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Sample records for nijmegen medical centre

  1. Prevalence, molecular characterization, and phenotypic confirmation of extended-spectrum beta-lactamases in Escherichia coli, Klebsiella pneumoniae, and Klebsiella oxytoca at the Radboud University Nijmegen Medical Centre in The Netherlands.

    OpenAIRE

    Sturm, P.D.J.; Bochum, E.T.; Mook-Vermulst, S.V. van; Handgraaf, C.; Klaassen, T.; Melchers, W.J.G.

    2010-01-01

    The prevalence and molecular types of extended-spectrum beta-lactamases (ESBLs) were determined during a 1-year period in unselected clinical nonduplicate isolates of Escherichia coli (n = 1,738), Klebsiella pneumoniae (n = 436), and Klebsiella oxytoca (n = 208), cultured at the University Medical Centre Nijmegen, The Netherlands. Isolates identified as ESBL producer by the Phoenix automated system were collected prospectively and subjected to molecular analysis for the most common ESBLs TEM,...

  2. Prevalence, molecular characterization, and phenotypic confirmation of extended-spectrum beta-lactamases in Escherichia coli, Klebsiella pneumoniae, and Klebsiella oxytoca at the Radboud University Nijmegen Medical Centre in The Netherlands.

    NARCIS (Netherlands)

    Sturm, P.D.J.; Bochum, E.T.; Mook-Vermulst, S.V. van; Handgraaf, C.; Klaassen, T.; Melchers, W.J.G.

    2010-01-01

    The prevalence and molecular types of extended-spectrum beta-lactamases (ESBLs) were determined during a 1-year period in unselected clinical nonduplicate isolates of Escherichia coli (n = 1,738), Klebsiella pneumoniae (n = 436), and Klebsiella oxytoca (n = 208), cultured at the University Medical

  3. Understanding Financial Viability of Urban Consolidation Centres: Regent Street (London), Bristol/Bath & Nijmegen

    NARCIS (Netherlands)

    van Duin, Ron; van Dam, T; Wiegmans, B.; Tavasszy, L.A.

    2016-01-01

    The concept of an urban consolidation centre (UCC) has been extensively researched. Despite the potential positive environmental and social impact, the main obstacle remains the lack of a sustainable business model. The goal of this paper is to understand how to organize UCC viability as a concept

  4. Medical students’ gender awareness. Construction of the Nijmegen gender awareness in Medicine Scale (N-GAMS)

    NARCIS (Netherlands)

    Verdonk, P.; Benschop, Y.W.M.; Haes, J.C.J.M. de; Lagro-Janssen, A.L.M.

    2008-01-01

    Gender awareness in medicine consists of two attitudinal components: gender sensitivity and gender-role ideology. In this article, the development of a scale to measure these attitudes in Dutch medical students is described. After a pilot study and a feasibility study, 393 medical students in The

  5. Medical students’ gender awareness : construction of the Nijmegen Gender Awareness In Medicine Scale (N-GAMS)

    NARCIS (Netherlands)

    Verdonk, P.; Benschop, Y.W.M.; Haes, J.C.J.M. de; Lagro-Janssen, A.L.M.

    2008-01-01

    Gender awareness in medicine consists of two attitudinal components: gender sensitivity and gender-role ideology. In this article, the development of a scale to measure these attitudes in Dutch medical students is described. After a pilot study and a feasibility study, 393 medical students in The

  6. NIJMEGEN BREAKAGE SYNDROME

    Directory of Open Access Journals (Sweden)

    M. Y. Kagan

    2012-01-01

    Full Text Available Nijmegen breakage syndrome (NBS is a rare autosomal recessive syndrome of chromosomal instability mainly characterized by microcephaly at birth, dysmorphic facial features, combined immunodeficiency and predisposition to malignancies. Due to a founder mutation in the underlying NBN gene (c.657_661del5 the disease is encountered most frequently among Slavic populations. We report on a patient with NBS complicated acute leukemia.

  7. Nijmegen breakage syndrome (NBS

    Directory of Open Access Journals (Sweden)

    Chrzanowska Krystyna H

    2012-02-01

    Full Text Available Abstract Nijmegen breakage syndrome (NBS is a rare autosomal recessive syndrome of chromosomal instability mainly characterized by microcephaly at birth, combined immunodeficiency and predisposition to malignancies. Due to a founder mutation in the underlying NBN gene (c.657_661del5 the disease is encountered most frequently among Slavic populations. The principal clinical manifestations of the syndrome are: microcephaly, present at birth and progressive with age, dysmorphic facial features, mild growth retardation, mild-to-moderate intellectual disability, and, in females, hypergonadotropic hypogonadism. Combined cellular and humoral immunodeficiency with recurrent sinopulmonary infections, a strong predisposition to develop malignancies (predominantly of lymphoid origin and radiosensitivity are other integral manifestations of the syndrome. The NBN gene codes for nibrin which, as part of a DNA repair complex, plays a critical nuclear role wherever double-stranded DNA ends occur, either physiologically or as a result of mutagenic exposure. Laboratory findings include: (1 spontaneous chromosomal breakage in peripheral T lymphocytes with rearrangements preferentially involving chromosomes 7 and 14, (2 sensitivity to ionizing radiation or radiomimetics as demonstrated in vitro by cytogenetic methods or by colony survival assay, (3 radioresistant DNA synthesis, (4 biallelic hypomorphic mutations in the NBN gene, and (5 absence of full-length nibrin protein. Microcephaly and immunodeficiency are common to DNA ligase IV deficiency (LIG4 syndrome and severe combined immunodeficiency with microcephaly, growth retardation, and sensitivity to ionizing radiation due to NHEJ1 deficiency (NHEJ1 syndrome. In fact, NBS was most commonly confused with Fanconi anaemia and LIG4 syndrome. Genetic counselling should inform parents of an affected child of the 25% risk for further children to be affected. Prenatal molecular genetic diagnosis is possible if disease

  8. The DIY Digital Medical Centre.

    Science.gov (United States)

    Timmis, James Kenneth; Timmis, Kenneth

    2017-09-01

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

  9. Medication errors: pharmacovigilance centres in detection and prevention

    Science.gov (United States)

    Bencheikh, Rachida Soulaymani; Benabdallah, Ghita

    2009-01-01

    Detecting medication errors needs collaboration between various organizations, such as patient safety institutions, pharmacovigilance centres, and poison control centres. In order to evaluate the input of pharmacovigilance centres and poison control centres in detecting and evaluating medication errors a pilot project was initiated by the World Alliance for Patient Safety in collaboration with the Uppsala Monitoring Centre; the Moroccan pharmacovigilance centre acted as project coordinator. As part of this project, a questionnaire on detecting medication errors was circulated to pharmacovigilance centres and poison control centres around the world, in order to assess their ability to detect and analyse medication errors. The results showed that through their databases pharmacovigilance centres can detect, identify, analyse, and classify medication errors and carry out root cause analysis, which is an important tool in preventing medication errors. The duties of pharmacovigilance centres in preventing medication errors include informing health-care professionals about the importance of reporting such errors and creating a culture of patient safety. Pharmacovigilance centres aim to prevent medication errors in collaboration with poison control centres. Such collaboration allows improved detection and improved preventive strategies. In addition, collaboration with regulatory authorities is important in finalizing decisions. Collaboration between pharmacovigilance centres and poison control centres should be strengthened and bridges need to be built linking pharmacovigilance centres, poison control centres, and organizations dedicated to patient safety, in order to avoid duplication of workload. PMID:19594539

  10. Integrating gender into a basic medical curriculum.

    NARCIS (Netherlands)

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

    2005-01-01

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

  11. The Nijmegen hyperon-nucleon potentials

    International Nuclear Information System (INIS)

    Timmermans, R.

    1994-01-01

    The Nijmegen YN potential models are reviewed. Differences with the models constructed by the Juelich group are highlighted. A mini- review is given of the status of the scalar mesons and their relevance for the NN and YN interactions. Finally, the reactions bar NN → bar YY are discussed

  12. First aid and basic life support of junior doctors: A prospective study in Nijmegen, the Netherlands.

    NARCIS (Netherlands)

    Tan, E.C.T.H.; Severien, I.; Metz, J.C.; Berden, H.J.J.M.; Biert, J.

    2006-01-01

    According to the Dutch medical education guidelines junior doctors are expected to be able to perform first aid and basic life support. A prospective study was undertaken to assess the level of first aid and basic life support (BLS) competence of junior doctors at the Radboud University Nijmegen

  13. De verkeers(on)veiligheid in de gemeente Nijmegen.

    NARCIS (Netherlands)

    Vis, A.A. & Wegman, F.C.M.

    1993-01-01

    This paper analyses the accident rate in the Dutch municipality of Nijmegen in comparison with that of a reference area consisting of the following Dutch cities: The Hague, Eindhoven, Geleen, Haarlem, Heerlen, Leyden, Schiedam and Utrecht. The results of this study show that Nijmegen can be

  14. Medical applications of accelerators at Tata Memorial Centre

    International Nuclear Information System (INIS)

    Dinshaw, K.A.

    2003-01-01

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

  15. Cranial MRI in the Nijmegen breakage syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Bekiesinska-Figatowska, M. [Department of Diagnostic Imaging, Central Railway Hospital, Warsaw (Poland); Chrzanowska, K.H.; Krajewska-Walasek, M. [Department of Medical Genetics, Children' s Memorial Health Institute, Warsaw (Poland); Sikorska, J.; Walecki, J. [Department of Diagnostic Imaging, Medical Centre for Postgraduate Education, Warsaw (Poland); Jozwiak, S. [Department of Neurology, Children' s Memorial Health Institute, Warsaw (Poland); Kleijer, W.J. [Department of Clinical Genetics, Erasmus University Rotterdam (Netherlands)

    2000-01-01

    We present the results of MRI examinations in ten patients with documented Nijmegen breakage syndrome (NBS), aged 1.75-19 years. T1-, Proton-Density- and T2-weighted spin-echo sequences were performed in three planes. All patients showed microcephaly with decreased size of the frontal lobes and narrow frontal horns. In four patients agenesis of the posterior part of the corpus callosum was found, with colpocephaly and temporal horns dilatation. In one patient callosal hypoplasia was accompanied by abnormal cerebrospinal fluid spaces and wide cerebral cortex, suspicious of pachygyria. Sinusitis was present in all ten patients, as a result of primary immunodeficiency. As in ataxia teleangiectasia and other breakage syndromes, patients with NBS show an inherited susceptibility to malignancy and hypersensitivity to X- and {gamma}-radiation. CT is therefore contraindicated in these patients and MRI should be the method of choice for diagnostic imaging. (orig.)

  16. Cranial MRI in the Nijmegen breakage syndrome

    International Nuclear Information System (INIS)

    Bekiesinska-Figatowska, M.; Chrzanowska, K.H.; Krajewska-Walasek, M.; Sikorska, J.; Walecki, J.; Jozwiak, S.; Kleijer, W.J.

    2000-01-01

    We present the results of MRI examinations in ten patients with documented Nijmegen breakage syndrome (NBS), aged 1.75-19 years. T1-, Proton-Density- and T2-weighted spin-echo sequences were performed in three planes. All patients showed microcephaly with decreased size of the frontal lobes and narrow frontal horns. In four patients agenesis of the posterior part of the corpus callosum was found, with colpocephaly and temporal horns dilatation. In one patient callosal hypoplasia was accompanied by abnormal cerebrospinal fluid spaces and wide cerebral cortex, suspicious of pachygyria. Sinusitis was present in all ten patients, as a result of primary immunodeficiency. As in ataxia teleangiectasia and other breakage syndromes, patients with NBS show an inherited susceptibility to malignancy and hypersensitivity to X- and γ-radiation. CT is therefore contraindicated in these patients and MRI should be the method of choice for diagnostic imaging. (orig.)

  17. Intensive Care Unit Admissions in Federal Medical Centre Umuahia ...

    African Journals Online (AJOL)

    Background: The Federal Medical Centre Umuahia(FMCU) is a tertiary referral centre in Abia state, southeast Nigeria serving a catchment area made of Abia state and environs . An intensive care unit(ICU) was established in the hospital in December 2009 to improve healthcare delivery to critically ill patients. Objective: To ...

  18. Malaria Training Centre | Malenga | Malawi Medical Journal

    African Journals Online (AJOL)

    [Introduction]: The Malaria Training Centre is part of a collaborative effort in malaria research and training between the College of Medicine and Liverpool School of Tropical Medicine (LSTM). Funding for a period of 5 years has been secured through the Gates Malaria Programme (GMP) of the London School of Hygiene ...

  19. Further delineation of the Nijmegen breakage syndrome

    International Nuclear Information System (INIS)

    Taalman, R.D.; Hustinx, T.W.; Weemaes, C.M.; Seemanova, E.; Schmidt, A.; Passarge, E.; Scheres, J.M.

    1989-01-01

    We report on five independent families with a chromosome instability disorder that earlier had been called the Nijmegen breakage syndrome (NBS). These families, two from the Netherlands and three from Czechoslovakia, had a total of eight patients, five of whom are still alive. The main clinical manifestations were microcephaly, short stature, a ''bird-like'' face, immunological defects involving both the humoral and cellular system. In four of the five living patients it has been possible to study the chromosomes of cultured lymphocytes. The basic karyotype in these patients were normal, but in 17% to 35% of the metaphases rearrangements were found, preferentially involving chromosomes 7 and/or 14 at the sites 7p13, 7q34, and 14q11. The chromosomes of all five living patients were very sensitive to ionizing radiation. In addition, the DNA synthesis in their cultured lymphocytes and fibroblasts was more resistant to X-rays than in cells from controls. The NBS shares a number of important features with ataxia telangiectasia (AT). Both syndromes are characterized by the occurrence of typical rearrangements of chromosomes 7 and/or 14, cellular and chromosomal hypersensitivity to X-irradiation, radioresistance of DNA replication and immunodeficiency. However, there are also obvious differences: NBS patients have microcephaly but neither ataxia nor telangiectasia, and in contrast to the situation in AT the alpha-fetoprotein level in their serum is normal

  20. Medical students’ and patients’ perceptions of patient-centred attitude

    Directory of Open Access Journals (Sweden)

    Yera Hur

    2017-03-01

    Full Text Available Purpose Patient-centred care can increase patient satisfaction and lead to better clinical outcomes for them, such as improved physical status and higher health-related quality of life. However, doctors’ and patients’ views on patient-centred attitude might differ and could be affected by culture and the community environment. To clarify the differences in primary care patients’ and senior medical students’ perceptions of medical students’ patient-centred attitude. Methods A total of 1,025 subjects—827 patients from primary care institutions and 198 fourth-year medical students from a medical college in South Korea—completed the Patient Practitioner Orientation Scale (PPOS. The students completed the self-reported questionnaire at the end of their clinical clerkship. Descriptive statistics, t-tests, and one-way analysis of variances were conducted in SPSS version 21.0. Results Firstly, sharing subscale scores were higher among patients than among medical students (students, 3.61 vs. patients, 3.76; p<0.001, but secondly, caring subscale scores were higher among medical students (students, 4.18 vs. patients, 3.82; p<0.001. Thirdly, PPOS total scores were higher among medical students (students, 3.90 vs. patients, 3.79; p=0.001. Finally, male students had the lowest sharing scores (F=6.811, p<0.001 and female students showed the highest PPOS total scores (F=5.805, p=0.001. Conclusion Significant differences between medical students’ and patients’ perceptions of medical students’ patient-centred attitudes suggest the necessity of educational efforts to overcome the gap between the groups.

  1. A learning resources centre: its utilization by medical students.

    Science.gov (United States)

    Premkumar, K; Baumber, J S

    1996-11-01

    Innovations in medical education have led to the increasing use of problem-based learning techniques, a committee system organization, and more time for independent study in many undergraduate programmes. There has been an increase in availability of alternative methods for presentation of information. To encourage self-directed learning, resources such as computers, videos and models, among others, should be readily available to students. The University of Calgary Faculty of Medicine has provided various resources contained in one area, called the Bacs Learning Resource Centre (BLRC). Since the maintenance and further development of such a centre requires significant resources, it is important to determine student utilization of the various components used in their learning. For those who are about to set up such a learning resource centre this information gives guidance on which materials are most useful. The utilization of the centre by 69 first year medical students was studied using questionnaires. The utilization during a specific course was determined by analysing the entries in the individual log books given to the students at the beginning of the Integrative Course. With the exception of one student, all those who responded to the questionnaire used the Centre, with 20% or less of their total study time being spent there. The BLRC was most used for the Musculoskeletal, Cardiovascular and Reticulo-Endothelial courses. All categories of resources were found to be useful, with the tape/slides least utilized. Utilization was most influenced by the quality of resources available and recommendations by peers. The development of a centre such as the BLRC, with a variety of resources concentrated in one area, suitable for individual or group study and accessible 24 hours a day, should be considered by all medical schools to enhance self-directed learning in medical students.

  2. bacterial meningitis among children in federal medical centre

    African Journals Online (AJOL)

    ABSTRACT. Cerebrospinal fluid (CSF) samples from one hundred and fifty children suspected of bacterial meningitis in the children's ward of the Federal Medical Centre, Bide, between January and December 2001 were studied. The children were aged twelve and below. Only twenty five (16.7%) of the samples were ...

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

    Background: Information was collected on 1500 obstetric fistula patients attending Bugando Medical Centre (BMC) in Mwanza, Tanzania. Objectives: To identify high risk populations of fistula patients treated from 1998-2006. Design: A prospective description study of 1294 patients treated for urine and faecal incontinence ...

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

    African Journals Online (AJOL)

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

  6. Proposed medical applications of the National Accelerator Centre facilities

    International Nuclear Information System (INIS)

    Jones, D.T.L.

    1982-01-01

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

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

    Science.gov (United States)

    McLean, Michelle; Gibbs, Trevor J

    2009-12-01

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

  8. Medical data transmission system for remote healthcare centres

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  9. Medical data transmission system for remote healthcare centres

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, E A; Cagnolo, F J; Olmos, C E; Centeno, C A; Riva, G G; Zerbini, C A [Clinical Engineering Group, National Technological University, Cordoba Regional Faculty, Maestro M Lopez St and Cruz Roja Argentina St, Cordoba (Argentina)

    2007-11-15

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

  10. AMSTERDAM-NIJMEGEN EVERYDAY LANGUAGE TEST - CONSTRUCTION, RELIABILITY AND VALIDITY

    NARCIS (Netherlands)

    BLOMERT, L; KEAN, ML; KOSTER, C; SCHOKKER, J

    1994-01-01

    The Amsterdam-Nijmegen Everyday Language Test (ANELT) is designed to measure, first, the level of verbal communicative abilities of aphasic patients and, second, changes in these abilities over time. The level of communicative effectiveness is determined by the adequacy of bringing a message across.

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

    DEFF Research Database (Denmark)

    Andrioti, Despena; Kotrotsou, Christina; Tsakatara, Vanta

    2013-01-01

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

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

    Science.gov (United States)

    Alligood, Martha Raile

    2011-11-01

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

  13. Implementation of a computerized physician medication order entry system at the Academic Medical Centre in Amsterdam.

    Science.gov (United States)

    Kalmeijer, Mathijs D; Holtzer, Wouter; van Dongen, René; Guchelaar, Henk-Jan

    2003-06-01

    In the period 1997-2001 the Academic Medical Centre in Amsterdam implemented the computerized physician medication order entry (CPmOE) system Medicator. This article describes several important aspects of this program: technological architecture, features, implementation project, authentication and training, continuous support, human resource investments, route of prescription, logistics and administration. Furthermore important advantages and disadvantages of the CPmOE system are discussed. Advantages mainly concern patient safety and drug logistics, while disadvantages are related to access to a computer, user friendliness of the software and printer problems.

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

    Directory of Open Access Journals (Sweden)

    Nwafor Chukwuemeka Charles

    2014-09-01

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

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

    DEFF Research Database (Denmark)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte

    2018-01-01

    BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We...... records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. RESULTS: Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15...... years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights...

  16. Bijdragen aan Hoofdstukken 2-6: Landschapsbiografie Dijkteruglegging Nijmegen-Lent

    NARCIS (Netherlands)

    Heunks, Eckhart

    2016-01-01

    Contributions to a synthesis of landscape archaeological activities carried out in Nijmegen-Lent as part of heritage management by Gemeente Nijmegen during expansion of the city and reconstruction of the Waal river dike and bridges in the past decade. In 2014-2015, Dr. Kim Cohen advised to the

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

    Science.gov (United States)

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

    2018-01-05

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

  18. Developments at the High Field Magnet Laboratory in Nijmegen

    Science.gov (United States)

    Perenboom, J. A. A. J.; Maan, J. C.; van Breukelen, M. R.; Wiegers, S. A. J.; den Ouden, A.; Wulffers, C. A.; van der Zande, W. J.; Jongma, R. T.; van der Meer, A. F. G.; Redlich, B.

    2013-03-01

    The High Field Magnet Laboratory at the Radboud University Nijmegen is rapidly expanding its capabilities. The developments encompass both organizational changes and new possibilities for research. The organization of the HFML was strengthened as a consequence of stronger participation of the Foundation for Fundamental Research on Matter (FOM), and an increase of the core-funding. This change makes that HFML is now considered on a national level as large research facility that operates at an international scale. At the same time work is underway to build new and powerful magnets, and provide electromagnetic radiation for magneto-spectroscopic studies. Electromagnetic radiation in the infrared and far-infrared spectrum will soon be available in the HFML with wavelengths between 3 μm and 1.5 mm, produced by the `FELIX' facility, comprising the long-wavelength free electron laser `FLARE' that in September 2011 produced its first light and the free electron lasers that have been moved from Rijnhuizen to Nijmegen. In magnet technology great strides are made to make magnets available for the user community with unprecedented performance: late in 2012 we hope to commission a new all-resistive magnet system that will generate a steady magnetic field as high as 38 T, by fully exploiting the maximum power of the installation, i.e. 20 MW, and using all available improvements in the design and construction of `Florida-Bitter' resistive magnets. We are also well underway with the design of a 45 T hybrid magnet system, using Nb3Sn superconductors and wind-and-react Cable-in-Conduit technology.

  19. [Patient participation in medical decision making among breast cancer patients--a comparison of breast centre care units and non-centre hospitals].

    Science.gov (United States)

    Ernst, Jochen; Weissflog, Gregor; Hohlfeld, Sylvia; Wittekind, Christian; Brähler, Elmar

    2011-08-01

    This study investigated the extent of involvement of breast cancer patients in medical decisions in comparison between certified breast cancer centres vs. non-centres. Data on the participation in medical decision making were collected in a retrospective cross-sectional design from 652 breast cancer patients. 9 different dimensions of participation were analysed. In the descriptive analysis, there is only one significant difference in participation between breast centres and non-centres (dimension: time of treatment). In multivariate analysis, the treatment in a breast cancer centre was a predictor for increased patient participation in 3 dimensions of participation in medical decisions (p younger age and good health are of statistical significance for participation in medical decision making. There is a higher participation of patients in breast centres in only few subdimensions of medical decision making, but not in general. Georg Thieme Verlag KG Stuttgart · New York.

  20. Measuring continuity of care: psychometric properties of the Nijmegen Continuity Questionnaire.

    NARCIS (Netherlands)

    Uijen, A.A.; Schers, H.J.; Schellevis, F.G.; Mokkink, H.G.A.; Weel, C. van; Bosch, W.J.H.M. van den

    2012-01-01

    BACKGROUND: Recently, the Nijmegen Continuity Questionnaire (NCQ) was developed. It aims to measure continuity of care from the patient perspective across primary and secondary care settings. Initial pilot testing proved promising. AIM: To further examine the validity, discriminative ability, and

  1. Measuring continuity of care: psychometric properties of the Nijmegen Continuity Questionnaire.

    NARCIS (Netherlands)

    Uijen, A.A.; Schers, H.J.; Schellevis, F.G.; Mokkink, H.G.A.; Weel, C. van; Bosch, W.J.H.M. van den

    2012-01-01

    Background: Recently, the Nijmegen Continuity Questionnaire (NCQ) was developed. It aims to measure continuity of care from the patient perspective across primary and secondary care settings. Initial pilot testing proved promising. Aim: To further examine the validity, discriminative ability, and

  2. Measuring continuity of care: psychometric properties of the Nijmegen Continuity Questionnaire

    NARCIS (Netherlands)

    Uijen, A.A.; Schers, H.J.; Schellevis, F.G.; Mokkink, H.G.; van Weel, C.; van den Bosch, W.J.

    2012-01-01

    Background: Recently, the Nijmegen Continuity Questionnaire (NCQ) was developed. It aims to measure continuity of care from the patient perspective across primary and secondary care settings. Initial pilot testing proved promising. Aim: To further examine the validity, discriminative ability, and

  3. Nijmegen-Bethesda assay to measure factor VIII inhibitors.

    Science.gov (United States)

    Duncan, Elizabeth; Collecutt, Margaret; Street, Alison

    2013-01-01

    Hemophilia A is an inherited bleeding disorder caused by a deficiency of factor VIII coagulant activity (FVIII:C). Patients are treated with infusions of either plasma-derived or recombinant factor VIII. However, some patients develop inhibitory antibodies (inhibitors) to infused factor VIII which render it ineffective. The original Bethesda method was developed to standardize measurement of inhibitors in a factor VIII neutralization assay. One Bethesda unit is defined as that amount of inhibitor that results in 50% residual FVIII:C activity of a defined test mixture. In the Nijmegen modification of the original Bethesda method, the pH and the protein concentration of the test mixture is further standardized. As a result, the FVIII:C in the test mixture is less prone to artifactual deterioration and the test has improved specificity. Even with a standardized procedure a number of factors can affect the performance of the test and it is important for laboratory staff to be aware of their impact on the result outcome.

  4. International Medical Graduates and the Discursive Patterns of Patient-Centred Communication

    Science.gov (United States)

    Woodward-Kron, Robyn

    2016-01-01

    In many Western countries such as Australia, international medical graduates (IMGs) play a crucial role in meeting health workforce needs. For doctors for whom English is an additional language and who have received their medical education in non-Western settings, a challenge is the patient-centred approach to communication, which is well…

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

    Science.gov (United States)

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

    2011-07-01

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

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

    LENUS (Irish Health Repository)

    Cassidy, Nicola

    2012-02-01

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

  7. Integrating public health and medical intelligence gathering into homeland security fusion centres.

    Science.gov (United States)

    Lenart, Brienne; Albanese, Joseph; Halstead, William; Schlegelmilch, Jeffrey; Paturas, James

    Homeland security fusion centres serve to gather, analyse and share threat-related information among all levels of governments and law enforcement agencies. In order to function effectively, fusion centres must employ people with the necessary competencies to understand the nature of the threat facing a community, discriminate between important information and irrelevant or merely interesting facts and apply domain knowledge to interpret the results to obviate or reduce the existing danger. Public health and medical sector personnel routinely gather, analyse and relay health-related inform-ation, including health security risks, associated with the detection of suspicious biological or chemical agents within a community to law enforcement agencies. This paper provides a rationale for the integration of public health and medical personnel in fusion centres and describes their role in assisting law enforcement agencies, public health organisations and the medical sector to respond to natural or intentional threats against local communities, states or the nation as a whole.

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

    Science.gov (United States)

    Yoon, Hee Sook; Sok, Sohyune R

    2016-12-01

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

  9. Utilization of Alternative Medical Services In An Urban Centre Of ...

    African Journals Online (AJOL)

    Alasia Datonye

    Background: The use of alternative therapy is becoming more popular in the recent times especially due to the increasing cost, distrust and limitations of modern western medical care. There is a universal trend toward naturalness and herbal medicine is now being modernized and being accepted by people who would not ...

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

    African Journals Online (AJOL)

    Ten (20.4%) walked without support, 9(18.4%) discharged against medical advice and 4(8.2%) were discharged on wheel chair. Twenty-two (44.9%) were referred and there were 4 (8.2%) mortalities. Conclusion: There were more traumatic than non-traumatic injuries. The most common traumatic cause was motor vehicle ...

  11. Improving care for victims: a study protocol of the evaluation of a centre for sexual and family violence.

    Science.gov (United States)

    Zijlstra, E; LoFoWong, S; Hutschemaekers, G; Lagro-Janssen, A

    2016-09-12

    Worldwide, sexual and family violence are highly prevalent problems. Victims of sexual and family violence often do not seek formal help in the acute phase. When they do seek help, they encounter a system of scattered care. For this reason, a centre for sexual and family violence was launched in Nijmegen, the Netherlands. The centre provides multidisciplinary care for victims of acute sexual and/or family violence. With the study described in this study protocol, we want to evaluate the implementation process and the reach of the Center for Sexual and Family Violence Nijmegen (CSFVN). We will conduct a mixed-methods study including quantitative and qualitative methods of data collection and analysis. Data about the implementation process will be obtained via semistructured interviews and focus group discussions. Content analysis will be done in software program Atlas.ti. Analysis of file data will be undertaken to assess the reach of the CSFVN (patient characteristics and characteristics of the care they received). The data will be analysed in SPSS. The Medical Ethics Committee of the Radboud University Nijmegen Medical Center approved the study protocol under file number 2012-1218. Dissemination will be done by submitting scientific articles to academic peer-reviewed journals. We will present the results at relevant international, national and local conferences and meetings. We will send press releases to relevant media. We will share the results with the network of assault centres in the Netherlands. 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/

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

    Science.gov (United States)

    Donetto, Sara

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  14. Defragmenting paediatric anorexia nervosa: the Flinders Medical Centre Paediatric Eating Disorder Program.

    Science.gov (United States)

    Suetani, Shuichi; Yiu, Sau Man; Batterham, Michael

    2015-06-01

    To describe the establishment and the main characteristics of the Flinders Medical Centre Paediatric Eating Disorder Program. While the programme is still in its infancy, it is hoped that our model of care can provide a sustainable, long term contribution to the management of paediatric eating disorders. © The Royal Australian and New Zealand College of Psychiatrists 2015.

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

    Science.gov (United States)

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

    2012-10-01

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

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

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  17. Side effects after radiotherapy of age-related macular degeneration with the Nijmegen technique.

    NARCIS (Netherlands)

    Hoyng, C.B.; Tromp, A.I.; Meulendijks, C.F.M.; Leys, A.; Maazen, R.W.M. van der; Deutman, A.F.; Vingerling, J.R.

    2002-01-01

    BACKGROUND: In a randomized trial concerning radiotherapy for age-related macular degeneration, fluorescein angiograms were taken of controls and patients. In this study the frequency of side effects in eyes receiving radiotherapy with the Nijmegen technique is compared with the findings in the eyes

  18. SHV-14, a novel beta-lactamase variant in Klebsiella pneumoniae isolates from Nijmegen, The Netherlands.

    NARCIS (Netherlands)

    Yuan, M.; Hall, L.M.; Hoogkamp-Korstanje, J.A.A.; Livermore, D.M.

    2001-01-01

    Four ceftazidime-resistant isolates of a Klebsiella pneumoniae strain were collected from intensive care unit patients in Nijmegen, The Netherlands. These isolates had TEM-29 and SHV-14 beta-lactamases. SHV-14 is a novel variant, with two substitutions compared with the sequence of SHV-1: Ile8Phe

  19. Nijmegen Continuity Questionnaire: Development and testing of a questionnaire that measures continuity of care

    NARCIS (Netherlands)

    Uijen, A.A.; Schellevis, F.G.; Bosch, W.J. van den; Mokkink, H.G.A.; Weel, C. van; Schers, H.J.

    2011-01-01

    OBJECTIVE: To develop and pilot test a generic questionnaire to measure continuity of care from the patient's perspective across primary and secondary care settings. STUDY DESIGN AND SETTING: We developed the Nijmegen Continuity Questionnaire (NCQ) based on a systematic literature review and

  20. Nijmegen Continuity Questionnaire: development and testing of a questionnaire that measures continuity of care.

    NARCIS (Netherlands)

    Uijen, A.A.; Schellevis, F.G.; Bosch, W.J.H.M. van den; Mokkink, H.G.A.; Weel, C. van; Schers, H.J.

    2011-01-01

    Abstract: To develop and pilot test a generic questionnaire to measure continuity of care from the patient's perspective across primary and secondary care settings. We developed the Nijmegen Continuity Questionnaire (NCQ) based on a systematic literature review and analysis of 30 patient interviews.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  2. Challenges in interprofessional collaboration: experiences of care providers and policymakers in a newly set-up Dutch assault centre.

    Science.gov (United States)

    Zijlstra, Elza; Lo Fo Wong, Sylvie; Teerling, Anne; Hutschemaekers, Giel; Lagro-Janssen, Antoine

    2017-08-03

    Sexual and family violence are problems that affect many women and men, and the negative health consequences of violence are numerous. As adequate acute interprofessional care can prevent negative health consequences and improve forensic medical examination, a Centre for Sexual and Family Violence was set up. We aimed to improve our understanding of the challenges in interprofessional collaboration in a newly set-up centre for sexual and family violence. We conducted a qualitative study with semi-structured interviews about the experiences with interprofessional collaboration of 16 stakeholders involved in the Centre for Sexual and Family Violence Nijmegen. Participants were selected by purposive sampling. Participants found that the interprofessional collaboration had improved communication and competences. However, there were challenges too. Firstly, the interprofessional collaboration had brought parties closer together, but the collaboration also forced professionals to strongly define their boundaries. Mutual trust and understanding needed to be built up. Secondly, a balance had to be struck between pursuing the shared vision - which was to improve quality of care for victims - and giving space to organizations' and professionals' own interest. Thirdly, care for victims of sexual and family violence could be demanding on healthcare providers in an emotional sense, which might jeopardize professional's initial motivation for joining the Centre for Sexual and Family Violence Nijmegen. The interprofessional collaboration in an assault centre improves quality of care for victims, but there are also challenges. The tasks of an assault centre are to create opportunities to discuss professional roles and professional interests, to build up good interpersonal relations in which trust and understanding can grow, to formulate a strong and shared victim-centred vision and to support care providers with training, feedback and supervision. © 2017 Nordic College of Caring

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

    OpenAIRE

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

    2013-01-01

    This study reports about teacher motivation and work engagement in a Dutch University Medical Centre (UMC). We examined factors affecting the motivation for teaching in a UMC, the engagement of UMC Utrecht teaching faculty in their work, and their engagement in teaching compared with engagement in patient care and research. Based on a pilot study within various departments at the UMCU, a survey on teaching motivation and work engagement was developed and sent to over 600 UMCU teachers. About ...

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

    Directory of Open Access Journals (Sweden)

    Rachel M. Little

    2013-12-01

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

  5. Perceived need to take medication is associated with medication non-adherence in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Zwikker HE

    2014-11-01

    Full Text Available Hanneke E Zwikker,1,2 Sandra van Dulmen,3–5 Alfons A den Broeder,1,2 Bart J van den Bemt,1,2,6 Cornelia H van den Ende1,2 1Department of Rheumatology, 2Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands; 3Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; 4NIVEL (Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 5Department of Health Science, Buskerud and Vestfold University College, Drammen, Norway; 6Department of Pharmacy, Radboud University Medical Centre, Nijmegen, the Netherlands Background: This is the first cross-sectional study that aims to examine associations between beliefs about medication and non-adherence in patients with rheumatoid arthritis (RA using disease-modifying antirheumatic drugs, taking potential psychological confounders into account.Methods: Eligible patients (diagnosed with RA for ≥1 year or ≥18 years, using greater than or equal to one disease-modifying antirheumatic drug were included by their rheumatologist during regular outpatient visits between September 2009 and September 2010. Included patients received questionnaires. The Beliefs about Medicines Questionnaire was used to measure the perceived need to take medication (necessity beliefs, the concerns about taking medication (concern beliefs, general medication beliefs, and attitudes toward taking medication. Medication non-adherence (no/yes was measured using the Compliance Questionnaire Rheumatology (CQR. Associations between beliefs and non-adherence, and the influence of demographical, clinical, and psychological factors (symptoms of anxiety/depression, illness cognitions, self-efficacy were assessed using logistic regression.Results: A total of 580 of the 820 eligible patients willing to participate were included in the analyses (68% female, mean age 63 years, 30% non-adherent to their medication. Weaker necessity beliefs (OR [odds ratio]: 0.8, 95% CI

  6. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania.

    Science.gov (United States)

    Mpogoro, Filbert J; Mshana, Stephen E; Mirambo, Mariam M; Kidenya, Benson R; Gumodoka, Balthazar; Imirzalioglu, Can

    2014-01-01

    Surgical site infection (SSI) is the second most common infectious complication after urinary tract infection following a delivery by caesarean section (CS). At Bugando Medical Centre there has no study documenting the epidemiology of SSI after CS despite the large number of CSs performed and the relatively common occurrence of SSIs. This was a prospective cohort study involving pregnant women who underwent a CS between October 2011 and February 2012 at Bugando Medical Centre. A total of 345 pregnant women were enrolled. Preoperative, intraoperative and postoperative data were collected using a standardized questionnaire. Wound specimens were collected and processed as per standard operative procedures; and susceptibility testing was carried out using a disc diffusion technique. Data was analyzed using STATA version 11. The overall cumulative incidence of SSI was 10.9% with an incidence rate of 37.5 per 10,000 people/day (95% CI, 26.8-52.4). The median time from CS to the development of SSI was 7 days (interquartile range [IQR] = 6-9 days). Six independent risk factors for post caesarean SSI as identified in this study by multivariate analysis are: hypertensive disorders of pregnancy (HR: 2.5; 95% CI, 1.1-5.6; P = 0.021), severe anaemia (HR: 3.8; 95% CI, 1.2-12.4, P = 0.028), surgical wound class III (HR: 2.4; 95% CI, 1.1-5.0; P = 0.021), multiple vaginal examinations (HR: 2.5; 95% CI, 1.2-5.1; P = 0.011), prolonged duration of operation (HR: 2.6; 95% CI, 1.2-5.5; P = 0.015) and an operation performed by an intern or junior doctor (HR: 4.0; 95% CI, 1.7-9.2; P = 0.001). Staphylococcus aureus was the most common organism (27.3%), followed by Klebsiella pneumoniae (22.7%). Patients with a SSI had a longer average hospital stay than those without a SSI (12.7 ± 6.9 vs. 4 ± 1.7; P < 0.0001) and the case fatality rate among patients with a SSI was 2.9%. SSIs are common among women undergoing CSs at Bugando Medical Centre. SSIs were commonly associated with multiple

  7. Unique morphological spectrum of lymphomas in Nijmegen breakage syndrome (NBS) patients with high frequency of consecutive lymphoma formation.

    NARCIS (Netherlands)

    Gladkowska-Dura, M.; Dzierzanowska-Fangrat, K.; Dura, W.T.; Krieken, J.H.J.M. van; Chrzanowska, K.H.; Dongen, J.J.; Langerak, A.W.

    2008-01-01

    Nijmegen breakage syndrome (NBS) is an autosomal recessive disorder characterized by microcephaly, immunodeficiency, radiation hypersensitivity, chromosomal instability and increased incidence of malignancies. In Poland 105 NBS cases showing mutations in the NBS gene (nibrin, NBN), have been

  8. Nijmegen Continuity Questionnaire: development and testing of a questionnaire that measures continuity of care.

    OpenAIRE

    Uijen, A.A.; Schellevis, F.G.; Bosch, W.J.H.M. van den; Mokkink, H.G.A.; Weel, C. van; Schers, H.J.

    2011-01-01

    Abstract: To develop and pilot test a generic questionnaire to measure continuity of care from the patient's perspective across primary and secondary care settings. We developed the Nijmegen Continuity Questionnaire (NCQ) based on a systematic literature review and analysis of 30 patient interviews. The questionnaire consisted of 16 items about the patient-provider relationship to be answered for five different care providers and 14 items each on the collaboration between four groups of care ...

  9. Measuring continuity of care: psychometric properties of the Nijmegen Continuity Questionnaire.

    OpenAIRE

    Uijen, A.A.; Schers, H.J.; Schellevis, F.G.; Mokkink, H.G.A.; Weel, C. van; Bosch, W.J.H.M. van den

    2012-01-01

    Background: Recently, the Nijmegen Continuity Questionnaire (NCQ) was developed. It aims to measure continuity of care from the patient perspective across primary and secondary care settings. Initial pilot testing proved promising. Aim: To further examine the validity, discriminative ability, and reliability of the NCQ. Design: A prospective psychometric instrument validation study in primary and secondary care in the Netherlands. Method: The NCQ was administered to patients with a chronic di...

  10. Life scripts and life realities: women in nineteenth-century Nijmegen

    OpenAIRE

    Engelen, Theo

    2014-01-01

    "On average, more than one fifth of the 19th century Nijmegen brides were pregnant at the date of marriage. In a society where extramarital sexuality was explicitly forbidden, and where the success of marriage restriction depended on following that rule, this finding is remarkable. Obviously, the cultural life script that allowed sexuality only within marriage was not a script all inhabitants lived up to. A remarkable secondary finding is that the protestant population had a much higher propo...

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

    Science.gov (United States)

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

    2018-01-01

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

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

    DEFF Research Database (Denmark)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte

    2018-01-01

    performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch...... records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. RESULTS: Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15...

  13. Virtual Simulation Teaching Centre in Dental Education: a Report from Fujian Medical University, China.

    Science.gov (United States)

    Yu, Hao; Zhang, Chang Yuan; Zhang, Si Hui; Cheng, Hui; Chen, Jiang

    This report gives a brief introduction to the Virtual Simulation Teaching Centre of Fujian Medical University School of Stomatology (VSFMUSS), China. As one of the best dental simulation laboratories in China, the VSFMUSS aims to train dental students and clinicians to be professionals who are able to provide optimal oral health care by giving them the best virtual patient care experience possible in a nonclinical setting. The features, achievements and future directions of the VSFMUSS are addressed. Moreover, the role of the VSFMUSS was evaluated and discussed based on the students' and faculties' perceptions, rate of employment after graduation, and so on.

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

    Science.gov (United States)

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

    2016-08-30

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  16. Access Factors Affecting Supply Chain Efficiency of Medical Supplies in public Health Centres in kenya: A Case Study of Public Health Centres in Elgeyo Marakwet Count

    OpenAIRE

    Mark Kemboi Kanda; Mike Amuhaya Iravo

    2015-01-01

    The purpose of this study was to determine factors affecting efficiency of supply chain of pharmaceutical products (drugs) to Public Health facilities in 47 Counties of Kenya. The study precisely sought to establish whether: procurement processes, ICT infrastructure, distribution channels and competency of medical staff in supply chain, are factors affecting efficiency of supply chain of pharmaceutical products to Health Centres in Kenya. A population size of 120 employees was targeted in 15 ...

  17. A medical cyclotron, facilities and program at the King Faisal Specialist Hospital and Research Centre

    International Nuclear Information System (INIS)

    Barrall, R.C.; Feteih, N.; Merendino, K.A.

    1983-01-01

    A new Cancer Therapy Institute at the King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia became fully operational in November 1982. The new building incorporates extensive facilities for the production of medically useful radionuclides and additional cancer treatment capability including two neutron therapy machines and an electron linear accelerator. A model CS30 medical cyclotron with 7 beam lines was supplied by the Cyclotron Corporation, Berkeley, California. The hot laboratory facilities include five hot cells and a radioactive gas processing station to deliver short-lived radioactive gases to a station in the positron emission tomography (PET) camera room. Facilities for radiopharmaceutical processing, quality control and packaging of radioactive materials are provided. A PDP 11/70 computer controls a fully automated air monitoring system while other computers control permission to operate equipment and monitor status of shielding doors and radiation levels both inside and outside the shielded rooms. A high level gamma irradiation facility for medical sterilization and other uses, designed to hold up to 2 million Curies of cobalt-60 is also provided. The new facility will produce short lived radionuclides for hospitals and other institutions in the Kingdom and the nearby area while also providing an opportunity to investigate the effectiveness of high energy neutrons in cancer treatment

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2018-01-01

    INTRODUCTION: When general practitioners (GPs) order an ambulance, their calls are handled by staff at the emergency medical dispatch centre (EMDC) who then select an appropriate response. There are currently no data evaluating this mode of communication between the GPs and the staff at the EMDC....... 
METHODS: A retrospective study was performed based on evaluation of calls during which GPs requested a rapid response ambulance. Over a period of three months of 2014, 1,334 calls were included for evaluation according to specific parameters including a transactional analysis of the communication....... 
RESULTS: We found problematic communication in less than 2% (n = 25) of the evaluated calls. In 68% of the 25 problematic cases transactional analysis showed that the staff at the EMDC initiated the problematic communication. In 4% (n = 51) of the calls, the GP delegated the call to a secretary or nurse...

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

    Science.gov (United States)

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

    2017-05-17

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Safa Majidi Rahbar

    2017-07-01

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

  3. Nijmegen Cochlear Implant Questionnaire (NCIQ): translation, cultural adaptation, and application in adults with cochlear implants.

    Science.gov (United States)

    Santos, Nathália Porfírio Dos; Couto, Maria Inês Vieira; Martinho-Carvalho, Ana Claudia

    2017-12-11

    Cross-cultural adaptation and translation of the Nijmegen Cochlear Implant Questionnaire (NCIQ) into Brazilian Portuguese and analysis of quality of life (QoL) results in adults with cochlear implant (CI). The NCIQ instrument was translated into Brazilian Portuguese and culturally adapted. After that, a cross-sectional and clinical QoL evaluation was conducted with a group of 24 adults with CI. The questionnaire title in Brazilian Portuguese is 'Questionário Nijmegen de Implantes Cocleares' (NCIQ-P). The version of the NCIQ questionnaire translated into Brazilian Portuguese presented good internal consistency (0.78). The social and physical domains presented the highest scores, with the basic and advanced sound perception subdomains achieving the highest scores. No correlation between gender and time of device use was found for the questionnaire domains and subdomains. The cross-cultural adaptation and translation of the NCIQ into Brazilian Portuguese suggests that this instrument is reliable and useful for clinical and research purposes in Brazilian adults with CI.

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

    Directory of Open Access Journals (Sweden)

    Azman Ismail

    2016-12-01

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

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

    Science.gov (United States)

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

    2014-11-11

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    S. Gayathriedevi Sellathamby

    2017-06-01

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

  8. Relationship between medication beliefs, self-reported and refill adherence, and symptoms in patients with asthma using inhaled corticosteroids

    Directory of Open Access Journals (Sweden)

    Van Steenis MNA

    2014-01-01

    Full Text Available MNA Van Steenis,1 JA Driesenaar,2 JM Bensing,2,3 R Van Hulten,4 PC Souverein,4 L Van Dijk,2,4 PAGM De Smet,5 AM Van Dulmen2,6,71Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands; 2NIVEL (Netherlands institute for health services research, Utrecht, The Netherlands; 3Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands; 4Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands; 5IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 6Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 7Department of Health Sciences, Buskerud University College, Drammen, NorwayBackground: Beliefs play a crucial role in medication adherence. Interestingly, the relationship between beliefs and adherence varies when different adherence measures are used. How adherence, in turn, is related to asthma symptoms is still unclear. Our aim was to investigate the relationship between beliefs (ie, necessities and concerns about inhaled corticosteroids (ICS and subjectively as well as objectively measure adherence and the agreement between these measures. Further, the relationship between adherence and asthma symptoms was examined.Methods: A total of 280 patients aged 18–80 years who filled at least two ICS prescriptions in the preceding year were recruited to complete a questionnaire. The questionnaire included the Beliefs about Medicines Questionnaire to assess necessity beliefs and concerns about ICS, four questions about ICS use to measure self-reported adherence, and the Asthma Control Questionnaire to assess asthma symptoms. Proportion of days covered was used to determine pharmacy refill adherence.Results: Data from 93 patients with asthma were analyzed. Necessities were positively related to self-reported adherence (P = 0.01. No other

  9. Support needs for medication use and the suitability of eHealth technologies to address these needs: a focus group study of older patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Mathijssen EGE

    2018-03-01

    Full Text Available Elke GE Mathijssen,1 Johanna E Vriezekolk,1 Agnes MM Eijsbouts,1 Frank HJ van den Hoogen,1,2 Bart JF van den Bemt3 1Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands; 2Department of Rheumatology, Radboud University Medical Centre, Nijmegen, the Netherlands; 3Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands Objective: The objectives of this study were to explore the needs of patients with rheumatoid arthritis (RA regarding support for medication use and to gain insight into their perspective on the suitability of eHealth technologies to address these needs.Methods: Three focus groups were conducted with 28 patients with RA. Audio recordings made during the focus groups were transcribed verbatim. Two researchers independently performed an inductive, thematic analysis on the data (ie, the transcripts and field notes.Results: The following three themes that described support needs of patients with RA for medication use were identified in the data: 1 informational support; 2 practical support; and 3 emotional support. Informational support reflected the provision of information and facts, including advice, suggestions, and feedback from health care providers. Practical support included the reinforcement of practical skills as well as the provision of medication aids and pharmacy services. Emotional support reflected a trusted patient–health care provider relationship, characterized by good communication. Although potential advantages of eHealth technologies to address the patients’ support needs were recognized, concerns over matters such as personal interaction with health care providers, privacy and data security, and the quality and reliability of online information were prevalent.Conclusion: Patients with RA have informational, practical, and emotional support needs for medication use. Informational support seems to be most important. From the patients’ perspective, eHealth technologies may

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

    Directory of Open Access Journals (Sweden)

    Don O'Mahony

    2014-02-01

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

  11. A five year review of ectopic pregnancy at Federal Medical Centre, Owerri, South East, Nigeria.

    Science.gov (United States)

    Cornelius, Amajuoyi C; Onyegbule, A; Onyema; Uchenna, Ejelonu T; Duke, Onyeabochukwu A

    2014-01-01

    Ectopic pregnancy remains a leading cause of maternal morbidity and mortality in the first trimester of pregnancy in developing countries. To determine the incidence, pattern of presentation and management of ectopic pregnancies at Federal Medical Centre (FMC) Owerri. This was a retrospective descriptive study of all cases of ectopic gestations managed at FMC Owerri between 1st January 2009 and 31st December, 2013. The case notes were retrieved from the hospital's Records Department and information on socio-demographic characteristics, age, and parity, clinical presentation, findings at laparotomy, estimated blood loss and the need for blood transfusion were obtained. Data were entered into SPSS 17.0 and analysed descriptively. There were 382 cases of ectopic gestations out of the total 9880 total deliveries within the study period. The incidence of ectopic pregnancy was 38.66 per 1,000 live births or I in 26 deliveries. Nulliparous women were 132 (34.5%). At presentation, 99.47% of patients had rupture with haemoperitoneum, with the commonest site being the ampulla of the fallopian tube as seen in 338 (88.4%). Salpingectomy was done in majority of cases, accounting for 355 (93%), while 248 (65%) had blood transfusion. Five (1.3%) maternal deaths occurred during period of study. Ectopic pregnancy presents a major public health challenge among women of reproductive age groups in Nigeria. Efforts should be directed to public awareness on sex education, contraception, prevention and treatment of common risk factors for ectopic pregnancy.

  12. Cryptococcosis and cryptococcal meningitis: New predictors and clinical outcomes at a United States academic medical centre.

    Science.gov (United States)

    Kashef Hamadani, Bahar H; Franco-Paredes, Carlos; McCollister, Bruce; Shapiro, Leland; Beckham, J David; Henao-Martínez, Andrés F

    2017-12-28

    As the diagnosis of cryptococcosis is challenging in low-prevalence settings, uncovering predictive factors can improve early diagnosis and timely treatment. The aim of the study was to relate clinical outcomes to predictive variables for the presence of cryptococcosis. A retrospective case-control study matched by collection date, age and gender at a 1:2 ratio (55 cases and 112 controls) was performed in case patients diagnosed with Cryptococcus infection at the University of Colorado Hospital between 2000 and 2017 (n = 167). A bivariate and a forward, stepwise multivariable logistic regression model were performed to identify predictors of cryptococcosis infection. In an adjusted multivariable model, cryptococcal infection was significantly associated with the presence of respiratory symptoms, hyponatremia, lung disease or corticosteroids. Additionally, cryptococcal meningitis was associated with headaches, corticosteroids or increased CSF protein. Conversely, a reduced risk of cryptococcosis was associated with hypertension or peripheral monocytosis. Cryptococcal meningitis leads to subsequent hearing impairment (16% vs 4% (control), P = .013), muscle weakness (40% vs 20%, P = .021), cognitive deficits (33% vs 6%, P = .0001) or any adverse outcome (84% vs 29%, P = .0001). We uncovered novel clinical predictors for the presence of cryptococcal infection or cryptococcal meningitis. This study in patients at a low-prevalence US medical centre underscores the importance of early diagnosis in this population. © 2017 Blackwell Verlag GmbH.

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

    Science.gov (United States)

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

    2013-11-01

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

  14. Schwartz Centre Rounds: a new initiative in the undergraduate curriculum-what do medical students think?

    Science.gov (United States)

    Gishen, Faye; Whitman, Sophia; Gill, Deborah; Barker, Rhiannon; Walker, Steven

    2016-09-22

    Training to be a doctor and caring for patients are recognized as being stressful and demanding. The wellbeing of healthcare professionals impacts upon the wellbeing and care of patients. Schwartz Centre Rounds (SCRs), multidisciplinary meetings led by a trained facilitator and designed for hospital staff, were introduced to enhance communication and compassion, and have since been widely adopted as a way of fostering compassion. The continuum of education suggests that medical students need to develop these attributes in conjunction with resilience and maintaining empathy. The benefits of SCRs in fostering this development in medical students is unexplored. The objective of this study was to examine the potential of SCRs within the undergraduate curriculum. Two student-focused SCRs were piloted at a major medical school. The sessions were based on the current format implemented across the US and UK: a presentation of cases by a multidisciplinary panel followed by an open discussion with the audience. Participants were asked to complete an evaluative questionnaire immediately following the sessions. Seven students took part in a focus group to explore their views on the SCR. Data sets were examined using descriptive statistics and thematic analysis. Feedback was obtained from 77 % (258/334) Year 5 and 37 % (126/343) Year 6 students. Mean student ratings of the session on a five-point scale, where 1 = poor and 5 = exceptional, were 3.5 (Year 5) and 3.3 (Year 6). Over 80 % of respondents either agreed or strongly agreed that the presentation of cases was helpful and gave them insight into how others feel/think about caring for patients. Eighty percent said they would attend a future SCR and 64 % believed SCRs should be integrated into the curriculum. Focus group participants felt SCRs promoted reflection and processing of emotion. Students identified smaller group sizes and timing in the curriculum as ways of improving SCRs. Students were positive about

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

    Directory of Open Access Journals (Sweden)

    E. V. Shlyakhto

    2016-01-01

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

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

    Science.gov (United States)

    Draper, K; Ley, C; Parsonnet, J

    2017-05-30

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

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

    Science.gov (United States)

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

    2012-01-01

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

  18. Gastric outlet obstruction at Bugando Medical Centre in Northwestern Tanzania: a prospective review of 184 cases.

    Science.gov (United States)

    Jaka, Hyasinta; Mchembe, Mabula D; Rambau, Peter F; Chalya, Phillipo L

    2013-09-25

    Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. There is a paucity of published data on this subject in our setting. This study was undertaken to highlight the etiological spectrum and treatment outcome of gastric outlet obstruction in our setting and to identify prognostic factors for morbidity and mortality. This was a descriptive prospective study which was conducted at Bugando Medical Centre between March 2009 and February 2013. All patients with a clinical diagnosis of gastric outlet obstruction were, after informed consent for the study, consecutively enrolled into the study. Statistical data analysis was done using SPSS computer software version 17.0. A total of 184 patients were studied. More than two-third of patients were males. Patients with malignant gastric outlet obstruction were older than those of benign type. This difference was statistically significant (p Gastric cancer was the commonest malignant cause of gastric outlet obstruction where as peptic ulcer disease was the commonest benign cause. In children, the commonest cause of gastric outlet obstruction was congenital pyloric stenosis (13.0%). Non-bilious vomiting (100%) and weight loss (93.5%) were the most frequent symptoms. Eighteen (9.8%) patients were HIV positive with the median CD 4+ count of 282 cells/μl. A total of 168 (91.3%) patients underwent surgery. Of these, gastro-jejunostomy (61.9%) was the most common surgical procedure performed. The complication rate was 32.1 % mainly surgical site infections (38.2%). The median hospital stay and mortality rate were 14 days and 18.5% respectively. The presence of postoperative complication was the main predictor of hospital stay (p = 0.002), whereas the age > 60 years, co-existing medical illness, malignant cause, HIV positivity, low CD 4 count (Gastric outlet obstruction in our setting is more prevalent in males and the cause is mostly malignant. The

  19. Successful strategies to improve RN retention and patient outcomes in a large medical centre in Hawaii.

    Science.gov (United States)

    Kooker, Barbara Molina; Kamikawa, Cynthia

    2011-01-01

    The purpose of this paper is to describe an assessment of a major retention initiative implemented at The Queen's Medical Center in Honolulu, Hawaii, in response to the nursing workforce shortage in the state. After tracking the situation for several years, nursing leadership at the medical centre critically analysed their registered nurse retention data. The retention rate among new nurses in their first year of employment was only 55·97%. A training programme was initiated to improve registered nurse retention and patient care outcomes with external funding from the US Health Resources and Services Administration. New nurses were supported via additional training and clinical coaches beyond the basic orientation period. Leadership skills of nurse managers were expanded to strengthen their role in retention of new nurses. Four inpatient nursing units became Magnet Pilot Units to demonstrate progress towards achievement of Magnet standards and improvement of patient outcomes. From 2005-2009, first-year-registered nurse retention improved from 55·97-68·20%; registered nurse vacancy rate decreased from 11·26-2·19%; patient satisfaction increased from 84·6-87·8%; registered nurse satisfaction-autonomy improved from 43·55-49·29; registered nurse satisfaction-decision-making went from 41·13-47·97%; and nosocomial decubitus ulcer rate decreased from 15·3-6·7% in the intensive care units. Dedicated resources and targeted activities can make a difference in outcomes for both nurses and patients. Keys to success included engaging staff, having high expectations coupled with high support, providing data to unit-level staff to measure improvements emphasising renewed accountability and maintaining the focus on quality patient care. When the goal is to provide the highest level of quality patient care, professional development of staff and managers is important to meet performance expectations and achieve target clinical goals. Improving registered nurse retention

  20. Gastric outlet obstruction at Bugando Medical Centre in Northwestern Tanzania: a prospective review of 184 cases

    Science.gov (United States)

    2013-01-01

    Background Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. There is a paucity of published data on this subject in our setting. This study was undertaken to highlight the etiological spectrum and treatment outcome of gastric outlet obstruction in our setting and to identify prognostic factors for morbidity and mortality. Methods This was a descriptive prospective study which was conducted at Bugando Medical Centre between March 2009 and February 2013. All patients with a clinical diagnosis of gastric outlet obstruction were, after informed consent for the study, consecutively enrolled into the study. Statistical data analysis was done using SPSS computer software version 17.0. Results A total of 184 patients were studied. More than two-third of patients were males. Patients with malignant gastric outlet obstruction were older than those of benign type. This difference was statistically significant (p outlet obstruction where as peptic ulcer disease was the commonest benign cause. In children, the commonest cause of gastric outlet obstruction was congenital pyloric stenosis (13.0%). Non-bilious vomiting (100%) and weight loss (93.5%) were the most frequent symptoms. Eighteen (9.8%) patients were HIV positive with the median CD 4+ count of 282 cells/μl. A total of 168 (91.3%) patients underwent surgery. Of these, gastro-jejunostomy (61.9%) was the most common surgical procedure performed. The complication rate was 32.1 % mainly surgical site infections (38.2%). The median hospital stay and mortality rate were 14 days and 18.5% respectively. The presence of postoperative complication was the main predictor of hospital stay (p = 0.002), whereas the age > 60 years, co-existing medical illness, malignant cause, HIV positivity, low CD 4 count (outlet obstruction in our setting is more prevalent in males and the cause is mostly malignant. The majority of patients present late with poor

  1. Clinical spectrum and various forms of thyrotoxcosis in endocrine clinic of Jinnah Postgraduate Medical Centre

    International Nuclear Information System (INIS)

    Ahsan, T.; Banu, Z.; Jabeen, R.; Farooq, M. U.

    2013-01-01

    Objective: To evaluate clinical symptoms, signs and various forms of thyrotoxicosis, and to assess the thyroid function status at the first 6-week follow-up. Methods: The retrospective chart review involved thyrotoxic patients presenting at the Endocrine Clinic of Jinnah Postgraduate Medical Centre, Karachi, between April 2007 and January 2011. All hyperthyroid patients were included with the exception of those with suspected or proven malignancy. The records were maintained on a structured proforma and analysed statistically to work out frequencies and percentages. Results: A total of 507 patients were included. Most common form of thyrotoxicosis was Graves disease, with diffuse toxic goiter affecting 269 (53%) patients; followed by toxic multinodular goiter in 102 (20.1%); solitary toxic nodule in 56 (11%); thyrotoxicosis without goiter in 44 (8.7%); subclinical hyperthyroidism in 22 (4.3.%); thyroiditis in 9 (1.8%); and thyrotoxicosis with solitary cold nodule in 4 (0.9%). The common presenting symptoms and signs were goiter (n=415; 85.7%), with eye signs present in 137 (27.7%) patients and heart failure in 20 (4.8%) patients. Of the 321 patients who attended the first six-week follow-up, 309 (94.4%) had their FT4 levels checked. Out of them, 130(42.1%) had euthyroid levels; 113 (36.6%) had lower but still toxic level; 36 (11.7%) had no change; and 30(9.7%) became hypothyroid. TSH levels at first follow-up remained suppressed in 211 (73%) patients; normal in 47(16.3%); and increased in 31 (10.7%). Conclusions: Graves disease was found to be the most common cause of hyperthyroidism. At first follow-up 10.4% of patients had become hypothyroid. Therefore the starting dose of antithyroid drugs was reduced in the clinic. Thyroid stimulating hormone assay was of little help in adjusting treatment at the 6-week follow-up, as almost all cases of hypothyroidism could have been picked up on FT4 assay alone. (author)

  2. Nijmegen Continuity Questionnaire: development and testing of a questionnaire that measures continuity of care.

    Science.gov (United States)

    Uijen, Annemarie A; Schellevis, François G; van den Bosch, Wil J H M; Mokkink, Henk G A; van Weel, Chris; Schers, Henk J

    2011-12-01

    To develop and pilot test a generic questionnaire to measure continuity of care from the patient's perspective across primary and secondary care settings. We developed the Nijmegen Continuity Questionnaire (NCQ) based on a systematic literature review and analysis of 30 patient interviews. The questionnaire consisted of 16 items about the patient-provider relationship to be answered for five different care providers and 14 items each on the collaboration between four groups of care providers. The questionnaire was distributed among patients with a chronic disease recruited from general practice. We used principal component analysis (PCA) to identify subscales. We refined the factors by excluding several items, for example, items with a high missing rate. In total, 288 patients filled out the questionnaire (response rate, 72%). PCA yielded three subscales: "personal continuity: care provider knows me," "personal continuity: care provider shows commitment," and "team/cross-boundary continuity." Internal consistency of the subscales ranged from 0.82 to 0.89. Interscale correlations varied between 0.42 and 0.61. The NCQ shows to be a comprehensive, reliable, and valid instrument. Further testing of reliability, construct validity, and responsiveness is needed before the NCQ can be more widely implemented. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Measuring continuity of care: psychometric properties of the Nijmegen Continuity Questionnaire

    Science.gov (United States)

    Uijen, Annemarie A; Schers, Henk J; Schellevis, François G; Mokkink, Henk GA; van Weel, Chris; van den Bosch, Wil JHM

    2012-01-01

    Background Recently, the Nijmegen Continuity Questionnaire (NCQ) was developed. It aims to measure continuity of care from the patient perspective across primary and secondary care settings. Initial pilot testing proved promising. Aim To further examine the validity, discriminative ability, and reliability of the NCQ. Design A prospective psychometric instrument validation study in primary and secondary care in the Netherlands. Method The NCQ was administered to patients with a chronic disease recruited from general practice (n = 145) and hospital outpatient departments (n = 123) (response rate 76%). A principal component analysis was performed to confirm three subscales that had been found previously. Construct validity was tested by correlating the NCQ score to scores of other scales measuring quality of care, continuity, trust, and satisfaction. Discriminative ability was tested by investigating differences in continuity subscores of different subgroups. Test–retest reliability was analysed in 172 patients. Results Principal factor analysis confirmed the previously found three continuity subscales — personal continuity, care provider knows me; personal continuity, care provider shows commitment; and team/cross-boundary continuity. Construct validity was demonstrated through expected correlations with other variables and discriminative ability through expected differences in continuity subscores of different subgroups. Test–retest reliability was high (the intraclass correlation coefficient varied between 0.71 and 0.82). Conclusion This study provides evidence for the validity, discriminative ability, and reliability of the NCQ. The NCQ can be of value to identify problems in continuity of care. PMID:22782001

  4. Imaging study of lymphoreticular tumor development in ataxia-telangiectasia and Nijmegen breakage syndrome

    International Nuclear Information System (INIS)

    Martinez-Leon, M. I.; Ceres-Ruiz, L.; Cuesta, M. A.; Garcia-Martin, F. J.

    2003-01-01

    Ataxia-telangiectasia (AT), or Louis-Bar syndrome, is an autosomal recessive illness characterized by progressive cerebellar ataxia, oculo-cutaneous telangiectasia, immunodeficiency combined with susceptibility to sinopulmonary infections and high incidence of neoplastic development. Nijmegen breakage syndrome (NBS) is a variant of AT, is also an autosomal recessive illness that presents cerebellar ataxia, as well as combined immunodeficiency and a tendency toward tumor development. Contrary to Louis-Bar syndrome, it doesn't present telangiectasia and exhibits a characteristics phenotype (short stature, bird-like face and microcephaly). Both entities are classified as syndrome of chromosomal instability or chromosomal fragility, a group which also includes Bloom syndrome and Fanconi anemia. All of these show an increase in the frequency of neoplastic pathologies, mainly lymphoid tumors. We present three patients,two with AT and one with NBS, who developed different lymphoma types in the course of the illness. We highlight the most outstanding aspects from a clinical-radiological point of view. (Author) 17 refs

  5. Measuring continuity of care: psychometric properties of the Nijmegen Continuity Questionnaire.

    Science.gov (United States)

    Uijen, Annemarie A; Schers, Henk J; Schellevis, François G; Mokkink, Henk G A; van Weel, Chris; van den Bosch, Wil Jhm

    2012-07-01

    Recently, the Nijmegen Continuity Questionnaire (NCQ) was developed. It aims to measure continuity of care from the patient perspective across primary and secondary care settings. Initial pilot testing proved promising. To further examine the validity, discriminative ability, and reliability of the NCQ. A prospective psychometric instrument validation study in primary and secondary care in the Netherlands. The NCQ was administered to patients with a chronic disease recruited from general practice (n = 145) and hospital outpatient departments (n = 123) (response rate 76%). A principal component analysis was performed to confirm three subscales that had been found previously. Construct validity was tested by correlating the NCQ score to scores of other scales measuring quality of care, continuity, trust, and satisfaction. Discriminative ability was tested by investigating differences in continuity subscores of different subgroups. Test-retest reliability was analysed in 172 patients. Principal factor analysis confirmed the previously found three continuity subscales - personal continuity, care provider knows me; personal continuity, care provider shows commitment; and team/cross-boundary continuity. Construct validity was demonstrated through expected correlations with other variables and discriminative ability through expected differences in continuity subscores of different subgroups. Test-retest reliability was high (the intraclass correlation coefficient varied between 0.71 and 0.82). This study provides evidence for the validity, discriminative ability, and reliability of the NCQ. The NCQ can be of value to identify problems in continuity of care.

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

    Directory of Open Access Journals (Sweden)

    Olajide O Adelugba

    2016-01-01

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

  7. A comparison of usual care, a patient-centred education intervention and motivational interviewing to improve medication adherence and readmissions of adults in an acute-care setting.

    Science.gov (United States)

    Hyrkas, Kristiina; Wiggins, Marjorie

    2014-04-01

    To compare medication adherence and readmissions in patients who received usual care vs. patient-centred interventions. Medication adherence is a complex behaviour that may be improved with patient-centred strategies. A non-concurrent convenience sample of 303 hospitalised patients received either usual care (n = 98) or patient-centred interventions (n = 205). Intervention patients received teach-back and medication tools (n = 137) or motivational interviewing (n = 68). Data were collected at discharge (T1), at 48-72 hours (T2) and 30 days after discharge (T3). No significant differences were found in medication adherence, therapeutic alliance, patients' experience and readmissions between groups. Patients in the motivational interview group reported lower confidence with medication adherence at T1 (P = 0.01) and T2 (P = 0.00) than the patient-centred intervention group. Motivational interviewing was a significant predictor (β = -1.55, P = 0.01, OR 0.21, 95% CI 0.06, 0.72) of fewer readmissions. Overall, patients reported very low levels of non-adherence and very high levels of confidence and importance of medication adherence. Medication adherence continues to be an important area for clinical inquiry. For those patients who lack confidence for medication adherence, comprehensive patient-centred strategies such as motivational interviewing may improve treatment outcomes. © 2014 John Wiley & Sons Ltd.

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

    International Nuclear Information System (INIS)

    Ivanova, S.P.; )

    2005-01-01

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

  9. HIV serostatus and tumor differentiation among patients with cervical cancer at Bugando Medical Centre

    Directory of Open Access Journals (Sweden)

    Matovelo Dismas

    2012-08-01

    Full Text Available Abstract Background Evidence for the association between Human immunodeficiency virus infection and cervical cancer has been contrasting, with some studies reporting increased risk of cervical cancer among HIV positive women while others report no association. Similar evidence from Tanzania is scarce as HIV seroprevalence among cervical cancer patients has not been rigorously evaluated. The purpose of this study was to determine the association between HIV and tumor differentiation among patients with cervical cancer at Bugando Medical Centre and Teaching Hospital in Mwanza, North-Western Tanzania. Methods This was a descriptive analytical study involving suspected cervical cancer patients seen at the gynaecology outpatient clinic and in the gynaecological ward from November 2010 to March 2011. Results A total of 91 suspected cervical cancer patients were seen during the study period and 74 patients were histologically confirmed with cervical cancer. The mean age of those confirmed of cervical cancer was 50.5 ± 12.5 years. Most patients (39 of the total 74–52.7% were in early disease stages (stages IA-IIA. HIV infection was diagnosed in 22 (29.7% patients. On average, HIV positive women with early cervical cancer disease had significantly more CD4+ cells than those with advanced disease (385.8 ± 170.4 95% CI 354.8-516.7 and 266.2 ± 87.5, 95% CI 213.3-319.0 respectively p = 0.042. In a binary logistic regression model, factors associated with HIV seropositivity were ever use of hormonal contraception (OR 5.79 95% CI 1.99-16.83 p = 0.001, aged over 50 years (OR 0.09 95% CI 0.02-0.36 p = 0.001, previous history of STI (OR 3.43 95% CI 1.10-10.80 p = 0.035 and multiple sexual partners OR 5.56 95% CI 1.18-26.25 p = 0.030. Of these factors, only ever use of hormonal contraception was associated with tumor cell differentiation (OR 0.16 95% CI 0.06-0.49 p = 0.001. HIV seropositivity was weakly associated with

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

    Science.gov (United States)

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

    2017-09-22

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

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

    Science.gov (United States)

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

    2016-09-21

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

  12. Medication errors made by health care professionals. Analysis of the Finnish Poison Information Centre data between 2000 and 2007.

    Science.gov (United States)

    Kuitunen, Tapio; Kuisma, Pia; Hoppu, Kalle

    2008-08-01

    The purpose of this study was to analyse the extent, type and time trends of medication errors made by health care professionals leading to a call to the Finnish Poison Information Centre (PIC). The PIC database consisting of all calls (277,300) received between 1 June 2000 and 31 May 2007 was analysed in terms of medication errors. Of 189,956 calls involving acute human poisonings, 1270 (0.7%) concerned medication errors (n = 1275), of which 779 (60.9%) involved administration of the wrong drug, 429 (33.6%) involved administration of the wrong dose and 70 (5.5%) involved erroneous route of administration. Incidents involving the elderly (80-89 years of age, n = 231; 18.2%) and children below 10 years (n = 136; 10.7%) were most likely to result in a call to the PIC about a medication error. In children, the most common error was wrong dose, while in adults, it was wrong drug. The number of medication errors was greatest during the summer months and in December. Medication errors seem to be different in children and the elderly. They are also more likely prone to occur during holiday seasons.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  14. Mutation inactivation of Nijmegen breakage syndrome gene (NBS1 in hepatocellular carcinoma and intrahepatic cholangiocarcinoma.

    Directory of Open Access Journals (Sweden)

    Yan Wang

    Full Text Available Nijmegen breakage syndrome (NBS with NBS1 germ-line mutation is a human autosomal recessive disease characterized by genomic instability and enhanced cancer predisposition. The NBS1 gene codes for a protein, Nbs1(p95/Nibrin, involved in the processing/repair of DNA double-strand breaks. Hepatocellular carcinoma (HCC is a complex and heterogeneous tumor with several genomic alterations. Recent studies have shown that heterozygous NBS1 mice exhibited a higher incidence of HCC than did wild-type mice. The objective of the present study is to assess whether NBS1 mutations play a role in the pathogenesis of human primary liver cancer, including HBV-associated HCC and intrahepatic cholangiocarcinoma (ICC. Eight missense NBS1 mutations were identified in six of 64 (9.4% HCCs and two of 18 (11.1% ICCs, whereas only one synonymous mutation was found in 89 control cases of cirrhosis and chronic hepatitis B. Analysis of the functional consequences of the identified NBS1 mutations in Mre11-binding domain showed loss of nuclear localization of Nbs1 partner Mre11, one of the hallmarks for Nbs1 deficiency, in one HCC and two ICCs with NBS1 mutations. Moreover, seven of the eight tumors with NBS1 mutations had at least one genetic alteration in the TP53 pathway, including TP53 mutation, MDM2 amplification, p14ARF homozygous deletion and promoter methylation, implying a synergistic effect of Nbs1 disruption and p53 inactivation. Our findings provide novel insight on the molecular pathogenesis of primary liver cancer characterized by mutation inactivation of NBS1, a DNA repair associated gene.

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

    Science.gov (United States)

    Urban, Michal; Leššo, Roman; Pelclová, Daniela

    2016-07-01

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

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

    DEFF Research Database (Denmark)

    Zeeberg, P; Olesen, Jes; Jensen, R

    2009-01-01

    The classification subcommittee of the International Headache Society (IHS) has recently suggested revised criteria for medication overuse headache (MOH) and chronic migraine (CM). We field tested these revised criteria by applying them to the headache population at the Danish Headache Centre...... and the possibility of a renewed effect of prophylactic drugs due to medication withdrawal. We therefore recommend the implementation of the appendix criteria for both MOH and CM into the main body of the International Classification of Headache Disorders....... and compared the results with those using the current criteria. For CM we also tested two alternative criteria, one requiring > or = 4 migraine days/month and > or = 15 headache days/month, the second requiring > or = 15 headache days/month and > or = 50% migraine days. We included 969 patients with migraine...

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

    Science.gov (United States)

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

    2002-09-27

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

  18. English for the Workplace: Doing Patient-Centred Care in Medical Communication

    Science.gov (United States)

    Dahm, Maria R.; Yates, Lynda

    2013-01-01

    Canada, like other first-world countries, relies in large part on professional immigrants trained in other cultures and languages to complement its workforce in a wide range of professions, including medicine. International medical graduates (IMGs) who are nonnative English-speaking (NNES) and who have trained in different medical contexts are…

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

    OpenAIRE

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

    2006-01-01

    In an ethnically diverse society cultural competence is indispensable for medical doctors. At present 10% of the Dutch population are first- or second-generation non-Western immigrants. With 8% Western and 18% non-Western immigrants, originating from 30 different countries, the 2001 Rotterdam first-year students highly out-rated the national average of immigrant medical students. Diverse student populations may enhance students’ cultural competence but can also generate conflicts or even raci...

  20. Clinical outcome of elderly peritoneal dialysis patients with assisted care in a single medical centre: a 25 year experience.

    Science.gov (United States)

    Cheng, Chi-Hung; Shu, Kuo-Hsiung; Chuang, Ya-Wen; Huang, Shih-Ting; Chou, Ming-Chih; Chang, Horng-Rong

    2013-06-01

    Peritoneal dialysis (PD) is an alternative treatment for elderly patients with end-stage renal disease (ESRD). In Taiwan, non-professional personnel are employed to provide assisted care for elderly patients. Whether assisted care is appropriate for elderly patients is unknown. The aim of this paper is to evaluate the outcomes of assisted care in a single centre. This is a retrospective cohort study in a single medical centre. The outcomes were derived from the assessment of patient survival, technique survival and peritonitis incidence between self-care patients and assisted-care patients. From 1984 to 2010, there were 138 elderly PD patients at Taichung Veterans General Hospital, of which 70% were assisted-care patients and 30% self-care patients. The mean duration of PD survival was 49.2 months in self-care patients, which was significantly longer than the 17.0 months of assisted-care patients (P self-care patients had a lower risk in both patient survival (Hazard Ratio 0.15; 95% confidence interval (CI) 0.2-0.94, P care patients. Type of assistance was not a risk factor for PD-related peritonitis. Our elderly assisted care had patients had a poorer survival and technique survival rates than those of the self-care patients. We argue that this is because early recognition of medical deterioration and early medical intervention are necessary for a better outcome for elderly PD patients. © 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-10-01

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

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Less equal than others? Experiences of AYUSH medical officers in primary health centres in Andhra Pradesh.

    Science.gov (United States)

    Lakshmi, J K

    2012-01-01

    The National Rural Health Mission (NRHM) includes, inter alia, the establishment of an AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) component (practitioner, trained assistants, drugs and equipment) in every primary health centre (PHC). However, five years following the launch of the NRHM, the AYUSH mainstreaming scenario is below expectations, riddled with ethical and governance issues. Accounts from AYUSH practitioners at PHCs in various regions of the state of Andhra Pradesh reveal enormous lacunae in implementation: unfilled positions, inequitable emoluments, inadequate or absent infrastructure, assistance and supplies, unethical interpersonal arrangements, and limited support from non-AYUSH personnel. The widespread negative impact of these conditions undermines the value of AYUSH, demotivating both practitioners and patients, and failing to provide the intended support to the public health system.

  5. Introduction: Centre and periphery in the eighteenth-century Habsburg 'medical empire'.

    Science.gov (United States)

    Spary, E C

    2012-09-01

    This paper introduces a collection of essays exploring different aspects of the relationship between medical knowledge and administration in the Habsburg Monarchy. The collection brings together a range of perspectives upon the confrontation between programmes for centralised medical bureaucracy emanating from Vienna, and their implementation in a variety of different cultural, linguistic, social and practical circumstances. Such confrontations raise issues about the nature and limits of enlightened universalism, the relationship between knowledge and government in the seventeenth and eighteenth centuries, and the similarities between the processes of centralisation and the issues addressed by historians of empire. The case of Gerard van Swieten, Catholic Dutch medical practitioner appointed as the chief physician to the Habsburg Imperial family, is used to illustrate some of the main issues involved. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Singapore National Medical Image Resource Centre (SN.MIRC): a world wide web resource for radiology education.

    Science.gov (United States)

    Yang, Guo-Liang; Lim, C C Tchoyoson

    2006-08-01

    Radiology education is heavily dependent on visual images, and case-based teaching files comprising medical images can be an important tool for teaching diagnostic radiology. Currently, hardcopy film is being rapidly replaced by digital radiological images in teaching hospitals, and an electronic teaching file (ETF) library would be desirable. Furthermore, a repository of ETFs deployed on the World Wide Web has the potential for e-learning applications to benefit a larger community of learners. In this paper, we describe a Singapore National Medical Image Resource Centre (SN.MIRC) that can serve as a World Wide Web resource for teaching diagnostic radiology. On SN.MIRC, ETFs can be created using a variety of mechanisms including file upload and online form-filling, and users can search for cases using the Medical Image Resource Center (MIRC) query schema developed by the Radiological Society of North America (RSNA). The system can be improved with future enhancements, including multimedia interactive teaching files and distance learning for continuing professional development. However, significant challenges exist when exploring the potential of using the World Wide Web for radiology education.

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  8. Extended-Spectrum β-lactam Resistance in the Enteric Flora of Patients at a Tertiary Care Medical Centre.

    Science.gov (United States)

    Landers, T F; Mollenkopf, D F; Faubel, R L; Dent, A; Pancholi, P; Daniels, J B; Wittum, T E

    2017-03-01

    The dissemination of Enterobacteriaceae expressing resistance to extended-spectrum cephalosporins, which are therapeutically used in both human and veterinary medicine, is of critical concern. The normal commensal flora of food animals may serve as an important reservoir for the zoonotic food-borne transmission of Enterobacteriaceae harbouring β-lactam resistance. We hypothesized that the predominant AmpC and ESBL genes reported in US livestock and fresh retail meat products, bla CMY -2 and bla CTX -M , would also be predominant in human enteric flora. We recovered enteric flora from a convenience sample of patients included in a large tertiary medical centre's Clostridium difficile surveillance programme to screen for and estimate the frequency of carriage of AmpC and ESBL resistance genes. In- and outpatient diarrhoeic submissions (n = 692) received for C. difficile testing at the medical centre's clinical diagnostic laboratory from July to December, 2013, were included. Aliquoted to a transport swab, each submission was inoculated to MacConkey broth with cefotaxime, incubated at 37°C and then inoculated to MacConkey agars supplemented with cefoxitin and cefepime to select for the AmpC and ESBL phenotypes, with bla CMY and bla CTX -M genotypes confirmed by PCR and sequencing. From the 692 diarrhoeic submissions, our selective culture yielded 184 isolates (26.6%) with reduced susceptibility to cefotaxime. Of these, 46 (6.7%) samples harboured commensal isolates carrying the AmpC bla CMY . Another 21 (3.0%) samples produced isolates harbouring the ESBL bla CTX -M : 19 carrying CTX-M-15 and 2 with CTX-M-27. Our results indicate that β-lactam resistance genes likely acquired through zoonotic food-borne transmission are present in the enteric flora of this hospital-associated population at lower levels than reported in livestock and fresh food products. © 2016 Blackwell Verlag GmbH.

  9. Driving forces of biomedical science education and research in state-of-the arts academic medical centres: the United States as example.

    Science.gov (United States)

    John, T A

    2011-06-01

    Basic science departments in academic medical centres are influenced by changes that are commonly directed at medical education and financial gain. Some of such changes may have been detrimental to or may have enhanced basic science education. They may have determined basic science research focus or basic science research methods. However, there is lack of research on the educational process in the basic sciences including training of PhD's while there is ample research on medical education pertaining to training of medical doctors. The author here identifies, from university websites and available literature, some forces that have driven teaching and research focus and methods in state-of-the-arts academic medical centres in recent times with a view of seeing through their possible influences on basic science education and research, using the United States of America as an example. The "forces" are: Changes in medical schools; Medical educational philosophies: problem based learning, evidence based medicine, cyberlearning and self-directed learning; Shifting impressions of the value of basic sciences in medical schools; Research trends in Basic Sciences: role of antivivisectionists, alternative experimentations, explosion of molecular and cell biology; Technological advancements; Commercialization of research; and Funding agencies. The author encourages African leaders in academia to pay attention to such forces as the leadership seeks to raise African Universities as centres of knowledge that have a major role in acquiring, preserving, imparting, and utilizing knowledge.

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2017-01-01

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

  12. Targeted simulation and education to improve cardiac arrest recognition and telephone assisted CPR in an emergency medical communication centre.

    Science.gov (United States)

    Hardeland, Camilla; Skåre, Christiane; Kramer-Johansen, Jo; Birkenes, Tonje S; Myklebust, Helge; Hansen, Andreas E; Sunde, Kjetil; Olasveengen, Theresa M

    2017-05-01

    Recognition of cardiac arrest and prompt activation time by emergency medical dispatch are key process measures that have been associated with improved survival after out-of-hospital cardiac arrest (OHCA). The aim of this study is to improve recognition of OHCA and time to initiation of telephone assisted chest compressions in an emergency medical communication centre (EMCC). A prospective, interventional study implementing targeted interventions in an EMCC. Interventions included: (1) lectures focusing on agonal breathing and interrogation strategy (2) simulation training (3) structured dispatcher feedback (4) web-based telephone assisted CPR training program. All ambulance-confirmed OHCA calls in the study period were assessed and relevant process and result measures were recorded pre- and post-intervention. Cardiac arrest was reported as (1) recognised, (2) not recognised or (3) delayed recognition. We included 331 and 230 calls pre- and post-intervention, respectively. Recognition of cardiac arrest improved significantly after intervention (89 vs. 95%, p=0.024). Delayed recognition was significantly reduced (21 vs. 6%, p>0.001), as was misinterpretation of agonal breathing (25 vs. 10%, pquality metrics can facilitate development of targeted education and training. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

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

  14. STUDY ON SPINAL DYSRAPHISM IN TERTIARY CARE CENTRE, ANDHRA MEDICAL COLLEGE, VISAKHAPATNAM

    Directory of Open Access Journals (Sweden)

    Hayagriva Rao

    2015-12-01

    cases (11, 20.37% sphincter function remained status quo same as in the preoperative period. CONCLUSION A spinal dysraphism patient should receive treatment from an experienced multidisciplinary team including neonatologist, neurosurgeon, and plastic surgeon and rehabilitation experts. Inadequate treatment at peripheral centers should be avoided. Patient should be referred to higher tertiary centre where the complete team is available. The post-operative care is equally important to avoid complications and for better outcome.

  15. Evaluation of Electronic Medical Record (EMR at large urban primary care sexual health centre.

    Directory of Open Access Journals (Sweden)

    Christopher K Fairley

    Full Text Available OBJECTIVE: Despite substantial investment in Electronic Medical Record (EMR systems there has been little research to evaluate them. Our aim was to evaluate changes in efficiency and quality of services after the introduction of a purpose built EMR system, and to assess its acceptability by the doctors, nurses and patients using it. METHODS: We compared a nine month period before and after the introduction of an EMR system in a large sexual health service, audited a sample of records in both periods and undertook anonymous surveys of both staff and patients. RESULTS: There were 9,752 doctor consultations (in 5,512 consulting hours in the Paper Medical Record (PMR period and 9,145 doctor consultations (in 5,176 consulting hours in the EMR period eligible for inclusion in the analysis. There were 5% more consultations per hour seen by doctors in the EMR period compared to the PMR period (rate ratio = 1.05; 95% confidence interval, 1.02, 1.08 after adjusting for type of consultation. The qualitative evaluation of 300 records for each period showed no difference in quality (P>0.17. A survey of clinicians demonstrated that doctors and nurses preferred the EMR system (P<0.01 and a patient survey in each period showed no difference in satisfaction of their care (97% for PMR, 95% for EMR, P = 0.61. CONCLUSION: The introduction of an integrated EMR improved efficiency while maintaining the quality of the patient record. The EMR was popular with staff and was not associated with a decline in patient satisfaction in the clinical care provided.

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

    Science.gov (United States)

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

    2011-10-01

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  18. Survey of medical X-ray centres in the municipal area of Munich to evaluate their technical equipments

    International Nuclear Information System (INIS)

    Dielschneider, K.

    1988-01-01

    Data were collected on the facilities and installations in various medical X-ray centres in the Munich municipal area that were to form the basis of a large-scales survey demanded by the EC Council. Questionnaires especially designed to serve that purpose were sent out to 550 adminstrative bodies maintaining X-ray centres and completed by 67.6% of these. It was evident from the survey that the firms Siemens, CHF Mueller, Hofmann, Picker and Koch and Sterzel are sharing the market between them, leaving only a small portion to a group of other suppliers. The majority of X-ray units were found to data from the period between 1971 and 1980, even though 7.4% were purchased before 1960 and have thus been in use for more than twenty years. Most generators still are of the six-pulse type, but hospitals in particular now appear to be showing a pre-dilection for twelve-pulse and multipulse generators. Special-purpose facilities are mostly encountered in clinics and similar institutions. Among these, devices for taking sectional roentgenograms prevail. The majority of fluoroscopes feature built-in spot-film devices, devices for image-intensified television and multi-leaf collimators. Most radiographic units come complete with cassette support, examining table and grid as well as multi-leaf collimators. The X-rays taken are generally processed by machine. The analysis led to the conclusion that the X-ray services available to the population of the Munich municipal area can be regarded as being very satisfactory. (orig./HP) [de

  19. Assessing residents’ knowledge of patient satisfaction: a cross-sectional study at a large academic medical centre

    Science.gov (United States)

    Stewart, Diana E; Dang, Bich N; Trautner, Barbara; Cai, Cecilia; Torres, Sergio; Turner, Teri

    2017-01-01

    Objectives Patient satisfaction impacts healthcare quality and outcomes. Residents play an important role in patient satisfaction at academic institutions. This study aims to assess residents’ patient satisfaction knowledge and determine which learning experiences contributed to their knowledge acquisition. Settings This study was conducted at a health science university in a large, urban, tertiary-care academic medical centre in the USA. Participants All residents from internal medicine (n=185) and paediatrics (n=156) were asked to participate. Design Residents completed a survey from April 2013 to December 2013 that assessed (1) knowledge of factors that impact patient satisfaction and (2) learning experiences that may have contributed to their understanding of the drivers of patient satisfaction (eg, experiential (personal or clinical) or didactics). Trainees identified the importance of factors in determining patient satisfaction on a five-point Likert scale; answers were compiled into a knowledge score. The score was correlated with prior personal/clinical experience and didactics. Results Of the 341 residents, 247 (72%) completed the survey. No difference was found in knowledge among training levels or residency programme. More than 50% incorrectly thought physician board certification, patient’s education, patient’s income and physician’s age impacted satisfaction. Personal experience, through hospitalisation of a relative or friend, was correlated with higher knowledge (67% vs 71%, p=0.03). Ninety-nine per cent (n=238) stated peer observation, and all stated faculty feedback impacted their patient satisfaction knowledge. Seventy-seven per cent (n=185) had attended didactics on satisfaction, but attendance did not correlate with higher scores. Conclusions Our study showed trainees have a few gaps in their patient satisfaction knowledge, and attending past educational sessions on patient satisfaction did not correlate with higher knowledge scores. Our

  20. Sexual harassment during clinical clerkships in Dutch medical schools.

    NARCIS (Netherlands)

    Rademakers, J.J.D.J.M.; Muijsenbergh, M.E.T.C. van den; Slappendel, G.; Lagro-Janssen, A.L.M.; Borleffs, J.C.C.

    2008-01-01

    CONTEXT: Sexual harassment of medical students has been the focus of many international studies. Prevalence rates from 18% to over 60% have been reported. However, a Dutch study at Nijmegen Medical School found the prevalence rate to be lower (13.3% in the total group; 20% among female students

  1. Sexual harassment during clinical clerkships in Dutch medical schools

    NARCIS (Netherlands)

    Rademakers, J.J.D.J.M.; Muijsenbergh, M.E.T.C. van den; Slappendel, G.; Lagro-Janssen, A.L.M.; Borleffs, J.C.C.

    2008-01-01

    Context Sexual harassment of medical students has been the focus of many international studies. Prevalence rates from 18% to over 60% have been reported. However, a Dutch study at Nijmegen Medical School found the prevalence rate to be lower (13.3% in the total group; 20% among female students

  2. Work-related frustration among senior nurses at a medical centre.

    Science.gov (United States)

    Wang, Pei-Hern; Ku, Yan-Chiou; Chen, Chi-Chi; Jeang, Shiow-Rong; Chou, Frank Huang-Chih

    2016-07-01

    To investigate the levels and causes of work-related frustration among senior nurses. Role changes and the associated expectations and setbacks faced by senior middle-aged nurses can easily result in low morale. Therefore, working setbacks experienced by senior nurses must be investigated. A cross-sectional questionnaire study. Purposive sampling was used to select questionnaire recipients. In total, 482 senior nurses completed and returned a structured questionnaire. The predictive factors for frustration at work among senior nurses included age, service unit, and the impact of sleep disorders, which jointly explained 54% of the variance. In particular, age and service unit were important predictive factors for frustration at work. Senior nurses had medium-to-low scores for frustration at work and did not perceive a high level of frustration. The outpatient departments and other medical departments in this sector should provide a reasonable system of incentives and promotion opportunities if they are to retain their most senior and experienced nurses. The results of this study could serve as a reference for hospital administrations. © 2016 John Wiley & Sons Ltd.

  3. Radiation shielding analysis of medical cyclotron at Radiation Medicine Centre, Parel

    International Nuclear Information System (INIS)

    Gathibandhe, M.V.; Agrawal, R.A.; Utge, C.G.

    2003-01-01

    Full text: PET (Positron Emission Tomography) is a diagnostic method to obtain 3-D functional images of the distribution of radio-nuclides introduced in the human body as tracers for specific biological processes. Tracers are produced by bombardment of different target nuclides by protons and deuterons of high energy produced in the cyclotron. A Wipro-GE medical cyclotron was installed in the basement of RMC, Parel. Shielding around the cyclotron is provided in the form of borated concrete walls of required thickness to limit dose rates to design values as per AERB criteria. The roof of the cyclotron room is made of heavy concrete. Entry in to the room is through a maze. Shielding analysis for the cyclotron room has been carried out using computer code ANISN. The maze has been analyzed using code MCNP. Based on the analysis carried out additional shielding was recommended to meet the design requirements. The paper discusses the shielding analysis carried out for the cyclotron room and the maze. Dose rate estimated at various locations are highlighted

  4. Modified Alvarado Scoring System as a diagnostic tool for Acute Appendicitis at Bugando Medical Centre, Mwanza, Tanzania

    Directory of Open Access Journals (Sweden)

    Rambau Peter

    2011-02-01

    Full Text Available Abstract Background Decision-making in patients with acute appendicitis poses a diagnostic challenge worldwide, despite much advancement in abdominal surgery. The Modified Alvarado Scoring System (MASS has been reported to be a cheap and quick diagnostic tool in patients with acute appendicitis. However, differences in diagnostic accuracy have been observed if the scores were applied to various populations and clinical settings. The purpose of this study was to evaluate the diagnostic value of Modified Alvarado Scoring System in patients with acute appendicitis in our setting. Methods A cross-sectional study involving all patients suspected to have acute appendicitis at Bugando Medical Centre over a six-month period between November 2008 and April 2009 was conducted. All patients who met the inclusion criteria were consecutively enrolled in the study. They were evaluated on admission using the MASS to determine whether they had acute appendicitis or not. All patients underwent appendicectomy according to the hospital protocol. The decision to operate was the prerogative of the surgeon or surgical resident based on overall clinical judgment and not the MASS. The diagnosis was confirmed by histopathological examination. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software. Results A total number of 127 patients were studied. Their ages ranged from eight to 76 years (mean 29.64 ± 12.97. There were 37 (29.1% males and 90 (70.9% females (M: F = 1:2.4. All patients in this study underwent appendicectomy. The perforation rate was 9.4%. Histopathological examination confirmed appendicitis in 85 patients (66.9% and the remaining 42 patients had normal appendix giving a negative appendicectomy rate of 33.1% (26.8% for males and 38.3% for females. The sensitivity and specificity of MASS in this study were 94.1% (males 95.8% and females 88.3% and 90.4% (males 92.9% and females 89.7% respectively

  5. Outcomes of Bone Anchored Hearing Aid Implant at Universiti Kebangsaan Malaysia Medical Centre (UKMMC).

    Science.gov (United States)

    Rahim, Suhana Abdul; Goh, Bee-See; Zainor, Safinaz; Rahman, Roslenda Abdul; Abdullah, Asma

    2018-03-01

    The cross sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center (UKMMC), Malaysia from August 2012 to December 2013. All patients implanted with in UKMMC from December 2001 until December 2012 was included. Glasgow Benefit Inventory (GBI) questionnaires and UKMMC questionnaires were used as part of the assessment tool. The GBI is a scoring which measures the change in health status produced by surgical interventions. UKMMC questionnaires was invented by our department to assess questions related to social and life style of patients and also the cosmetic perspective Baha implant and other daily related activities. The audiological assessment was assessed using hearing aid gain threshold. Complication with regards to skin reaction was graded using Holger Skin Classification. A total of 40 patients underwent Baha implant were recruited but only 35 patients fulfilled the criteria and included in this study for analysis. Age of patients ranged from 5 year old to 38 year old, with median of 13 years old. There were 22 patients (62.8%) were male and 13 patients (37.1%) were females. Almost all cases were canal atresia except one adult patient was a case of bilateral chronic discharging ear with chronic irritation with ear mould. Majority of patients 21 (60%) have hearing level of moderate to severe hearing loss (40-89 dB) and 14 patients (40%) have mild to moderate hearing loss (20-39 dB). The level of hearing was retested post operatively. All of the patients have improvement in their aided hearing with the range of 10-25 dBL which is statistically significant at p value of aided hearing which is statistically significant at p value of <0.05. BAHA has been proven to show significant benefit in audiological improvement and quality of life.

  6. Development of an instrument (the COLT) to measure conceptions on learning and teaching of teachers, in student-centred medical education.

    Science.gov (United States)

    Jacobs, Johanna C G; Van Luijk, Scheltus J; Van Berkel, Henk; Van der Vleuten, Cees P M; Croiset, Gerda; Scheele, Fedde

    2012-01-01

    Conceptions of medical teachers regarding learning and teaching affect their teaching practice. Therefore conceptions should be addressed in faculty development. To facilitate this, we constructed the Conceptions Of Learning and Teaching (COLT) instrument. The COLT was adapted based on experts' comments during a meeting and interviews, followed by a Delphi procedure (Part I). It was administered to teachers from two Dutch medical schools with different traditions in student-centred education (Part II; N=646). The data were analyzed using confirmatory factor analysis and reliability analysis. 324 Teachers (50.2%) completed the questionnaire. Confirmatory factor analysis did not confirm the underlying theoretical model, but an alternative model demonstrated a good fit. This led to an instrument with eighteen items reflecting three underlying factors: 'teacher centredness', 'appreciation of active learning', and 'orientation to professional practice'. We found significant differences in COLT scores between the faculty of the two medical schools. The COLT appears to be a construct valid tool resulting in reliable scores of teachers' conceptions of learning and teaching, in student-centred medical education. Two of the three factors are new and may be specific for student-centred medical education. The COLT may be a promising tool to improve faculty development.

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

    Science.gov (United States)

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

    2014-02-01

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

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

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

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

    International Nuclear Information System (INIS)

    McEwen, M; Rogers, D; Johns, P

    2016-01-01

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

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

    Science.gov (United States)

    Liu, Wei; Gerdtz, Marie; Manias, Elizabeth

    2016-10-01

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

  12. Ocular trauma injuries: a 1-year surveillance study in the University of Malaya Medical Centre, Malaysia. 2008.

    Science.gov (United States)

    Soong, Terrence Kwong-Weng; Koh, Alan; Subrayan, Visvaraja; Loo, Angela Voon Pei

    2011-12-01

    To describe the epidemiology of ocular injuries presenting to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Prospective analysis of all ocular trauma injuries presenting to the Department of Ophthalmology in UMMC from 1 January 2008 to 31 December 2008. A total of 603 eyes of 546 patients were recruited for the study. All patients presenting to the department with ocular trauma injuries were assessed by an ophthalmologist. Data on the type and source of injury, demographic profile of the patients, and clinical presentation were documented using a uniform and validated datasheet. Among eye injury cases, 481 patients (88.1%) were male, with a male-to-female ratio of 7.4:1. Of the patients, 412 (75.5%) were Malaysian while the remaining 134 (24.5%) were of non-Malaysian nationality. The average age was 31.5 years (range 1-81 years). A total of 238 injured eyes (43.6%) were work-related. The common sources of eye trauma include the use of high-powered tools (30.8%), motor vehicle accident (23.1%), and domestic accidents (17.7%). Only six patients (2.5%) reported to having used eye protective device (EPD) at time of their work-related injuries. A major cause of preventable ocular injuries in Malaysia was work-related trauma. Ocular injuries can be reduced by the use of eye protection devices and the implementation of appropriate preventive strategies to address each risk factor. Effective training is an integral part of occupational safety and health, which should be made mandatory at the workplace. In addition, there should be a continual assessment of safety and health issues at the workplace. A long-term database of all ocular injuries in Malaysia is recommended, to aid research on a larger scale and the development of new preventive strategies for ocular injuries.

  13. Knowledge, attitudes and practice of confidentiality of patients' health records among health care professionals at Federal Medical Centre, Bida.

    Science.gov (United States)

    Adeleke, I T; Adekanye, A O; Adefemi, S A; Onawola, K A; Okuku, A G; Sheshi, E U; James-Adeniran, J A; Francis, M; Elegbe, T R O; Ayeni, A M; Tume, A A

    2011-01-01

    The quality of information shared with health care professionals depends on their ability to keep it confidential especially in this information technology age when unguided access is imminent. In view ofthis, the study described knowledge, attitude and practice of confidentiality of patients' health records amongst health care professionals at Federal Medical Centre Bida, Nigeria. A semi-structured self-administered.questionnaire on the subject was administered to 313 health professionals chosen by stratified random sampling in the hospital. Majority (161, 66.8%) of the participants were less than ten years in practice. Virtually, all (232, 96.3%) have heard about confidentiality mostly from schools (134, 55.6%), on-the-job (61, 25.3%) and from multiple sources (18, 7.5%). On responsibility for confidentiality; only 35 (14.5%) knew it is the responsibility of every health professional, while the majority; 117 (48.5%) felt it was exclusively meant for health information management professionals. Responses to issues on confidentiality range from 58.1% (revelation of documented next of kin to relatives of dead patients by staff) to 94.2% (employing the service of untrained interpreter). Very few (28, 11.6%) argued that confidentiality and privacy are not synonymous. Recommendations given to improve the practice of confidentiality include among others, observance of good health records practice by all professionals/stakeholders, continuing sensitisation of all staffandsanction against erring staff. Although, most professionals were aware of confidentiality, there appears a gap of in-depth knowledge and lack of awareness of respective responsibility towards it. However, they will do better if given the enabling environment and continuing education on the subject.

  14. The epidemiology and management of tibia and fibula fractures at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania.

    Science.gov (United States)

    Clelland, Samuel John; Chauhan, Priyesh; Mandari, Faiton Ndesanjo

    2016-01-01

    Tibia/fibula fractures are one of the commonest admissions to the orthopaedic department at a resource-limited Northern Tanzanian hospital. These fractures are associated with poor prognosis and pose a huge socioeconomic burden on developing countries. However, to date there is a paucity of epidemiological data on lower-limb fractures in Tanzania. A retrospective review of admissions to the orthopaedic department at Kilimanjaro Christian Medical Centre (KCMC) was completed between February 2015 and 2016. Inpatient record books were used to source epidemiological data which was subsequently analysed. 199 of the 1016 patients admitted sustained tibia/fibula fractures. 78% (n=156) of admissions were male and the most frequently affected age group was 21-30 years. Motor traffic accidents (MTAs) were the most common cause and accounted for 78% of fractures, with nearly half of these involving motorbikes (42%). Falls were identified as the second most common cause (13%). It was determined that 72% (n=143) of fractures were open, 19% (n=38) were comminuted and the most common site of injury was the distal-third of tibia/fibula. The most frequently recorded treatments were surgical toilet/debridement (66% of patients) and the application of a backslab (34% of patients). Males in the 21-30 age group, who were involved in MTAs, were most commonly affected by tibia/fibula fractures. Given that MTA incidence is increasing in Tanzania, there is a growing public health concern that this will be reflected by a step-increase in the number of people who sustain lower-limb fractures.

  15. Poor semen parameters among infertile couples presenting at a gynaecological clinic of Federal Medical Centre Birnin Kudu North-west Nigeria

    OpenAIRE

    Ugwa, Emmanuel Ajuluchukwu; Ashimi, Adewale; Abubakar, Mohammed; Obadire, Samuel

    2015-01-01

    Background: Male partners contribute significantly to infertile couple problem. The present study was undertaken to review the seminal fluid analysis (SFA) of couples presenting with inability to conceive at the gynecological clinic of Federal Medical Centre, Birnin Kudu, Jigawa State using World Health Organization 2010 criteria, identify the correlation between poor semen quality and age and to identify culture and sensitivity patterns of isolates. Materials and Methods: This was a retrospe...

  16. Attention to gender in communication skills assessment instruments in medical education: a review.

    Science.gov (United States)

    Dielissen, Patrick; Bottema, Ben; Verdonk, Petra; Lagro-Janssen, Toine

    2011-03-01

    Gender is increasingly regarded as an important factor in doctor-patient communication education. This review aims to assess if and how gender is addressed by current assessment instruments for communication skills in medical education. In 2009 at Radboud University Nijmegen Medical Centre, an online search was conducted in the bibliographic databases PubMed, PsycINFO and ERIC for references about communication skills assessment instruments designed to be completed by trained faculty staff and used in medical education. The search strategy used the following search terms: 'consultation skills'; 'doctor-patient communication'; 'physician-patient relations'; 'medical education'; 'instruments'; 'measurement', and 'assessment'. Papers published between January 1999 and June 2009 were included. The assessment instruments identified were analysed for gender-specific content. The search yielded 21 communication skills assessment instruments. Only two of the 17 checklists obtained explicitly considered gender as a communication-related issue. Only six of 21 manuals considered gender in any way and none gave specific details to explain which aspects of communication behaviour should be assessed with regard to gender. Very few communication assessment instruments in medical education focus on gender. Nevertheless, interest exists in using gender in communication skills assessment. The criteria for and purpose of assessing gender in communication skills in medical education are yet to be clarified. © Blackwell Publishing Ltd 2011.

  17. Signature in the microcosm with Professor Bas S.C.J.J. Kortmann, Rector Magnificus Dr Anton A.J.M. Franken, Vice President Radboud University Nijmegen Kingdom of the Netherlands and Dr. Jos Engelen, Chief Scientific Officer of CERN.

    CERN Multimedia

    Maximilien Brice

    2008-01-01

    Signature in the microcosm with Professor Bas S.C.J.J. Kortmann, Rector Magnificus Dr Anton A.J.M. Franken, Vice President Radboud University Nijmegen Kingdom of the Netherlands and Dr. Jos Engelen, Chief Scientific Officer of CERN.

  18. Imaging study of lymphoreticular tumor development in ataxia-telangiectasia and Nijmegen breakage syndrome; Estudio por imagen del desarrollo de tumores linforreticulares en la ataxia telangiectasia y el sindrome de Nijmegen

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Leon, M. I.; Ceres-Ruiz, L.; Cuesta, M. A.; Garcia-Martin, F. J. [Hospital Materno-Infantil C.H.U. Carlos Haya. Malaga (Spain)

    2003-07-01

    Ataxia-telangiectasia (AT), or Louis-Bar syndrome, is an autosomal recessive illness characterized by progressive cerebellar ataxia, oculo-cutaneous telangiectasia, immunodeficiency combined with susceptibility to sinopulmonary infections and high incidence of neoplastic development. Nijmegen breakage syndrome (NBS) is a variant of AT, is also an autosomal recessive illness that presents cerebellar ataxia, as well as combined immunodeficiency and a tendency toward tumor development. Contrary to Louis-Bar syndrome, it doesn't present telangiectasia and exhibits a characteristics phenotype (short stature, bird-like face and microcephaly). Both entities are classified as syndrome of chromosomal instability or chromosomal fragility, a group which also includes Bloom syndrome and Fanconi anemia. All of these show an increase in the frequency of neoplastic pathologies, mainly lymphoid tumors. We present three patients,two with AT and one with NBS, who developed different lymphoma types in the course of the illness. We highlight the most outstanding aspects from a clinical-radiological point of view. (Author) 17 refs.

  19. Caracterización clínica, citogenética y molecular de un nuevo caso de síndrome de Nijmegen en Chile

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    Marcelain C,Katherine; Aracena A,Mariana; Be R,Cecilia; Navarrete S,Carmen Luz; Moreno H,Rosa; Santos A,Manuel; Pincheira V,Juana

    2004-01-01

    The Nijmegen Breakage Syndrome (NBS) is a rare autosomal recessive disorder associated with microcephaly, immunodeficiency, chromosome instability and cancer proneness. The mutated gene that results in NBS codes for nibrin (Nbs1/p95), a DNA repair protein that is functionally linked to ATM, the kinase protein product of the gene responsible of ataxia-telangiectasia (A-T). We report the clinical, cytogenetic and molecular characterization of a second case of NBS in Chile detected by us. The pa...

  20. Patient perspectives on continuity of care: adaption and preliminary psychometric assessment of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ-N)

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    Hetlevik, Oystein; Hustoft, Merethe; Uijen, A.A.; Assmus, Jorg; Gjesdal, Sturla

    2017-01-01

    Background Continuity of care is regarded as a core quality element in healthcare. Continuity can be related to one or more specific caregivers but also applies to collaboration within a team or across boundaries of healthcare. Measuring continuity is important to identify problems and evaluate quality improvement of interventions. This study aimed to assess the feasibility and psychometric properties of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ). Methods The NCQ was d...

  1. Patient perspectives on continuity of care: adaption and preliminary psychometric assessment of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ-N).

    Science.gov (United States)

    Hetlevik, Øystein; Hustoft, Merethe; Uijen, Annemarie; Aßmus, Jörg; Gjesdal, Sturla

    2017-11-21

    Continuity of care is regarded as a core quality element in healthcare. Continuity can be related to one or more specific caregivers but also applies to collaboration within a team or across boundaries of healthcare. Measuring continuity is important to identify problems and evaluate quality improvement of interventions. This study aimed to assess the feasibility and psychometric properties of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ). The NCQ was developed in The Netherlands. It measures patients' experienced continuity of care across multiple care settings and as a multidimensional concept regardless of morbidity. The NCQ comprises 28 items categorised into three subscales; two personal continuity scales, "care giver knows me" and "shows commitment", asked regarding the patient's general practitioner (GP) and the most important specialist; and one "team/cross boundary continuity" scale, asked regarding primary care, specialised care and cooperation between GP and specialist, with a total of seven factors. The NCQ was translated and adapted to Norwegian (NCQ-N) and distributed among patients referred to somatic rehabilitation (N = 984, response rate 34.5%). Confirmatory factor analyses (CFA), Cronbach's alpha, intra-class correlation (ICC) and Bland-Altman plots were used to assess psychometric properties. All patients (N = 375) who had responded to all parts of the NCQ-N were included in CFA. The CFA fit indices (CFI 0.941, RMSEA 0.064 (95% CI 0.059-0.070), SRMR 0.041) support a seven-factor structure in the NCQ-N based on the three subscales of the original NCQ. Cronbach's alpha showed internal consistency (0.84-0.97), and was highest for the team/cross-boundary subscales. The NCQ-N showed overall high reliability with ICC 0.84-91 for personal continuity factors and 0.67-0.91 for team factors, with the lowest score for team continuity within primary care. Psychometric assessment of the NCQ-N supports that this instrument, based

  2. Patient perspectives on continuity of care: adaption and preliminary psychometric assessment of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ-N

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    Øystein Hetlevik

    2017-11-01

    Full Text Available Abstract Background Continuity of care is regarded as a core quality element in healthcare. Continuity can be related to one or more specific caregivers but also applies to collaboration within a team or across boundaries of healthcare. Measuring continuity is important to identify problems and evaluate quality improvement of interventions. This study aimed to assess the feasibility and psychometric properties of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ. Methods The NCQ was developed in The Netherlands. It measures patients’ experienced continuity of care across multiple care settings and as a multidimensional concept regardless of morbidity. The NCQ comprises 28 items categorised into three subscales; two personal continuity scales, “care giver knows me” and “shows commitment”, asked regarding the patient’s general practitioner (GP and the most important specialist; and one “team/cross boundary continuity” scale, asked regarding primary care, specialised care and cooperation between GP and specialist, with a total of seven factors. The NCQ was translated and adapted to Norwegian (NCQ-N and distributed among patients referred to somatic rehabilitation (N = 984, response rate 34.5%. Confirmatory factor analyses (CFA, Cronbach’s alpha, intra-class correlation (ICC and Bland–Altman plots were used to assess psychometric properties. Results All patients (N = 375 who had responded to all parts of the NCQ-N were included in CFA. The CFA fit indices (CFI 0.941, RMSEA 0.064 (95% CI 0.059–0.070, SRMR 0.041 support a seven-factor structure in the NCQ-N based on the three subscales of the original NCQ. Cronbach’s alpha showed internal consistency (0.84–0.97, and was highest for the team/cross-boundary subscales. The NCQ-N showed overall high reliability with ICC 0.84–91 for personal continuity factors and 0.67–0.91 for team factors, with the lowest score for team continuity within primary care

  3. The role of nibrin in doxorubicin-induced apoptosis and cell senescence in Nijmegen Breakage Syndrome patients lymphocytes.

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    Olga Alster

    Full Text Available Nibrin plays an important role in the DNA damage response (DDR and DNA repair. DDR is a crucial signaling pathway in apoptosis and senescence. To verify whether truncated nibrin (p70, causing Nijmegen Breakage Syndrome (NBS, is involved in DDR and cell fate upon DNA damage, we used two (S4 and S3R spontaneously immortalized T cell lines from NBS patients, with the founding mutation and a control cell line (L5. S4 and S3R cells have the same level of p70 nibrin, however p70 from S4 cells was able to form more complexes with ATM and BRCA1. Doxorubicin-induced DDR followed by cell senescence could only be observed in L5 and S4 cells, but not in the S3R ones. Furthermore the S3R cells only underwent cell death, but not senescence after doxorubicin treatment. In contrary to doxorubicin treatment, cells from all three cell lines were able to activate the DDR pathway after being exposed to γ-radiation. Downregulation of nibrin in normal human vascular smooth muscle cells (VSMCs did not prevent the activation of DDR and induction of senescence. Our results indicate that a substantially reduced level of nibrin or its truncated p70 form is sufficient to induce DNA-damage dependent senescence in VSMCs and S4 cells, respectively. In doxorubicin-treated S3R cells DDR activation was severely impaired, thus preventing the induction of senescence.

  4. Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania

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    Imirzalioglu Can

    2011-08-01

    Full Text Available Abstract Background Surgical site infection (SSI continues to be a major source of morbidity and mortality in developing countries despite recent advances in aseptic techniques. There is no baseline information regarding SSI in our setting therefore it was necessary to conduct this study to establish the prevalence, pattern and predictors of surgical site infection at Bugando Medical Centre Mwanza (BMC, Tanzania. Methods This was a cross-sectional prospective study involving all patients who underwent major surgery in surgical wards between July 2009 and March 2010. After informed written consent for the study and HIV testing, all patients who met inclusion criteria were consecutively enrolled into the study. Pre-operative, intra-operative and post operative data were collected using standardized data collection form. Wound specimens were collected and processed as per standard operative procedures; and susceptibility testing was done using disc diffusion technique. Data were analyzed using SPSS software version 15 and STATA. Results Surgical site infection (SSI was detected in 65 (26.0% patients, of whom 56 (86.2% and 9 (13.8% had superficial and deep SSI respectively. Among 65 patients with clinical SSI, 56(86.2% had positive aerobic culture. Staphylococcus aureus was the predominant organism 16/56 (28.6%; of which 3/16 (18.8% were MRSA. This was followed by Escherichia coli 14/56 (25% and Klebsiella pneumoniae 10/56 (17.9%. Among the Escherichia coli and Klebsiella pneumoniae isolates 9(64.3% and 8(80% were ESBL producers respectively. A total of 37/250 (14.8% patients were HIV positive with a mean CD4 count of 296 cells/ml. Using multivariate logistic regression analysis, presence of pre-morbid illness (OR = 6.1, use of drain (OR = 15.3, use of iodine alone in skin preparation (OR = 17.6, duration of operation ≥ 3 hours (OR = 3.2 and cigarette smoking (OR = 9.6 significantly predicted surgical site infection (SSI Conclusion SSI is common

  5. Factors associated with medication information in diabetes care: differences in perceptions between patients and health care professionals

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    Längst G

    2015-10-01

    Full Text Available Gerda Längst,1 Hanna Marita Seidling,2,3 Marion Stützle,2,3 Dominik Ose,1 Ines Baudendistel,1 Joachim Szecsenyi,1 Michel Wensing,1,4 Cornelia Mahler1 1Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany; 2Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany; 3Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany; 4Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands Purpose: This qualitative study in patients with type 2 diabetes and health care professionals (HCPs aimed to investigate which factors they perceive to enhance or impede medication information provision in primary care. Similarities and differences in perspectives were explored.Methods: Eight semistructured focus groups were conducted, four with type 2 diabetes patients (n=25 and four with both general practitioners (n=13 and health care assistants (n=10. Sessions were audio and video recorded, transcribed verbatim, and subjected to computer-aided qualitative content analysis.Results: Diabetes patients and HCPs broadly highlighted similar factors as enablers for satisfactory medication information delivery. Perceptions substantially differed regarding impeding factors. Both patients and HCPs perceived it to be essential to deliver tailored information, to have a trustful and continuous patient–provider relationship, to regularly reconcile medications, and to provide tools for medication management. However, substantial differences in perceptions related to impeding factors included the causes of inadequate information, the detail required for risk-related information, and barriers to medication reconciliation. Medication self-management was a prevalent topic among patients, whereas HCPs’ focus was on fulfilling therapy and medication management responsibilities

  6. [What illegal substances are used by sportsmen? a study in Midi-Pyrénées Doping Preventing Medical Centre (AMPD-MP)].

    Science.gov (United States)

    Senard-Ojero, Ana; Durrieu, Geneviève; Depiesse, Frédéric; Schmitt, Laurent; Riviere, Daniel; Montastruc, Jean-Louis

    2010-01-01

    Doping Preventing Medical Centres (Antennes Médicales de Prévention du Dopage) were established in France in 2000 in order to help sportsmen using illegal substances. These services are also information centres on illegal substances (drugs or others) used in sport. The aim of the study was to analyze the characteristics of sportsmen outpatient clinics in Antenne Médicale de Prevention du Dopage Midi-Pyrénées (AMPD-MP). We present the results of outpatient clinics in AMPD-MP from 2002 to 2008. A descriptive analysis of demographic data, substances used and sports practised were performed. During this 7 year-period, 35 outpatient clinics were performed [32 men, 3 women, mean age: 28 years (extreme values: 18-47; 10 patients ≥ 30 years)]. They were mainly involved in national (16), international (8) or regional (7) competitions. The main sports involved were rugby (9) followed by cycling (5), athletics (3) and body-building (3). The most frequently used illegal substances were cannabis (15) followed by glucocorticoïds (9), androgens (4), indirect sympathomimetics amphetaminics (4), beta 2 adrenergic agonists (2) and NSAIDs (2). Two veterinary substances (clenbuterol, boldone-veterinaire) were also found in body-builders. This study shows a clear under use of Doping Preventing Medical Centres by sportsmen and practitioners. It also indicates a relative high age for sportsmen referred to the centre. The main sports involved were rugby and cycling. Cannabis and glucocorticoïds were the drugs more often involved in doping behaviours.

  7. Comparison of Selected Parameters of Redox Homeostasis in Patients with Ataxia-Telangiectasia and Nijmegen Breakage Syndrome

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    Barbara Pietrucha

    2017-01-01

    Full Text Available This study compared the antioxidant status and major lipophilic antioxidants in patients with ataxia-telangiectasia (AT and Nijmegen breakage syndrome (NBS. Total antioxidant status (TAS, total oxidant status (TOS, oxidative stress index (OSI, and concentrations of coenzyme Q10 (CoQ10 and vitamins A and E were estimated in the plasma of 22 patients with AT, 12 children with NBS, and the healthy controls. In AT patients, TAS (median 261.7 μmol/L was statistically lower but TOS (496.8 μmol/L was significantly elevated in comparison with the healthy group (312.7 μmol/L and 311.2 μmol/L, resp.. Tocopherol (0.8 μg/mL and CoQ10 (0.1 μg/mL were reduced in AT patients versus control (1.4 μg/mL and 0.3 μg/mL, resp.. NBS patients also displayed statistically lower TAS levels (290.3 μmol/L, while TOS (404.8 μmol/L was comparable to the controls. We found that in NBS patients retinol concentration (0.1 μg/mL was highly elevated and CoQ10 (0.1 μg/mL was significantly lower in comparison with those in the healthy group. Our study confirms disturbances in redox homeostasis in AT and NBS patients and indicates a need for diagnosing oxidative stress in those cases as a potential disease biomarker. Decreased CoQ10 concentration found in NBS and AT indicates a need for possible supplementation.

  8. Oxidative stress, mitochondrial abnormalities and antioxidant defense in Ataxia-telangiectasia, Bloom syndrome and Nijmegen breakage syndrome

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    Mateusz Maciejczyk

    2017-04-01

    Full Text Available Rare pleiotropic genetic disorders, Ataxia-telangiectasia (A-T, Bloom syndrome (BS and Nijmegen breakage syndrome (NBS are characterised by immunodeficiency, extreme radiosensitivity, higher cancer susceptibility, premature aging, neurodegeneration and insulin resistance. Some of these functional abnormalities can be explained by aberrant DNA damage response and chromosomal instability. It has been suggested that one possible common denominator of these conditions could be chronic oxidative stress caused by endogenous ROS overproduction and impairment of mitochondrial homeostasis. Recent studies indicate new, alternative sources of oxidative stress in A-T, BS and NBS cells, including NADPH oxidase 4 (NOX4, oxidised low-density lipoprotein (ox-LDL or Poly (ADP-ribose polymerases (PARP. Mitochondrial abnormalities such as changes in the ultrastructure and function of mitochondria, excess mROS production as well as mitochondrial damage have also been reported in A-T, BS and NBS cells. A-T, BS and NBS cells are inextricably linked to high levels of reactive oxygen species (ROS, and thereby, chronic oxidative stress may be a major phenotypic hallmark in these diseases. Due to the presence of mitochondrial disturbances, A-T, BS and NBS may be considered mitochondrial diseases. Excess activity of antioxidant enzymes and an insufficient amount of low molecular weight antioxidants indicate new pharmacological strategies for patients suffering from the aforementioned diseases. However, at the current stage of research we are unable to ascertain if antioxidants and free radical scavengers can improve the condition or prolong the survival time of A-T, BS and NBS patients. Therefore, it is necessary to conduct experimental studies in a human model.

  9. Quality of out-of-hospital palliative emergency care depends on the expertise of the emergency medical team--a prospective multi-centre analysis.

    Science.gov (United States)

    Wiese, Christoph H R; Bartels, Utz E; Marczynska, Karolina; Ruppert, David; Graf, Bernhard M; Hanekop, Gerd G

    2009-12-01

    The number of palliative care patients who live at home and have non-curable life-threatening diseases is increasing. This is largely a result of modern palliative care techniques (e.g. specialised out-of-hospital palliative medical care services), changes in healthcare policy and the availability of home care services. Accordingly, pre-hospital emergency physicians today are more likely to be involved in out-of-hospital emergency treatment of palliative care patients with advanced disease. In a prospective multi-centre study, we analysed all palliative emergency care calls during a 24-month period across four emergency services in Germany. Participating pre-hospital emergency physicians were rated according to their expertise in emergency and palliative care as follows--group 1: pre-hospital emergency physicians with high experience in emergency and palliative medical care, group 2: pre-hospital emergency physicians with high experience in emergency medical care but less experience in palliative medical care and group 3: pre-hospital emergency physicians with low experience in palliative and emergency medical care. During the period of interest, the centres received 361 emergency calls requiring a response to palliative care patients (2.8% of all 12,996 emergency calls). Ten percent of all patients were treated by group 1; 42% were treated by group 2 and 47% were treated by group 3. There was a statistically significant difference in the treatment of palliative care patients (e.g. transfer to hospital, symptom control, end-of-life decision) as a result of the level of expertise of the investigated pre-hospital emergency physicians (pmedical treatment of palliative care patients depends on the expertise in palliative medical care of the pre-hospital emergency physicians who respond to the call. In our investigation, best out-of-hospital palliative medical care was given by pre-hospital emergency physicians who had significant expertise in palliative and emergency

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

    Science.gov (United States)

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

    2017-12-16

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

  11. The impact of a person-centred community pharmacy mental health medication support service on consumer outcomes.

    Science.gov (United States)

    McMillan, Sara S; Kelly, Fiona; Hattingh, H Laetitia; Fowler, Jane L; Mihala, Gabor; Wheeler, Amanda J

    2018-04-01

    Mental illness is a worldwide health priority. As medication is commonly used to treat mental illness, community pharmacy staff is well placed to assist consumers. To evaluate the effectiveness of a multifaceted, community pharmacy medication support service for mental health consumers. Pharmacists and pharmacy support staff in three Australian states were trained to deliver a flexible, goal-oriented medication support service for adults with mental illness over 3-6 months. Consumer-related outcome measures included perceptions of illness and health-related quality of life, medication beliefs, treatment satisfaction and medication adherence. Fifty-five of 100 trained pharmacies completed the intervention with 295 of the 418 recruited consumers (70.6% completion rate); 51.2% of consumers received two or more follow-ups. Significant improvements were reported by consumers for overall perceptions of illness (p mental health domain of quality of life (p medication (p = 0.001) and global satisfaction with medication (p medication adherence (p = 0.005). A community pharmacy mental health medication support service that is goal-oriented, flexible and individualised, improved consumer outcomes across various measures. While further research into the cost-effectiveness and sustainability of such a service is warranted, this intervention could easily be adapted to other contexts.

  12. Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study.

    Science.gov (United States)

    Aftyka, Anna; Rybojad, Beata; Rudnicka-Drozak, Ewa

    2014-10-01

    To compare interventions of medical emergency teams in urban and rural areas with particular emphasis on response time and on-site medical rescue activities. A retrospective analysis of ambulance call reports from two emergency medical service substations: one in the city and the other in a rural area. Two emergency medical service substations: one in the city and the other in a rural area. Medical emergency teams. Interventions in the city were associated with a substantially shorter response time in comparison to rural areas. In the city, the distances were generally less than 10 km. In the rural area, however, such short distances accounted for only 7.2% of events, while 33.8% were over 30 km. Medical emergency teams more often acted exclusively on-site or ceased any interventions in rural areas. Compared with the city, actions in the rural setting were associated with significantly increased use of cervical collars and decreased use of intravenous access. The presence of a physician in the team raised the probability of pharmacotherapy. The relationship between medical emergency teams activities and the location of intervention shows the real diversity of the functioning of emergency medical service within a city and rural areas. Further research should aim to improve the generalisability of these findings. © 2014 National Rural Health Alliance Inc.

  13. Evidence for a pre-malignant cell line in a skin biopsy from a patient with Nijmegen breakage syndrome.

    Science.gov (United States)

    Habib, Raneem; Neitzel, Heidemarie; Ernst, Aurelie; Wong, John K L; Goryluk-Kozakiewicz, Bozenna; Gerlach, Antje; Demuth, Ilja; Sperling, Karl; Chrzanowska, Krystyna

    2018-01-01

    Nijmegen breakage syndrome is an autosomal recessive disorder characterized by microcephaly, immunodeficiency, hypersensitivity to X-irradiation, and a high predisposition to cancer. Nibrin, the product of the NBN gene, is part of the MRE11/RAD50 (MRN) complex that is involved in the repair of DNA double strand breaks (DSBs), and plays a critical role in the processing of DSBs in immune gene rearrangements, telomere maintenance, and meiotic recombination. NBS skin fibroblasts grow slowly in culture and enter early into senescence. Here we present an incidental finding. Skin fibroblasts, derived from a 9 year old NBS patient, showed a mosaic of normal diploid cells (46,XY) and those with a complex, unbalanced translocation. The aberrant karyotype was analysed by G-banding, comparative genomic hybridization, and whole chromosome painting. The exact breakpoints of the derivative chromosome were mapped by whole genome sequencing: 45,XY,der(6)(6pter → 6q11.1::13q11 → 13q21.33::20q11.22 → 20qter),-13. The deleted region of chromosomes 6 harbors almost 1.400 and that of chromosome 13 more than 500 genes, the duplicated region of chromosome 20 contains about 700 genes. Such unbalanced translocations are regularly incompatible with cellular survival, except in malignant cells. The aberrant cells, however, showed a high proliferation potential and could even be clonally expanded. Telomere length was significantly reduced, hTERT was not expressed. The cells underwent about 50 population doublings until they entered into senescence. The chromosomal preparation performed shortly before senescence showed telomere fusions, premature centromere divisions, endoreduplications and tetraploid cells, isochromatid breaks and a variety of marker chromosomes. Inspection of the site of skin biopsy 18 years later, presented no evidence for abnormal growth. The aberrant cells had a significant selective advantage in vitro. It is therefore tempting to speculate that this

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

    Science.gov (United States)

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

    2018-01-08

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

  15. [Sexual harassment of medical students during their period of work placement

    NARCIS (Netherlands)

    Muijsenbergh, M.E.T.C. van den; Lagro-Janssen, A.L.M.

    2005-01-01

    OBJECTIVE: To investigate the incidence, type and consequences of sexual harassment of medical students at the Radboud University in Nijmegen, the Netherlands, during their period of work placement, as well as the students' need for care thereafter. DESIGN: Questionnaire. METHOD: During the period

  16. Attention to gender in communication skills assessment instruments in medical education: a review.

    NARCIS (Netherlands)

    Dielissen, P.W.; Bottema, B.J.A.M.; Verdonk, P.; Lagro-Janssen, T.

    2011-01-01

    CONTEXT: Gender is increasingly regarded as an important factor in doctor-patient communication education. This review aims to assess if and how gender is addressed by current assessment instruments for communication skills in medical education. METHODS: In 2009 at Radboud University Nijmegen

  17. Towards the complete eradication of mother-to-child HIV/HBV coinfection at Saint Camille Medical Centre in Burkina Faso, Africa

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    Denise Ilboudo

    Full Text Available The coinfection of HIV and hepatitis B virus (HBV and their vertical transmission constitute a public health problem in sub-Saharan countries of Africa. The objectives of this research are: i identify the pregnant women that are coinfected by HIV and HBV at Saint Camille Medical Centre; ii use three antiretroviral drugs (zidovudine, nevirapine and lamivudine to interrupt the vertical transmission of HIV and HBV from infected mothers; and iii use the PCR technique to diagnose children who are vertically infected by these viruses in order to offer them an early medical assistance. At Saint Camille Medical Centre, 115 pregnant women, aged from 19 to 41 years, were diagnosed as HIV-positive and, among them, 14 coinfected with HBV. They had at least 32 weeks of amenorrhoea and all of them received the HAART, which contained lamivudine. Two to six months after childbirth, the babies underwent PCR diagnosis for HIV and HBV. The results revealed that, among these mothers, 64.4% were housewives, 36.5% were illiterates, and only 1.7% had a university degree. The rate of vertical transmission of HIV and HBV was 0.0% (0/115 and 21.4% (3/14, respectively. The 3 mothers who transmitted the HBV to their children had all HBsAg, HbeAg, and HBV DNA positive. An antiretroviral therapy that in addition to zidovudine and nevirapine includes lamivudine could, as in the present study, block or reduce the vertical transmission in HIV positive pregnant women who are coinfected with HBV.

  18. Utilization of day surgery services at Upper hill Medical Centre and the Karen hospital in Nairobi: the influence of medical providers, cost and patient awareness.

    Science.gov (United States)

    Odhiambo, Mildred Adhiambo; Njuguna, Susan; Waireri-Onyango, Rachel; Mulimba, Josephat; Ngugi, Peter Mungai

    2015-01-01

    Health systems face challenges of improving access to health services due to rising health care costs. Innovative services such as day surgery would improve service delivery. Day surgery is a concept where patients are admitted for surgical procedures and discharged the same day. Though used widely in developed countries due to its advantages, utilization in developing countries has been low. This study sought to establish how utilization of day surgery services was influenced by medical providers, patient awareness and cost among other factors. The study design was cross sectional with self administered questionnaires used to collect data. Data analysis was done by using statistical package for social science (SPSS) and presented as frequencies, percentages and Spearman's correlation to establish relationship among variables. Medical providers included doctors, their employees and medical insurance providers. Most doctors were aware of day surgery services but their frequency of utilization was low. Furthermore, medical insurance providers approved only half of the requests for day surgery. Doctors' employees were aware of the services and most of them would recommend it to patients. Although, most patients were not aware of day surgery services those who were aware would prefer day surgery to in patient. Moreover, doctors and medical insurance providers considered day surgery to be cheaper than in patient. The study showed that medical providers and patient awareness had influence over day surgery utilization, though, cost alone did not influence day surgery utilization but as a combination with other factors.

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

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    Rashmi Kumari

    2016-03-01

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

  20. Propiedades psicométricas de la versión Española del cuestionario de interacción trabajo-familia (SWING) [Psychometric properties of the Spanish version of the Survey Work-Home Interaction Nijmegen (SWING)

    NARCIS (Netherlands)

    Moreno-Jiménez, B.; Sanz Vergel, A.I.; Rodriguez Muñoz, A.; Geurts, S.A.E.

    2009-01-01

    Psychometric properties of the Spanish version of the Survey Work-Home Interaction Nijmegen (SWING). The aim of this work was to analyze the psychometric properties of the Spanish version of the «Survey Work-Home Interaction Nijmegen» (SWING) developed by S. Geurts and colleagues to evaluate the

  1. Effect of medication-related factors on adherence in people with schizophrenia: a European multi-centre study

    NARCIS (Netherlands)

    Meier, Johanna; Becker, Thomas; Patel, Anita; Robson, Debbie; Schene, Aart; Kikkert, Martijn; Barbui, Corrado; Burti, Lorenzo; Puschner, Bernd

    2010-01-01

    To investigate the relation between medication-related factors and adherence in people with schizophrenia in outpatient treatment. The sample comprised 409 outpatients (ICD-10 diagnosis of schizophrenia) with clinician-rated instability in four European cities (Amsterdam, The Netherlands; Verona,

  2. Response to Ronald M Perkin and David B Resnik: the agony of trying to match sanctity of life and patient-centred medical care.

    Science.gov (United States)

    Kuhse, Helga

    2002-08-01

    Perkin and Resnik advocate the use of muscle relaxants to prevent the "agony of agonal respiration" arguing that this is compatible with the principle of double effect. The proposed regime will kill patients as certainly as smothering them would. This may lead some people to reject the argument as an abuse of the principle of double effect. I take a different view. In the absence of an adequate theory of intention, the principle of double effect cannot distinguish between the intentional and merely foreseen termination of life, and cannot rule out end-of-life decisions that are often regarded as impermissible. What Perkin and Resnik are in effect saying is that there are times when physicians have good reasons to end a patient's life--deliberately and intentionally--for the patient's (and the family's) sake. Why not say so--instead of going through the agony of trying to match sanctity of life and patient-centred medical care?

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

    Science.gov (United States)

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

    2014-01-01

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

  4. A study of childhood poisoning at National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi.

    Science.gov (United States)

    Gupta, Suresh Kumar; Peshin, Sharda Shah; Srivastava, Amita; Kaleekal, Thomas

    2003-05-01

    A retrospective analysis of the poisoning calls received by the National Poisons Information Centre (NPIC) showed a total of 2,720 calls during a period of three years (April 1999-March 2002). Poisoning in children was reported in 995 calls (36.6%). The age ranged from less than 1 yr to 18 yr and the age groups involved were divided into four categories (0-6 yr, >6-12 yr, >12-16 yr, >16-18 yr). The most vulnerable age group included children from less than one year to 6 yr old. Males outnumbered females (M=628, F=367). Although the accidental mode was the commonest (79.7%), intentional attempts were also noticed (20.2%) in the >12-16 yr and >16-18 yr age groups. In the majority of cases, the route was oral (96.8%) followed by dermal exposure (3.2%) comprising bites and stings. Various types of agents belonged to classes of household products (47.0%), drugs (21.8%), industrial chemicals (7.9%), agricultural pesticides (9.1%), bites and stings (3.2%), plants (1.5%), miscellaneous products (5.3%) and unknown products (4.0%). The incidence of poisoning was highest due to household products comprising mainly pyrethroids, parad/thermometer mercury, rodenticides, phenyl, detergents and corrosives, etc. Poisoning due to drugs mainly included anticonvulsants, thyroid hormones, benzodiazepines, analgesics and oral contraceptives. Among the agricultural pesticides aluminium phosphide was the most commonly consumed, followed by organochlorines and organophosphates, etc. Paint thinners were common among industrial chemicals. Bites and stings were mainly snake bites and scorpion stings. Poisoning due to plants was low and Datura was commonly ingested. Although these data may not give an exact picture of the incidence rate in our country, due to underreporting of calls to the Centre and because the actual incidence might be higher or even variable, but they do give the trend in India, indicating that a strong emphasis should be placed on a prevention campaign which can at least

  5. Profile of HIV seropositive patients attending Integrated Counseling & Testing Centre (ICTC: an experience from a medical college in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Santanu Ghosh

    2013-08-01

    Full Text Available Objectives Voluntary counseling and testing is one of the cost-effective ways of reducing HIV transmission in resource-poor countries like India. The present study aimed at determining the socio-demographic profile of HIV seropositive clients of an Integrated Counseling and Testing Centre (ICTC, association, if any, between sex and sociodemographic characteristics , their referral pattern, HIV status of the spouses/partners and trend, if any, in number of seropositives for HIV/AIDS over the years. Methods The descriptive record based study was conducted among the registered HIV seropositive clients at ICTC of Calcutta National Medical College & Hospital, a Government run Medical College in West Bengal, India. Data were collected for a period of five years (2007-08 to 2011-12 from the relevant registers using proforma based on Operational Guidelines for ICTC of National AIDS Control Organization (NACO. Data were analyzed using SPSS (Version 19.0 and Chi-square tests were conducted at 5% level of significance. Results Among 461 HIV seropositive clients, 62.7% were males and 83.9% belonged to 15-49 year age group. Daily wage laborers (65.1% and Housewives constituted majority (47.5% of males and females respectively. Significant association between male and female with educational status (d.f =2, p=0.036 and current marital status (d.f=2, p= 0.00 was observed. About 6% provided history of transfusion of blood and blood products. Only 6% attended ICTC voluntarily. About 4% were referred from Directly Observed Treatment, Short course (DOTS Centre for tuberculosis. Only 27.7% of spouses/partners of the eligible seropositives could be tested and most of them (65.8% were seropositives. Conclusion Immediate attention should be paid towards implementation of blood safety; increase in voluntary attendance at ICTC and spouse/partner testing.

  6. Profile of HIV seropositive patients attending Integrated Counseling & Testing Centre (ICTC: an experience from a medical college in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Santanu Ghosh

    2013-01-01

    Full Text Available Objectives Voluntary counseling and testing is one of the cost-effective ways of reducing HIV transmission in resource-poor countries like India. The present study aimed at determining the socio-demographic profile of HIV seropositive clients of an Integrated Counseling and Testing Centre (ICTC, association, if any, between sex and sociodemographic characteristics , their referral pattern, HIV status of the spouses/partners and trend, if any, in number of seropositives for HIV/AIDS over the years. Methods The descriptive record based study was conducted among the registered HIV seropositive clients at ICTC of Calcutta National Medical College & Hospital, a Government run Medical College in West Bengal, India. Data were collected for a period of five years (2007-08 to 2011-12 from the relevant registers using proforma based on Operational Guidelines for ICTC of National AIDS Control Organization (NACO. Data were analyzed using SPSS (Version 19.0 and Chi-square tests were conducted at 5% level of significance. Results Among 461 HIV seropositive clients, 62.7% were males and 83.9% belonged to 15-49 year age group. Daily wage laborers (65.1% and Housewives constituted majority (47.5% of males and females respectively. Significant association between male and female with educational status (d.f =2, p=0.036 and current marital status (d.f=2, p= 0.00 was observed. About 6% provided history of transfusion of blood and blood products. Only 6% attended ICTC voluntarily. About 4% were referred from Directly Observed Treatment, Short course (DOTS Centre for tuberculosis. Only 27.7% of spouses/partners of the eligible seropositives could be tested and most of them (65.8% were seropositives. Conclusion Immediate attention should be paid towards implementation of blood safety; increase in voluntary attendance at ICTC and spouse/partner testing.

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

    Directory of Open Access Journals (Sweden)

    Said Said A

    2012-11-01

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

  8. Application of time series analysis in modelling and forecasting emergency department visits in a medical centre in Southern Taiwan

    OpenAIRE

    Juang, Wang-Chuan; Huang, Sin-Jhih; Huang, Fong-Dee; Cheng, Pei-Wen; Wann, Shue-Ren

    2017-01-01

    Objective Emergency department (ED) overcrowding is acknowledged as an increasingly important issue worldwide. Hospital managers are increasingly paying attention to ED crowding in order to provide higher quality medical services to patients. One of the crucial elements for a good management strategy is demand forecasting. Our study sought to construct an adequate model and to forecast monthly ED visits. Methods We retrospectively gathered monthly ED visits from January 2009 to December 2016 ...

  9. Our experience with pre-operative haemostatic assessment of paediatric patients undergoing adenotonsillectomy at Federal Medical Centre, Makurdi

    Directory of Open Access Journals (Sweden)

    Amali Adekwu

    2016-01-01

    Full Text Available Background: In 2-4% of all patients requiring adenoidectomy, tonsillectomy or adenotonsillectomy, pre-operative screening tests for coagulation disorders are indicated to detect surgical bleeding complications. However, because of cost effect on the patients, the usefulness of these tests is being challenged. We therefore highlight our experience in paediatric patients undergoing adenoidectomy, tonsillectomy or both in our centre. Patients and Methods: This is a 3½-year analysis of the data of 165 paediatric patients who had adenoidectomy, tonsillectomy or both over the study period. The data collected included age, sex, procedure done and detailed clinical bleeding history. Results: A total of 165 children had either adenoidectomy or tonsillectomy, or both. There were 76 males and 89 females giving a male to female ratio of 1:1.2. Their ages ranged from 10 months to 18 years. Eighty-five (51.5% patients had adenotonsillectomy, 48 (29.1% and 32 (19.4% had only tonsillectomies and adenoidectomies, respectively. Only 11 (6.7% families volunteered the history of either prolonged bleeding with minor injury on the skin or occasional slight nose bleeding. Six (3.6% patients including 3 of the children with positive family history had posttonsillectomy bleed, out of which 4 (66.7% were moderate whereas the remaining 2 (33.3% were severe bleeding, which was not statistically significant (P = 0.041. The two cases of severe bleeding had fresh whole blood transfused whereas the rest that had no bleeding issues were discharged home 48 h postoperatively. Conclusion: Our experience in this study suggests that detailed bleeding history is necessary as well as pre-operative haemostatic assessment, if available and affordable for paediatric patients undergoing adenotonsillectomy.

  10. Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use

    Directory of Open Access Journals (Sweden)

    Janet M. Johnston

    2013-08-01

    Full Text Available Background. Between 1995 and 1998, tribally owned Southcentral Foundation (SCF incrementally assumed responsibility from the Indian Health Service (IHS for primary care services on the Alaska Native Medical Center (ANMC campus in Anchorage, Alaska. In 1999, SCF began implementing components of a Patient-Centered Medical Home (PCMH model to improve access and continuity of care. Objective. To evaluate hospitalisation trends before, during and after PCMH implementation. Design. Time series analysis of aggregated medical record data. Methods. Regression analysis with correlated errors was used to estimate trends over time for the percent of customer-owners hospitalised overall and for specific conditions during 4 time periods (March 1996–July 1999: SCF assumes responsibility for primary care; August 1999–July 2000: PCMH implementation starts; August 2000–April 2005: early post-PCMH implementation; May 2005–December 2009: later post-PCMH implementation. Analysis was restricted to individuals residing in Southcentral Alaska and receiving health care at ANMC. Results. The percent of SCF customer-owners hospitalised per month for any reason was steady before and during PCMH implementation, declined steadily immediately following implementation and subsequently stabilised. The percent hospitalised per month for unintentional injury or poisoning also declined during and after the PCMH implementation. Among adult asthma patients, the percent hospitalised annually for asthma declined prior to and during implementation and remained lower thereafter. The percent of heart failure patients hospitalised annually for heart failure remained relatively constant throughout the study period while the percent of hypertension patients hospitalised for hypertension shifted higher between 1999 and 2002 compared to earlier and later years. Conclusion. Implementation of PCMH at SCF was accompanied by decreases in the percent of customer-owners hospitalised monthly

  11. Medical advice for citizens in the Erzgebirge provided by the Information Centre of the Federal Office for Radiation Protection

    International Nuclear Information System (INIS)

    Laude, G.; Meyer, W.

    1995-01-01

    In the Erzgebirge region of Saxony, long-term uranium mining and the existence of waste tips from medieval silver mining have resulted in elevated subsoil radioactivity. Jointly with the Federal Office for Radiation Protection, the Robert Koch Institute, being one of the successors to the Federal Health Office, has offered consultations on problems of radiation and environmental medicine in Schlema, Erzgebirge, since 1990. It has been the objective of this activity, to provide expert information on radiation and environmental exposure levels in that region and possible risk for human health and thus to reduce exaggerated apprehensions about existing radiation hazards. 242 out of a total of 3547 persons who appeared during consultation hours offered by the Federal Office for Radiation Protection asked for medical consultation. The most frequently stated reasons for taking advantage of the consultations offered included questions associated with the influence of radioactivity on human health, requests for checking on occupational exposure and decisions made in the framework of expert opinions, requests for radon measurements in homes and other buildings as well as interpretation of levels measured under medical aspects. Recently, there has been an increasing number of requests for clinical examination for assessment of the health status of the persons concerned. Furthermore, queries referred to general problems of environemental medicine and of genetics and to consequences of the Chernobyl reactor accident. (orig.) [de

  12. Fixing missing links in shopping routes: Reflections on intra-urban borders and city center redevelopment in Nijmegen, the Netherlands

    NARCIS (Netherlands)

    Spierings, B.

    2013-01-01

    This paper analyses the fixing of missing links in shopping routes and puts redevelopment strategies for Dutch city centres in the theoretical context of entrepreneurial urbanism. The aim is to scrutinize and critically reflect upon how collaborating local authorities, property developers,

  13. Corrigendum: Development and application of a health-related quality-of-life instrument for adults with cochlear implants : The Nijmegen Cochlear Implant Questionnaire (vol. 123, pg. 756, 2000)

    NARCIS (Netherlands)

    Hinderink, J. B.; Krabbe, P. F. M.; van den Broek, P.

    Hinderink JB, Krabbe PFM, van den Broek P. Development and application of a health-related quality-of-life instrument for adults with cochlear implants: The Nijmegen Cochlear Implant Questionnaire. Otolaryngol Head Neck Surg. 2000;123:756-765. (Original DOI: 10.1067/mhn.2000.108203) In the Code book

  14. [Potentially inappropriate prescribing cardiovascular medications in the aged population: prospective study in a district hospital centre (France)].

    Science.gov (United States)

    Gentes, Élodie; Hertzog, Maurice; Vogel, Thomas; Lang, Pierre Olivier

    2015-02-01

    Cardiovascular disease is a leading cause of morbidity and mortality in the elderly population. We evaluated the adequacy of prescribing (miss and under used) with respect to STOPP-START criteria. A sample of 100 patients hospitalized in cardiovascular specialty divisions (medicine or surgery) or in the different sectors making up the geriatric network (day-care hospital, short or rehabilitation ward, nursing home) has been considered. Drug prescriptions at the admission time were analysed. Eight hundred and seventy-four prescriptions were analysed. In 65% of patients, from 5 to 10 medications were prescribed and in 28% over 10. Fifty-four percent of patients had, at least, one potentially inappropriate prescription (PIP) by STOPP. Among them, 48% of PIP prescriptions contained 1, 41% 2 and 11% 3 or more. The omission of one medication according to START criteria concerned 57% of the sample. Among them, 46% had one omission, 44% 2 to 3 and 10% 4 omissions or over. The cardiovascular system is the one most concerned by the PIP. Whether 28.1% of the PIP by STOPP criteria concerned cardiovascular drugs, the omission of prescription, according to START criteria, was 41.8%. There was no significant difference between the different settings studied. There was no effect of age or sex on the impact of PIP (P>0.20) or being polymédiqué (P=0.44). According to the criteria STOPP-A, the prescription of antiplatelet (indication and dose) was highlighted. Prescribing omission also concerned antiplatelet agents but also statins in patients with atherosclerosis as well as antiplatelet and anticoagulant in patients with permanent atrial fibrillation and inhibitor of angiotensin converting enzyme (ACE) after myocardial infarction or with chronic heart failure. Potentially inappropriate prescribing medications were very common in elderly patients with cardiovascular conditions. They concerned as much as underusing of important drugs with potential benefits and prescribing

  15. Perceived and normative needs, utilization of oral healthcare services, and barriers to utilization of dental care services at peripheral medical centre: Poonjeri, Mamallapuram, India

    Directory of Open Access Journals (Sweden)

    Prabhu Subramani

    2017-01-01

    Full Text Available Introduction: Dental care utilization is limited, and teeth are often left untreated or extracted in India. Several barriers exist for the utilization of dental services. The present study was undertaken to assess the oral healthcare needs, utilization pattern of oral healthcare services, and barriers to utilization of oral healthcare services among the outpatients of Peripheral Medical Centre, Poonjeri, Mamallapuram, India. Materials and Methods: Simple random sampling was conducted among outpatients and their attenders reporting to the health centre; demographic profile of the patients were recorded followed by interviewer-administered questionnaire for recording the self-perceived dental needs and barriers in utilizing dental care services followed by Type II clinical examination to assess normative dental treatment needs. Results: N =282 study participants participated in the present study; majority of the study participants were from upper lower class and lower middle class. Among the study subjects n = 124 (44% have not accessed any dentist, n = 112 (39.7% had visited dentist for toothache. Common reason cited as Self – perceived barriers for dental care are n = 184 (65.2% – 'Unaware of the dental problems' and n = 118 (41.8% 'Fear of dental treatment'. Logistic regression showed that significant difference was seen in gender, socioeconomic status, and barriers to dental care (P < 0.05 in influencing the utilization pattern of dental care. Conclusion: Perceived and normative dental needs were high among the study population due to problem-oriented care, and it is influenced by various barriers such as unawareness of dental problems, fear, cost, accessibility, and time.

  16. On-site visits to radiotherapy centres: Medical physics procedures. Quality Assurance Team for Radiation Oncology (QUATRO)

    International Nuclear Information System (INIS)

    2007-03-01

    The IAEA has a long standing history of providing support and assistance for radiotherapy dosimetry audits in Member States, for educating and training radiotherapy professionals, and for reviewing the radiotherapy process in a variety of situations. Since 1969, and in collaboration with the World Health Organization (WHO), the IAEA has implemented a dosimetry audit service using mailed thermoluminescent dosimeters (TLD) to verify the calibration of radiotherapy beams in hospitals in Member States. The IAEA/WHO TLD service aims at improving the accuracy and consistency of clinical radiotherapy dosimetry worldwide. Detailed follow-up procedures have been implemented for correcting incorrect beam calibrations. When necessary, on-site visits by IAEA experts in radiotherapy physics are organized to identify and rectify dosimetry problems in hospitals. The IAEA has also been requested to organize expert missions in response to problems found during the radiation treatment planning process. Assessment of the doses received by affected patients and a medical assessment were undertaken when appropriate. Although vital for the radiotherapy process, accurate beam dosimetry and treatment planning alone cannot guarantee the successful treatment of a patient. The quality assurance (QA) of the entire radiotherapy process has to be taken into account. Hence, a new approach has been developed and named 'Quality Assurance Team for Radiation Oncology (QUATRO)'. The principal aim of QUATRO is to review the radiotherapy process, including the organization, infrastructure, clinical and medical physics aspects of the radiotherapy services. It also includes reviewing the hospital's professional competence, with a view to quality improvement. The QUATRO methodology is described in the IAEA publication Comprehensive Audits of Radiotherapy Practices: A Tool for Quality Improvement. QUATRO, in addition, offers assistance in the resolution of suspected or actual dose misadministrations (over

  17. Ceftazidime/avibactam activity tested against Gram-negative bacteria isolated from bloodstream, pneumonia, intra-abdominal and urinary tract infections in US medical centres (2012).

    Science.gov (United States)

    Flamm, Robert K; Farrell, David J; Sader, Helio S; Jones, Ronald N

    2014-06-01

    The activity of ceftazidime/avibactam and comparator agents was monitored at 73 medical centres across all nine US census bureau regions during 2012. Bacterial isolates were collected from patients hospitalized with pneumonia, urinary tract infections (UTI), intra-abdominal infections (IAI) and bloodstream infections (BSI). The study protocol predetermined the target numbers of strains for each of the requested bacterial species that sites were to collect. Isolates were determined to be clinically relevant at the medical centre and only one isolate per patient episode was collected. There were 1466 Gram-negative isolates from BSI, 3245 from pneumonia patients, 501 from IAI and 2356 from UTI. Ceftazidime/avibactam was active against Enterobacteriaceae from each infection type. The MIC90 values for ceftazidime/avibactam against Enterobacteriaceae isolates from BSI, pneumonia patients, IAI or UTI were 0.25 mg/L. The extended-spectrum cephalosporin resistance rates for Escherichia coli were 8.5% (UTI), 10.4% (IAI), 12.7% (BSI) and 17.5% (pneumonia patients). The extended-spectrum cephalosporin resistance rates for Klebsiella spp. were 13.0% (UTI), 13.9% (BSI), 16.3% (IAI) and 19.3% (pneumonia patients). A total of 96.5% of the Pseudomonas aeruginosa isolates from BSI, 95.8% from pneumonia patients, 96.3% from IAI and 98.7% from UTI exhibited a ceftazidime/avibactam MIC of ≤8 mg/L (CLSI susceptible breakpoint for ceftazidime when tested alone against P. aeruginosa). Most tested agents showed limited activity against Acinetobacter baumannii, except for colistin. A total of 31.2% of A. baumannii displayed ceftazidime/avibactam MIC values of ≤8 mg/L. Ceftazidime/avibactam demonstrated potent broad-spectrum activity against Gram-negative pathogens collected in the USA during 2012 from BSI, pneumonia patients, IAI and UTI. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For

  18. Application of time series analysis in modelling and forecasting emergency department visits in a medical centre in Southern Taiwan.

    Science.gov (United States)

    Juang, Wang-Chuan; Huang, Sin-Jhih; Huang, Fong-Dee; Cheng, Pei-Wen; Wann, Shue-Ren

    2017-12-01

    Emergency department (ED) overcrowding is acknowledged as an increasingly important issue worldwide. Hospital managers are increasingly paying attention to ED crowding in order to provide higher quality medical services to patients. One of the crucial elements for a good management strategy is demand forecasting. Our study sought to construct an adequate model and to forecast monthly ED visits. We retrospectively gathered monthly ED visits from January 2009 to December 2016 to carry out a time series autoregressive integrated moving average (ARIMA) analysis. Initial development of the model was based on past ED visits from 2009 to 2016. A best-fit model was further employed to forecast the monthly data of ED visits for the next year (2016). Finally, we evaluated the predicted accuracy of the identified model with the mean absolute percentage error (MAPE). The software packages SAS/ETS V.9.4 and Office Excel 2016 were used for all statistical analyses. A series of statistical tests showed that six models, including ARIMA (0, 0, 1), ARIMA (1, 0, 0), ARIMA (1, 0, 1), ARIMA (2, 0, 1), ARIMA (3, 0, 1) and ARIMA (5, 0, 1), were candidate models. The model that gave the minimum Akaike information criterion and Schwartz Bayesian criterion and followed the assumptions of residual independence was selected as the adequate model. Finally, a suitable ARIMA (0, 0, 1) structure, yielding a MAPE of 8.91%, was identified and obtained as Visit t =7111.161+(a t +0.37462 a t -1). The ARIMA (0, 0, 1) model can be considered adequate for predicting future ED visits, and its forecast results can be used to aid decision-making processes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Unilateral cleft lip and palate : treatment outcome and long-term craniofacial growth

    NARCIS (Netherlands)

    Nollet, Petrus Josephus Paulinus Maria

    2006-01-01

    Treatment results of children with a complete Unilateral Cleft Lip and Palate (UCLP) from the Cleft Palate Craniofacial Unit of the Radboud University Nijmegen Medical Centre were evaluated and compared with prominent European cleft centers. Treatment outcome of the Nijmegen patients with UCLP and

  20. Graduated compression stockings for runners: friend, foe, or fake?

    NARCIS (Netherlands)

    Bovenschen, H.J.; Booij, M.T.; Vleuten, C.J.M. van der

    2013-01-01

    OBJECTIVE: To assess the effect of graduated compression stockings (GCS) on lower leg volume and leg complaints in runners during and after exercise. DESIGN: Cross-sectional study. SETTING: Radboud University Nijmegen Medical Centre and an outdoor running track in Nijmegen, The Netherlands. PATIENTS

  1. Benefit and quality of life after bone-anchored hearing aid fitting in children with unilateral or bilateral hearing impairment

    NARCIS (Netherlands)

    Wolf, M.J. de; Hol, M.K.S.; Mylanus, E.A.M.; Snik, A.F.M.; Cremers, C.W.R.J.

    2011-01-01

    OBJECTIVE: To evaluate the benefits of a bone-anchored hearing aid (BAHA) in the daily lives of hearing-impaired children. DESIGN: Retrospective questionnaire study. SETTING: Nijmegen Medical Centre, Nijmegen, the Netherlands. PATIENTS: Thirty-eight BAHA users with a minimum age of 4 years at BAHA

  2. Frequent relocations between asylum-seeker centres are associated with mental distress in asylum-seeking children: a longitudinal medical record study.

    Science.gov (United States)

    Goosen, Simone; Stronks, Karien; Kunst, Anton E

    2014-02-01

    There are concerns about negative effects of relocations between asylum-seeker centres on the mental health of asylum-seeking children. However, empirical evidence comes from cross-sectional studies only. In this longitudinal medical record study, we aimed to assess: (i) whether relocations during the asylum process are associated with the incidence of newly recorded mental distress in asylum-seeking children; and (ii) whether this association is stronger among vulnerable children. Data were extracted from the electronic medical records database of the Community Health Services for Asylum Seekers in The Netherlands (study period: 1 January 2000-31 December 2008). Included were 8047 children aged 4 to 17 years. Case attribution was done using International Classification of Primary Care codes for mental, behavioural or psychosocial problems. The association between annual relocation rate and incidence of mental distress was measured using relative risks (RR) estimated with multivariate Cox regression models. A high annual relocation rate (>1 relocation/year) was associated with increased incidence of mental distress [RR = 2.70; 95% confidence interval (CI) 2.30-3.17]. The relative risk associated with a high annual relocation rate was larger in children who had experienced violence (RR = 3.87; 95% CI 2.79-5.37) and in children whose mothers had been diagnosed with post-traumatic stress disorder or depression (RR = 3.40; 95% CI 2.50-4.63). The risk of mental distress was greater in asylum-seeking children who had undergone a high annual relocation rate. This risk increase was stronger in vulnerable children. These findings contribute to the appeal for policies that minimize the relocation of asylum seekers.

  3. Clinical Impact of Education Provision on Determining Advance Care Planning Decisions among End Stage Renal Disease Patients Receiving Regular Hemodialysis in University Malaya Medical Centre.

    Science.gov (United States)

    Hing Wong, Albert; Chin, Loh Ee; Ping, Tan Li; Peng, Ng Kok; Kun, Lim Soo

    2016-01-01

    Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States. To assess the clinical impact of education provision on determining ACP decisions among end-stage renal disease patients on regular hemodialysis at University Malaya Medical Centre (UMMC). To study the knowledge and attitude of patients toward ACP and end-of-life issues. Fifty-six patients were recruited from UMMC. About 43 questions pretest survey adapted from Lyon's ACP survey and Moss's cardiopulmonary resuscitation (CPR) attitude survey was given to patients to answer. An educational brochure is then introduced to these patients, and a posttest survey carried out after that. The results were analyzed using SPSS version 22.0. Opinion on ACP, including CPR decisions, showed an upward trend on the importance percentage after the educational brochure exposure, but this was statistically not significant. Seventy-five percent of participants had never heard of ACP before, and only 3.6% had actually prepared a written advanced directive. The ACP educational brochure clinically impacts patients' preferences and decisions toward end-of-life care; however, this is statistically not significant. Majority of patients have poor knowledge on ACP. This study lays the foundation for execution of future larger scale clinical trials, and ultimately, the incorporation of ACP into clinical practice in Malaysia.

  4. FOOD SAFETY KNOWLEDGE, ATTITUDE AND PRACTICES AMONG WOMEN IN FIELD PRACTICE AREA OF URBAN HEALTH TRAINING CENTRE, ANDHRA MEDICAL COLLEGE, VISAKHAPATNAM

    Directory of Open Access Journals (Sweden)

    Sarada

    2015-10-01

    Full Text Available INTRODUCTION: Food safety describes handling, prep aration and storage of food in ways to prevent foodborne illness . The contamination of food may occur at any stage in the process from food production to consumption (“farm to plate” - theme for World Health Day 2015.Unsafe food creates a vicious cycle of disease and malnutrition, particularly affecting infants, young children, elderly and the sick. Foodborne diseases include a wide spectrum of illnesses and a growing public health problem worldwide. METHODOLOGY: A cross - sectional community based study was done among 150 women in the field practice area of urban health training centre, Andhra Medical College, Visakhapatnam. Data was collected by administering questionnaire after taking informed consent. Data was entered in Epi data version 3.1 and analysed by usi ng SPSS version 16.Results were represented in form of proportions and Fischer’s Exact test was used to find significant association between variables. RESULTS: Among 150 participants, most of them were in age group of 21 - 30 years with mean age 33±11years.Ab out 68% belonged to low socioeconomic status, 76.7% were housewives, and 79.3% were literates. Among the participants, 94.7% had good knowledge regarding food safety, 30.7% had good practices showing gap between knowledge and practices. In 12% of cases ther e was history of foodborne illness. There was significant association between knowledge and literacy status; knowledge and past history of foodborne diseases (p<0.05. CONCLUSION: There is need for an education program in the community to improve the pract ices among women regarding food safety to fill the observed gap between knowledge and practices.

  5. Cefepime versus Ceftriaxone for perioperative systemic antibiotic prophylaxis in elective orthopedic surgery at Bugando Medical Centre Mwanza, Tanzania: a randomized clinical study.

    Science.gov (United States)

    Marwa, Joel M; Ngayomela, Isidor H; Seni, Jeremiah; Mshana, Stephen E

    2015-12-23

    Antimicrobial prophylaxis reduces the incidence of postoperative wound infections especially among patients undergoing orthopedics surgery. However, there is dearth of information on the clinical effectiveness, spectrum limitations and practical contextual information on third and fourth generation cephalosporins. The aim of this study was to evaluate the efficacy and safety of cefepime and ceftriaxone as peri-operative systemic antimicrobial prophylaxis in elective orthopedic surgery in our center. This study was a prospective, randomized, open label comparative clinical study of patients undergoing elective orthopedic procedures at the Bugando Medical Centre (BMC) between June 2014 and February 2015. Two hundred thirty participants were enrolled in the study and randomly assigned into Ceftriaxone regimen (group A) or Cefepime regimen (group B). Participants in ceftriaxone or cefepime group received 50 mg/kg up to 2 g single dose perioperative intravenous infusion at least 30 min before incision. Both groups were followed for 30 days using a Center for Disease Control superficial surgical site infection criterion for the outcome. A two-tailed margin of equivalence was set at 5% analyzed on the intent to treat. All 230 participants were subjected to final analysis with no patient being lost to follow-up. Superficial surgical site infection occurred in 5 out of 117 (4.3%, 0.6 to 7.9 at 95% CI) patients receiving cefepime compared to 3 out of 113 (2.7%, 0.3 to 5.6 at 95% CI) among patients receiving ceftriaxone regimen. The absolute difference of 1.6% (95% Confidence Interval: -6.3 to 3.1), equivocally lies outside the 5% statistically significant margin of presumed clinical equivalence. The difference between cefepime and ceftriaxone in preventing SSIs following elective clean orthopedic surgery was not statistically significant. Pan African Clinical Trial Registry: PACTR201406000803420.

  6. [Characteristics and treatment of tuberculosis patients in Dekkerswald, 2000-2005

    NARCIS (Netherlands)

    Magis-Escurra Ibanez, C.; Miedema, J.R.; Lange, W.C.M. de; Ingen, J. van; Dekhuijzen, P.N.R.; Boeree, M.J.

    2008-01-01

    OBJECTIVE: To describe the patient population in Dekkerswald, Nijmegen, one of two tuberculosis (TB) centres in The Netherlands. DESIGN: Descriptive, retrospective study. METHOD: Examination of medical records for all TB patients hospitalised between 2000 and 2005, including demographic, social,

  7. CERI: Ionizing Radiation Calibration Centre

    International Nuclear Information System (INIS)

    Bouteiller, E.

    1979-01-01

    The CERI has been granted by the National Bureau of Metrology (BNM) as an Ionizing Radiation Calibration Centre and as an Estimation and Qualification Centre for the ionizing radiation measurement devices. This article gives some information on the scope covered by the BNM's grant and on the various equipment on which the laboratory relies. It describes the calibration and estimation activities and mentions many kinds of services which are offered to the users mainly in the medical and industrial fields [fr

  8. The Quality of Healthcare Service Delivery in Nigeria: An Assessment of the Availability of Some Basic Medical Devices/Equipment in the Primary Health Care Centres in Delta State

    Directory of Open Access Journals (Sweden)

    Omuta GED

    2016-05-01

    Full Text Available Background: Ordinarily, accessibility implies locational proximity. However, this study limits its use to the quality of what is accessed. There is, therefore, service-delivery inaccessibility, when health care seekers can only access poor quality service, because of the poor quality of the equipment at the disposal of primary health care centres. Service-delivery equipment are, therefore, surrogate indicators of the quality of the health care services that are geographically accessible. Methodology: Both qualitative and quantitative approaches of investigation were deployed, using structured questionnaires and focus group discussions/key informant interviews, respectively. It covered nine local government areas, three each from the senatorial districts. The paper discusses three basic medical devices/equipment that determine the quality of services delivered by PHCs, namely available and functioning general purpose equipment; most commonly used methods of sterilization; and availability of different types of laboratory tests. The quantitative data were cleaned up, processed and analysed, using the SPSS 10.0. Results: There were variations in the availability of devices and equipment. Syringes/needles and stethoscopes were available in more than three-quarters of the centres, while less than ten (10 per cent had microscopes. About 15 per cent of the centres either had no methods of sterilization at all or used ‘inappropriate’ ones. In spite of the prevalence of malaria, only 28.89 per centres could test for the parasite. Conclusion: The quality of services were perceived as poor because the basic medical devices and equipment were either lacking or inadequate. Policy implication is that government should increase resource allocation to the PHC subsector to procure the basic facilities for efficient service delivery.

  9. Medical Ethics and the Learner-Centred Approach: Developing Materials on Organ Transplant and Euthanasia in an English as a Foreign Language Classroom in Higher Education

    Science.gov (United States)

    Jamrichová, Valéria; Zamborová, Katarína

    2016-01-01

    A learner-centred approach puts students amidst the learning process and helps them become involved in that process. It provides an opportunity for students to choose and direct the course of the lesson. This approach is especially appropriate when dealing with ethical concerns that might be sensitive issues. When it comes to the sources for the…

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

    DEFF Research Database (Denmark)

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

    2003-01-01

    services for both men and women was high infertility-related stress in the marital, personal and social domain. CONCLUSIONS: A supportive attitude from medical staff and the provision of both medical and psychosocial information and support should be integral aspects of medical care in fertility clinics......BACKGROUND: The aims were (i) to identify gender differences in motivations to seek assisted reproduction and gender differences in expectations about medical and psychosocial services and (ii) to examine factors that predict the perceived importance of, and intention to use, psychosocial services...... among infertile people. METHODS: We conducted an epidemiological study based on questionnaires among all new couples attending five fertility clinics with a response rate of 80.0% and a total of 2250 patients. RESULTS: The vast majority of both men and women considered a high level of medical...

  11. Ärztliche Zentralbibliothek – Mitgestalterin einer elektronischen Lernumgebung am Universitätsklinikum Hamburg-Eppendorf / Central Medical Library (Ärztliche Zentralbibliothek – participating in the development of an e-learning environment at the University Medical Centre Hamburg-Eppendorf

    Directory of Open Access Journals (Sweden)

    Sunderbrink, Norbert

    2007-12-01

    Full Text Available The development of e-learning has brought new tasks to libraries as a providers of information services. The Central Medical Library (ÄZB has played an active part in the development of the concept for an e-learning platform at the University Medical Centre Hamburg-Eppendorf (UKE since 2006. The responsibilities of the ÄZB within the faculty's e-learning project are: to ensure the compliance with standards, to integrate recent developments, to provide first level support to users and creators of e-learning modules. The ÄZB developed a modular concept for training and assisting teachers in the creation of e-learning modules as well as on the spot hotline support. This article presents the e-learning platform „Mephisto" at the University Medical Centre Hamburg-Eppendorf including the services provided by the Central Medical Library (ÄZB. E-learning systems are primarily seen as teaching aids but they can also be turned into useful instruments for the daily work of a library. The ÄZB developed its own e-learning module in order to enhance the internal flow of information and the structured provision of materials. By using these modules, staff come in contact with new web-based technologies and their enhanced understanding will also improve the support of users. After the test phase the concept developed by the ÄZB could be used as a template for Medical Centre wide applications on the departmental or institute level.

  12. An epidemiological study of poisoning cases reported to the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi.

    Science.gov (United States)

    Srivastava, Amita; Peshin, Sharda Shah; Kaleekal, Thomas; Gupta, Suresh Kumar

    2005-06-01

    A retrospective analysis of poisoning calls received by the National Poisons Information Centre showed a total of 2719 calls over a period of three years (April 1999-March 2002). The queries were made on poisoning management (92%) and information (8%) about various products and functioning of the centre. The data were analysed with respect to age, sex, mode and type of poisoning. The agents belonged to various groups: household products, agricultural pesticides, industrial chemicals, drugs, plants, animal bites and stings, miscellaneous and unknown groups respectively. The age ranged from less than 1 to 70 years, with the highest incidence in the range of 14-40 years, with males (57%) outnumbering females (43%). The most common mode of poisoning was suicidal (53%), followed by accidental (47%). The route of exposure was mainly oral (88%). Dermal (5%), inhalation and ocular exposure contributed 7% to the total. The highest incidence of poisoning was due to household agents (44.1%) followed by drugs (18.8%), agricultural pesticides (12.8%), industrial chemicals (8.9%), animals bites and stings (4.7%), plants (1.7%), unknown (2.9%) and miscellaneous groups (5.6%). Household products mainly comprised of pyrethroids, rodenticides, carbamates, phenyl, detergents, corrosives etc. Drugs implicated included benzodiazepines, anticonvulsants, analgesics, antihistamines, tricyclic antidepressants, thyroid hormones and oral contraceptives. Among the agricultural pesticides, aluminium phosphide was the most commonly consumed followed by organochlorines, organophosphates, ethylene dibromide, herbicides and fungicides. Copper sulphate and nitrobenzene were common among industrial chemicals. The bites and stings group comprised of snake bites, scorpion, wasp and bee stings. Poisoning due to plants was low, but datura was the most commonly ingested. An alarming feature of the study was the high incidence of poisoning in children (36.5%). The age ranged from less than 1 to 18 years

  13. Pesticide poisoning trend analysis of 13 years: a retrospective study based on telephone calls at the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi.

    Science.gov (United States)

    Peshin, Sharda Shah; Srivastava, Amita; Halder, Nabanita; Gupta, Yogendra Kumar

    2014-02-01

    The study was designed to analyze the incidence and pattern of pesticide poisoning calls reported to the National Poisons Information Centre (NPIC), AIIMS, New Delhi and highlight the common classes of pesticides involved in poisoning. The telephone calls received by the Centre during the thirteen year period (1999-2012) were entered into a preset proforma and then into a retrievable database. A total of 4929 calls of pesticide poisoning were recorded. The data was analyzed with respect to age, gender, mode and type of poisoning. The age ranged from 1 to 65 years with the preponderance of males (M = 62.19%, F = 37.80%). The age group mainly involved in poisoning was 18-35 years. While 59.38% calls pertained to household pesticides, 40.61% calls related to agricultural pesticides. The common mode of poisoning was intentional (64.60%) followed by accidental (34.40%) and unknown (1%). Amongst the household pesticides, the highest number of calls were due to pyrethroids (26.23%) followed by rodenticides (17.06%), organophosphates (6.26%), carbamates (4.95%) and others (4.86%). In agricultural pesticides group, the organophosphates (9.79%) ranked the first followed by, aluminium phosphide (9.65%), organochlorines (9.31%), pyrethroids (3.87%), herbicides, weedicides and fungicides (3.20%), ethylene dibromide (2.82%), and others (1.70%). The data analysis shows a high incidence of poisoning due to household pesticides as compared to agricultural pesticides, clearly emphasizing the need for creating awareness and education about proper use and implementation of prevention programmes. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  14. Nuclear research centres - The Egyptian experiment

    International Nuclear Information System (INIS)

    Abdelrazek, I.D.

    2001-01-01

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

  15. Do primary health centres and hospitals contribute equally towards achievement of the transversal clinical competencies of medical students? Performance on the Objective Structured Clinical Examination (OSCE) in competency acquisition.

    Science.gov (United States)

    Soler-González, Jorge; Buti, Miquel; Boada, Jordi; Ayala, Victoria; Peñascal, Eduard; Rodriguez, Toni

    2016-01-01

    The adaptation of the educational programmes of European faculties of medicine to the European Higher Education Area guidelines has focused curricula design on competence acquisition. Competencies are defined as the achievements of a predetermined level of efficacy in real-world scenarios. Our objective was to assess whether performance on a common competence evaluation test, the Objective Structured Clinical Examination (OSCE), resulted in different scores for second-year students after a practical medical training course took place in a primary health centre (PHC) or in a hospital. A descriptive study was conducted during the 2010-2014 academic year of the OSCE test scores obtained by all second-year students. Faculty of Medicine at the University of Lleida (Catalonia, Spain). We performed a correlation analysis between students who completed their practical medical training at the PHC and hospitals utilising Student's t-test for comparison of means. 423 students who completed internships at the PHC and at hospitals obtained OSCE mean scores of 7.32 (SD; IC) (0.82; 7.18-7.47) points and 7.17 (0.83; 6.07-7.26) points, respectively (p=0.07). Second-year medical students acquired similar competency levels in the two analysed training scenarios. The two areas both serve their teaching purpose. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  16. The effectiveness of the Australian Medical Sheepskin for the prevention of pressure ulcers in somatic nursing home patients: a prospective multi-centre randomised controlled trial (ISRCTN17553857).

    NARCIS (Netherlands)

    Mistiaen, P.; Achterberg, W.; Ament, A.; Halfens, R.; Huizinga, J.; Montgomery, K.; Post, H.; Spreeuwenberg, P.; Francke, A.

    2010-01-01

    A multicenter prospective randomized clinical trial was undertaken to investigate the effectiveness of the Australian Medical Sheepskin (AMS) in the prevention of sacral pressure ulcers in somatic nursing home patients. Patients were randomized at admission and were then followed daily for 30 days.

  17. A Multi-Centre Audit of the Use of Medication for the Management of Behavioural Problems in Adults with Intellectual Disabilities

    Science.gov (United States)

    Unwin, Gemma L.; Deb, Shoumitro

    2008-01-01

    The aim was to investigate prescribing practices surrounding the use of medication for the management of behavioural problems in adults with intellectual disabilities with reference to a national guideline development project. A case note review methodology was employed to explore adherence to the audit criteria that were derived from the…

  18. Empathy among undergraduate medical students: A multi-centre cross-sectional comparison of students beginning and approaching the end of their course.

    Science.gov (United States)

    Quince, Thelma A; Kinnersley, Paul; Hales, Jonathan; da Silva, Ana; Moriarty, Helen; Thiemann, Pia; Hyde, Sarah; Brimicombe, James; Wood, Diana; Barclay, Matthew; Benson, John

    2016-03-15

    Although a core element in patient care the trajectory of empathy during undergraduate medical education remains unclear. Empathy is generally regarded as comprising an affective capacity: the ability to be sensitive to and concerned for, another and a cognitive capacity: the ability to understand and appreciate the other person's perspective. The authors investigated whether final year undergraduate students recorded lower levels of empathy than their first year counterparts, and whether male and female students differed in this respect. Between September 2013 and June 2014 an online questionnaire survey was administered to 15 UK, and 2 international medical schools. Participating schools provided both 5-6 year standard courses and 4 year accelerated graduate entry courses. The survey incorporated the Jefferson Scale of Empathy-Student Version (JSE-S) and Davis's Interpersonal Reactivity Index (IRI), both widely used to measure medical student empathy. Participation was voluntary. Chi squared tests were used to test for differences in biographical characteristics of student groups. Multiple linear regression analyses, in which predictor variables were year of course (first/final); sex; type of course and broad socio-economic group were used to compare empathy scores. Five medical schools (4 in the UK, 1 in New Zealand) achieved average response rates of 55 % (n = 652) among students starting their course and 48 % (n = 487) among final year students. These schools formed the High Response Rate Group. The remaining 12 medical schools recorded lower response rates of 24.0 % and 15.2 % among first and final year students respectively. These schools formed the Lower Response Rate Group. For both male and female students in both groups of schools no significant differences in any empathy scores were found between students starting and approaching the end of their course. Gender was found to significantly predict empathy scores, with females scoring higher

  19. The role of the sexual assault centre.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

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

  20. A computer-based medical record system and personal digital assistants to assess and follow patients with respiratory tract infections visiting a rural Kenyan health centre

    OpenAIRE

    Diero, Lameck; Rotich, Joseph K; Bii, John; Mamlin, Burke W; Einterz, Robert M; Kalamai, Irene Z; Tierney, William M

    2006-01-01

    Abstract Background Clinical research can be facilitated by the use of informatics tools. We used an existing electronic medical record (EMR) system and personal data assistants (PDAs) to assess the characteristics and outcomes of patients with acute respiratory illnesses (ARIs) visiting a Kenyan rural health center. Methods We modified the existing EMR to include details on patients with ARIs. The EMR database was then used to identify patients with ARIs who were prospectively followed up by...

  1. Manche centre; Centre de la Manche

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-05-01

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

  2. A computer-based medical record system and personal digital assistants to assess and follow patients with respiratory tract infections visiting a rural Kenyan health centre.

    Science.gov (United States)

    Diero, Lameck; Rotich, Joseph K; Bii, John; Mamlin, Burke W; Einterz, Robert M; Kalamai, Irene Z; Tierney, William M

    2006-04-10

    Clinical research can be facilitated by the use of informatics tools. We used an existing electronic medical record (EMR) system and personal data assistants (PDAs) to assess the characteristics and outcomes of patients with acute respiratory illnesses (ARIs) visiting a Kenyan rural health center. We modified the existing EMR to include details on patients with ARIs. The EMR database was then used to identify patients with ARIs who were prospectively followed up by a research assistant who rode a bicycle to patients' homes and entered data into a PDA. A total of 2986 clinic visits for 2009 adult patients with respiratory infections were registered in the database between August 2002 and January 2005; 433 patients were selected for outcome assessments. These patients were followed up in the villages and assessed at 7 and 30 days later. Complete follow-up data were obtained on 381 patients (88%) and merged with data from the enrollment visit's electronic medical records and subsequent health center visits to assess duration of illness and complications. Symptoms improved at 7 and 30 days, but a substantial minority of patients had persistent symptoms. Eleven percent of patients sought additional care for their respiratory infection. EMRs and PDA are useful tools for performing prospective clinical research in resource constrained developing countries.

  3. A computer-based medical record system and personal digital assistants to assess and follow patients with respiratory tract infections visiting a rural Kenyan health centre

    Directory of Open Access Journals (Sweden)

    Mamlin Burke W

    2006-04-01

    Full Text Available Abstract Background Clinical research can be facilitated by the use of informatics tools. We used an existing electronic medical record (EMR system and personal data assistants (PDAs to assess the characteristics and outcomes of patients with acute respiratory illnesses (ARIs visiting a Kenyan rural health center. Methods We modified the existing EMR to include details on patients with ARIs. The EMR database was then used to identify patients with ARIs who were prospectively followed up by a research assistant who rode a bicycle to patients' homes and entered data into a PDA. Results A total of 2986 clinic visits for 2009 adult patients with respiratory infections were registered in the database between August 2002 and January 2005; 433 patients were selected for outcome assessments. These patients were followed up in the villages and assessed at 7 and 30 days later. Complete follow-up data were obtained on 381 patients (88% and merged with data from the enrollment visit's electronic medical records and subsequent health center visits to assess duration of illness and complications. Symptoms improved at 7 and 30 days, but a substantial minority of patients had persistent symptoms. Eleven percent of patients sought additional care for their respiratory infection. Conclusion EMRs and PDA are useful tools for performing prospective clinical research in resource constrained developing countries.

  4. Organization of teletherapy treatment planning training process for medical physicists and engineers of radiotherapy departments at N.N. Alexandrov national cancer centre of Belarus

    International Nuclear Information System (INIS)

    Titovich, E.V.; Gertsik, O.A.; Potepalov, P.O.; Tarutin, I.G.; Gatskevich, G.V.

    2017-01-01

    Training was provided for all employees of the Radiotherapy engineering and medical physics department of the N.N. Alexandrov NCCB in accordance with their job duties. The developed instruction describes the following procedures for the operation of equipment for radiation therapy: CT and PET images registration procedure, analysis of the treatment planning statistics, import of the patient data to the Eclipse TPS, patient data transfer from CT to the dedicated data server, CT and MRI images registration procedure, 3D treatment planning using MasterPlan TPS, 3D treatment planning using Eclipse TPS, IMRT and VMAT verification using EPID, IMRT and VMAT verification using Octavius 4D, EPID calibrations, IMRT treatment planning using Eclipse TPS, VMAT treatment planning using Eclipse TPS. Conclusions. Introduction of the developed instruction in the clinical practice of N.N. Alexandrov NCCB made it possible to streamline the process of training the staff of the Radiotherapy engineering and medical physics department and to competently approach the evaluation of the knowledge acquired by the personnel that is operating of the radiotherapy equipment

  5. [The TraumaRegister DGU® as the basis of medical quality management. Ten years experience of a national trauma centre exemplified by emergency room treatment].

    Science.gov (United States)

    Helm, M; Bitzl, A; Klinger, S; Lefering, R; Lampl, L; Kulla, M

    2013-07-01

    The trauma register of the German Society of Trauma Surgery (TraumaRegister DGU®/TR-DGU) has been proven to be a valuable tool for external assessment of quality in the treatment of patients with major trauma. This publication shows for the first time how the quality of trauma treatment in a level I trauma centre could be improved over a period of almost ten years with the help of continuous quality management, i.e. recognizing a problem, developing a solution and evaluating its effect. Tracer parameters and indicators of quality are presented in four periods over a total study period from 1st January 1989 to 31st March 2007. The division into four periods is due to major changes in the trauma treatment algorithms or structural changes in the trauma room. The results are displayed for all patients treated in the trauma room and for those patients with an injury severity score (ISS)≥16. Over all four periods a total number of n=2,239 patients were admitted to the trauma room. Based on the results of the trauma register a number of changes were made, not only structural changes, such as the introduction of point-of-care diagnostics, initially conventional X-ray, then digital X-ray and finally multislice computed tomography (CT) scanning in the trauma room but also changes in the way personnel participating in the trauma treatment are trained. Advanced trauma life support (ATLS®) has become the standard training for doctors and prehospital trauma life support (PHTLS®) for nurses. Time efficient treatment algorithms were introduced. All measures led to changes in several parameters which are chosen as indicators for good treatment quality. It was for instance possible to reduce the average total trauma treatment time for patients with an ISS≥16 from initially 90.9±48.6 min to 37.4±18.  min in the final study period. The external quality management performed by the TR-DGU has proved to be a constant source of inspiration. The effects of the changes made can

  6. Efficacy of porcine dermal collagen (PermacolTM) injection for passive faecal incontinence in a dedicated Colorectal Unit at the Wits Donald Gordon Medical Centre.

    Science.gov (United States)

    Harran, N; Herold, J; Bentley, A; Bebington, B D

    2017-06-01

    Passive faecal incontinence (FI) due to a defect of the internal anal sphincter is a distressing condition and can be difficult to manage medically and surgically. The use of a trans-anally injected bulking agent to improve continence has been published internationally with contradictory results. Patients with passive FI due to confirmed internal anal sphincter deficits that had been treated with PermacolTM injections were followed up. They were asked to complete the Wexner faecal incontinence scores and Rockwood QoL scores for both their pre- and post-treatment continence state. Of the 14 patients who completed the questionnaires, most were women with a mean (SD) age of 56.4 (13.4) years. The majority of the patients had a history of a predisposing event. They reported a significant improvement in both the Wexner scores (p life scores in patients with passive faecal incontinence for up to two years.

  7. Untitled

    African Journals Online (AJOL)

    2 Queen Elizabeth Central Hospital, Department of Medicine, Blantyre, Malawi. 3 Department of Virology, University Medical Centre Utrecht, the Netherlands. 4 Department of Clinical Pharmacy, University Medical Centre Nijmegen, the Netherlands. 5 Department of Community Health, College of Medicine, University of ...

  8. CLINICAL SPECTRUM OF COMORBID COELIAC DISEASE IN TYPE 1 DIABETES MELLITUS- A TERTIARY CARE CENTRE BASED STUDY IN ASSAM MEDICAL COLLEGE AND HOSPITAL

    Directory of Open Access Journals (Sweden)

    Apurba Dutta

    2017-09-01

    Full Text Available BACKGROUND The relationship between T1DM and CD has been known due to their identical genetic and autoimmune background. The prevalence of CD in T1DM in Assam has not been determined. We examined the prevalence and clinical profile of CD in patient with T1DM in Assam. MATERIALS AND METHODS A cross-sectional study with 96 patients with T1DM from the Outpatient or Inpatient Department of Medicine of Assam Medical College and Hospital, Dibrugarh, was undertaken in the study period from July 1, 2015, to June 30, 2016. Anti-Tissue Transglutaminase Antibody (anti-TTG measurement was done by ELISA in all patients. Duodenal biopsy were performed for T1DM patients with positive and negative serology for anti-TTG antibodies. RESULTS Total 96 T1DM patients (51 males and 45 females with the age ranging from 12-50 years (mean ± SD 24.24 ± 6.89 were studied. Elevated anti-TTG levels were found in the sera of 4 (4.17% out of 96. The male-to-female ratio of the anti-TTG positive is 1:1. Serology positive patients had typical symptoms along with statistically significant association of neuropathy, anaemia, hypoalbuminaemia and hypocalcaemia. Duodenal mucosal biopsy of one IgA tTG positive patient was Marsh3a type. Out of 12 T1DM who were serology negative for CD, 1 had Marsh type 3a, 2 had type 2, 5 had type 1 and 4 had type 0 (normal. CONCLUSION Celiac disease in T1DM is not uncommon in this part and prevalence is 4.17%. Suspected cases needs evaluation by serological test along with histopathological examination of duodenal mucosa. Serum IgA measurement and genetic study can be considered in serology-negative patients with typical symptoms of celiac disease.

  9. Human-centred Governance

    DEFF Research Database (Denmark)

    Bason, Christian

    2017-01-01

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

  10. Food insecurity and health status in deprived populations, 2014: a multicentre survey in seven of the social and medical healthcare centres (CASOs) run by Doctors of the World, France.

    Science.gov (United States)

    Laurence, S; Durand, E; Thomas, E; Chappuis, M; Corty, J F

    2017-02-01

    To document eating practices and socio-economic profiles of patients seen in the social and medical healthcare centres (CASOs in its French acronym) run by Doctors of the World (Médecins du Monde, MdM) in France and evaluate their nutritional and health status. The survey was carried out between April and May 2014 in seven CASOs in France. All the patients attending MdM clinics were given a nutrition and health questionnaire. Their anthropometric measurements were taken on site. 77.7% of the households surveyed were food insecure due to constrained resources. On average, the patients interviewed declared spending €2.5 per person per day on food. A total of 46.3% of adults declared not having eaten for a whole day at least once in the month preceding the survey. One third of the patients declared having lost weight over the last two weeks. A chronic pathology was diagnosed in more than one in two patients; 19% were obese and 34% were overweight. Constrained resources lead people living in very precarious conditions to eat without adequate nutrition, which could have consequences for their health, such as diabetes, obesity and cardiovascular disease. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. Group B Streptococcus infection: epidemiology, serotypes, and antimicrobial susceptibility of selected isolates in the population beyond infancy (excluding females with genital tract- and pregnancy-related isolates) at the University Malaya Medical Centre, Kuala Lumpur.

    Science.gov (United States)

    Karunakaran, Rina; Raja, Nadeem Sajjad; Hafeez, Asma; Puthucheary, Savithri D

    2009-05-01

    Group B Streptococcus (GBS) infection was studied in 49 patients collected at convenience (convenience sampling), excluding infants and women with genital tract- and pregnancy-related isolates, according to the availability of stocked isolates and easy accessibility to epidemiological data. The data were examined both prospectively and retrospectively from 2003-2005 at a tertiary-level multidisciplinary hospital in Kuala Lumpur, Malaysia. Skin and soft-tissue infections in 35 patients (71.4%) were the most common clinical presentation, while diabetes mellitus was the most common underlying condition (35 patients, 71.4%). All GBS isolates were sensitive to penicillin, and most isolates tested were sensitive to erythromycin (97.7%). Serotyping of 45 GBS isolates using a commercial serotyping kit revealed that the most common serotype was Ia (22.2%), followed by VI (17.8%), III and V (13.3% each). Others included Ib, II, IV, VIII, and VII; 13.3% were nontypeable. The findings of this pilot study are limited by the small sample size, the sampling method and the possibility that the cases are not wholly representative of the University Malaya Medical Centre population. Further studies from our hospital with larger numbers and using probabilistic sampling techniques are required to confirm the relatively high occurrence of serotype VI (the second most common serotype) in the population studied.

  12. CMS Centre at CERN

    CERN Multimedia

    2007-01-01

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

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

    African Journals Online (AJOL)

    EagleMarkRes

    % of the procedure was carried out by registrars with consultants accounting for only 13.1%. Conclusion: The CS rate has steadily been on the increase in our facility compared with the last, though better than most, reported in this country.

  14. Canadian Irradiation Centre

    International Nuclear Information System (INIS)

    1987-05-01

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

  15. SAP Nuclear Competence Centre

    International Nuclear Information System (INIS)

    Andrlova, Z.

    2009-01-01

    In this issue we continue and introduce the SAP Nuclear Competence Centre and its head Mr. Igor Dzama. SAP Nuclear Competence Centrum is one of the fi rst competence centres outside ENEL headquarters. It should operate in Slovakia and should have competencies within the whole Enel group. We are currently dealing with the issues of organisation and funding. We are trying to balance the accountability to the NPP directors and to the management of the competence centres at Enel headquarters; we are looking at the relations between the competence centres within the group and defining the services that we will provide for the NPPs. author)

  16. Ce que nous faisons | Page 65 | CRDI - Centre de recherches pour ...

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

    Ouest et du Centre. Sujet(s): MEDICAL EDUCATION, ENVIRONMENTAL HEALTH, CURRICULUM DEVELOPMENT, UNIVERSITIES, RESEARCH CENTRES. Région(s): Africa, South of Sahara. Programme(s): Alimentation, environnement et ...

  17. Discharged of the nuclear wastes by health service centres

    International Nuclear Information System (INIS)

    Mazur, G.; Jednorog, S.

    1993-01-01

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

  18. Group medical visits in the follow-up of women with a BRCA mutation: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hoogerbrugge Nicoline

    2011-08-01

    Full Text Available Abstract Background BRCA mutation carriers have a 40-80% life-time risk of developing breast cancer. They may opt for yearly breast cancer surveillance or for prophylactic mastectomy. Both options show increased survival rates. It is a complex choice to be made between these two options. As a result most women experience high levels of distress and high needs for information. To fulfill the needs for psychosocial support and information we have introduced group medical consultations (GMCs. A GMC provides individual medical visits conducted within a group. This 90 minute group-visit with 8-12 patients gives patients the opportunity to spend more time with their clinician and a behavioral health professional and learn from other patients experiencing similar topics. However, it should be noted that group sessions may increase fear in some patients or influence their decision making. Methods/design In this randomized controlled trial, 160 BRCA mutation carriers diagnosed maximally 2 years ago are recruited from the Radboud University Nijmegen Medical Centre. Participants are randomized in a 1:1 ratio to either the GMC intervention group (onetime participation in a GMC instead of a standard individual visit or to a usual care control group. Primary outcome measures are empowerment and psychological distress (SCL 90. Secondary outcome measures are fear of cancer, information needs before the consultation and the received information, self-examination of the breasts, patient satisfaction, quality of life and cost-effectiveness. Data are collected via self-reported questionnaires 1 week before the visit, and at 1 week and at 3 months follow-up. A pilot study was conducted to test all procedures and questionnaires. Discussion The possibility for interaction with other BRCA mutation carriers within a medical visit is unique. This study will assess the effectiveness of GMCs for BRCA mutation carriers to improve empowerment and decrease distress compared

  19. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

    2008-01-01

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

  20. Review at National Eye Centre, Kaduna

    African Journals Online (AJOL)

    Aims and Objectives: To describe the pattern of paediatric ocular trauma seen at the National Eye Centre,. Kaduna, between January 1995 and December 1997; and the factors that affect the visual and ocular. OutCOme. Materials and Methods: The medical records of all the children 15 years or younger, with ocular injuries.

  1. Regional Dermatology Training Centre in Moshi, Tanzania ...

    African Journals Online (AJOL)

    governmental organisation (NGO) that focuses on albinism. The latest African country to provide medical trainees for this programme is Malawi, a country currently without a specialist dermatologist. Professors Henning Grossman and John Masenga in the Regional. Dermatology Training Centre (RDTC) library.

  2. FUNCfIONS OF A HEALm CENTRE*

    African Journals Online (AJOL)

    few units reserved for the elderly, with several homes for the aged, provide accommodation for 320 persons not ..... nate refuse disposal; a promotive hygiene sectIOn mcludmg health education and research; infectious disease .... functions of the health centre, medical and nursing care of acute emergencies are occasionally ...

  3. Medical assistance in case of nuclear accident

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  4. Role and functions of Poisons Information Centre.

    Science.gov (United States)

    Lall, S B; Peshin, S S

    1997-01-01

    The Poisons Information Centre (PIC) is a specialized unit providing information on prevention, early diagnosis and treatment of poisoning and hazard management. Most of the developed and many developing countries have well established poison control centres with poisons information service, patient management facility and analytical laboratory. In India, the National Poisons Information Centre (NPIC) was established in February, 1995 in the Department of Pharmacology at the All India Institute of Medical Sciences, New Delhi. The centre provides toxicological information and advice on the management of poisoned patients adopted to the level of the enquirer. The basis of this service are the databases on poisoning, drug reactions and also the continuous and systematic collection of data from the library. This information service is available round the clock. The PIC has the training responsibility extending to medical and other health professionals and community. The NPIC organized two successive training courses for medical professionals and para professionals at all health levels. Further, NPIC is a participant of INTOX project of IPCS/WHO, receiving regular yearly training on the use of INTOX database. Laboratory service is an essential component of a poisons control programme, providing analytical services on emergency basis to help in diagnosis and management. The NPIC is developing facilities for quick diagnosis of poisoning cases. Toxicovigilance and prevention of poisoning is another major function of PIC. The Centre has prepared manuals and leaflets on prevention and management cards on treatment of various poisonings. Thus the Centre provides a service with considerable health benefits, reducing morbidity and mortality from poisoning and gives significant financial savings to the community.

  5. The Bruce Energy Centre

    International Nuclear Information System (INIS)

    Jones, R.I.

    1982-06-01

    The Bruce Energy Centre Development Corporation is a joint venture of the Ontario Energy Corporation and 6 private companies formed to market surplus steam from the Bruce Nuclear Power Development. The corporation will also sell or lease land near Bruce NPD. The Bruce Energy Centre has an energy output of 900 BTU per day per dollar invested. Potential customers include greenhouse operators, aquaculturalists, food and beverage manufacturers, and traditional manufacturers

  6. The Aube centre

    International Nuclear Information System (INIS)

    1996-07-01

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

  7. Pattern of medical admissions at the Federal Medical Centre, Asaba ...

    African Journals Online (AJOL)

    One thousand and eight of these [1008; 54.2%], were male, while eight hundred and fifty two [850; 45.8%] were female, making a female/male ratio of 1:1.18.The patients ages ranged between fifteen and ninety years, with amean of 51.56 ± 18.35 years.The age range ofmale patients ranged from16 to 88 years,with amean ...

  8. [The level of first aid and basic life support for the next generation of physicians

    NARCIS (Netherlands)

    Severien, I.; Tan, E.C.T.H.; Metz, J.C.; Biert, J.; Berden, H.J.J.M.

    2005-01-01

    According to Dutch medical-education guidelines junior doctors are expected to be able to carry out first aid and basic life support. We determined the level of first aid and basic life support of junior doctors at the Radboud University Nijmegen Medical Centre, The Netherlands. Of the 300 junior

  9. Successfully sustaining sex and gender issues in undergraduate medical education: a case study.

    Science.gov (United States)

    van der Meulen, Francisca; Fluit, Cornelia; Albers, Mieke; Laan, Roland; Lagro-Janssen, Antoine

    2017-12-01

    Although several projects have addressed the importance of gender health issues in medical education, the sustainability of change efforts in medical education has rarely been addressed. Understanding the possible facilitators or barriers to sustainability may help to develop future interventions that are effective in maintaining gender health issues as a topic in medical curricula. The aim of this study is to provide a longitudinal evaluation of changes regarding gender health issues that occurred in the past decade and the factors that influenced this process. The coursebooks of eight theoretical courses of the Nijmegen medical curriculum were screened on the basis of criteria for an integrated gender perspective in medical education. To assess the sustainability of gender health issues, the screening results from 2014 were compared with those of a similar project in 2005. In addition, open interviews were conducted with eight coordinators to identify facilitators and barriers influencing the sustainability of gender health issues. Analysis showed that, over the past decade, the implementation of gender health issues was mainly sustained and additional changes were made, resulting in an ongoing gender perspective in the Nijmegen medical curriculum. The coordinators mentioned several factors that influenced the sustainability of implementation in medical education: coordinators' and teachers' gender-sensitive attitude, competing demands, the presence of sex and gender in learning objectives, examinations and evaluation, organizational support and curriculum revisions. Our findings suggest that, in implementing sex and gender in medical education, medical faculties need to focus on top-down support in incorporating sex and gender into core objectives and time spent on incorporating sex and gender into medicine, and on the continuous training of teaching staff.

  10. Information Centre Radioactivity Switzerland; Beratungsstelle Radioaktivitaet Schweiz

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-07-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  12. Academic Drug Discovery Centres

    DEFF Research Database (Denmark)

    Kirkegaard, Henriette Schultz; Valentin, Finn

    2014-01-01

    Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic and organi......Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic...... their performance....

  13. The Structural Integrity Centre

    International Nuclear Information System (INIS)

    Tomkins, B.

    1987-01-01

    The paper concerns the development and work of the Structural Integrity Centre (SIC) at Risley Nuclear Laboratories, United Kingdom. The centre was set up to provide authoritative advice to plant designers and operators on the integrity and life assessment of structures and components across the reactor projects in the United Kingdom. A description is given of the structure and role of the SIC, as well as the Structural Integrity Assessment work. The assessment methods are described for thermally loaded structures and welded structures. Finally, defect significance assessment and environmental effects are outlined. (U.K.)

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

    Directory of Open Access Journals (Sweden)

    Verhoeven WMA

    2011-05-01

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

  15. Fuel cycle centres

    International Nuclear Information System (INIS)

    Hagen, M.

    1977-01-01

    The concept of co-locating and integrating fuel cycle facilities at one site is discussed. This concept offers considerable advantages, especially in minimizing the amount of radioactive material to be transported on public roads. Safeguards and physical protection as relating to such an integrated system of facilities are analysed in detail, also industrial and commercial questions. An overall risk-benefit evaluation turns out to be in favour of fuel cycle centres. These centres seem to be specifically attractive with regard to the back end of the fuel cycle, including on-site disposal of radioactive wastes. The respective German approach is presented as an example. Special emphasis is given to the site selection procedures in this case. Time scale and cost for the implementation of this concept are important factors to be looked at. Since participation of governmental institutions in these centres seems to be indispensable their respective roles as compared to industry must be clearly defined. The idea of adjusting fuel cycle centres to regional rather than national use might be an attractive option, depending on the specific parameters in the region, though results of existing multinational ventures are inconclusive in this respect. Major difficulties might be expected e.g. because of different national safety regulations and standards as well as commercial conditions among partner countries. Public acceptance in the host country seems to be another stumbling block for the realization of this type of multinational facilities

  16. CENTRE FOR CONTEMPORARY STUDIES

    Indian Academy of Sciences (India)

    ROOPA

    Venue: Seminar Hall, Centre for Contemporary Studies,. Indian Institute of Science, Bangalore 560 012. All are cordially invited. Tea/Coffee will be served at 10:30 a.m.. Jean Taylor is Professor of Mathematics Emerita of the Rutgers University and currently a visitor at the Courant Institute for Mathematical Sciences, NYU.

  17. consequent and Centre

    African Journals Online (AJOL)

    Among the issues being explored both in South Mrica and abroad with respect to cost containment in health care are ... Centre for the Study of Health Policy, Department of. Community Health, University of the ... policies aimed at improving the cost-effectiveness of prescribing and dispensing. These policies may be divided ...

  18. Nuclear Science Centre

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 2; Issue 10. Nuclear Science Centre. N Madhavan. Information and Announcements Volume 2 Issue 10 October 1997 pp 92-96. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/002/10/0092-0096 ...

  19. Implementing Responsibility Centre Budgeting

    Science.gov (United States)

    Vonasek, Joseph

    2011-01-01

    Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

  20. Official Centre Hospitality

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

    Sylvain Dufour

    Approved by the Management Executive Committee. - 1 -. Version 3.1.0 effective 2017-06-28. Official Centre Hospitality. 1. Objective. 2. Application. 3. Definitions. 4. Roles and Responsibilities. 5. Authorization. 6. Consultants and Contractors. 7. Reimbursement. 1. Objective. To define the circumstances under which ...

  1. ATLAS Visitors Centre

    CERN Multimedia

    claudia Marcelloni

    2009-01-01

    ATLAS Visitors Centre has opened its shiny new doors to the public. Officially launched on Monday February 23rd, 2009, the permanent exhibition at Point 1 was conceived as a tour resource for ATLAS guides, and as a way to preserve the public’s opportunity to get a close-up look at the experiment in action when the cavern is sealed.

  2. Entrepreneurship Development Centre (EDC)

    African Journals Online (AJOL)

    PROF EKWUEME

    Entrepreneurship Development Centre (EDC). University of Calabar, Calabar. Title of book: Issues in development: leadership, education and religion ... entry examinations and the essence of education. Chapter three: Religion and development. This chapter is composed of six sections: parenting; behaviour and religion;.

  3. Official Centre Hospitality

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

    Sylvain Dufour

    Corporate Policy. Approved by the Management Executive Committee. - 1 -. Version 3.0.1 effective 2016-05-01. Official Centre Hospitality. 1. Objective. 2. ... and social interaction. 4. Roles and Responsibilities ... Authorization. The prime level of managerial responsibility for authorizing hospitality expenses rests with the.

  4. Emergency Centre care for sexual assault victims

    Directory of Open Access Journals (Sweden)

    Allana M. Krolikowski

    2012-03-01

    Full Text Available Sexual assault is a topic of importance worldwide to health professionals that provide emergency care. Victims of sexual assault include adult men, adult women, and children. The prevalence of sexual assault is likely under-reported. These patients should be offered comprehensive medical care upon arrival to the emergency centre. This includes assessment for acute injuries; medical history; physical examination; and possible collection of evidence. Depending on the patient's situation, he or she may be offered prophylactic and therapeutic management, which includes pregnancy testing and emergency contraception, prophylaxis for sexually transmitted infections, and HIV post-exposure prophylaxis. This article addresses the most up-to-date information on this management. Patients should also be offered mental health counselling on-site if appropriate health professionals are available. A number of countries have national protocols for care of the sexual assault patient. Implementing these protocols can be strengthened through such interventions as hiring sexual assault nurse examiners or creating a sexual assault centre within the emergency centre. The patient's immediate and future safety and emotional needs should be evaluated and a plan formulated for safety when the patient is discharged. Medical follow up is recommended and should be strongly encouraged.

  5. Tele-centres in Ghana

    DEFF Research Database (Denmark)

    Falch, Morten

    2004-01-01

    Tele-centres offer a low cost opportunity for the many who cannot afford their own phone or Internet connection. This paper presents a field study of tele-centres in Ghana and analyses how they contribute to universal access.......Tele-centres offer a low cost opportunity for the many who cannot afford their own phone or Internet connection. This paper presents a field study of tele-centres in Ghana and analyses how they contribute to universal access....

  6. Malformação congénita das vias aéreas pulmonares: Experiência de cinco centros Congenital cystic adenomatoid malformation of the lung: The experience of five medical centres

    Directory of Open Access Journals (Sweden)

    Gustavo Rocha

    2007-07-01

    lesão assintomática é controverso; a cirurgia está indicada devido à baixa morbilidade e possibilidade de prevenção de complicações tardias, como a degenerescência maligna.Background: The clinical spectrum of congenital cystic adenomatoid malformation of the lung (CCAML ranges from asymptomatic lesions to neonatal respiratory distress and hydrops fetalis. Aim: To review our experience with CCAML, emphasising natural history, management and outcome. Material and methods: A retrospective chart review of all CCAML-diagnosed neonates admitted to the neonatal intensive care units of five tertiary medical centres in the north of Portugal between 1996 and 2005. Results: Fifteen neonates with CCAML were identified, 9F/6M, birth weight 3100 g (645-3975, gestational age 38 weeks (24-40. The incidence of CCAML was 1: 9300 births. There were 11 (73% cases of cystic lung lesion diagnosed during pregnancy, median age 22 weeks (19-30. The lesion was right sided in six (40% and left sided in nine (60% cases. In utero spontaneous regression of the lesion was observed in two cases. Antenatal intervention (pleurocentesis and thoracoamniotic shunting was performed in one foetus with impending hydrops. Normal lung radiographic findings at birth were present in five cases, with an abnormal CT scan. Three (20% neonates became symptomatic during the neonatal period (respiratory distress and one (70% after the neonatal period (spontaneous pneumothorax. Two neonates (13% died. Six (40% patients underwent thoracotomy and appropriate excisional surgery. Histological examination showed definitive features of CCAML (Stocker classification: type I = 4; type II = 1; type III = 2. Eight (53% patients remain asymptomatic and did not undergo surgery. Conclusions: Antenatally diagnosed CCAML has a good prognosis in the absence of severe foetal distress; normal radiographic findings at birth do not rule out CCAML; treatment of asymptomatic CCAML is controversial; surgery may be advocated

  7. International Seismological Centre

    Science.gov (United States)

    Spall, H.; Hughes, A.

    1979-01-01

    The International Seismological Centre had its origins when the British seismologist Professor John Milne returned to England from Japan in 1895 to retire at Shide on the Isle of Eight. In cooperation with the British Association for the Advancement of Science, Milne had set up a number of seismographic stations around the world and, while Tokyo, had published a Catalogue of 8,33 Earthquakes Recorded in Japan, 1885-1892. 

  8. International Data Centre (IDC)

    International Nuclear Information System (INIS)

    Johansson, P.

    2002-01-01

    The presentation outlines the International Data Centre (Indc) mission, objective and historical background. The Indc progressive commissioning and organizational plans are presented on charts. The IMS stations providing data to Indc operations and the global communication infrastructure are plotted on world maps. The various types of IMS data are thus listed as seismic, hydroacoustic, infrasound and radionuclide. Finally Indc products and services together with its main achievements are listed

  9. Historical centres: changing definitions

    Directory of Open Access Journals (Sweden)

    Roberta Lazzarotti

    2014-02-01

    Full Text Available Since the end of the Second World War, the architectural and planning culture has been showing a fluctuating attention to the theme of historical centres and their enhancement. First of all this uneven progress explains the difficulty to reach a homogeneous definition and this is still lacking. During a long phase of this period, the historical parts of the town were considered as objects to be preserved in an integral way, as urban monuments. This is mostly due to the high symbolic value of these settlements, that represent fundamental landmarks. Identity building and empowerment of local communities are indispensable conditions for any development programme, especially in the case of centres or other historic environments at risk of abandonment. The progressive evolution of this concept brings awareness of the impossibility of separating – either in analytical or in planning terms ­ historical centres from their urban and territorial contexts, which are linked by mutual, deep relationships. This article attempts to retrace the steps signaled by the publication of international documents and conventions, from the Charter of Gubbio (1960 to the Charter of Krakow and the European Landscape Convention (2000; they obviously represent particular points of view, not exhaustive of the richness of the positions in the debate, but extremely significant in terms of diffusion and consensus.

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

    Directory of Open Access Journals (Sweden)

    Ruth Alma Ramos

    2015-11-01

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

  11. DGNB certified Healthcare Centres

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Larsen, Tine Steen

    2015-01-01

    for sustainability and wants a certification. This research investigates the decision‐making and design process (DMaDP) behind four DGNB certified Healthcare Centres (HCC) in Northern Jutland in Denmark. In general, knowledge about the DMaDP is important. However it is important to know what part DGNB plays...... a dialog about DGNB and energy concept is important even before anyone start sketching. Experiences with the different approaches will be further outlined in the paper.Future research has the intention to collect further knowledge about DGNB and DMaDP in practise. This project was limited to Healthcare...

  12. Patient-centred Prevention among PAD Patients

    DEFF Research Database (Denmark)

    Pii, Kathrine Hoffmann

    2015-01-01

    of a patient-centred prevention programme aimed at PAD patients, which includes medical treatment as well as individual nurse-led lifestyle-oriented conversations (inspired by psychological theory and methods such as Motivational Interviewing). Method: The findings are based on four months ethnographic field...... study at two vascular clinics in the period 2009-10 including ethnographic interviews with health professionals and patients. Results: The paper shows that the preventive programme’s patient-centred approach and ambition to ensure patient autonomy is challenged by patients involved in the programme....... The paper shows that the programme’s attempt to facilitate that patients make their “own” decision is challenged by patients who understand the preventive programme in relational terms and even demand more intervention from the professionals in terms of expert advice, involvement, and discipline. Conclusion...

  13. Organization of brachytherapy treatment planning and after loaders maintenance training process for medical physicists and engineers of radiotherapy departments in the N.N. Alexandrov national cancer centre of Belarus

    International Nuclear Information System (INIS)

    Kozlovskij, D.I.; Titovich, E.V.; Tarutin, I.G.; Gatskevich, G.V.

    2017-01-01

    The instruction on standard operations of the personnel of the Radiotherapy engineering and medical physics department in Russian and an educational program for the training of specialists that are operating radiotherapy equipment have been developed. Training was conducted for all employees of the Radiotherapy engineering and medical physics department of the N. N. Alexandrov NCCB in accordance with their job duties. Introduction of the developed instruction in the clinical practice of the N. N. Alexandrov NCCB allowed to streamline the process of training the staff of the the Radiotherapy engineering and medical physics department and to competently approach the evaluation of the knowledge acquired by the personnel that is operating of the radiotherapy equipment

  14. Update on System Coordination Centre

    International Nuclear Information System (INIS)

    Stangl, W.

    1998-01-01

    The new System Coordination Centre at the Power Pool of Alberta was designed to meet the unique requirements of Alberta's electric industry under the new regulatory regime. Development of the Centre, key provisions of the energy management system (EMS) are highlighted. The centre will provide an energy management system for the Pool's system controller function and interface with the Power Pool Administrator's market functions and the operations of the Transmission Administrator. System controllers are expected to be operating from the new location by the end of 1998. Unique EMS features of the centre include: (1) real-time management of energy market and network operations using diverse SCADA/EMS, (2) inter-control centre protocol used to accommodate the unique participant information requirements, and (3) special custom applications. The Centre is expected to be fully functioning by July 1999. 1 fig

  15. Call Centre- Computer Telephone Integration

    Directory of Open Access Journals (Sweden)

    Dražen Kovačević

    2012-10-01

    Full Text Available Call centre largely came into being as a result of consumerneeds converging with enabling technology- and by the companiesrecognising the revenue opportunities generated by meetingthose needs thereby increasing customer satisfaction. Regardlessof the specific application or activity of a Call centre, customersatisfaction with the interaction is critical to the revenuegenerated or protected by the Call centre. Physical(v, Call centreset up is a place that includes computer, telephone and supervisorstation. Call centre can be available 24 hours a day - whenthe customer wants to make a purchase, needs information, orsimply wishes to register a complaint.

  16. International Development Research Centre Act Loi sur le Centre de ...

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

    1 juin 2009 ... 31 (1) Every copy of a consolidated statute or consolidated regulation ... Assimilation à organisme de bienfaisance enregistré. Financial. Dispositions financières. 20. International Development Research Centre Account. 20. Compte du ...... cal year, including the financial statements of the Centre and the ...

  17. Startup : Philippine Community eCentres Network | CRDI - Centre ...

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

    Startup : Philippine Community eCentres Network. More than 300 Community eCenters or telecentres are currently operating as part of local government units throughout the Philippines. Exchange visits with the M.S. Swaminathan Research Foundation of India have enabled these centres to evolve in such a way as to ...

  18. [Brief history of creation and activities of Research Institute of Hygiene and Health Protection of Children and Adolescents State Institution Research Centre of Children's Health Protection, Russian Academy of Medical Sciences].

    Science.gov (United States)

    Baranov, A A; Kuchma, V R

    2009-01-01

    The Institute was founded to study effects of environmental factors on the health status and day-to-day activities of children and adolescents in organized groups and to use the data obtained for the elaboration of measures for the protection and promotion of their health. The Institute is up to now the sole research institution of this kind in the Russian Federation entitled to coordinate problem-solving efforts on a national scale. Since 2000, it has been functioning as the National Centre for support of the European network of health promoting schools. The Institute developed a concept of research designed to resolve topical problems facing hygienic science and practical health service; it implicates elaboration of hygienic norms and regulations taking into account age, sex, health status, and the level of mental and physical development of individual children. The main lines of research carried out at the Institute are listed with special reference to the theoretical aspects of such cardinal problems of child hygiene as adaptation, hygienic regulation and standardization, etc. The Institute participated in the development of a new basic curriculum and the state education standard law. The authors present results of multidisciplinary research and developments obtained at the Institute. Specialists of the Institute are involved in the work of international scientific societies.

  19. Council celebrates CERN Control Centre

    CERN Multimedia

    2006-01-01

    With the unveiling of its new sign, the CERN Control Centre was officially inaugurated on Thursday 16 March. To celebrate its startup, CERN Council members visited the sleek centre, a futuristic-looking room filled with a multitude of monitoring screens.

  20. CANDU 9 Control Centre Mockup

    International Nuclear Information System (INIS)

    Webster, A.; Macbeth, M.J.

    1996-01-01

    This paper provides a summary of the design process being followed, the benefits of applying a systematic design using human factors engineering, presents an overview of the CANDU 9 control centre mockup facility, illustrates the control centre mockup with photographs of the 3D CADD model and the full scale mockup, and provides an update on the current status of the project. (author)

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  2. Imbuing medical professionalism in relation to safety: a study protocol for a mixed-methods intervention focused on trialling an embedded learning approach that centres on the use of a custom designed board game.

    LENUS (Irish Health Repository)

    Ward, Marie

    2017-07-17

    Healthcare organisations have a responsibility for ensuring that the governance of workplace settings creates a culture that supports good professional practice. Encouraging such a culture needs to start from an understanding of the factors that make it difficult for health professionals to raise issues of concern in relation to patient safety. The focus of this study is to determine whether a customised education intervention, developed as part of the study, with interns and senior house officers (SHOs) can imbue a culture of medical professionalism in relation to patient safety and support junior doctors to raise issues of concern, while shaping a culture of responsiveness and learning.

  3. Authorship issues in multi-centre clinical trials

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  4. Authorship issues in multi-centre clinical trials

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  5. East African Medical Journal

    African Journals Online (AJOL)

    East African Medical Journal Vol: 93 No. 10 (Supplement) October 2016. UPTAKE OF ISONIAZID PREVENTIVE THERAPY AND ITS ASSOCIATED FACTORS AMONG HIV POSITIVE. PATIENTS IN AN URBAN HEALTH CENTRE, KENYA. E.N. Omesa, MBChB, MPH, Resident, Field Epidemiology and Laboratory Training ...

  6. The Adult Education Centre

    Directory of Open Access Journals (Sweden)

    Olga Drofenik

    1997-01-01

    Full Text Available The Adult Education Centre has drafted the professional foundations for the Master Plan for Adult Education which, according to the provisions stipulated in the Adult Education Act, will be adopted by the Parliament. The Master Plan specifies the goals, priority target groups, priority areas and a draft financial projection. The professional foundations include the ratings of adult education in studies about adult education trends in Slovenia and abroad. The paper presents research results relevant to the Master Plan and documents issued by international organizations, including research into the Decisive Global Factors of EC Development after 1992, the Report of Ministers of the OECD, and the Economic Development Strategy of Slovenia . All the above-mentioned documents emphasize the importance of life­long learning in achieving a more fulfilling personal life, faster economic growth and maintenance of social ties. In principle, the same views are shared in Slovenia. However, in practice the "multi-dimensional" nature of adult education often gives way to "education for production". This is why we especially stress the importance of adult education in the social and cultural context.

  7. Thailand's nuclear research centre

    International Nuclear Information System (INIS)

    Yamkate, P.

    2001-01-01

    The Office of Atomic Energy for Peace, Thailand, is charged with three main tasks, namely, Nuclear Energy development Plan, Utilization of Nuclear Based technology Plan and Science and Technology Plan. Its activities are centred around the research reactor TRR-1/M1. The main areas of contribution include improvement in agricultural production, nuclear medicine and nuclear oncology, health care and nutrition, increasing industrial productivity and efficiency and, development of cadre competent in nuclear science and technology. The office also has the responsibility of ensuring nuclear safety, radiation safety and nuclear waste management. The office has started a new project in 1997 under which a 10 MWt research reactor, an isotope production facility and a waste processing and storage facility would be set up by General Atomic of USA. OAEP has a strong linkage with the IAEA and has been an active participant in RCA programmes. In the future OAEP will enhance its present capabilities in the use of radioisotopes and radiation and look into the possibility of using nuclear energy as an alternative energy resource. (author)

  8. Medical education in Singapore.

    Science.gov (United States)

    Samarasekera, Dujeepa D; Ooi, Shirley; Yeo, Su Ping; Hooi, Shing Chuan

    2015-02-19

    Abstract Allopathic medical education in Singapore extends for more than a century from its simple beginnings. In recent times, changes have been rapid, both in undergraduate and postgraduate specialty medical training. Over the last decade, undergraduate medical education has increased from a single to three medical schools and the postgraduate training has expanded further by incorporating the Accreditation Council for Graduate Medical Education International framework. With these changes, the curricula, assessment systems, as well as teaching and learning approaches, with the use of technology-enhanced learning and program evaluation processes have expanded, largely based on best evidence medical education. To support these initiatives and the recent rapid expansion, most training institutions have incorporated faculty development programs, such as the Centre for Medical Education at the National University of Singapore.

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    NARCIS (Netherlands)

    Batenburg, R.; Eyck, A.

    2011-01-01

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

  11. Imbuing medical professionalism in relation to safety: a study protocol for a mixed-methods intervention focused on trialling an embedded learning approach that centres on the use of a custom designed board game.

    Science.gov (United States)

    Ward, Marie; McAuliffe, Eilish; Ní Shé, Éidín; Duffy, Ann; Geary, Una; Cunningham, Una; Holland, Catherine; McDonald, Nick; Egan, Karen; Korpos, Christian

    2017-07-17

    Healthcare organisations have a responsibility for ensuring that the governance of workplace settings creates a culture that supports good professional practice. Encouraging such a culture needs to start from an understanding of the factors that make it difficult for health professionals to raise issues of concern in relation to patient safety. The focus of this study is to determine whether a customised education intervention, developed as part of the study, with interns and senior house officers (SHOs) can imbue a culture of medical professionalism in relation to patient safety and support junior doctors to raise issues of concern, while shaping a culture of responsiveness and learning. We will use quantitative and qualitative methods to collect data. The sample size will be approximately 200 interns and SHOs across the two hospital sites. Two surveys will be included with one measuring leadership inclusiveness and psychological safety and a second capturing information on safety concerns that participants may have witnessed in their places of work. The PlayDecide embedded learning intervention will be developed with key stakeholders. This will be trialled in the middle stage of data collection for both interns and SHOs. A detailed content analysis will be conducted on the surveys to assess any changes in reporting following the PlayDecide intervention. This will be compared with the incident reporting levels and the results of the preintervention and postintervention leadership inclusiveness and psychological safety survey. Statistical analysis will be conducted using SPSS. Differences will be considered statistically significant at p<0.05. Semistructured interviews using a critical incident technique will be used for the ongoing analysis and evaluation of the project. These will be transcribed, de-identified and coded into themes. The study has been granted ethics approval from University College Dublin (Ref. LS-15-19-Ward-McAuliffe: Imbuing Medical

  12. The centre of the action

    CERN Multimedia

    2008-01-01

    The CERN Control Centre (CCC) has all the ingredients of an action movie control room: hundreds of screens, technicians buzzing in and out, huge floor-to-ceiling windows revealing the looming vista of a mountain range, flashing lights, microphones… This is the place where not just the LHC, but the whole of CERN’s accelerator complex and technical support is based - truly the centre of the action at CERN.

  13. Training centres - organization and management

    International Nuclear Information System (INIS)

    Kovar, P.

    1986-01-01

    In the lecture 'Training centres - organization and management' some principles and requirements which influence the organization, management and activity pattern of nuclear training centres, are briefly introduced. It is demonstrated, step by step, how these general principles are implemented in the development of the Czechoslovak nuclear power programme, it means, how the training of the NPP personnel proceeds in Czechoslovak nuclear training centres. General principles which are selected: a connection between the capacity of the training centre and the scope and needs of the nuclear power programme, a position of the training center within the institutional set-up, a structure and organization of the training system which complies with the system of NPP construction, reflect the pattern and the activity of the nuclear training centre and nuclear power technical level, a research group of workers in the nuclear training centre, main tasks and technical facilities, management of the training process and a transfer of knowledge and research results into the training process. The lecture is supplemented by pictures and slides. (orig.)

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

    Science.gov (United States)

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

    2009-05-01

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

  15. A designated centre for people with disabilities operated by Pilgrim House Community Ltd - Co. Dublin

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

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

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

    Science.gov (United States)

    Hecke, Torsten L; Hoyer, Jens Martin

    2009-01-01

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

  17. Nuclear Information Centre is building branch reference centre

    International Nuclear Information System (INIS)

    Nejezchleb, V.

    1988-01-01

    Reference services are being prepared by the Nuclear Information Centre (NIC) in order to improve information services for nuclear science and technology. The objective is to analyse the user's request, to determine suitable information sources and to provide the end user with a reference to the appropriate information centre, specialized organization or a specialist, or to directly provide the requested information using own information sources. The reference services will use a number of the Centre's own information data files, the data bank of relevant information sources, a personal and corporate file, the record of Czechoslovak nonconventional materials, the data bank of NIC publishing operations, the auxiliary NIC services record, a catalogue of books and journals, and the data bases at NIC. Most information files will be automated and stored on IBM-compatible personal computers. (J.B.). 1 fig., 3 refs

  18. Reconstrucción facial postraumática: Experiencia en un centro hospitalario no gubernamental Post-traumatic facial reconstruction: Experience in a private third level medical centre

    Directory of Open Access Journals (Sweden)

    V.J. Visag Castillo

    2012-03-01

    Full Text Available El trauma facial se asocia a importantes defectos funcionales y estéticos, por lo tanto, su tratamiento rápido y apropiado mejorará los resultados tanto estéticos como funcionales. Realizamos un estudio retrospectivo, observacional y descriptivo en el que se analizan los registros médico-quirúrgicos de los pacientes sometidos a reconstrucción facial postraumática por cirujanos plásticos en nuestro centro hospitalario entre enero del 2006 y diciembre del 2009. En total, revisamos 51 casos de trauma facial con reconstrucción; el sexo masculino fue el más afectado, la edad media de los pacientes fue de 29 años; el principal tipo de trauma fue el contuso por accidente automovilístico; las reparaciones realizadas de urgencia fueron la mayoría (91 % y la fractura facial más frecuente fue la de órbita y dentro de ella, la de piso orbitario. Las fijaciones más usadas fueron miniplacas y tornillos de titanio, mientras que para el piso de la órbita se empleó la malla de titanio. La media de tiempo quirúrgico fue de 120 minutos. Las principales complicaciones se presentaron en los pacientes más graves y se relacionaron con el evento traumático. Con este estudio intentamos demostrar que en el Hospital Medica Sur (México DF, se presentan los mismos tipos de trauma facial que se reflejan en la literatura al respecto, y que la reparación realizada de urgencia y por cirujanos plásticos tiene buenos resultados tanto funcionales como estéticos.Facial trauma is associated with important functional and aesthetic defects; therefore a quick and correct management improves the functional and aesthetic results. We present a retrospective, observational and descriptive study analyzing the medical charts of those patients who suffered post-traumatic face reconstruction by plastic surgeons, between january 2006 and december 2009. We analyze 51 cases of facial trauma; men where more affected, average age was 29.33 years, the most frequent trauma

  19. The ideal Atomic Centre; Le Centre Atomique ideal

    Energy Technology Data Exchange (ETDEWEB)

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

    1965-07-01

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

  20. Contextualisation of patient-centred care

    DEFF Research Database (Denmark)

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

    2018-01-01

    Patients' family relations play an important part in the provision of patient-centred cancer care, not least when healthcare professionals encounter seriously ill patients with dependent children. Little is known about how children are perceived and dealt with in clinical encounters. In this qual......Patients' family relations play an important part in the provision of patient-centred cancer care, not least when healthcare professionals encounter seriously ill patients with dependent children. Little is known about how children are perceived and dealt with in clinical encounters....... In this qualitative comparative study, we explore the influence of medical contexts in three Danish hospital wards, haematology, oncological gynaecology and neuro-intensive care, on communication with patients about their children. In exploring the degree to which the inclusion of children in clinical encounters...... is dependent on context, we took a comparative approach based on fieldwork in wards either exclusively focusing on cancer treatment or partially involved in critical phases of cancer treatment. We conducted 49 semi-structured, in-depth interviews with doctors and nurses, and 27 days of participant observation...

  1. The Belgian nuclear research centre

    International Nuclear Information System (INIS)

    Moons, F.

    2001-01-01

    The Belgian Nuclear Research Centre is almost exclusively devoted to nuclear R and D and services and is able to generate 50% of its resources (out of 75 million Euro) by contract work and services. The main areas of research include nuclear reactor safety, radioactive waste management, radiation protection and safeguards. The high flux reactor BR2 is extensively used to test fuel and structural materials. PWR-plant BR3 is devoted to the scientific analysis of decommissioning problems. The Centre has a strong programme on the applications of radioisotopes and radiation in medicine and industry. The centre has plans to develop an accelerator driven spallation neutron source for various applications. It has initiated programmes to disseminate correct information on issues of nuclear energy production and non-energy nuclear applications to different target groups. It has strong linkages with the IAEA, OECD-NEA and the Euratom. (author)

  2. Technical support and emergency centre

    International Nuclear Information System (INIS)

    Bohun, L.; Kapisovsk y, M.

    1997-01-01

    This paper presents technical support and emergency management center which will be on two places: Mochovce NPP Emergency Centre (Technical support center and Support working center) and Reserve Emergency Centre in Levice (Reserve emergency center and Environmental Evaluation Center). The main aims of the emergency management centers are: the management and coordination of all persons and organisations; provision of the all information needed to evaluation of the accident and its mitigation; continuous evaluation of the potential or real radiological consequences; taking measure for an early notification of the governmental bodies and the organizations, warning and protection of the public; and other aims. In the next part the data for technical support and emergency centre are discussed

  3. Training centres in Latin America

    International Nuclear Information System (INIS)

    1959-01-01

    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

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

    International Nuclear Information System (INIS)

    Prevot, S.

    2008-01-01

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

  5. The DEMETER Science Mission Centre

    Czech Academy of Sciences Publication Activity Database

    Lagoutte, D.; Brochot, J.; Y.; de Carvalho, D.; Elie, F.; Harivelo, F.; Hobara, Y.; Madrias, L.; Parrot, M.; Pincon, J. L.; Berthelier, J. J.; Peschard, D.; Seran, E.; Gangloff, M.; Sauvaud, J. A.; Lebreton, J. P.; Štverák, Štěpán; Trávníček, Pavel M.; Grygorczuk, J.; Slominski, J.; Wronowski, R.; Barbier, S.; Bernard, P.; Gaboriaud, A.; Wallut, J. M.

    2006-01-01

    Roč. 54, č. 5 (2006), s. 428-440 ISSN 0032-0633 Institutional research plan: CEZ:AV0Z30420517 Keywords : Mission Centre * Data processing Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 1.509, year: 2006

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-03-01

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

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

    OpenAIRE

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

    2007-01-01

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

  8. Blood transfusion practice in surgery at Bugando Medical Centre in ...

    African Journals Online (AJOL)

    Background: Preoperative over-ordering of blood for surgical intervention, in excess of the actual and anticipated needs is a common practice in many developing countries. This can be decreased by simple means of changing the blood cross matching and ordering schedule depending upon the type of surgery performed.

  9. Caesarian Section Rate at Federal Medical Centre, Makudi, Revisited

    African Journals Online (AJOL)

    Results: The overall caesarean section (CS) rate was 15.2%. The CS rate in 2010, 2011 and 2012 showed a steady increase of 14.2%, 14.6% and 16.8% respectively. Cephalopelvic disproportion ( 25.3%) was the commonest indication for CS, followed by fetal distress (16.6%) and previous CS for booked patients.

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

    African Journals Online (AJOL)

    stoicism during labor and delivery. Serious complications could therefore be concealed by this misplaced stoicism, leading to maternal mortality.[13]. It is universally accepted that non‑attendance of antenatal care (ANC) is associated with high maternal mortality.[8]. Twenty‑five percent each of our cases booked at the FMCY ...

  11. Bite injuries at Bugando Medical Centre, Mwanza, Tanzania: A five ...

    African Journals Online (AJOL)

    Background: Bite injuries constitute a continuing challenge to trauma or general surgeons practicing in developing countries. Little work has been done on bite injuries in our setting. This study describes our experience in the management of bite injuries, outlining the etiological spectrum, injury patterns and results of ...

  12. Pancreatic Pseudocyst in Federal Medical Centre, Gombe and ...

    African Journals Online (AJOL)

    Non specific symptoms in the early stage and subsequent confusion with various intra abdominal pathologies are among the reasons for late diagnosis and delayed intervention. Pseudocyst is amenable to surgical treatment. Early recognition is imperative in preventing complications and in defining the true incidence of this ...

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

    African Journals Online (AJOL)

    6] Although regional variation in maternal mortality exist in Nigeria, the North. East has one of the worst indices in Nigeria.[7] The average MMR for Nigeria is 545/100,000 live births,[7] while that of Borno state ..... Eko Le Meridien Hotel. Victoria ...

  14. genito-urinary fistula patients at bugando medical centre

    African Journals Online (AJOL)

    2010-07-07

    Jul 7, 2010 ... Objectives: To identify high risk populations of fistula patients treated from 1998-. 2006. Design: A prospective ... Main outcome measures: Of the 1294 surgical repairs, 84% of the patients were cured,. 12% had stress incontinence and 4% ..... pelvic floor exercises in such cases. The districts of highest risk ...

  15. Incidence of Diabetes mellitus at the Federal Medical Centre Katsina ...

    African Journals Online (AJOL)

    A six-year (2002 – 2007) retrospective study of hospital records (in-patients) was carried out to investigate the incidence of Diabetes Mellitus in Katsina. The records showed that a total of 754 cases were attended within the study period. The study showed yearly increase in the incidence of the disease with the highest ...

  16. Education for Medical Decision Support at EuroMISE Centre

    Czech Academy of Sciences Publication Activity Database

    Martinková, Patrícia; Zvára Jr., Karel; Dostálová, T.; Zvárová, Jana

    2013-01-01

    Roč. 1, č. 1 (2013), s. 40-40 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : education * decision support * knowledge evaluation * e- learning Subject RIV: IN - Informatics, Computer Science

  17. Assessing scientific quality in a multidisciplinary academic medical centre

    NARCIS (Netherlands)

    van Kammen, J.; van Lier, R. A. W.; Gunning-Schepers, L. J.

    2009-01-01

    In their article 'The Hirsch-index: a simple, new tool for the assessment of scientific output of individual scientists: The case of Dutch professors in clinical cardiology', Opthof and Wilde discuss the evaluation of scientific performance and refer to the self-evaluation carried out in the AMC in

  18. The CCCB is a cultural centre, not a tourist centre

    Directory of Open Access Journals (Sweden)

    Elena Xirau

    2004-04-01

    Full Text Available Last February, Barcelona's Centre of Contemporary Culture (CCCB celebrated its first ten years in existence. During this time, this institution has looked to be a showcase to the most modern and innovative cultural expressions focused on reflecting on the concept of the city. In this interview, Josep Ramoneda offers his personal view, as the CCCB's director. He talks of how this cultural project was born, of how the concept of the institution took shape in the CCCB, of its relations with Barcelona's Strategic Plan, of how the project has evolved, of the architectural remodelling of the Casa de la Caritat building for its conversion into a cultural centre, of the relations with other institutions and its future.

  19. Gestion du Centre | CRDI - Centre de recherches pour le ...

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

    Le Comité de gestion du Centre (CGC) est composé des membres de la haute direction du CRDI, notamment les directeurs de nos quatre bureaux régionaux et de nos principaux secteurs de programme. Le CGC travaille en collaboration avec le président afin de soutenir la recherche pour le développement, lui fournissant ...

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

    Science.gov (United States)

    Conford, Philip

    2016-04-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  2. Institutional Support : Centre for Research and Technology ...

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

    year-old science and technology research centre at Maseno University in western Kenya. The Centre focuses on science and technology research to influence both national policies and development practices at the community level. Currently ...

  3. Neighbourhood Centres – Organisation, Management and Finance

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    public subsidy. Some of the centres have high number of users on a daily basis, whereas others are only rarely used. It is explored how organisation, management and financial set-up differs among the centres. Quantitative data on financial issues and annual accounts of fifteen centres were analysed...... to identify different financial models and analyse economic sustainability. As regards organisational and management models data were collected through documentary sources and by means of personal interviews and field visits to ten centres. Even within the analysed limited population of centres economic...... and institutional sustainability varies significantly. In organisational terms centres range from fully-integrated in the municipal administration to independent voluntary managed centres. In terms of financial, or economic, models variation is less pronounced as all centres to some degree are dependent on current...

  4. Japanese maintenance centres strive for greater realism

    International Nuclear Information System (INIS)

    Nedderman, J.

    1987-01-01

    Japanese utilities have devoted considerable efforts to ensuring that realistic plant conditions are simulated at their maintenance centres. In some centres, eg that of Kansai Electric Power Co, realism extends to difficult access, limited lighting and restricted ventilation. (author)

  5. ReviewsGCSE Book Review: Modular Science for AQA GCSE Book Review: Modular Science for Edexcel GCSE Book Review: Revise for GCSE Science (Edexcel Modular Foundation and Higher) GCSE Book Review: AQA GCSE Physics, AQA GCSE Physics Additions Book Review: Studying Maths and its Applications Book Review: Medical Physics, 2nd edition Book Review: The Physics of Hockey Book Review: Nine Crazy Ideas In Science Book Review: Light and Dark Talking Point: The Skeptical Environmentalist Places To Visit: Centre for Alternative Technology, Machynlleth, Powys Resources: Sources of Energy Web Watch: Terence, this is stupid stuff...

    Science.gov (United States)

    2003-03-01

    GCSE BOOK REVIEWS (162) Modular Science for AQA Modular Science for Edexcel Revise for GCSE Science (Edexcel Modular Foundation and Higher) AQA GCSE Physics, AQA GCSE Physics Additions BOOK REVIEWS (166) Studying Maths and its Applications Medical Physics, 2nd edition The Physics of Hockey Nine Crazy Ideas In Science Light and Dark TALKING POINT (169) The Skeptical Environmentalist PLACES TO VISIT (170) Centre for Alternative Technology, Machynlleth, Powys RESOURCES (172) Sources of Energy WEB WATCH (173) Terence, this is stupid stuff...

  6. How lecturers experience student-centred teaching

    OpenAIRE

    Brown, Norman Leslie

    2003-01-01

    This thesis reports the findings of an essentially phenomenographic research study into nurse teachers’ Conceptions of Student-Centred Teaching and Student-Centred Approaches to Teaching. The focus on the experience of student-centred aspects of teaching is a departure from previous research from this perspective in Higher Education that has focused upon teachers’ experience of teaching. The approach and focus of this study is also a departure from research into student-centred teaching in nu...

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

    Science.gov (United States)

    Ray, Rajat; Dhawan, Anju; Chopra, Anita

    2013-10-01

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

  8. Radwaste Treatment Centre Jaslovske Bohunice

    International Nuclear Information System (INIS)

    2000-01-01

    In this leaflet the Bohunice Radwaste Treatment Centre (BSC RAO) is presented. BSC RAO is designed to process and treat liquid and solid radwaste, arising from the NPP A-1 decommissioning, from NPPs V-1, V-2, and Mochovce operations, as well as institutional radwaste of diverse institutional (hospitals, research institutes) in the Slovak Republic. Transport, sorting, incineration, compacting, concentration and cementation of radwaste as well as monitoring of emission are described

  9. The Aube storage centre: Annual report 2010

    International Nuclear Information System (INIS)

    2011-01-01

    After a presentation of the Aube storage centre, a storage centre for low and intermediate activity nuclear wastes, this report gives an overview of measures related to nuclear security, to radioprotection and to nuclear safety. It indicates the incidents and accidents which occurred in 2010, describes how the centre's wastes are managed, and indicates the actions performed in terms of public information

  10. Assessing patient‐centred communication in teaching: a systematic review of instruments

    OpenAIRE

    Brouwers, Marianne; Rasenberg, Ellemieke; van Weel, Chris; Laan, Roland; van Weel‐Baumgarten, Evelyn

    2017-01-01

    Context Patient‐centred communication is a key component of patient centredness in medical care. Therefore, adequate education in and assessment of patient‐centred communication skills are necessary. In general, feedback on communication skills is most effective when it is provided directly and is systematic. This calls for adequate measurement instruments. Objectives The aim of this study was to provide a systematic review of existing instruments that measure patient centredness in doctor–pa...

  11. Sudan Journal of Medical Sciences

    African Journals Online (AJOL)

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

  12. [Transition from paediatric to adult cystic fibrosis care centre].

    Science.gov (United States)

    Durieu, I; Reynaud, Q; Nove-Josserand, R

    2016-02-01

    The number of adolescents and young adults with chronic diseases has increased dramatically over the last decade. This led paediatric teams to organize the transition to adult centres with the aim to ensure the quality of care and prognosis, adherence to survey and treatment. To promote a good work and family life is also a challenge. Several studies have shown the importance of a successful transition in cystic fibrosis (CF) in order to prevent complications and loss monitoring and to improve the perception of patients and their families. In France in 2003, cystic fibrosis centres (CRCM) have been identified and among them of adult CF centres. The regular increase of the adult centre's active file requires improving the transition process. It is necessary to improve the transition process and to prepare the young patient and their family early during adolescence. The process in place should concern the whole aspects of care, i.e., medical, psychological and educational. The transition to adulthood will be successful if it results in a stable state of the disease allowing family and career plans. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. A designated centre for people with disabilities operated by St Aidan's Day Care Centre Ltd., Wexford

    LENUS (Irish Health Repository)

    Gibbons, C

    2015-02-01

    Ireland has seen a steady increase in paediatric sickle cell disease (SCD). In 2005, only 25% of children with SCD were referred to the haemoglobinopathy service in their first year. A non-funded screening programme was implemented. This review aimed to assess the impact screening has had. All children referred to the haemoglobinopathy service born in Ireland after 2005 were identified. Data was collected from the medical chart and laboratory system. Information was analysed using Microsoft Excel. 77 children with SCD were identified. The median age at antibiotic commencement in the screened group was 56 days compared with 447 days in the unscreened group, p = < 0.0003. 22 (28%) of infants were born in centre\\'s that do not screen and 17 (81%) were over 6 months old at referral, compared with 14 (21%) in the screened group. 6 (27%) of those in the unscreened group presented in acute crisis compared with 2 (3%) in the screened population. The point prevalence of SCD in Ireland is 0.2% in children under 15 yr of African and Asian descent. We identified delays in referral and treatment, which reflect the lack of government funded support and policy. We suggest all maternity units commence screening for newborns at risk of SCD. It is a cost effective intervention with a number needed to screen of just 4 to prevent a potentially fatal crisis.

  14. MEDICAL SERVICE - URGENT CALLS

    CERN Multimedia

    Service Médical

    2000-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    specialists. If an asylum seeker needed more than three specialist consultations for mental illness or five consultations for physical illness the referrals had to be approved by The Danish Immigration Service. Between July 2001 - December 2002 the Red Cross prospectively registered health related data on all......BACKGROUND: The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic...... group of asylum seekers to study if the incidence of mental disorders increased with length of stay. METHODS: The study population was asylum seekers in Danish asylum centres run by the Danish Red Cross. General medical care was provided by Red Cross staff who could refer selected cases to medical...

  16. Centre for nuclear engineering University of Toronto annual report 1984

    International Nuclear Information System (INIS)

    1984-12-01

    The annual report of the Centre for Nuclear Engineering, University of Toronto covers the following subjects: message from the Dean; Chairman's message; origins of the centre; formation of the centre; new nuclear appointments; and activities of the centre, 1984

  17. Perceptual centres in speech - an acoustic analysis

    Science.gov (United States)

    Scott, Sophie Kerttu

    Perceptual centres, or P-centres, represent the perceptual moments of occurrence of acoustic signals - the 'beat' of a sound. P-centres underlie the perception and production of rhythm in perceptually regular speech sequences. P-centres have been modelled both in speech and non speech (music) domains. The three aims of this thesis were toatest out current P-centre models to determine which best accounted for the experimental data bto identify a candidate parameter to map P-centres onto (a local approach) as opposed to the previous global models which rely upon the whole signal to determine the P-centre the final aim was to develop a model of P-centre location which could be applied to speech and non speech signals. The first aim was investigated by a series of experiments in which a) speech from different speakers was investigated to determine whether different models could account for variation between speakers b) whether rendering the amplitude time plot of a speech signal affects the P-centre of the signal c) whether increasing the amplitude at the offset of a speech signal alters P-centres in the production and perception of speech. The second aim was carried out by a) manipulating the rise time of different speech signals to determine whether the P-centre was affected, and whether the type of speech sound ramped affected the P-centre shift b) manipulating the rise time and decay time of a synthetic vowel to determine whether the onset alteration was had more affect on P-centre than the offset manipulation c) and whether the duration of a vowel affected the P-centre, if other attributes (amplitude, spectral contents) were held constant. The third aim - modelling P-centres - was based on these results. The Frequency dependent Amplitude Increase Model of P-centre location (FAIM) was developed using a modelling protocol, the APU GammaTone Filterbank and the speech from different speakers. The P-centres of the stimuli corpus were highly predicted by attributes of

  18. Egyptian Journal of Medical Laboratory Sciences

    African Journals Online (AJOL)

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

  19. Moral counselling: a method in development.

    Science.gov (United States)

    de Groot, Jack; Leget, Carlo

    2011-01-01

    This article describes a method of moral counselling developed in the Radboud University Medical Centre Nijmegen (The Netherlands). The authors apply insights of Paul Ricoeur to the non-directive counselling method of Carl Rogers in their work of coaching patients with moral problems in health care. The developed method was shared with other health care professionals in a training course. Experiences in the course and further practice led to further improvement of the method.

  20. A designated centre for people with disabilities operated by St John of God Community Services Limited, Kildare

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

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

  1. Scheduling participants of Assessment Centres

    DEFF Research Database (Denmark)

    Lysgaard, Jens; Løber, Janni

      Assessment Centres are used as a tool for psychologists and coaches to observe a number of dimensions in a person's behaviour and test his/her potential within a number of chosen focus areas. This is done in an intense course, with a number of different exercises which expose each participant......'s ability level in the chosen focus areas. The participants are observed by assessors with the purpose of gathering material for reaching a conclusion on each participant's personal profile. We consider the particular case that arises at the company Human Equity (www.humanequity.dk), where Assessment...

  2. The emergence of urban centres

    DEFF Research Database (Denmark)

    Lazaro, Evelyn; Agergaard, Jytte; Larsen, Marianne Nylandsted

    by Tanzanian market liberalizations and its long term effects on private enterprise. The paper is based on a study of four EUCs in Tanzania (Ilula, Igowole, Madizini and Kibaigwa) and seeks to answer three research questions: 1) What economic and spatial trends, including national policies, have formed...... the pathway for rural transformation and early densification towards the emergence of urban centres in Tanzania? 2) What characterize the relationship between value chain dynamics and rural densification? 3) How do migration and investments contribute to the consolidation of EUCs as places of attraction...

  3. Powering the Future Data Centre

    DEFF Research Database (Denmark)

    Zhang, Zhe

    2010-01-01

    The extended run Uninterruptible Power Supply system (UPSs) which powered by fuel cells and supercapcitors, is a promising solution for future data centre to obtain environmentfriendly energy efficient and cost effective. There are many challenges in power electronic interface circuits, because...... individually and simultaneously. The multiinput ports extension method and its limitation are discussed. Through circuit level decoupling, the 3LNPC inverter can be decoupled into two DC-DC converters in each region, making the controller design much simpler. It is possible to reduce the switching losses...

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  5. Patient centred care in diabetology: an Islamic perspective from Iran.

    Science.gov (United States)

    Larijani, Bagher; Zahedi, Farzaneh

    2013-05-10

    Patient-centred system of care is essential in managing many disorders such as diabetes mellitus. The cultural and religious context can influence the involvement of patients and their families in such a care. We intend to discuss patient-centred care in diabetology in view of Islam. For more clarification, we will take into consideration a few illustrative lines of argument in detail about situation in Iran. In conclusion, dynamic spirit of Islamic jurisprudence is reflected in its adaptability to change in medical practice. In recent decades, Iranian religious scholars have provided scientists in new fields of science and research with appropriate directions and guidelines. Decree issued by Iranian religious leaders permitting research on stem cells for therapeutic purposes in many disorders including diabetes mellitus is one example. Understanding of the nature of Islam is importance for communication with patients in Islamic countries.

  6. The IOC Centres of Excellence bring prevention to sports medicine.

    Science.gov (United States)

    Engebretsen, Lars; Bahr, Roald; Cook, Jill L; Derman, Wayne; Emery, Carolyn A; Finch, Caroline F; Meeuwisse, Willem H; Schwellnus, Martin; Steffen, Kathrin

    2014-09-01

    The protection of an athlete's health and preventing injuries and illnesses in sport are top priorities for the IOC and its Medical Commission. The IOC therefore partners with selected research centres around the world and supports research in the field of sports medicine. This has enabled the IOC to develop an international network of expert scientists and clinicians in sports injury and disease prevention research. The IOC wants to promote injury and disease prevention and the improvement of physical health of the athlete by: (1) establishing long-term research programmes on injury and disease prevention (including studies on basic epidemiology, risk factors, injury mechanisms and intervention), (2) fostering collaborative relationships with individuals, institutions and organisations to improve athletes' health, (3) implementing and collaborating with applied, ongoing and novel research and development within the framework and long-term strategy of the IOC and (4) setting up knowledge translation mechanisms to share scientific research results with the field throughout the Olympic Movement and sports community and converting these results into concrete actions to protect the health of the athletes. In 2009, the IOC also identified four research centres that had an established track record in research, educational and clinical activities to achieve these ambitions: (1) the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Australia; (2) the Sport Injury Prevention Research Centre (SIPRC), Canada; (3) the Clinical Sport and Exercise Medicine Research (CSEM), South Africa and (4) the Oslo Sports Trauma Research Center (OSTRC), Norway. This paper highlights the work carried out by these four IOC Centres of Excellence over the past 6 years and their contribution to the world of sports medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. The new AMS control centre

    CERN Multimedia

    Anaïs Schaeffer

    2011-01-01

    Construction work for the future AMS control room began in November 2010 and should be finished this June. The new building, which will have been completed in record time thanks to the professionalism of the project team, will soon be ready to receive the initial data from the AMS experiment.     Luigi Scibile and Michael Poehler, from the GS department, at the AMS control centre construction site.   The Alpha Magnetic Spectrometer (AMS) is due to wing its way towards the International Space Station (ISS) on board the shuttle Discovery in April. Mainly intended for research on antimatter and dark matter, the data collected by AMS will be sent to Houston in the United States and then directly to CERN’s new Building 946. Construction work for the AMS control centre building on the Route Gentner at CERN’s Prévessin site started in November 2010 and must be completed in time to receive the first data from the spectrometer in June. “It normall...

  8. Activities of Radiation Protection Centre in 2000

    CERN Document Server

    Radiat. Prot. Cent. Vilnius

    2001-01-01

    Description of the activities of Radiation Protection Centre in 2000 is presented. Radiation Protection Centre is responsible for radiation protection issues. Currently there are six departments at Radiation Protection Centre: two in Vilnius - Department of Radiation Protection Supervision and Control and Department of Programs and Expertise, and four in the districts. Brief information on subject controlled by each departments is provided focusing on main achievements and events.

  9. Introducing the Centre for Applied Archaeology

    OpenAIRE

    Perring, Dominic

    2008-01-01

    The Centre for Applied Archaeology (CAA) is a new research centre within the Institute of Archaeology, established in 2006 to develop the work of the Institute’s Field Archaeology Unit, Archaeology South-East (ASE), through the creation of a productive research environment and the building of links with academic staff members of the Institute. In this article the Director of CAA defines “applied archaeology” and describes the aims and work of the Centre.

  10. Bangalore looks to new interdisciplinary science centre

    Science.gov (United States)

    Ramachandran, Ramaseshan

    2008-09-01

    A new centre to boost interdisciplinary research in India is being established in Bangalore - India's IT and software capital. The International Centre for Theoretical Sciences (ICTS) will be led by Spenta Wadia, a theoretical physicist from the Tata Institute of Fundamental Research (TIFR) in Mumbai, which is setting up the new centre. He expects construction of the ICTS, the first of its kind in India, to start by November 2009.

  11. Smart work centres in rural areas

    DEFF Research Database (Denmark)

    Lorentzen, Anne Birte

    This paper discusses the establishment of telework centres as an element in local development strategies in rural areas, with a particular view to two new telework centres in region North Denmark. The paper argues that telework centres do not represent an easy solution to problems of local develo...... development and environmental sustainability, and further, that technology may not even be the most important feature needed to make them function as such....

  12. Criteria of Categorizing Logistics and Distribution Centres

    Directory of Open Access Journals (Sweden)

    Darko Babić

    2011-07-01

    Full Text Available Logistics and distribution centres represent very significant infrastructure elements of the macro-logistic system. The creation of the logistics and distribution centres and their connection into a wide (global network have resulted in the creation of conditions for an adequate distribution of labour and significant increase in the productivity of all the logistics elements and processes, noting that the logistics and distribution centres in this concept have a superregional significance. This paper represents the summary (results of the research that was carried out on a large number of logistics and distribution centres with the aim of considering the complexity and the issues related to the logistics and distribution centres and the distribution network, their elements and action of the subsystems according to the following criteria: spatial, technical, technological, and organizational, with the aim of defining the categorisation model of the logistics and distribution centres. The analysis of the selected data collected during the research has resulted in defining of the categorisation model of the logistics and distribution centres which foresees six categories. Each of the foreseen categories has been defined according to the set model by the mentioned traffic, technical and technological, and organisational characteristics and the level of service. This is precisely where the application of the categorisation model of the logistics and distribution centres can be found, which will define the relevant categories of the centres applicable in the creation of effective distribution

  13. Assessing quality of diabetes care and its variation in Aboriginal community health centres in Australia.

    Science.gov (United States)

    Si, Damin; Bailie, Ross; Dowden, Michelle; Kennedy, Catherine; Cox, Rhonda; O'Donoghue, Lynette; Liddle, Helen; Kwedza, Ru; Connors, Christine; Thompson, Sandra; Burke, Hugh; Brown, Alex; Weeramanthri, Tarun

    2010-09-01

    Examining variation in diabetes care across regions/organizations provides insight into underlying factors related to quality of care. The aims of this study were to assess quality of diabetes care and its variation among Aboriginal community health centres in Australia, and to estimate partitioning of variation attributable to health centre and individual patient characteristics. During 2005-2009, clinical medical audits were conducted in 62 Aboriginal community health centres from four states/territories. Main outcome measures include adherence to guidelines-scheduled processes of diabetes care, treatment and medication adjustment, and control of HbA(1c), blood pressure, total cholesterol and albumin/creatinine ratio (ACR). Wide variation was observed across different categories of diabetes care measures and across centres: (1) overall adherence to delivery of services averaged 57% (range 22-83% across centres); (2) medication adjustment rates after elevated HbA(1c): 26% (0-72%); and (3) proportions of patients with HbA(1c) quality of care measures provide multiple opportunities for improvement. The majority of variation in quality of diabetes care appears to be attributable to patient level characteristics. Further understanding of factors affecting variation in the care of individuals should assist clinicians, managers and policy makers to develop strategies to improve quality of diabetes care in Aboriginal communities. 2010 John Wiley & Sons, Ltd.

  14. Large-scale fuel cycle centres

    International Nuclear Information System (INIS)

    Smiley, S.H.; Black, K.M.

    1977-01-01

    The US Nuclear Regulatory Commission (NRC) has considered the nuclear energy centre concept for fuel cycle plants in the Nuclear Energy Centre Site Survey 1975 (NECSS-75) Rep. No. NUREG-0001, an important study mandated by the US Congress in the Energy Reorganization Act of 1974 which created the NRC. For this study, the NRC defined fuel cycle centres as consisting of fuel reprocessing and mixed-oxide fuel fabrication plants, and optional high-level waste and transuranic waste management facilities. A range of fuel cycle centre sizes corresponded to the fuel throughput of power plants with a total capacity of 50,000-300,000MW(e). The types of fuel cycle facilities located at the fuel cycle centre permit the assessment of the role of fuel cycle centres in enhancing the safeguard of strategic special nuclear materials - plutonium and mixed oxides. Siting fuel cycle centres presents a smaller problem than siting reactors. A single reprocessing plant of the scale projected for use in the USA (1500-2000t/a) can reprocess fuel from reactors producing 50,000-65,000MW(e). Only two or three fuel cycle centres of the upper limit size considered in the NECSS-75 would be required in the USA by the year 2000. The NECSS-75 fuel cycle centre evaluation showed that large-scale fuel cycle centres present no real technical siting difficulties from a radiological effluent and safety standpoint. Some construction economies may be achievable with fuel cycle centres, which offer opportunities to improve waste-management systems. Combined centres consisting of reactors and fuel reprocessing and mixed-oxide fuel fabrication plants were also studied in the NECSS. Such centres can eliminate shipment not only of Pu but also mixed-oxide fuel. Increased fuel cycle costs result from implementation of combined centres unless the fuel reprocessing plants are commercial-sized. Development of Pu-burning reactors could reduce any economic penalties of combined centres. The need for effective fissile

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

    LENUS (Irish Health Repository)

    Mulroy, M

    2013-09-01

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

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

    African Journals Online (AJOL)

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

  17. Tropical Journal of Medical Research - Vol 12, No 1 (2008)

    African Journals Online (AJOL)

    Incidence Of Discharge Against Medical Advice (Dama) In Adult Medical Wards Of The Federal Medical Centre Asaba · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. CU Odenigbo, OC Oguejiofor, 42-44. http://dx.doi.org/10.4314/tjmr.v12i1.30490 ...

  18. Establishment of a South African nuclear science exhibition centre

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-01

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

  19. Establishment of a South African nuclear science exhibition centre

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  20. Patient monitoring in Polish assisted reproductive technology centres

    Directory of Open Access Journals (Sweden)

    Anna Krawczak

    2016-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-31

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

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

    International Nuclear Information System (INIS)

    Tochon-Danguy, H.J.

    1997-01-01

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

  3. Australian International Food Security Research Centre | IDRC ...

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

    Australian International Food Security Research Centre. Australian International Food Security Research Centre. http://aciar.gov.au/AIFSC. Cultivate Africa's Future. The Cultivate Africa's Future research partnership is designed to support applied research to combat hunger in sub-Saharan Africa by harnessing the potential ...

  4. Communications strategy for the Chernobyl Centre

    International Nuclear Information System (INIS)

    Kurilchik, Mykola; Green, Len

    2000-01-01

    This Communications Strategy was developed for the International Chernobyl Centre (ICC) as part of a joint UK/Ukraine project, sponsored by the Department of Trade and Industry and NNC Limited. The Plan was developed during four weeks of workshop discussions in the UK between staff from the centre and experienced PR Professionals from NNC Limited. The requirements for a sustained communications activity at the ICC go much further than simply enhancing or promoting the Centre's scientific and technical activities. Raising sufficient awareness of the Centre among potential funding agents and commercial partners is critical to its future development as a major centre for international co-operation and research. It is only through establishing and developing effective communications that the Centre will become well enough known and understood both within the Ukraine, and internationally, to secure its long term future. However, as the workshop programme unfolded, it also became clear that communications was in itself a legitimate and necessary function of the Centre, and part of the foundations of its existence. The Centre has a fundamental role as an 'information exchange', collecting and communicating information from within the Ukraine to the rest of the world, and interpreting world interest and attitudes to the Ukraine Government and nuclear industry. As such compliments the efforts of individual power plant and corporate PR functions within the Ukraine nuclear energy sector

  5. Australian International Food Security Research Centre | IDRC ...

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

    Australian International Food Security Research Centre. Australian International Food Security Research Centre. http://aciar.gov.au/aifsc/ · What we do · Funding · Resources · About IDRC. Knowledge. Innovation. Solutions. Careers · Contact Us · Site map. Sign up now for IDRC news and views sent directly to your inbox ...

  6. Product Lifecycle Management Centre of Technology

    CSIR Research Space (South Africa)

    Barnard, Rentia

    2017-10-01

    Full Text Available • Skills Development – Access to Learning Centre(s) • Collaboration Hub to connect industry players – Products, Equipment, Facilities, Experts, etc 9 PLM important building block and enabler 10 11 Facility – concept design 12 13 Panel...

  7. Centre de ressources communautaires Nganyi : une station ...

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

    Centre de ressources communautaires Nganyi : une station radiophonique communautaire diffuse des prévisions météorologiques et des nouvelles sur le changement climatique aux agriculteurs du Kenya. 04 mai 2016. Image. Membres de la collectivité au lancement du centre Nganyi. Des membres de la collectivité au ...

  8. Sarwat Salem | IDRC - International Development Research Centre

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

    Sarwat Salem launched his career working in private industry in Montreal before moving to the Canadian Commercial Corporation, a Crown corporation. He has worked as a regional controller for IDRC since his career with the Centre began in Cairo in 1988. Two years later he moved to the Centre's Regional Office of East ...

  9. LABORATORY SERVICES IN HEALTH CENTRES WITHIN ...

    African Journals Online (AJOL)

    1999-05-05

    May 5, 1999 ... Objective: To identify current problems in laboratory services and elicit suggestions from the technicians aimed at improving the services in health centres within Amhara region, north Ethiopia. Design: Cross-sectional study using a pre-tested questionnaire. Settings: Twenty seven health centres in Amhara ...

  10. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...

  11. Effects of shared medical appointments on quality of life and cost-effectiveness for patients with a chronic neuromuscular disease. Study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van der Wilt Gert-Jan

    2011-08-01

    Full Text Available Abstract Background Shared medical appointments are a series of one-to-one doctor-patient contacts, in presence of a group of 6-10 fellow patients. This group visits substitute the annual control visits of patients with the neurologist. The same items attended to in a one-to- one appointment are addressed. The possible advantages of a shared medical appointment could be an added value to the present management of neuromuscular patients. The currently problem-focused one-to-one out-patient visits often leave little time for the patient's psychosocial needs, patient education, and patient empowerment. Methods/design A randomized, prospective controlled study (RCT with a follow up of 6 months will be conducted to evaluate the clinical and cost-effectiveness of shared medical appointments compared to usual care for 300 neuromuscular patients and their partners at the Radboud University Nijmegen Medical Center. Every included patient will be randomly allocated to one of the two study arms. This study has been reviewed and approved by the medical ethics committee of the region Arnhem-Nijmegen, the Netherlands. The primary outcome measure is quality of life as measured by the EQ-5D, SF-36 and the Individualized neuromuscular Quality of Life Questionnaire. The primary analysis will be an intention-to-treat analysis on the area under the curve of the quality of life scores. A linear mixed model will be used with random factor group and fixed factors treatment, baseline score and type of neuromuscular disease. For the economic evaluation an incremental cost-effectiveness analysis will be conducted from a societal perspective, relating differences in costs to difference in health outcome. Results are expected in 2012. Discussion This study will be the first randomized controlled trial which evaluates the effect of shared medical appointments versus usual care for neuromuscular patients. This will enable to determine if there is additional value of shared

  12. : tous les projets | Page 373 | CRDI - Centre de recherches pour le ...

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

    Sujet: MEDICAL RESEARCH, OPERATIONS RESEARCH, ORGANIZATION OF RESEARCH, RESEARCH CAPACITY, RESEARCH CENTRES, INSTITUTION BUILDING. Région: Zambia, North of Sahara, South of Sahara. Programme: Santé des mères et des enfants. Financement total : CA$ 406,569.00. Coordination et ...

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  14. Phelan-McDermid syndrome in two adult brothers: atypical bipolar disorder as its psychopathological phenotype?

    Directory of Open Access Journals (Sweden)

    Verhoeven WMA

    2012-04-01

    Full Text Available Willem MA Verhoeven1,2, Jos IM Egger1,3,4, Marjolein H Willemsen5, Gert JM de Leijer6, Tjitske Kleefstra51Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, 2Erasmus University Medical Centre, Department of Psychiatry, Rotterdam, 3Donders Centre for Cognition, Radboud University Nijmegen, Nijmegen, 4Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, 5Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, 6Dichterbij, Institutes for Intellectual Disabilities, Gennep, The NetherlandsAbstract: The 22q13.3 deletion, or Phelan-McDermid syndrome, is characterized by global intellectual disability, generalized hypotonia, severely delayed or absent speech associated with features of autism spectrum disorder, and minor dysmorphisms. Its behavioral phenotype comprises sleep disturbances, communication deficits, and motor perseverations. Data on psychological dysfunctions are so far not available. Previous studies have suggested that the loss of one copy of the gene SH3 and multiple ankyrin repeat domains 3 (SHANK3 is related to the neurobehavioral phenotype. Additional genes proximal to SHANK3 are also likely to play a role in the phenotype of patients with larger deletions. The present paper describes two adult brothers with an identical 2.15 Mb 22qter (22q13.32q13.33 deletion, of whom the youngest was referred for evaluation of recurrent mood changes. In both patients, magnetic resonance imaging of the brain showed hypoplasia of the vermis cerebelli. Extensive clinical examinations led to a final diagnosis of atypical bipolar disorder, of which symptoms fully remitted during treatment with a mood stabilizer. In the older brother, a similar psychopathological picture appeared to be present, although less severe and with a later onset. It is concluded that the behavioral phenotype of the 22q13.3 deletion syndrome comprises absent or delayed speech and perseverations

  15. Capturing Reality at Centre Block

    Science.gov (United States)

    Boulanger, C.; Ouimet, C.; Yeomans, N.

    2017-08-01

    The Centre Block of Canada's Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS) of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  16. CAPTURING REALITY AT CENTRE BLOCK

    Directory of Open Access Journals (Sweden)

    C. Boulanger

    2017-08-01

    Full Text Available The Centre Block of Canada’s Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  17. Laparoscopic adrenalectomy: Single centre experience.

    LENUS (Irish Health Repository)

    O'Farrell, N J

    2012-02-01

    BACKGROUND: Laparoscopic adrenalectomy is an attractive alternative to the traditional open approach in the surgical excision of an adrenal gland. It has replaced open adrenalectomy in our institution and we review our experience to date. METHODS: All cases of laparoscopic adrenalectomies in our hospital over eight years (from 2001 to May 2009) were retrospectively reviewed. Patient demographics, diagnosis, length of hospital stay, histology and all operative and post-operative details were evaluated. RESULTS: Fifty-five laparoscopic adrenalectomies (LA) were performed on 51 patients over eight years. The mean age was 48 years (Range 16-86 years) with the male: female ratio 1:2. Twenty-three cases had a right adrenalectomy, 24 had a left adrenalectomy and the remaining four patients had bilateral adrenalectomies. 91% were successfully completed laparoscopically with five converted to an open approach. Adenomas (functional and non functional) were the leading indication for LA, followed by phaeochromocytomas. Other indications for LA included Cushing\\'s disease, adrenal malignancies and rarer pathologies. There was one mortality from necrotising pancreatitis following a left adrenalectomy for severe Cushing\\'s disease, with subsequent death 10 days later. CONCLUSION: Laparoscopic adrenalectomy is effective for the treatment of adrenal tumours, fulfilling the criteria for the ideal minimally invasive procedure. It has replaced the traditional open approach in our centre and is a safe and effective alternative. However, in the case of severe Cushing\\'s disease, laparoscopic adrenalectomy has the potential for significant adverse outcomes and mortality.

  18. CLINICAL SPECTRUM OF HYPONATRAEMIA IN TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Suresh Chincholi

    2017-02-01

    Full Text Available BACKGROUND Hyponatraemia is defined as a serum sodium level less than 135 mEq/L. High mortality among the patients of hyponatraemia is secondary to the underlying medical condition. Frequency is high in elderly patients. MATERIALS AND METHODS The study was conducted at a tertiary care centre (Basaveshwar Teaching and General Hospital, Gulbarga, from the period September 2014 to August 2016. These patients were evaluated for the underlying cause of hyponatraemia, which included detailed history and physical examination followed by appropriate laboratory investigations. Patients were followed up till the hyponatraemia was treated or patients were discharged from the hospital. RESULTS 100 patients of hyponatraemia were included in the study. 46% of the patients were asymptomatic. 33% patients had lethargy, 28% patients had postural dizziness and 19% had abnormal behaviour. Overall incidence of hyponatraemia was 4.58% in the hospitalised population, whereas its incidence in ICU patients was 22.4%. Twelve patients of symptomatic severe hyponatraemia were treated with hypertonic saline infusion, 25% patients were given loop diuretics with oral supplementation of sodium chloride for free water excretion in SIADH cases and in patients with hypervolaemia, hyponatraemia, fluid restriction was advised to 44 patients, oral supplementation of sodium chloride was given in 36 patients and 64 patients received normal saline. 9 patients included in the study died, 5 of which had advanced cirrhosis of liver as underlying cause. One patient developed Osmotic Demyelination Syndrome (ODS. CONCLUSION The possible cause of hyponatraemia should always be sought as outcome in severe hyponatraemia is governed by aetiology, and not by the serum sodium level. Treatment of severe symptomatic hyponatraemia with hypertonic saline is safe if recommendation for the rate of correction of hyponatraemia is strictly followed.

  19. Victims’ use of professional services in a Dutch sexual assault centre

    Directory of Open Access Journals (Sweden)

    Iva Bicanic

    2014-06-01

    Full Text Available Background: Prior research endorsed the establishment of sexual assault centres in the Netherlands because of the potential benefit for victims’ mental recovery. In 2012, the first Dutch sexual assault centre was founded at the University Medical Center Utrecht. The aim of the centre is to provide 24/7 coordinated and integrated services (i.e., medical, forensic, and psychological in one location. Objective: The purpose of the present study was to describe demographic, background, and assault characteristics of victims seen at the centre within one week post-assault, and their use of post-assault services in order to improve current services. Method: From January 2012 to September 2013, prospective data of 108 patients were collected. To describe the population included, frequency counts and proportions were generated for categorical variables. Results: The mean age was 21.3 years (SD=9.8. Most victims were female (91.7%. A large proportion of victims reported background characteristics known to increase the risk for post-traumatic stress disorder (PTSD and revictimisation such as prior sexual abuse (32.4%, pre-existing use of mental health services (45.4%, and not living with both biological parents (61.7%. Most patients (88.9% consulted the centre within 72 hours post-assault. The uptake of services was high: 82.4% received emergency medical care, 61.7% underwent a forensic–medical exam, 34% reported to the police, and 82.4% utilised psychological services. Conclusion: To prevent revictimisation and PTSD, current psychological services could be improved with immediate trauma-focused treatments. Current forensic services may be improved with the use of standard top to toe forensic–medical examinations for both children and adults.

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

    Science.gov (United States)

    Algra, Annemijn M; Dekker, Friedo W

    2015-01-01

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

  1. The politics of patient-centred care.

    Science.gov (United States)

    Kreindler, Sara A

    2015-10-01

    Despite widespread belief in the importance of patient-centred care, it remains difficult to create a system in which all groups work together for the good of the patient. Part of the problem may be that the issue of patient-centred care itself can be used to prosecute intergroup conflict. This qualitative study of texts examined the presence and nature of intergroup language within the discourse on patient-centred care. A systematic SCOPUS and Google search identified 85 peer-reviewed and grey literature reports that engaged with the concept of patient-centred care. Discourse analysis, informed by the social identity approach, examined how writers defined and portrayed various groups. Managers, physicians and nurses all used the discourse of patient-centred care to imply that their own group was patient centred while other group(s) were not. Patient organizations tended to downplay or even deny the role of managers and providers in promoting patient centredness, and some used the concept to advocate for controversial health policies. Intergroup themes were even more obvious in the rhetoric of political groups across the ideological spectrum. In contrast to accounts that juxtaposed in-groups and out-groups, those from reportedly patient-centred organizations defined a 'mosaic' in-group that encompassed managers, providers and patients. The seemingly benign concept of patient-centred care can easily become a weapon on an intergroup battlefield. Understanding this dimension may help organizations resolve the intergroup tensions that prevent collective achievement of a patient-centred system. © 2013 John Wiley & Sons Ltd.

  2. IDRANAP - European Centre of Excellence

    International Nuclear Information System (INIS)

    Buzatu, Florin D.

    2003-01-01

    Selected by the European Commission (EC) experts out of 185 proposals from 11 countries, IDRANAP (Inter-Disciplinary Research and Applications based on Nuclear and Atomic Physics) is the only EC Centre of Excellence in nuclear physics. The project, initiated and developed by a remarkable team from our institute, researchers with a recognized international scientific level, has as main objectives: - promotion in Romania and in the region of modern applications derived from basic and applied research in nuclear and atomic physics; - disciplinary research in ecology, health, biology, science of materials; - specific nuclear and atomic physics research aimed to open new possibilities for applications; - to ensure stimulative conditions for PhD students from Romania and other EC candidate countries to improve their knowledge and experience by joining scientific activities in the region, a fact that might counteract their tendency to migrate to Western countries. The high scientific level of researchers, their access to national and international facilities as well as the link with prestigious laboratories abroad and the socio-economic demand motivated the development of the project. Among expected results, we mention: improving and spreading the scientific knowledge by publications; producing new facilities, devices and instruments; application of nuclear methods in industry, health-care and environment protection, and training of young researchers. The project consists of 18 workpackages structured in 5 distinct areas: - Determining environmental pollution; - Nuclear methods in biology and medicine; - Radionuclide metrology; - Analysis and characterization of materials; - Nuclei far from stability, decay modes, cosmic rays, and facilities.We make an up-to-date presentation of obtained results and activities performed within IDRANAP project, as well as a short overview of our institute. (author)

  3. Big Surveys, Big Data Centres

    Science.gov (United States)

    Schade, D.

    2016-06-01

    Well-designed astronomical surveys are powerful and have consistently been keystones of scientific progress. The Byurakan Surveys using a Schmidt telescope with an objective prism produced a list of about 3000 UV-excess Markarian galaxies but these objects have stimulated an enormous amount of further study and appear in over 16,000 publications. The CFHT Legacy Surveys used a wide-field imager to cover thousands of square degrees and those surveys are mentioned in over 1100 publications since 2002. Both ground and space-based astronomy have been increasing their investments in survey work. Survey instrumentation strives toward fair samples and large sky coverage and therefore strives to produce massive datasets. Thus we are faced with the "big data" problem in astronomy. Survey datasets require specialized approaches to data management. Big data places additional challenging requirements for data management. If the term "big data" is defined as data collections that are too large to move then there are profound implications for the infrastructure that supports big data science. The current model of data centres is obsolete. In the era of big data the central problem is how to create architectures that effectively manage the relationship between data collections, networks, processing capabilities, and software, given the science requirements of the projects that need to be executed. A stand alone data silo cannot support big data science. I'll describe the current efforts of the Canadian community to deal with this situation and our successes and failures. I'll talk about how we are planning in the next decade to try to create a workable and adaptable solution to support big data science.

  4. The Canadian Astronomy Data Centre

    Science.gov (United States)

    Ball, Nicholas M.; Schade, D.; Astronomy Data Centre, Canadian

    2011-01-01

    The Canadian Astronomy Data Centre (CADC) is the world's largest astronomical data center, holding over 0.5 Petabytes of information, and serving nearly 3000 astronomers worldwide. Its current data collections include BLAST, CFHT, CGPS, FUSE, Gemini, HST, JCMT, MACHO, MOST, and numerous other archives and services. It provides extensive data archiving, curation, and processing expertise, via projects such as MegaPipe, and enables substantial day-to-day collaboration between resident astronomers and computer specialists. It is a stable, powerful, persistent, and properly supported environment for the storage and processing of large volumes of data, a condition that is now absolutely vital for their science potential to be exploited by the community. Through initiatives such as the Common Archive Observation Model (CAOM), the Canadian Virtual Observatory (CVO), and the Canadian Advanced Network for Astronomical Research (CANFAR), the CADC is at the global forefront of advancing astronomical research through improved data services. The CAOM aims to provide homogeneous data access, and hence viable interoperability between a potentially unlimited number of different data collections, at many wavelengths. It is active in the definition of numerous emerging standards within the International Virtual Observatory, and several datasets are already available. The CANFAR project is an initiative to make cloud computing for storage and data-intensive processing available to the community. It does this via a Virtual Machine environment that is equivalent to managing a local desktop. Several groups are already processing science data. CADC is also at the forefront of advanced astronomical data analysis, driven by the science requirements of astronomers both locally and further afield. The emergence of 'Astroinformatics' promises to provide not only utility items like object classifications, but to directly enable new science by accessing previously undiscovered or intractable

  5. FUNCTIONS OF A NEUROMUSCULAR CENTRE

    Directory of Open Access Journals (Sweden)

    Janez Zidar

    2004-12-01

    Full Text Available Main functions of a neuromuscular (NM centre are making diagnosis, treatment and counselling. Some other functions, e. g. forming a register and epidemiological endeavours, could be added. All these activities are expected to be achieved by multidisciplinary approach with the idea that members use the same guidelines and share the same knowledge.NM diseases affect lower levels of the nervous system that is motor units (motor cells in the brainstem and spinal cord, nerve roots, cranial and peripheral nerves, neuromuscular junction, and muscles. There are many such diseases; a few are more common others are rare.Rational approach in making a diagnosis can be divided into several steps. The process begins with a person with clinical symptoms and signs which raise the suspicion of NM disease. The first step is the description of the predominant pattern of muscular wasting and weakness (e. g. limb-girdle, distal, ocular, facio-scapulo-humeral. Each of these syndromes require a differential diagnosis within the motor unit territory what is achieved by means of EMG and muscle biopsy. The latter is even more important to define the nature of the abnormality. Disease nature can also be determined biochemically and, as NM disorders are commonly genetically determined, at the molecular genetic level. Treatment modalities include drugs (causative and symptomatic and other measures such as promoting and maintaining good general health, preventing skeletal deformities, physiotherapy, orthoses, surgery, and prevention of respiratory and cardiac functions. Counselling is mainly by social workers that focus on the practical aspects of coping with illness and disability and by genetic counsellors who gave advise on family planning.

  6. Potential of Natural Ventilation in Shopping Centres

    DEFF Research Database (Denmark)

    Diederichsen, Alice; Friis, Kristina; Brohus, Henrik

    2008-01-01

    ) in shopping centres with focus on both the achieved IEQ and energy consumptions for air movement. By thermal building simulations it is found that there exists an interesting potential for hybrid ventilation of shopping centres, which can lead to great savings in the electrical energy consumptions......The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV...

  7. Attitude of Farmers towards Kisan Call Centres

    Directory of Open Access Journals (Sweden)

    Shely Mary Koshy

    2017-09-01

    Full Text Available The present study was conducted to measure the attitude of farmers in Kerala, India towards Kisan Call Centre (KCC. Kisan Call Centre provides free agricultural advisory services to every citizen involved in agriculture through a toll free number. One hundred and fifty farmers who have utilized the Kisan Call Centre service were selected from the database of KCC. The results showed that the respondents had moderately favourable attitude towards KCC followed by highly favourable attitude. The variables digital divide, temporal awareness on KCC, satisfaction towards KCC and utilization of KCC were found to have a positive correlation with the attitude of respondents towards KCC.

  8. Review of CERN Data Centre Infrastructure

    Science.gov (United States)

    Andrade, P.; Bell, T.; van Eldik, J.; McCance, G.; Panzer-Steindel, B.; Coelho dos Santos, M.; Traylen and, S.; Schwickerath, U.

    2012-12-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project's motivations, current status and areas for future investigation.

  9. Review of CERN Data Centre Infrastructure

    International Nuclear Information System (INIS)

    Andrade, P; Bell, T; Van Eldik, J; McCance, G; Panzer-Steindel, B; Coelho dos Santos, M; Traylen and, S; Schwickerath, U

    2012-01-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project's motivations, current status and areas for future investigation.

  10. Associating science and development - the Trieste Centre

    International Nuclear Information System (INIS)

    Hamende, A.

    1982-01-01

    The International Centre for Theoretical Physics, located in Trieste, Italy, is supported by income from the Italian Government, from UNESCO and from the IAEA. The Centre organizes research sessions, workshops and extended courses on advanced topics in the physical and mathematical sciences and encourages scientists, especially from developing countries, to visit the ICTP for extended periods. With the aim of facilitating the transfer of knowledge to scientists from developing countries, the Centre's current scientific programme is divided up into five major disciplines: physics and energy; physics and frontiers of knowledge; physics and technology; physics and the environment and natural resources; applicable mathematics

  11. Review of CERN Data Centre Infrastructure

    CERN Document Server

    Andrade, P; van Eldik, J; McCance, G; Panzer-Steindel, B; Coelho dos Santos, M; Traylen, S; Schwickerath, U

    2012-01-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project’s motivations, current status and areas for future investigation.

  12. International Network of Nuclear Reaction Data Centres

    International Nuclear Information System (INIS)

    Otsuka, Naohiko; Dunaeva, Svetlana

    2010-11-01

    The activities of fourteen nuclear data centres are summarized, and their cooperation under the auspices of the International Atomic Energy Agency is described. Each of the centres provides coverage for different geographical zones and/or specific types of nuclear data, thus together providing a complete service for users worldwide. The International Network of Nuclear Reaction Data Centres (NRDC) was established with the objective of providing nuclear physics databases that are required for nuclear technology (encompassing energy and non-energy applications) by coordinating the collection, compilation and dissemination of nuclear data on an international scale. (author)

  13. Evaluation of Radiation Protection Status in Some Health Centres in Sudan

    International Nuclear Information System (INIS)

    Sulieman, A.; Khalifa, S.; Elfadil, M.

    2011-01-01

    This study aims to evaluate the radiation protection status in some health centres, in Omdurman city in Sudan. It was carried out in four health care centres: (Aldaw-Hajoj (A), Abo-Sed (B), Alrakha (C) Wad-Nobawi (D)). The following parameters were investigated: X ray machine performance, ambient dose, patient dose, X ray room design, and radiation protection knowledge for technologists and medical doctors. Thermoluminescence dosimeters (TLDs) were used to measure patients' entrance skin dose (ESD). All the centres investigated are equipped with mobile X ray machines. Radiation exposure surveys were carried out using survey meters and quality control test tools. Knowledge level of doctors concerning radiation doses received by patients when they undergo commonly requested radiological examinations were investigated using questionnaires. The patient dose was measured in 108 patients in four centres in Omdurman city. The mean ESDs were 0.25 mGy for the chest, 0.3 mGy for the upper limbs and 0.4 mGy for the lower limbs. The results of the tests were acceptable in all parameters except the test of filtration, which showed that the filtration was insufficient. The machines at centres A and D were lacking a light beam to check the collimations. The knowledge of medical doctors and technologists in the field of radiation protection concepts is insufficient and in agreement with previous studies. (author)

  14. Histomorphological study of germinal centre of vermiform appendix in Bangladeshi cadaver.

    Science.gov (United States)

    Rahman, M M; Sultana, S Z; Mannan, S; Ara, Z G; Chowdhury, A I; Ara, A; Mukta, T B

    2013-01-01

    The study was done to find out the number of germinal centre in human vermiform appendix of Bangladeshi people to magnify the knowledge regarding the diverse number of germinal centre of human vermiform appendix in our population in the department of Anatomy, Mymensingh Medical College, Bangladesh from July 2006 to June 2007. Total 40 appendices were collected for histological study of different age and sex during postmortem examination in the autopsy laboratory of department of Forensic Medicine, Mymensingh Medical College. This cross sectional study was done by convenient sampling technique. For convenience of differentiating the changes in number of germinal centre of vermiform appendix in relation to age and sex, findings were classified in four groups, Group A up to 20 years, Group B 21-35 years, Group C 36-55 years and Group D 56-70 years. In the present study the number of germinal centre was highest in Group B (52.38%) but in Group D it was nil. Here mean number of germinal centre in male (1.05) were more than in female (0.8).

  15. Report on Greece. Establishment of an atomic centre

    International Nuclear Information System (INIS)

    1959-01-01

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

  16. The nuclear research centre at Bariloche, Argentina

    International Nuclear Information System (INIS)

    Abriata, J.P.

    2001-01-01

    The nuclear research centre at Bariloche (CAB) is one of the four centres under the Atomic Energy Commission of Argentina (CNEA). The research programme of CAB addresses various issues like nuclear reactor development, nuclear fuel and fuel cycle, applications of radioisotopes and radiation, and waste management. There is also a basic nuclear science component. The human resource development in the areas of physics and nuclear engineering is done in an associated Balseiro Institute which has undergraduate and graduate programmes as well as doctoral and postdoctoral research. The Centre interacts well with the society and provides services in the nuclear area. It has a close interaction with the nuclear sector of Argentina as also with many international organisations. Regulatory control over the Centre is carried out by the Nuclear Regulatory Authority of Argentina. (author)

  17. Identity Theft: A Study in Contact Centres

    Science.gov (United States)

    Moir, Iain; Weir, George R. S.

    This paper explores the recent phenomenon of identity theft. In particular, it examines the contact centre environment as a mechanism for this to occur. Through a survey that was conducted amongst forty-five contact centre workers in the Glasgow area we determined that contact centres can and do provide a mechanism for identity theft. Specifically, we found a particularly high incidence of agents who had previously dealt with phone calls that they considered suspicious. Furthermore, there are agents within such environments who have previously been offered money in exchange for customers' details, or who know of fellow workers who received such offers. Lastly, we identify specific practices within contact centres that may contribute to the likelihood of identity theft.

  18. Medical physics 1981

    International Nuclear Information System (INIS)

    Bunde, E.

    1982-01-01

    This volume continues the series of congress publications with which the Deutsche Gesellschaft fuer Medizinische Physik has been completely documenting its annual meetings for some years. The meeting was aimed to show the complexity not only of the scientific specialty medical physics but also of the practical activities of medical physicists, or at least give some idea of it. The conference was centred on the following points: Possibilities of optimization and methods for re-examination of techniques used in X-ray diagnostics, nuclear diagnostics and ultrasonographic diagnostics; bases of dosimetry in practical radiotherapy, especially with a view to the plans to make gauging of therapeutical dosemeters compulsory; current state of neutron therapy and dosimetry; safety and constancy of irradiation devices in operation; planning and equipment of modern radiotherapy departments. Furthermore topics from medical optics and nuclearbiological research were dealt with. Reports were given on the clinical use of whole-body counters. Climatology and surgical research were marginally dealt with in two synoptical papers. Short reports on work currently under way completed the subject groups given and allowed insight into further topical fields of work of medical physicists in science and practice. Finally, the question of education received particular interest. (orig./MG) [de

  19. Planetary Radars Operating Centre PROC

    Science.gov (United States)

    Catallo, C.; Flamini, E.; Seu, R.; Alberti, G.

    2007-12-01

    Planetary exploration by means of radar systems, mainly using Ground Penetrating Radars (GPR) plays an important role in Italy. Numerous scientific international space programs are currently carried out jointly with ESA and NASA by Italian Space Agency, the scientific community and the industry. Three important experiments under Italian leadership ( designed and manufactured by the Italian industry), provided by ASI either as contribution to ESA programs either within a NASA/ASI joint venture framework, are now operating: MARSIS on-board Mars Express, SHARAD on-board Mars Reconnaissance Orbiter and CASSINI Radar on-board Cassini spacecraft. In order to support all the scientific communities, institutional customers and experiment teams operation three Italian dedicated operational centers have been realized, namely SHOC, (Sharad Operating Centre), MOC (Marsis Operating Center) and CASSINI PAD ( Processing Altimetry Data). Each center is dedicated to a single instrument management and control, data processing and distribution. Although they had been conceived to operate autonomously and independently one from each other, synergies and overlaps have been envisaged leading to the suggestion of a unified center, the Planetary Radar Processing Center (PROC). PROC is conceived in order to include the three operational centers, namely SHOC, MOC and CASSINI PAD, either from logistics point of view and from HW/SW capabilities point of view. The Planetary Radar Processing Center shall be conceived as the Italian support facility to the scientific community for on-going and future Italian planetary exploration programs. Therefore, scalability, easy use and management shall be the design drivers. The paper describes how PROC is designed and developed, to allow SHOC, MOC and CASSINI PAD to operate as before, and to offer improved functionalities to increase capabilities, mainly in terms of data exchange, comparison, interpretation and exploitation. Furthermore, in the frame of

  20. Building an applied activation analysis centre

    International Nuclear Information System (INIS)

    Bartosek, J.; Kasparec, I.; Masek, J.

    1972-01-01

    Requirements are defined and all available background material is reported and discussed for the building up of a centre of applied activation analysis in Czechoslovakia. A detailed analysis of potential users and the centre's envisaged availability is also presented as part of the submitted study. A brief economic analysis is annexed. The study covers the situation up to the end of 1972. (J.K.)

  1. Social innovation for People-Centred Development

    DEFF Research Database (Denmark)

    Hulgård, Lars; P.K., Shajahan

    2013-01-01

    Social innovation is closely related to the people-centred development (PCD) framework of knowledge production. The discussion of PCD in this chapter particularly expands on the feature of empowerment and socio-political mobilization of people in social innovation......Social innovation is closely related to the people-centred development (PCD) framework of knowledge production. The discussion of PCD in this chapter particularly expands on the feature of empowerment and socio-political mobilization of people in social innovation...

  2. Karlsruhe Nuclear Research Centre. Programme budget 1988

    International Nuclear Information System (INIS)

    1987-01-01

    Following a general survey of tasks, planned activities and developmental trends of the nuclear research centre, the report gives an account of the activities to be performed in the subject fields of main interest, showing the budgeting figures for annual expenditure (for personnel, investments, operating costs) up to the year 1991. Further information explains the infrastructure of the centre and the distribution of overall expenditure as well as the budgetary planning. (UA) [de

  3. Joint Research Centre. Ispra establishment-Italy

    International Nuclear Information System (INIS)

    Angelini, Antonio

    1976-01-01

    A comprehensive review of the work carried out during 1974 and 1975 in the Ispra establishment of the Joint Research Centre is presented. A description of the activity carried out within the context of the running programmes is given. Some of the most relevant scientific and technical achievement are described from the viewpoints of the Scientific Departments of the Centre. The technical and administrative support activities are also presented. A list of publications issued by the Ispra Scientific staff is given

  4. Medical tourism.

    Science.gov (United States)

    Leggat, Peter

    2015-01-01

    Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.

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

    Science.gov (United States)

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

    2015-02-01

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

  6. Towards Human-Centred Design

    Science.gov (United States)

    Bannon, Liam J.

    The field of HCI has evolved and expanded dramatically since its origin in the early 1980’s. The HCI community embraces a large community of researchers and practitioners around the world, from a variety of disciplinary backgrounds in the human and social sciences, engineering and informatics, and more recently, the arts and design disciplines. This kaleidoscope of cultures and disciplines as seen at INTERACT Conferences provides a rich pool of resources for examining our field. Applications are increasingly exploring our full range of sensory modalities, and merging the digital and physical worlds. WiFi has opened up a huge design space for mobile applications. A focus on usability of products and services has been complemented by an emphasis on engagement, enjoyment and experience. With the advent of ubiquitous computing, and the emergence of “The Internet of Things”, new kinds of more open infrastructures make possible radically new kinds of applications. The sources of innovation have also broadened, to include human and social actors outside of the computing and design organizations. The question is to what extent is our mainstream thinking in the HCI field ready for the challenges of this Brave New World? Do the technological and social innovations that we see emerging require us to re-shape, or even, re-create, our field, or is it a case of a more gradual evolution and development of that which we already know? In this closing Keynote, I will provide a perspective on the evolution and development of the HCI field, looking backwards as well as forwards, in order to determine what are some of the changes of significance in the field. This “broad-brush” approach to what I term “ human-centred design” will be complemented by the examination of specific projects and applications, to help anchor some of the discussion. Areas such as user-centred design, participatory design, computer-supported cooperative work and learning, and interaction design, in

  7. Medical Management

    Science.gov (United States)

    ... email share facebook twitter google plus linkedin Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  8. Medication Errors

    Science.gov (United States)

    ... for You Agency for Healthcare Research and Quality: Medical Errors and Patient Safety Centers for Disease Control and ... Quality Chasm Series National Coordinating Council for Medication Error Reporting and Prevention ... Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & ...

  9. [Medical negligence].

    Science.gov (United States)

    Zipper, St G

    2016-06-01

    Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.

  10. Thyroidectomy During Medical Outreach | Ikechukwu | Journal of ...

    African Journals Online (AJOL)

    Background: Goiters are commonly seen in the low socioeconomic group with limited access to the specialists and specialized centres where this condition can be safely managed. Medical outreaches bring an opportunity for reprieve, but the setting and available facilities are often far from optimum. This study seeks to ...

  11. March 2001 EAST AFRICAN MEDICAL JOURNAL

    African Journals Online (AJOL)

    2001-03-01

    Mar 1, 2001 ... Request for reprints to: Dr. D.l-I.O. Kwamanga, Centre for Respiratory Diseases, Kenya Medical Research Institute, PO. Box 47855, Nairobi. ... factors of cigarette smoking and tobacco consumption among primary school teachers in Nairobi. .... Basic education system in Nairobi, like in all other provinces in ...

  12. South Sudan Medical Journal: Editorial Policies

    African Journals Online (AJOL)

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

  13. [Medical technology and medical education].

    Science.gov (United States)

    von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F

    2010-08-01

    The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.

  14. Evaluation of the ATBEF Youth Centre in Lome, Togo | Speizer ...

    African Journals Online (AJOL)

    In 1998, the Association Togolaise Pour le Bien Etre Familiale launched a youth centre in Lomé, Togo. To evaluate the centre, a three-year panel study was undertaken. Three years after being launched, about 10% of surveyed youth had visited the centre. Youth who lived close to the centre had contact with a peer ...

  15. The INTEGRAL ground segment and its science operations centre

    Science.gov (United States)

    Much, R.; Barr, P.; Hansson, L.; Kuulkers, E.; Maldari, P.; Nolan, J.; Oosterbroek, T.; Orr, A.; Parmar, A. N.; Schmidt, M.; Sternberg, J.; Williams, O. R.; Winkler, C.

    2003-11-01

    The INTEGRAL ground segment is divided into operational and scientific components. The operational component consists of the Mission Operations Centre, the ground stations and communications lines while the scientific component comprises of a Science Operations Centre and Science Data Centre. The overall architecture of the ground segment is described paying particular attention to the tasks and functionalities of the INTEGRAL Science Operations Centre.

  16. Optics design of the extraction lines for the MedAustron hadron therapy centre

    CERN Document Server

    Benedikt, Michael

    2005-01-01

    The MedAustron hadron therapy centre will provide proton and carbon ion beams for tumour treatment. The accelerator complex is based on a synchrotron that will employ slow resonant extraction to provide beams with the time structure required for active scanning. Four medical treatment rooms and two research rooms are foreseen for the centre. The present paper describes the optics design of the extraction lines that link the synchrotron to the different beam application rooms. A modular approach has been adopted to facilitate running-in and operation and to minimise the number of different magnets and power converters to reduce the overall cost. Specific attention was given to the rather special transverse properties of the slow-extracted beam and to the correct matching of the strongly asymmetric beam to the rotational optics of the gantries. Another important aspect for the design was the overall compactness of the centre.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    children and adolescents were included. The median age was 13 (range: 0-17) years. Boys accounted for 60.6% of the cases. Accidents accounted for 97.2%, violence 1.4% and self-inflicted injuries 0.4%. More than three fourths of the injuries occurred either in traffic or at home. The occurrence was greatest......INTRODUCTION: The epidemiology of children or adolescents admitted to a Scandinavian trauma centre is largely unknown. The aim of this paper was to describe the epidemiology and severity of potentially severely injured children and adolescents admitted to a university hospital trauma centre....... METHODS: This was a descriptive study of all children and adolescents aged 0-17 admitted to the university level trauma centre at Odense University Hospital, Denmark in the 2002-2011 period. Data were extracted from the Southern Danish Trauma Register and from medical records. RESULTS: A total of 950...

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

    Science.gov (United States)

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

    2007-01-01

    Background The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic group of asylum seekers to study if the incidence of mental disorders increased with length of stay. Methods The study population was asylum seekers in Danish asylum centres run by the Danish Red Cross. General medical care was provided by Red Cross staff who could refer selected cases to medical specialists. If an asylum seeker needed more than three specialist consultations for mental illness or five consultations for physical illness the referrals had to be approved by The Danish Immigration Service. Between July 2001 – December 2002 the Red Cross prospectively registered health related data on all new applications (n = 4516) to the Immigration Service regarding referrals to medical specialists. We used these records to analyse the association between length of stay in the asylum centres and overall rate of referral for mental disorders. Data was analysed using weighted linear regression. Results We found that referrals for mental disorders increased with length of stay in asylum centres in a large, multiethnic population of asylum seekers. The association was found in all the categories of psychiatric illness studied and for a majority of the nationality groups studied. Conclusion Length of stay in asylum centres was associated with an increase in referrals for mental disorders in a large, multiethnic group of asylum seekers. The present study supports the view that prolonged length of stay in an asylum centre is a risk factor for mental health. The risk of psychiatric illness among asylum seekers should be addressed by political and humanitarian means, giving prevention of illness the highest priority. PMID:17931414

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

    Science.gov (United States)

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

    2007-10-11

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

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

    Directory of Open Access Journals (Sweden)

    Stæhr Mia A

    2007-10-01

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

  2. Prescription, Transcription and Administration Errors in Out- Patient Day Care Unit of a Regional Cancer Centre in South India.

    Science.gov (United States)

    Mathaiyan, Jayanthi; Jain, Tanvi; Dubashi, Biswajit; Batmanabane, Gitanjali

    2016-01-01

    Medication errors are common but most often preventable events in any health care setup. Studies on medication errors involving chemotherapeutic drugs are limited. We studied three aspects of medication errors - prescription, transcription and administration errors in 500 cancer patients who received ambulatory cancer chemotherapy at a resource limited setting government hospital attached cancer centre in South India. The frequency of medication errors, their types and the possible reasons for their occurrence were analysed. Cross-sectional study using direct observation and chart review in anmbulatory day care unit of a Regional Cancer Centre in South India. Prescription charts of 500 patients during a three month time period were studied and errors analysed. Transcription errors were estimated from the nurses records for these 500 patients who were prescribed anticancer medications or premedication to be administered in the day care centre, direct observations were made during drug administration and administration errors analysed. Medical oncologists prescribing anticancer medications and nurses administering medications also participated. A total of 500 patient observations were made and 41.6% medication errors were detected. Among the total observed errors, 114 (54.8%) were prescription errors, 51(24.5%) were transcribing errors and 43 (20.7%) were administration errors. The majority of the prescription errors were due to missing information (45.5%) and administration errors were mainly due to errors in drug reconstitution (55.8%). There were no life threatening events during the observation period since most of the errors were either intercepted before reaching the patient or were trivial. A high rate of potentially harmful medication errors were intercepted at the ambulatory day care unit of our regional cancer centre. Suggestions have been made to reduce errors in the future by adoption of computerised prescriptions and periodic sensitisation of the

  3. [Sexual harassment of medical students during their period of work placement].

    Science.gov (United States)

    van den Muijsenbergh, M E T C; Lagro-Janssen, A L M

    2005-04-02

    To investigate the incidence, type and consequences of sexual harassment of medical students at the Radboud University in Nijmegen, the Netherlands, during their period of work placement, as well as the students' need for care thereafter. Questionnaire. During the period from 1 July to 31 December 2003, 5th and 6th year medical students were asked about their experiences with sexual harassment by means of a questionnaire. Sexual harassment was defined as unwelcome, sexually-coloured attention. Of the 183 questionnaires distributed, 113 (62%) were returned. 15 (20%) of the 75 female students and none of the 38 male students had experienced sexual harassment. The offenders included 9 patients and 6 doctors (54 men and 1 woman). In 7 of the 15 cases the harassment consisted of combinations of unwanted behaviour and unwanted sexually-coloured remarks. 9 of the 15 students had discussed their experiences with their peers, 7 with a supervisor and 3 with nobody. The most important reason to discuss it first in their peer group was that, despite the fact that the students were convinced that the offender's behaviour was unacceptable, they still doubted their own judgement. 5 students felt inhibited in their contacts with patients after the incident. 8 of the 15 offenders were not confronted with their behaviour. 6 of the 15 students were not satisfied with the way their case was handled. The problem of sexual harassment of medical students during their period of work placement should not be underestimated. It has a negative impact on the personal and professional conduct of future doctors. This subject should be part of the training of both medical students and their supervisors.

  4. The Aube centre. 1997 statement; Le centre de l`Aube. Bilan 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    Since January 1992 the Aube centre ensures the storage of 90% of the short life radioactive wastes produced in France. This educational booklet describes the organization of the activities in the centre from the storage of wastes to the radioactivity surveillance of the environment (air, surface and ground waters, river sediments, plants and milk). (J.S.)

  5. A reference regional nuclear fuel centre

    International Nuclear Information System (INIS)

    1978-01-01

    A nuclear fuel centre groups the facilities for spent fuel reprocessing, plutonium fuel fabrication, waste conditioning, and interim storage on a single site. The technical aspects of safety and protection, and the socio-economic consequences of two types of centre have been studied. The reference centre has an initial reprocessing capacity of 1500 tonnes. This capacity is quadrupled by the construction of two new units in 15 years. The other centre considered is a quarter of this size. A description is given of the processes used, the personal and capital requirements for construction and operation of the plant, the transport of radioactive waste and products, and the quantities involved. The local radiological impact is low and could be further reduced to a level well below that of natural radioactivity. The resulting increase in economic activity, employment, income redistribution and the new infrastructure requirements are estimated for a rural or semi-rural region. Measures to prevent tension are proposed. The impact of the host country's balance of payments, finances, employment situation and technological knowhow is evaluated. The original centre is compared with equivalent facilities scattered geographically

  6. Visits to Tier-1 Computing Centres

    CERN Multimedia

    Dario Barberis

    At the beginning of 2007 it became clear that an enhanced level of communication is needed between the ATLAS computing organisation and the Tier-1 centres. Most usual meetings are ATLAS-centric and cannot address the issues of each Tier-1; therefore we decided to organise a series of visits to the Tier-1 centres and focus on site issues. For us, ATLAS computing management, it is most useful to realize how each Tier-1 centre is organised, and its relation to the associated Tier-2s; indeed their presence at these visits is also very useful. We hope it is also useful for sites... at least, we are told so! The usual participation includes, from the ATLAS side: computing management, operations, data placement, resources, accounting and database deployment coordinators; and from the Tier-1 side: computer centre management, system managers, Grid infrastructure people, network, storage and database experts, local ATLAS liaison people and representatives of the associated Tier-2s. Visiting Tier-1 centres (1-4). ...

  7. CMS centres worldwide: A new collaborative infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Lucas; /Northeastern U.; Gottschalk, Erik; /Fermilab

    2010-01-01

    The CMS Experiment at the LHC is establishing a global network of inter-connected 'CMS Centres' for controls, operations and monitoring. These support: (1) CMS data quality monitoring, detector calibrations, and analysis; and (2) computing operations for the processing, storage and distribution of CMS data. We describe the infrastructure, computing, software, and communications systems required to create an effective and affordable CMS Centre. We present our highly successful operations experiences with the major CMS Centres at CERN, Fermilab, and DESY during the LHC first beam data-taking and cosmic ray commissioning work. The status of the various centres already operating or under construction in Asia, Europe, Russia, South America, and the USA is also described. We emphasise the collaborative communications aspects. For example, virtual co-location of experts in CMS Centres Worldwide is achieved using high-quality permanently-running 'telepresence' video links. Generic Web-based tools have been developed and deployed for monitoring, control, display management and outreach.

  8. UV LED lighting for automated crystal centring

    International Nuclear Information System (INIS)

    Chavas, Leonard M. G.; Yamada, Yusuke; Hiraki, Masahiko; Igarashi, Noriyuki; Matsugaki, Naohiro; Wakatsuki, Soichi

    2011-01-01

    A low-cost light-emitting diode (LED) UV source has been developed for facilitating macromolecular sample centring in the X-ray beam. A direct outcome of the exponential growth of macromolecular crystallography is the continuously increasing demand for synchrotron beam time, both from academic and industrial users. As more and more projects entail screening a profusion of sample crystals, fully automated procedures at every level of the experiments are being implemented at all synchrotron facilities. One of the major obstacles to achieving such automation lies in the sample recognition and centring in the X-ray beam. The capacity of UV light to specifically react with aromatic residues present in proteins or with DNA base pairs is at the basis of UV-assisted crystal centring. Although very efficient, a well known side effect of illuminating biological samples with strong UV sources is the damage induced on the irradiated samples. In the present study the effectiveness of a softer UV light for crystal centring by taking advantage of low-power light-emitting diode (LED) sources has been investigated. The use of UV LEDs represents a low-cost solution for crystal centring with high specificity

  9. The illusion of client-centred practice.

    Science.gov (United States)

    Gupta, Jyothi; Taff, Steven D

    2015-07-01

    A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession's philosophical basis and espoused commitment to client-centred practice. The current practice of occupational therapy in the reimbursement-driven practice arena in the United States is incongruent with the profession's espoused philosophy and values of client-centred practice. Occupational therapy differentiates itself from medicine's expert model aimed at curing disease and remediating impairment, by its claim to client-centred practice focused on restoring health through occupational enablement. Practice focused on impairment and function is at odds with the profession's core tenet, occupation, and minimizes the lasting impact of interventions on health and well-being. The profession cannot unleash the therapeutic power of human occupation in settings where body systems and body functions are not occupation-ready at the requisite levels for occupational participation. Client-centred practice is best embodied by occupation-focused interventions in the natural environment of everyday living. Providing services that are impairment-focused in unfamiliar settings is not a good fit for client-centred practice, which is the unique, authentic, and sustainable orientation for the profession.

  10. Scavenger hunt in the CERN Computing Centre

    CERN Multimedia

    CERN Bulletin

    2013-01-01

    Hidden among the racks of servers and disks in the CERN Computing Centre, you’ll find Hawaiian dancers, space aliens, gorillas… all LEGO® figurines! These characters were placed about the Centre for the arrival of Google’s Street View team for the world to discover.   PLEASE NOTE THAT THE COMPETITION IS OVER. ONLY FOR REFERENCE, HERE IS THE ORIGINAL ARTICLE. We’re pleased to announce our first global scavenger hunt! Spot three LEGO® figurines using Google’s Street View and you’ll be entered to win a gift of your choice from our CERN Gift Guide. A LEGO® figurine in the CERN Computing Centre, as seen on Google Street View. Here are the details: Find at least three LEGO® figurines hidden around the CERN Computing Centre using Google Street View.   Take screencaps of the figurines and e-mail the pictures to TreasureHunt-ComputingCentre@cern.ch. This email is no longer active.   The...

  11. Studies on possibility of building radiation centre in Hunan Province

    International Nuclear Information System (INIS)

    Tang Chuandao

    1987-01-01

    Hunan province is rich in agriculture products and their by-products. The processing and preservation of those products after porduction is an urgent problem to solve. However, radiation techniques can solve the problem of the processing and preservation of part of those products which can not be solved by normal ways. Only in Changsha area, the products such as leather and their products, dried and fresh fruit, medical equipments, industrial chemicals and so on, which can be provided to irradiate, weigh over 1 x 10 5 tons a year. In order to advance the research and application of radiation techniques in the province, over 40 units have been investigated in the province and other provinces. Since 1983, six informal discussions or demonstration meetings were held. 15 pieces of various reports and materials have been put forward. The necessity, possibility, size, place, development aim and united research of building a radiation centre have been scientificly demonstrated and a certain basis have been provided for building radiation centre

  12. Laparoscopy in Urology Practice at a Tertiary Care Centre

    International Nuclear Information System (INIS)

    Quddus, M. B.; Mahmud, S. M.

    2014-01-01

    Objective: To describe the results of laparoscopic procedures at a Urology - Nephrology tertiary care centre. Study Design: Case series / observational study. Place and Duration of Study: The Kidney Centre Postgraduate Training Institute, Karachi, from August 2007 to March 2012. Methodology: Medical records of all planned laparoscopic surgery conducted during the study period were reviewed. Those cases which to open surgery were excluded. All were performed by a single surgeon, initially as supervised and later independently. Data was maintained for demographic data, procedure details, length of hospital stay, and complications including conversion to open surgeries. Data was analyzed through SPSS 17.0. Results: There were 36 planned laparoscopic surgeries in the specified period. Out of 36 cases, 8 were converted to open surgery. Those who underwent laparoscopic surgery include two diagnostic procedures and renal cyst deroofing each, four ureterolithotomy, nineteen simple nephrectomy and one radical nephrectomy. So in total 28 cases were performed on 15 females and 13 males with mean age of 33.01 A +- 10.9 years. The mean operative time was 216 A +- 100 minutes and mean length of hospital stay was as 2.7 A +- 1.04 days. There were 10 complications in 28 cases, majority being Clavien Grade II including 7% (2/28) blood transfusion. Conclusion: There are technical challenges in learning laparoscopy for practicing urologists. Following some learning model in a systematic manner will help surmounting the technical challenges in learning laparoscopy. (author)

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  14. A One Decade Trend of Transforming Medical Doctors to Surgeons ...

    African Journals Online (AJOL)

    These Institutions included a public institution Muhimbili University of Health and Allied Sciences (MUHAS), Private faith based (Kilimanjaro Christian Medical Centre (KCMC) and Bugando University College of Health Sciences (BUCHS) and private for profit (International Medical and Technology (IMTU) and Hurbert ...

  15. Egyptian Journal of Medical Laboratory Sciences: Editorial Policies

    African Journals Online (AJOL)

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

  16. Occupational deprivation in an asylum centre:

    DEFF Research Database (Denmark)

    Morville, Anne-Le; Erlandsson, Lena-Karin

    2013-01-01

    This article presents a study of three asylum-seeking men from Iran and Afghanistan. It aimed to explore how and if they experienced occupations as occupations in a Danish asylum centre and how their life experience shaped their choice and value of current occupations. In-depth narrative interviews...... explored the participants’ occupational history and its influence on their occupations in the asylum centre. A thematic analysis showed that the participants had been subjected to occupational disruption and deprivation by politically oppressive systems even before their flight. Their occupations...... in Denmark were to a certain extent influenced by their earlier occupations and the current occupational deprivation they all experienced was due to limited possibilities in the centre. Although they tried their best to fill their days and create structure, there was a loss of valued occupations...

  17. The EPFL Plasma Physics Research Centre

    International Nuclear Information System (INIS)

    2001-01-01

    The Plasma Physics Research Centre (CRPP) is a non-departmental unit of the EPFL, and currently employs about 130 people, about 105 on the EPFL site and the rest at the Paul Scherrer Institute, PSI, in Villigen, Switzerland. The CRPP is a National Competence Centre in the field of Plasma Physics. In addition to plasma physics teaching, its missions are primarily the pursuit of scientific research in the field of controlled fusion within the framework of the EURATOM-Swiss Confederation Association and the development of its expertise as well as technology transfer in the field of materials research. As the body responsible for all scientific work on controlled fusion in Switzerland, the CRPP plays a national role of international significance. This document of 6 pages presents the explanation of the Plasma Physics Research Centre' activities (CRPP). (author)

  18. A day in the CERN Control Centre

    CERN Multimedia

    Rosaria Marraffino

    2015-01-01

    The CERN Control Centre (CCC) is the nerve centre of the CERN beam systems. From this room, the experts prepare, monitor, adjust, and control the particle beams that circulate throughout the accelerator complex while ensuring that the services and the technical infrastructure work flawlessly. Buttons, screens, telephones, lights (but no sound): in the CCC, everything is ready to make it possible for the LHC to reach the unprecedented energies expected at Run 2.   Seen from above, the CERN Control Centre resembles the shape of a quadrupole magnet. The consoles are distributed in four circles, called “islands”, dedicated to the LHC, the SPS, the PS Complex and the Technical Infrastructure (TI) respectively. Spread between TI and LHC are the Cryogenics consoles. Being in the same room allows the 24h-manned islands to be constantly in touch with one another, thus ensuring the best performance of the machines. At the LHC island, operators are currently busy training the magnet...

  19. Learning Styles of Independent Learning Centre Users

    Directory of Open Access Journals (Sweden)

    Tarik Uzun

    2014-09-01

    Full Text Available Learning style research has been a significant field within language teaching and learning. There have been very few attempts, however, to seek possible links between independent learning and learning style preferences. This paper aims to identify the learning styles of students who use the Independent Learning Centre (ILC on a regular basis at a state university in Turkey (n=102. The findings of the learning style analysis revealed that, contrary to expectations, most of the regular users of the centre were synoptic learners, which implies that these learners might not necessarily have conscious control over their own learning processes. An in-depth analysis of learning styles and recommendations to improve the services offered in the centre are also included in the paper.

  20. Field size and centring for conventional X-ray equipment

    International Nuclear Information System (INIS)

    Klimpel, H.; Kreienfeld, H.; Overbeck, R.

    1989-01-01

    Since 1973, all X-ray equipment for medical applications in the Federal Republic of Germany has had to be examined according to the requirements of the German ''Rontgenverordnung'' before it is used on patients and after each essential modification of design or construction. These examinations are carried out by inspectors appointed by the authorities, e.g. TUV. The field size adjustment and the centring of the radiation beam in relation to the image reception area is checked, along with other tests. To increase quality assurance in X-ray diagnosis, since the mid-1980s X-ray equipment has also been subject to in-service inspections to an increasing extent. (author)

  1. Information security requirements in patient-centred healthcare support systems.

    Science.gov (United States)

    Alsalamah, Shada; Gray, W Alex; Hilton, Jeremy; Alsalamah, Hessah

    2013-01-01

    Enabling Patient-Centred (PC) care in modern healthcare requires the flow of medical information with the patient between different healthcare providers as they follow the patient's treatment plan. However, PC care threatens the stability of the balance of information security in the support systems since legacy systems fall short of attaining a security balance when sharing their information due to compromises made between its availability, integrity, and confidentiality. Results show that the main reason for this is that information security implementation in discrete legacy systems focused mainly on information confidentiality and integrity leaving availability a challenge in collaboration. Through an empirical study using domain analysis, observations, and interviews, this paper identifies a need for six information security requirements in legacy systems to cope with this situation in order to attain the security balance in systems supporting PC care implementation in modern healthcare.

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

    Directory of Open Access Journals (Sweden)

    Sihaam Jardien-Baboo

    2016-10-01

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

  3. Family-centred care in the paediatric intensive care unit: an integrative review of the literature.

    Science.gov (United States)

    Butler, Ashleigh; Copnell, Beverley; Willetts, Georgina

    2014-08-01

    To review extant research on family-centred care in a paediatric intensive care environment and identify gaps in the literature. Family-centred care is currently a core concept in paediatric nursing, focusing on the premise that families are central to a child's well-being, and as such, should be included as equal members of the child's healthcare team. Due to the nature of critical care, family-centred care may be challenging to implement and maintain. An integrative literature review. The review was conducted using the Cumulative Index to Nursing and Allied Health Literature, PubMed, OVID MEDLINE and Google Scholar databases, from 1990 to present. The search focused on the following terms: 'p(a)ediatric critical care', 'paediatric intensive care unit', 'family cent(e)red care', 'parental needs', 'family presence' and 'family/nurse roles'. Additionally, the search was limited to studies conducted in a developed country and published in English. Eighteen studies were included in the review. The results demonstrated that implementing family-centred care into a paediatric intensive care environment posed several challenges. The discrepancy between nurses' and parents' perception of their roles, the reluctance of medical staff to share potentially negative or rapidly changing information, restrictive family presence and poor understanding of family needs emerged as the key difficulties. No studies evaluated strategies to improve family-centred care practice. Family-centred care presents many challenges in a paediatric intensive care environment; however, nurses are uniquely positioned to foster relationships with families, encourage accurate and honest information sharing and advocate for families to be present when they choose. This review outlines the extant research to enhance awareness of the unique state of family-centred care in paediatric intensive care and makes recommendations for future research. © 2013 John Wiley & Sons Ltd.

  4. THE ELUSIVENESS OF LEARNER-CENTRED TEACHING

    Directory of Open Access Journals (Sweden)

    Ervin Kovačević

    2016-03-01

    Full Text Available This research will explore teaching styles of university professors. Teaching style is an umbrella term for teaching decisions made during the entire teaching process – planning, delivery, and evaluation. Contemporary university teachers are advised to adopt the learner-centred teaching style which is assumed to produce remarkable possibilities. In the Fall Semester 2015 fifty-two respondents in different faculties of International University of Sarajevo were surveyed using The Principles of Adult Learning Scale inventory designed by Gary J. Conti. Inventory scores were calculated according to guidelines suggested by the author of the inventory. The scores revealed that majority of respondents strongly supported teacher-centred rather than learner-centred styles of instruction. Scores were analysed on gender lines and across three different faculties, namely: Arts and Social Sciences; Business and Administration; Engineering and Natural Sciences. In all five groups none of the seven teaching style indicators was found to conform with the learner-centred teaching criteria. There was no statistically significant difference between the two genders’ preference for a teaching style. And there was no statistically significant difference between teaching style preference across the three different faculties.The results of this research imply that the learner-centred style of instruction is not frequently implemented. Secondly, the results indicate that the requirements necessary for proper application of the learner-centred teaching style are not easy to meet in current written and unwritten norms. Finally, the results show that traditional teaching styles, which have been preserved in different scientific fields, still predominate in universities.

  5. Optimizing Data Centre Energy and Environmental Costs

    Science.gov (United States)

    Aikema, David Hendrik

    Data centres use an estimated 2% of US electrical power which accounts for much of their total cost of ownership. This consumption continues to grow, further straining power grids attempting to integrate more renewable energy. This dissertation focuses on assessing and reducing data centre environmental and financial costs. Emissions of projects undertaken to lower the data centre environmental footprints can be assessed and the emission reduction projects compared using an ISO-14064-2-compliant greenhouse gas reduction protocol outlined herein. I was closely involved with the development of the protocol. Full lifecycle analysis and verifying that projects exceed business-as-usual expectations are addressed, and a test project is described. Consuming power when it is low cost or when renewable energy is available can be used to reduce the financial and environmental costs of computing. Adaptation based on the power price showed 10--50% potential savings in typical cases, and local renewable energy use could be increased by 10--80%. Allowing a fraction of high-priority tasks to proceed unimpeded still allows significant savings. Power grid operators use mechanisms called ancillary services to address variation and system failures, paying organizations to alter power consumption on request. By bidding to offer these services, data centres may be able to lower their energy costs while reducing their environmental impact. If providing contingency reserves which require only infrequent action, savings of up to 12% were seen in simulations. Greater power cost savings are possible for those ceding more control to the power grid operator. Coordinating multiple data centres adds overhead, and altering at which data centre requests are processed based on changes in the financial or environmental costs of power is likely to increase this overhead. Tests of virtual machine migrations showed that in some cases there was no visible increase in power use while in others power use

  6. [Structured care in an ISO certified centre for patients with cystic fibrosis and their families].

    Science.gov (United States)

    Ellemunter, H; Eder, J; Steinkamp, G

    2011-10-01

    Cystic fibrosis (CF) is a chronic, life-shortening disease of multiple organ systems. Guidelines recommend that patients should be treated in specialised CF centres with multi-professional teams. We describe the organisation of medical care at the CF centre of Innsbruck University as well as results of treatment. Procedures and delivery of multi-professional care have been elaborated and structured. Since 2006 the Centre has been repeatedly certified according to DIN ISO 9001:2000. The patient database is being used during the doctor's consultation and for the continuous monitoring of treatment results. In 2010, 71 of the 148 patients (48%) were between 18 and 56 years old. The total number of patients has doubled and the proportion of adults tripled since 1995. Nevertheless, median FEV1 remained stable (>80% of predicted) during the last 15 years. Compared with 18 CF centres of the German Benchmarking Group, patients treated in Innsbruck had favourable FEV1 values: 52% of adults had a normal FEV1 (>80% pred.) and only 23% an FEV1 <50% of predicted. A structured programme of multi-professional care was associated with favourable treatment results, both longitudinally and in comparison to other CF centres. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Medical criminalistics.

    Science.gov (United States)

    Pollak, S

    2007-01-17

    Medical criminalistics is an essential part of legal/forensic medicine. It includes the clinical examination of surviving victims and suspects, the inspection of the scene in suspicious deaths with subsequent performance of medico-legal autopsies, the assessment of (biological) traces and the reconstruction of criminal events under medical aspects. Just as the circumstances of life and the manifestations of crime are changing with time, there is a permanent alteration regarding the issues of medical criminalistics. Legal/forensic medicine is a university subject in most countries and therefore, research work is one of the main tasks also in medical criminalistics. In contrast to clinical medicine and basic research, some common study designs are not suitable for the special needs of medical criminalistics, whereas other types are more appropriate like epidemiological evaluations, cross-sectional studies and (retrospective) observation studies. Moreover, experimental model tests and case reports also rate high in medical criminalistics.

  8. Bureaucracy, professionalization and school centred innovation strategies

    Science.gov (United States)

    Morris, Paul

    1990-03-01

    This paper examines an attempt to promote a school centred innovation strategy within a highly centralized educational system. The School Based Curriculum Project Scheme, which was introduced into Hong Kong in 1988, is analysed in terms of a professional-bureaucratic dichotomy. It is argued that the operational details of the scheme are designed to satisfy a range of bureaucratic concerns and these are not conducive to promoting the professional work ethic which is required for school centred innovation. Finally the paper identifies the implications which arise for policies designed to promote curriculum innovation.

  9. Description of the Nuclear Training Centre

    International Nuclear Information System (INIS)

    Wagadarikar, V.K.

    1974-01-01

    The Department of Atomic Energy, Government of India has developed an on-going programme for constructing and operating heavy water moderated, natural uranium fuelled power stations of the CANDU-type. With the view to train personnel required for operation and maintenance of these stations, a Nuclear Training Centre has been set up at the site of the Rajasthan Atomic Power Station. A description of the nuclear training centre with its facilities is given. The training programme for engineers, operators, mechanical, electrical and control maintainers etc. is given in detail, along with the actual syllabi for respective courses. Examples of the typical field check list are provided. (K.B.)

  10. Extraction of centre line from curvilinear objects

    Science.gov (United States)

    Rokicki, J.; Matiukas, V.; Ušinskas, A.; Adaškevičius, R.

    2011-03-01

    This tutorial paper surveys three methods designed to detect the centre line in curvilinear structures. These are the iterative thinning, Steger's and derivatives' methods. We aim to illustrate the effectivness of the chosen methods for processing laser-trace images and magnetic resonance slices of human head. The essence of each three methods is presented and important parameters are discussed. Experiments have been carried out and results are discussed in the light of the quality of the centre line produced and work time of all three methods.

  11. Imperial College Reactor Centre annual report. 1984

    International Nuclear Information System (INIS)

    1985-01-01

    The following new equipment is noted; for atomic absorption spectrometry to supplement the neutron activation analysis, and an additional nuclear data analysis system to improve the quality and speed of the service to users of the Centre's facilities. Users include undergraduates from the University of London, outside bodies such as the British Musueum, as well as departments of Colleges of the University of London. The reactor lost only three days through failures or faults. Two replacement fuel elements were put into the reactor during the year. The report contains brief accounts of 34 research programmes at the Centre. (U.K.)

  12. Enhancing person-centred communication in NICU

    DEFF Research Database (Denmark)

    Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

    2015-01-01

    Aims of this article were (a) to explore how parents of premature infants experience guided family-centred care (GFCC), and (b) to compare how parents receiving GFCC versus standard care (SC) describe nurse-parent communication in the neonatal intensive care unit.......Aims of this article were (a) to explore how parents of premature infants experience guided family-centred care (GFCC), and (b) to compare how parents receiving GFCC versus standard care (SC) describe nurse-parent communication in the neonatal intensive care unit....

  13. Review of CERN Computer Centre Infrastructure

    CERN Multimedia

    CERN. Geneva

    2012-01-01

    The CERN Computer Centre is reviewing strategies for optimizing the use of the existing infrastructure in the future, and in the likely scenario that any extension will be remote from CERN, and in the light of the way other large facilities are today being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote computer centres. This presentation will give the details on the project’s motivations, current status and areas for future investigation.

  14. Byurakan Astrophysical Observatory as Cultural Centre

    Science.gov (United States)

    Mickaelian, A. M.; Farmanyan, S. V.

    2017-07-01

    NAS RA V. Ambartsumian Byurakan Astrophysical Observatory is presented as a cultural centre for Armenia and the Armenian nation in general. Besides being scientific and educational centre, the Observatory is famous for its unique architectural ensemble, rich botanical garden and world of birds, as well as it is one of the most frequently visited sightseeing of Armenia. In recent years, the Observatory has also taken the initiative of the coordination of the Cultural Astronomy in Armenia and in this field, unites the astronomers, historians, archaeologists, ethnographers, culturologists, literary critics, linguists, art historians and other experts. Keywords: Byurakan Astrophysical Observatory, architecture, botanic garden, tourism, Cultural Astronomy.

  15. Medical marijuana.

    OpenAIRE

    Marmor, J B

    1998-01-01

    Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several...

  16. Applicability of the Rivermead Behavioural Memory Test – Third Edition (RBMT-3 in Korsakoff's syndrome and chronic alcoholics

    Directory of Open Access Journals (Sweden)

    Wester AJ

    2013-06-01

    Full Text Available Arie J Wester,1 Judith C van Herten,2 Jos IM Egger,2–4 Roy PC Kessels1,2,5 1Korsakoff Clinic, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands; 2Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands; 3Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands; 4Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands; 5Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Purpose: To examine the applicability of the newly developed Rivermead Behavioural Memory Test – Third Edition (RBMT-3 as an ecologically-valid memory test in patients with alcohol-related cognitive disorders. Patients and methods: An authorized Dutch translation of the RBMT-3 was developed, equivalent to the UK version, and administered to a total of 151 participants – 49 patients with amnesia due to alcoholic Korsakoff's syndrome, 49 patients with cognitive impairment and a history of chronic alcoholism, not fulfilling the Korsakoff criteria, and 53 healthy controls. Between-group comparisons were made at subtest level, and the test's diagnostic accuracy was determined. Results: Korsakoff patients performed worse than controls on all RBMT-3 subtests (all P-values < 0.0005. The alcoholism group performed worse than controls on most (all P-values < 0.02, but not all RBMT-3 subtests. Largest effects were found between the Korsakoff patients and the controls after delayed testing. The RBMT-3 had good sensitivity and adequate specificity. Conclusion: The RBMT-3 is a valid test battery to demonstrate everyday memory deficits in Korsakoff patients and non-Korsakoff patients with alcohol abuse disorder. Korsakoff patients showed an impaired performance on subtests relying on orientation, contextual memory and delayed testing. Our findings provide valuable information for treatment

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

    Science.gov (United States)

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

    2017-01-06

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

  18. Medical records and radiation exposure cards

    International Nuclear Information System (INIS)

    Vigan, C.

    1975-01-01

    Some ideas concerning medical records at the Ispra Centre are exposed. The approved medical practitioner has two main tasks: he must gather enough relevant information to decide on the worker's suitability and also to determine his physical condition, normal or otherwise, and he must record it with enough detail to permit comparison with findings at later examinations. for the purposes of medical records, clinical examinations and complementary investigations, a large proportion of the measurements are of course made on the critical organs. The problems of the container or physical medium receiving the information to be recorded is considered. The possibilities offered by computer techniques are discussed

  19. Medical error

    African Journals Online (AJOL)

    QuickSilver

    is only when mistakes are recognised that learning can occur...All our previous medical training has taught us to fear error, as error is associated with blame. This fear may lead to concealment and this is turn can lead to fraud'. How real this fear is! All of us, during our medical training, have had the maxim 'prevention is.

  20. The assessment centre: testing the fairness hypothesis

    Directory of Open Access Journals (Sweden)

    D. N. Hurst

    1994-06-01

    Full Text Available Accumulated international research reveals that assessment centre technology appears to be reasonably 'fair' based on race, sex, and age. Similar research on the assessment centre in South Africa is mostly unknown and/or un-documented. The sample of this study consisted of 317 white and disadvantaged males assessed at the supervisory level. The assessment centre predicted job performance for both the advantaged group (whites as well as the disadvantaged groups (blacks and 'coloureds'. Similarly, in terms of deary's (1968 model of 'fairness', we found no evidence of bias in the predictive validity of the assessment centre for the two groups. Opsomming Geakkumuleerde internasionale navorsing toon dat die takseersentrum redelik 'billik' is ten opsigte van ras, geslag en ouderdom. Soortgelyke navorsing met betrekking tot die takseersentrum in Suid-Afrika is egter grootliks onbekend en ongedokumenteer. Die steekproef in die huidige studie bestaan uit 317 wit en minder bevoorregte mans wat op toesighouer vlak geevalueer is. Die takseersentrum voorspel werkprestasie vir beide die bevoorregte groep (Wit en die minder bevoorregte groep (Swart en 'Kleurlinge'. In terme van Cleary (1968 se model van 'billikheid' is daar geen bewys van sydigheid in die voorspellingsgeldigheid van die takseersentrum vir die twee groepe gevind nie.

  1. Examining Whiteness in a Children's Centre

    Science.gov (United States)

    Clarke, Verity; Watson, Debbie

    2014-01-01

    This article utilises critical whiteness theory to explore the ethnic discourses observed in a children's centre in South London. Whilst critical whiteness has been used as a framework to understand race, racism and multiculturalism in a number of settings, including education, there are few studies that have sought to understand ethnicity in…

  2. National Centre for Radioactive Ion Beams (NCRIB)

    International Nuclear Information System (INIS)

    Chintalapudi, S.N.

    1999-01-01

    Radioactive Ion (nuclear) Beams have become prolific recently. Nuclear physics and associated subjects have staged a comeback to almost the beginning with the advent of RIB. A dedicated National Centre for RIB (NCRIB) proposed, discussed at several forums and under serious consideration is described

  3. National Centre for Radioactive Ion Beams (NCRIB)

    International Nuclear Information System (INIS)

    Chintalapudi, S.N.

    1999-01-01

    A dedicated National Centre for RIB (NCRIB) proposed discussed at several forums is presented. The production of (RIB) radioactive ion beams and applications of beams leading to competitive studies in nuclear structure, nuclear reactions, condensed matter, bio-science and radioactive isotope production etc. are mentioned

  4. Startup - Philippines Community Electronic Centres Academy | CRDI ...

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

    The Philippines telecentre movement has gathered momentum in recent years, mainly due to the Philippines Community e-Centres Network (PhilCeCNet) developed with financial and technical support from IDRC's telecentre.org under project 104285. Over 800 telecentres and a number of government departments, private ...

  5. Startup - Philippines Community Electronic Centres Academy | IDRC ...

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

    The Philippines telecentre movement has gathered momentum in recent years, mainly due to the Philippines Community e-Centres Network (PhilCeCNet) developed with financial and technical support from IDRC's telecentre.org under project 104285. Over 800 telecentres and a number of government departments, private ...

  6. Institutional Support : Centre for Population and Environmental ...

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

    Nigeria's Centre for Population and Environmental Development (CPED) is an independent, nonprofit organization formally registered in 1998. Its mandate is to carry out action-based research on poverty reduction and sustainable development in Nigeria in general and in the Niger Delta in particular. Communities in this ...

  7. Frequency selectivity at very low centre frequencies

    DEFF Research Database (Denmark)

    Orellana, Carlos Andrés Jurado; Pedersen, Christian Sejer; Marquardt, Torsten

    2010-01-01

    measurements based on OAE suppression techniques and notched-noise masking data psychophysically measured for centre frequencies in the range 50-125 Hz, this study examines how individual differences in frequency selectivity, as well as in masking, may occur at very low CFs due to individual differences...

  8. Homi Bhabha Centre for Science Education (TIFR)

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 3; Issue 2. Homi Bhabha Centre for Science Education (TIFR). S Ramaseshan. Information and Announcements Volume 3 Issue 2 February 1998 pp 91-95. Fulltext. Click here to view fulltext PDF. Permanent link:

  9. Spatial Diversity of Biotechnology Centres in Germany

    Directory of Open Access Journals (Sweden)

    Dorocki Sławomir

    2014-06-01

    Full Text Available Biotechnology is considered one of the key advanced technology sectors of the future. Its development is conditional on basic research in technologically advanced research institutes and appropriately qualified human resources. The optimum environment stimulating the development of biotechnology is that of production centres having joint industrial and R&D operations.

  10. Proposal for an ecoradiological centre model

    International Nuclear Information System (INIS)

    Perovic, S.M.; Zunic, Z.; Demajo, M.; Konjevic, N.

    1998-01-01

    The problem of establishing an optimal Ecoradiological Centre Model is studied in some detail for the town of Kotor which is under the protection of the World Cultural and Natural Heritage. The proposed structure of the Centre is analyzed from the view of Engineering, Education and Scientific parameters. This Model is suitable for implementation as a network Centre Model for the state of Montenegro. Further, the modelling strategy of the ecoradiological condition control of natural, construction, bio and technological systems is elaborated. The proposal includes the ecoradiological monitoring, radioactive and electromagnetic radiation processing and protection for different natural zones as well as their different geostructures, aerial and hydrogeological conditions. The programme also includes all housing objects (hotels, flats, houses, office premises etc.). Here will also be presented the radiation protection and recommendations for the implementation of Title VII of the European Basic Safety Standards Directive (BSS), concerning significant increase in exposure due to natural radiation sources. Also, the proposal of Local Radiation Protection for the town of Kotor is presented. Our proposal for an Ecoradiological Centre Model presented here is in a form of a pilot programme, applicable also for other towns and states. (author)

  11. Scaling science | IDRC - International Development Research Centre

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

    2017-12-07

    Dec 7, 2017 ... Scaling our impact IDRC is committed to supporting the generation, identification, and testing of scalable ideas and innovation, as highlighted in Objective 1 of the Centre's Strategic Plan. With this agenda in mind, we're focussed on advancing our understanding of how scaling up research and innovation ...

  12. In the Field: The Canadian Ecology Centre.

    Science.gov (United States)

    Magee, Clare

    2000-01-01

    The Canadian Ecology Centre (Ontario) offers year-round residential and day programs in outdoor and environmental education for secondary students, field placement and internship opportunities for college students, and ecotourism programs, while providing employment and tax revenues to the local community. Dubbed consensus environmentalism, the…

  13. Institutional Support : Economic Policy Research Centre (EPRC ...

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

    The Economic Policy Research Centre (EPRC) was established in 1993 as an autonomous not-for-profit policy research institute with support from the Government of Uganda, donor agencies and ... Addressing Africa's unmet need for family planning by intensifying sexual and reproductive and adolescent health research.

  14. Nganyi Community Resource Centre: Community radio station ...

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

    2016-05-04

    Nganyi Community Resource Centre: Community radio station broadcasts weather forecasts, climate change news to farmers in Kenya. May 04, 2016. Image ... To boost access, KMS distributed radio handsets to communities with a built-in solar power generator and wind-up system. KMS senior assistant director Samuel ...

  15. Institutional Support : Centre for Population and Environmental ...

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

    Chargé(e) de projet. Mr. Johnson E. Dudu. Chargé(e) de projet. Andrew G. Onokerhoraye. Chargé(e) de projet. Andrew G. Onokerhoraye. Institution. Centre for Population and Environmental Development. Pays d' institution. Nigeria. Site internet. http://www.cpedng.org. Contenus connexes. Bulletin de BRAS - juin 2017.

  16. Person-Centred (Deictic) Expressions and Autism

    Science.gov (United States)

    Hobson, R. Peter; Garcia-Perez, Rosa M.; Lee, Anthony

    2010-01-01

    We employed semi-structured tests to determine whether children with autism produce and comprehend deictic (person-centred) expressions such as "this"/"tilde" "here"/"there" and "come"/"go", and whether they understand atypical non-verbal gestural deixis in the form of directed head-nods to indicate location. In Study 1, most participants…

  17. Zimbabwe | IDRC - International Development Research Centre

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

    Zimbabwe was already a recognized centre for research and higher education when we began supporting research there in 1981. Deteriorating economic and political ... Information on pregnancy-related deaths has led authorities to improve the quality of health services for expectant and new mothers. Total IDRC Support ...

  18. RESOURCE CENTRE AT THE SOUTH AFRICAN MUSEUM

    African Journals Online (AJOL)

    ciunl ictlt.P cnnipc;. Material from other museums. Worksheets, activity books, guides, pamp~lets and other educational material from museums 1n Southern. Africa and overseas are kept in the museum education section of the Resource Centre. General infonnation on museums and museum technology are also collected.

  19. A herpetological reconnaissance of Mpala Research Centre ...

    African Journals Online (AJOL)

    Reptiles and amphibians are reported from Mpala Research Centre, located in semi¬-arid savannah on the Laikipia Plateau of central Kenya, at 1650 m elevation at 0.293° N and 36.899° E. An intensive survey was undertaken 5-7 July 1998, supplemented by incidental sampling on other occasions. A total of 17 species ...

  20. the Avian Park Service Learning Centre story

    African Journals Online (AJOL)

    The Ukwanda Centre for Rural Health (UCRH) opened in 2001, followed 10 years later by the establishment of the Ukwanda Rural Clinical School in one of the rural health districts of the Western Cape. This paper relates the journey of the Faculty with the underserviced community of Avian Park through the provision of ...

  1. The INTEGRAL science data centre (ISDC)

    DEFF Research Database (Denmark)

    Courvoisier, T.J.L.; Walter, Rasmus; Beckmann, V.

    2003-01-01

    The INTEGRAL Science Data Centre (ISDC) provides the INTEGRAL data and means to analyse them to the scientific community. The ISDC runs a gamma ray burst alert system that provides the position of gamma ray bursts on the sky within seconds to the community. It operates a quick-look analysis of th...

  2. Copyright | IDRC - International Development Research Centre

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

    Where copyright is held by IDRC Unless otherwise stated, the copyright to material on this website is held by the International Development Research Centre (IDRC). IDRC permits reading, downloading, copying, redistributing, printing, linking and searching, for non-commercial or academic purposes, of any of its content, ...

  3. Kathryn Toure | IDRC - International Development Research Centre

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

    Kathryn Toure started her career in New York City in refugee resettlement before working for the Centre for International and Comparative Studies at the University of Iowa. She moved to West Africa where she worked with Africa Online, the Educational Research Network for West and Central Africa, and eventually as ...

  4. President | IDRC - International Development Research Centre

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

    International Development Research Centre Selection Criteria Education A degree from a recognized university in a relevant field of study, or an acceptable combination of education, job-related training and/or experience. A post graduate degree would be considered an asset. Experience Leadership experience in a ...

  5. Search Results | IDRC - International Development Research Centre

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

    2018-03-26

    Results 1 - 10 of 8494 ... IDRC will participate in and support the 2018 Next Einstein Forum (NEF) Global Gathering, under the patronage this year of Paul Kagame, President of the Republic of Rwanda. Event date(s). March 26, 2018 to March 28, 2018. Event location. Kigali Convention Centre Kigali,. Rwanda. Books ...

  6. UV LED lighting for automated crystal centring.

    Science.gov (United States)

    Chavas, Leonard M G; Yamada, Yusuke; Hiraki, Masahiko; Igarashi, Noriyuki; Matsugaki, Naohiro; Wakatsuki, Soichi

    2011-01-01

    A direct outcome of the exponential growth of macromolecular crystallography is the continuously increasing demand for synchrotron beam time, both from academic and industrial users. As more and more projects entail screening a profusion of sample crystals, fully automated procedures at every level of the experiments are being implemented at all synchrotron facilities. One of the major obstacles to achieving such automation lies in the sample recognition and centring in the X-ray beam. The capacity of UV light to specifically react with aromatic residues present in proteins or with DNA base pairs is at the basis of UV-assisted crystal centring. Although very efficient, a well known side effect of illuminating biological samples with strong UV sources is the damage induced on the irradiated samples. In the present study the effectiveness of a softer UV light for crystal centring by taking advantage of low-power light-emitting diode (LED) sources has been investigated. The use of UV LEDs represents a low-cost solution for crystal centring with high specificity.

  7. Renovation of the CERN Computer Centre

    CERN Multimedia

    Patrice Loïez

    2003-01-01

    The Computer Centre at CERN is seen after half of the equipment is the large ground floor room has been removed. A large-scale spring-cleaning operation took place before renovation work for the new CERN Grid system began. Fifteen kilometres of cables that were no longer needed were removed from the cavity floor for recycling.

  8. Brazil | IDRC - International Development Research Centre

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

    IDRC-supported research in Brazil has informed policy debates on a variety of issues, including democracy, economic growth, health, social services, ... national centre of excellence, informing policies regarding Haiti on reconstruction after the 2010 earthquake, including food security and public-private sector partnerships.

  9. Centre Management | IDRC - International Development Research ...

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

    Senior staff members comprise IDRC's Centre Management Committee. Committee members include our four regional office directors and the directors from our main program focus areas. The Committee works with the president to support research for development — providing advice and guidance on corporate objectives ...

  10. The fragility of human-centred design

    NARCIS (Netherlands)

    Steen, M.G.D.

    2008-01-01

    In human-centred design (HCD), researchers and designers develop products in cooperation with the potential users of these products. They attempt to give users a voice or a role in their projects, with the intention of developing products that match users' needs and preferences. This approach is

  11. Writing Centre Tutoring Sessions: Addressing Students' Concerns

    Science.gov (United States)

    Winder, Roger; Kathpalia, Sujata S.; Koo, Swit Ling

    2016-01-01

    The guiding principle behind university writing centres is to focus on the process of writing rather than the finished product, prioritising higher order concerns related to organisation and argumentation of texts rather than lower order concerns of grammar and punctuation. Using survey-based data, this paper examines students' concerns regarding…

  12. Legal Counsel | IDRC - International Development Research Centre

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

    The Legal Counsel assists the Corporate Secretary and General Counsel in advising, and providing support to, Centre management and the Board of Governors on ... This involves providing strategic and tactical advice to, and working as an integral member of, IDRC negotiating teams on particular transactions towards:.

  13. Poison centre network saves lives | IDRC - International ...

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

    2010-10-27

    Oct 27, 2010 ... Snakebites, food poisoning, exposure to toxic chemicals: all are potentially fatal if the correct antidote isn't identified and applied — fast. Since 1988, INTOX, a computer-based program involving a global network of poison centres, has been providing those life-saving capabilities in minutes.

  14. User account | IDRC - International Development Research Centre

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

    Log in(active tab) · Request new password. Username *. Enter your IDRC - International Development Research Centre username. Password *. Enter the password that accompanies your username. IDRC Login (for IDRC staff / team members only) · What we do · Funding · Resources · About IDRC. Knowledge. Innovation.

  15. The young centre of the Earth

    DEFF Research Database (Denmark)

    Uggerhøj, Ulrik Ingerslev; Mikkelsen, Rune E.; Faye, Jan

    2016-01-01

    We treat, as an illustrative example of gravitational time dilation in relativity, the observation that the centre of the Earth is younger than the surface by an appreciable amount. Richard Feynman first made this insightful point and presented an estimate of the size of the effect in a talk...

  16. Flexible Processes in Project-Centred Learning

    NARCIS (Netherlands)

    Ceri, Stefano; Matera, Maristella; Raffio, Alessandro; Spoelstra, Howard

    2007-01-01

    Ceri, S., Matera, M., Raffio, A. & Spoelstra, H. (2007). Flexible Processes in Project-Centred Learning. In E. Duval, R. Klamma, and M. Wolpers (Eds.), European Conference on Technology Enhanced Learning, Lecture Notes in Computer Science, Vol. 4753, pp. 463-468. Berlin Heidelberg: Springer-Verlag

  17. Crystallographic Data Centre Services and Publications.

    Science.gov (United States)

    Cambridge Univ. (England). Chemical Lab.

    The Cambridge Crystallographic Data Centre is concerned with the retrieval, evaluation, synthesis, and dissemination of structural data based on diffraction methods. The source of input is almost entirely primary journals. Bibliographic information and numeric data on crystal and molecular structures are on magnetic tapes. The bibliographic file…

  18. The Australian Centre for Minesite Rehabilitation Research

    International Nuclear Information System (INIS)

    Bell, L.C.

    1994-01-01

    The Australian Centre for Minesite Rehabilitation Research (ACMRR) is a joint venture between the Australian mining industry through the Australian Mineral Industries Research Association Ltd. (AMIRA) and three of the organizations working most actively in this area in Australia: CSIRO Minesite Rehabilitation Research Program; University of Queensland Centre for Mined Land Rehabilitation; and Curtin University Mulga Research Centre. The ACMRR was established in July 1993 to provide a national framework to conduct Strategic Research into minesite rehabilitation. It is an industry led and funded initiative. The Goals of the Centre include: to conduct strategic research into minesite rehabilitation to provide sustainable environmental solutions which are acceptable to industry, government and the community; to be recognized as a center of excellence undertaking commissioned research on minesite rehabilitation in an independent and thorough manner; to provide scientific and technological foundations to facilitate industry and government in setting acceptable standards; to act as networking and communications focus; and to enhance education and training in minesite rehabilitation. Strategic Research Programs in: Water Systems--downstream surface and groundwater quality; Land--the long-term behavior and stability of constructed landforms; Ecosystems--the long-term sustainability of constructed landforms; Waste--the long-term treatment and disposal of waste products; will allow the ACMRR to achieve these goals through specific research projects in these areas, developed with industry sponsors. This paper will discuss their progress to date, research projects underway, and plans for the future

  19. Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre

    International Nuclear Information System (INIS)

    Kildea, John; Hijal, Tarek

    2016-01-01

    We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.

  20. Medical Abortion.

    Science.gov (United States)

    Costescu, Dustin; Guilbert, Edith; Bernardin, Jeanne; Black, Amanda; Dunn, Sheila; Fitzsimmons, Brian; Norman, Wendy V; Pymar, Helen; Soon, Judith; Trouton, Konia; Wagner, Marie-Soleil; Wiebe, Ellen; Gold, Karen; Murray, Marie-Ève; Winikoff, Beverly; Reeves, Matthew

    2016-04-01

    This guideline reviews the evidence relating to the provision of first-trimester medical induced abortion, including patient eligibility, counselling, and consent; evidence-based regimens; and special considerations for clinicians providing medical abortion care. Gynaecologists, family physicians, registered nurses, midwives, residents, and other healthcare providers who currently or intend to provide pregnancy options counselling, medical abortion care, or family planning services. Women with an unintended first trimester pregnancy. Published literature was retrieved through searches of PubMed, MEDLINE, and Cochrane Library between July 2015 and November 2015 using appropriately controlled vocabulary (MeSH search terms: Induced Abortion, Medical Abortion, Mifepristone, Misoprostol, Methotrexate). Results were restricted to systematic reviews, randomized controlled trials, clinical trials, and observational studies published from June 1986 to November 2015 in English. Additionally, existing guidelines from other countries were consulted for review. A grey literature search was not required. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force for Preventive Medicine rating scale (Table 1). Medical abortion is safe and effective. Complications from medical abortion are rare. Access and costs will be dependent on provincial and territorial funding for combination mifepristone/misoprostol and provider availability. Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.