

Objective: To determine the degree to which the medical humanities have been integrated into the fields of internal medicine and psychiatry, the authors assessed the presence of medical humanities articles in selected psychiatry and internal medicine journals from 1950 to 2000. Methods: The journals searched were the three highest-ranking…

International Society for Quality of Life Research commentary on the draft European Medicines Agency reflection paper on the use of patient-reported outcome (PRO) measures in oncology studies.

Science.gov (United States)

Kyte, Derek; Reeve, Bryce B; Efficace, Fabio; Haywood, Kirstie; Mercieca-Bebber, Rebecca; King, Madeleine T; Norquist, Josephine M; Lenderking, William R; Snyder, Claire; Ring, Lena; Velikova, Galina; Calvert, Melanie

2016-02-01

In 2014, the European Medicines Agency (EMA) released for comment a draft reflection paper on the use of patient-reported outcome (PRO) measures in oncology studies. A twelve-member International Society for Quality of Life Research (ISOQOL) taskforce was convened to coordinate the ISOQOL response. Twenty-one ISOQOL members provided detailed comments and suggestions on the paper: 81 % from academia and 19 % from industry. Taskforce members consolidated and further refined these comments and shared the recommendations with the wider ISOQOL membership. A final response was submitted to the EMA in November 2014. The impending publication of the EMA reflection paper presents a valuable opportunity for ISOQOL to comment on the current direction of EMA PRO guidance and strategy. The EMA paper, although focused on cancer, could serve as a model for using PROs in other conditions, as it provides a useful update surrounding some of the design issues common to all trial research including PRO endpoints. However, we believe there are a number of additional areas in need of greater consideration. The purpose of this commentary is therefore to highlight the strengths of this timely and potentially useful document, but also to outline areas that may warrant further discussion.

International society of sports nutrition position stand: nutrient timing

OpenAIRE

Kerksick, Chad M.; Arent, Shawn; Schoenfeld, Brad J.; Stout, Jeffrey R.; Campbell, Bill; Wilborn, Colin D.; Taylor, Lem; Kalman, Doug; Smith-Ryan, Abbie E.; Kreider, Richard B.; Willoughby, Darryn; Arciero, Paul J.; VanDusseldorp, Trisha A.; Ormsbee, Michael J.; Wildman, Robert

2017-01-01

Position statement The International Society of Sports Nutrition (ISSN) provides an objective and critical review regarding the timing of macronutrients in reference to healthy, exercising adults and in particular highly trained individuals on exercise performance and body composition. The following points summarize the position of the ISSN: Nutrient timing incorporates the use of methodical planning and eating of whole foods, fortified foods and dietary supplements. The timing of energy inta...

Dentistry and internal medicine: from the focal infection theory to the periodontal medicine concept.

Science.gov (United States)

Pizzo, Giuseppe; Guiglia, Rosario; Lo Russo, Lucio; Campisi, Giuseppina

2010-12-01

During past decades the relationship between dentistry and internal medicine and especially the concept of the so-called focal infection theory have long been a matter of debate. The pathogenesis of focal diseases has been classically attributed to dental pulp pathologies and periapical infections. Nonetheless, in recent years, their role is being dismissed while increasing interest is being devoted to the possible associations between periodontal infection and systemic diseases. In fact, periodontal pathogens and their products, as well as inflammatory mediators produced in periodontal tissues, might enter the bloodstream, causing systemic effects and/or contributing to systemic diseases. On the basis of this mechanism, chronic periodontitis has been suggested as a risk factor for cardiovascular diseases associated with atherosclerosis, bacterial endocarditis, diabetes mellitus, respiratory disease, preterm delivery, rheumatoid arthritis, and, recently, osteoporosis, pancreatic cancer, metabolic syndrome, renal diseases and neurodegenerative diseases such as Alzheimer's disease. Various hypotheses, including common susceptibility, systemic inflammation, direct bacterial infection and cross-reactivity, or molecular mimicry, between bacterial antigens and self-antigens, have been postulated to explain these relationships. In this scenario, the association of periodontal disease with systemic diseases has set the stage for introducing the concept of periodontal medicine. This narrative review summarizes the evolution of focal infection theory up to the current pathophysiology of periodontal disease, and presents an update on the relationships between chronic periodontitis and systemic diseases. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Update in Internal Medicine

Science.gov (United States)

López-Jiménez, Francisco; Brito, Máximo; Aude, Y. Wady; Scheinberg, Phillip; Kaplan, Mariana; Dixon, Denise A.; Schneiderman, Neil; Trejo, Jorge F.; López-Salazar, Luis Humberto; Ramírez-Barba, Ector Jaime; Kalil, Roberto; Ortiz, Carmen; Goyos, José; Buenaño, Alvaro; Kottiech, Samer; Lamas, Gervasio A.

2009-01-01

More than 500,000 new medical articles are published every year and available time to keep updated is scarcer every day. Nowadays, the task of selecting useful, consistent, and relevant information for clinicians is a priority in many major medical journals. This review has the aim of gathering the results of the most important findings in clinical medicine in the last few years. It is focused on results from randomized clinical trials and well-designed observational research. Findings were included preferentially if they showed solid results, and we avoided as much as possible including only preliminary data, or results that included only non-clinical outcomes. Some of the most relevant findings reported here include the significant benefit of statins in patients with coronary artery disease even with mean cholesterol level. It also provides a substantial review of the most significant trials assessing the effectiveness of IIb/IIIa receptor blockers. In gastroenterology many advances have been made in the H. pylori eradication, and the finding that the cure of H. pylori infection may be followed by gastroesophageal reflux disease. Some new antivirals have shown encouraging results in patients with chronic hepatitis. In the infectious disease arena, the late breaking trials in anti-retroviral disease are discussed, as well as the new trends regarding antibiotic resistance. This review approaches also the role of leukotriene modifiers in the treatment of asthma and discusses the benefit of using methylprednisolone in patients with adult respiratory distress syndrome, among many other advances in internal medicine. PMID:11068074

A new model for accreditation of residency programs in internal medicine.

Science.gov (United States)

Goroll, Allan H; Sirio, Carl; Duffy, F Daniel; LeBlond, Richard F; Alguire, Patrick; Blackwell, Thomas A; Rodak, William E; Nasca, Thomas

2004-06-01

A renewed emphasis on clinical competence and its assessment has grown out of public concerns about the safety, efficacy, and accountability of health care in the United States. Medical schools and residency training programs are paying increased attention to teaching and evaluating basic clinical skills, stimulated in part by these concerns and the responding initiatives of accrediting, certifying, and licensing bodies. This paper, from the Residency Review Committee for Internal Medicine of the Accreditation Council for Graduate Medical Education, proposes a new outcomes-based accreditation strategy for residency training programs in internal medicine. It shifts residency program accreditation from external audit of educational process to continuous assessment and improvement of trainee clinical competence.

The association of students requiring remediation in the internal medicine clerkship with poor performance during internship.

Science.gov (United States)

Hemann, Brian A; Durning, Steven J; Kelly, William F; Dong, Ting; Pangaro, Louis N; Hemmer, Paul A

2015-04-01

To determine whether the Uniformed Services University (USU) system of workplace performance assessment for students in the internal medicine clerkship at the USU continues to be a sensitive predictor of subsequent poor performance during internship, when compared with assessments in other USU third year clerkships. Utilizing Program Director survey results from 2007 through 2011 and U.S. Medical Licensing Examination (USMLE) Step 3 examination results as the outcomes of interest, we compared performance during internship for students who had less than passing performance in the internal medicine clerkship and required remediation, against students whose performance in the internal medicine clerkship was successful. We further analyzed internship ratings for students who received less than passing grades during the same time period on other third year clerkships such as general surgery, pediatrics, obstetrics and gynecology, family medicine, and psychiatry to evaluate whether poor performance on other individual clerkships were associated with future poor performance at the internship level. Results for this recent cohort of graduates were compared with previously published findings. The overall survey response rate for this 5 year cohort was 81% (689/853). Students who received a less than passing grade in the internal medicine clerkship and required further remediation were 4.5 times more likely to be given poor ratings in the domain of medical expertise and 18.7 times more likely to demonstrate poor professionalism during internship. Further, students requiring internal medicine remediation were 8.5 times more likely to fail USMLE Step 3. No other individual clerkship showed any statistically significant associations with performance at the intern level. On the other hand, 40% of students who successfully remediated and did graduate were not identified during internship as having poor performance. Unsuccessful clinical performance which requires remediation in

Whither the Pulmonary Ward Attending? Preserving Subspecialty Exposure in United States Internal Medicine Residency Training.

Science.gov (United States)

Santhosh, Lekshmi; Babik, Jennifer; Looney, Mark R; Hollander, Harry

2017-04-01

Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. At University of California-San Francisco, this has been accompanied by declining percentages of residency graduates who enter subspecialty training in internal medicine. The decline in subspecialty medicine interest can be attributed to many factors, including differences in compensation, decreased subspecialist exposure, and a changing research funding landscape. Although there has not been systematic documentation of this trend in pulmonary and critical care medicine, we have noted previously pulmonary and critical care-bound trainees switching to hospital medicine instead. With our broad, multiorgan system perspective, pulmonary and critical care faculty should embrace teaching general medicine. Residency programs have instituted creative solutions to encourage more internal medicine residents to pursue careers in subspecialty medicine. Some solutions include creating rotations that promote more contact with subspecialists and physician-scientists, creating clinician-educator tracks within fellowship programs, and appointing subspecialists to internal medicine residency leadership positions. We need more rigorous research to track the trends and implications of the generalist-specialist balance of inpatient ward teams on resident career choices, and learn what interventions affect those choices.

Transfusion medicine on American television.

Science.gov (United States)

Karp, J K

2014-02-01

Television is a beloved American pastime and a frequent American export. As such, American television shapes how the global public views the world. This study examines how the portrayal of blood transfusion and blood donation on American television may influence how domestic and international audiences perceive the field of transfusion medicine. American television programming of the last quarter-century was reviewed to identify programmes featuring topics related to blood banking/transfusion medicine. The included television episodes were identified through various sources. Twenty-seven television episodes airing between 1991 and 2013 were identified as featuring blood bank/transfusion medicine topics. Although some accurate representations of the field were identified, most television programmes portrayed blood banking/transfusion medicine inaccurately. The way in which blood banking/transfusion medicine is portrayed on American television may assist clinicians in understanding their patient's concerns about blood safety and guide blood collection organisations in improving donor recruitment. © 2013 The Author. Transfusion Medicine © 2013 British Blood Transfusion Society.

Readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons and the American Orthopaedic Society for Sports Medicine.

Science.gov (United States)

Ganta, Abhishek; Yi, Paul H; Hussein, Khalil; Frank, Rachel M

2014-04-01

Although studies have revealed high readability levels of orthopedic patient education materials, no study has evaluated sports medicine-related patient education materials. We conducted a study to assess the readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Society for Sports Medicine (AOSSM). All sports medicine patient education articles available online in 2012 from the AAOS and the AOSSM, including the Stop Sports Injuries Campaign (STOP), were identified, and their readability was assessed with the Flesch-Kinkaid (FK) readability test. Mean overall FK grade level of the 170 articles reviewed (104 from AAOS, 36 from AOSSM, 30 from STOP) was 10.2. Mean FK levels for the 3 sources were 9.5 (AAOS), 11.0 (AOSSM), and 11.5 (STOP) (P = .16). Fifteen (8.8%) of the 170 articles had a readability level at or below eighth grade (average reading level of US adults); only 2 (1.2%) of the 170 articles were at or below the recommended sixth-grade level. The majority of sports medicine-related patient education materials from AAOS and AOSSM had reading levels higher than recommended, indicating that the majority of the patient population may find it difficult to comprehend these articles.

Quality assurance and harmonisation of nuclear medicine investigations in Europe

International Nuclear Information System (INIS)

Bergmann, H.; Busemann-Sokole, E.; Horton, P.W.

1995-01-01

A survey of all member societies of the European Association of Nuclear Medicine has shown that a satisfactory degree of harmonisation exists for the quality assurance of the preparation and handling of radiopharmaceuticals and the performance of nuclear medicine instrumentation. However, variations were found in acquisition protocols, data analysis and the interpretation and presentation of clinical results. Harmonisation of these areas of a nuclear medicine investigation would help ensure the overall quality. A European initiative is proposed to collect and collate procedures in these areas in order to produce a reference framework of good practice for the acquisition, analysis and interpretation of nuclear medicine investigations. This would involve collaboration between national societies and exchange of information with and support from European organisations, taking into account relevant international activities. The reference framework should be compatible with quality management guidelines. (orig.)

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.

An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation.

Science.gov (United States)

McMahon, Chris G; Althof, Stanley; Waldinger, Marcel D; Porst, Hartmut; Dean, John; Sharlip, Ira; Adaikan, P G; Becher, Edgardo; Broderick, Gregory A; Buvat, Jacques; Dabees, Khalid; Giraldi, Annamaria; Giuliano, François; Hellstrom, Wayne J G; Incrocci, Luca; Laan, Ellen; Meuleman, Eric; Perelman, Michael A; Rosen, Raymond; Rowland, David; Segraves, Robert

2008-08-01

To develop a contemporary, evidence-based definition of premature ejaculation (PE). There are several definitions of PE; the most commonly quoted, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders - 4th Edition - Text Revision, and other definitions of PE, are all authority-based rather than evidence-based, and have no support from controlled clinical and/or epidemiological studies. Thus in August 2007, the International Society for Sexual Medicine (ISSM) appointed several international experts in PE to an Ad Hoc Committee for the Definition of PE. The committee met in Amsterdam in October 2007 to evaluate the strengths and weaknesses of current definitions of PE, to critically assess the evidence in support of the constructs of ejaculatory latency, ejaculatory control, sexual satisfaction and personal/interpersonal distress, and to propose a new evidence-based definition of PE. The Committee unanimously agreed that the constructs which are necessary to define PE are rapidity of ejaculation, perceived self-efficacy, and control and negative personal consequences from PE. The Committee proposed that lifelong PE be defined as a male sexual dysfunction characterized by ejaculation which always or nearly always occurs before or within about one minute of vaginal penetration, and the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. This definition is limited to men with lifelong PE who engage in vaginal intercourse. The panel concluded that there are insufficient published objective data to propose an evidence-based definition of acquired PE. The ISSM definition of lifelong PE represents the first evidence-based definition of PE. This definition will hopefully lead to the development of new tools and patient-reported outcome measures for diagnosing and assessing the efficacy of treatment

Combined residency training in emergency medicine and internal medicine: an update on career outcomes and job satisfaction.

Science.gov (United States)

Kessler, Chad S; Stallings, Leonard A; Gonzalez, Andrew A; Templeman, Todd A

2009-09-01

This study was designed to provide an update on the career outcomes and experiences of graduates of combined emergency medicine-internal medicine (EM-IM) residency programs. The graduates of the American Board of Emergency Medicine (ABEM) and American Board of Internal Medicine (ABIM)-accredited EM-IM residencies from 1998 to 2008 were contacted and asked to complete a survey concerning demographics, board certification, fellowships completed, practice setting, academic affiliation, and perceptions about EM-IM training and careers. There were 127 respondents of a possible 163 total graduates for a response rate of 78%. Seventy graduates (55%) practice EM only, 47 graduates (37%) practice both EM and IM, and nine graduates (7%) practice IM or an IM subspecialty only. Thirty-one graduates (24%) pursued formal fellowship training in either EM or IM. Graduates spend the majority of their time practicing clinical EM in an urban (72%) and academic (60%) environment. Eighty-seven graduates (69%) spend at least 10% of their time in an academic setting. Most graduates (64%) believe it practical to practice both EM and IM. A total of 112 graduates (88%) would complete EM-IM training again. Dual training in EM-IM affords a great deal of career opportunities, particularly in academics and clinical practice, in a number of environments. Graduates hold their training in high esteem and would do it again if given the opportunity.

Attitudes of members of the German Society for Palliative Medicine toward complementary and alternative medicine for cancer patients.

Science.gov (United States)

Conrad, A C; Muenstedt, K; Micke, O; Prott, F J; Muecke, R; Huebner, J

2014-07-01

A high proportion of cancer patients use complementary and alternative medicine (CAM). In oncology, risks of CAM are side effects and interactions. Our aim was to conduct a survey on professionals in palliative care regarding attitudes toward CAM. An internet-based survey with a standardized questionnaire was sent to all members of the German Society for Palliative Care. The questionnaire collected data on attitude toward CAM and experiences. Six hundred and ninety questionnaires (19 %) were returned (49 % physicians, 35 % nurses, 3 % psychologists). Acceptance of CAM is high (92 % for complementary and 54 % for alternative medicine). Most participants had already been asked on CAM by patients (95 %) and relatives (89 %). Forty-four percent already had used complementary methods and 5 % alternative methods. Only 21 % think themselves adequately informed. Seventy-four percent would use complementary methods in a patient with advanced tumor, and 62 % would use alternative therapy in patients if there was no other therapy. Even from those who are skeptical 45 % would treat a patient with alternative methods. In order to inform patients on CAM and to further patients' autonomy, evidence on benefits and harms of CAM must be provided. As awareness of risks from CAM is low and critical appraisal especially of alternative medicine missing, but interest on information on CAM is high, experts should provide evidence-based recommendations for CAM in palliative care to members of different professions. This could be done by a curriculum focusing on the most often used CAM methods.

[The QR code in society, economy and medicine--fields of application, options and chances].

Science.gov (United States)

Flaig, Benno; Parzeller, Markus

2011-01-01

2D codes like the QR Code ("Quick Response") are becoming more and more common in society and medicine. The application spectrum and benefits in medicine and other fields are described. 2D codes can be created free of charge on any computer with internet access without any previous knowledge. The codes can be easily used in publications, presentations, on business cards and posters. Editors choose between contact details, text or a hyperlink as information behind the code. At expert conferences, linkage by QR Code allows the audience to download presentations and posters quickly. The documents obtained can then be saved, printed, processed etc. Fast access to stored data in the internet makes it possible to integrate additional and explanatory multilingual videos into medical posters. In this context, a combination of different technologies (printed handout, QR Code and screen) may be reasonable.

Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents.

Science.gov (United States)

West, Colin P; Shanafelt, Tait D; Kolars, Joseph C

2011-09-07

Physician distress is common and has been associated with negative effects on patient care. However, factors associated with resident distress and well-being have not been well described at a national level. To measure well-being in a national sample of internal medicine residents and to evaluate relationships with demographics, educational debt, and medical knowledge. Study of internal medicine residents using data collected on 2008 and 2009 Internal Medicine In-Training Examination (IM-ITE) scores and the 2008 IM-ITE survey. Participants were 16,394 residents, representing 74.1% of all eligible US internal medicine residents in the 2008-2009 academic year. This total included 7743 US medical graduates and 8571 international medical graduates. Quality of life (QOL) and symptoms of burnout were assessed, as were year of training, sex, medical school location, educational debt, and IM-ITE score reported as percentage of correct responses. Quality of life was rated "as bad as it can be" or "somewhat bad" by 2402 of 16,187 responding residents (14.8%). Overall burnout and high levels of emotional exhaustion and depersonalization were reported by 8343 of 16,192 (51.5%), 7394 of 16,154 (45.8%), and 4541 of 15,737 (28.9%) responding residents, respectively. In multivariable models, burnout was less common among international medical graduates than among US medical graduates (45.1% vs 58.7%; odds ratio, 0.70 [99% CI, 0.63-0.77]; P $200,000 relative to no debt). Residents reporting QOL "as bad as it can be" and emotional exhaustion symptoms daily had mean IM-ITE scores 2.7 points (99% CI, 1.2-4.3; P ITE scores 5.0 points (99% CI, 4.4-5.6; P ITE scores.

Minimal experimental requirements for definition of extracellular vesicles and their functions: a position statement from the International Society for Extracellular Vesicles

Directory of Open Access Journals (Sweden)

Jan Lötvall

2014-12-01

Full Text Available Secreted membrane-enclosed vesicles, collectively called extracellular vesicles (EVs, which include exosomes, ectosomes, microvesicles, microparticles, apoptotic bodies and other EV subsets, encompass a very rapidly growing scientific field in biology and medicine. Importantly, it is currently technically challenging to obtain a totally pure EV fraction free from non-vesicular components for functional studies, and therefore there is a need to establish guidelines for analyses of these vesicles and reporting of scientific studies on EV biology. Here, the International Society for Extracellular Vesicles (ISEV provides researchers with a minimal set of biochemical, biophysical and functional standards that should be used to attribute any specific biological cargo or functions to EVs.

Impact of personal goals on the internal medicine R4 subspecialty match: a Q methodology study.

Science.gov (United States)

Daniels, Vijay J; Kassam, Narmin

2013-12-21

There has been a decline in interest in general internal medicine that has resulted in a discrepancy between internal medicine residents' choice in the R4 subspecialty match and societal need. Few studies have focused on the relative importance of personal goals and their impact on residents' choice. The purpose of this study was to assess if internal medicine residents can be grouped based on their personal goals and how each group prioritizes these goals compared to each other. A secondary objective was to explore whether we could predict a resident's desired subspecialty choice based on their constellation of personal goals. We used Q methodology to examine how postgraduate year 1-3 internal medicine residents could be grouped based on their rankings of 36 statements (derived from our previous qualitative study). Using each groups' defining and distinguishing statements, we predicted their subspecialties of interest. We also collected the residents' first choice in the subspecialty match and used a kappa test to compare our predicted subspecialty group to the residents' self-reported first choice. Fifty-nine internal medicine residents at the University of Alberta participated between 2009 and 2010 with 46 Q sorts suitable for analysis. The residents loaded onto four factors (groups) based on how they ranked statements. Our prediction of each groups' desired subspecialties with their defining and/or distinguishing statements are as follows: group 1 - general internal medicine (variety in practice); group 2 - gastroenterology, nephrology, and respirology (higher income); group 3 - cardiology and critical care (procedural, willing to entertain longer training); group 4 - rest of subspecialties (non-procedural, focused practice, and valuing more time for personal life). There was moderate agreement (kappa = 0.57) between our predicted desired subspecialty group and residents' self-reported first choice (p internal medicine subspecialty. The key goals that define

Factors associated with the subspecialty choices of internal medicine residents in Canada.

Science.gov (United States)

Horn, Leora; Tzanetos, Katina; Thorpe, Kevin; Straus, Sharon E

2008-06-26

Currently, there are more residents enrolled in cardiology training programs in Canada than in immunology, pharmacology, rheumatology, infectious diseases, geriatrics and endocrinology combined. There is no published data regarding the proportion of Canadian internal medicine residents applying to the various subspecialties, or the factors that residents consider important when deciding which subspecialty to pursue. To address the concern about physician imbalances in internal medicine subspecialties, we need to examine the factors that motivate residents when making career decisions. In this two-phase study, Canadian internal medicine residents participating in the post graduate year 4 (PGY4) subspecialty match were invited to participate in a web-based survey and focus group discussions. The focus group discussions were based on issues identified from the survey results. Analysis of focus group transcripts grew on grounded theory. 110 PGY3 residents participating in the PGY4 subspecialty match from 10 participating Canadian universities participated in the web-based survey (54% response rate). 22 residents from 3 different training programs participated in 4 focus groups held across Canada. Our study found that residents are choosing careers that provide intellectual stimulation, are consistent with their personality, and that provide a challenge in diagnosis. From our focus group discussions it appears that lifestyle, role models, mentorship and the experience of the resident with the specialty appear to be equally important in career decisions. Males are more likely to choose procedure based specialties and are more concerned with the reputation of the specialty as well as the anticipated salary. In contrast, residents choosing non-procedure based specialties are more concerned with issues related to lifestyle, including work-related stress, work hours and time for leisure as well as the patient populations they are treating. This study suggests that internal

Factors associated with the subspecialty choices of internal medicine residents in Canada

Directory of Open Access Journals (Sweden)

Thorpe Kevin

2008-06-01

Full Text Available Abstract Background Currently, there are more residents enrolled in cardiology training programs in Canada than in immunology, pharmacology, rheumatology, infectious diseases, geriatrics and endocrinology combined. There is no published data regarding the proportion of Canadian internal medicine residents applying to the various subspecialties, or the factors that residents consider important when deciding which subspecialty to pursue. To address the concern about physician imbalances in internal medicine subspecialties, we need to examine the factors that motivate residents when making career decisions. Methods In this two-phase study, Canadian internal medicine residents participating in the post graduate year 4 (PGY4 subspecialty match were invited to participate in a web-based survey and focus group discussions. The focus group discussions were based on issues identified from the survey results. Analysis of focus group transcripts grew on grounded theory. Results 110 PGY3 residents participating in the PGY4 subspecialty match from 10 participating Canadian universities participated in the web-based survey (54% response rate. 22 residents from 3 different training programs participated in 4 focus groups held across Canada. Our study found that residents are choosing careers that provide intellectual stimulation, are consistent with their personality, and that provide a challenge in diagnosis. From our focus group discussions it appears that lifestyle, role models, mentorship and the experience of the resident with the specialty appear to be equally important in career decisions. Males are more likely to choose procedure based specialties and are more concerned with the reputation of the specialty as well as the anticipated salary. In contrast, residents choosing non-procedure based specialties are more concerned with issues related to lifestyle, including work-related stress, work hours and time for leisure as well as the patient populations

ROLE OF THE INTERNATIONAL ORGANIZATIONS IN PREVENTING THE COUNTERFEIT MEDICINES ENTRY INTO THE WORLD MARKETS.

Science.gov (United States)

Stukina, Valeryia; Dohnal, Jiri; Saloun, Jan

2016-09-01

30 years have passed since Conference of Experts on the Rational Use of Drugs was held in Nairobi, Kenya, from 25 to 29 November 1985, where the problem of counterfeit medicines was mentioned as the international for the first time. The problem of counterfeit medicines is not only a major threat to public health and national and private economy, but also it is of great interest for key decision-making actors at the international level. The authors analyzed what has been done since that time by international organizations. Combating the counterfeiting of medicines cannot be successfully achieved by the health sector alone - World Health Organization (WHO), - so the efforts of the other United Nations (UN) organizations relevant to counterfeiting were in need and were studied in the article: World Intellectual Property Organization (WIPO), World Trade Organization (WTO), World Customs Organization (WCO), United Nations Office on Drugs and Crime (UNODC), etc. Today WHO is unable to coordinate all their activities, so the few existing proposals for establishing a new mechanism of international cooperation have been examined. Will the MEDICRIME Convention that will enter into force on January 1, 2016 be the start of the new era in the combating with the counterfeit medicines? - the authors offered their vision on the international developments.

Annual International DIC Society Conference and SEM Fall Conference

CERN Document Server

Reu, Phillip

2017-01-01

This collection represents a single volume of technical papers presented at the Annual International DIC Society Conference and SEM Fall Conference organized by the Society for Experimental Mechanics and Sandia National Laboratories and held in Philadelphia, PA, November 7-10, 2016. The volume presents early findings from experimental, standards development and various other investigations concerning digital image correlation - an important area within Experimental Mechanics. The area of Digital Image Correlation has been an integral track within the SEM Annual Conference spearheaded by Professor Michael Sutton from the University of South Carolina. In 2016, the SEM and Sandia joined their collaborative strengths to launch a standing fall meeting focusing specifically on developments in the area of Digital Image Correlation. The contributed papers within this volume span numerous technical aspects of DIC including standards development for the industry. .

Citation analysis of The Korean Journal of Internal Medicine from KoMCI, Web of Science, and Scopus.

Science.gov (United States)

Huh, Sun

2011-03-01

The Korean Journal of Internal Medicine (KJIM) is the international journal published in English by the Korean Association of Internal Medicine. To understand the position of the journal in three different databases, the citation indicators were elucidated. From databases such as Korean Medical Citation Index (KoMCI), Web of Science, and Scopus, citation indicators such as the impact factor, SCImago journal rank (SJR), or Hirsch Index were calculated according to the year and the results were drawn. The KJIM 2010 impact factor increased to 0.623 in Web of Science. That of year 2009 in KoMCI was a 0.149. The 2009 SJR in Scopus was 0.073, with a ranking of 27/72 (37.5%) in the category of internal medicine and 414/1,618 (25.6%) in the category of medicine, miscellaneous. The Hirsch Index from KoMCI, Web of Science and Scopus were 5, 14, and 16, respectively. The KJIM is now cited more by international researchers than Korean researchers, indicating that the content of the journal is now valued at the international level.

The Assessment of I-131 Internal Doses of Nuclear Medicine Workers in Korea Using Thyroid uptake system

International Nuclear Information System (INIS)

Bahn, Young Kag; Oh, Gi Back; Lee, Chang Ho; Lee, Jong Doo; Yeom, Yu Sun; Hwang, Young Muk

2012-01-01

There are possibilities the radiation workers could intake the radiation when workers deal with radiation-materials. Therefore, internal radiation doses of radiation workers need to be assessed. Although an application of the nuclear medicine is continuously increased in Korea, there is not a proper tool and form to monitor the internal doses of nuclear medicine workers. However, it is possible to attain the internal doses of I-131 to evaluate using thyroid uptake and well count system. In this study, we measured and evaluated the I-131 internal doses of nuclear medicine workers in Korea using thyroid uptake and well count system and performed an air sampling

Postgraduate internal medicine residents' roles at patient discharge - do their perceived roles and perceptions by other health care providers correlate?

Science.gov (United States)

Card, Sharon Elizabeth; Ward, Heather A; Chipperfield, Dylan; Sheppard, M Suzanne

2014-01-01

Knowing one's own role is a key collaboration competency for postgraduate trainees in the Canadian competency framework (CanMEDS®). To explore methods to teach collaborative competency to internal medicine postgraduate trainees, baseline role knowledge of the trainees was explored. The perceptions of roles (self and others) at patient discharge from an acute care internal medicine teaching unit amongst 69 participants, 34 physicians (25 internal medicine postgraduate trainees and 9 faculty physicians) and 35 health care professionals from different professions were assessed using an adapted previously validated survey (Jenkins et al., 2001). Internal medicine postgraduate trainees agreed on 8/13 (62%) discharge roles, but for 5/13 (38%), there was a substantial disagreement. Other professions had similar lack of clarity about the postgraduate internal medicine residents' roles at discharge. The lack of interprofessional and intraprofessional clarity about roles needs to be explored to develop methods to enhance collaborative competence in internal medicine postgraduate trainees.

Abstract to publication ratio for papers presented at scientific meetings: how does emergency medicine compare?

Science.gov (United States)

Walby, A; Kelly, A M; Georgakas, C

2001-12-01

The aims of the present study were to determine the publication rate of abstracts presented by Australasian emergency physicians at major emergency medicine meetings and to identify the site of publication of papers. All free paper abstracts presented (oral and poster) by Australasian emergency physicians and trainees at five Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings between 1995 and 1998 were identified retrospectively from conference programmes. In order to determine whether or not the abstract had been published, the PubMed database (http://www4.ncbi.nlm.nih.gov/PubMed/) was searched using the presenter's name and key words from the abstract. In addition, a hand search of the non-abstracted journal Emergency Medicine was conducted. Of the 207 free paper abstracts identified, 73 (35%) had been published as full articles. Papers were published in a variety of journals; however, Emergency Medicine accounted for almost half the published papers. The mean time between presentation and publication was 12.6 months (median 11 months). The abstract to publication rate for papers presented by Australasian emergency physicians and trainees at Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings is 35%, which is lower than that reported by some other established specialities, but comparable to rates reported for US-based national and international emergency medicine meetings. Future research should look at barriers to the publication of findings and ways to assist the publication process.

Effect of Experience of Internal Medicine Residents during Infectious Disease Elective on Future Infectious Disease Fellowship Application

Science.gov (United States)

2017-10-04

Experience of !ntcrnal Medicine Residents during Infectious Disease Elective on Future lntCctious Di~casc Fcllo\\vship Application Sb. GRANT N_UMBER...undefined. Since 2008 at our institution. internal medicine (!!vi) residents have been required to do a four-\\\\’eek inpatient !D rotation as an intern... Medicine Residents during Infectious Disease Elective on Fut ure Infectious Disease Fellowship Application ~ Poeter# 1440 .,...._,: OVfil"S~ ti

Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency

Science.gov (United States)

Zeger, Scott L.; Kolars, Joseph C.

2007-01-01

BACKGROUND Knowledge acquisition is a goal of residency and is measurable by in-training exams. Little is known about factors associated with medical knowledge acquisition. OBJECTIVE To examine associations of learning habits on medical knowledge acquisition. DESIGN, PARTICIPANTS Cohort study of all 195 residents who took the Internal Medicine In-Training Examination (IM-ITE) 421 times over 4 years while enrolled in the Internal Medicine Residency, Mayo Clinic, Rochester, MN. MEASUREMENTS Score (percent questions correct) on the IM-ITE adjusted for variables known or hypothesized to be associated with score using a random effects model. RESULTS When adjusting for demographic, training, and prior achievement variables, yearly advancement within residency was associated with an IM-ITE score increase of 5.1% per year (95%CI 4.1%, 6.2%; p international medical school graduation, −3.4% (95%CI −6.5%, −0.36%; p = .03). CONCLUSIONS Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training. PMID:17468889

Overspecialized and undertrained? Patient diversity encountered by medical students during their internal medicine clerkship at a university hospital.

Science.gov (United States)

Melderis, Simon; Gutowski, Jan-Philipp; Harendza, Sigrid

2015-03-31

During the four-month internal medicine clerkship in their final year, undergraduate medical students are closely involved in patient care. Little is known about what constitutes their typical learning experiences with respect to patient diversity within the different subspecialties of internal medicine and during on call hours. 25 final year medical students (16 female, 9 male) on their internal medicine clerkship participated in this observational single-center study. To detail the patient diversity encountered by medical students at a university hospital during their 16-week internal medicine clerkship, all participants self-reported their patient contacts in the different subspecialties and during on call hours on patient encounter cards. Patients' chief complaint, suspected main diagnosis, planned diagnostic investigations, and therapy in seven different internal medicine subspecialties and the on call medicine service were documented. 496 PECs were analysed in total. The greatest diversity of chief complaints (CC) and suspected main diagnoses (SMD) was observed in patients encountered on call, with the combined frequencies of the three most common CCs or SMDs accounting for only 23% and 25%, respectively. Combined, the three most commonly encountered CC/SMD accounted for high percentages (82%/63%), i.e. less diversity, in oncology and low percentages (37%/32%), i.e. high diversity, in nephrology. The percentage of all diagnostic investigations and therapies that were classified as "basic" differed between the subspecialties from 82%/94% (on call) to 37%/50% (pulmonology/oncology). The only subspecialty with no significant difference compared with on call was nephrology for diagnostic investigations. With respect to therapy, nephrology and infectious diseases showed no significant differences compared with on call. Internal medicine clerkships at a university hospital provide students with a very limited patient diversity in most internal medicine

Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases

Directory of Open Access Journals (Sweden)

J. Scott Weese

2011-01-01

Full Text Available Urinary tract disease is a common reason for use (and likely misuse, improper use, and overuse of antimicrobials in dogs and cats. There is a lack of comprehensive treatment guidelines such as those that are available for human medicine. Accordingly, guidelines for diagnosis and management of urinary tract infections were created by a Working Group of the International Society for Companion Animal Infectious Diseases. While objective data are currently limited, these guidelines provide information to assist in the diagnosis and management of upper and lower urinary tract infections in dogs and cats.

Russian Identities and the Idea of International Society 20 Years after the Fall of the USSR

Directory of Open Access Journals (Sweden)

Andrey S. Makarychev

2014-12-01

Full Text Available In the paper the author analyzes different Russian international identities of the post-Soviet period. Stressing that the Russian identity discourse cannot be simply reduced to the Soviet one, the paper emphasizes the plurality of Russia’s identity discourses. At the same time the menu of Russian foreign policy identities to a large extent depends upon a variety of international structures in which Russia may imagine to engage with. The paper suggests that there are four possible types (models of the international society, which different Russian identities might be inscribed in. The author seeks to explain the range of Russian international identities by the variety of the patterns of international society which co-exist and offer alternative policy strategies for Moscow.

Radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy. Contributed papers

International Nuclear Information System (INIS)

2001-01-01

An International Conference on the Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy organized by the International Atomic Energy Agency and co-sponsored by the European Commission, the Pan American Health Organization and the World Health Organization was held in Malaga, Spain, from 26 to 30 March 2001. The Government of Spain hosted this Conference through the Ministerio de Sanidad y Consumo, the Consejo de Seguridad Nuclear, the Junta de Andalucia, the Universidad de Malaga and the Grupo de Investigacion en Proteccion Radiologica de la Universidad de Malaga (PRUMA). The Conference was organized in co-operation with the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), the International Commission on Radiological Protection (ICRP) and the following professional societies: International Organization of Medical Physicists (IOMP), International Radiation Protection Association (IRPA), International Society of Radiation Oncology (ISRO), International Society of Radiology (ISR), International Society of Radiographers and Radiological Technologists (ISRRT) and World Federation of Nuclear Medicine and Biology (WFNMB). This publication contains contributed papers submitted to the Conference Programme Committee. The papers are in one of the two working languages of this Conference, English and Spanish. The topics covered by the Conference are as follows: Radiological protection of patients in general diagnostic radiology (radiography), Radiological protection of patients in general diagnostic radiology (fluoroscopy), Radiological protection issues in specific uses of diagnostic radiology, such as mammography and computed tomography (with special consideration of the impact of digital techniques), Radiological protection in interventional radiology, including fluoroscopy not carried out by radiologists, Radiological protection of patients in nuclear medicine, Developing and

Radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy. Contributed papers

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-03-01

An International Conference on the Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy organized by the International Atomic Energy Agency and co-sponsored by the European Commission, the Pan American Health Organization and the World Health Organization was held in Malaga, Spain, from 26 to 30 March 2001. The Government of Spain hosted this Conference through the Ministerio de Sanidad y Consumo, the Consejo de Seguridad Nuclear, the Junta de Andalucia, the Universidad de Malaga and the Grupo de Investigacion en Proteccion Radiologica de la Universidad de Malaga (PRUMA). The Conference was organized in co-operation with the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), the International Commission on Radiological Protection (ICRP) and the following professional societies: International Organization of Medical Physicists (IOMP), International Radiation Protection Association (IRPA), International Society of Radiation Oncology (ISRO), International Society of Radiology (ISR), International Society of Radiographers and Radiological Technologists (ISRRT) and World Federation of Nuclear Medicine and Biology (WFNMB). This publication contains contributed papers submitted to the Conference Programme Committee. The papers are in one of the two working languages of this Conference, English and Spanish. The topics covered by the Conference are as follows: Radiological protection of patients in general diagnostic radiology (radiography), Radiological protection of patients in general diagnostic radiology (fluoroscopy), Radiological protection issues in specific uses of diagnostic radiology, such as mammography and computed tomography (with special consideration of the impact of digital techniques), Radiological protection in interventional radiology, including fluoroscopy not carried out by radiologists, Radiological protection of patients in nuclear medicine, Developing and

Recommendations for promoting the health and well-being of lesbian, gay, bisexual, and transgender adolescents: a position paper of the Society for Adolescent Health and Medicine.

Science.gov (United States)

2013-04-01

Adolescent health care providers frequently care for patients who identify as lesbian, gay, bisexual, or transgendered (LGBT), or who may be struggling with or questioning their sexual orientation or gender identity. Whereas these youth have the same health concerns as their non-LGBT peers, LGBT teens may face additional challenges because of the complexity of the coming-out process, as well as societal discrimination and bias against sexual and gender minorities. The Society for Adolescent Health and Medicine encourages adolescent providers and researchers to incorporate the impact of these developmental processes (and understand the impacts of concurrent potential discrimination) when caring for LGBT adolescents. The Society for Adolescent Health and Medicine also encourages providers to help positively influence policy related to LGBT adolescents in schools, the foster care system, and the juvenile justice system, and within the family structure. Consistent with other medical organizations, the Society for Adolescent Health and Medicine rejects the mistaken notion that LGBT orientations are mental disorders, and opposes the use of any type of reparative therapy for LGBT adolescents. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Role of international organizations in promoting nuclear medicine in the developing countries

Energy Technology Data Exchange (ETDEWEB)

Nofal, M

1993-12-31

Today, because of the diversity of its applications - radiation and radionuclides for medical and biological purposes are used in more countries and in more laboratories than any other application of atomic energy. International organizations, mainly the IAEA and the WHO, have played a significant role in the spread of this nuclear technology in developing countries. There are altogether 112 member states of the Agency, about 71 of them can be classified as developing countries. Out of them, nearly 56 have some kind of nuclear medicine. By that I mean there is some medical use of radioisotopes, be it imaging, radioimmunoassay or the old thyroid uptake. In most of these countries, the personnel working in nuclear medicine has been trained abroad. Training can be as short as few weeks abroad in the form of attendance at one of the four or six week training courses offered by an international organization. Occasionally it is through a fellowship offered by the same organizations. In terms of technology and training, Nuclear Medicine, in its present form, can thus be considered a high technology imported medicine in many of these countries

Role of international organizations in promoting nuclear medicine in the developing countries

International Nuclear Information System (INIS)

Nofal, M.

1992-01-01

Today, because of the diversity of its applications - radiation and radionuclides for medical and biological purposes are used in more countries and in more laboratories than any other application of atomic energy. International organizations, mainly the IAEA and the WHO, have played a significant role in the spread of this nuclear technology in developing countries. There are altogether 112 member states of the Agency, about 71 of them can be classified as developing countries. Out of them, nearly 56 have some kind of nuclear medicine. By that I mean there is some medical use of radioisotopes, be it imaging, radioimmunoassay or the old thyroid uptake. In most of these countries, the personnel working in nuclear medicine has been trained abroad. Training can be as short as few weeks abroad in the form of attendance at one of the four or six week training courses offered by an international organization. Occasionally it is through a fellowship offered by the same organizations. In terms of technology and training, Nuclear Medicine, in its present form, can thus be considered a high technology imported medicine in many of these countries

Basic survival needs and access to medicines--coming to grips with TRIPS: conversion + calculation.

Science.gov (United States)

Van Puymbroeck, Rudolf V

2010-01-01

"Access to medicines" is a broad concept. After a review of three authoritative frameworks that help to identify its constitutive components, this essay summarizes the actual situation on the ground in low- and middle-income countries on the basis of recent empirical work. An analysis of survey data from 36 countries concluded that developing countries should promote generic medicines as a key policy option for improving access to medicines. Taking an international perspective to that recommendation, this essay reviews the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and, particularly, how this agreement has been applied in practice. As shown by the experience of Thailand, Brazil, and the Philippines, in order to deal effectively with international pressures for an excessive application of the TRIPS Agreement, some sort of conversion experience appears to be required, which then leads to a switch from a private enterprise, supply-driven approach to a public health vision that insists on universal and affordable access. But moral conviction is not sufficient. In order to muster and sustain the political will to face down international forces, civil society and government offices must be able and ready to show the costs and other adverse consequences of the TRIPS-based model for medicines. This calculation needs to reach beyond the health sector and calls for new alliances, nationally as well as internationally. © 2010 American Society of Law, Medicine & Ethics, Inc.

New developments in education and training in sexual medicine.

Science.gov (United States)

Reisman, Yacov; Eardley, Ian; Porst, Hartmut

2013-04-01

INTRODUCTION.: The past 12 months have been historic ones for the field of Sexual Medicine in that we have seen the creation of the European Board examination in Sexual Medicine with the title of "Fellow of the European Committee on Sexual Medicine" (FECSM) offered to successful candidates. AIM.: The study aims to promote a high standard of care in Sexual Medicine. METHODS.: An important way of promoting high standards of care is by the development of training, regulation, and assessment framework. The background to these developments and the recent educational activities of the European Society for Sexual Medicine (ESSM) are described in this article. RESULTS.: The creation of the Multidisciplinary Joint Committee on Sexual Medicine (MJCSM) under the auspices of the European Union of Medical Specialists, with the primary purpose to develop the highest possible standards of training in Sexual Medicine in Europe, made it possible to create a process for qualification in Sexual Medicine. The ESSM educational activities created opportunities to support trainees in Sexual Medicine and the first MJCSM exam was held in Amsterdam with a high overall success rate. CONCLUSION.: These activities are intended to improve quality. The FECSM examination is the first of its type and provides a real opportunity for Sexual Medicine physicians to demonstrate and document their knowledge. © 2013 International Society for Sexual Medicine.

Internal Medicine Residents Reject ?Longer and Gentler? Training

OpenAIRE

Gopal, R. K.; Carreira, F.; Baker, W. A.; Glasheen, J. J.; Crane, L. A.; Miyoshi, T. J.; Prochazka, A. V.

2007-01-01

Background Increasing complexity of medical care, coupled with limits on resident work hours, has prompted consideration of extending Internal Medicine training. It is unclear whether further hour reductions and extension of training beyond the current duration of 3?years would be accepted by trainees. Objective We aimed to determine if further work-hour reductions and extension of training would be accepted by trainees and whether resident burnout affects their opinions. Design A postal surv...

Tomography in nuclear medicine. Proceedings of an international symposium

International Nuclear Information System (INIS)

1996-01-01

Single photon emission computed tomography (SPECT) is currently being used universally in clinical practice, while positron emission tomography (PET), originally developed as a technique for research, has also gradually moved from the research laboratory to the clinical environment. However, there are significant differences in nuclear medicine capabilities, especially in tomography, between developed and developing countries. The present status and future prospects of nuclear medicine tomography were the main topics of discussion at this latest international symposium, organized by the IAEA in co-operation with the World Health Organization and held in Vienna from 21 to 25 August 1995. The purpose of the meeting was to share experience and information on new developments and clinical applications of two promising tomographic techniques: SPECT and PET. Eight invited papers and 34 regular papers from 23 countries were presented. In addition, there was a panel discussion on the future and direction of tomography in nuclear medicine for developing countries. Refs, figs, tabs

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

Science.gov (United States)

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

2013-12-01

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

Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey.

Science.gov (United States)

Goren, Eric N; Leizman, Debra S; La Rochelle, Jeffrey; Kogan, Jennifer R

2015-09-01

Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described. We aimed to determine the current status of medical students' overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators' perceptions of the importance of overnight work during internal medicine rotations. In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1-5 Likert scale, 1 = very unimportant and 5 =  ery important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively. The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences for medical students.

Meeting American Geriatrics Society Competencies: Are Residents Meeting Expectations for Quality Care of Older Adults?

Science.gov (United States)

Bynum, Debra L; Wilson, Lindsay A; Ong, Thuan; Callahan, Kathryn E; Dalton, Thomas; Ohuabunwa, Ugochi

2015-09-01

In order to determine how often internal medicine and family medicine residents performed specific actions related to the geriatric competencies established by the American Geriatrics Society (AGS) when caring for older hospitalized adults, a cross-sectional anonymous survey of residents at the University of North Carolina, University of Washington, Wake Forest University, Duke University, and Emory University was undertaken. Data on frequency of self-reported behaviors were analyzed, with comparisons made for different levels of training, institution, and program. A total of 375 residents responded for an overall response rate of 48%. Residents reported that they often do not demonstrate all of the AGS recommended core competencies when caring for older adults in the hospital setting. Residents report more frequently performing activities that are routinely integrated into hospital systems such as reviewing medication lists, working with an interdisciplinary team, evaluating for inappropriate bladder catheters, and evaluating for pressure ulcers. There were no consistent differences between institutions and only minor differences noted between Family Medicine and Internal Medicine residents. Operationalizing core competencies by integrating them into hospital systems' quality process indicators may prompt more consistent high-quality care and ensure systems support residents' competence. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation.

Science.gov (United States)

McMahon, Chris G; Althof, Stanley E; Waldinger, Marcel D; Porst, Hartmut; Dean, John; Sharlip, Ira D; Adaikan, P G; Becher, Edgardo; Broderick, Gregory A; Buvat, Jacques; Dabees, Khalid; Giraldi, Annamaria; Giuliano, François; Hellstrom, Wayne J G; Incrocci, Luca; Laan, Ellen; Meuleman, Eric; Perelman, Michael A; Rosen, Raymond C; Rowland, David L; Segraves, Robert

2008-07-01

The medical literature contains several definitions of premature ejaculation (PE). The most commonly quoted definition, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision, and other definitions of PE are all authority based rather than evidence based, and have no support from controlled clinical and/or epidemiological studies. The aim of this article is to develop a contemporary, evidence-based definition of PE. In August 2007, the International Society for Sexual Medicine (ISSM) appointed several international experts in PE to an Ad Hoc Committee for the Definition of Premature Ejaculation. The committee met in Amsterdam in October 2007 to evaluate the strengths and weaknesses of current definitions of PE, to critique the evidence in support of the constructs of ejaculatory latency, ejaculatory control, sexual satisfaction, and personal/interpersonal distress, and to propose a new evidence-based definition of PE. The committee unanimously agreed that the constructs that are necessary to define PE are rapidity of ejaculation, perceived self-efficacy and control, and negative personal consequences from PE. The committee proposed that lifelong PE be defined as ". . . a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration, and the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy." This definition is limited to men with lifelong PE who engage in vaginal intercourse. The panel concluded that there are insufficient published objective data to propose an evidence-based definition of acquired PE. The ISSM definition of lifelong PE represents the first evidence-based definition of PE. This definition will hopefully lead to the development of new tools and Patient Reported

Communication skills curriculum for foreign medical graduates in an internal medicine residency program.

Science.gov (United States)

Ramaswamy, Ravishankar; Williams, Alicia; Clark, Elizabeth M; Kelley, Amy S

2014-11-01

Effective communication is an important aspect of caring for the elderly, who are more likely to have multimorbidity, limited health literacy, and psychosocial barriers to care. About half of Internal Medicine (IM) trainees in the United States are foreign medical graduates, and may not have been exposed to prior communication skills education. This novel communication skills curriculum for IM interns aimed to increase trainees' confidence and use of specific communication tools with older adults, particularly in delivering bad news and conducting family meetings. The workshop consisted of two interactive sessions in a small group with two learners and one or two facilitators, during the 4-week geriatrics block in IM internship training year. Twenty-three IM interns at an urban Veterans Affairs Medical Center were surveyed at the beginning and at the end of the 4-week block and 3 months after completion of the workshop about their knowledge, confidence, and skill in communication and asked about challenges to effective communication with older adults. The primary outcome measure was change in self-reported confidence and behavior in communication at 4 weeks. On a 4-point Likert scale, there was average improvement of 0.70 in self-reported confidence in communication, which was sustained 3 months after completion of the workshop. Participants reported several patient, physician, and system barriers to effective communication. Communication skills education in a small-group setting and the opportunity for repeated practice and self-reflection resulted in a sustained increase in overall confidence in IM interns in communication with older adults and may help overcome certain patient- and physician-specific communication barriers. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

A nomogram to predict the probability of passing the American Board of Internal Medicine examination

Directory of Open Access Journals (Sweden)

Andrei Brateanu

2012-10-01

Full Text Available Background : Although the American Board of Internal Medicine (ABIM certification is valued as a reflection of physicians’ experience, education, and expertise, limited methods exist to predict performance in the examination. Purpose : The objective of this study was to develop and validate a predictive tool based on variables common to all residency programs, regarding the probability of an internal medicine graduate passing the ABIM certification examination. Methods : The development cohort was obtained from the files of the Cleveland Clinic internal medicine residents who began training between 2004 and 2008. A multivariable logistic regression model was built to predict the ABIM passing rate. The model was represented as a nomogram, which was internally validated with bootstrap resamples. The external validation was done retrospectively on a cohort of residents who graduated from two other independent internal medicine residency programs between 2007 and 2011. Results : Of the 194 Cleveland Clinic graduates used for the nomogram development, 175 (90.2% successfully passed the ABIM certification examination. The final nomogram included four predictors: In-Training Examination (ITE scores in postgraduate year (PGY 1, 2, and 3, and the number of months of overnight calls in the last 6 months of residency. The nomogram achieved a concordance index (CI of 0.98 after correcting for over-fitting bias and allowed for the determination of an estimated probability of passing the ABIM exam. Of the 126 graduates from two other residency programs used for external validation, 116 (92.1% passed the ABIM examination. The nomogram CI in the external validation cohort was 0.94, suggesting outstanding discrimination. Conclusions : A simple user-friendly predictive tool, based on readily available data, was developed to predict the probability of passing the ABIM exam for internal medicine residents. This may guide program directors’ decision

Recommended integrative medicine competencies for family medicine residents.

Science.gov (United States)

Locke, Amy B; Gordon, Andrea; Guerrera, Mary P; Gardiner, Paula; Lebensohn, Patricia

2013-01-01

The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care. © 2013 Elsevier Inc. All rights reserved.

Closing the gap in travel medicine: reframing research questions for a new era.

Science.gov (United States)

Chen, Lin H; Leder, Karin; Wilson, Mary E

2017-07-01

Travel medicine needs are changing. New patterns of travel, including greater travel by individuals from emerging economies with different values in costs, risks and benefits, must be considered. This review aims to (1) highlight selected studies that have been published that address previously identified gaps in knowledge; (2) propose possible ways to consider questions regarding travel medicine practice for travelers from emerging economies, underscoring priorities for research focusing on these important populations; (3) highlight potential deficiencies in relevance of current international guidelines as they pertain to travelers from emerging economies; (4) frame research questions for travelers from emerging economies and (5) consider roles for ISTM in closing the gap. We reviewed past travel medicine research priorities published in 2010 to identify publications that responded to some research questions posed. We also reviewed CDC and WHO recommendations and assessed their applicability to travelers from emerging economies. Recent publications have responded to some research questions, but gaps remain and new questions have emerged. Re-framing of several key research questions is needed for travelers from emerging economies. A new challenge looms for traditional travel medicine fields to identify and attend to knowledge and guideline gaps, particularly to rethink questions regarding travel medicine to make them relevant for travelers from emerging economies. The International Society of Travel Medicine is well positioned to assist emerging economies assess their resources and needs, formulate research priorities and tailor the development of travel medicine into a framework aligned to their requirements. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Knowledge, attitudes, and practices evaluation about travel medicine in international travelers and medical students in Chile.

Science.gov (United States)

Guerrero-Lillo, Lisette; Medrano-Díaz, Jorge; Pérez, Carmen; Chacón, Rodrigo; Silva-Urra, Juan; Rodriguez-Morales, Alfonso J

2009-01-01

Because information about travel medicine in Chile is lacking, a knowledge, attitudes, and practices evaluation in international travelers and medical students was done. The travelers and medical students did not know the travel medicine and sanitary conditions of their destinations, although they perceived travel-associated health risks, but <10% had any vaccination and 5% got sick during international trips.

Global view on radiation protection in medicine

International Nuclear Information System (INIS)

Vano, E.

2011-01-01

When planning good management of ionising radiation in medicine, key factors such as ensuring that health professionals work together and convincing them that radiation protection (RP) represents a substantial part of the quality management system in their clinical practice are of utmost importance. The United Nations Scientific Committee on the Effects of Atomic Radiation has decided that one of the thematic priorities will be medical radiation exposure of patients. The International Commission on Radiological Protection has recently updated the report on RP in medicine and continues to work on focused documents centred on specific areas where advice is needed. The roles of the International Atomic Energy Agency, World Health Organization and the European Commission, in the area of RP in medicine, are described in the present document. The industry, the standardisation organisations as well as many scientific and professional societies are also dedicating significant effort to radiation safety aspects in medicine. Some of the efforts and priorities contemplated in RP in medicine over the coming years are suggested. The best outcome will be accomplished when all the actors, i.e. medical doctors, other health professionals, regulators, health authorities and the industry manage to work together. (authors)

4th International Workshop on Adaptive Optics for Industry and Medicine

CERN Document Server

Wittrock, Ulrich

2005-01-01

This book treats the development and application of adaptive optics for industry and medicine. The contributions describe recently developed components for adaptive-optics systems such as deformable mirrors, wavefront sensors, and mirror drivers as well as complete adaptive optical systems and their applications in industry and medicine. Applications range from laser-beam forming and adaptive aberration correction for high-power lasers to retinal imaging in ophthalmology. The contributions are based on presentations made at the 4th International Workshop on Adaptive Optics in Industry and Medicine which took place in Münster, Germany, in October 2003. This highly successful series of workshops on adaptive optics started in 1997 and continues with the 5th workshop in Beijing in 2005.

Internal Medicine Residents Do Not Accurately Assess Their Medical Knowledge

Science.gov (United States)

Jones, Roger; Panda, Mukta; Desbiens, Norman

2008-01-01

Background: Medical knowledge is essential for appropriate patient care; however, the accuracy of internal medicine (IM) residents' assessment of their medical knowledge is unknown. Methods: IM residents predicted their overall percentile performance 1 week (on average) before and after taking the in-training exam (ITE), an objective and well…

The practice of travel medicine in Europe.

Science.gov (United States)

Schlagenhauf, P; Santos-O'Connor, F; Parola, P

2010-03-01

Europe, because of its geographical location, strategic position on trade routes, and colonial past, has a long history of caring for travellers' health. Within Europe, there is great diversity in the practice of travel medicine. Some countries have travel medicine societies and provisions for a periodic distribution of recommendations, but many countries have no national pre-travel guidelines and follow international recommendations such as those provided by the WHO. Providers of travel medicine include tropical medicine specialists, general practice nurses and physicians, specialist 'travel clinics', occupational physicians, and pharmacists. One of the core functions of the European Centre for Disease Prevention and Control-funded network of travel and tropical medicine professionals, EuroTravNet, is to document the status quo of travel medicine in Europe. A three-pronged approach is used, with a real-time online questionnaire, a structured interview with experts in each country, and web searching.

Views of new internal medicine faculty of their preparedness and competence in physician-patient communication

Directory of Open Access Journals (Sweden)

Duncan Alan K

2006-05-01

Full Text Available Abstract Background We sought to assess self-rated importance of the medical interview to clinical practice and competence in physician-patient communication among new internal medicine faculty at an academic medical center. Methods Since 2001, new internal medicine faculty at the Mayo Clinic College of Medicine (Rochester, Minnesota have completed a survey on physician-patient communication. The survey asks the new faculty to rate their overall competence in medical interviewing, the importance of the medical interview to their practice, their confidence and adequacy of previous training in handling eight frequently encountered challenging communication scenarios, and whether they would benefit from additional communication training. Results Between 2001 and 2004, 75 general internists and internal medicine subspecialists were appointed to the faculty, and of these, 58 (77% completed the survey. The faculty rated (on a 10-point scale the importance of the medical interview higher than their competence in interviewing; this difference was significant (average ± SD, 9.4 ± 1.0 vs 7.7 ± 1.2, P Conclusion Although new internal medicine faculty rate high the importance of the medical interview, they rate their competence and adequacy of previous training in medical interviewing relatively low, and many indicate that they would benefit from additional communication training. These results should encourage academic medical centers to make curricula in physician-patient communication available to their faculty members because many of them not only care for patients, but also teach clinical skills, including communication skills, to trainees.

Short Sleep Times Predict Obesity in Internal Medicine Clinic Patients

Science.gov (United States)

Buscemi, Dolores; Kumar, Ashwani; Nugent, Rebecca; Nugent, Kenneth

2007-01-01

Study Objectives: Epidemiological studies have demonstrated an association between short sleep times and obesity as defined by body mass index (BMI). We wanted to determine whether this association occurs in patients with chronic medical diagnoses since the number of confounding factors is likely higher in patients than the general population. Methods: Two hundred patients attending internal medicine clinics completed a survey regarding sleep habits, lifestyle characteristics, and medical diagnoses. An independent surveyor collected the information on the questionnaires and reviewed the medical records. Height and weight were measured by clinic personnel. Data were analyzed with multivariate logistic regression. Results: Subjects with short sleep times (< 7 hours) had an increased likelihood of obesity as defined by a BMI ≥ 30 kg/m2 when compared to the reference group of (8, 9] hours (odds ratio 2.93; 95% confidence interval, 1.06–8.09). There was a U-shaped relationship between obesity and sleep time in women but not in men. Young age (18 to 49 years), not smoking, drinking alcohol, hypertension, diabetes, and sleep apnea were also associated with obesity in the overall model. Conclusions: This study demonstrates an association between short sleep times and obesity in undifferentiated patients attending an internal medicine clinic using models adjusting for age, lifestyle characteristics, and some medical diagnoses. The U-shaped relationship in women suggests that sleep patterns may have gender specific associations. These observations provide the background for therapeutic trials in weight loss in patients with established medical problems. Citation: Buscemi D; Kumar A; Nugent R; Nugent K. Short sleep times predict obesity in internal medicine clinic patients. J Clin Sleep Med 2007;3(7):681–688. PMID:18198800

The Third International Genomic Medicine Conference (3rd IGMC, 2015: overall activities and outcome highlights

Directory of Open Access Journals (Sweden)

Muhammad Abu-Elmagd

2016-10-01

Full Text Available Abstract The Third International Genomic Medicine Conference (3rd IGMC was organised by the Centre of Excellence in Genomic Medicine Research (CEGMR at the King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia (KSA. This conference is a continuation of a series of meetings, which began with the first International Genomic Medicine Conference (1st IGMC, 2011 followed by the second International Genomic Medicine Conference (2nd IGMC, 2013. The 3rd IGMC meeting presented as a timely opportunity to bring scientists from across the world to gather, discuss, and exchange recent advances in the field of genomics and genetics in general as well as practical information on using these new technologies in different basic and clinical applications. The meeting undoubtedly inspired young male and female Saudi researchers, who attended the conference in large numbers, as evidenced by the oversubscribed oral and poster presentations. The conference also witnessed the launch of the first content for npj Genomic Medicine, a high quality new journal was established in partnership by CEGMR with Springer Nature and published as part of the Nature Partner Journal series. Here, we present a brief summary report of the 2-day meeting including highlights from the oral presentations, poster presentations, workshops, poster prize-winners and comments from the distinguished scientists.

Physical Activity and Psychological Benefits. International Society of Sport Psychology Position Statement.

Science.gov (United States)

Physician and Sportsmedicine, 1992

1992-01-01

International Society of Sport Psychology clarifies the psychological benefits of physical activity, noting the positive relationship between physical activity level and mental health. Exercise can reduce anxiety, decrease depression levels, reduce neuroticism and anxiety, reduce stress, and have beneficial emotional effects for both sexes across…

Sepsis in Internal Medicine wards: current knowledge, uncertainties and new approaches for management optimization.

Science.gov (United States)

Zaccone, Vincenzo; Tosoni, Alberto; Passaro, Giovanna; Vallone, Carla Vincenza; Impagnatiello, Michele; Li Puma, Domenica Donatella; De Cosmo, Salvatore; Landolfi, Raffaele; Mirijello, Antonio

2017-11-01

Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving. This is due to Internists' increased adherence to guidelines and "bundles". The routine use of SOFA score helps physicians in the definition of septic patients, even if the optimal score has still to come. Point-of-care ultrasonography, lactates, procalcitonin and beta-d-glucan are of help for treatment optimization. The purpose of this narrative review is to focus on the management of sepsis in Internal Medicine departments, particularly on crucial concepts regarding diagnosis, risk assessment and treatment. Key Messages Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. The prevalence of sepsis is constantly increasing, affecting more hospital patients than any other disease. At least half of patients affected by sepsis are admitted to Internal Medicine wards. Adherence to guidelines, routine use of clinical and lab scores and point-of-care ultrasonography are of help for early recognition of septic patients and treatment optimization.

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

Science.gov (United States)

Bartůněk, Petr

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

Radiation physics in medicine and veterinary medicine studies

International Nuclear Information System (INIS)

Popovic, D.; Djuric, G.

2000-01-01

Medical and veterinary medicine staff and specialists represent an important decision making group in national administration and institutions dealing with radiation protection and environmental protection matters in general. Still, their education in physics, especially in radiation physics is fragmentary and loose, both from technical and theoretical point of view. Within medicine and veterinary medicine studies as well as within other biomedical sciences (biology, pharmacology, biotechnology) radiation physics is usually incorporated in the first year curricula as a part of general physics or biophysics course. Some segments of radiation physics mainly as a technical base for different instrumentation methods and techniques could be also found within different graduate and post-graduate courses of radiology, physical therapy, radiation hygiene, environmental protection, etc. But the traditional approach in presenting the matter and inflexibility of the educational system strongly confront the growing public concern for the environmental problems dealing with radiation and demands for better informing and technical education for those involved in informing and administration. This paper considers some of these problems presenting a new approach in education in radiation physics for medical and veterinary medicine students based on education through student projects and work in the field, as well as on the strong collaboration among administration, universities and professional societies on the national and international level. (author)

Problematic communications during 2016 fellowship recruitment in internal medicine.

OpenAIRE

Cornett, PA; Williams, C; Alweis, RL; McConville, J; Frank, M; Dalal, B; Kopelman, RI; Luther, VP; O'connor, AB; Muchmore, EA

2017-01-01

ABSTRACT Some internal medicine residency program directors have expressed concerns that their third-year residents may have been subjected to inappropriate communication during the 2016 fellowship recruitment season. The authors sought to study applicants’ interpersonal communication experiences with fellowship programs. Many respondents indicated that they had been asked questions that would constitute violations of the National Residency Matching Program (NRMP) Communications Code of Condu...

Deconstructing Civil Society Actors and Functions: On the Limitations of International Frameworks for Fragile States

Directory of Open Access Journals (Sweden)

Simone Datzberger

2018-02-01

Full Text Available Over the past three decades, there has been a steady increase of funds by the international community to support civil society organizations (CSOs in fragile states. Surprisingly, this growing attention has not strengthened local civil society landscapes in a way that it would lead to processes of social transformation. On the contrary, civic freedom and space is shrinking around the globe. In analyzing prominent international aid-effectiveness frameworks and donor strategies towards civil society, this paper will put forward one central argument. The way in which civil society actors and functions are currently appropriated threatens deep-rooted social transformation thereby impeding processes of structural and political change—necessary for the transition from conflict to sustainable peace. In delineating, how actors and functional approaches informed peacebuilding and development policy and practice, their strengths and limitations will be examined. Doing so, we draw on different case studies and examples from the literature. We find that existing frameworks for fragile states operate on a presumed model of a public sphere and civil society that may or may not exist. Such an approach disregards an organic formation of a civil society landscape thereby impeding processes of structural, social, and political change in times of fragility.

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

Science.gov (United States)

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

2016-01-01

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

Core Addiction Medicine Competencies for Doctors, An International Consultation on Training.

LENUS (Irish Health Repository)

Ayu, Astri Parawita

2017-07-18

Despite the high prevalence of substance use disorders, associated comorbidities and the evidence-base upon which to base clinical practice, most health systems have not invested in standardised training of healthcare providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, we undertook this study to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education.

Radiation and society: Comprehending radiation risk. V. 3. Proceedings of an international conference

International Nuclear Information System (INIS)

1997-01-01

This IAEA international conference on Radiation and Society was the first major international meeting devoted to the comprehension of radiation risk, public attitude towards radiation risk and hazards encountered by the general public in contaminated areas. Volume three of the proceedings contains the speeches, ten introductory papers, summaries of the technical discussion sessions, the key note paper on uncertainties in the health impact of environmental pollutants. Refs, figs, tabs

Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

Directory of Open Access Journals (Sweden)

Sonja E. Raaum

2015-10-01

Full Text Available Purpose: Smartphone technology offers a multitude of applications (apps that provide a wide range of functions for healthcare professionals. Medical trainees are early adopters of this technology, but how they use smartphones in clinical care remains unclear. Our objective was to further characterize smartphone use by medical trainees at two United States academic institutions, as well as their prior training in the clinical use of smartphones. Methods: In 2014, we surveyed 347 internal medicine and emergency medicine resident physicians at the University of Utah and Brigham and Women’s Hospital about their smartphone use and prior training experiences. Scores (0%–100% were calculated to assess the frequency of their use of general features (email, text and patient-specific apps, and the results were compared according to resident level and program using the Mann-Whitney U-test. Results: A total of 184 residents responded (response rate, 53.0%. The average score for using general features, 14.4/20 (72.2% was significantly higher than the average score for using patient-specific features and apps, 14.1/44 (33.0%, P<0.001. The average scores for the use of general features, were significantly higher for year 3–4 residents, 15.0/20 (75.1% than year 1–2 residents, 14.1/20 (70.5%, P=0.035, and for internal medicine residents, 14.9/20 (74.6% in comparison to emergency medicine residents, 12.9/20 (64.3%, P= 0.001. The average score reflecting the use of patient-specific apps was significantly higher for year 3–4 residents, 16.1/44 (36.5% than for year 1–2 residents, 13.7/44 (31.1%; P=0.044. Only 21.7% of respondents had received prior training in clinical smartphone use. Conclusion: Residents used smartphones for general features more frequently than for patient-specific features, but patient-specific use increased with training. Few residents have received prior training in the clinical use of smartphones.

Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Mobile Learning (Lisbon, Portugal, March 14-16, 2013)

Science.gov (United States)

Sánchez, Inmaculada Arnedillo, Ed.; Isaías, Pedro, Ed.

2013-01-01

These proceedings contain the papers of the International Conference on Mobile Learning 2013, which was organised by the International Association for Development of the Information Society, in Lisbon, Portugal, March 14-16, 2013. The Mobile Learning 2013 International Conference seeks to provide a forum for the presentation and discussion of…

Information exchange of the Atomic Energy Society of Japan with nuclear societies worldwide

International Nuclear Information System (INIS)

Hori, Masao; Tomita, Yasushi

2000-01-01

The Atomic Energy Society of Japan (AESJ) exchanges information with nuclear societies worldwide by intersocietal communication through international councils of nuclear societies and through bilateral agreements between foreign societies and by such media as international meetings, publications, and Internet applications

Clinical Holistic Medicine: Chronic Pain in Internal Organs

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available Holistic medicine seems to be efficient in the treatment of chronic pain in internal organs, especially when the pain has no known cause. It is quite surprising that while chronic pain can be one of the toughest challenges in the biomedical clinic, it is often one of the simplest things to alleviate in the holistic clinic. These pains are regarded as being caused by repressed emotions and are explained as psychosomatic reactions. Using holistic medicine, the patients can often be cured of their suffering when they assume responsibility for the repressed feelings. The holistic process theory of healing states that the return to the natural (pain free state of being is possible whenever the person obtains the resources needed for existential healing. This shift is explained by the related quality of life and life mission theories. The resources needed are “holding” or genuine care in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for the holistic healing to take place are “love” and trust. Obtaining the full trust of the patient, therefore, seems to be the biggest challenge of holistic medicine, especially when dealing with a patient in pain.

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

Science.gov (United States)

Kabelka, Ladislav

2017-10-01

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

Travel medicine physician adherence to guidelines for the emergency self treatment of malaria.

Science.gov (United States)

Flaherty, Gerard T; Walden, Lucas M; Townend, Michael

2016-05-01

Few studies have examined emergency self treatment (EST) antimalarial prescribing patterns. 110 physician-members of the Travel Medicine Society of Ireland and British Global and Travel Health Association participated in this study. There was a trend towards the prescription of EST for travel to remote low-risk malaria areas; for long-term residents living in low-risk areas; and for frequent travellers to low-risk areas. This study provides insights into the use of EST in travellers' malaria. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients

Science.gov (United States)

Huang, Chun-Che; Huang, Yu-Tung; Hsu, Nin-Chieh; Chen, Jin-Shing; Yu, Chong-Jen

2016-01-01

Abstract Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan. A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ≥20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays. Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16–1.39; P internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment. PMID:26871788

Complementary and alternative medicine use by visitors to rural Japanese family medicine clinics: results from the international complementary and alternative medicine survey.

Science.gov (United States)

Shumer, Gregory; Warber, Sara; Motohara, Satoko; Yajima, Ayaka; Plegue, Melissa; Bialko, Matthew; Iida, Tomoko; Sano, Kiyoshi; Amenomori, Masaki; Tsuda, Tsukasa; Fetters, Michael D

2014-09-25

There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world, however previous research done in Japan has focused primarily on CAM use in major cities. The purpose of this study was to develop and distribute a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) to assess the use of CAM among people who visit rural Japanese family medicine clinics. Using a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q), a cross-sectional survey was conducted in three rural family medicine clinics. All patients and those accompanying patients who met inclusion criteria were eligible to participate. Data were entered into SPSS Statistics and analyzed for use by age, gender, and location. Of the 519 respondents who participated in the project, 415 participants reported CAM use in the past 12 months (80.0%). When prayer is excluded, the prevalence of CAM use drops to 77.3% in the past year, or 403 respondents. The most common forms of CAM used by respondents were pain relief pads (n = 170, 32.8%), herbal medicines/supplements (n = 167, 32.2%), and massage by self or family (n = 166, 32.0%). Female respondents, individuals with higher levels of education, and those with poorer overall health status were more likely to use CAM than respondents without these characteristics. Only 22.8% of CAM therapies used were reported to physicians by survey participants. These data indicate that CAM use in rural Japan is common. The results are consistent with previous studies that show that Japanese individuals are more interested in forms of CAM such as pain relief pads and massage, than in mind-body forms of CAM like relaxation and meditation. Due to the high utilization of certain CAM practices, and given that most CAM users do not disclose their CAM use to their doctors, we conclude that physicians in rural Japan would benefit by asking about CAM use

[On the occasion of the fiftieth anniversary of the Croatian scientific society for the history of health culture].

Science.gov (United States)

Škrobonja, Ante; Salopek, Igor

2017-12-01

A group of intellectuals, predominantly lecturers from the Faculty of Medicine, founded in Rijeka on May 29, 1966 the branch of the Yugoslav Scientific Society for the History of Health Culture, which after the independence of Croatia in 1991 continues its work under the name Croatian Scientific Society for the History of Health Culture. Over the past 50 years, within activities of the Society more than 250 professional and scientific conferences have been held in Rijeka and other Croatian cities. In addition, a dozen of professional-scientific trips to neighbouring countries were organized. From the original activities are highlighted the science conventions with international participation "Rijeka and Its Citizens in Medical History", where, since 2001, have been regularly presented free topics from other regions. Another important activity is the international journal "AMHA - Acta medico-historica Adriatica", which has been published since 2003 with two issues per year. Today, this is an established journal present on Medline - PubMed Service, andindexed in several respectable international databases, which guarantees quality and enables access to the world's research community. In 2005, the accompanying "AMHA Library" was launched - a series of monographs devoted to the most important medical historians, scientific conferences dedicated to individual medical laureates, and similar subjects. Ten years ago, the Society's work has been refined by the activities of a group of medical students who, under the motto "In honour of Asclepius and Orpheus", strive to affirm the links between medicine and art. Of the many performances the most significant is the traditional humanitarian concert, attended by students from all faculties of medicine from Croatia and Ljubljana.

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

NARCIS (Netherlands)

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

2013-01-01

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

Student performance of the general physical examination in internal medicine: an observational study

Science.gov (United States)

2014-01-01

Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

Examining the Reading Level of Internet Medical Information for Common Internal Medicine Diagnoses.

Science.gov (United States)

Hutchinson, Nora; Baird, Grayson L; Garg, Megha

2016-06-01

The National Institutes of Health (NIH) recommend that health materials be written at a grade 6-7 reading level, which has generally not been achieved in online reading materials. Up to the present time, there have not been any assessments focused on the reading level of online educational materials across the most popular consumer Web sites for common internal medicine diagnoses. In this study, we examined the readability of open-access online health information for 9 common internal medicine diagnoses. Nine of the most frequently encountered inpatient and ambulatory internal medicine diagnoses were selected for analysis. In November and December 2014, these diagnoses were used as search terms in Google, and the top 5 Web sites across all diagnoses and a diagnosis-specific site were analyzed across 5 validated reading indices. On average, the lowest reading grade-level content was provided by the NIH (10.7), followed by WebMD (10.9), Mayo Clinic (11.3), and diagnosis-specific Web sites (11.5). Conversely, Wikipedia provided content that required the highest grade-level readability (14.6). The diagnoses with the lowest reading grade levels were chronic obstructive pulmonary disease (10.8), followed by diabetes (10.9), congestive heart failure (11.7), osteoporosis (11.7) and hypertension (11.7). Depression had the highest grade-level readability (13.8). Despite recommendations for patient health information to be written at a grade 6-7 reading level, our examination of online educational materials pertaining to 9 common internal medicine diagnoses revealed reading levels significantly above the NIH recommendation. This was seen across both diagnosis-specific and general Web sites. There is a need to improve the readability of online educational materials made available to patients. These improvements have the potential to greatly enhance patient awareness, engagement, and physician-patient communication. Published by Elsevier Inc.

Prevalence of delirium in hospitalized internal medicine and surgical adult patients in Shohadaye ashayer hospital of Khoram abad

Directory of Open Access Journals (Sweden)

raheleh Asaee

2008-10-01

Full Text Available Asaee R1, Nasari H2,Hoseini S3 1. Assistant professor, Department of Physiology, Faculty of Medicine, Lorestanl University of Medical Sciences, Khorramabad, Iran 1. Assistant professor, Department of Psychiatry, Faculty of Medicine, Lorestanl University of Medical Sciences, Khorramabad, Iran 2. G.P, Khorramabad, Iran Abstract Background: Delirium is common in elderly persons and in hospitalized patients especially after surgical procedures. But many of them are undetected and don’t receive treatment so they involve with increased mortality and morbidity, adverse outcomes, length of hospital stay and mental disability sequels. Unfortunetly , despite the importance of this syndrom , physicians and staff are able to diagnose only one thirth of the patients. Material and methods: In this cross sectional study, 240 inpatiants (120 from surgery ward and 120 from miernal medicine ward from Shohadaye Ashayer hospital of Khorramabad were selected randomly. The diagnostic criteria for delirium were Mini-Mental state examination (MMSE questionnaire, and patients daily examination for 4 days by MMSE. Results: Delirium was observed in 37 (30.8% of the patients of internal medicine ward and 25 (20.8% of the patients of surgery ward. 27 (22.5% of the patients of internal medicine ward and 37 (30.8% of the patients of surgery ward were suspicious for delirium. In age group of 58-77 years in surgery ward and patients over 77 years in internal medicine ward had the most frequency of delirium. There was significant relationship (p=0.01 between two sex in surgery ward. But there was not significant difference (p=0.92 between two sex in internal medicine ward for delirium. Conclusion: Reading the results of this study and frequency of delirum in surgery and internal medicine wards, presence of a psychiatrist in mentioned wards is necessary of early diagnosis and control of delirium.

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

Developing educators, investigators, and leaders during internal medicine residency: the area of distinction program.

Science.gov (United States)

Kohlwes, R Jeffrey; Cornett, Patricia; Dandu, Madhavi; Julian, Katherine; Vidyarthi, Arpana; Minichiello, Tracy; Shunk, Rebecca; Jain, Sharad; Harleman, Elizabeth; Ranji, Sumant; Sharpe, Brad; O'Sullivan, Patricia; Hollander, Harry

2011-12-01

Professional organizations have called for individualized training approaches, as well as for opportunities for resident scholarship, to ensure that internal medicine residents have sufficient knowledge and experience to make informed career choices. To address these training issues within the University of California, San Francisco, internal medicine program, we created the Areas of Distinction (AoD) program to supplement regular clinical duties with specialized curricula designed to engage residents in clinical research, global health, health equities, medical education, molecular medicine, or physician leadership. We describe our AoD program and present this initiative's evaluation data. METHODS AND PROGRAM EVALUATION: We evaluated features of our AoD program, including program enrollment, resident satisfaction, recruitment surveys, quantity of scholarly products, and the results of our resident's certifying examination scores. Finally, we described the costs of implementing and maintaining the AoDs. AoD enrollment increased from 81% to 98% during the past 5 years. Both quantitative and qualitative data demonstrated a positive effect on recruitment and improved resident satisfaction with the program, and the number and breadth of scholarly presentations have increased without an adverse effect on our board certification pass rate. The AoD system led to favorable outcomes in the domains of resident recruitment, satisfaction, scholarship, and board performance. Our intervention showed that residents can successfully obtain clinical training while engaging in specialized education beyond the bounds of core medicine training. Nurturing these interests 5 empower residents to better shape their careers by providing earlier insight into internist roles that transcend classic internal medicine training.

Characteristics of Homeopathy Users among Internal Medicine Patients in Germany.

Science.gov (United States)

Steel, Amie; Cramer, Holger; Leung, Brenda; Lauche, Romy; Adams, Jon; Langhorst, Jost; Dobos, Gustav

2016-01-01

Homeopathy use continues to grow in many European countries, and some studies have examined the characteristics of patients using homeopathy within the general population. The aim of this study was to identify predictors for homeopathy use among internal medicine patients. A cross-sectional analysis was conducted among all patients being referred to the Department of Internal and Integrative Medicine at Essen, Germany, over a 3-year period. The analysis examined whether patients had used homeopathy for their primary medical complaint before, the perceived benefit, and the perceived harm of homeopathy use. Odds ratios with 95% confidence intervals were calculated using multiple logistic regression analysis. Of 2,045 respondents, 715 (35.0%) reported having used homeopathy for their primary medical complaint (diagnosis according to the International Statistical Classification of Diseases and Related Health Problems), with 359 (50.2%) reporting perceived benefits and 15 (2.1%) reporting harm. Homeopathy use was positively associated with female gender, high school level education, suffering from fibromyalgia or subthreshold depression, and being fast food abstinent, while patients with osteoarthritis, spinal or other pain, smokers, and patients with a high external-social health locus of control were less likely to use homeopathy. Personal characteristics and health status may impact on the use and the perceived helpfulness of homeopathy. © 2016 S. Karger GmbH, Freiburg.

The research rotation: competency-based structured and novel approach to research training of internal medicine residents

Directory of Open Access Journals (Sweden)

Dimitrov Vihren

2006-10-01

Full Text Available Abstract Background In the United States, the Accreditation Council of graduate medical education (ACGME requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

Research ethics in the era of personalized medicine: updating science's contract with society.

Science.gov (United States)

Meslin, Eric M; Cho, Mildred K

2010-01-01

With the completed sequence of the human genome has come the prospect of substantially improving the quality of life for millions through personalized medicine approaches. Still, any advances in this direction require research involving human subjects. For decades science and ethics have enjoyed an allegiance reflected in a common set of ethical principles and procedures guiding the conduct of research with human subjects. Some of these principles emphasize avoiding harm over maximizing benefit. In this paper we revisit the priority given to these ethical principles - particularly the principles that support a cautious approach to science - and propose a reframing of the 'social contract' between science and society that emphasizes reciprocity and meeting public needs.

Real time curriculum map for internal medicine residency

Directory of Open Access Journals (Sweden)

Roberts J Mark

2007-11-01

Full Text Available Abstract Background To manage the voluminous formal curriculum content in a limited amount of structured teaching time, we describe the development and evaluation of a curriculum map for academic half days (AHD in a core internal medicine residency program. Methods We created a 3-year cyclical curriculum map (an educational tool combining the content, methodology and timetabling of structured teaching, comprising a matrix of topics under various specialties/themes and corresponding AHD hours. All topics were cross-matched against the ACP-ASIM in-training examination, and all hours were colour coded based on the categories of core competencies. Residents regularly updated the map on a real time basis. Results There were 208 topics covered in 283 AHD hours. All topics represented core competencies with minimal duplication (78% covered once in 3 years. Only 42 hours (15% involved non-didactic teaching, which increased after implementation of the map (18–19 hours/year versus baseline 5 hours/year. Most AHD hours (78% focused on medical expert competencies. Resident satisfaction (90% response was high throughout (range 3.64 ± 0.21, 3.84 ± 0.14 out of 4, which improved after 1 year but returned to baseline after 2 years. Conclusion We developed and implemented an internal medicine curriculum map based on real time resident input, with minimal topic duplication and high resident satisfaction. The map provided an opportunity to balance didactic versus non-didactic teaching, and teaching on medical versus non medical expert topics.

Item Analysis to Improve Reliability for an Internal Medicine Undergraduate OSCE

Science.gov (United States)

Auewarakul, Chirayu; Downing, Steven M.; Praditsuwan, Rungnirand; Jaturatamrong, Uapong

2005-01-01

Utilization of objective structured clinical examinations (OSCEs) for final assessment of medical students in Internal Medicine requires a representative sample of OSCE stations. The reliability and generalizability of OSCE scores provides validity evidence for OSCE scores and supports its contribution to the final clinical grade of medical…

The Current Status and Future Perspectives of Nuclear Medicine in Korea

International Nuclear Information System (INIS)

Lee, Myung Chul; Oh, So Won; Chung, June Key; Lee, Dong Soo

2010-01-01

Since the introduction of nuclear medicine in 1959, Korea accomplished a brilliant development in terms of both clinical practice and research activities, which was mainly due to the dedication of nuclear medicine specialists, consisting of physicians, technicians, and scientists, and strong support from the Korean Government. Now, Korea has 150 medical institutes, performing approximately 561,000 nuclear imaging procedures and 11.6 million in vitro studies in 2008, and ranked fourth in the number of presentations at the Annual Meeting of the Society of Nuclear Medicine (SNM) in 2008. The successful progress in this field has allowed Korea to focus on the international promotion of nuclear medicine, especially in the developing and underdeveloped countries. In consequence, the Asian Regional Cooperative Council for Nuclear Medicine (ARCCNM) was established in 2001, and Seoul hosted the 9th Congress of the World Federation of Nuclear Medicine and Biology (WFNMB) in 2006. In the future, Korea will strive to sustain its rate of advancement in the field and make every effort to share its progress and promote the exchange of scientific information at the international level.

A modified Elixhauser score for predicting in-hospital mortality in internal medicine admissions.

Science.gov (United States)

Fabbian, Fabio; De Giorgi, Alfredo; Maietti, Elisa; Gallerani, Massimo; Pala, Marco; Cappadona, Rosaria; Manfredini, Roberto; Fedeli, Ugo

2017-05-01

In-hospital mortality (IHM) is an indicator of the quality of care provided. The two most widely used scores for predicting IHM by International Classification of Diseases (ICD) codes are the Elixhauser (EI) and the Charlson Comorbidity indexes. Our aim was to obtain new measures based on internal medicine ICD codes for the original EI, to detect risk for IHM. This single-center retrospective study included hospital admissions for any cause in the department of internal medicine between January 1, 2000, and December 31, 2013, recorded in the hospital database. The EI was calculated for evaluation of comorbidity, then we added age, gender and diagnosis of ischemic heart disease. IHM was our outcome. Only predictors positively associated with IHM were taken into consideration and the Sullivan's method was applied in order to modify the parameter estimates of the regression model into an index. We analyzed 75,586 admissions (53.4% females) and mean age was 72.7±16.3years. IHM was 7.9% and mean score was 12.1±7.6. The points assigned to each condition ranged from 0 to 16, and the possible range of the score varied between 0 and 89. In our population the score ranged from 0 to 54, and it was higher in the deceased group. Receiver operating characteristic curve of the new score was 0.721 (95% CI 0.714-0.727, pInternal Medicine. Published by Elsevier B.V. All rights reserved.