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Sample records for preventive medicine department

  1. Reflections on preventive medicine.

    Science.gov (United States)

    Miettinen, Olli S

    2014-10-01

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

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

    Science.gov (United States)

    Barker, William H., Ed.

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

  3. Integrative Medicine in Preventive Medicine Education

    OpenAIRE

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

    2015-01-01

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

  4. Security in the nuclear medicine department

    International Nuclear Information System (INIS)

    Bassingham, S.; Gane, J.; Chan, P.S.; Heenan, S.; Gulliver, N.; McVey, J.

    2005-01-01

    The current threat from terrorism highlights the need for awareness of adequate security of radioactive sources by health bodies to prevent the opportunistic access to, theft of. or accidental loss of sources, together with stringent security measures in place to prevent the international misuse of radioactive sources as a weapon by unauthorised access. This presentation discusses the processes undertaken to ensure the safety and security of radioactive materials within the nuclear medicine department in line with current regulations and guidelines. These include risk assessments, security systems, audit trails, restricted access and personnel background checks

  5. Teleophthalmology in preventive medicine

    CERN Document Server

    Michelson, Georg

    2014-01-01

    This book provides an up-to-date overview of the clinical applications, methods, and technologies of teleophthalmology within the field of preventive medicine. The ability of novel methods to detect the initial signs of neurodegenerative diseases on the basis of alterations in the retina is reviewed, and detailed attention is paid to the role of teleophthalmology in screening for vision-threatening diseases such as diabetic retinopathy, glaucoma, and age-related macular degeneration. A major part of the book is devoted to novel imaging methods and the latest information technologies, including advanced mobile communication and Web 2.0 applications in teleophthalmology. In addition, the initial projects of an interdisciplinary cooperation in preventive medicine are described. All of the authors are experienced in the scientific and practical aspects of teleophthalmology, including e-learning, and have produced a book that will meet the needs of all medical care providers interested in using teleophthalmology.

  6. Integrative Medicine in Preventive Medicine Education

    Science.gov (United States)

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

    2016-01-01

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

  7. Essentials of periodontal medicine in preventive medicine.

    Science.gov (United States)

    Gulati, Minkle; Anand, Vishal; Jain, Nikil; Anand, Bhargavi; Bahuguna, Rohit; Govila, Vivek; Rastogi, Pavitra

    2013-09-01

    Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer's disease, gastrointestinal disease, prostatitis, renal diseases, which has also been scientifically validated. This side of the oral-systemic link has been termed Periodontal Medicine and is potentially of great public health significance, as periodontal disease is largely preventable and in many instances readily treatable, hence, providing many new opportunities for preventing and improving prognosis of several systemic pathologic conditions. This review article highlights the importance of prevention and treatment of periodontal diseases as an essential part of preventive medicine to circumvent its deleterious effects on general health.

  8. Essentials of periodontal medicine in preventive medicine

    Directory of Open Access Journals (Sweden)

    Minkle Gulati

    2013-01-01

    Full Text Available Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer′s disease, gastrointestinal disease, prostatitis, renal diseases, which has also been scientifically validated. This side of the oral-systemic link has been termed Periodontal Medicine and is potentially of great public health significance, as periodontal disease is largely preventable and in many instances readily treatable, hence, providing many new opportunities for preventing and improving prognosis of several systemic pathologic conditions. This review article highlights the importance of prevention and treatment of periodontal diseases as an essential part of preventive medicine to circumvent its deleterious effects on general health.

  9. Radiopharmaceutical prescription in nuclear medicine departments

    International Nuclear Information System (INIS)

    Biechlin-Chassel, M.L.; Lao, S.; Bolot, C.; Francois-Joubert, A.

    2010-01-01

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

  10. Medical Services: Preventive Medicine

    Science.gov (United States)

    1990-10-15

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

  11. Routine dosimetry in a nuclear medicine department

    International Nuclear Information System (INIS)

    Dreuille, O. de; Carbonieres, H. de; Briand-Champlong, J.; Foehrenbach, H.; Guevel, E.; Maserlin, P.; Gaillard, J.F.; Treguier, J.Y.

    2002-01-01

    The nuclear medicine department of the Val de Grace Hospital, in cooperation with the Radiological Protection Army Service, has performed an evaluation of the staff's radio-exposure based on routine dosimetry for six months. The most exposed people are the technicians (2.6 mSv/yr) and the nurse (1.7 mS/yr). The nuclear medicine physicians (0.6 mSv/yr) and the secretaries (0.07 mSv/yr) are far less exposed. The most irradiant occupations are the preparation and the injection of the radiopharmaceuticals (18 mSv/dy) and the realization of the Positron Emission Tomography examinations (19 mSv/dy). The increasing number of PET exams and the development of new tomographs, requiring higher activities, will still increase the exposition level of this working post. This study demonstrates that the exposition doses in nuclear medicine are low compared to the regular limits. Based on these results, only the technicians and the nurse are relevant to the A class. However, these dose levels cannot be neglected for particular positions such as the injection and the PET management. (author)

  12. Teaching Prevention in Internal Medicine Clerkships.

    Science.gov (United States)

    Kinsinger, Linda

    2000-01-01

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

  13. Emergency department discharge prescription interventions by emergency medicine pharmacists.

    Science.gov (United States)

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

    2013-02-01

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

  14. Nosocomial Infections in Nuclear Medicine Departments: some considerations

    International Nuclear Information System (INIS)

    Metello, L.F.; Cunha, L.; Martins, M.; Isabel, O.; Ribeiro, G.

    2002-01-01

    Aim: Surveillance for Nosocomial Infection has become an integral part of hospital practice. Studies conducted more than 30 years ago by the Centers for Disease Control and Prevention (CDC) documented the efficacy of these surveillance activities in reducing Nosocomial Infection occurrence. It is clear that surveillance for Nosocomial Infection involves more than just documenting infection rates. However, many times the professionals involved have tended to stop at the point where rates are reported and fail to complete the task of implementing changes based on the analysis of rates or disseminating information. Moreover specific documentation regarding Nuclear Medicine Departments is not available. We therefore decided to produce this work based in the recognition of this specific need. Methods and Conclusions: Having previously defined the 'state-of-the-art' from science and technology concerning Nosocomial Infection Control and after particular study regarding technical/clinical reality of Nuclear Medicine Departments, namely introducing the radioactivity as a factor that must be taken into account with all its implications and interactions, we have obtained a group of considerations and/or recommendations to be considered in order to accomplish the maximum Quality and Efficiency regarding the Control of Nosocomial Infection in Nuclear Medicine Departments

  15. THE STRUCTURE AND FUNCTION OF DEPARTMENTS OF MEDICINE.

    Science.gov (United States)

    Landefeld, C Seth

    2016-01-01

    The structure and function of departments of medicine are important for several reasons. First, departments of medicine are the biggest departments in virtually every medical school and in most universities with a medical school, and they are the largest professional units in most academic medical centers. In fact, Petersdorf described them as "the linchpins of medical schools" (1). Departments of medicine account for one-fourth or more of the academic medical enterprise: they include about one-fourth of the faculty of medical school, account for roughly one-fourth of the patient care and clinical revenue of academic medical centers, and their faculty perform a disproportionate share of teaching and research, accounting for up to 45% of National Institutes of Health (NIH) - funded research in some medical schools. Second, the department's ability to fulfill its role and advance its mission depends on its structure and function. Finally, lessons learned from examining the structure and function of departments of medicine may guide other departments and schools of medicine themselves in improving their structure and function. This paper describes the issues that face departments of medicine in 2016. I begin by providing the context for these issues with a definition of a department of medicine, describing briefly the history of departments, and stating their mission.

  16. Behavioral Medicine and University Departments of Family Practice

    OpenAIRE

    Grantham, Peter

    1983-01-01

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

  17. Fall prevention strategy in an emergency department.

    Science.gov (United States)

    Muray, Mwali; Bélanger, Charles H; Razmak, Jamil

    2018-02-12

    Purpose The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services. Design/methodology/approach The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ 2 analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables. Findings In total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool. Originality/value Canadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care.

  18. Preventive evolutionary medicine of cancers.

    Science.gov (United States)

    Hochberg, Michael E; Thomas, Frédéric; Assenat, Eric; Hibner, Urszula

    2013-01-01

    Evolutionary theory predicts that once an individual reaches an age of sufficiently low Darwinian fitness, (s)he will have reduced chances of keeping cancerous lesions in check. While we clearly need to better understand the emergence of precursor states and early malignancies as well as their mitigation by the microenvironment and tissue architecture, we argue that lifestyle changes and preventive therapies based in an evolutionary framework, applied to identified high-risk populations before incipient neoplasms become clinically detectable and chemoresistant lineages emerge, are currently the most reliable way to control or eliminate early tumours. Specifically, the relatively low levels of (epi)genetic heterogeneity characteristic of many if not most incipient lesions will mean a relatively limited set of possible adaptive traits and associated costs compared to more advanced cancers, and thus a more complete and predictable understanding of treatment options and outcomes. We propose a conceptual model for preventive treatments and discuss the many associated challenges.

  19. Change, Challenge and Opportunity: Departments of Medicine and Their Leaders.

    Science.gov (United States)

    Feussner, John R; Landefeld, C Seth; Weinberger, Steven E

    2016-01-01

    Academic Health Centers are evolving to larger and more complex Academic Health Systems (AHS), reflecting financial stresses requiring them to become nimble, efficient, and patient (consumer) and faculty (employee) focused. The evolving AHS organization includes many positive attributes: unity of purpose, structural integration, collaboration and teamwork, alignment of goals with resource allocation, and increased financial success. The organization, leadership, and business acumen of the AHS influence directly opportunities for Departments of Medicine. Just as leadership capabilities of the AHS affect its future success, the same is true for departmental leadership. The Department of Medicine is no longer a quasi- autonomous entity, and the chairperson is no longer an independent decision-maker. Departments of Medicine will be most successful if they maintain internal unity and cohesion by not fragmenting along specialty lines. Departments with larger endowments or those with public financial support have more flexibility when investing in the academic missions. The chairpersons of the future should serve as change agents while simultaneously adopting a "servant leadership" model. Chairpersons with executive and team building skills, and business acumen and experience, are more likely to succeed in managing productive and lean departments. Quality of patient care and service delivery enhance the department's effectiveness and credibility and assure access to additional financial resources to subsidize the academic missions. Moreover, the drive for excellence, high performance and growth will fuel financial solvency. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  20. The liquidation of liquid radioactive waste on nuclear medicine departments

    International Nuclear Information System (INIS)

    Fueriova, A.

    1995-01-01

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

  1. The liquidation of liquid radioactive waste on nuclear medicine departments

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-12-31

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

  2. Radioprotection in nuclear medicine department of 'Porto Alegre Clinical Hospital'

    International Nuclear Information System (INIS)

    Dias, T.M.; Pinto, A.L.; Bacelar, A.L.; Dytz, A.S.; Bernasiuk, M.E.; Baptista, I.S.

    1996-01-01

    The use of ionizing radiation in medicine allows great benefits. Nuclear Medicine uses ionizing radiation for medical diagnostic, such as: tumor, cancer, and dysfunctions location. However the use of ionizing radiation must be controlled in order to avoid likely biological effects in human beings. In order to extremely minimize that these effects appear, the Medical Physics Department of the Porto Alegre Clinical Hospital has implemented some procedures to assure that handling and use of radioactive material are in a safe way. This preoccupation is considered in all the places of nuclear medicine sector since the moment when the radioactive material is brought into including its manipulation and retirement, the exam process being accompanied. (authors). 4 refs

  3. Reduction of doses to staff in a nuclear medicine department

    International Nuclear Information System (INIS)

    Van Every, B.

    1982-01-01

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

  4. Internal Contamination by 131I in nuclear medicine department

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  5. Digital nuclear medicine department: Is a filmless environment conceivable?

    International Nuclear Information System (INIS)

    Hacker, M.; Bauerschaper, B.; Dresel, S.; Weiss, M.; Heiss, D.; Hahn, K.; Muenchen Univ.

    2000-01-01

    Recent hardware improvements, the installation and development of fast networks and new technologies for storage of large data volumes all contribute to the propagation of digital reading and reporting of nuclear medicine studies. Thus, the vision of a fully digitized nuclear medicine department becomes reality. The high costs of purchasing hardware- and software-components are compensated by saving costs of films and by the improvement of the work flow in the long run. Independently from these issues, filmless reporting proves to be advantageous over conventional film reading in many facts that justify to switch to a digital department. Problems that occur in the process of becoming film-free are mainly based on compatibility issues and demand strong cooperation between the user and the manufacturer of the imaging devices in order to integrate all systems into one reading and reporting tool. The departments of nuclear medicine and radiology of the University of Munich, Innenstadt, now are reviewing a one-year process of being film-free, which makes a return to conventional film reading unconceivable. (orig.) [de

  6. Evaluation of radiation protection in some nuclear medicine department

    International Nuclear Information System (INIS)

    Abdelrahim, Yassir Mohammed

    2015-12-01

    This study was carryout to evaluate the radiation protection in nuclear medicine department in Sudan, accordance with the standards international recommendation and code of practice for radiation protection in nuclear medicine, the evaluation was done for three nuclear medicine departments, included direct measurement of dose rate and the contamination level in some areas, were radiation sources, radiation workers and public are involved. The data was collected and analyzed from the results for three nuclear medicine departments that the average reading of ambient dose rate in : outside the door of imaging room (SPECT) 0.18μSv/h in hospital (1)& and 0.19μSv/h in hospital(2) and 0.19μSv/h hospital(3), inside control of imaging room (SPECT) 27.8μSv/h in hospital(1)& 0.14μSv/h in hospital(2)& 14μSv/h in hospital(3), inside the injection room 28.81μSv/h in hospital(1), 0.36μSv/h in hpspital(2), 0.06μSv/h in hospital(3) outside the door of lap, 0.65μSv/h in hospital(1), 0.13μSv/h in hospital(2) & 0.12μSv/h in hospital(3), inside the hot lap, 9.68μSv/h in hospital(1) & 0.30μSv/h in hospital(2) & 0.85 μSv/h in hospital(3), in outsidee the door of waiting room of injected patient 1.41μSv/h in hospital(1)& 0.16μSv/h in hospital(2) & 1.08μSv/h in hospital(3). Avaerge reading of contamination in: Floor of hot lap 44.50 B/cm"2 hospital(1) & 4.42B/cm"2in hospital(2) & 6.22 B/cm"2 in hospital (3) . on the bench tap 186.30 B/cm"2 hospital(1), 19.91 B/cm"2 in hospital(2) & 8.77B/cm"2 in hospital(3) floor of injection room 12.60 B/cm"2 in hospital(1) & 11.70 B/cm"2 in hospital(2) & 13.73 B/cm"2 hospital(3) & table of injection room 13.00 B/cm"2 in hospital(1)& 11.70 B/cm"2in hospital(2)& 13.73 B/cm"2 in hospital & tble of injection room 13.00 B/cm"2 in hospital(1) & 20.40 B/cm"2 in hospital(2) & 23.23 B/cm"2 B/cm"2 in hospital(3) on the shield of working surface 144.30 B/cm in hospital(1)& 47.00 B/cm"2 in hospital(2) & 52.33 B/cm"2 in hospital(3) , and makes check

  7. The medical physicist in a nuclear medicine department

    International Nuclear Information System (INIS)

    Trujillo Z, F.E.; Gomez A, E.

    2007-01-01

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

  8. Complementary and alternative medicine use among paediatric emergency department patients.

    Science.gov (United States)

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

    2015-09-01

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

  9. The Emergency Department: Challenges and Opportunities for Suicide Prevention.

    Science.gov (United States)

    Asarnow, Joan Rosenbaum; Babeva, Kalina; Horstmann, Elizabeth

    2017-10-01

    Emergency departments (EDs) can offer life-saving suicide prevention care. This article focuses on the ED and emergency services as service delivery sites for suicide prevention. Characteristics of EDs, models of emergency care, ED screening and brief intervention models, and practice guidelines and parameters are reviewed. A care process model for youths at risk for suicide and self-harm is presented, with guidance for clinicians based on the scientific evidence. Strengthening emergency infrastructure and integrating effective suicide prevention strategies derived from scientific research are critical for advancing suicide prevention objectives. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Magistral preparation in nuclear medicine departments: Requirements for their realization

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  11. Mortality risk factors during readmission at the Department of Medicine.

    Science.gov (United States)

    Trakulthong, Chayanis; Phunmanee, Anakapong

    2017-01-01

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

  12. Use of Standard Guidelines for Department of Medicine Summary Letters.

    Science.gov (United States)

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

    2018-04-12

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

  13. Mentorship in an academic department of family medicine.

    Science.gov (United States)

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

    2014-01-01

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

  14. The design of a purpose-built nuclear medicine department

    International Nuclear Information System (INIS)

    Dixon, J.; Walker, B.

    1999-01-01

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

  15. Emergency department operations and management education in emergency medicine training

    Institute of Scientific and Technical Information of China (English)

    Bret A Nicks; Darrell Nelson

    2012-01-01

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

  16. Occupational radiation exposure in nuclear medicine department in Kuwait

    Science.gov (United States)

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

    2017-11-01

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

  17. Information resources for US Department of Energy pollution prevention programs

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, K.L.; Snowden-Swan, L.J.; Butner, R.S.

    1994-01-01

    In support of the US Department of Energy`s (DOE`s) pollution prevention efforts being conducted under the aegis of DOE`s Office of Environmental Restoration and Waste Management (EM) program, Pacific Northwest Laboratory was tasked with evaluating pollution prevention information resources. The goal of this activity was to improve the effectiveness of DOE`s pollution prevention activities through improved information flow, both within the complex, and more specifically, between DOE and other organizations that share similar pollution prevention challenges. This report presents our findings with respect to the role of information collection and dissemination within the complex, opportunities for teaming from successes of the private sector, and specific information needs of the DOE pollution prevention community. These findings were derived from a series of interviews with pollution prevention coordinators from across the DOE complex, review of DOE site and facility pollution prevention plans, and workshops with DOE information users as well as an information resources workshop that brought together information specialists from private industry, non-profit organizations, as well as state and regional pollution prevention assistance programs.

  18. Preliminary program evaluation of emergency department HIV prevention counseling.

    Science.gov (United States)

    Sitlinger, Andrea P; Lindsell, Christopher J; Ruffner, Andrew H; Wayne, D Beth; Hart, Kimberly W; Trott, Alexander T; Fichtenbaum, Carl J; Lyons, Michael S

    2011-07-01

    Controversy surrounds the linkage of prevention counseling with emergency department (ED)-based HIV testing. Further, the effectiveness and feasibility of prevention counseling in the ED setting is unknown. We investigate these issues by conducting a preliminarily exploration of several related aspects of our ED's HIV prevention counseling and testing program. Our urban, academic ED provides formal client-centered prevention counseling in conjunction with HIV testing. Five descriptive, exploratory observations were conducted, involving surveys and analysis of electronic medical records and programmatic data focused on (1) patient perception and feasibility of prevention counseling in the ED, (2) patient perceptions of the need to link prevention counseling with testing, and (3) potential effectiveness of providing prevention counseling in conjunction with ED-based HIV testing. Of 110 ED patients surveyed after prevention counseling and testing, 98% believed privacy was adequate, and 97% reported that their questions were answered. Patients stated that counseling would lead to improved health (80%), behavioral changes (72%), follow-up testing (77%), and discussion with partners (74%). However, 89% would accept testing without counseling, 32% were willing to seek counseling elsewhere, and 26% preferred not to receive the counseling. Correct responses to a 16-question knowledge quiz increased by 1.6 after counseling (95% confidence interval 1.3 to 12.0). The program completed counseling for 97% of patients tested; however, 6% of patients had difficulty recalling the encounter and 13% denied received testing. Among patients undergoing repeated testing, there was no consistent change in self-reported risk behaviors. Participants in the ED prevention counseling and testing program considered counseling acceptable and useful, though not required. Given adequate resources, prevention counseling can be provided in the ED, but it is unlikely that all patients benefit

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Haq Nawaz

    2016-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Management of Pneumothorax in Emergency Medicine Departments: Multicenter Trial

    Science.gov (United States)

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

    2013-01-01

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

  3. Obesity Prevention: The Impact of Local Health Departments

    Science.gov (United States)

    Chen, Zhuo (Adam); Roy, Kakoli; Gotway Crawford, Carol A

    2013-01-01

    Objective To examine the association between bodyweight status and provision of population-based prevention services. Data Sources The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2004 and 2005. Study Design Multilevel logistic regressions were used to examine the association between provision of obesity-prevention services and the change in risk of being obese or morbidly obese among BRFSS respondents. The estimation sample was stratified by sex. Low-income samples were also examined. Falsification tests were used to determine whether there is counterevidence. Principal Findings Provision of population-based obesity-prevention services within the jurisdiction of local health departments and specifically those provided by the local health departments are associated with reduced risks of obesity and morbid obesity from 2004 to 2005. The magnitude of the association appears to be stronger among low-income populations and among women. Results of the falsification tests provide additional support of the main findings. Conclusions Population-based obesity-prevention services may be useful in containing the obesity epidemic. PMID:22816510

  4. Factors affecting patients’ satisfaction in nuclear medicine department in Egypt

    Directory of Open Access Journals (Sweden)

    Maged Abdel Galil Hamed

    2014-03-01

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

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

    Science.gov (United States)

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

    2001-01-01

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

  6. Cancer Prevention in the Precision Medicine Era

    Science.gov (United States)

    Dr. Rebbeck’s research focuses on the etiology and prevention of cancer, with an emphasis on cancers with a genetic etiology and those that are associated with disparities in incidence or mortality by race. He has directed multiple large molecular epidemiologic studies and international consortia that have been used to identify and characterize genes involved in cancer etiology, understand the relationship of allelic variation with biochemical or physiological traits, explore interactions of inherited and somatic genomic variation with epidemiological risk factors. His research also focuses on the roles of biological and social factors on prostate cancer disparities and prostate cancer in Africa through the Men of African Descent and Carcinoma of the Prostate (MADCaP) consortium. He has also led a number of consortia that study carriers of BRCA1 or BRCA2 mutations to understand breast, ovarian, and prostate cancer risk and precision prevention interventions that may reduce that risk. In addition to his research activities, Dr. Rebbeck leads a number of initiatives on the Harvard Campus. He serves as Associate Director for Equity and Engagement in the Dana-Farber / Harvard Cancer Center and Co-Director for the Collective Impact Program of Harvard Catalyst. In this role, he prioritizes the cancer research agenda to maximize disease prevention and risk reduction in Massachusetts. He also oversees a team charged with ensuring that this research engages with and positively impacts communities with the greatest disease burden.  As Director of Global Oncology at the Dana Farber Cancer Institute, Dr. Rebbeck oversees formal and informal training and research partnerships between Dana Farber investigators and trainees with international partners.

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

    Science.gov (United States)

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

    2017-02-01

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

  8. Nuclear medicine. The management of patients coming out of a nuclear medicine department - Radiation protection sheet ED 4242

    International Nuclear Information System (INIS)

    2006-03-01

    This sheet aims at providing elements for the preparation of the management of a patient by a department or unit other than a nuclear medicine department after this patient has been submitted to an examination or treatment involving the use of radionuclides in unsealed sources, as this exposure may result in an internal or external exposure risk for the personnel, other persons and relatives. It briefly describes the modalities of performance of nuclear medicine act, the modalities of information of patients and of their relatives, indicates instructions to departments hosting the patient (instruction regarding the patient and wastes), and instructions for pregnant or breast feeding women

  9. Cancer Prevention in the Precision Medicine Era | Division of Cancer Prevention

    Science.gov (United States)

    Speaker | Timothy R. Rebbeck, PhD will present "Cancer Prevention in the Precision Medicine Era" on March 20, 2018, from 11:00 am - 12:00 pm at the NCI Shady Grove Campus. Learn more about this lecture.

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

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

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

    Science.gov (United States)

    Jung, Joon Young

    2012-12-01

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

  12. Operational measurements during medical examinations: nuclear medicine department

    International Nuclear Information System (INIS)

    Gardin, I.

    2009-01-01

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

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

    International Nuclear Information System (INIS)

    Legras, B.; Kohler, F.

    1984-01-01

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

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

    Science.gov (United States)

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

    2015-06-09

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

  15. Violence prevention education program for psychiatric outpatient departments.

    Science.gov (United States)

    Feinstein, Robert E

    2014-10-01

    Approximately 40 % of psychiatrists and up to 64 % of psychiatric residents have been physically assaulted. Ranges of 72-96 % of psychiatric residents in various studies have been verbally threatened. As violence risk occurs in outpatient settings, our department developed a quality and safety curriculum designed to prepare psychiatric residents and staff to optimally respond to aggressive outpatients and violence threats or events. In 2011 and 2012, we offered an 8-part violence prevention performance improvement curriculum/program including (1) situational awareness/creating a safe environment; (2) violence de-escalation training; (3) violence risk assessment training, use of risk assessment tools, and medical record documentation; (4) violence safety discharge planning; (5) legal issues and violence; (6) "shots fired on campus" video/discussion; (7) "2011 violence threat simulation" video/discussion; and (8) violence threat simulation exercise. This program was offered to approximately 60 psychiatric residents/staff in each year. We obtained qualitative comments about the entire program and data from 2 years of post-event surveys on the usefulness of the "violence threat simulation exercise." The large majority of comments about program elements 1 to 7 were positive. In 2011 and 2012, respectively, 76 and 86 % of participants responded to a post-event survey of the violence threat simulation exercise; 90 and 88 % of participants, respectively, reported the simulation to be very helpful/somewhat helpful; and 86 and 82 % of participants, respectively, reported feeling much better/better prepared to deal with a violent event. Although some participants experienced anxiety, sleep disturbances, increase in work safety concerns, and/or traumatic memories, the majority reported no post-simulation symptoms (72 and 80 %, respectively). Although we are unable to demonstrate that this program effectively prevents violence, the overall positive response from participants

  16. 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.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  18. [Prevention of soil deterioration during cultivation of medicinal plants].

    Science.gov (United States)

    Guo, Lan-ping; Huang, Lu-qi; Jiang, You-xu; Lv, Dong-mei

    2006-05-01

    This paper summarized the aspects of the soil deterioration due to continuous growth of medicinal plants, such as nutrition insufficient, pH variation, harmful salt accumulating, harmful microbe and allelopathic substance increasing, soil physics and chemistry properties variation. And the ways to prevent and rehabilitate the deteriorated soil was indicated, which included anti-adversity species selecting, scientific management such as whorl cropping, nutrient elements supplement, usage of physical methods, nutrient liquid cultivating and VAM inoculating etc.

  19. Study of Scientific Production of Community Medicines' Department Indexed in ISI Citation Databases.

    Science.gov (United States)

    Khademloo, Mohammad; Khaseh, Ali Akbar; Siamian, Hasan; Aligolbandi, Kobra; Latifi, Mahsoomeh; Yaminfirooz, Mousa

    2016-10-01

    In the scientometric, the main criterion in determining the scientific position and ranking of the scientific centers, particularly the universities, is the rate of scientific production and innovation, and in all participations in the global scientific development. One of the subjects more involved in repeatedly dealt with science and technology and effective on the improvement of health is medical science fields. In this research using scientometric and citation analysis, we studied the rate of scientific productions in the field of community medicine, which is the numbers of articles published and indexed in ISI database from 2000 to 2010. This study is scientometric using the survey and analytical citation. The study samples included all of the articles in the ISI database from 2000 to 2010. For the data collection, the advance method of searching was used at the ISI database. The ISI analyses software and descriptive statistics were used for data analysis. Results showed that among the five top universities in producing documents, Tehran University of Medical Sciences with 88 (22.22%) documents are allocated to the first rank of scientific products. M. Askarian with 36 (90/9%) published documents; most of the scientific outputs in Community medicine, in the international arena is the most active author in this field. In collaboration with other writers, Iranian departments of Community Medicine with 27 published articles have the greatest participation with scholars of English authors. In the process of scientific outputs, the results showed that the scientific process was in its lowest in the years 2000 to 2004, and while the department of Community medicine in 2009 allocated most of the production process to itself. Iranian Journal of Public Health and Saudi Medical Journal each of them had 16 articles which had most participation rate in the publishing of community medicine's department. On the type of carrier, community medicine's department by

  20. Transforming Cancer Prevention through Precision Medicine and Immune-oncology.

    Science.gov (United States)

    Kensler, Thomas W; Spira, Avrum; Garber, Judy E; Szabo, Eva; Lee, J Jack; Dong, Zigang; Dannenberg, Andrew J; Hait, William N; Blackburn, Elizabeth; Davidson, Nancy E; Foti, Margaret; Lippman, Scott M

    2016-01-01

    We have entered a transformative period in cancer prevention (including early detection). Remarkable progress in precision medicine and immune-oncology, driven by extraordinary recent advances in genome-wide sequencing, big-data analytics, blood-based technologies, and deep understanding of the tumor immune microenvironment (TME), has provided unprecedented possibilities to study the biology of premalignancy. The pace of research and discovery in precision medicine and immunoprevention has been astonishing and includes the following clinical firsts reported in 2015: driver mutations detected in circulating cell-free DNA in patients with premalignant lesions (lung); clonal hematopoiesis shown to be a premalignant state; molecular selection in chemoprevention randomized controlled trial (RCT; oral); striking efficacy in RCT of combination chemoprevention targeting signaling pathway alterations mechanistically linked to germline mutation (duodenum); molecular markers for early detection validated for lung cancer and showing promise for pancreatic, liver, and ovarian cancer. Identification of HPV as the essential cause of a major global cancer burden, including HPV16 as the single driver of an epidemic of oropharyngeal cancer in men, provides unique opportunities for the dissemination and implementation of public health interventions. Important to immunoprevention beyond viral vaccines, genetic drivers of premalignant progression were associated with increasing immunosuppressive TME; and Kras vaccine efficacy in pancreas genetically engineered mouse (GEM) model required an inhibitory adjuvant (Treg depletion). In addition to developing new (e.g., epigenetic) TME regulators, recent mechanistic studies of repurposed drugs (aspirin, metformin, and tamoxifen) have identified potent immune activity. Just as precision medicine and immune-oncology are revolutionizing cancer therapy, these approaches are transforming cancer prevention. Here, we set out a brief agenda for the

  1. A scientific model to determine the optimal radiographer staffing component in a nuclear medicine department

    International Nuclear Information System (INIS)

    Shipanga, A.N.; Ellmann, A.

    2004-01-01

    Full text: Introduction: Nuclear medicine in South Africa is developing fast. Much has changed since the constitution of a scientific model for determining an optimum number of radiographer posts in a Nuclear Medicine department in the late 1980's. Aim: The aim of this study was to ascertain whether the number of radiographers required by a Nuclear Medicine department can still be determined according to the norms established in 1988. Methods: A quantitative study using non-experimental evaluation design was conducted to determine the ratios between current radiographer workload and staffing norms. The workload ratios were analysed using the procedures statistics of the Nuclear Medicine department at Tygerberg Hospital. Radiographers provided data about their activities related to patient procedures, including information about the condition of the patients, activities in the radiopharmaceutical laboratory, and patient related administrative tasks. These were factored into an equation relating this data to working hours, including vacation and sick leave. The calculation of Activity Standards and an annual Standard Workload was used to finally calculate the staffing requirements for a Nuclear Medicine department. Results: Preliminary data confirmed that old staffing norms cannot be used in a modern Nuclear Medicine department. Protocols for several types of study have changed, including the additional acquisition of tomographic studies. Interest in the use of time-consuming non-imaging studies has been revived and should be factored Into the equation. Conclusions: All Nuclear Medicine departments In South Africa, where the types of studies performed have changed over the past years, should look carefully at their radiographer staffing ratio to ascertain whether the number of radiographers needed is adequate for the current workload. (author)

  2. Difficult airway equipment in departments of emergency medicine in Ireland: results of a national survey.

    LENUS (Irish Health Repository)

    Walsh, K

    2012-02-03

    BACKGROUND AND OBJECTIVE: Adverse effects associated with difficult airway management can be catastrophic and include death, brain injury and myocardial injury. Closed-malpractice claims have shown prolonged and persistent attempts at endotracheal intubation to be the most common situation leading to disastrous respiratory events. To date, there has been no evaluation of the types of difficult airway equipment currently available in Irish departments of emergency medicine. The objective of this survey was to identify the difficult airway equipment available in Irish departments of emergency medicine. METHODS: Departments of emergency medicine in the Republic of Ireland with at least one dedicated Emergency Medicine consultant were surveyed via telephone. RESULTS: All of the departments contacted held at least one alternative device on site for both ventilation and intubation. The most common alternative ventilation device was the laryngeal mask airway (89%). The most common alternative intubating device was the surgical airway device (100%). CONCLUSIONS: Irish departments of emergency medicine compare well with those in the UK and USA, when surveyed concerning difficult airway equipment. However, we believe that this situation could be further improved by training inexperienced healthcare providers in the use of the laryngeal mask airway and intubating laryngeal mask airway, by placing greater emphasis on the ready availability of capnography and by the increased use of portable difficult airway storage units.

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

    Directory of Open Access Journals (Sweden)

    Juan E Corral

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

  4. Application of Balance Score Card (BSC) in a Nuclear Medicine Department

    International Nuclear Information System (INIS)

    Rayo, J.I.; Serrano, J.; Martin, R.; Corral, C.

    2002-01-01

    Balanced Scorecard (BSC) is a concept helping you translate strategy into action. BSC provides management with a comprehensive picture of business operations and a methodology that facilitates the communication and understanding of business goals and strategies at all levels of an organization. Traditional performance measurement, focusing on external accounting data, was quickly becoming obsolete and something more was needed to provide the information age enterprises with efficient planning tools, For this purpose Kaplan and Norton introduced four different perspectives. Aim: Application of BSC to a Nuclear Medicine Department for provides four perspectives: financial perspective, customer perspective, process perspective and learning and innovation perspective. Conclusion: BSC helps align key performance measures with strategy at all levels of a Nuclear Medicine Department, facilitates communication and understanding, provides feedback and learning and reduce the vast amount of information the Nuclear Medicine Department into essentials

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

    Science.gov (United States)

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

    2013-12-01

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

  6. [Quaternary prevention: An attempt to avoid the excesses of Medicine].

    Science.gov (United States)

    Noble, María

    2015-09-01

    Seduced by technology, biometrics, practical guidelines and the use of medication, medicine has been driven away from the subject of its care. Quaternary prevention is, among other voices around the world, trying to denounce the consequent excesses of medical practice given by this situation. There are visible excesses, such as the long list of studies being performed on patients without indication, and others, much more subtle, as excessive prevention and the continuous and progressive medicalization of life itself that are rooted in our culture and demanded by a society that requests certainty at almost any cost. Quaternary prevention proposes a series of actions leaning towards avoiding and diminishing the damage produced by health care activities, in order to protect the subject of overdiagnosis and overtreatment; offering also ethical and viable alternatives in which the balance of risks and benefits (based on the best evidences) respects the autonomy of the subject by properly informing and allowing him to decide among the best options he has; altogether in a process that contemplates a rational and equitable use of resources. In order to achieve this, reliable sources of information and a medical education not dependent on industries related to technology or pharmaceuticals, are vital; in conjuction with a medicine that restablishes the subject as its main and central interest.

  7. [The department of interdisciplinary emergency medicine: organization, structure and process optimization].

    Science.gov (United States)

    Bernhard, Michael; Pietsch, Christian; Gries, André

    2009-06-01

    The essential tasks of a department of interdisciplinary emergency medicine are the initial triage and assessment of vital function as well as the subsequent organization und initiation of emergency treatment. A previously defined set of diagnostic and therapeutic measures is carried out before the patient is allocated to an in-hospital clinical service and is admitted to a ward. Moreover, diagnosis and treatment for outpatients are performed. "Time" is a critical factor to be considered for all organizational and structural aspects of a department of interdisciplinary emergency medicine.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-03-01

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

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

    International Nuclear Information System (INIS)

    Komninos, C.; Roach, P.J.

    1998-01-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  11. Assimilating Traditional Healing Into Preventive Medicine Residency Curriculum.

    Science.gov (United States)

    Kesler, Denece O; Hopkins, L Olivia; Torres, Eliseo; Prasad, Arti

    2015-11-01

    Comprehensive cultural competency includes knowledge and awareness of culturally based healing and wellness practices. Healthcare providers should be aware of the individual patient's beliefs, culture, and use of culturally based health practices because patients may adopt such practices for general wellness or as adjunct therapies without the benefit of discussion with their healthcare provider. This article describes the culturally based traditional healing curriculum that has been implemented in the University of New Mexico Public Health and General Preventive Medicine Residency Program in order to fulfill this knowledge necessity. Curricular elements were added in a stepwise manner starting in 2011, with the full content as described implemented starting in 2013. Data were collected annually with evaluation of the full curriculum occurring in 2015. New Mexico has a diverse population base that includes predominantly Hispanic and Native American cultures, making the inclusion of curriculum regarding traditional healing practices very pertinent. Residents at the University of New Mexico were educated through several curricular components about topics such as Curanderismo, the art of Mexican Folk Healing. An innovative approach was used, with a compendium of training methods that included learning directly from traditional healers and participation in healing practices. The incorporation of this residency curriculum resulted in a means to produce physicians well trained in approaching patient care and population health with knowledge of culturally based health practices in order to facilitate healthy patients and communities. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  12. The practice and earnings of preventive medicine physicians.

    Science.gov (United States)

    Salive, M E

    1992-01-01

    A shortage of preventive medicine (PM) physicians exists in the United States. Researchers know little about these physicians' earnings and practice characteristics. The American College of Preventive Medicine (ACPM) mailed a survey to all self-identified PM physicians on the American Medical Association (AMA) Physician Masterfile. A total of 3,771 (54%) responded; respondents' sex and region of residence were typical for PM physicians in general, with a slight excess of older physicians and those reporting board certification. A total of 2,664 (71%) were working full time, with median earnings of $85,000 (mean $90,000). Among full-time physicians, relatively higher earnings were associated with the following characteristics: male sex; age 45 to 64 years; major source of income from clinical, business, or industrial sources, rather than governmental or academic; and PM board certification. Full-time PM physicians earned much less than office-based private practitioners in several primary care specialties in 1989. The gap in earnings between PM specialists in government positions and those in the private sector is also substantial. Both disparities may require creative solutions.

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

    Directory of Open Access Journals (Sweden)

    Shafe A.

    2016-09-01

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

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

    International Nuclear Information System (INIS)

    Goran Vuleta

    2007-01-01

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

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

    International Nuclear Information System (INIS)

    Cabral, Geovanna Oliveira de Mello

    2001-03-01

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

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

    International Nuclear Information System (INIS)

    Harding, L.K.

    1987-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Science.gov (United States)

    Hamasaki, Tomoko; Hagihara, Akihito

    2015-10-24

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

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

    Science.gov (United States)

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

    2017-08-01

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

  20. Application of medical psychology in the reception of nuclear medicine department

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  1. Nutritional aspects to prevent heart diseases in traditional Persian medicine.

    Science.gov (United States)

    Kordafshari, Gholamreza; Kenari, Hoorieh Mohammadi; Esfahani, Mohammad Mehdi; Ardakani, Mohammad Reza Shams; Keshavarz, Mansoor; Nazem, Esmaeil; Moghimi, Maryam; Zargaran, Arman

    2015-01-01

    Cardiovascular diseases are major health complications currently in various societies. Management of heart diseases as a prevention step or as treatment with low-cost procedures like lifestyle modifications including nutrition are important current trends. Although the term nutrition dates back to 2 past centuries, Persian physicians contributed to this term at least from 1000 years ago. Rhazes (865-925 AD) was one of the pioneers in this field. He preferred using foods in treating illnesses. "Foods and drinks" were 1 subject from 6 principles (Setteh Zarorieh) that Persian physicians believed can affect human health. In this review, we described some medieval Persian views on the role of nutrition in heart diseases and compare their prescriptions with current findings. Interestingly, current investigations mostly support Persian medicine principles. Historically, this work shows that the concept of nutrition in heart diseases has had a successful background at least from 1000 years ago in Persia. © The Author(s) 2014.

  2. Level of occupational exposure during daily work in a Nuclear Medicine Department

    Energy Technology Data Exchange (ETDEWEB)

    Schwarcke, Marcelo, E-mail: mschwarcke@usp.br [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Dept. de Fisica e Matematica; Ferreira, Nadya [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil). Dept. de Engenharia Nuclear; Cardoso, Domingos [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    Workers of the Nuclear Medicine Department have a very complex geometric exposition. The source of irradiation is not collimated and irradiated for all direction, the interaction with many structural tissue is inside the body before could be detected outside. The professional who works in a Nuclear Medicine Department is exposed to this condition and different energies. This work proposes a good approach to estimate the mensal dose level according to the dose rate during their daily routine. To measure the dose rate, a Babyline 81 ionization chamber was used, and the most frequent exams using {sup 99m}Tc were chosen. A previous study was conducted to determine the most frequent exams made in the Nuclear Medicine Department at the Central Army Hospital in Rio de Janeiro, and previous environment monitoring determine the places with higher exposure that could interfere in the measurement of this paper. The Renal scintigraphy with diethylenetriaminepentaacetic acid (DTPA) had an average dose rate of (2.50{+-}0.25) {mu}Sv/h; for the Renal scintigraphy with dimercaptosuccinic acid (DMSA), it was of (1.20{+-}0.25) {mu}Sv/h; for Bone scintigraphy using two different protocols, it was (2.63{+-}0.30) {mu}Sv/h and (3.09{+-}0.30) {mu}Sv/h. Exposition during elution, dose preparing and clinical procedure was considered a critical moment in the daily routine of the employee. The dose rate obtained in this study demonstrated that the professional cannot exceed the public dose limit in one day of his work routine. Therefore, for the Radioprotection Department, this is a good approach to make a radioprotection plan in the Nuclear Medicine Department. (author)

  3. Application of ISO 9001:2000 in a Nuclear Medicine Department

    International Nuclear Information System (INIS)

    Rayo, J.I.; Serrano, J.; Martin, R.; Corral, C.

    2002-01-01

    Since 1947 ISO has been developing voluntary technical standards over almost all sectors of business, industry, and technology. The ISO 9000 standards were published in 1987, and new versions of the standards saw daylight in 1994 and 2000. The highlights of ISO 9001:2000 are: quality management system, management responsibility, resource management, product realization and measurement, analysis and improvement. Aim: Application of ISO 9001:2000 to a Nuclear Medicine Department for provides the organization with a model to follow, customer focus, people will understand the goals of the organization and are motivated to work for objectives and lower costs and shorter cycle times through effective use of resources. Conclusion: ISO 9001:2000 focuses on continual improvement of business processes that should be a permanent objective of the Nuclear Medicine Department

  4. [SOCIAL IMPACT BONDS FOR HEALTH PROMOTION AND PREVENTIVE MEDICINE].

    Science.gov (United States)

    Moran, Roni S; Moran, Daniel S; Fire, Gil

    2018-01-01

    The World Health Organization (WHO) has declared obesity a global epidemic. WHO sheds much light on this matter in its publications on health promotion and preventative medicine. Lack of physical activity, an unbalanced diet and an unhealthy lifestyle are the leading causes of developing obesity and chronic diseases. In Israel, the growing rate of obesity is a reason for concern. About 500,000 diabetics, mainly as a result of obesity, live in Israel today and by 2030 the number is expected to rise to 2,000,000. Every third child born is expected to develop diabetes by the time they reach the age of 40 unless a profound change is made in health policy. The State of Israel recognizes its responsibility in promoting awareness against obesity as well as its role in prevention. In spite of the country's recognition of the problem, it still has not managed to implement long term solutions which address the issue. Therefore, creative and innovative solutions are called for. The social impact bond (SIB), a newly developed financial model is a possible solution. This model suggests the entry of private investors into the public sector, a field which is within the responsibility of the government. The private investor will be in charge of running a social program on a topic which will be finalized with the government. The private investor and the government will have a contract outlining the program and the criteria for the evaluation and the success of the program. To note, the private investor will only be paid according to the success of the program. Thus the purpose of SIB is in motion processes and is set to serve as a model for several years, and then the authorities will take over the responsibility and continue with the program that the SIB handled. In March 2016, a new SIB was launched in Israel to prevent Type 2 diabetes. This involves 2250 pre-diabetic adults who are at risk to develop Type 2 diabetes and will be identified by their Health Maintenance

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

    Directory of Open Access Journals (Sweden)

    Ajit Kumar Sah

    2017-03-01

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

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

    Science.gov (United States)

    2012-05-15

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

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

    OpenAIRE

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

    2008-01-01

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

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

    International Nuclear Information System (INIS)

    Kapuscinski, J.

    2007-01-01

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

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

    Science.gov (United States)

    Hulbert, Shannon M; Carlson, Katherine A

    2009-09-01

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

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

    Science.gov (United States)

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

    2003-02-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  12. Evolution in obesity and chronic disease prevention practice in California public health departments, 2010.

    Science.gov (United States)

    Schwarte, Liz; Ngo, Samantha; Banthia, Rajni; Flores, George; Prentice, Bob; Boyle, Maria; Samuels, Sarah E

    2014-11-13

    Local health departments (LHDs) are dedicating resources and attention to preventing obesity and associated chronic diseases, thus expanding their work beyond traditional public health activities such as surveillance. This study investigated practices of local health departments in California to prevent obesity and chronic disease. We conducted a web-based survey in 2010 with leaders in California's LHDs to obtain diverse perspectives on LHDs' practices to prevent obesity and chronic disease. The departmental response rate for the 2010 survey was 87% (53 of California's 61 LHDs). Although staff for preventing obesity and chronic disease decreased at 59% of LHDs and stayed the same at 26% of LHDs since 2006, LHDs still contributed the same (12%) or a higher (62%) level of effort in these areas. Factors contributing to internal changes to address obesity and chronic disease prevention included momentum in the field of obesity prevention, opportunities to learn from other health departments, participation in obesity and chronic disease prevention initiatives, and flexible funding streams for chronic disease prevention. LHDs that received foundation funding or had a lead person or organizational unit coordinating or taking the lead on activities related to obesity and chronic disease prevention were more likely than other LHDs to engage in some activities related to obesity prevention. California LHDs are increasing the intensity and breadth of obesity and chronic disease prevention. Findings provide a benchmark from which further changes in the activities and funding sources of LHD chronic disease prevention practice may be measured.

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

    Science.gov (United States)

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

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

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

    OpenAIRE

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

    2011-01-01

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

  15. [New approaches in neurosurgery and hyperbaric medicine--the importance of preventive and industrial medicine].

    Science.gov (United States)

    Kohshi, K; Munaka, M; Abe, H; Tosaki, T

    1999-12-01

    Neurosurgical patients have been mainly treated by surgical procedures over the past decades. In addition, hyperbaric oxygen (HBO) therapy in neurosurgery has been used in patients with ischemic cerebrovascular diseases, head trauma, spinal damage, postoperative brain edema and others. However, the main therapeutic methods for neurosurgical diseases have changed dramatically due to developments in radiological techniques, such as radiosurgery and intravascular surgery. With changes in therapeutic methods, HBO therapy may become a very important treatment option for neurosurgical patients. For example, HBO therapy combined with radiotherapy (UOEH regimen) and anticoagulant therapy appear to be very effective in the treatments of malignant brain tumors and ischemic cerebrovascular diseases, respectively. On the other hand, medical examinations under hyper- and hypobaric environments have not yet been fully studied in the central nervous system compared to those in the cardiopulmonary systems. Moreover, the mechanisms of cerebral lesions in decompression sickness and acute mountain sickness remain unclear. Clinical neurologic approaches are very important in these fields. Hence, clinicians and researchers skilled in both neurosurgery and hyperbaric medicine will be required for advanced treatment and preventive and industrial medicine.

  16. Veterinary Preventive Medicine Curriculum Development at Louisiana State University

    Science.gov (United States)

    Hubbert, William T.

    1976-01-01

    The program aims at training veterinarians, with interdepartmental faculty participation the rule rather than the exception. Included in the curriculum are: avian medicine, herd health management, veterinary public health, veterinary food hygiene, and regulatory veterinary medicine. (LBH)

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  19. Pragmatic prevention of preterm birth and evidence based medicine.

    Science.gov (United States)

    Hoyme, Udo B

    2016-07-01

    Effective prevention of preterm birth is one of the unsolved problems in modern medicine. In the Thuringia campaign 2000 based on a simple screening with intravaginal pH self-measurements, adequate medical diagnosis and immediate antimicrobial therapy of genital infection, the rate of newborns ever seen in any of the German states. Therefore, the regime should be implicated as a necessary step of optimizing and rationalizing the health care system. However, in the discussion we had to learn that the best way to inhibit progress is to cope with problems by preferring the most complicated policies under persistent renunciation of simple solutions. As long as we do not have other alternative safe, simple and cheap methods, do we really have to wait even more decades to come for a prospectively randomized double-blinded almost impracticable study to convince the latest skeptical scientist that we have plenty of evidence-based means to reduce the incidence of premature birth, now, by decreasing infectious morbidity in pregnancy and by the same action childbed fever as well? Insisting scholastically on nothing but the 100 % pure evidence sometimes can hamper innovations and potential benefit. Would a similar caution ever had allowed us for instance to introduce handwashing according to Semmelweis? Good news, the Government of the State of Thuringia has decided this year to reestablish a pH selfcare screening programme.

  20. Preventive medicines: vaccination, prophylaxis of infectious diseases, disinfectants.

    Science.gov (United States)

    Heininger, Ulrich

    2011-01-01

    Immunizations belong to the most successful interventions in medicine. Like other drugs, vaccines undergo long periods of pre-clinical development, followed by careful clinical testing through study Phases I, II, and III before they receive licensure. A successful candidate vaccine will move on to be an investigational vaccine to undergo three phases of pre-licensure clinical trials in a stepwise fashion before it can be considered for approval, followed by an optional fourth phase of post-marketing assessment. The overall risk-benefit assessment of a candidate vaccine is very critical in making the licensure decision for regulatory authorities, supported by their scientific committees. It includes analyses of immunogenicity, efficacy, reactogenicity or tolerability, and safety of the vaccine. Public trust in vaccines is a key to the success of immunization programs worldwide. Maintaining this trust requires knowledge of the benefits and scientific understanding of real or perceived risks of immunizations. Under certain circumstances, pre- or post-exposure passive immunization can be achieved by administration of immunoglobulines. In terms of prevention of infectious diseases, disinfection can be applied to reduce the risk of transmission of pathogens from patient to patient, health-care workers to patients, patients to health-care workers, and objects or medical devices to patients.

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

    Science.gov (United States)

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

    2017-11-01

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

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

    Science.gov (United States)

    Kabelka, Ladislav

    2017-10-01

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

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

    Science.gov (United States)

    Petrak, Jelka; Sember, Marijan; Granić, Davorka

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

    1979-01-01

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

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

    Science.gov (United States)

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

    2000-12-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    International Nuclear Information System (INIS)

    Sudbrock, Ferdinand

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Science.gov (United States)

    Lobão, Maria João; Sousa, Paulo

    2017-09-29

    occurred in patients that had the bladder catheter placed in the emergency department, before the admission to the internal medicine ward, which highlights the need to assess the urinary catheterization practices in those departments. The high rate of catheter associated urinary tract infection that occurred in the absence of bladder placement indication reinforces the need to implement prevention strategies that contemplate the reduction of its use. Emergency departments should be part of quality improvement projects in this area. Causes for the early onset of catheter associated urinary tract infection in this cohort should be investigated.

  11. Evaluation of the radiological protection in several departments of nuclear medicine

    International Nuclear Information System (INIS)

    Lopez Bejerano, G.; Jova Sed, L.

    2001-01-01

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

    Ahmed, Amel Bushra Abaker

    2001-01-01

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

  15. Family Medicine in a Consumer Age — Part 4: Preventive Medicine, Professional Satisfaction, and the Rise of Consumerism

    Science.gov (United States)

    Warner, Morton M.

    1977-01-01

    In an attempt to find out if the physician perceives the same strengths and weaknesses in today's practice of family medicine as does the consumer, the Lay Advisory Committee of the College's B.C. Chapter initiated a survey of physicians' and consumers' attitudes. This article, the fourth and last in a series, presents some of the results of the survey as they relate to preventive-medicine, professional satisfaction and the rise of consumerism.

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

    Science.gov (United States)

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

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Francesco Ventrella

    2014-09-01

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

  18. 222Radon concentration and irradiation dose inside the department of nuclear medicine in Wuhan

    International Nuclear Information System (INIS)

    Cheng Xiaoli; Wang Changyin; Gao Jianhua; Zou Xiaofeng

    2002-01-01

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

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

    Science.gov (United States)

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

    2007-02-01

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

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

    International Nuclear Information System (INIS)

    Boudouin, E.

    2011-01-01

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

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

    International Nuclear Information System (INIS)

    Lepej, L.; Messingerova, M.

    1995-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-12-31

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

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

    International Nuclear Information System (INIS)

    Ali, Naemat Abdalla Mohamed

    2001-01-01

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

  4. [Prevention of cardiovascular complications associated with diabetes mellitus: hospital emergency department involvement].

    Science.gov (United States)

    Agudo Villa, Teresa; Álvarez-Rodríguez, Esther; Caurel Sastre, Zaida; Martín Martínez, Alfonso; Merinero Palomares, Raúl; Alvarez Rodríguez, Virginia; Portero Sánchez, Isabel

    2015-06-01

    To analyze the risk profile of patients with diabetes who seek care from hospital emergency departments and emergency department involvement in preventing cardiovascular complications in these patients. Cross-sectional analysis of case series from 2 Spanish hospital emergency departments. We included all patients with a history or final diagnosis of diabetes mellitus who were treated in the emergency department between November 1, 2010, and June 30, 2011. Each patient's cardiovascular risk profile was analyzed. The main outcome was the appropriate of prescribed treatment to prevent cardiovascular complications according to the 2012 guidelines of the American Diabetes Association on the patient's discharge from emergency care. A total of 298 patients were included; 275 (92%) had type II diabetes. Ninety percent of the series (269 patients) had at least 1 cardiovascular risk factor and 147 (49%) had prior target organ damage; target organ damage was newly diagnosed in 41 (14%). Fifty-eight percent (172 patients) were discharged home from the emergency department. Although 215 patients (72%) were not adhering to at least 1 previously prescribed preventive treatment and 30 (10%) were not adhering to any prescribed treatment, drug prescriptions were modified only in 1.1% to 3.3% of patients and no follow-up was recommended in 42 cases (24%). Although diabetic patients treated in emergency departments are at high risk for cardiovascular complications, their visit is not used to optimize preventive treatment for these complications or ensure appropriate follow-up.

  5. Assessing Injury and Violence Prevention in North Carolina's Local Health Departments.

    Science.gov (United States)

    Mouw, Mary S; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E; Maman, Suzanne; Proescholdbell, Scott K

    2016-01-01

    Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) has not been well described. One objective of the current study is to provide a baseline assessment of IVP in the state's LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. The study will also describe a replicable, cost-effective method for systematic assessment of regional IVP. This is an observational, cross-sectional study that was conducted through a survey of North Carolina's 85 LHDs. Representatives from 77 LHDs (91%) responded. Nearly one-third (n = 23; 30%) reported that no staff members were familiar with evidence-based interventions in IVP, and over one-third (n = 29; 38%) reported that their LHD did not train staff in IVP. Almost one-half (n = 37; 48%) had no dedicated funding for IVP. On average, respondents said that about half of their programs were evidence-based; however, there was marked variation (mean, 52%; standard deviation = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs' programs. Despite funding constraints, North Carolina's LHDs engaged in a broad range of IVP activities. However, programming did not uniformly address state injury and violence priorities, nor local injury and violence burden. Staff members need training in evidence-based strategies that target priority areas. Multisector partnerships were common and increased LHDs' capacity. These findings are actionable at the state and local level. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

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

    Science.gov (United States)

    Perret, Danielle; Knowlton, Tiffany; Worsowicz, Gregory

    2018-03-01

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Anita Sabzghabaei

    2014-09-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  11. Department

    African Journals Online (AJOL)

    USER

    2016-09-20

    Sep 20, 2016 ... Department of Biological and Environmental Sciences, Kibabii University. Abstract. This study ... Key Words: Climate Change, Regional Circulation Model, PRECIS, Bungoma County ... by different computer models is much.

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

    Directory of Open Access Journals (Sweden)

    Zhang-xiu SHENG

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Ayub Irmadani Anwar

    2016-06-01

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

  14. Effectiveness of preventive medicine education and its determinants among medical students in Malaysia.

    Science.gov (United States)

    Anil, Shirin; Zawahir, Mohamed Shukry; Al-Naggar, Redhwan Ahmed

    2016-03-01

    Preventive medicine has been incorporated in the medical school curriculum, but its effectiveness and the factors that affect it are yet to be widely looked into in the context of Malaysia. We aimed to measure the familiarity with, perception about the importance to learn, and the ability to practice preventive medicine as well as its determinants among the medical students in Malaysia. Thus, a cross sectional study was conducted through an anonymous online survey among 387 randomly selected final year medical students of four large public medical schools in Malaysia from March to September 2014. Of the total sample, 340 (response rate 87.8%) gave a written informed consent and took part in the survey. The familiarity of the sample with preventive medicine was measured in 19 preventive medicine areas, and their perception about the importance of preventive medicine and their ability to practice it were gauged on a Likert scale (low score indicates disagreement and high indicates agreement). Descriptive statistical analysis was performed, followed by logistic regression. The mean age of the respondents was 23.7 (SD 0.77) years, and 61.2% (n = 208) of them were females. Results showed that 22.9% of the sample (n = 78) had a low familiarity with preventive medicine, whereas 76.8% (n = 261) had a high familiarity. The study sample specified that among all the preventive medicine subjects, screening and control as well as smoking cessation and immunization are "extremely important to learn." In univariable analysis, being a female, medical school, family size, and perception about the importance to learn preventive medicine were associated with the ability to practice it. In multivariable analysis, the perception towards the importance to learn preventive medicine was the only significant determinant: aOR (adjusted odds ratio) for those who "agreed" 17.28 (95% CI aOR 4.44-67.26, P < 0.001) and for "strongly agreed" 35.87 (95% CI aOR 8.04-159.87, P < 0.001). Considering

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Directory of Open Access Journals (Sweden)

    K Asish

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Salt and its Role in Health and Disease Prevention from the Perspectives of Iranian Medicine and Modern Medicine.

    Science.gov (United States)

    Mokhtari, Masoud; Vahid, Hamide

    2016-05-01

    Salt in Iranian medical sources is mentioned as Malh and has a special place in people's nutrition. The purpose of this study was to investigate the effect of correct use of salt on health and disease prevention in the context of Iranian medicine and its comparison with modern medicine. This article reviews Iranian medicine references on the usage of salt and its benefits. Additionally, modern medicine references were searched to identify the dos and don'ts of salt consumption. Then the results from both approaches were compared and analyzed. The main application salt in Iranian medical resources includes usage in latif supplier, solvent, dryer, laxative of phlegm and melancholy, slimy moisture body repellent, opening obstruction of liver and spleen, aid in digestion, beneficial for seeds and corruption of foods, appetizing, cold foods reformer and improving the flavor of foods. On the other hand, the major benefits of salt according to modern medicine resources are; aiding the balance of electrolytes and fluids, carry nutrients into cells, regulation of acid-base balance, support transfer of nerve impulses, regulate blood pressure, and secretion of gastric acid. According to the Iranian medicine, the amount and type of salt to maintain health and prevent diseases is determined based on factors such as temperament, age, health and disease, season, and location. While a unique approach is not prescribed for every individual, in modern medicine resources, a fixed set of guidelines is recommended for all healthy individuals. Consequently, the modern medicine pays less attention to physiological, structural, and genetic issues. Considering the importance of salt and its undeniable impact on human health, it is apparent that additional research is required to determine factors affecting the actual amount of salt per person.

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

    Science.gov (United States)

    Bartůněk, Petr

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

  2. Education Department Effort to Prevent Colleges from Releasing Crime Records Suffers Setback.

    Science.gov (United States)

    Jaschik, Scott

    1991-01-01

    The Department of Education has suffered legal defeats in Missouri and Arkansas in its campaign to prevent colleges from publicly releasing names of students arrested by campus security. Controversy involves interpretation of a 1974 privacy-protection law, the Buckley Amendment. College officials are unsure about how to deal with the issue. (MSE)

  3. 50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

    Science.gov (United States)

    Lertakyamanee, Jariya

    2016-05-01

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

  4. Managed care, consumerism, preventive medicine: does a causal connection exist?

    Science.gov (United States)

    Rizzo, John A; Xie, Yang

    2006-07-01

    Managed care plans, and HMOs in particular, have long touted that their emphasis is on preventive care, to avoid expensive illness later in life. However, few articles in the contemporary literature adequately address this claim. The available evidence seems to support that HMOs do, in fact, provide greater access to preventive services, but the limitations of this research are substantial. This article discusses the scientific evidence on the relationships between managed care arrangements and the implications for preventive care in the current era, emphasizing consumer choices and less-restrictive plan structures.

  5. Dose received by occupationally exposed workers at a nuclear medicine department

    Science.gov (United States)

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

    2012-10-01

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

  6. Workplace monitoring at the nuclear medicine department of IPO-CROL

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Science.gov (United States)

    Régny, P; Cathébras, P

    2016-04-01

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

  9. Potential pollution prevention and waste minimization for Department of Energy operations

    International Nuclear Information System (INIS)

    Griffin, J.; Ischay, C.; Kennicott, M.; Pemberton, S.; Tull, D.

    1995-10-01

    With the tightening of budgets and limited resources, it is important to ensure operations are carried out in a cost-effective and productive manner. Implementing an effective Pollution Prevention strategy can help to reduce the costs of waste management and prevent harmful releases to the environment. This document provides an estimate of the Department of Energy's waste reduction potential from the implementation of Pollution Prevention opportunities. A team of Waste Minimization and Pollution Prevention professionals was formed to collect the data and make the estimates. The report includes a list of specific reduction opportunities for various waste generating operations and waste types. A generic set of recommendations to achieve these reduction opportunities is also provided as well as a general discussion of the approach and assumptions made for each waste generating operation

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

    Science.gov (United States)

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

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

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

    DEFF Research Database (Denmark)

    Hallas, P; Folkestad, L; Brabrand, M

    2009-01-01

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

  12. A bibliometric analysis in the fields of preventive medicine, occupational and environmental medicine, epidemiology, and public health

    Directory of Open Access Journals (Sweden)

    Soteriades Elpidoforos S

    2006-12-01

    Full Text Available Abstract Background Research in the fields of Preventive Medicine, Occupational/Environmental Medicine, Epidemiology and Public Health play an important role in the advancement of knowledge. In order to map the research production around the world we performed a bibliometric analysis in the above fields. Methods All articles published by different world regions in the above mentioned scientific fields and cited in the Journal Citation Reports (JCR database of the Institute for Scientific Information (ISI during the period 1995 and 2003, were evaluated. The research production of different world regions was adjusted for: a the gross domestic product in 1995 US dollars, and b the population size of each region. Results A total of 48,861 articles were retrieved and categorized. The USA led the research production in all three subcategories. The percentage of articles published by USA researchers was 43%, 44% and 61% in the Preventive Medicine, Epidemiology, and Public Health subcategories, respectively. Canada and Western Europe shared the second position in the first two subcategories, while Oceania researchers ranked second in the field of Public Health. Conclusion USA researchers maintain a leadership position in the production of scientific articles in the fields of Preventive Medicine, Occupational/Environmental Medicine and Epidemiology, at a level similar to other scientific disciplines, while USA contribution to science in the field of Public Health is by all means outstanding. Less developed regions would need to support their researchers in the above fields in order to improve scientific production and advancement of knowledge in their countries.

  13. 8 CFR 215.4 - Procedure in case of alien prevented from departing from the United States.

    Science.gov (United States)

    2010-01-01

    ... departing from the United States. 215.4 Section 215.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS CONTROLS OF ALIENS DEPARTING FROM THE UNITED STATES § 215.4 Procedure in case of alien prevented from departing from the United States. (a) Any alien, other than an enemy alien, whose departure...

  14. Wellness Programs: Preventive Medicine to Reduce Health Care Costs.

    Science.gov (United States)

    Martini, Gilbert R., Jr.

    1991-01-01

    A wellness program is a formalized approach to preventive health care that can positively affect employee lifestyle and reduce future health-care costs. Describes programs for health education, smoking cessation, early detection, employee assistance, and fitness, citing industry success figures. (eight references) (MLF)

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

    International Nuclear Information System (INIS)

    Lopez Diaz, A.

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-22

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

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

    Science.gov (United States)

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

    2015-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Mansoureh Taghavinia

    2012-07-01

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

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

    International Nuclear Information System (INIS)

    Sanchez U, N. A.

    2011-01-01

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

  20. History of “health risk” and its place in the development of preventive medicine

    Directory of Open Access Journals (Sweden)

    Е.Е. Shigan

    2016-06-01

    Full Text Available The main stages of the introduction and development of preventive medicine and the term HEALTH RISK are described. The “risk” definition is related to the works by Max Fasmer and Frank Knight. The development of preventive medicine was also influenced by the works of scientists and physicians of the ancient world and the Middle Ages. Particular attention is paid to the appearance, formation and development of the medical school of Salerno, and the impact of its work and the activities of scientists and teachers on further development of prevention and treatment. The relationship of these two concepts and their history is shown. The author dwells on the prevention development in Russia, paying particular attention to domestic researchers, especially after the victory of the Great October Revolution. Works by N.A. Semashko, Z.P. Soloviev, G.V. Khlopin, A.N. Sysin and F.G. Krotkov played a huge role in the development of preventive medicine in Russia and in the world. The article also represents the prevention medicine development facts in the post-war years – the creation of large schools of medicine, aimed at the prevention of diseases and epidemiological studies of the risk incurred. The article also pays attention to the foundation of International Institute for Applied Systems Analysis (IIASA, some areas of its work, especially in relation to research on the health risks. The itegration at mathematical modeling and forecasting with medicine in general and health in particular, as well as the study of the health concepts of risks at individual nosological examples are written.

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

    Science.gov (United States)

    Okamoto, Yasuyuki

    2003-04-01

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

  2. [Review of the approach to exercise behavior modification from the viewpoint of preventive medicine].

    Science.gov (United States)

    Nomura, Takuo; Kouta, Munetsugu; Shigemori, Kenta; Yoshimoto, Yoshinobu; Sato, Atsushi

    2008-05-01

    The purpose of this study was to summarize the approaches to behavior modification for exercise from the viewpoint of preventive medicine. Articles were searched according to the particular field of preventive medicine, i.e., primary prevention, secondary prevention, tertiary prevention, and other fields of prevention. In the field of primary prevention for elderly people living at home, many fall prevention programs were found to have been carried out. In these studies, various programs were found to be effective if the exercise proved to be sufficient. Although some approaches were observed to be based on the productive aging theory and social capital, the number of such studies was small. In the field of secondary prevention, illness and functional disorders are prevented from becoming worse. It is therefore important for each individual to exercise by himself/herself and also acquire sufficient self-monitoring skills. Social capital is useful for learning good exercise habits. In the field of tertiary prevention, although exercise therapy is effective for improving physical functions and preventing disease recurrence in patients with chronic disease, some patients nevertheless find it difficult to continue such an exercise therapy. The approaches to behavior modification were extremely effective for patients with chronic disease. In other fields of preventive medicine, daily exercises such stair climbing are effective methods for reducing the risk of chronic disease and such a behavior modification may lead to a considerable public health gain. In the future, further studies with a many lines of evidence should be performed, and approaches based on behavioral science should be established.

  3. The U.S. Department of Energy pollution prevention program: Applications for small business

    Energy Technology Data Exchange (ETDEWEB)

    Betsch, M.D.

    1997-05-14

    This report shows the benefits small businesses can realize by instituting cost-effective pollution prevention improvements. It is a series of pollution prevention assessments that were conducted at small businesses in Richland, Washington. It describes a technology transfer test of US Department of Energy (USDOE) pollution prevention methods to small businesses through eleven pollution prevention assessments conducted at small businesses in the city of Richland. The assessment method tested was first developed at the USDOE Hanford Site, located in Richland, Washington. Two pilot studies were initially conducted to determine the usefulness of the assessment method for small businesses. Then, four additional pollution prevention assessments were conducted using a refined process. In order to determine the assessment method`s usefulness by different practitioners, a number of the assessments contained in this report were conducted by the undergraduate and graduate students at Washington State University at Tri-Cities as part of their class projects. These students were trained in the pollution prevention assessment process by the author of this report and conducted five small business assessments using the same methods and materials as in the remainder of the study.

  4. The U.S. Department of Energy pollution prevention program: Applications for small business

    International Nuclear Information System (INIS)

    Betsch, M.D.

    1997-01-01

    This report shows the benefits small businesses can realize by instituting cost-effective pollution prevention improvements. It is a series of pollution prevention assessments that were conducted at small businesses in Richland, Washington. It describes a technology transfer test of US Department of Energy (USDOE) pollution prevention methods to small businesses through eleven pollution prevention assessments conducted at small businesses in the city of Richland. The assessment method tested was first developed at the USDOE Hanford Site, located in Richland, Washington. Two pilot studies were initially conducted to determine the usefulness of the assessment method for small businesses. Then, four additional pollution prevention assessments were conducted using a refined process. In order to determine the assessment method's usefulness by different practitioners, a number of the assessments contained in this report were conducted by the undergraduate and graduate students at Washington State University at Tri-Cities as part of their class projects. These students were trained in the pollution prevention assessment process by the author of this report and conducted five small business assessments using the same methods and materials as in the remainder of the study

  5. Preventing interpersonal violence in emergency departments: practical applications of criminology theory.

    Science.gov (United States)

    Henson, Billy

    2010-01-01

    Over the past two decades, rates of violence in the workplace have grown significantly. Such growth has been more prevalent in some fields than others, however. Research shows that rates of violence against healthcare workers are continuously among the highest of any career field. Within the healthcare field, the overwhelming majority of victims of workplace violence are hospital employees, with those working in emergency departments (EDs) experiencing the lion's share of violent victimization. Though this fact is well-known by medical researchers and practitioners, it has received relatively little attention from criminal justice researchers or practitioners. Unfortunately, this oversight has severely limited the use of effective crime prevention techniques in hospital EDs. The goal of this analysis is to utilize techniques of situational crime prevention to develop an effective and easily applicable crime prevention strategy for hospital EDs.

  6. [Employment opportunities and education needs of physicians with specialty training in Hygiene and Preventive Medicine.].

    Science.gov (United States)

    Fara, Gaetano M; Nardi, Giuseppe; Signorelli, Carlo; Fanti, Mila

    2005-01-01

    This survey was carried out under the sponsorship of the Italian Society of Hygiene (SItI), to evaluate the current professional position of physicians who completed their post-graduate professional training in Hygiene and Preventive Medicine in the years 2000 through 2003. An ad-hoc questionnaire was administered to 689 such specialists across Italy with a response rate of 40%. The results show that specialists in Hygiene and Preventive Medicine are generally satisfied with their professional choice though most specialists were found to have only temporary employment. Post-specialty training courses of major interest to specialists in Hygiene and Preventive medicine are those regarding occupational health, statistical analysis and epidemiology, and quality of health care.

  7. Conflict prevention, conflict mitigation, and manifestations of conflict during emergency department consultations.

    Science.gov (United States)

    Chan, Teresa; Bakewell, Francis; Orlich, Donika; Sherbino, Jonathan

    2014-03-01

    The objective was to determine the causes of and mitigating factors for conflict between emergency physicians and other colleagues during consultations. From March to September 2010, a total of 61 physicians (31 residents and 30 attendings from emergency medicine [EM], internal medicine, and general surgery) were interviewed about how junior learners should be taught about emergency department (ED) consultations. During these interviews, they were asked if and how conflict manifests during the ED consultation process. Two investigators reviewed the transcripts independently to generate themes related to conflict until saturation was reached. Disagreements were resolved by consensus. The trustworthiness of the analysis was ensured by generating an audit trail, which was subsequently audited by an investigator not involved with the initial analysis. This analysis was compared to previously proposed models of trust and conflict from the sociology and business literature. All participants recalled some manifestation of conflict. There were 12 negative conflict-producing themes and 10 protective conflict-mitigating themes. When comparing these themes to a previously developed model of the domains of trust, each theme mapped to domains of the model. Conflict affects the ED consultation process. Areas that lead to conflict are identified that map to previous models of trust and conflict. This work extends the current understanding about intradisciplinary conflict in the clinical realm. These new findings may improve the understanding of the nature of conflicts that occur and form the foundation for interventions that may decrease conflict during ED consultations. © 2014 by the Society for Academic Emergency Medicine.

  8. Motivators and barriers for dog and cat owners and veterinary surgeons in the United Kingdom to using preventative medicines.

    Science.gov (United States)

    Belshaw, Zoe; Robinson, Natalie J; Dean, Rachel S; Brennan, Marnie L

    2018-06-01

    Routine use of preventative medicines is advocated as part of responsible dog and cat ownership. However, it has been suggested that the number of owners in the United Kingdom (UK) using preventative medicines to protect their pets is in decline. The aim of this novel study was to use a qualitative methodology to explore the attitudes of pet owners and veterinary surgeons in the UK to using preventative medicine products in dogs and cats. Preventative medicine was defined as "a drug or any other preparation used to prevent disease, illness or injury." Semi-structured interviews were conducted by telephone with owners and veterinary surgeons who had recently participated in a preventative healthcare consultation. Thematic analysis of transcribed recordings of these interviews identified four themes. This paper reports the theme related to motivators and barriers to using preventative medicines. Owners' understanding varied widely about the importance of preventative medicines for pets, as did their confidence in the safety of prescription products. A good relationship with their veterinary surgeon or practice, seeing adverts on the television about specific diseases, advice from a breeder and having personally seen infected animals appeared to be motivators for owners to use preventative medicines. Concern about adverse events and uncertainty about the necessity of using preventative medicines were barriers. Owners who trusted their veterinary surgeons to advise them on preventative medicine products described little use of alternative information sources when making preventative medicine choices. However, owners who preferred to do their own research described reading online opinions, particular in relation to the safety of preventative medicines, which they found confusing. In contrast, veterinary surgeons described broad confidence in the safety and efficacy of prescription preventative medicines and described protection of pet health as a strong motivator for

  9. Prevention and Treatment of Flatulence From a Traditional Persian Medicine Perspective

    Science.gov (United States)

    Larijani, Bagher; Esfahani, Mohammad Medhi; Moghimi, Maryam; Shams Ardakani, Mohammad Reza; Keshavarz, Mansoor; Kordafshari, Gholamreza; Nazem, Esmaiel; Hasani Ranjbar, Shirin; Mohammadi Kenari, Hoorieh; Zargaran, Arman

    2016-01-01

    Context The feeling of abdominal fullness, bloating, and movement of gas in the abdomen is a very uncomfortable sensation termed flatulence. Since flatulence is one of the most common gastrointestinal symptoms that is bothersome to patients, it is important to identify effective methods to resolve this issue. In modern medicine, management of flatulence is often not satisfactory. On the other hand, traditional systems of medicine can be considered good potential sources to find new approaches for preventing and treating flatulence. The aim of this study is to review flatulence treatments from a traditional Persian medicine (TPM) viewpoint. Evidence Acquisition In this study, the reasons for flatulence and methods for its prevention and treatment are reviewed in traditional Persian medicine (TPM) texts and then related with evidence from modern medicine by searching in databases, including PubMed, Scopus, Google Scholar, and IranMedex. Results From a traditional Persian scholar viewpoint, one of the most important causes of flatulence is an incorrect manner of eating; valuable advice to correct bad eating habits will be illustrated. In addition, traditional practitioners describe some herbs and vegetables as well as herbal compounds that are effective food additives to relieve flatulence. The anti-flatulent effect of most of these herbs has been experimentally verified using modern medicine. Conclusions Attention to TPM can lead to the identification of new preventive and curative approaches to avoid and treat flatulence. In addition, Persian viewpoints from the medieval era regarding flatulence are historically important. PMID:27275398

  10. Prevention and Treatment of Flatulence From a Traditional Persian Medicine Perspective.

    Science.gov (United States)

    Larijani, Bagher; Esfahani, Mohammad Medhi; Moghimi, Maryam; Shams Ardakani, Mohammad Reza; Keshavarz, Mansoor; Kordafshari, Gholamreza; Nazem, Esmaiel; Hasani Ranjbar, Shirin; Mohammadi Kenari, Hoorieh; Zargaran, Arman

    2016-04-01

    The feeling of abdominal fullness, bloating, and movement of gas in the abdomen is a very uncomfortable sensation termed flatulence. Since flatulence is one of the most common gastrointestinal symptoms that is bothersome to patients, it is important to identify effective methods to resolve this issue. In modern medicine, management of flatulence is often not satisfactory. On the other hand, traditional systems of medicine can be considered good potential sources to find new approaches for preventing and treating flatulence. The aim of this study is to review flatulence treatments from a traditional Persian medicine (TPM) viewpoint. In this study, the reasons for flatulence and methods for its prevention and treatment are reviewed in traditional Persian medicine (TPM) texts and then related with evidence from modern medicine by searching in databases, including PubMed, Scopus, Google Scholar, and IranMedex. From a traditional Persian scholar viewpoint, one of the most important causes of flatulence is an incorrect manner of eating; valuable advice to correct bad eating habits will be illustrated. In addition, traditional practitioners describe some herbs and vegetables as well as herbal compounds that are effective food additives to relieve flatulence. The anti-flatulent effect of most of these herbs has been experimentally verified using modern medicine. Attention to TPM can lead to the identification of new preventive and curative approaches to avoid and treat flatulence. In addition, Persian viewpoints from the medieval era regarding flatulence are historically important.

  11. Mustard Group Chemical War Agents from Preventive Medicine Perspective

    Directory of Open Access Journals (Sweden)

    Muharrem Ucar

    2007-06-01

    Full Text Available Although many preventive efforts and treaties, chemical warfare agents have still been a severe assault form against both military and civilian individuals. The most important chemical warfare agents sulphur mustard and others are easy to handle and cheap those the important reasons to accept sulphur mustard as a chemical warfare agent. Many individuals attacked by sulphur mustard have severe health problems such as respiratory system diseases. After ten years of sulphur mustard exposure, several health problems such as respiratory tract problems (%42.5, eye problems (%40 and other systemic diseases have been observed to insist on induviduals when examined. Exposure of even single sulphur mustard exposure has been seen to result high level of disability and early deaths. In spite of the fact that there is no available antidote and/or remedy against sulphur mustard exposure, our country has an incremental chemical assault threat for both military personels and civilians because of its jeopolitics position. Experimental studies regarding sulphur mustard toxicity will be helpful for novel preventive strategies and antidot devolepment. [TAF Prev Med Bull 2007; 6(3.000: 209-214

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

    Science.gov (United States)

    Reißhauer, A; Liebl, M E

    2012-07-01

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

  13. Knowledge, attitude, and belief regarding burn first aid among caregivers attending pediatric emergency medicine departments.

    Science.gov (United States)

    Alomar, Mohammed; Rouqi, Faisal Al; Eldali, Abdelmoneim

    2016-06-01

    Emergency departments witness many cases of burns that can be prevented with various first-aid measures. Immediate and effective burn first aid reduces morbidity and determines the outcome. Thus, it is imperative that measures of primary burn prevention and first-aid knowledge be improved. This descriptive study determines the current level of knowledge, attitude, and belief regarding burn first aid among caregivers. Caregivers attending four pediatric emergency departments answered a structured questionnaire for demographic information, knowledge, and the burn first aid they provide including two case scenarios. Applying cold water for 15-20min, smothering burning clothes, and covering the pot of oil on fire with a wet cloth were considered appropriate responses. The main outcome measure was the proportion of caregivers who were aware of burn first aid and did not use inappropriate remedies. Additional questions regarding the best means of educating the public on burn first aid were included. Individual chi-squared tests and univariate logistic regressions were performed to correlate knowledge with demographic features, history of burns, and first-aid training. The 408 interviewed caregivers (55% women) reflected a wide range of age, occupation, and educational level. Sixty percent (60%) of respondents had a large family, with 52% reporting a history of burns. Overall, 41% treated burns with cool or cold water, although 97% had inappropriate or no knowledge of the duration. Further, 32% treated burns with nonscientific remedies alone or in combination, including honey, egg white, toothpaste, white flour, tomato paste, yogurt, tea, sliced potato, butter, or ice. Only 15% had first-aid training. While 65% of caregivers covered a pot of oil on fire with a wet cloth, only 24% reported smothering burning clothes. Participants preferred learning more of first aid for burns via social media (41%), hospital visits (30%), and television (TV) (16%). No significant

  14. A Military Doctor Pioneer of the Preventive Medicine in Turkey: Colonel Dr. Huseyin Remzi Bey

    Directory of Open Access Journals (Sweden)

    Dogan Ceyhan

    2008-08-01

    Full Text Available One of the most important turning points in Turkish History of Medicine is the transfer of Western / European medical knowledge to Ottoman medicine in 19th century. This knowledge is mostly transferred by government employed Ottoman citizens and aimed at improving the health status of the Ottoman State’s elites, troops and people. Most important contributions of transferring and popularizing the concepts of microbe and vaccination to Ottoman medicine, concerning both disease and preventive medicine, were made by a military doctor, “Colonel Dr. Huseyin Remzi Bey”. He served in a large spectrum of military and civilian health services from field medicine to professorship in higher educational institutes and made important contributions for education of modern medicine in Turkish language. He was a part of the Ottoman team visiting Pasteur to learn the rabies vaccine and given credit to be one of the first users of microbiological knowledge and applications in Ottoman Country. He also tried to disseminate the knowledge about health amongst people and wrote more than 50 manuscripts, most of them published as books or newspaper periodicals. He is a figure who made important contributions of the accumulation and distribution of modern medical knowledge, including preventive medicine, in Turkey. [TAF Prev Med Bull 2008; 7(4.000: 347-350

  15. Ambient radiation dose reduction within a newly remodeled Nuclear Medicine Department

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tomasz Konopka

    2017-06-01

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

  18. Internal Medicine Hospitalists' Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures.

    Science.gov (United States)

    Tan, Eng Keong; Loh, Kah Poh; Goff, Sarah L

    2017-12-01

    Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center. The interviews were analyzed with directed content analysis. Internal medicine hospitalists consider secondary osteoporotic hip fracture prevention as the responsibility of outpatient physicians. Identified barriers were stratified based on themes including physicians' perception, patients' characteristics, risks and benefits of osteoporosis treatment, healthcare delivery system, and patient care transition from the inpatient to the outpatient setting. Some of the recommendations include building an integrated system that involves a multidisciplinary team such as the fracture liaison service, initiating a change to the hospital policy to facilitate inpatient care and management of osteoporosis, and creating a smooth patient care transition to the outpatient setting. Our study highlighted how internal medicine hospitalists perceive their role in the secondary prevention of osteoporotic hip fractures and what they perceive as barriers to initiating preventive measures in the hospital. Inconsistency in patient care transition and the fragmented nature of the existing healthcare system were identified as major barriers. A fracture liaison service could remove some of these barriers.

  19. THE ROLE OF THE PREVENTIVE MEDICINE IN SUSTAINABLE DEVELOPMENT. A STUDY CASE ON THE PRIVATE MEDICINE SECTOR IN ORADEA

    Directory of Open Access Journals (Sweden)

    Unita Lucian

    2011-12-01

    intercultural preventative medical approaches, and the good governance, policy relevance, and corporate social responsibility, and were analyzed mainly referring to the potential of the Romanian private medicine sector in preventive medicine. The conclusions of the paper reveal the fact that the region of Oradea is much above the average index of Romania when it comes to preventive medicine, but still behind the other EU Member States. So, the background for meeting the precondition for economic growth and sustainable development in Oradea was created, but there are still a lots to be done on short term, even because of the features of this area, which situates it at the top of the cancer diseases registered cases in the country.

  20. It Could Never Happen Here: Promoting Violence Prevention Education for Emergency Department Nurses.

    Science.gov (United States)

    Koller, Lynne H

    2016-08-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.1 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "It Could Never Happen Here: Promoting Violence Prevention Education for Emergency Department Nurses," found on pages 356-360, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Suggest strategies targeted for emergency department nurses to prevent or mitigate their exposure

  1. Zeroing in on methicillin-resistant Staphylococcus aureus: US Department of Veterans Affairs' MRSA Prevention Initiative.

    Science.gov (United States)

    Kralovic, Stephen M; Evans, Martin E; Simbartl, Loretta A; Ambrose, Meredith; Jain, Rajiv; Roselle, Gary A

    2013-05-01

    Implementation of a methicillin-resistant Staphylococcus aureus (MRSA) Prevention Initiative within US Department of Veterans Affairs medical facilities was associated with a significant reduction in MRSA health care-associated infection (HAI) rates nationwide. The first 36 months of data from the Initiative were analyzed to determine how many facilities reported zero MRSA HAIs each month. From October 2007 through September 2010, there was a 37.6% increase nationwide in the number of facilities achieving zero MRSA HAIs each month. Published by Mosby, Inc.

  2. Assessing the effectiveness of problem-based learning of preventive medicine education in China.

    Science.gov (United States)

    Ding, Xiaojie; Zhao, Liping; Chu, Haiyan; Tong, Na; Ni, Chunhui; Hu, Zhibin; Zhang, Zhengdong; Wang, Meilin

    2014-05-30

    Problem-based learning (PBL) is defined as a student-centered pedagogy which can provide learners more opportunities for application of knowledge acquired from basic science to the working situations than traditional lecture-based learning (LBL) method. In China, PBL is increasingly popular among preventive medicine educators, and multiple studies have investigated the effectiveness of PBL pedagogy in preventive medicine education. A pooled analysis based on 15 studies was performed to obtain an overall estimate of the effectiveness of PBL on learning outcomes of preventive medicine. Overall, PBL was associated with a significant increase in students' theoretical examination scores (SMD = 0.62, 95% CI = 0.41-0.83) than LBL. For the attitude- and skill-based outcomes, the pooled PBL effects were also significant among learning attitude (OR = 3.62, 95% CI = 2.40-5.16), problem solved skill (OR = 4.80, 95% CI = 2.01-11.46), self-directed learning skill (OR = 5.81, 95% CI = 3.11-10.85), and collaborative skill (OR = 4.21, 95% CI = 0.96-18.45). Sensitivity analysis showed that the exclusion of a single study did not influence the estimation. Our results suggest that PBL of preventive medicine education in China appears to be more effective than LBL in improving knowledge, attitude and skills.

  3. [Recognizing prevention and treatment of burn sepsis with the concept of holistic integrative medicine].

    Science.gov (United States)

    Huan, J N

    2017-04-20

    Sepsis remains a major cause of death in severe burns. The effect of sepsis management is influenced by its complicated pathophysiologic changes. In order to improve the outcome of burn sepsis, the predisposing factor of sepsis after burn analyzed by advanced technology, the early prevention, antibiotics therapy, and combined treatment in severe burns with sepsis are discussed using the concept of holistic integrative medicine.

  4. Ethical considerations in clinical research on herbal medicine for prevention of cardiovascular disease in the ageing.

    Science.gov (United States)

    Koonrungsesomboon, Nut; Karbwang, Juntra

    2016-10-15

    Cardiovascular disease (CVD) in the ageing is a major public health problem worldwide. The nature of most CVD is subclinical with pathological processes that can span over years. Use of preventive measures could be an appropriate approach to prevailing over CVD in the ageing, and herbal medicine is one of the promising preventive approaches and is currently of interest among medical societies. In the evidence-based era, herbal medicine is, however, often underestimated and approached with skepticism, mainly due to the paucity of scientific evidence. Properly designed clinical trials on herbal medicine for prevention of CVD in a geriatric population are thus of importance and of clinical value. To review ethical issues and discuss considerations when such research is proposed. Four ethical issues, including the scientific validity of research, risk-benefit assessments, subject selection and vulnerability, and informed consent, are structured and extensively discussed in this article. Ethical core considerations of prevention research of CVD on herbal medicine involve particular attention on the scientific validity of research, risk-benefit assessments, subject selection and vulnerability, and informed consent. These issues and considerations are keys, although they must be adapted to an individual research setting in which a clinical study is proposed. Copyright © 2015 Elsevier GmbH. All rights reserved.

  5. Perceived Benefits and Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health Departments

    Science.gov (United States)

    Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A.; Brownson, Ross C.

    2014-01-01

    Introduction Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. Methods A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ2 tests, and analysis of variance were conducted. Results The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges “lack of communication across programs” (P = .02) and “funding might be reduced” differed by program area (P organizational support for coordinated approaches, and create benefits for organizational partners. PMID:24809362

  6. Special issue review of pollution prevention management within the Department of Energy, final report

    International Nuclear Information System (INIS)

    1994-08-01

    The Department of Energy's (DOE) national role and overall mission has been undergoing significant change. In the post-Cold War era, a new emphasis on cleaning up the wastes from the past has emerged. These changes provide both significant challenges as well as new opportunities for DOE. While the challenges may seem overwhelming as DOE realizes the magnitude of its environmental problems, its network of national laboratories and sites provide the resources to become a leader in environmental management through the development of new technologies and management practices. Because of the growing importance of pollution prevention in the United States and more specifically to DOE's environmental management strategy, the Office of Environmental Audit (EH-24) identified this as an area worthy of a Special Issue Review. A Special Issue Review is not an audit but rather an in-depth review of key environmental programs or activities which cut across organizational boundaries. The purpose of a Special Issue Review is to identify strengths and weaknesses of a program as well as significant crosscutting issues or challenges that are important to the future success of that program. The scope of the review included an assessment of pollution prevention program activities at Headquarters, selected operations offices, and selected sites offices and contractor organizations. All aspects of a pollution prevention program were considered including program strategy, infrastructure, management systems, and implementation practices. Also summarized are future pollution prevention challenges and recommendations

  7. Prognostic importance of glycaemic variability on hospital mortality in patients hospitalised in Internal Medicine Departments.

    Science.gov (United States)

    Sáenz-Abad, D; Gimeno-Orna, J A; Pérez-Calvo, J I

    2015-12-01

    The objective was to assess the prognostic importance of various glycaemic control measures on hospital mortality. Retrospective, analytical cohort study that included patients hospitalised in internal medicine departments with a diagnosis related to diabetes mellitus (DM), excluding acute decompensations. The clinical endpoint was hospital mortality. We recorded clinical, analytical and glycaemic control-related variables (scheduled insulin administration, plasma glycaemia at admission, HbA1c, mean glycaemia (MG) and in-hospital glycaemic variability and hypoglycaemia). The measurement of hospital mortality predictors was performed using univariate and multivariate logistic regression. A total of 384 patients (50.3% men) were included. The mean age was 78.5 (SD, 10.3) years. The DM-related diagnoses were type 2 diabetes (83.6%) and stress hyperglycaemia (6.8%). Thirty-one (8.1%) patients died while in hospital. In the multivariate analysis, the best model for predicting mortality (R(2)=0.326; P<.0001) consisted, in order of importance, of age (χ(2)=8.19; OR=1.094; 95% CI 1.020-1.174; P=.004), Charlson index (χ(2)=7.28; OR=1.48; 95% CI 1.11-1.99; P=.007), initial glycaemia (χ(2)=6.05; OR=1.007; 95% CI 1.001-1.014; P=.014), HbA1c (χ(2)=5.76; OR=0.59; 95% CI 0.33-1; P=.016), glycaemic variability (χ(2)=4.41; OR=1.031; 95% CI 1-1.062; P=.036), need for corticosteroid treatment (χ(2)=4.03; OR=3.1; 95% CI 1-9.64; P=.045), administration of scheduled insulin (χ(2)=3.98; OR=0.26; 95% CI 0.066-1; P=.046) and systolic blood pressure (χ(2)=2.92; OR=0.985; 95% CI 0.97-1.003; P=.088). An increase in initial glycaemia and in-hospital glycaemic variability predict the risk of mortality for hospitalised patients with DM. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  8. Six sigma tools for a patient safety-oriented, quality-checklist driven radiation medicine department.

    Science.gov (United States)

    Kapur, Ajay; Potters, Louis

    2012-01-01

    The purpose of this work was to develop and implement six sigma practices toward the enhancement of patient safety in an electronic, quality checklist-driven, multicenter, paperless radiation medicine department. A quality checklist process map (QPM), stratified into consultation through treatment-completion stages was incorporated into an oncology information systems platform. A cross-functional quality management team conducted quality-function-deployment and define-measure-analyze-improve-control (DMAIC) six sigma exercises with a focus on patient safety. QPM procedures were Pareto-sorted in order of decreasing patient safety risk with failure mode and effects analysis (FMEA). Quantitative metrics for a grouped set of highest risk procedures were established. These included procedural delays, associated standard deviations and six sigma Z scores. Baseline performance of the QPM was established over the previous year of usage. Data-driven analysis led to simplification, standardization, and refinement of the QPM with standard deviation, slip-day reduction, and Z-score enhancement goals. A no-fly policy (NFP) for patient safety was introduced at the improve-control DMAIC phase, with a process map interlock imposed on treatment initiation in the event of FMEA-identified high-risk tasks being delayed or not completed. The NFP was introduced in a pilot phase with specific stopping rules and the same metrics used for performance assessments. A custom root-cause analysis database was deployed to monitor patient safety events. Relative to the baseline period, average slip days and standard deviations for the risk-enhanced QPM procedures improved by over threefold factors in the NFP period. The Z scores improved by approximately 20%. A trend for proactive delays instead of reactive hard stops was observed with no adverse effects of the NFP. The number of computed potential no-fly delays per month dropped from 60 to 20 over a total of 520 cases. The fraction of computed

  9. [The euthyroid sick syndrome. Its incidence and clinical significance in an internal medicine department].

    Science.gov (United States)

    Di Napoli, M; Reda, G; Zannoni, G; Russo, S; Morace, G; Vasselli, C

    1994-04-01

    In this paper the authors have evaluated the incidence and the clinical implications of sick euthyroid syndrome (SES) in a group of 144 patients in a department of internal medicine. SES is an alteration of thyroid hormone values in the absence of a thyroid disease, which is seen in patients suffering from serious diseases. Having classified SES into 3 subgroups according to the different alterations seen in the values of T3, T4, FT3, FT4, TSH, rT3 and TBG, they show the hypotheses that explain the biochemical mechanisms which are at the basis of these hormonal alterations. Fourteen of the 144 patients under observation were excluded as they were suffering from ascertained or subclinical thyroid disease. Thirty (23% of cases) of the remaining 130 patients had alterations of the thyroid hormones in accordance with SES diagnosis. Of these 30 patients, 19 had hormone values found in SES type I (63%), 2 in SES type II (6.5%) and 9 in SES type III (30.5%). In SES type I the diseases seen, in order of frequency, were: obstructive chronic bronchopneumopathy with acute respiratory failure, diabetic ketoacidosis, neoplasms, ischemic heart disease, cardiac failure, chronic renal failure, liver diseases, acute cerebral vasculopathies, sepsis and collagenopathies. The disease seen in the 2 cases of SES type II was obstructive chronic bronchopneumopathy with acute respiratory failure. In SES type III the diseases seen were, in order of frequency: diabetic ketoacidosis, lung diseases, ischemic heart disease, cardiac failure, peripheral arteriopathies, acute cerebral vasculopathies, neoplasms, liver diseases, acute renal failure. The incidence of SES in 23% of the admitted to hospital patients was found to be slightly higher than in other studies; this could be explained by a stricter selection of inpatients: in fact self-sufficient patients or those not needing urgent admission, were sent to an efficient out patient clinic where necessary examinations were quickly carried out

  10. Gene–Environment Interactions in Preventive Medicine: Current Status and Expectations for the Future

    Directory of Open Access Journals (Sweden)

    Hiroto Narimatsu

    2017-01-01

    Full Text Available The progression of many common disorders involves a complex interplay of multiple factors, including numerous different genes and environmental factors. Gene–environmental cohort studies focus on the identification of risk factors that cannot be discovered by conventional epidemiological methodologies. Such epidemiological methodologies preclude precise predictions, because the exact risk factors can be revealed only after detailed analyses of the interactions among multiple factors, that is, between genes and environmental factors. To date, these cohort studies have reported some promising results. However, the findings do not yet have sufficient clinical significance for the development of precise, personalized preventive medicine. Especially, some promising preliminary studies have been conducted in terms of the prevention of obesity. Large-scale validation studies of those preliminary studies, using a prospective cohort design and long follow-ups, will produce useful and practical evidence for the development of preventive medicine in the future.

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

    Science.gov (United States)

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

    2000-01-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stoneking LR

    2016-08-01

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

  14. Role of diagnosis of dyslipidemia in primary and secondary vascular prevention in a neurology department.

    Science.gov (United States)

    Horváth, Eszter; Vadasdi, Károly; Vastagh, Ildikó; Folyovich, András

    2010-03-30

    Lipids have important functions in the human body, but high serum cholesterol level is an important risk factor for cardiovascular and cerebrovascular diseases. Prevention of stroke includes modifying risk factors, like dyslipidemias. Based on this theory, we examined in practice the possible role of a public care neurology and stroke department with a large patient turnover in vascular risk screening with regard to the diagnosis of hyperlipidemia. We reviewed all the medical records (irrespective of disease group;) of patients hospitalized in 2007 at Department of Neurclogy and Stroke Center of Szent János Hospital of the Municipality of the City of Budapest. Patients included in the study were classified into three groups: (1) those admitted with acute stroke; (2) those with a history of acute stroke, but without evidence of a novel cerebrovascular event; (3) no history and evidence of cerebrovascular disease during hospitalization. Our data show that 17.6% of patients was diagnosed with hyperlipidemia during hospital care, and another 18.5% was known to have elevated cholesterol levels. Altogether, 36.1% of the 1438 patients evaluated had hyper ipidemia. Known hypercholesterolemia was 18.4% in patierts admitted for acute stroke, 26.9% in patients formerly (but not currently) treated for cerebrovascular disease, and 13.6% in the third group. Newly diagnosed elevated cholesterol levels had highest rate (22.6%) in former stroke patierts (currently treated for other diseases); 20.4% in patients with acute stroke, and 13.2% in the third group. In the first two groups, the number of patients newly diagnosed with elevated serum cholesterol almost equaled to those with already known hypercholesterolemia. Based on our data, neurology departments have an important role in diagnosing hyperlipidemia and vascular prevention.

  15. Role of Iranian Traditional Medicine in the Prevention of Respiratory Infectious Diseases.

    Science.gov (United States)

    Soroushzadeh, Sayed Mohammad Ali; Khiveh, Ali; Gerayelimalek, Valiollah

    2016-05-01

    In order to define appropriate plans for respiratory infectious diseases, in accordance with Iranian traditional medicine, one should cover the topic of "havae vabai". "Havae vabai" is related to the epidemics of respiratory infectious diseases. This study is a review of the role of Iranian traditional medicine in the prevention of respiratory infectious diseases .Resources of traditional medicine with the keyword "havae vabai" were reviewed in Noor digital library. The perspective of traditional medicine for the prevention of disease in "havae vabai" is based on self-recuperation and air modification. Items that are mentioned are; refine the surrounding air, move to a proper space, live in a house with no source of water like fountains and limited flow of air, air-drying, use air freshener, smell fruit sticks, use in-house plants, and place a cloth soaked with vinegar in front of the nose. For self-recuperation, reducing body moisture with proper foods and drugs or with vomiting, diarrhea, phlebotomy, wet-cupping, reduction in food and drink intake, avoiding sexual intercourse, bathing, heavy exercise, inactivity, overeating, hunger, thirst, milk, sweets, fish, fatty foods, fruits especially juicy fruits are recommended. The food that tends to have a sour taste, eating meat cooked with sour taste like vinegar is suggested. The use of the solutions offered in traditional medicine to control air is helpful as it can reduce epidemics, such as influenza; that yearly kills many patients with a heavy financial burden.

  16. Bibliometric investigation on preventive medicine in North Korea: a coauthor and keyword network analysis.

    Science.gov (United States)

    Jung, Minsoo

    2013-01-01

    This study examined the 2 preventive medicine journals in North Korea by using coauthor and keyword network analysis on the basis of medical informatics and bibliometrics. Used were the Journal of Chosun Medicine (JCM) and the Journal of Preventive Medicine (JPM) (from the first volume of 1997 to the fourth volume of 2006) as data. Extracted were 1734 coauthors from 1104 articles and 1567 coauthors from 1172 articles, respectively. Huge single components were extracted in the coauthor analysis, which indicated a tendency toward structuralization. However, the 2 journals differed in that JPM showed a relative tendency toward specialization, whereas JCM showed one toward generalization. Seventeen and 33 keywords were extracted from each journal in the keyword analysis; JCM mainly concerned pathological research, whereas JPM mainly concerned virus and basic medicine studies that were based on infection and immunity. In contrast to South Korea, North Korea has developed Juche medicine, which came from self-reliance ideology and gratuitous medical service. According to the present study, their ideology was embodied by the discovery of bacteria, study on immune system, and emphasis on pathology, on the basis of experimental epidemiology. However, insufficient research has been conducted thus far on population health and its related determinants.

  17. Clinical Cancer Genetics and Prevention

    Science.gov (United States)

    Olufunmilayo F. Olopade MD, FACP, Professor of Medicine and Human Genetics and Director of the Cancer Risk Clinic Department of Medicine, BSD Section of Hematology/Oncology University of Chicago, presented "Clinical Cancer Genetics and Prevention".

  18. The Acceptability of Incorporating a Youth Smoking Prevention Intervention in the Pediatric Emergency Department

    Science.gov (United States)

    Mahabee-Gittens, E. Melinda; Chen, Chen; Huang, Bin; Gordon, Judith

    2014-01-01

    The pediatric emergency department (PED) is under-utilized as a setting in which to provide tobacco prevention interventions for at-risk children. We sought to determine the acceptability and feasibility of incorporating a brief, parental tobacco prevention intervention to 520 parents during the PED visit. Mean age (SD) of parents and children was 38.6 (7.1) and 11.5 (1.1), respectively; 47% of children were female; 45% were African American; 36% of parents had an annual income less than $25,000; 28.8% of parents were current smokers. Over 90% of parents said the intervention provided “useful” and “easy to understand” information and 97% of practitioners said it did not “interfere with clinical care.” Given the high prevalence of parental smoking in the PED, there is a high likelihood that their children will initiate smoking in the future. Thus, the use of the PED as a venue to providing tobacco prevention interventions warrants further evaluation. PMID:24858886

  19. Associations Between the Department of Veterans Affairs' Suicide Prevention Campaign and Calls to Related Crisis Lines

    Science.gov (United States)

    Bossarte, Robert M.; Lu, Naiji; Tu, Xin; Stephens, Brady; Draper, John; Kemp, Janet E.

    2014-01-01

    Objective The Transit Authority Suicide Prevention (TASP) campaign was launched by the Department of Veterans Affairs (VA) in a limited number of U.S. cities to promote the use of crisis lines among veterans of military service. Methods We obtained the daily number of calls to the VCL and National Suicide Prevention Lifeline (NSPL) for six implementation cities (where the campaign was active) and four control cities (where there was no TASP campaign messaging) for a 14-month period. To identify changes in call volume associated with campaign implementation, VCL and NSPL daily call counts for three time periods of equal length (pre-campaign, during campaign, and post-campaign) were modeled using a Poisson log-linear regression with inference based on the generalized estimating equations. Results Statistically significant increases in calls to both the VCL and the NSPL were reported during the TASP campaign in implementation cities, but were not reported in control cities during or following the campaign. Secondary outcome measures were also reported for the VCL and included the percentage of callers who are veterans, and calls resulting in a rescue during the study period. Conclusions Results from this study reveal some promise for suicide prevention messaging to promote the use of telephone crisis services and contribute to an emerging area of research examining the effects of campaigns on help seeking. PMID:25364053

  20. Ambient radiation monitoring at a PET/CT imaging center within a nuclear medicine department

    International Nuclear Information System (INIS)

    Lai, Y.C.; Chen, Y.W.; Chuang, Y.W.

    2006-01-01

    Full text of publication follows: Potential environmental dose rates in a patient waiting room at the PET/CT Imaging Center within our Nuclear Medicine Department (N.M.D.) are evaluated by both of the computer modeling method and real-time monitoring in practical settings. The maximum dose rate is directly read from a peak dose-rate frozen-up, digital gamma G-M survey meter. The design basis of our PET/CT Imaging Center facility has assumed a maximum total of five 18 FDG-patients presented at any given time either in an Am or a Pm session according to two separated drug batch delivering runs. Due to the relatively high gamma energy of 511 keV emitted by the F- 18 labeled compound, we have remodeled our facility with a 0.5-cm thick Pb wall and larger space separations between rooms that include a PET/CT scan room, two separated 18 FDG i.v. injection rooms, and a delayed-phase patient waiting room. Patient could normally complete two separate PET/CT scan runs, if a delayed-phase scan is needed, within three hours time frame from an initial dose of 370 MBq (10 mCi) that has a physical half-live of 110 minutes for an F-18 labeled compound. When all the needed scans are finished, the patient is released from our PET/CT Imaging Center that has to follow the radiation safety guideline of less than 50 mSv/hr (5 m R/hr) at one meter distance. During typical operation, each drug i.v. injection room or the scan room is restricted to one patient access only. As a worst case scenario, the maximum ambient dose rate may only occur when two or more delayed phase patients would stay in the PET/CT waiting room that is excluded for other non-PET patient use. Theoretically using a computer discrete-ordinate integrating methods, dose rates at one meter distance from a mid-point geometry, based on a simulated 10 mCi F-18 point, line or volumetric source (assuming 170 cm in height and 20 cm in radius of homogeneous water media), can also be calculated to give values of 5.71, 4.73 and 3

  1. Evolutionary medicine--the quest for a better understanding of health, disease and prevention.

    Science.gov (United States)

    Brüne, Martin; Hochberg, Ze'ev

    2013-04-29

    Clinical medicine has neglected the fact that the make-up of organs and body functions, as well as the human-specific repertoire of behaviors and defenses against pathogens or other potential dangers are the product of adaptation by natural and sexual selection. Even more, for many clinicians it does not seem straightforward to accept a role of evolution in the understanding of disease, let alone, treatment and prevention.Accordingly, this Editorial seeks to set the stage for an article collection that aims at dealing precisely with the question of why evolutionary aspects of health and disease are not only interesting, but necessary to improve clinical medicine.

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  3. Perspectives of family medicine physicians on the importance of adolescent preventive care: a multivariate analysis.

    Science.gov (United States)

    Taylor, Jaime L; Aalsma, Matthew C; Gilbert, Amy L; Hensel, Devon J; Rickert, Vaughn I

    2016-01-20

    The study objective was to identify commonalities amongst family medicine physicians who endorse annual adolescent visits. A nationally weighted representative on-line survey was used to explore pediatrician (N = 204) and family medicine physicians (N = 221) beliefs and behaviors surrounding adolescent wellness. Our primary outcome was endorsement that adolescents should receive annual preventive care visits. Pediatricians were significantly more likely (p family medicine physicians, bivariate comparisons were conducted between those who endorsed an annual visit (N = 164) compared to those who did not (N = 57) with significant predictors combined into two multivariate logistic regression models. Model 1 controlled for: patient race, proportion of 13-17 year olds in provider's practice, discussion beliefs scale and discussion behaviors with parents scale. Model 2 controlled for the same first three variables as well as discussion behaviors with adolescents scale. Model 1 showed for each discussion beliefs scale topic selected, family medicine physicians had 1.14 increased odds of endorsing annual visits (p family medicine physicians had 1.15 increased odds of also endorsing the importance of annual visits (p Family medicine physicians that endorse annual visits are significantly more likely to affirm they hold strong beliefs about topics that should be discussed during the annual exam. They also act on these beliefs by talking to parents of teens about these topics. This group appears to focus on quality of care in thought and deed.

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  6. Evaluation of Cases Admitted for Age Estimation to Forensic Medicine Department Between 2006 and 2010 Years

    Directory of Open Access Journals (Sweden)

    Ali Yildirim

    2011-06-01

    Conclusion: In conclusion age determination continues to be one of the important issues of forensic medicine. In cases of age determination, more accurate estimates can be accomplished when radiologically determined age is considered in conjunction with clinical findings such as dental, mental, and psychologic development. [J Contemp Med 2011; 1(2.000: 56-61

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

    Science.gov (United States)

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

    2009-02-01

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

  8. Fundamentals of risk/benefit analysis in radiation uses in preventive medicine

    International Nuclear Information System (INIS)

    Stieve, F.E.

    1977-01-01

    The term 'risk' stems from the insurance branch. It serves to estimate the probability of making statements about future events on the basis of events which have taken place. Risk estimations are increasingly being made in medicine, especially for determining the advantages and dangers brought to the population by preventive measures. The international radiation protection commission has, for some time, been expressing the dangers of ionising radiation in terms of risk and using these terms as basis for the dose limit values it determined for the professional and general population. This paper deals with possibilities of determining risks in preventive medicine. For doing this, acceptable risk values must be determined and risks resulting from diseases, esp. from those which were not recognized in time, must be compared with those resulting from the application of ionising radiation. (orig.) [de

  9. Medicines

    Science.gov (United States)

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

  10. Herbal Medicine Goshajinkigan Prevents Paclitaxel-Induced Mechanical Allodynia without Impairing Antitumor Activity of Paclitaxel

    OpenAIRE

    Bahar, Muh. Akbar; Andoh, Tsugunobu; Ogura, Keisuke; Hayakawa, Yoshihiro; Saiki, Ikuo; Kuraishi, Yasushi

    2013-01-01

    Chemotherapy-induced peripheral neuropathy is a major dose-limiting side effect of commonly used chemotherapeutic agents. However, there are no effective strategies to treat the neuropathy. We examined whether Goshajinkigan, a herbal medicine, would prevent paclitaxel-induced allodynia without affecting the anticancer action in mice. Murine breast cancer 4T1 cells were inoculated into the mammary fat pad. Paclitaxel (10 and 20 mg/kg, intraperitoneal, alternate day from day 7 postinoculation) ...

  11. Lifestyle precision medicine: the next generation in type 2 diabetes prevention?

    Science.gov (United States)

    Mutie, Pascal M; Giordano, Giuseppe N; Franks, Paul W

    2017-09-22

    The driving force behind the current global type 2 diabetes epidemic is insulin resistance in overweight and obese individuals. Dietary factors, physical inactivity, and sedentary behaviors are the major modifiable risk factors for obesity. Nevertheless, many overweight/obese people do not develop diabetes and lifestyle interventions focused on weight loss and diabetes prevention are often ineffective. Traditionally, chronically elevated blood glucose concentrations have been the hallmark of diabetes; however, many individuals will either remain 'prediabetic' or regress to normoglycemia. Thus, there is a growing need for innovative strategies to tackle diabetes at scale. The emergence of biomarker technologies has allowed more targeted therapeutic strategies for diabetes prevention (precision medicine), though largely confined to pharmacotherapy. Unlike most drugs, lifestyle interventions often have systemic health-enhancing effects. Thus, the pursuance of lifestyle precision medicine in diabetes seems rational. Herein, we review the literature on lifestyle interventions and diabetes prevention, describing the biological systems that can be characterized at scale in human populations, linking them to lifestyle in diabetes, and consider some of the challenges impeding the clinical translation of lifestyle precision medicine.

  12. Public Health and Preventive Medicine Meet Integrative Health: Applications of Competency Mapping to Curriculum Education at the University of Michigan.

    Science.gov (United States)

    Wells, Eden V; Benn, Rita K; Warber, Sara L

    2015-11-01

    The University of Michigan School of Public Health Preventive Medicine Residency (UMSPH PMR) Integrative Medicine Program (IMP) was developed to incorporate integrative medicine (IM), public health, and preventive medicine principles into a comprehensive curriculum for preventive medicine residents and faculty. The objectives of this project were to (1) increase the preventive medicine workforce skill sets based in complementary and alternative medicine and IM that would address individual and population health issues; (2) address the increasing demand for evidence-based IM by training physicians to implement cost-effective primary and secondary prevention services and programs; and (3) share lessons learned, curriculum evaluations, and best practices with the larger cohort of funded IM PMR programs. The UMSPH PMR collaborated with University of Michigan IM faculty to incorporate existing IM competencies with those already established for preventive medicine and public health residency training as the first critical step for IMP curriculum integration. Essential teaching strategies incorporated didactic and practicum methods, and made use of seasoned IM faculty, along with newly minted preventive medicine integrative teaching faculty, and PMR resident learners as IM teachers. The major components of the IMP curriculum included resident participation in IMP Orientation Sessions, resident leadership in epidemiology graduate IM seminars, resident rotations in IM month-long clinical practicums, resident participation in interprofessional health system-wide IM clinical case conferences, and PMR faculty enrollment in the renowned Faculty Scholars Program in Integrative Healthcare. This paper describes the novel interdisciplinary collaborations and key curriculum components that resulted in the IMP, as well as evaluation of strengths, weaknesses, and lessons learned. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

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

    International Nuclear Information System (INIS)

    Glawe, M.

    2005-01-01

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

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

    International Nuclear Information System (INIS)

    Ugrinska, Ana; Crcareva, Biljana; Andonovski, Boris

    2010-01-01

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

  17. 15th Anniversary of the Molecular Techniques Unit at the Department of Forensic Medicine at Wroclaw Medical University.

    Science.gov (United States)

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

    2017-01-01

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

  18. PRECISION MEDICINE - The Golden Gate for Detection, Treatment and Prevention of Alzheimer's Disease.

    Science.gov (United States)

    Hampel, H; O'Bryant, S E; Castrillo, J I; Ritchie, C; Rojkova, K; Broich, K; Benda, N; Nisticò, R; Frank, R A; Dubois, B; Escott-Price, V; Lista, S

    2016-12-01

    During this decade, breakthrough conceptual shifts have commenced to emerge in the field of Alzheimer's disease (AD) recognizing risk factors and the non-linear dynamic continuum of complex pathophysiologies amongst a wide dimensional spectrum of multi-factorial brain proteinopathies/neurodegenerative diseases. As is the case in most fields of medicine, substantial advancements in detecting, treating and preventing AD will likely evolve from the generation and implementation of a systematic precision medicine strategy. This approach will likely be based on the success found from more advanced research fields, such as oncology. Precision medicine will require integration and transfertilization across fragmented specialities of medicine and direct reintegration of Neuroscience, Neurology and Psychiatry into a continuum of medical sciences away from the silo approach. Precision medicine is biomarker-guided medicine on systems-levels that takes into account methodological advancements and discoveries of the comprehensive pathophysiological profiles of complex multi-factorial neurodegenerative diseases, such as late-onset sporadic AD. This will allow identifying and characterizing the disease processes at the asymptomatic preclinical stage, where pathophysiological and topographical abnormalities precede overt clinical symptoms by many years to decades. In this respect, the uncharted territory of the AD preclinical stage has become a major research challenge as the field postulates that early biomarker guided customized interventions may offer the best chance of therapeutic success. Clarification and practical operationalization is needed for comprehensive dissection and classification of interacting and converging disease mechanisms, description of genomic and epigenetic drivers, natural history trajectories through space and time, surrogate biomarkers and indicators of risk and progression, as well as considerations about the regulatory, ethical, political and

  19. PRECISION MEDICINE - The Golden Gate for Detection, Treatment and Prevention of Alzheimer’s Disease

    Science.gov (United States)

    Hampel, H.; O’Bryant, S.E.; Castrillo, J.I.; Ritchie, C.; Rojkova, K.; Broich, K.; Benda, N.; Nisticò, R.; Frank, R.A.; Dubois, B.; Escott-Price, V.; Lista, S.

    2016-01-01

    During this decade, breakthrough conceptual shifts have commenced to emerge in the field of Alzheimer’s disease (AD) recognizing risk factors and the non-linear dynamic continuum of complex pathophysiologies amongst a wide dimensional spectrum of multi-factorial brain proteinopathies/neurodegenerative diseases. As is the case in most fields of medicine, substantial advancements in detecting, treating and preventing AD will likely evolve from the generation and implementation of a systematic precision medicine strategy. This approach will likely be based on the success found from more advanced research fields, such as oncology. Precision medicine will require integration and transfertilization across fragmented specialities of medicine and direct reintegration of Neuroscience, Neurology and Psychiatry into a continuum of medical sciences away from the silo approach. Precision medicine is biomarker-guided medicine on systems-levels that takes into account methodological advancements and discoveries of the comprehensive pathophysiological profiles of complex multi-factorial neurodegenerative diseases, such as late-onset sporadic AD. This will allow identifying and characterizing the disease processes at the asymptomatic preclinical stage, where pathophysiological and topographical abnormalities precede overt clinical symptoms by many years to decades. In this respect, the uncharted territory of the AD preclinical stage has become a major research challenge as the field postulates that early biomarker guided customized interventions may offer the best chance of therapeutic success. Clarification and practical operationalization is needed for comprehensive dissection and classification of interacting and converging disease mechanisms, description of genomic and epigenetic drivers, natural history trajectories through space and time, surrogate biomarkers and indicators of risk and progression, as well as considerations about the regulatory, ethical, political and

  20. Measurements Of Fingers Doses Of Staff Members In Nuclear Medicine Department

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  1. Value-Based Health Care Delivery, Preventive Medicine and the Medicalization of Public Health

    Science.gov (United States)

    2017-01-01

    The real paradigm shift for healthcare is often stated to include a transition from accentuating health care production and instead emphasize patient value by moving to a ‘value-based health care delivery’. In this transition, personalized medicine is sometimes referred to as almost a panacea in solving the current and future health challenges. In theory, the progress of precision medicine sounds uncontroversial and most welcomed with its promise of a better healthcare for all, with real benefits for the individual patient provided a tailored and optimized treatment plan suitable for his or her genetic makeup. And maybe, therefore, the assumptions underpinning personalized medicine have largely escaped questioning. The use of personalized medicine and the use of digital technologies is reshaping our health care system and how we think of health interventions and our individual responsibility. However, encouraging individuals to engage in preventive health activities possibly avoids one form of medicalization (clinical), but on the other hand, it takes up another form (preventive medicine and ‘self-care’) that moves medical and health concerns into every corner of everyday life. This ought to be of little value to the individual patient and public health. We ought to instead demand proof of these value ideas and the lacking research. Before this is in place critical appraisal and cynicism are requisite skills for the future. Otherwise, we are just listening to visionaries when we put our future health into their hands and let personalized solutions reach into people's everyday life regardless of patient safety and integrity. PMID:28409064

  2. Value-Based Health Care Delivery, Preventive Medicine and the Medicalization of Public Health.

    Science.gov (United States)

    Vilhelmsson, Andreas

    2017-03-01

    The real paradigm shift for healthcare is often stated to include a transition from accentuating health care production and instead emphasize patient value by moving to a 'value-based health care delivery'. In this transition, personalized medicine is sometimes referred to as almost a panacea in solving the current and future health challenges. In theory, the progress of precision medicine sounds uncontroversial and most welcomed with its promise of a better healthcare for all, with real benefits for the individual patient provided a tailored and optimized treatment plan suitable for his or her genetic makeup. And maybe, therefore, the assumptions underpinning personalized medicine have largely escaped questioning. The use of personalized medicine and the use of digital technologies is reshaping our health care system and how we think of health interventions and our individual responsibility. However, encouraging individuals to engage in preventive health activities possibly avoids one form of medicalization (clinical), but on the other hand, it takes up another form (preventive medicine and 'self-care') that moves medical and health concerns into every corner of everyday life. This ought to be of little value to the individual patient and public health. We ought to instead demand proof of these value ideas and the lacking research. Before this is in place critical appraisal and cynicism are requisite skills for the future. Otherwise, we are just listening to visionaries when we put our future health into their hands and let personalized solutions reach into people's everyday life regardless of patient safety and integrity.

  3. Breaking Boundaries: Complementary and Alternative Medicine Provider Framing of Preventive Care.

    Science.gov (United States)

    Agarwal, Vinita

    2017-11-01

    This textual examination extends understandings of how complementary and alternative medicine (CAM) providers constitute preventive care in their discourse by identifying the frame of breaking boundaries referencing relational, structural, and philosophical orientations in their practice with their clients. Analysis of semistructured, in-depth interviews with CAM providers ( n = 17) reveals that the frame of breaking boundaries was comprised of three themes: finding one's own strength; I don't prescribe, so I'm exploring; and ground yourself, and have an escape route. The themes describe preventive care by identifying how CAM providers negotiate their relational positionality in connecting with clients, structural positionality within the field of health care, and philosophical positionality within the ontological understandings that guide how health is defined and conceptualized. The study contributes toward enhancing diverse understandings of constituting preventive care in practice and suggests pragmatic implications for addressing biomedical provider communication with their patients seeking CAM care alongside conventional treatments.

  4. Sports Biostatistician: a critical member of all sports science and medicine teams for injury prevention.

    Science.gov (United States)

    Casals, Martí; Finch, Caroline F

    2017-12-01

    Sports science and medicine need specialists to solve the challenges that arise with injury data. In the sports injury field, it is important to be able to optimise injury data to quantify injury occurrences, understand their aetiology and most importantly, prevent them. One of these specialty professions is that of Sports Biostatistician. The aim of this paper is to describe the emergent field of Sports Biostatistics and its relevance to injury prevention. A number of important issues regarding this profession and the science of sports injury prevention are highlighted. There is a clear need for more multidisciplinary teams that incorporate biostatistics, epidemiology and public health in the sports injury area. 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/.

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

    Science.gov (United States)

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

    2016-06-23

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

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

    Science.gov (United States)

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

    2011-12-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  8. Adolescent Female Text Messaging Preferences to Prevent Pregnancy After an Emergency Department Visit: A Qualitative Analysis.

    Science.gov (United States)

    Chernick, Lauren Stephanie; Schnall, Rebecca; Stockwell, Melissa S; Castaño, Paula M; Higgins, Tracy; Westhoff, Carolyn; Santelli, John; Dayan, Peter S

    2016-09-29

    Over 15 million adolescents use the emergency department (ED) each year in the United States. Adolescent females who use the ED for medical care have been found to be at high risk for unintended pregnancy. Given that adolescents represent the largest users of text messaging and are receptive to receiving text messages related to their sexual health, the ED visit represents an opportunity for intervention. The aim of this qualitative study was to explore interest in and preferences for the content, frequency, and timing of an ED-based text message intervention to prevent pregnancy for adolescent females. We conducted semistructured, open-ended interviews in one urban ED in the United States with adolescent females aged 14-19 years. Eligible subjects were adolescents who were sexually active in the past 3 months, presented to the ED for a reproductive health complaint, owned a mobile phone, and did not use effective contraception. Using an interview guide, enrollment continued until saturation of key themes. The investigators designed sample text messages using the Health Beliefs Model and participants viewed these on a mobile phone. The team recorded, transcribed, and coded interviews based on thematic analysis using the qualitative analysis software NVivo and Excel. Participants (n=14) were predominantly Hispanic (13/14; 93%), insured (13/14; 93%), ED users in the past year (12/14; 86%), and frequent text users (10/14; 71% had sent or received >30 texts per day). All were interested in receiving text messages from the ED about pregnancy prevention, favoring messages that were "brief," "professional," and "nonaccusatory." Respondents favored texts with links to websites, repeated information regarding places to receive "confidential" care, and focused information on contraception options and misconceptions. Preferences for text message frequency varied from daily to monthly, with random hours of delivery to maintain "surprise." No participant feared that text

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

    Directory of Open Access Journals (Sweden)

    Daniela Galimberti

    2013-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-01-01

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

  11. Preventing and managing workplace violence against healthcare workers in Emergency Departments.

    Science.gov (United States)

    D'Ettorre, Gabriele; Pellicani, Vincenza; Mazzotta, Mauro; Vullo, Annamaria

    2018-02-21

    Healthcare workers (HCWs) employed in Emergency Departments (EDs) frequently face with patients becoming violent because of long wait or diseases or under the influence of alcohol or drugs. Globally, workplace violence (WPV) in EDs is a major challenge to safety for HCWs, involving significant consequences to the victims, patients, and healthcare organizations. We reviewed the current literature with the aim to explore the topics focused on and to detect new evidences about approaching the issue of WPV toward HCWs in EDs. A search for articles regarding WPV toward HCWs employed in EDs and published from January 2007 through December 2017 was performed; using predetermined criteria for inclusion, selected articles were reviewed and qualitatively assessed for the aims of the review. We found 60 papers which matched our inclusion criteria; the topics, discussed in order of frequency from highest to lowest, were: "Risk Assessment", "Occurrence Rates", "Risk Management", and "Physical/non Physical Consequences". Dementia, schizophrenia, anxiety, acute stress reaction, suicidal ideation, and alcohol and drug intoxication were found as predictors of physical violence perpetrated by patients against HCWs. A strategic way to the effective management of WPV should prioritize training courses focused on: constructing HCW-patient relationship, improving the workers' communication skills, accurate reporting of each violent incident, and improving the labor context through management commitment and employee involvement in WPV prevention programs. A special effort is required in implementing workplace design effective in minimizing stressful conditions in waiting rooms which turned out to be the most frequent site of assaults.

  12. Traditional Chinese medicine and new concepts of predictive, preventive and personalized medicine in diagnosis and treatment of suboptimal health.

    Science.gov (United States)

    Wang, Wei; Russell, Alyce; Yan, Yuxiang

    2014-02-13

    The premise of disease-related phenotypes is the definition of the counterpart normality in medical sciences. Contrary to clinical practices that can be carefully planned according to clinical needs, heterogeneity and uncontrollability is the essence of humans in carrying out health studies. Full characterization of consistent phenotypes that define the general population is the basis to individual difference normalization in personalized medicine. Self-claimed normal status may not represent health because asymptomatic subjects may carry chronic diseases at their early stage, such as cancer, diabetes mellitus and atherosclerosis. Currently, treatments for non-communicable chronic diseases (NCD) are implemented after disease onset, which is a very much delayed approach from the perspective of predictive, preventive and personalized medicine (PPPM). A NCD pandemic will develop and be accompanied by increased global economic burden for healthcare systems throughout both developed and developing countries. This paper examples the characterization of the suboptimal health status (SHS) which represents a new PPPM challenge in a population with ambiguous health complaints such as general weakness, unexplained medical syndrome (UMS), chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS) and chronic fatigue immune dysfunction syndrome (CFIDS). We applied clinical informatic approaches and developed a questionnaire-suboptimal health status questionnaire-25 (SHSQ-25) for measuring SHS. The validity and reliability of this approach were evaluated in a small pilot study and then in a cross-sectional study of 3,405 participants in China. We found a correlation between SHS and systolic blood pressure, diastolic blood pressure, plasma glucose, total cholesterol and high-density lipoprotein (HDL) cholesterol among men, and a correlation between SHS and systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  14. Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation.

    Science.gov (United States)

    Robinson, N J; Brennan, M L; Cobb, M; Dean, R S

    2016-02-01

    Preventive-medicine consultations account for a large proportion of the veterinary caseload and previous research has suggested these consultations are fundamentally different from those in which the animal is presented for a specific health problem. There has been recent controversy around some aspects of preventive medicine for cats and dogs, and the full health benefits of the preventive-medicine consultation remain unclear. The aim of this study was to compare characteristics of the consultation and the problems discussed during the consultation between preventive-medicine consultations and other types of consultations. Data were gathered during direct observation of small-animal consultations in seven first-opinion practices in the United Kingdom. Data collected included type of clinical examination performed, patient signalment, and details of all problems discussed (including whether the problem was presenting or non-presenting, new or pre-existing, who had raised the problem, body system affected and whether an action was taken). A two-level multivariable logistic-regression model was developed, with canine and feline patients at Level 1 nested within consulting veterinary surgeons at Level 2, and a binary outcome variable of preventive-medicine consultation versus specific health-problem consultation. A total of 1807 patients were presented, of which 690 (38.2%) presented for a preventive-medicine consultation. Dogs were the most frequently presented species (n=1168; 64.6%) followed by cats (n=510; 28.2%), rabbits (n=86; 4.8%) and patients of other species (n=43; 2.4%). The five variables remaining in the multi-level model were whether multiple patients were presented, patient age, clinical examination type, weighing and number of problems discussed. Species, breed, sex, neutering status and practice did not remain in the final model. Many non-presenting problems, including both preventive-medicine problems and specific-health problems, were discussed and

  15. Flexible technologies and smart clothing for citizen medicine, home healthcare, and disease prevention.

    Science.gov (United States)

    Axisa, Fabrice; Schmitt, Pierre Michael; Gehin, Claudine; Delhomme, Georges; McAdams, Eric; Dittmar, André

    2005-09-01

    Improvement of the quality and efficiency of healthcare in medicine, both at home and in hospital, is becoming more and more important for patients and society at large. As many technologies (micro technologies, telecommunication, low-power design, new textiles, and flexible sensors) are now available, new user-friendly devices can be developed to enhance the comfort and security of the patient. As clothes and textiles are in direct contact with about 90% of the skin surface, smart sensors and smart clothes with noninvasive sensors are an attractive solution for home-based and ambulatory health monitoring. Moreover, wearable devices or smart homes with exosensors are also potential solutions. All these systems can provide a safe and comfortable environment for home healthcare, illness prevention, and citizen medicine.

  16. A Nurse Associate in a Department of Family Medicine: Developing a Role Definition

    OpenAIRE

    1981-01-01

    The activities of a nurse associated with a family practice were documented and categorized into functional activities to give a role description. Over two years, the mean distribution of her time has spent in well child care (28.6%), pre- and postnatal care (14.7%), health education and counselling (9.6%), liaison (2.6%), student education (23.7%) and practice management (20.8%). Two important conclusions are that her major role is in preventive care and health promotion, complementary to th...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-11-15

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

  18. An overview of radioactive waste disposal procedures of a nuclear medicine department

    Science.gov (United States)

    Ravichandran, R.; Binukumar, J. P.; Sreeram, Rajan; Arunkumar, L. S.

    2011-01-01

    Radioactive wastes from hospitals form one of the various types of urban wastes, which are managed in developed countries in a safe and organized way. In countries where growth of nuclear medicine services are envisaged, implementations of existing regulatory policies and guidelines in hospitals in terms of handling of radioactive materials used in the treatment of patients need a good model. To address this issue, a brief description of the methods is presented. A designed prototype waste storage trolley is found to be of great help in decaying the I-131 solid wastes from wards before releasing to waste treatment plant of the city. Two delay tanks with collection time of about 2 months and delay time of 2 months alternately result in 6 releases of urine toilet effluents to the sewage treatment plant (STP) of the hospital annually. Samples of effluents collected at releasing time documented radioactive releases of I-131 much below recommended levels of bi-monthly release. External counting of samples showed good statistical correlation with calculated values. An overview of safe procedures for radioactive waste disposal is presented. PMID:21731225

  19. An overview of radioactive waste disposal procedures of a nuclear medicine department.

    Science.gov (United States)

    Ravichandran, R; Binukumar, J P; Sreeram, Rajan; Arunkumar, L S

    2011-04-01

    Radioactive wastes from hospitals form one of the various types of urban wastes, which are managed in developed countries in a safe and organized way. In countries where growth of nuclear medicine services are envisaged, implementations of existing regulatory policies and guidelines in hospitals in terms of handling of radioactive materials used in the treatment of patients need a good model. To address this issue, a brief description of the methods is presented. A designed prototype waste storage trolley is found to be of great help in decaying the I-131 solid wastes from wards before releasing to waste treatment plant of the city. Two delay tanks with collection time of about 2 months and delay time of 2 months alternately result in 6 releases of urine toilet effluents to the sewage treatment plant (STP) of the hospital annually. Samples of effluents collected at releasing time documented radioactive releases of I-131 much below recommended levels of bi-monthly release. External counting of samples showed good statistical correlation with calculated values. An overview of safe procedures for radioactive waste disposal is presented.

  20. An overview of radioactive waste disposal procedures of a nuclear medicine department

    Directory of Open Access Journals (Sweden)

    R Ravichandran

    2011-01-01

    Full Text Available Radioactive wastes from hospitals form one of the various types of urban wastes, which are managed in developed countries in a safe and organized way. In countries where growth of nuclear medicine services are envisaged, implementations of existing regulatory policies and guidelines in hospitals in terms of handling of radioactive materials used in the treatment of patients need a good model. To address this issue, a brief description of the methods is presented. A designed prototype waste storage trolley is found to be of great help in decaying the I-131 solid wastes from wards before releasing to waste treatment plant of the city. Two delay tanks with collection time of about 2 months and delay time of 2 months alternately result in 6 releases of urine toilet effluents to the sewage treatment plant (STP of the hospital annually. Samples of effluents collected at releasing time documented radioactive releases of I-131 much below recommended levels of bi-monthly release. External counting of samples showed good statistical correlation with calculated values. An overview of safe procedures for radioactive waste disposal is presented.

  1. [The department budget, in the context of the hospital global budget. Initial results in general medicine].

    Science.gov (United States)

    Besançon, F

    1984-02-23

    In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

  2. Image fusion in open-architecture quality-oriented nuclear medicine and radiology departments

    Energy Technology Data Exchange (ETDEWEB)

    Pohjonen, H

    1998-12-31

    Imaging examinations of patients belong to the most widely used diagnostic procedures in hospitals. Multimodal digital imaging is becoming increasingly common in many fields of diagnosis and therapy planning. Patients are frequently examined with magnetic resonance imaging (MRI), X-ray computed tomography (CT) or ultrasound imaging (US) in addition to single photon (SPET) or positron emission tomography (PET). The aim of the study was to provide means for improving the quality of the whole imaging and viewing chain in nuclear medicine and radiology. The specific aims were: (1) to construct and test a model for a quality assurance system in radiology based on ISO standards, (2) to plan a Dicom based image network for fusion purposes using ATM and Ethernet technologies, (3) to test different segmentation methods in quantitative SPET, (4) to study and implement a registration and visualisation method for multimodal imaging, (5) to apply the developed method in selected clinical brain and abdominal images, and (6) to investigate the accuracy of the registration procedure for brain SPET and MRI 90 refs. The thesis includes also six previous publications by author

  3. Image fusion in open-architecture quality-oriented nuclear medicine and radiology departments

    International Nuclear Information System (INIS)

    Pohjonen, H.

    1997-01-01

    Imaging examinations of patients belong to the most widely used diagnostic procedures in hospitals. Multimodal digital imaging is becoming increasingly common in many fields of diagnosis and therapy planning. Patients are frequently examined with magnetic resonance imaging (MRI), X-ray computed tomography (CT) or ultrasound imaging (US) in addition to single photon (SPET) or positron emission tomography (PET). The aim of the study was to provide means for improving the quality of the whole imaging and viewing chain in nuclear medicine and radiology. The specific aims were: (1) to construct and test a model for a quality assurance system in radiology based on ISO standards, (2) to plan a Dicom based image network for fusion purposes using ATM and Ethernet technologies, (3) to test different segmentation methods in quantitative SPET, (4) to study and implement a registration and visualisation method for multimodal imaging, (5) to apply the developed method in selected clinical brain and abdominal images, and (6) to investigate the accuracy of the registration procedure for brain SPET and MRI

  4. Image fusion in open-architecture quality-oriented nuclear medicine and radiology departments

    Energy Technology Data Exchange (ETDEWEB)

    Pohjonen, H

    1997-12-31

    Imaging examinations of patients belong to the most widely used diagnostic procedures in hospitals. Multimodal digital imaging is becoming increasingly common in many fields of diagnosis and therapy planning. Patients are frequently examined with magnetic resonance imaging (MRI), X-ray computed tomography (CT) or ultrasound imaging (US) in addition to single photon (SPET) or positron emission tomography (PET). The aim of the study was to provide means for improving the quality of the whole imaging and viewing chain in nuclear medicine and radiology. The specific aims were: (1) to construct and test a model for a quality assurance system in radiology based on ISO standards, (2) to plan a Dicom based image network for fusion purposes using ATM and Ethernet technologies, (3) to test different segmentation methods in quantitative SPET, (4) to study and implement a registration and visualisation method for multimodal imaging, (5) to apply the developed method in selected clinical brain and abdominal images, and (6) to investigate the accuracy of the registration procedure for brain SPET and MRI 90 refs. The thesis includes also six previous publications by author

  5. An overview of radioactive waste disposal procedures of a nuclear medicine department

    International Nuclear Information System (INIS)

    Ravichandran, R.; Binukumar, J.P.; Sreeram, Rajan; Arunkumar, L.S.

    2011-01-01

    Radioactive wastes from hospitals form one of the various types of urban wastes, which are managed in developed countries in a safe and organized way. In countries where growth of nuclear medicine services are envisaged, implementations of existing regulatory policies and guidelines in hospitals in terms of handling of radioactive materials used in the treatment of patients need a good model. To address this issue, a brief description of the methods is presented. A designed prototype waste storage trolley is found to be of great help in decaying the 131 I solid wastes from wards before releasing to waste treatment plant of the city. Two delay tanks with collection time of about 2 months and delay time of 2 months alternately result in 6 releases of urine toilet effluents to the sewage treatment plant (STP) of the hospital annually. Samples of effluents collected at releasing time documented radioactive releases of 131 I- much below recommended levels of bi-monthly release. External counting of samples showed good statistical correlation with calculated values. An overview of safe procedures for radioactive waste disposal is presented. (author)

  6. Greening the Department of Energy through waste prevention, recycling, and Federal acquisition. Strategic plan to implement Executive Order 13101

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-11-01

    This Plan provides strategies and milestones to implement Executive Order 13101, Greening the Government Through Waste Prevention, Recycling, and Federal Acquisition, and to achieve the new Secretarial goals for 2005 and 2010. It serves as the principal Secretarial guidance to Department of Energy (DOE) Headquarters, Field Offices, and laboratory and contractor staff to improve sanitary waste prevention, recycling, and the purchase and use of recycled content and environmentally preferable products and services in the DOE.

  7. Action of mechanism of traditional Chinese medicine in prevention and treatment of nonalcoholic fatty liver disease

    Directory of Open Access Journals (Sweden)

    HOU Yixin

    2016-04-01

    Full Text Available In recent years, extensive studies have been conducted on the pathogenesis of nonalcoholic fatty liver disease (NAFLD, and the action of mechanism of traditional Chinese medicine (TCM in NAFLD has become a new research topic. TCM has achieved good clinical efficacy in the treatment of NAFLD, with the advantages of specific, flexible, multilevel, and multi-target treatment. This article introduces the role of TCM in improving insulin, regulating lipid metabolism, preventing lipid peroxidation, regulating cytokines, regulating and maintaining the dynamic balance of factors involved in lipid metabolism, and maintaining the balance of intestinal microflora, and analyzes the major problems in TCM research.

  8. [Exploration and practice in the construction of curriculum on epidemiology in preventive medicine].

    Science.gov (United States)

    Zhu, Y M; Le, Y L; Yu, Y X; Wang, J B; Jin, M J; Tang, M L; Chen, K

    2017-12-10

    Epidemiology is one of main courses for undergraduate students majoring in preventive medicine. There are some limitations in the traditional epidemiology teaching, which is usually characterized in indoctrinated education: "lectured by the teachers and listened by the students." In Zhejiang University, staff of the epidemiology division tried to explore a new teaching mode as 'student-centered, teacher-leading, question-based, and combining with literature discussion and course practice.' After practicing for two years, students were inspired in learning initiatives, with teaching effectiveness obviously improved.

  9. Suicide Prevention in an Emergency Department Population: The ED-SAFE Study.

    Science.gov (United States)

    Miller, Ivan W; Camargo, Carlos A; Arias, Sarah A; Sullivan, Ashley F; Allen, Michael H; Goldstein, Amy B; Manton, Anne P; Espinola, Janice A; Jones, Richard; Hasegawa, Kohei; Boudreaux, Edwin D

    2017-06-01

    Suicide is a leading cause of deaths in the United States. Although the emergency department (ED) is an opportune setting for initiating suicide prevention efforts, ED-initiated suicide prevention interventions remain underdeveloped. To determine whether an ED-initiated intervention reduces subsequent suicidal behavior. This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: (1) a treatment as usual (TAU) phase from August 2010 to December 2011, (2) a universal screening (screening) phase from September 2011 to December 2012, and (3) a universal screening plus intervention (intervention) phase from July 2012 to November 2013. Screening consisted of universal suicide risk screening. The intervention phase consisted of universal screening plus an intervention, which included secondary suicide risk screening by the ED physician, discharge resources, and post-ED telephone calls focused on reducing suicide risk. The primary outcome was suicide attempts (nonfatal and fatal) over the 52-week follow-up period. The proportion and total number of attempts were analyzed. A total of 1376 participants were recruited, including 769 females (55.9%) with a median (interquartile range) age of 37 (26-47) years. A total of 288 participants (20.9%) made at least 1 suicide attempt, and there were 548 total suicide attempts among participants. There were no significant differences in risk reduction between the TAU and screening phases (23% vs 22%, respectively). However, compared with the TAU phase, patients in the intervention phase showed a 5% absolute reduction in suicide attempt risk (23% vs 18%), with a relative risk reduction of 20%. Participants in the intervention phase had 30% fewer total suicide attempts than participants in the TAU phase. Negative binomial regression analysis indicated that the participants in the intervention phase had significantly fewer total suicide attempts

  10. Hemoglobin levels and blood transfusion in patients with sepsis in Internal Medicine Departments.

    Science.gov (United States)

    Muady, Gassan Fuad; Bitterman, Haim; Laor, Arie; Vardi, Moshe; Urin, Vitally; Ghanem-Zoubi, Nesrin

    2016-10-13

    Acute reduction in hemoglobin levels is frequently seen during sepsis. Previous studies have focused on the management of anemia in patients with septic shock admitted to intensive care units (ICU's), including aggressive blood transfusion aiming to enhance tissue oxygenation. To study the changes in hemoglobin concentrations during the first week of sepsis in the setting of Internal Medicine (IM) units, and their correlation to survival. Observational prospective study. We recorded hemoglobin values upon admission and throughout the first week of hospital stay in a consecutive cohort of septic patients admitted to IM units at a community hospital, the patients were enrolled into a prospective registry. Data on blood transfusions was also collected, we examined the correlation between hemoglobin concentrations during the first week of sepsis and survival, the effect of blood transfusion was also assessed. Eight hundred and fifteen patients (815) with sepsis were enrolled between February 2008 to January 2009. More than 20 % of them had hemoglobin levels less than 10g/dL on admission, a rate that was doubled during the first week of sepsis. Overall, 68 (8.3 %) received blood transfusions, 14 of them (20.6 %) due to bleeding. Typically, blood transfusion was given to older patients with a higher rate of malignancy and lower hemoglobin levels. While hemoglobin concentration on admission had strong correlation with in-hospital mortality (O.R-0.83 [95 % C.I. 0.74-0.92], blood transfusion was not found to be an independent predicting factor for mortality. Anemia is very common in sepsis. While hemoglobin level on admission exhibit independent correlation with survival, blood transfusion do not.

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  12. Assessing Injury and Violence Prevention in North Carolina’s Local Health Departments

    Science.gov (United States)

    Mouw, Mary S.; Counts, Jennifer; Fordham, Corinne; Francis, Molly Merrill; Bach, Laura E.; Maman, Suzanne; Proescholdbell, Scott K.

    2016-01-01

    Context Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) is not well described. Objectives 1) Provide a baseline assessment of IVP in the state’s LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. 2) Describe a replicable, cost-effective method for systematic assessment of regional IVP. Design An observational, cross-sectional study, through a survey of NC’s 85 LHDs. Results Representatives from 77 LHDs (91%) responded. Nearly a third (n=23, 30%) reported no staff were familiar with evidence-based interventions in IVP; over a third (n=29, 38%) reported their LHD did not train staff in IVP. Almost half (n=37, 46%) had no dedicated funding. On average, respondents said about half of their programs were evidence-based; however, there was marked variation (mean 52%, SD = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs’ programs. Conclusions Despite funding constraints, NC’s LHDs are engaged in a broad range of IVP activities. Programming did not uniformly address state injury and violence priorities, however, nor local injury and violence burden. Staff need training in evidence-based strategies targeting priority areas. Multi-sector partnerships were common and increased LHDs’ capacity. These findings are actionable at the state and local-level. PMID:27621337

  13. The Mechanisms of Traditional Chinese Medicine Underlying the Prevention and Treatment of Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Xiaoliang Li

    2017-09-01

    Full Text Available Parkinson's disease (PD, characterized with bradykinesia, static tremor, rigidity and disturbances in balance, is the second most common neurodegenerative disorder. Along with the largely aging population in the world, the incidence is increasing year by year, which imposes the negative impacts on patients, their families and the whole society. Traditional Chinese medicine (TCM has a positive prospect for the prevention and cure of PD due to its advantages of less side effects and multi-target effects. At present, the pathogenesis of PD is not yet fully discovered. This paper elaborates the mechanisms of TCM underlying the prevention and treatment of PD with regards to the inhibition of oxidative stress, the regulation of mitochondrial dysfunction, the reduction of toxic excitatory amino acids (EAA, the inhibition of neuroinflammation, the inhibition of neuronal apoptosis, and the inhibition of abnormal protein aggregation.

  14. Eurycoma longifolia: Medicinal Plant in the Prevention and Treatment of Male Osteoporosis due to Androgen Deficiency

    Directory of Open Access Journals (Sweden)

    Nadia Mohd Effendy

    2012-01-01

    Full Text Available Osteoporosis in elderly men is now becoming an alarming health issue due to its relation with a higher mortality rate compared to osteoporosis in women. Androgen deficiency (hypogonadism is one of the major factors of male osteoporosis and it can be treated with testosterone replacement therapy (TRT. However, one medicinal plant, Eurycoma longifolia Jack (EL, can be used as an alternative treatment to prevent and treat male osteoporosis without causing the side effects associated with TRT. EL exerts proandrogenic effects that enhance testosterone level, as well as stimulate osteoblast proliferation and osteoclast apoptosis. This will maintain bone remodelling activity and reduce bone loss. Phytochemical components of EL may also prevent osteoporosis via its antioxidative property. Hence, EL has the potential as a complementary treatment for male osteoporosis.

  15. Transport medicine, osteochondrosis, diagnostic, preventions of complications, physiotherapy, impulse magnetic stimulation

    Directory of Open Access Journals (Sweden)

    V. V. Loboiko

    2017-01-01

      Summary Offered us medical and rehabilitation complex using pulsed magnetic stimulation for the prevention and treatment of complications of destructive-degenerative disorders of the spine in patients with low back pain lumbar zone greatly increases the effectiveness sanogenetic mechanisms to improve trophic processes in the spinal segments, both in the area of formation of pathological disorders and in areas distal lower extremities. The positive dynamics of functioning structures spinal nerve under the influence of pulsed magnetic stimulation provides improved hemodynamic performance throughout the vascular bed in the lower extremities. It was established that the basis sanogenetic improve the mechanisms of blood vessels, are processes that define their tone, elasticity and adequacy of response to treatment and rehabilitation influence factors. High efficiency pulsed magnetic stimulation achieved by potentiating its effect on biological effects, which are formed in the body using standard treatments for osteoarthritis. Key words. Transport medicine, osteochondrosis, diagnostic, preventions of complications, physiotherapy, impulse magnetic stimulation.

  16. Pulmonary thromboembolic disease – clinical and etiological aspects in internal medicine department

    Directory of Open Access Journals (Sweden)

    Mazilu Laura

    2015-05-01

    Full Text Available Background: Pulmonary embolism (PE represents the third most frequent vascular disease following acute myocardial ischemic disease and stroke. It is a common and potentially lethal disease. Aim: We observed etiological spectrum, clinical aspects and diagnostic tests for patients with PE. Material and methods: Retrospective observational study that included 53 patients diagnosed with PE between 01.01.2009- 31.12.2013. We followed epidemiological aspects, risk factors, clinical manifestations and methods for positive diagnosis. Results: 53 patients which represents 0.66% from the patients admitted in our department (n=8,011, were diagnosed with PE. The main risk factor for PE was malignancy (n=16. Twenty patients with PE presented deep venous thrombosis (DVT and 12 patients arterial thrombosis (AT. Main clinical syndromes of patients with PE were pulmonary infarction (n=32, isolated dyspnea (n=11 and circulatory collapse (n=10. A lot of paraclinical investigation sustained positive diagnosis,mainly by high performance techniques. Four cases were diagnosed postmortem.

  17. Where Is Obesity Prevention on the Map? Distribution and Predictors of Local Health Department Prevention Activities in Relation to County-Level Obesity Prevalence in the US

    Science.gov (United States)

    Stamatakis, Katherine A.; Leatherdale, Scott T.; Marx, Christine; Yan, Yan; Colditz, Graham A.; Brownson, Ross C.

    2013-01-01

    Context The system of local health departments (LHD) in the US has potential to advance a locally-oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown. Objective This study examines the extent to which LHDs across the US have responded to local levels of obesity by examining the association between jurisdiction level obesity prevalence and the existence of obesity prevention programs. Design Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n=2,300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering. Setting 2,300 local health department jurisdictions defined with respect to county boundaries Participants Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments. Main Outcome Measures Likelihood of having obesity prevention activities and association with area-level obesity prevalence Results The existence of obesity prevention activities was not associated with prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering. Conclusions This paper identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance. PMID:22836530

  18. Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children.

    Science.gov (United States)

    Hawke, Kate; van Driel, Mieke L; Buffington, Benjamin J; McGuire, Treasure M; King, David

    2018-04-09

    Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs each year. Although these infections are self limiting, the symptoms can be distressing. Many treatments are used to control symptoms and shorten the duration of illness. They often have minimal benefit and may lead to adverse effects. Oral homeopathic medicinal products could play a role in the treatment of ARTIs for children if evidence for effectiveness is established. To assess the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat acute respiratory tract infections in children. We searched CENTRAL (2017, Issue 11), which contains the Cochrane Acute Respiratory Infections Specialised Register, MEDLINE (1946 to 27 November 2017), Embase (2010 to 27 November 2017), CINAHL (1981 to 27 November 2017), AMED (1985 to December 2014), CAMbase (searched 29 March 2018), British Homeopathic Library (searched 26 June 2013 - no longer operating). We also searched the WHO ICTRP and ClinicalTrials.gov trials registers (29 March 2018), checked references, and contacted study authors to identify additional studies. Double-blind, randomised controlled trials (RCTs) or double-blind cluster-RCTs comparing oral homeopathy medicinal products with identical placebo or self selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years. We used standard methodological procedures expected by Cochrane. We included eight RCTs of 1562 children receiving oral homeopathic medicinal products or a control treatment (placebo or conventional treatment) for upper respiratory tract infections (URTIs). Four treatment studies examined the effect on recovery from URTIs, and four studies investigated the effect on preventing URTIs after one to three months of treatment and followed up for the remainder of the year. Two treatment and two prevention studies

  19. Communication Concepts for Prevention and Early Intervention in Aesthetic Medicine: Consensus and Literature Review.

    Science.gov (United States)

    Gout, Uliana; Anand, Chytra V; Braz, Andre; Chao, Yates Yen Yu; Fabi, Sabrina Guillen; Kerscher, Martina; Landau, Marina; Pavicic, Tatjana; Peng, Peter Hsien Li; Rzany, Berthold; Sattler, Gerhard; Tiryaki, Tunk; Waldorf, Heidi A; Besins, Thierry

    2017-09-01

    Communication concepts relating to prevention and early intervention (P&E) within aesthetic medicine are poorly understood and highly underexplored. However, effective communication is a key criterion for successful outcomes. To introduce the framework for P&E communication strategies within a younger population and explore the barriers that may be encountered. A literature review on P&E communication strategies in aesthetic medicine and related topics of interest was conducted and used to construct a working framework that may be applied in clinical practice. Examination of existing literature revealed a need for a more structured communication framework for P&E encompassing up-to-date evidence-based learning and educational marketing that is tailored to individual needs and target populations. Message framing-the way in which a message is presented-is an important consideration in the dissemination of information to promote changes in health behaviour. A structured consultation is key to optimising patient engagement and ensures a tailored approach to understanding and catering to the specific needs of each patient. This is the first paper to discuss the communication concepts behind P&E within aesthetic medicine and paves the way for further research and focus in this significant field. J Drugs Dermatol. 2017;16(9):859-864..

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

    Science.gov (United States)

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

    2016-06-01

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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

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

    Science.gov (United States)

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

    2001-12-01

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

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

    OpenAIRE

    小山, 真; Koyama, Shin

    2001-01-01

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

  5. Journey to a safe environment: fall prevention in an emergency department at a level I trauma center.

    Science.gov (United States)

    Alexander, Danette; Kinsley, Terry L; Waszinski, Christine

    2013-07-01

    Predicting which patients will fall is a challenging task, especially in the often unpredictable setting of an emergency department of a Level I Trauma Center. Unfortunately, there is a great potential for falls to occur in this environment. Fall risk assessment tools used in inpatient settings do not adequately capture the risk factors of patients presenting to the emergency department. The ability to accurately identify patients at risk for falling at the point of entry is the first step toward preventing patient harm. Once patients are identified as at risk for a fall, the next challenge is to be sure that they do not fall. We created the KINDER1 Fall Risk Assessment Tool for use in the emergency department. This instrument was specifically designed for the rapid identification of patients at risk for a fall as well as the re-evaluation of patients for fall risk throughout their stay in the emergency department. Once we had an appropriate assessment tool, our next challenge was for staff to consistently apply fall prevention interventions. Performing a mini-root cause analysis on each fall showed trends and in turn led to the design and implementation of specific fall prevention interventions to motivate the nursing staff to focus on fall prevention that the ED nursing leadership used to select change strategies. With improved identification of fall risk patients and consistent application of innovative prevention strategies, we were able to show a trend toward reduction of falls and fall-related injuries in our emergency department. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  6. [A retrospective study on the incidence of chronic renal failure in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo (the capital city of Madagascar)].

    Science.gov (United States)

    Ramilitiana, Benja; Ranivoharisoa, Eliane Mikkelsen; Dodo, Mihary; Razafimandimby, Evanirina; Randriamarotia, Willy Franck

    2016-01-01

    Chronic renal failure is a global public health problem. In developed countries, this disease occurs mainly in the elderly, but in Africa it rather affects active young subjects. This disease need for expensive treatments in a low income country, because of its costs. Our aim is to describe the epidemiology of new cases of chronic renal failure in Madagascar. This is a retrospective, descriptive study of 239 patients with chronic renal failure over a 3 year period, starting from 1 January 2007 to 31 December 2009, in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo. The incidence was 8.51% among patients hospitalized in the Department. The average age of patients was 45.4 years with extremes of 16 and 82 years and a sex ratio 1,46. The main antecedent was arterial hypertension (59.8%). Chronic renal failure was terminal in 75.31% of the cases (n=180). The causes of chronic renal failure were dominated by chronic glomerulonephritis (40.1%), nephroangiosclerosis (35.5%). Hemodialysis was performed in 3 patients (1.26%), no patient was scheduled for a renal transplantation. Mortality rate in the Department was 28.87%. Chronic renal failure is a debilitating disease with a dreadful prognosis which affects young patients in Madagascar. Its treatment remains inaccessible to the majority of patients. The focus must be mainly on prevention, especially on early effective management of infections, arterial hypertension and diabetes to reduce its negative impacts on the community and public health. The project on renal transplantation: living donor, effective and less expensive treatment compared to hemodialysis could also be a good solution for these Malagasy young subjects.

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Giovanni Pedretti

    2014-05-01

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

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

    Science.gov (United States)

    Münstedt, Karsten; Brenken, Anja; Kalder, Matthias

    2009-09-01

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

  10. PGD for all cystic fibrosis carrier couples: novel strategy for preventive medicine and cost analysis.

    Science.gov (United States)

    Tur-Kaspa, I; Aljadeff, G; Rechitsky, S; Grotjan, H E; Verlinsky, Y

    2010-08-01

    Over 1000 children affected with cystic fibrosis (CF) are born annually in the USA. Since IVF with preimplantation genetic diagnosis (PGD) is an alternative to raising a sick child or to aborting an affected fetus, a cost-benefit analysis was performed for a national IVF-PGD program for preventing CF. The amount spent to deliver healthy children for all CF carrier-couples by IVF-PGD was compared with the average annual and lifetime direct medical costs per CF patient avoided. Treating annually about 4000 CF carrier-couples with IVF-PGD would result in 3715 deliveries of non-affected children at a cost of $57,467 per baby. Because the average annual direct medical cost per CF patient was $63,127 and life expectancy is 37 years, savings would be $2.3 million per patient and $2.2 billion for all new CF patients annually in lifetime treatment costs. Cumulated net saving of an IVF-PGD program for all carrier-couples for 37 years would be $33.3 billion. A total of 618,714 cumulative years of patients suffering because of CF and thousands of abortions could be prevented. A national IVF-PGD program is a highly cost-effective novel modality of preventive medicine and would avoid most births of individuals affected with debilitating genetic disease. 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  11. First Consensus on Primary Prevention and Early Intervention in Aesthetic Medicine.

    Science.gov (United States)

    Landau, Marina; Anand, Chytra V; Besins, Thierry; Chao, Yates Yen Yu; Fabi, Sabrina Guillen; Gout, Uliana; Kerscher, Martina; Pavicic, Tatjana; Peng, Peter Hsien Li; Rzany, Berthold; Sattler, Gerhard; Tiryaki, Tunk; Waldorf, Heidi A; Braz, Andre

    2017-09-01

    Facial aging is a complex interplay of extrinsic and intrinsic factors leading to progressive changes in the skin, subcutaneous tissue, and bone. Clinical experience suggests that early aesthetic intervention may slow the signs of aging, but treatment in the absence of symptoms or with minimal signs of aging has not yet been properly addressed. To provide treatment recommendations for primary prevention and early intervention in individuals with no or minimal signs of aging. Fourteen specialists in aesthetic medicine convened over a full-day meeting under the guidance of a certified moderator. Tailored treatment recommendations have been provided for prevention and early intervention of fine wrinkles, static lines and folds, irregular pigmentation, laxity, and subcutaneous volume loss by protecting the epidermis, stimulating neocollagenesis, reducing hyperkinetic musculature, and reinforcing supporting structures. Preventive measures and early therapeutic interventions that may alter the course of facial aging were defined. Further studies are needed to support these recommendations with the best possible evidence. J Drugs Dermatol. 2017;16(9):846-854..

  12. Herbal Medicine Goshajinkigan Prevents Paclitaxel-Induced Mechanical Allodynia without Impairing Antitumor Activity of Paclitaxel

    Directory of Open Access Journals (Sweden)

    Muh. Akbar Bahar

    2013-01-01

    Full Text Available Chemotherapy-induced peripheral neuropathy is a major dose-limiting side effect of commonly used chemotherapeutic agents. However, there are no effective strategies to treat the neuropathy. We examined whether Goshajinkigan, a herbal medicine, would prevent paclitaxel-induced allodynia without affecting the anticancer action in mice. Murine breast cancer 4T1 cells were inoculated into the mammary fat pad. Paclitaxel (10 and 20 mg/kg, intraperitoneal, alternate day from day 7 postinoculation inhibited the tumor growth, and Goshajinkigan (1 g/kg, oral, daily from day 2 postinoculation did not affect the antitumor action of paclitaxel. Mechanical allodynia developed in the inoculated region due to tumor growth and in the hind paw due to paclitaxel-induced neuropathy. Paclitaxel-induced allodynia was markedly prevented by Goshajinkigan, although tumor-associated allodynia was not inhibited by Goshajinkigan. These results suggest that Goshajinkigan prevents paclitaxel-induced peripheral neuropathy without interfering with the anti-cancer action of paclitaxel.

  13. Recent Scientific Studies of a Traditional Chinese Medicine, Tea, on Prevention of Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Chung S. Yang

    2014-01-01

    Full Text Available Green tea (綠茶 Lǜ Chá, made from the leaves of the plant Camellia sinensis, has traditionally been used as a medicine in China for thousands of years. According to the classical work of Li Shizhen (李時珍 Lǐ Shí Zhēn of the Ming Dynasty, “tea is cold and lowers the fire.” Since fire (inflammation causes many diseases, could tea be effective in the prevention of many diseases? The possible prevention of chronic diseases such as cancer, metabolic syndrome, obesity, diabetes, and cardiovascular diseases has been studied with contemporary scientific methods, and the results are promising. The molecular mechanisms underlining these observations will be discussed in this presentation. One of the reasons for the failure to demonstrate a disease-preventive effect of tea in some epidemiological studies is the lower quantities of tea consumption in humans. Can we increase the quantity of tea consumption to harness its health benefits without causing gastrointestinal irritation? This is a topic for further research.

  14. Traditional Chinese medicine for prevention and treatment of hepatocarcinoma: From bench to bedside

    Science.gov (United States)

    Hu, Bing; Wang, Shuang-Shuang; Du, Qin

    2015-01-01

    Traditional Chinese medicine (TCM) has played a positive role in the management of hepatocarcinoma. Hepatocarcinoma patients may present Qi-stagnation, damp-heat, blood stasis, Qi-deficiency, Yin-deficiency and other TCM syndromes (Zheng). Modern treatments such as surgery, transarterial chemoembolization (TACE) and high intensity focus ultrasound treatment would influence the manifestation of TCM syndromes. Herbs with traditional efficacy of tonifying Qi, blood and Yin, soothing liver-Qi stagnation, clearing heat and detoxifying and dissolving stasis, have been demonstrated to be potent to prevent hepatocarcinogenesis. TCM has been widely used in all aspects of integrative therapy in hepatocarcinoma, including surgical resection, liver transplantation, TACE, local ablative therapies and even as monotherapy for middle-advanced stage hepatocarcinoma. Clinical practices have confirmed that TCM is effective to alleviate clinical symptoms, improve quality of life and immune function, prevent recurrence and metastasis, delay tumor progression, and prolong survival time in hepatocarcinoma patients. The effective mechanism of TCM against hepatocarcinoma is related to inducing apoptosis, autophagy, anoikis and cell senescence, arresting cell cycle, regulating immune function, inhibiting metastasis and angiogenesis, reversing drug resistance and enhancing effects of chemotherapy. Along with the progress of research in this field, TCM will contribute more to the prevention and treatment of hepatocarcinoma. PMID:26019736

  15. Development of a Survey to Assess Local Health Department Organizational Processes and Infrastructure for Supporting Obesity Prevention.

    Science.gov (United States)

    Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B

    Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.

  16. [Institutional changes for the future of Hygiene and Preventive Medicine in Italy].

    Science.gov (United States)

    Faggioli, Antonio

    2011-01-01

    Following a brief overview of the initiatives undertaken since 2005 by the Italian Society of Hygiene (SitI) regarding he future of Hygiene and Public Health in Italy, the authors examine the latest proposals for renewing the organizational structure of the departments of Prevention, as well as for training programs and function of public health physicians. These changes, however, may be insufficient for a real renewal of public health, in the absence of institutional changes which would allocate administrative management of healthcare functions to local government, with community participation in health promotion. The planned establishment of "metropolitan cities" in 2012 is an opportunity for the SItI to show that the management of health administrative functions by the new local government organs is compatible with the institutional framework, is useful for achieving the objectives of health promotion and disease prevention, and facilitates health policy in local governments.

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

    Science.gov (United States)

    Pololi, Linda H; Evans, Arthur T

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  19. [Development of an instrument for the surveillance of quality indicators in specialized training in Preventive Medicine and Public Health].

    Science.gov (United States)

    Gil-Borrelli, Christian Carlo; Latasa, Pello; Reques, Laura; Alemán, Guadalupe

    2015-01-01

    This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Policies to restrict secondhand smoke exposure: American College of Preventive Medicine Position Statement.

    Science.gov (United States)

    Jacobs, Michelle; Alonso, Alina M; Sherin, Kevin M; Koh, Yumi; Dhamija, Asha; Lowe, Andrea L

    2013-09-01

    Secondhand smoke (SHS) exposure poses serious health risks for all nonsmokers, especially children and pregnant women. SHS is estimated to contribute to heart attacks in nonsmokers and nearly 53,800 deaths in the U.S. annually. A literature review of English-language articles was performed using PubMed, organizational websites, and pertinent review articles. Over the past 25 years, smokefree policies have protected nearly half the U.S. population from the adverse health effects of SHS. Smokefree policies have been shown to improve health outcomes with no consequences to local businesses. As of April 2013, a total of 24 states and 561 municipalities and territories, including the District of Columbia, New York City, Puerto Rico, and the U.S. Virgin Islands, have established laws that require nonhospitality workplaces, restaurants, and bars to be 100% smokefree. Four other states-Florida, Indiana, Louisiana, and Nevada-have smokefree laws that cover restaurants but provide an exemption for stand-alone bars. At least 14 states have no smokefree laws. This paper describes the benefits of policies that reduce SHS and concludes with recommendations for future directions. The American College of Preventive Medicine (ACPM) recommends expanded clean indoor air policies for workplaces, stand-alone bars, restaurants, and multi-use family housing such as apartment buildings. ACPM recommends clean air policies for all university campuses, secondary school campuses, primary schools, child care centers, and city landmarks to further shift social norms and protect the health of children, adolescents, and adults. ACPM recommends closing existing gaps in clean indoor air policies. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Awareness among Parents of β-Thalassemia Major Patients Regarding Prenatal Diagnosis and Premarital Screening in Day Care Centre of Transfusion Medicine Department.

    Science.gov (United States)

    Rudra, S; Chakrabarty, P; Hossain, M A; Ripon, M J; Rudra, M; Mirza, T T

    2016-01-01

    Thalassemia is one of the most common genetic diseases in the world. It is a major health problem, brings much morbidity, early mortality and a great deal of misery for a family both financially and emotionally. The patients suffering from beta thalassemia major do not survive for more than 5 years without blood transfusion. Blood transfusion is usually administered every two to five weeks to maintain the pre-transfusion hemoglobin level of 9-10 gm/dL. This study carried out in the department of Transfusion Medicine of Mymensingh Medical College Hospital from January 2014 to June 2014. A total of 200 parents were interviewed. There was a slight preponderance of females which accounted for 57.5% of the parents. Ninety seven (45.5%) had an income less than Rs. 5000 per month. Nearly 50% were illiterate with only 24.5% with a higher education. Consanguinity was positive in 72.5% of the parents with extended family history of thalassemia positive in 40.8%. Only 29.5% were immunized against Hepatitis B. Around 27.5% did not know whether they should be immunized. Fifty five percent of parents knew children should receive Dysferol. Twelve percent were aware of consanguinity to be a risk factor for thalassaemia with only 5% having undergone antenatal diagnosis. Parental knowledge about thalassemia and its preventive measures is inadequate; this requires intervention in the form of public health education programs concentrating on high risk/targeted population.

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

    Science.gov (United States)

    Sun, Xing-guo

    2015-07-01

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

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

    Science.gov (United States)

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

    2014-09-01

    This study investigated the circumstances and problems that departments of forensic medicine encounter with bereaved families regarding samples obtained from medico-legal autopsies. A questionnaire was posted to all 76 departments of forensic medicine performing medico-legal autopsies in Japan, and responses were received from 48 (63.2%). Of the respondents, 12.8% had approached and communicated with bereaved families about collecting samples from the deceased person during an autopsy and the storage of the samples. In addition, 23.4% of these had informed families that samples might be used in research. Eighteen departments had received enquiries and requests from families about the samples, with most requests concerning their return. The response to such requests varied according to the department. Few departments interacted with the bereaved families regarding the procedure for obtaining autopsy samples, and their methods for handling family concerns differed depending on the person within the department authorised to contact the family. Moreover, the procedures for engaging in such communication have long been unclear, and no legal or ethical consensus or agreement with the general public has been established. It is important for researchers to further discuss the correct way for forensic medicine departments to communicate with bereaved families. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective.

    Science.gov (United States)

    Tan, Lh; Kamarulzaman, A

    2006-01-01

    Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.

  6. Effect of the improving teaching method on the prevention of needle stick injuries in the department of infectious disease

    Directory of Open Access Journals (Sweden)

    Yi CHEN

    2014-11-01

    Full Text Available Objective: To discuss the effect of improving teaching method and strengthening the training of occupational protection on the prevention of needle stick injuries in the department of infectious disease. Methods: Collect 17 cases of needle stick injuries that occurred in 2012 among 178 nurses in department of infectious disease. The same cases occurred in 2013 when the nurses had received the occupational protection training and targeted countermeasures were also collected. Results: The incidence of needle stick injuries was 9.55% in infectious department in 2012, and it is down to 3.4% in 2013. Conclusion: Nursing students are more likely to cause needle stick injuries. Training of occupational protection together with nursing technical operation specification can effectively control the occurrence of needle stick injuries.

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

    Directory of Open Access Journals (Sweden)

    Romy Lauche

    2012-01-01

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

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

    Science.gov (United States)

    Yedidia, M J; Bickel, J

    2001-05-01

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

  9. [Employment opportunities and job satisfaction in the field of Public Health: a survey among recent graduates of the Hygiene and Preventive Medicine residency in Italy].

    Science.gov (United States)

    Soncini, Francesco; Odone, Anna; Lalic, Tijana; Miduri, Alessia; Paroni, Samuel; Vezzosi, Luigi; Privitera, Gaetano; Signorelli, Carlo

    2017-01-01

    We conducted an on-line survey among 255 specialists in Hygiene and Preventive Medicine in Italy who completed their training between October 2014 and July 2016, to assess their training experience, employment opportunities and current job satisfaction. Response rate was 49%. Mean age was 35 years. A high employment rate within two years from obtaining specialist qualification was reported by the 125 specialists who completed the questionnaire (76% are currently employed). The three main work settings of the participating specialists are hospital health directions (37%), universities (19%) and local Prevention Departments (16%). Two thirds (66%) have temporary positions and only 6% permanent positions. Job, pay, and training satisfaction are often below expectations with geographical differences that would need to be further investigated.

  10. Sustainable medical research by effective and comprehensive medical skills: overcoming the frontiers by predictive, preventive and personalized medicine.

    Science.gov (United States)

    Trovato, Guglielmo M

    2014-01-01

    Clinical research and practice require affordable objectives, sustainable tools, rewarding training strategies and meaningful collaboration. Our unit delivers courses on project design and management promoting ideas, useful skills, teaching and exploring implementation of networks and existing collaborations. We investigated the effectiveness of a sustainable approach of comprehensive diagnosis and care and its usefulness within concrete models of research project teaching methodology. The model of predictive, preventive and personalized medicine (PPPM) of adolescent hypertension, developed since 1976 and still active, was displayed. This is a paradigm of comprehensive PPPM aimed at the management of a recognized, but actually neglected, societal and clinical problem. The second model was addressed to the analysis of performance of an outpatient diagnostic and therapy unit and its relationship with the emergency department. Part of the patients, 4,057 cancer patients presenting at the emergency care, were addressed to the outpatient diagnostic and therapy unit for further assessment, treatment and follow-up. The stay in DH was 6.3 ± 2.1 non-consecutive days, with shortage of costs, vs. in-hospital stays. Research planning courses, based on these models, ensued in an increase of competitive project submission and successful funding. Active promotion of interdisciplinary knowledge and skills is warranted. Misleading messages and information are detrimental not only to healthy and sick people but, equally, to all health professionals: efforts for basing on evidence by research any statement are needed. The actual pre-requisite of personalized medicine is the coherent and articulated promotion of the professional quality of staff. Health professionals should and can be skilled in sustainable non-invasive diagnostic procedures, in non-pharmacological intervention, in translational research (from epidemiology to personalized therapy) and in timely dissemination of

  11. Traditional herbal medicine prevents postoperative recurrence of small hepatocellular carcinoma: A randomized controlled study.

    Science.gov (United States)

    Zhai, Xiao-Feng; Liu, Xiao-Lin; Shen, Feng; Fan, Jia; Ling, Chang-Quan

    2018-05-15

    To explore the clinical efficacy of traditional herbal medicine (THM) in the prevention of disease recurrence of small hepatocellular carcinoma after surgery, a prospective randomized controlled study was conducted between October 2006 and May 2010. The results indicated that THM prevented the recurrence of SHCC with an efficacy that was superior to that of transarterial chemoembolization (TACE) during a median follow-up of 26.61 months. The patients were followed up every 6 months, and the clinical data before October 20, 2015 were analyzed. The primary outcome measure was recurrence-free survival (RFS), and the secondary outcome measure was overall survival (OS). The 364 patients included 180 in the THM group and 184 in the TACE group. At the time of the data cutoff of October 20, 2015, a total of 205 patients demonstrated disease recurrence, including 85 patients in the THM group and 120 patients in the TACE group. The median RFS of the THM and TACE groups demonstrated a statistically significant difference (P<.001). Until October 20, 2105, there were 91 deaths, including 34 in the THM group and 57 in the TACE group. The median OS demonstrated a significant difference between the 2 groups (P = .008). Multivariate analysis indicated that THM was an independent factor influencing RFS and OS. The efficacy of THM was found to be superior to that of TACE in preventing disease recurrence in patients with small hepatocellular carcinoma and prolonging OS. Cancer 2018;124:2161-8. © 2018 American Cancer Society. © 2018 American Cancer Society.

  12. Complementary Role of Herbal Medicine and Exercise in Cardiovascular Disease Prevention and Management: A Review of Evidence.

    Science.gov (United States)

    Veluswamy, Sundar Kumar; Babu, Abraham Samuel; Sundar, Lakshmi Manickavasagam

    2017-01-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide. Herbal medicine and exercise interventions have individually been shown to be effective in the prevention and management of CVD. However, the complementary roles of herbal medicine and exercise interventions for CVD prevention and management have not been adequately reported. 1. Identify studies analysing complementary roles of herbal medicine and exercise intervention in CVD prevention and management, 2. Identify herbs and exercise strategies that have been reported to exhibit complementary roles in CVD prevention and management, and 3. Summarize evidence of complementary roles of herbal medicine and exercise interventions for CVD prevention and management. PubMed, CINAHL and Web of Science were searched with a customised search strategy in May 2015. Two reviewers screened the search results for inclusion using pre-specified criteria. Data were extracted from full text of selected abstracts in a predetermined template by two reviewers and verified by the third reviewer when needed. A total of 35 titles were identified for full texts review after screening 827 abstracts. Data were extracted from 23 titles, representing 12 human studies and six animal studies. This review identified effects of 14 different herbs and 10 exercise strategies on over 18 CVD risk factors and markers. Complementary roles of herbal medicine and exercise were reported from five studies. Evidence of complementary role of herbal medicine and exercise is emerging from animal studies. More robust clinical studies on proven risk factors are needed before they can be recommended for clinical practice. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  13. Responsibility of sport and exercise medicine in preventing and managing chronic disease: applying our knowledge and skill is overdue.

    Science.gov (United States)

    Matheson, Gordon O; Klügl, Martin; Dvorak, Jiri; Engebretsen, Lars; Meeuwisse, Willem H; Schwellnus, Martin; Blair, Steven N; van Mechelen, Willem; Derman, Wayne; Börjesson, Mats; Bendiksen, Fredrik; Weiler, Richard

    2011-12-01

    The rapidly increasing burden of chronic disease is difficult to reconcile with the large, compelling body of literature that demonstrates the substantial preventive and therapeutic benefits of comprehensive lifestyle intervention, including physical activity, smoking cessation and healthy diet. Physical inactivity is now the fourth leading independent risk factor for death caused by non-communicable chronic disease. Although there have been efforts directed towards research, education and legislation, preventive efforts have been meager relative to the magnitude of the problem. The disparity between our scientific knowledge about chronic disease and practical implementation of preventive approaches now is one of the most urgent concerns in healthcare worldwide and threatens the collapse of our health systems unless extraordinary change takes place. The authors believe that there are several key factors contributing to the disparity. Reductionism has become the default approach for healthcare delivery, resulting in fragmentation rather than integration of services. This, in turn, has fostered a disease-based rather than a health-based model of care and has produced medical school curricula that no longer accurately reflect the actual burden of disease. Trying to 'fit' prevention into a disease-based approach has been largely unsuccessful because the fundamental tenets of preventive medicine are diametrically opposed to those of disease-based healthcare. A clinical discipline within medicine is needed to adopt disease prevention as its own reason for existence. Sport and exercise medicine is well positioned to champion the cause of prevention by promoting physical activity. This article puts forward a strong case for the immediate, increased involvement of clinical sport and exercise medicine in the prevention and treatment of chronic disease and offers specific recommendations for how this may begin.

  14. Early prevention of pressure ulcers among elderly patients admitted through emergency departments: a cost-effectiveness analysis.

    Science.gov (United States)

    Pham, Ba'; Teague, Laura; Mahoney, James; Goodman, Laurie; Paulden, Mike; Poss, Jeff; Li, Jianli; Ieraci, Luciano; Carcone, Steven; Krahn, Murray

    2011-11-01

    Every year, approximately 6.2 million hospital admissions through emergency departments (ED) involve elderly patients who are at risk of developing pressure ulcers. We evaluated the cost-effectiveness of pressure-redistribution foam mattresses on ED stretchers and beds for early prevention of pressure ulcers in elderly admitted ED patients. Using a Markov model, we evaluated the incremental effectiveness (quality-adjusted life-days) and incremental cost (hospital and home care costs) between early prevention and current practice (with standard hospital mattresses) from a health care payer perspective during a 1-year time horizon. The projected incidence of ED-acquired pressure ulcers was 1.90% with current practice and 1.48% with early prevention, corresponding to a number needed to treat of 238 patients. The average upgrading cost from standard to pressure-redistribution mattresses was $0.30 per patient. Compared with current practice, early prevention was more effective, with 0.0015 quality-adjusted life-days gained, and less costly, with a mean cost saving of $32 per patient. If decisionmakers are willing to pay $50,000 per quality-adjusted life-year gained, early prevention was cost-effective even for short ED stay (ie, 1 hour), low hospital-acquired pressure ulcer risk (1% prevalence), and high unit price of pressure-redistribution mattresses ($3,775). Taking input uncertainty into account, early prevention was 81% likely to be cost-effective. Expected value-of-information estimates supported additional randomized controlled trials of pressure-redistribution mattresses to eliminate the remaining decision uncertainty. The economic evidence supports early prevention with pressure-redistribution foam mattresses in the ED. Early prevention is likely to improve health for elderly patients and save hospital costs. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  16. An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

    Energy Technology Data Exchange (ETDEWEB)

    Jofre, M J; Sierralta, M P [Military Hospital Nuclear Medicine Department, Santiago (Chile); Del Campo, G; Ide, A; Wiener, R [Department of Endocrinology of the Military Hospital, Santiago (Chile)

    2002-09-01

    An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

  17. An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

    International Nuclear Information System (INIS)

    Jofre, M.J.; Sierralta, M.P.; Del Campo, G.; Ide, A.; Wiener, R.

    2002-01-01

    An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  19. Multidrug resistant Salmonella enterica isolated from conventional pig farms using antimicrobial agents in preventative medicine programmes.

    Science.gov (United States)

    Cameron-Veas, Karla; Fraile, Lorenzo; Napp, Sebastian; Garrido, Victoria; Grilló, María Jesús; Migura-Garcia, Lourdes

    2018-04-01

    A longitudinal study was conducted to investigate the presence of multidrug antimicrobial resistance (multi-AR) in Salmonella enterica in pigs reared under conventional preventative medicine programmes in Spain and the possible association of multi-AR with ceftiofur or tulathromycin treatment during the pre-weaning period. Groups of 7-day-old piglets were treated by intramuscular injection with ceftiofur on four farms (n=40 piglets per farm) and with tulathromycin on another four farms (n=40 piglets per farm). A control group of untreated piglets (n=30 per farm) was present on each farm. Faecal swabs were collected for S. enterica culture prior to treatment, at 2, 7 and 180days post-treatment, and at slaughter. Minimal inhibitory concentrations of 14 antimicrobial agents, pulsed-field gel electrophoresis and detection of resistance genes representing five families of antimicrobial agents were performed. Plasmids carrying cephalosporin resistant (CR) genes were characterised. Sixty-six S. enterica isolates were recovered from five of eight farms. Forty-seven isolates were multi-AR and four contained bla CTX-M genes harboured in conjugative plasmids of the IncI1 family; three of these isolates were recovered before treatment with ceftiofur. The most frequent AR genes detected were tet(A) (51/66, 77%), sul1 (17/66, 26%); tet(B) (15/66, 23%) and qnrB (10/66, 15%). A direct relation between the use of ceftiofur in these conditions and the occurrence of CR S. enterica was not established. However, multi-AR was common, especially for ampicillin, streptomycin, sulphonamides and tetracycline. These antibiotics are used frequently in veterinary medicine in Spain and, therefore, should be used sparingly to minimise the spread of multi-AR. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. [Patient safety and errors in medicine: development, prevention and analyses of incidents].

    Science.gov (United States)

    Rall, M; Manser, T; Guggenberger, H; Gaba, D M; Unertl, K

    2001-06-01

    "Patient safety" and "errors in medicine" are issues gaining more and more prominence in the eyes of the public. According to newer studies, errors in medicine are among the ten major causes of death in association with the whole area of health care. A new era has begun incorporating attention to a "systems" approach to deal with errors and their causes in the health system. In other high-risk domains with a high demand for safety (such as the nuclear power industry and aviation) many strategies to enhance safety have been established. It is time to study these strategies, to adapt them if necessary and apply them to the field of medicine. These strategies include: to teach people how errors evolve in complex working domains and how types of errors are classified; the introduction of critical incident reporting systems that are free of negative consequences for the reporters; the promotion of continuous medical education; and the development of generic problem-solving skills incorporating the extensive use of realistic simulators wherever possible. Interestingly, the field of anesthesiology--within which realistic simulators were developed--is referred to as a model for the new patient safety movement. Despite this proud track record in recent times though, there is still much to be done even in the field of anesthesiology. Overall though, the most important strategy towards a long-term improvement in patient safety will be a change of "culture" throughout the entire health care system. The "culture of blame" focused on individuals should be replaced by a "safety culture", that sees errors and critical incidents as a problem of the whole organization. The acceptance of human fallability and an open-minded non-punitive analysis of errors in the sense of a "preventive and proactive safety culture" should lead to solutions at the systemic level. This change in culture can only be achieved with a strong commitment from the highest levels of an organization. Patient

  1. R&D implementation in a department of laboratory medicine and pathology: a systematic review based on pharmaceutical companies.

    Science.gov (United States)

    Feulefack, Joseph; Sergi, Consolato

    2015-01-01

    A systematic literature review on pharmaceutical companies may be a tool for guiding some procedures of R&D implementation in a department of Laboratory Medicine and Pathology. The use of pharmaceutical companies for this specific analysis arises from less variability of standards than healthcare facilities. In this qualitative and quantitative analysis, we focused on three useful areas of implementation, including R&D productivity, commercialization strategies, and expenditures determinants of pharmaceutical companies. Studies and reports of online databases from 1965 to 2014 were reviewed according to specific search terms. Initially, 218 articles and reports were found and examined, but only 91 were considered appropriate and used for further analysis.  We identified some suggested implementation strategies relevant for marketing to enhance companies' own R&D strategies; such as reliability of companies on "sourcing-in" R&D facilities and "think-tank" events. Regardless of the study and of the country, cash flow and profitability always positively influenced R&D expenditure, while sales and firm size did not. We consider that handling R&D determinants should require caution. It seems critical that implementation of R&D systems is directly related with productivity, if it reflects dual embodiment of efficiency and effectiveness. Scrutinizing the determinants of R&D expenditures emphasizes significant factors that are worth to highlight when planning an R&D investment strategy. Although there is no receipt fitting every situation, we think that health care plan makers may find relevant data in this systematic review in creating an initial implementation framework.

  2. Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

    Directory of Open Access Journals (Sweden)

    Weiland Tracey J

    2010-11-01

    Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

  3. Mortality in the elderly with acute kidney injury in an internal medicine department in Abidjan, Cote D'Ivoire

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    Hubert Kouamé Yao

    2018-01-01

    Full Text Available Acute kidney injury (AKI in the elderly is characterized by high mortality. The objective of this study is to identify the causes of death in the elderly with AKI. This is a prospective cohort study with a descriptive purpose which was carried out during the period from January 2009 to December 2014 in the Department of Nephrology-Internal Medicine of Treichville University Hospital. The diagnosis of AKI was made on the basis of serum creatinine (SCr values determined during hospitalization, according to KDIGO classification. Our study involved 107 elderly aged 65 and older with AKI. The hospital mortality rate was 46.7% (50/107. The average age of deceased patients was 71.8 ± 7 years with extremes of 65 and 90 years. We observed a male predominance with a sex ratio (41/9 of 4.55. AKI on admission was in Stage 1 in 16% of cases, in Stage 2 in 24%, and in Stage 3 in 60% cases. SCr was normal in 8%, the AKI was in Stage 1 in 34% (P = 0.09, Stage 2 in 18% (P = 0.001, and Stage 3 in 40% (P = 0.0001. AKI in deceased patients was organic in 36% of cases, obstructive in 30%, and functional in 6%. The etiologies of AKI were infections (46%, cancer (18%, benign tumors of the urinary tract (12%, malignant hypertension (6%, decompensated heart disease (6%, and drugs (6%. The main causes of death were sepsis (28%, cardiovascular disease (22%, severe renal failure (20%, pelvic cancers (16%, and liver failure (12%. All patients with cancer (P = 0.001 or HIV infected (P = 0.009 died. Sixty-eight percent of deaths occurred the 1st week. Death was earlier by sepsis and cardiovascular disease than by cancer. Mortality is high in the elderly. The main causes of death were sepsis, cardiovascular disease, renal failure, pelvic cancer, and liver failure.

  4. Balancing Herbal Medicine and Functional Food for Prevention and Treatment of Cardiometabolic Diseases through Modulating Gut Microbiota.

    Science.gov (United States)

    Lyu, Ming; Wang, Yue-Fei; Fan, Guan-Wei; Wang, Xiao-Ying; Xu, Shuang-Yong; Zhu, Yan

    2017-01-01

    It has become apparent that gut microbiota is closely associated with cardiometabolic diseases (CMDs), and alteration in microbiome compositions is also linked to the host environment. Next generation sequencing (NGS) has facilitated in-depth studies on the effects of herbal medicine and functional food on gut microbiota. Both herbal medicine and functional food contain fiber, polyphenols and polysaccharides, exerting prebiotics-like activities in the prevention and treatment of CMDs. The administrations of herbal medicine and functional food lead to increased the abundance of phylum Bacteroidetes, and genus Akkermansia, Bifidobacteria, Lactobacillus, Bacteroides and Prevotella , while reducing phylum Firmicutes and Firmicutes/Bacteroidetes ratio in gut. Both herbal medicine and functional food interact with gut microbiome and alter the microbial metabolites including short-chain fatty acids (SCFAs), bile acids (BAs) and lipopolysaccharides (LPS), which are now correlated with metabolic diseases such as type 2 diabetes (T2D), obesity and non-alcoholic fatty liver disease (NAFLD). In addition, trimethylamine (TMA)-N-oxide (TMAO) is recently linked to atherosclerosis (AS) and cardiovascular disease (CVD) risks. Moreover, gut-organs axes may serve as the potential strategy for treating CMDs with the intervention of herbal medicine and functional food. In summary, a balance between herbal medicine and functional food rich in fiber, polyphenols and polysaccharides plays a vital role in modulating gut microbiota (phylum Bacteroidetes, Firmicutes and Firmicutes/Bacteroidetes ratio, and genus Akkermansia, Bifidobacteria, Lactobacillus, Bacteroides and Prevotella ) through SCFAs, BAs, LPS and TMAO signaling regarding CMDs. Targeting gut-organs axes may serve as a new therapeutic strategy for CMDs by herbal medicine and functional food in the future. This review aims to summarize the balance between herbal medicine and functional food utilized for the prevention and

  5. Balancing Herbal Medicine and Functional Food for Prevention and Treatment of Cardiometabolic Diseases through Modulating Gut Microbiota

    Directory of Open Access Journals (Sweden)

    Ming Lyu

    2017-11-01

    Full Text Available It has become apparent that gut microbiota is closely associated with cardiometabolic diseases (CMDs, and alteration in microbiome compositions is also linked to the host environment. Next generation sequencing (NGS has facilitated in-depth studies on the effects of herbal medicine and functional food on gut microbiota. Both herbal medicine and functional food contain fiber, polyphenols and polysaccharides, exerting prebiotics-like activities in the prevention and treatment of CMDs. The administrations of herbal medicine and functional food lead to increased the abundance of phylum Bacteroidetes, and genus Akkermansia, Bifidobacteria, Lactobacillus, Bacteroides and Prevotella, while reducing phylum Firmicutes and Firmicutes/Bacteroidetes ratio in gut. Both herbal medicine and functional food interact with gut microbiome and alter the microbial metabolites including short-chain fatty acids (SCFAs, bile acids (BAs and lipopolysaccharides (LPS, which are now correlated with metabolic diseases such as type 2 diabetes (T2D, obesity and non-alcoholic fatty liver disease (NAFLD. In addition, trimethylamine (TMA-N-oxide (TMAO is recently linked to atherosclerosis (AS and cardiovascular disease (CVD risks. Moreover, gut-organs axes may serve as the potential strategy for treating CMDs with the intervention of herbal medicine and functional food. In summary, a balance between herbal medicine and functional food rich in fiber, polyphenols and polysaccharides plays a vital role in modulating gut microbiota (phylum Bacteroidetes, Firmicutes and Firmicutes/Bacteroidetes ratio, and genus Akkermansia, Bifidobacteria, Lactobacillus, Bacteroides and Prevotella through SCFAs, BAs, LPS and TMAO signaling regarding CMDs. Targeting gut-organs axes may serve as a new therapeutic strategy for CMDs by herbal medicine and functional food in the future. This review aims to summarize the balance between herbal medicine and functional food utilized for the prevention and

  6. Balancing Herbal Medicine and Functional Food for Prevention and Treatment of Cardiometabolic Diseases through Modulating Gut Microbiota

    Science.gov (United States)

    Lyu, Ming; Wang, Yue-fei; Fan, Guan-wei; Wang, Xiao-ying; Xu, Shuang-yong; Zhu, Yan

    2017-01-01

    It has become apparent that gut microbiota is closely associated with cardiometabolic diseases (CMDs), and alteration in microbiome compositions is also linked to the host environment. Next generation sequencing (NGS) has facilitated in-depth studies on the effects of herbal medicine and functional food on gut microbiota. Both herbal medicine and functional food contain fiber, polyphenols and polysaccharides, exerting prebiotics-like activities in the prevention and treatment of CMDs. The administrations of herbal medicine and functional food lead to increased the abundance of phylum Bacteroidetes, and genus Akkermansia, Bifidobacteria, Lactobacillus, Bacteroides and Prevotella, while reducing phylum Firmicutes and Firmicutes/Bacteroidetes ratio in gut. Both herbal medicine and functional food interact with gut microbiome and alter the microbial metabolites including short-chain fatty acids (SCFAs), bile acids (BAs) and lipopolysaccharides (LPS), which are now correlated with metabolic diseases such as type 2 diabetes (T2D), obesity and non-alcoholic fatty liver disease (NAFLD). In addition, trimethylamine (TMA)-N-oxide (TMAO) is recently linked to atherosclerosis (AS) and cardiovascular disease (CVD) risks. Moreover, gut-organs axes may serve as the potential strategy for treating CMDs with the intervention of herbal medicine and functional food. In summary, a balance between herbal medicine and functional food rich in fiber, polyphenols and polysaccharides plays a vital role in modulating gut microbiota (phylum Bacteroidetes, Firmicutes and Firmicutes/Bacteroidetes ratio, and genus Akkermansia, Bifidobacteria, Lactobacillus, Bacteroides and Prevotella) through SCFAs, BAs, LPS and TMAO signaling regarding CMDs. Targeting gut-organs axes may serve as a new therapeutic strategy for CMDs by herbal medicine and functional food in the future. This review aims to summarize the balance between herbal medicine and functional food utilized for the prevention and treatment

  7. Translating Personality Psychology to Help Personalize Preventive Medicine for Young-Adult Patients

    Science.gov (United States)

    Israel, Salomon; Moffitt, Terrie E.; Belsky, Daniel W.; Hancox, Robert J.; Poulton, Richie; Roberts, Brent; Thomson, W. Murray; Caspi, Avshalom

    2014-01-01

    The rising number of newly insured young adults brought on by healthcare reform will soon increase demands on primary-care physicians. Physicians will face more young-adult patients which presents an opportunity for more prevention-oriented care. In the current study, we evaluated whether brief observer reports of young adults’ personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the Dunedin Study cohort of 1,000 individuals, we show that very brief measures of young adults’ personalities predicted their midlife physical health across multiple domains (metabolic abnormalities, cardiorespiratory fitness, pulmonary function, periodontal disease, and systemic inflammation). Individuals scoring low on the traits of Conscientiousness and Openness-to-Experience went on to develop poorer health even after accounting for preexisting differences in education, socioeconomic status, smoking, obesity, self-reported health, medical conditions, and family medical history. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health-risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for healthcare professionals to personalize preventive medicine. Adding personality information to existing healthcare electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor-patient communication, health service use, and patient outcomes. PMID:24588093

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

    Directory of Open Access Journals (Sweden)

    Witt CM

    2015-01-01

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

  9. Diet Therapy for Cancer Prevention and Treatment Based on Traditional Persian Medicine.

    Science.gov (United States)

    Javadi, Behjat

    2018-04-01

    Cancer is the second leading cause of death with profound socio-economic consequences worldwide. Growing evidence suggests the crucial role of diet on cancer prevention and treatment. In Traditional Persian Medicine (TPM) there is a major focus on contribution of special diet and foods to cancer management. In the present article, the cytotoxic and antitumor activities of several food items including plants and animal products recommended by TPM as anticancer agents are discussed. Strong evidence supports the anticancer effects of beetroot (Beta vulgris) and its major compound betanin, cinnamon and cinnamaldehyde, barley (H. vulgare) and its products, extra-virgin olive oil, black pepper (P. nigrum) and its piperine, grapes (V. vinifera) and its compound resveratrol, ginger and its compound 6-gingerol, whey protein, fish, and honey. However, additional pharmacological studies and clinical trials are needed to elucidate their molecular and cellular mechanisms of actions, frequency, and amount of consumption, possible adverse effects, and optimum preparation methods. Moreover, studying mechanisms of actions of the bioactive compounds present in the discussed food items can be helpful in identifying and development of new anticancer agents.

  10. “HealthOmeter”: An Aid in Advancing Preventive Medicine Media Revolution

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    Erik Trell

    2015-01-01

    Full Text Available Subjective wellbeing is an important issue on the preventive medicine and political agenda and for mutual communication, information, and interaction in society and its individuals “requires new tools for measuring phenomena previously believed unmeasurable, as well as conceptual frameworks for interpreting such measurements…considering both happiness and misery.” The task is difficult, however, due to the great span of parameters and variables of age and gender, settings, socioeconomic conditions, wellness and illness, activities and functions, roles and habits, thoughts and feelings, and experiences and expectations involved over the panorama. HealthOmeter is a clinically tested and validated instrument with design and capacity in distinct coherent chapters to meet the new measurement and interpretation demands both contentwise and operationwise. Over the range of subjective and objective health it enables, in a uniform normalized layout in quintile balance between positive and negative, an all-round self-assessment and counsel in multimedia, preferably computer/mobile app distribution including storage, collation, and follow-up in full integrity and secrecy on the individual and aggregated level.

  11. Emergency Department Catheter-Associated Urinary Tract Infection Prevention: Multisite Qualitative Study of Perceived Risks and Implemented Strategies.

    Science.gov (United States)

    Carter, Eileen J; Pallin, Daniel J; Mandel, Leslie; Sinnette, Corine; Schuur, Jeremiah D

    2016-02-01

    Existing knowledge of emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention is limited. We aimed to describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs. In this qualitative comparative case study, we enrolled early-adopting EDs, that is, those using criteria for urinary catheter placement and tracking the frequency of catheters placed in the ED. At 6 diverse facilities, we conducted 52 semistructured interviews and 9 focus groups with hospital and ED participants. All ED CAUTI programs originated from a hospitalwide focus on CAUTI prevention. Staff were motivated to address CAUTI because they believed program compliance improved patient care. ED CAUTI prevention was perceived to differ from CAUTI prevention in the inpatient setting. To identify areas of ED CAUTI prevention focus, programs examined ED workflow and identified 4 CAUTI risks: (1) inappropriate reasons for urinary catheter placement; (2) physicians' limited involvement in placement decisions; (3) patterns of urinary catheter overuse; and (4) poor insertion technique. Programs redesigned workflow to address risks by (1) requiring staff to specify the medical reason for catheter at the point of order entry and placement; (2) making physicians responsible for determining catheter use; (3) using catheter alternatives to address patterns of overuse; and (4) modifying urinary catheter insertion practices to ensure proper placement. Early-adopting EDs redesigned workflow to minimize catheter use and ensure proper insertion technique. Assessment of ED workflow is necessary to identify and modify local practices that may increase CAUTI risk.

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

    Science.gov (United States)

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

    2012-02-01

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

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

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    Pines, Jesse M

    2006-05-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  16. Parent-Child Injury Prevention Conversations Following a Trip to the Emergency Department.

    Science.gov (United States)

    O'Neal, Elizabeth E; Plumert, Jodie M; Peterson, Carole

    2016-03-01

    The goal of the study was to examine how parents use conversation to promote the internalization of safety values after their child has been seriously injured. Parent interviews detailing postinjury conversations were coded for strategies mentioned to prevent injuries in the future and information about circumstances surrounding the injury. Logistic regression analyses revealed that parents were more likely to discuss why an activity was dangerous with older than younger children, and were more likely to urge daughters than sons to be more careful in the future. Injuries resulting from the presence of environmental hazards predicted parents telling children to be more careful in the future. Having others involved predicted parents urging children not to engage in the behavior again. Findings suggest that parents modulated strategies according to age, gender, and injury circumstances to maximize the likelihood that children would behave differently in the future. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Directory of Open Access Journals (Sweden)

    Boris Djindjic

    2007-01-01

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

  18. Challenges and opportunities of applying P4 medicine and traditional Chinese medicine for cancer treatment and prevention in the 21st century:Amedical oncologist’s perspectives

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    Edward H. Lin

    2016-10-01

    Full Text Available Being one of the deadliest diseases, cancer needs a stronger dose of P4 medicine (Predictive, Preventive, Personalized and Participatory first proposed by Dr. Hood and TCM intervention, as cancer treatment still largely relies on the decade-old cytotoxic chemotherapy, radiation and surgery. This overview uses colorectal cancer model to discuss pitfalls in current cancer prevention and treatment strategies, which saw many randomized phase III studies failing to meet the study primary endpoints or marginally meeting the study objectives. Complete sequencing of whole human genome provided much of the hopes as well as hypes for precision medicine, as genomic diversity, ever changing tumor mutation landscape, SNP and complex microRNA regulation from the intron region and epigenetics make genotype to phenotype correlation study increasingly challenging. As a participant of One hundred Persons Pioneers Project, I witnessed first hand how a comprehensive scientific wellness study that integrates whole genomics, microbiome, and metabolome nutrition along with comprehensive laboratory examinations can be used to diagnose pre-illness in all “healthy” participants. Pre-illness can be best intervened by none pharmaceutical means and traditional Chinese Medicine (TCM adept in restoring internal healing mechanisms, opening up the blocked network and balancing the five-elements homeostasis. Following TCM principles, we were able to design a therapy that effectively targets colon cancer stem cells and its microenvironment leading to more doubling of overall survival with reduction in overall toxicities. Pre-illness diagnosis, cancer immunotherapy, TCM medicine is about restoring internal healing power by letting go brakes on “good” immune systems to go after the “bad” cancer cells. Time is ripe to integrate our knowledge in genomics immune systems, stem cell biology, nutrition, inflammation, metabolism, systems medicine, and modern TCM to deliver a

  19. Ready or not: does household preparedness prevent absenteeism among emergency department staff during a disaster?

    Science.gov (United States)

    Mercer, Mary P; Ancock, Benedict; Levis, Joel T; Reyes, Vivian

    2014-01-01

    During major disasters, hospitals experience varied levels of absenteeism among healthcare workers (HCWs) in the immediate response period. Loss of critical hospital personnel, including Emergency Department (ED) staff, during this time can negatively impact a facility's ability to effectively treat large numbers of ill and injured patients. Prior studies have examined factors contributing to HCW ability and willingness to report for duty during a disaster. The purpose of this study was to determine if the degree of readiness of ED personnel, as measured by household preparedness, is associated with predicted likelihood of reporting for duty. Additionally, the authors sought to elucidate other factors associated with absenteeism among ED staff during a disaster. ED staff of five hospitals participated in this survey-based study, answering questions regarding demographic information, past disaster experience, household disaster preparedness (using a novel,15-point scale), and likelihood of reporting to work during various categories of disaster. The primary outcome was personal predicted likelihood of reporting for duty following a disaster. A total of 399 subjects participated in the study. ED staffs were most likely to report for duty in the setting of an earthquake (95 percent) or other natural disaster, followed by an epidemic (90 percent) and were less likely to report for work during a biological, chemical, or a nuclear event (63 percent). Degree of household preparedness was determined to have no association with an ED HCW's predicted likelihood of reporting for duty. Factors associated with predicted absenteeism varied based on type of disaster and included having dependents in the home, female gender, past disaster relief experience, having a spouse or domestic partner, and not owning pets. Having dependents in the home was associated with predicted absenteeism for all disaster types (OR 0.30-0.66). However, when stratified by gender, the presence of

  20. [Co-author and keyword networks and their clustering appearance in preventive medicine fields in Korea: analysis of papers in the Journal of Preventive Medicine and Public Health, 1991~2006].

    Science.gov (United States)

    Jung, Minsoo; Chung, Dongjun

    2008-01-01

    This study evaluated knowledge structure and its effect factor by analysis of co-author and keyword networks in Korea's preventive medicine sector. The data was extracted from 873 papers listed in the Journal of Preventive Medicine and Public Health, and was transformed into a co-author and keyword matrix where the existence of a 'link' was judged by impact factors calculated by the weight value of the role and rate of author participation. Research achievement was dependent upon the author's status and networking index, as analyzed by neighborhood degree, multidimensional scaling, correspondence analysis, and multiple regression. Co-author networks developed as randomness network in the center of a few high-productivity researchers. In particular, closeness centrality was more developed than degree centrality. Also, power law distribution was discovered in impact factor and research productivity by college affiliation. In multiple regression, the effect of the author's role was significant in both the impact factor calculated by the participatory rate and the number of listed articles. However, the number of listed articles varied by sex. This study shows that the small world phenomenon exists in co-author and keyword networks in a journal, as in citation networks. However, the differentiation of knowledge structure in the field of preventive medicine was relatively restricted by specialization.

  1. Recent Progress Toward Hydrogen Medicine: Potential of Molecular Hydrogen for Preventive and Therapeutic Applications

    Science.gov (United States)

    Ohta, Shigeo

    2011-01-01

    Persistent oxidative stress is one of the major causes of most lifestyle-related diseases, cancer and the aging process. Acute oxidative stress directly causes serious damage to tissues. Despite the clinical importance of oxidative damage, antioxidants have been of limited therapeutic success. We have proposed that molecular hydrogen (H2) has potential as a “novel” antioxidant in preventive and therapeutic applications [Ohsawa et al., Nat Med. 2007: 13; 688-94]. H2 has a number of advantages as a potential antioxidant: H2 rapidly diffuses into tissues and cells, and it is mild enough neither to disturb metabolic redox reactions nor to affect reactive oxygen species (ROS) that function in cell signaling, thereby, there should be little adverse effects of consuming H2. There are several methods to ingest or consume H2, including inhaling hydrogen gas, drinking H2-dissolved water (hydrogen water), taking a hydrogen bath, injecting H2-dissolved saline (hydrogen saline), dropping hydrogen saline onto the eye, and increasing the production of intestinal H2 by bacteria. Since the publication of the first H2 paper in Nature Medicine in 2007, the biological effects of H2 have been confirmed by the publication of more than 38 diseases, physiological states and clinical tests in leading biological/medical journals, and several groups have started clinical examinations. Moreover, H2 shows not only effects against oxidative stress, but also various anti-inflammatory and anti-allergic effects. H2 regulates various gene expressions and protein-phosphorylations, though the molecular mechanisms underlying the marked effects of very small amounts of H2 remain elusive. PMID:21736547

  2. Nighttime assaults: using a national emergency department monitoring system to predict occurrence, target prevention and plan services

    Directory of Open Access Journals (Sweden)

    Bellis Mark A

    2012-09-01

    Full Text Available Abstract Background Emergency department (ED data have the potential to provide critical intelligence on when violence is most likely to occur and the characteristics of those who suffer the greatest health impacts. We use a national experimental ED monitoring system to examine how it could target violence prevention interventions towards at risk communities and optimise acute responses to calendar, holiday and other celebration-related changes in nighttime assaults. Methods A cross-sectional examination of nighttime assault presentations (6.01 pm to 6.00 am; n = 330,172 over a three-year period (31st March 2008 to 30th March 2011 to English EDs analysing changes by weekday, month, holidays, major sporting events, and demographics of those presenting. Results Males are at greater risk of assault presentation (adjusted odds ratio [AOR] 3.14, 95% confidence intervals [CIs] 3.11-3.16; P 2 = 0.918; P  Conclusions To date, the role of ED data has focused on helping target nightlife police activity. Its utility is much greater; capable of targeting and evaluating multi-agency life course approaches to violence prevention and optimising frontline resources. National ED data are critical for fully engaging health services in the prevention of violence.

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

    DEFF Research Database (Denmark)

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

    1996-01-01

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

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

    International Nuclear Information System (INIS)

    Kapitola, J.

    1983-01-01

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  6. Brigadier General James Stevens Simmons (1890-1954), Medical Corps, United States Army: a career in preventive medicine.

    Science.gov (United States)

    Marble, Sanders

    2012-02-01

    James Simmons began his career in the US Army as a laboratory officer and his assignments progressed into tropical medicine research. His interests and work evolved into preventive medicine (PM, as the Army termed public health), and he took both a PhD and a Doctorate in Public Health. As the Army's leading PM officer he was appointed head of PM in 1940 and guided the Army's PM effort through World War II. His responsibility ran from gas masks through healthy nutrition and occupational health to an enormous variety of diseases; by the war's end, the breadth and importance of PM was reflected in the Preventive Medicine Division, having fully one-sixth of all military personnel at the Surgeon General's Office. Simmons used his strong professional credentials to tap into civilian medicine for expertise the Army lacked and he established organizations that survive to this day. After retirement, he sought to expand the field of public health and raise another generation of public health physicians.

  7. Predictive, Preventive and Personalised Medicine as the hardcore of ‘Horizon 2020’: EPMA position paper

    OpenAIRE

    Golubnitschaja, Olga; Kinkorova, Judita; Costigliola, Vincenzo

    2014-01-01

    The European Association for Predictive, Preventive and Personalised Medicine (EPMA) considers acute problems in medical sciences as well as the quality and management of medical services challenging health care systems in Europe and worldwide. This actuality has motivated the representatives of EPMA to comment on the efforts in promoting an integrative approach based on multidisciplinary expertise to advance health care-related research and management. The current paper provides a global ove...

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

    Science.gov (United States)

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

    2014-10-01

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

  9. 1980 Survey of Faculty Teaching in Departments of Medicinal/Pharmaceutical Chemistry at American Colleges of Pharmacy.

    Science.gov (United States)

    Matuszak, Alice Jean; Sarnoff, Darwin

    1981-01-01

    An American Association of Colleges of Pharmacy survey of medicinal/pharmaceutical chemistry faculty is reported. Data, including academic and experience backgrounds of faculty and their teaching load, are presented. Differences in training are noted in comparing the average chemistry professor to the average assistant professor. (Author/MLW)

  10. A Live Threat Violence Simulation Exercise for Psychiatric Outpatient Departments: A Valuable Aid to Training in Violence Prevention.

    Science.gov (United States)

    Feinstein, Robert E; Yager, Joel

    2017-10-30

    Violence in psychiatric outpatient settings is a ubiquitous concern. This article describes the development, implementation, and evaluation of a live threat violence simulation exercise, designed to reduce the risk of future outpatient clinic violence and minimize the effects of future incidents on staff. The psychiatric outpatient clinic at the University of Colorado Hospital developed, implemented, and evaluated a 4-hour live violence threat simulation exercise as a companion to a 7-hour violence prevention program. The simulation includes an orientation, two threat simulation scenarios, three debriefings, satisfaction surveys, problem identification, action plans, and annual safety and process improvements. The authors have conducted live violence simulation exercises from 2011-2016, and have collected survey data about our annual simulation exercise from 2014-2016. Each year ≥ 52% of participants responded, and each year ≥ 90% of respondents rated the simulation as "very helpful/helpful", ≥ 86% believed themselves to be "much better/better" prepared to deal with violent episodes, and simulation side effects such as worries about past trauma; anxiety; sleep problems; increase in workplace concerns. From 2011-2016, the clinic experienced 4 major violent episodes and 36 episodes of potential violence with no staff injuries and minimal psychological sequelae to one staff member. Violence prevention efforts and the development of close police/staff relationships may have contributed to these fortunate outcomes. Satisfaction surveys suggest that the simulations are very helpful/helpful, with participants feeling much better/ better prepared to manage violence. The exercises led the authors to initiate staff safety related behavioral changes as well as physical space and safety processes improvements. The violence prevention program and simulation exercises have promoted excellent relationships with police and a consistent safety record over six years. This

  11. Value-Based Health Care Delivery, Preventive Medicine and the Medicalization of Public Health

    OpenAIRE

    Vilhelmsson, Andreas

    2017-01-01

    The?real paradigm shift for healthcare is often stated to include a transition from accentuating health care production and instead emphasize patient value by moving to a??value-based health care delivery?. In this transition, personalized medicine is sometimes referred to as almost a panacea in solving the current and future health challenges.?In theory, the progress of precision medicine sounds uncontroversial and most welcomed with its promise of?a better healthcare for all, with real bene...

  12. Optimization of corrective and preventive maintenance on computers in Radiology, Nuclear Medicine and Radiotherapy

    International Nuclear Information System (INIS)

    Carrascosa Fernandez, C. B.; Gil Agudo, A.; Rodriguez Exodo, J. M.; Torres Donaire, J.; Zapata jimenez, J. C.; Arjona Gutierrez, J.

    2011-01-01

    One of the functions of a Service of Radio physics and Radiation Protection is the quality control of equipment emitting ionizing radiation and detectors for clinical use and verification to incidents and actions of the commercial house that could affect the dose or the quality image. The following is the procedure used in our hospital to track incidents that cause teams in Radiology (DR), Nuclear Medicine (MN) and Radiation Oncology (ONRT) in collaboration with the Electro medicine Service (EM .).

  13. Healthcare for the Healthy People: Miniaturization, Sensing and Actuation Trends and Needs in Preventive and Predictive Medicine

    Directory of Open Access Journals (Sweden)

    Alberto SANNA

    2007-10-01

    Full Text Available In modern medicine the role of prevention and prediction is acquiring an increasing market share, due to augmented awareness and interest of the population toward these issues, and to the recognition by public bodies that investing on prevention will be the only mean to afford economical sustainability in the future. Prediction must rely on the dynamic collection of several personal information, not only about the physical condition of the individual, but also about his/her behaviors and the environmental conditions. Prevention will increasingly imply the ability to modify the detected behaviors. However, monitoring these parameters and acting in response to undesired conditions requires a constant presence in people's everyday life. The target population for these services is healthy people that possibly won't spend too much in terms of time or money in invasive or costly solutions. For these reasons, we foresee an emerging role for sensing and actuation technologies able to provide miniaturization, pervasiveness and low costs.

  14. [Impact of the Core Training Law on preventive medicine and public health training and other common medical specialties].

    Science.gov (United States)

    Latasa, Pello; Gil-Borrelli, Christian; Aguilera, José Antonio; Reques, Laura; Barreales, Saúl; Ojeda, Elena; Alemán, Guadalupe; Iniesta, Carlos; Gullón, Pedro

    2016-01-01

    The purpose of the Core Training Law (CTL) is to amend specialised medical training to include 24 months of common training. The aim of this study is to assess its potential impact on the Preventive Medicine and Public Health (PM&PH) training programme and other medical specialties. The programmes of the 21 common medical specialties were analysed and the recommended training periods for each specialty collected, before the information was agreed upon by three observers. The training impact was calculated as the percentage of months that should be amended per specialty to adapt to the common training schedule. The Preventive Medicine and Public Health training programme is the specialty most affected by the Core Training Law (100%, 24 months). Intensive medicine (0%, 0 months) and medical oncology (17%, 4 months) is the least affected. The CTL affects the common medical specialties in different ways and requires a complete reorganisation of the activities and competencies of PM&PH professionals. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. Childhood socioeconomic position, young adult intelligence and fillings of prescribed medicine for prevention of cardiovascular disease in middle-aged men

    DEFF Research Database (Denmark)

    Kriegbaum, Margit; Kildemoes, Helle Wallach; Rasmussen, Jeppe Nørgaard

    2014-01-01

    To explore the relationship between childhood socioeconomic position (SEP) and filling of medicine prescriptions for prevention of cardiovascular diseases (CVDs), with young adult intelligence (IQ) as a potential mediator....

  16. [Holistic integrative medicine: application in prevention and treatment of oral mucosal diseases].

    Science.gov (United States)

    Jin, X; Xie, L; Zhao, X; Li, J; Zeng, X; Chen, Q M

    2017-08-09

    Holistic integrative medicine (HIM), as one of the important ideas in the field of medicine, arouses great concern recently. HIM regards the human body as a whole, turns data and evidence in medical research back to facts, integrates technologies and experience developed in clinical research into medical skills. The repeated practices at the levels of fact, experience, and medical skills will generate true knowledge to solve the wide spread problems brought by linearized thinking and fragmented knowledge. With the development of highly divided medical disciplines, how to utilize and practice HIM has become a common concern of the medical community. Specialization of stomatology, which is a first level discipline like medicine, has also become a trend for years. However, holistic concept cannot be overlooked, especially in the development of oral medicine. This article aims at the communication and exchange of knowledge about HIM among dental professionals. In order to serve the patients better, the authors look forward to practicing the HIM concept in the field of oral medicine through the efforts of us all.

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

    Science.gov (United States)

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

    2002-04-01

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

  18. Restructuring a State Nutrition Education and Obesity Prevention Program: Implications of a Local Health Department Model for SNAP-Ed.

    Science.gov (United States)

    Wu, Helen W; Backman, Desiree; Kizer, Kenneth W

    The US Department of Agriculture Supplemental Nutrition Assistance Program-Education (SNAP-Ed) funds state programs to improve nutrition and physical activity in low-income populations through its Nutrition Education and Obesity Prevention grants. States vary in how they manage and structure these programs. California substantially restructured its program in 2012 to universally position local health departments (LHDs) as the programmatic lead in all jurisdictions. This study sought to determine whether California's reorganization aligned with desirable attributes of decentralized public management. This study conducted 40 in person, semistructured interviews with 57 local, state, and federal SNAP-Ed stakeholders between October 2014 and March 2015. Local respondents represented 15 counties in all 7 of California's SNAP-Ed regions. We identified 3 common themes that outlined advantages or disadvantages of local public management, and we further defined subthemes within: (1) coordination and communication (within local jurisdictions, across regions, between local and state), (2) efficiency (administrative, fiscal, program), and (3) quality (innovation, skills). We conducted qualitative content analysis to evaluate how respondents characterized the California experience for each theme, identifying positive and negative experiences. California's LHD model offers some distinct advantages, but the model does not exhibit all the advantages of decentralized public management. Strategic planning, partnerships, subcontracting, and fiscal oversight are closer to communities than previously. However, administrative burden remains high and LHDs are limited in their ability to customize programs on the basis of community needs because of state and federal constraints. California's use of a universal LHD model for SNAP-Ed is novel. Recent federal SNAP-Ed changes present an opportunity for other states to consider this structure. Employing small-scale approaches initially (eg

  19. Society of Behavioral Medicine (SBM) position statement: restore CDC funding for firearms and gun violence prevention research.

    Science.gov (United States)

    Behrman, Pamela; Redding, Colleen A; Raja, Sheela; Newton, Tamara; Beharie, Nisha; Printz, Destiny

    2018-02-21

    The Society for Behavioral Medicine (SBM) urges restoration of Centers for Disease Control and Prevention (CDC) funding for firearms and gun violence prevention research. Gun violence in the United States is an important and costly public health issue in need of research attention. Unfortunately, there have been no concerted CDC-funded research efforts in this area since 1996, due to the passage of the Dickey Amendment. To remedy the information-gathering restrictions caused by the Dickey Amendment bans, it is recommended that Congress remove 'policy riders' on federal appropriations bills that limit firearms research at the CDC; expand NVDRS firearms-related data collection efforts to include all fifty states; fund CDC research on the risk and protective factors of gun use and gun violence prevention; fund research on evidence-based primary, secondary, and tertiary prevention and treatment initiatives for communities that are seriously impacted by the effects of gun violence; and support the development of evidence-based policy and prevention recommendations for gun use and ownership.

  20. [Analysis of the proportion of women at different qualification levels in departments of human medicine in Germany].

    Science.gov (United States)

    Zuber, M A

    2001-01-26

    In Germany leadership positions in medicine are characterized by an almost complete lack of women. The goal of this study was to determine the representation of women among different career ranks during medical school, residency and academic advancement during the past 20 years. The annual reports of the German Federal Statistic Office in Wiesbaden were checked for the numbers of medical students, dissertations, physicians, internists, fellows and trainees at universities, habilitations and professorships. Among medical students, final examination, dissertation, physicians, internists and trainees at universities a proportion of women can be found nowadays which is at a 15% higher percentage level than 20 years ago. Among assistant professors and habilitations at universities there is a very low proportion of women, which did increase only slightly from 5 to 10% during the past 20 years. Within the same period of time the total number of professors and the proportion of female professors were nearly unchanged. Reunification of East and West Germany led to an increase of the representation of women among all levels of qualification which is due to the much higher proportion of female physicians in the former GDR. The lack of women in leadership positions in medicine in Germany is not due to a general lack of women in medicine. Among all other career ranks the proportion of women increased by 15%. The completely unchanged number and composition of the professors during the past 20 years suggests that the lack of women among this professional group has to do with conservatism which is an inherent trait of university professors in Germany.

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

    Science.gov (United States)

    Stukina, Valeryia; Dohnal, Jiri; Saloun, Jan

    2016-09-01

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

  2. [The environment, knowledge and preventive medicine. 2. Reductionism and holism--a dichotomy in thinking].

    Science.gov (United States)

    Mersch-Sundermann, V

    1989-03-01

    The usual theories and methods of biological sciences and medicine are of important rank to valuate the potential risks of environmental pollutions. Because in notice of the represented system model the consideration of ecotoxicological processes shows, that a complete assessement of these risks and the effects of environmental pollutions against human health can only be attainable when holostic mode of thinking is integrated.

  3. Frequency of Burnout, Sleepiness and Depression in Emergency Medicine Residents with Medical Errors in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Alireza Aala

    2014-07-01

    Full Text Available Aims: Medical error is a great concern of the patients and physicians. It usually occurs due to physicians’ exhaustion, distress and fatigue. In this study, we aimed to evaluate frequency of distress and fatigue among emergency medicine residents reporting a medical error. Materials and Methods: The study population consisted of emergency medicine residents who completed an emailed questionnaire including self-assessment of medical errors, the Epworth Sleepiness Scale (ESS score, the Maslach Burnout Inventory, and PRIME-MD validated depression screening tool.   Results: In this survey, 100 medical errors were reported including diagnostic errors in 53, therapeutic errors in 24 and following errors in 23 subjects. Most errors were reported by males and third year residents. Residents had no signs of depression, but all had some degrees of sleepiness and burnout. There were significant differences between errors subtypes and age, residency year, depression, sleepiness and burnout scores (p<0.0001.   Conclusion: In conclusion, residents committing a medical error usually experience burnout and have some grades of sleepiness that makes them less motivated increasing the probability of medical errors. However, as none of the residents had depression, it could be concluded that depression has no significant role in medical error occurrence and perhaps it is a possible consequence of medical error.    Keywords: Residents; Medical error; Burnout; Sleepiness; Depression

  4. Workplace learning: an analysis of students' expectations of learning on the ward in the Department of Internal Medicine.

    Science.gov (United States)

    Köhl-Hackert, Nadja; Krautter, Markus; Andreesen, Sven; Hoffmann, Katja; Herzog, Wolfgang; Jünger, Jana; Nikendei, Christoph

    2014-01-01

    Learning on the ward as a practice-oriented preparation for the future workplace plays a crucial role in the medical education of future physicians. However, students' ward internship is partially problematic due to condensed workflows on the ward and the high workload of supervising physicians. For the first time in a German-speaking setting, students' expectations and concerns about their internship on the ward are examined in a qualitative analysis regarding their internal medicine rotation within clinical medical education. Of a total of 168 medical students in their 6th semester at the Medical Faculty of Heidelberg, 28 students (m=8, f=20, Ø 23.6 years) took part in focus group interviews 3 to 5 days prior to their internship on the internal medicine ward within their clinical internal medicine rotation. Students were divided into four different focus groups. The protocols were transcribed and a content analysis was conducted based on grounded theory. We gathered a total of 489 relevant individual statements. The students hope for a successful integration within the ward team, reliable and supportive supervisors and supervision in small groups. They expect to face the most common diseases, to train the most important medical skills, to assume full responsibility for their own patients and to acquire their own medical identity. The students fear an insufficient time frame to achieve their aims. They are also concerned they will have too little contact with patients and inadequate supervision. For the development and standardization of effective student internships, the greatest relevance should be attributed to guidance and supervision by professionally trained and well-prepared medical teachers, entailing a significant increase in staff and costs. A structural framework is required in order to transfer the responsibility for the treatment of patients to the students at an early stage in medical education and in a longitudinal manner. The data suggest that the

  5. Pulmonary ventilation/perfusion single photon emission tomography – Initial experience of a Nuclear Medicine Department

    Directory of Open Access Journals (Sweden)

    J. G. Santos

    2016-01-01

    Full Text Available Introduction: Lung ventilation/perfusion scintigraphy with planar images (V/QS-planar is very useful for the diagnosis and follow-up of pulmonary thromboembolism (PTE. Acquiring tomographic images (V/QS-SPECT is a recent development with potential to increase the technique's accuracy. The purpose of this work is to evaluate the added benefits of V/QS-SPECT studies as opposed to traditional planar imaging. Patients and methods: We prospectively revised 53 V/QS-planar and V/QS-SPECT exams, performed according to the European Association of Nuclear Medicine guidelines. We evaluated the exams independently, by consensus of two Nuclear Medicine physicians. For both methods, we gave each lung a score expressing the dimension and extension of perfusion defects with normal ventilation. For each lung, we compared the scores with the paired Wilcoxon test, estimating the 95% confidence interval (95CI for the respective difference. Results: We performed V/QS-SPECT exams without technical difficulties. The paired Wilcoxon test estimated the score difference to be −0.75 (95CI of −1.0 to −0.5; p-value = 9.6 × 10−7, expressing a statistically significant difference of about 1 subsegmental defect between both methods, with V/QS-SPECT detecting more defects. Discussion: The results demonstrate that V/QS-SPECT identifies a slightly larger number of perfusion defects than V/QS-planar, suggesting a higher sensitivity of this technique. However, more studies are necessary to evaluate the clinical meaning of this fact. Conclusion: V/QS-SPECT demonstrates a higher capability to identify perfusion defects. This method looks promising, allowing for a greater role of this exam in pulmonary thromboembolism diagnosis and follow-up. Keywords: Pulmonary thromboembolism, Lung, Scintigraphy, Single-photon emission-computed tomography (SPECT

  6. [Advances in animal model and traditional Chinese medicine prevention in coronary microvascular dysfunction].

    Science.gov (United States)

    Li, Lei; Liu, Jian-Xun; Ren, Jian-Xun; Guo, Hao; Lin, Cheng-Ren

    2017-01-01

    Coronary microvascular dysfunction (CMD) is a common mechanism for some heart disease like cardiac X syndrome and no-reflow phenomenon after percutaneous coronary intervention(PCI). With the development of medical imageology, CMD has received increased attention. Animal model of CMD is indispensable tool for the research of pathogenesis and treatment evaluation, therefor choose an appropriate animal model is the first issue to carry out CMD research. Experimental and clinical studies have shown unique effectiveness of traditional Chinese medicine(TCM) in CMD therapy. Clarifying of the TCM therapeutic effect mechanisms and seeking an optimal solution of combination of traditional Chinese and western medicine will be the focus of future research. This paper reviewed the establishment and evaluation of CMD animal model, as well as the intervention study of TCM on CMD. The article aims to provide reference for the basic research of CMD and the TCM experimental study on CMD. Copyright© by the Chinese Pharmaceutical Association.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

    To explore the oral anticoagulation (OAC) prescribing choices of Canadian internal medicine residents, at different training levels, in comparison with the Canadian Cardiovascular Society (CCS) guidelines for non-valvular atrial fibrillation (NVAF). Cross-sectional, web-based survey, involving clinical scenarios designed to favour the use of non-vitamin K antagonists (NOACs) as per the 2014 CCS NVAF guidelines. Additional questions were also designed to determine resident attitudes towards OAC prescribing. A total of 518 internal medicine responses were analysed, with 196 postgraduate year (PGY)-1s, 169 PGY-2s and 153 PGY-3s. The majority of residents (81%) reported feeling comfortable choosing OAC, with 95% having started OAC in the past 3 months. In the initial clinical scenario involving an uncomplicated patient with a CHADS2 score of 3, warfarin was favoured over any of the NOACs by PGY-1s (81.6% vs 73.9%), but NOACs were favoured by PGY-3s (88.3% vs 83.7%). This was the only scenario where OAC choices varied by PGY year, as each of the subsequent clinical scenarios residents generally favoured warfarin over NOACs irrespective of level of training. The majority of residents stated that they would no longer prescribe warfarin once NOAC reversal agents are available, and residents felt risk of adverse events was the most important factor when choosing OAC. Canadian internal medicine residents favoured warfarin over NOACs for patients with NVAF, which is in discordance with the evidence-based CCS guidelines. This finding persisted throughout the 3 years of core internal medicine training. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Acupuncture and Traditional Herbal Medicine Therapy Prevent Deliriumin Patients with Cardiovascular Disease in Intensive Care Units.

    Science.gov (United States)

    Matsumoto-Miyazaki, Jun; Ushikoshi, Hiroaki; Miyata, Shusaku; Miyazaki, Nagisa; Nawa, Takahide; Okada, Hideshi; Ojio, Shinsuke; Ogura, Shinji; Minatoguchi, Shinya

    2017-01-01

    The aim of this study was to determine the effect of combination therapy consisting of acupuncture and traditional herbal medicine (Kampo medicine) for reducing the incidence rate of delirium in patients with cardiovascular (CV) disease in ICUs. Twenty-nine patients who had been urgently admitted to the ICU in the control period were treated with conventional intensive care. Thirty patients in the treatment period received conventional therapy plus a combination therapy consisting of acupuncture and herbal medicine. Acupuncture treatment was performed once a day, and the herbal formula was administered orally three times a day during the first week of the ICU stay. The standard acupuncture points were GV20, Ex-HN3, HT7, LI4, Liv3, and KI3, and the main herbal preparation was Kamikihito. The incident rates of delirium, assessed using the confusion assessment method for ICU, in the treatment and control period were compared. The incidence rate of delirium was significantly lower in the treatment group than in the control group (6.6% vs. 37.9%, [Formula: see text]). Moreover, sedative drugs and non-pharmacological approaches against aggressive behavior of patients who were delirious were used less in the treatment group than in the control group. No serious adverse events were observed in the treatment group. Combination therapy consisting of acupuncture and herbal medicine was found to be effective in lowering the incidence of delirium in patients with CV disease in ICUs. Further studies with a large sample size and parallel randomized controlled design would be required to establish the effects of this therapy.

  10. [Recent advances on pericytes in microvascular dysfunction and traditional Chinese medicine prevention].

    Science.gov (United States)

    Liu, Lei; Liu, Jian-Xun; Guo, Hao; Ren, Jian-Xun

    2017-08-01

    Pericytesis a kind of widespread vascular mural cells embedded within the vascular basement membrane of blood microvessels, constituting the barrier of capillaries and tissue spaces together with endothelial cells. Pericytes communicate with microvascular endothelial cells through cell connections or paracrine signals, playing an important role in important physiological processes such as blood flow, vascular permeability and vascular formation. Pericytes dysfunction may participate in some microvascular dysfunction, and also mediate pathological repair process, therefore pericytes attracted more and more attention. Traditional Chinese medicine suggests that microvascular dysfunction belongs to the collaterals disease; Qi stagnation and blood stasis in collaterals result in function imbalance of internal organs. Traditional Chinese medicine (TCM) has shown effects on pericytes in microvascular dysfunction, for example qi reinforcing blood-circulation activating medicines can reduce the damage of retinal pericytes in diabetic retinopathy. However, there are some limitations of research fields, inaccuracy of research techniques and methods, and lack of mechanism elaboration depth in the study of microvascular lesion pericytes. This paper reviewed the biological characteristics of pericytes and pericytes in microvascular dysfunction, as well as the intervention study of TCM on pericytes. The article aims to provide reference for the research of pericytes in microvascular dysfunction and the TCM study on pericytes. Copyright© by the Chinese Pharmaceutical Association.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-02-15

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

  12. [Mind-body approach in the area of preventive medicine: focusing on relaxation and meditation for stress management].

    Science.gov (United States)

    Kang, Yunesik

    2010-09-01

    Emotional support and a stress management program should be simultaneously provided to clients as effective preventive services for healthy behavioral change. This study was conducted to review various relaxation and meditation intervention methods and their applicability for a preventive service program. The author of this paper tried to find various relaxation and meditation programs through a literature review and program searching and to introduce them. The 'Relaxation Response' and 'Mindfulness Based Stress Reduction (MBSR)' are the most the widely used meditative programs in mainstream medical systems. Abdominal breathing, Progressive Musclular Relaxation (PMR), Relaxative Imagery, Autogenic Training (AT) and Biofeedback are other well-known techniques for relaxation and stress management. I have developed and implemented some programs using these methods. Relaxation and meditation classes for cancer patients and a meditation based stress coping workshop are examples of this program. Relaxation and meditation seem to be good and effective methods for primary, secondary and tertiary preventive service programs. Program development and standardization and further study are needed for more and wider use of the mind-body approach in the preventive service area of medicine.

  13. Shenlingbaishusan, a chines herbal medicine, in the prevention and treatment of colo-rectal radiation reactions during pelvic tumor radiotherapy

    International Nuclear Information System (INIS)

    Hu Yueran; Liu Yajie; Wu Chaoquan; Chen Chuping; Wang Yaobang; Li Xianming; Zhong Heli; Wu Dong

    2005-01-01

    Objective: To study the effect of traditional Chinese herbal medicine-Shenlingbaishusan in preventing and treating colon and rectum radiation reactions. Methods: Ninty-six patients with female pelvic tumor (cervical and endometrial cancer) were randomly divided into two groups: radiotherapy (RT) alone group (47 patients) and RT+ Shenlingbaishusan group(49 patients). RT in both groups, being similar, 1.8-2.0 Gy/per fraction, five fractions/per week, to a total dose of 48-50 Gy/5-6 weeks to the whole pelvis by external irradiation plus brachytherapy: to a total dose of 42-49 Gy/6-7 weeks for cervix carcinoma, and 10-15 Gy/1-2 weeks for endometrial cancer. Results: All patients have been were followed for more than one year after radiotherapy. The incidence of acute and late colon and rectum radiation reactions. was:15 patients in the RT + Shenlingbaishusan group: grade I10 patients, Grade II3 patients, grade III2 patients incontrast to the 47 patients in the RT group: grade I 24 patients, grade II 14 patients and grade III 9 patients (P<0.01). Conclusions: The traditional Chinese medicine-Shenlingbaishusan is effective in preventing and treating colon and rectum radiation reactions during pelvic tumor radiotherapy.(authors)

  14. Predictive, Preventive and Personalised Medicine as the hardcore of ‘Horizon 2020’: EPMA position paper

    Science.gov (United States)

    2014-01-01

    The European Association for Predictive, Preventive and Personalised Medicine (EPMA) considers acute problems in medical sciences as well as the quality and management of medical services challenging health care systems in Europe and worldwide. This actuality has motivated the representatives of EPMA to comment on the efforts in promoting an integrative approach based on multidisciplinary expertise to advance health care-related research and management. The current paper provides a global overview of the problems related to medical services: pandemic scenario in the progression of common non-communicable diseases, delayed interventional approaches of reactive medicine, poor economy of health care systems, lack of specialised educational programmes, problematic ethical aspects of several treatments as well as inadequate communication among professional groups and policymakers. In the form of individual paragraphs, the article presents a consolidated position of PPPM professionals towards the new European programme ‘Horizon 2020’ providing the long-lasting instruments for scientific and technological progress in medical services and health care-related programmes. In the author's opinion, Horizon 2020 provides unlimited room for research and implementation in Predictive, Preventive and Personalised Medicine. However, the overall success of the programme strongly depends on the effective communication and consolidation of professionals relevant for PPPM as well as the communication quality with policymakers. Smart political decision is the prerequisite of the effective PPPM implementation in the health care sector. This position is focused on the patients' needs, innovative medical sciences, optimal health and disease management, expert recommendations for the relevant medical fields and optimal solutions which have a potential to advance health care services if the long-term strategies were to be effectively implemented as proposed here. PMID:24708704

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

    Science.gov (United States)

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

    2015-12-01

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

  16. U.S. Department of Energy's 'initiatives for proliferation prevention' program: solidification technologies for radioactive waste treatment in Russia - 16037

    International Nuclear Information System (INIS)

    Pokhitonov, Yuri; Kelley, Dennis

    2009-01-01

    Large amounts of liquid radioactive waste have existed in the U.S. and Russia since the 1950's as a result of the Cold War. Comprehensive action to treat and dispose of waste products has been lacking due to insufficient funding, ineffective technologies or no proven technologies, low priority by governments among others. Today the U.S. and Russian governments seek new, more reliable methods to treat liquid waste, in particular the legacy waste streams. A primary objective of waste generators and regulators is to find economical and proven technologies that can provide long-term stability for repository storage. In 2001, the V.G. Khlopin Radium Institute (Khlopin), St. Petersburg, Russia, and Pacific Nuclear Solutions (PNS), Indianapolis, Indiana, began extensive research and test programs to determine the validity of polymer technology for the absorption and immobilization of standard and complex waste streams. Over 60 liquid compositions have been tested including extensive irradiation tests to verify polymer stability and possible degradation. With conclusive scientific evidence of the polymer's effectiveness in treating liquid waste, both parties have decided to enter the Russian market and offer the solidification technology to nuclear sites for waste treatment and disposal. In conjunction with these efforts, the U.S. Department of Energy (DOE) will join Khlopin and PNS to explore opportunities for direct application of the polymers at predetermined sites and to conduct research for new product development. Under DOE's 'Initiatives for Proliferation Prevention' (IPP) program, funding will be provided to the Russian participants over a three year period to implement the program plan. This paper will present updated details of U.S. DOE's IPP program, the project structure and its objectives both short and long-term, polymer tests and applications for LLW, ILW and HLW, and new product development initiatives. (authors)

  17. 4Ps medicine of the fatty liver: the research model of predictive, preventive, personalized and participatory medicine-recommendations for facing obesity, fatty liver and fibrosis epidemics.

    Science.gov (United States)

    Trovato, Francesca Maria; Catalano, Daniela; Musumeci, Giuseppe; Trovato, Guglielmo M

    2014-01-01

    Relationship between adipose tissue and fatty liver, and its possible evolution in fibrosis, is supported by clinical and research experience. Given the multifactorial pathogenesis of non-alcoholic fatty liver disease (NAFLD), treatments for various contributory risk factors have been proposed; however, there is no single validated therapy or drug association recommended for all cases which can stand alone. Mechanisms, diagnostics, prevention and treatment of obesity, fatty liver and insulin resistance are displayed along with recommendations and position points. Evidences and practice can get sustainable and cost-benefit valuable outcomes by participatory interventions. These recommendations can be enhanced by comprehensive research projects, addressed to societal issues and innovation, market appeal and industry development, cultural acceptance and sustainability. The basis of participatory medicine is a greater widespread awareness of a condition which is both a disease and an easy documented and inclusive clue for associated diseases and unhealthy lifestyle. This model is suitable for addressing prevention and useful for monitoring improvement, worsening and adherence with non-invasive imaging tools which allow targeted approaches. The latter include health psychology and nutritional and physical exercise prescription expertise disseminated by continuous medical education but, more important, by concrete curricula for training undergraduate and postgraduate students. It is possible and recommended to do it by early formal teaching of ultrasound imaging procedures and of practical lifestyle intervention strategies, including approaches aimed to healthier fashion suggestions. Guidelines and requirements of research project funding calls should be addressed also to NAFLD and allied conditions and should encompass the goal of training by research and the inclusion of participatory medicine topics. A deeper awareness of ethics of competences in health professionals

  18. Investigation of the possible use of Arglabin, new antitumor medicine to prevent oncological diseases after radiation

    International Nuclear Information System (INIS)

    Shaikenov, T.; Karabalin, B.; Rakhimov, K.; Adekenov, S.

    1996-01-01

    Background: One of the heaviest effects of radiation exposure and its pollutants to the environment is a growth of oncologic diseases as a sequence of breakage of genetic body substance and transmission of Genetic load to the next generation. People of Kazakstan are anxious of the present situation with harmful effect of remaining radiation doses.Purpose of research: the examination of molecular mechanisms of action for a new drug 'Arglabin' was done with the purpose of preventing the malignant tumor occurrence for those people living on the territory of higher risk (in high radiation locations). Research work of the mechanisms of action for 'Arglabin' drug: - examination of the drug effectiveness to enzymes of prenylated proteins; - examination of the drug effectiveness on functioning the oncogene products; - examination of drug metabolism. Research work of the possibility for using 'Arglabin' to prevent oncology diseases includes: - establishment of experimental model of increased risk of oncologic disease on different groups of laboratory animals using the low-dosage radiation sphere; - examination of the drug effectiveness in oncology diseases prevention; - determination of mechanisms and the prevention's results on cancer

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

    Science.gov (United States)

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

    2018-04-10

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

  20. What California sea lions exposed to domoic acid might teach us about autism: lessons for predictive and preventive medicine.

    Science.gov (United States)

    Lahvis, Garet Paul

    2017-09-01

    Autism spectrum disorder (ASD) shares many biological and behavioral similarities with the deleterious effects of domoic acid (DA) exposure. DA is produced by marine algae and most commonly by species of Pseudo-nitzschia . Humans and marine mammals can be exposed to DA when they consume whole fish or shellfish. The mammalian fetus is highly sensitive to the deleterious effects of DA exposure. Both ASD and exposures to toxic levels of DA feature repetitive behaviors, challenges with social interaction, and seizures. They can also share a commonality in brain anatomy and function, particularly the balance between excitatory and inhibitory mechanisms. The current article is relevant to predictive, preventive, and personalized medicine for three reasons. First, shellfish consumption may be a risk factor for ASD and the regulatory limit for DA should be adjusted to prevent this possibility. Human contributions to increased algal production of DA in coastal waters should be identified and reduced. Second, evaluations of sentinel species wild and free-roaming in the environment, though typically outside the purview of biomedical research, should be much more fully employed to gain insights to risk factors for human disease. To better identify and prevent disease, biomedical researchers should study wild populations. Third, studies of DA exposure highlight the possibility that glutamate additives to processed foods may also have deleterious impacts on human brain development and behavior.

  1. Medicinal claims

    NARCIS (Netherlands)

    Meulen, van der Bernd

    2017-01-01

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

  2. THE ROLE OF PREVENTIVE MEDICINE AND MARKETING IN PROMOTING OF ANTI-SMOKING CAMPAIGNS

    Directory of Open Access Journals (Sweden)

    Alina-Costina LUCA

    2014-12-01

    Full Text Available In Europe, according to official statistics (ec.europa.eu the percentage of smokers is about 29% of the population, and smoking still remains the main reason underlying the deaths and illnesses that could have been prevented. In the past 12 months, 31% of EU smokers have tried to quit smoking. In this gloomy context, the European Commission already has a tradition in preventing and stopping smoking, in addition to the broader tobacco control: in recent years have been organized numerous campaigns that aim to inform the European public about the problems caused by consumption tobacco, increasing awareness of the dangers of smoking, thus contributing to the long-term objective proposed by the Commission as "Europe free from tobacco smoke."

  3. Prepsychotic treatment for schizophrenia: preventive medicine, social control, or drug marketing strategy?

    Science.gov (United States)

    Gosden, R

    1999-01-01

    The definition of schizophrenia is currently being extended to include a "prepsychotic" phase. Prepsychosis detection and intervention programs have already been established in Australia. These are intended to identify people "at-risk" for schizophrenia and treat them to prevent their transition into psychosis. However, analysis of leading research in this field shows high levels of arbitrariness in the selection of diagnostic indicators and a lack of convincing evidence about the efficacy of treatments. The favored prophylactic treatment is atypical neuroleptic medication, and sponsorship of research is providing manufacturers of these drugs with a ubiquitous presence in the field. Many risks are associated with atypical neuroleptics and adverse reactions include psychosis. Taken together these factors suggest that prepsychotic intervention may be more concerned with expanding the market for atypical neuroleptics than with preventing schizophrenia.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-11-15

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

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

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

    2013-07-01

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

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

    Science.gov (United States)

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

    2011-06-01

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

  8. 8 CFR 1215.4 - Procedure in case of alien prevented from departing from the United States.

    Science.gov (United States)

    2010-01-01

    ... IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS CONTROLS OF ALIENS DEPARTING FROM THE UNITED... represented by counsel of his own choice, (3) to have the opportunity to be heard and to present evidence, (4... the time and opportunity to produce evidence and witnesses on his own behalf, and (7) to reasonable...

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

    International Nuclear Information System (INIS)

    Bahnarel, I.

    2009-01-01

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

  10. Oriental medicine Kyung-Ok-Ko prevents and alleviates dehydroepiandrosterone-induced polycystic ovarian syndrome in rats.

    Directory of Open Access Journals (Sweden)

    Minhee Jang

    Full Text Available Kyung-Ok-Ko (KOK, a traditional herbal prescription composed of Rehmannia glutinosa Liboschitz var. purpurae, Lycium chinense, Aquillaria agallocha, Poria cocos, Panax ginseng, and honey, has been widely used in traditional Oriental medicine as a vitalizing medicine or as the prescription for patients with age-associated disorders such as amnesia and stroke. However, the potential protective value of KOK for the treatment of polycystic ovarian syndrome (PCOS is largely unknown. We investigated whether pre-administration (daily from 2 hours before PCOS induction and post-administration (daily after induction of PCOS of KOK (0.5, 1.0, and 2.0 g/kg/day, p.o. could have a protective effect in a dehydroepiandrosterone (DHEA, s.c.-induced PCOS rat model. Pre-administration of KOK significantly decreased the elevated body weight and ovary weight, elevated size and number of follicular cysts, elevated level of serum glucose, and estradiol after DHEA injection. KOK reduced the elevated percentage of CD8 (+ T lymphocytes in lymph nodes, the elevated mRNA expression of CD11b and CD3 in ovaries, and infiltration of macrophages in ovarian tissue with PCOS. KOK diminished the increased mRNA expression of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α, chemokines (IL-8, MCP-1, and iNOS in the ovaries, and increased the reduced mRNA expression of growth factors (EGF, TGF-β by DHEA injection. Post-administration of KOK also improved the DHEA-induced PCOS-like symptoms, generally similar to those evident from pre-administration of KOK. KOK may effectively prevent and improve DHEA-induced PCOS via anti-inflammatory action, indicating its preventive and therapeutic potential for suppressing PCOS.

  11. Kampo medicine "Dai-kenchu-to" prevents CPT-11-induced small-intestinal injury in rats.

    Science.gov (United States)

    Chikakiyo, Motoya; Shimada, Mitsuo; Nakao, Toshihiro; Higashijima, Jun; Yoshikawa, Kozo; Nishioka, Masanori; Iwata, Takashi; Kurita, Nobuhiro

    2012-01-01

    The key anticancer agent, CPT-11 (irinotecan hydrochloride), induces severe diarrhea clinically. We investigated the effect of a Kampo medicine, Dai-kenchu-to (DKT), on CPT-11-induced intestinal injuries in rats. Twenty-four male Wistar rats were divided into three groups: a control group; a CPT-11 group, given CPT-11 150 mg/kg intraperitoneally for 2 days; and a DKT group, given DKT 300 mg/kg orally for 5 days with CPT-11 150 mg/kg intraperitoneally on days 4 and 5. The rats were killed on day 6. Interleukin (IL)-1β, IL-12, interferon (IFN)-γ, and tumor necrosis factor-α expression in the small intestine of the CPT-11 group was significantly higher than that of the control group. Interleukin-1β and IFN-γ expression was improved significantly by DKT (P DKT (P DKT suppressed CPT-11 induced inflammatory cytokines and apoptosis in the intestinal mucosa and maintained the mucosal integrity.

  12. A Brief Discussion of Improving Quality Management and Prevention of Infection in Disinfection Supply Department of Local Hospital

    Directory of Open Access Journals (Sweden)

    Hua-lin HU

    2014-10-01

    Full Text Available Objective: In order to improve the quality management of supply department in our hospital, develop the quality of our nursing work, control hospital infection. Methods: Make scientific and standard working procedures, pay attention to training of staff in supply department, make strict rules and regulations, attach importance to process management, improve the quality of nursing work, reinforce the protection of our staff. Results: We improved the method of management, developed the level of management. Conclusion: Supply Department up to standards, scientific and standardized level through a series of management measures, plays an important role in controlling Infection of hospital.

  13. Current healthcare in Bulgaria: time for predictive diagnostics and preventive medicine.

    Science.gov (United States)

    Dimitrov, Dimiter V

    2010-12-01

    Since 1990 Bulgaria gradually moved from monopolistic to market regulated economy and healthcare. In 2007 the country became member of the European Union and started to adopt EU legislations. However, significant gaps between the average European and Bulgarian level of social, health and economic efficiency remain to be narrowed. The major challenge is the demographic situation, where recent trends give alarming signals. Plans for reformation include transition towards out-patient palliative healthcare centers for the aging population as well as reduction of the costs with new electronic system of health insurance. The favorable location of the country at the Black Sea coast gives opportunities for medical tourism, which can provide quality health service for foreign customers. Finally, national platforms on prevention of major non-communicable diseases, such as obesity, cancer and diabetes, must be established as coordinated actions for the health and wellness of next generations.

  14. Consensus recommendation for meningococcal disease prevention for Hajj and Umra pilgrimage/travel medicine.

    Science.gov (United States)

    Shibl, A; Tufenkeji, H; Khalil, M; Memish, Z

    2013-04-01

    The Islamic Hajj to Makkah (Mecca) has been associated with outbreaks of invasive meningococcal disease and the global spread of Neisseria meningitidis serogroup W-135. For Hajj pilgrims the quadrivalent vaccination against serogroups A, C, W-135 and Y is a mandatory requirement. Novel conjugate vaccines may provide benefits for the community by reduction of carriage. With the introduction of the new generation of quadrivalent meningococcal conjugate vaccines (Menveo, Menactra, and others pending license) and their recent implementation in Saudi Arabia, experts from 11 countries in the Middle East region met at a Meningococcal Leadership Forum (MLF), in Dubai in May 2010 to exchange opinions on meningococcal disease and prevention strategies. These experts discussed the importance of introducing conjugate vaccines for pilgrims and travellers, and elaborated a consensus recommendation to support healthcare professionals and decision-makers.

  15. Prevention is still the best medicine. Condom social marketing campaign changes attitudes and actions in Guinea.

    Science.gov (United States)

    Hess, L L

    1993-09-01

    In Guinea, jingles promoting Prudence condoms are heard on radio and television in 4 different national languages 5 times a day. This has produced an attitudinal change through an intense national media campaign orchestrated by the USAID-financed Social Marketing of Contraceptives Project carried out by Population Services International (PSI), which provides family planning information, products and services through public and private outlets for 500,000 sexually active couples. PSI's paid media campaign has sponsored call-in talk shows on women and AIDS and religion and AIDS at the rural radio station in Labe. Billboards placed in key locations remind people that using condoms helps prevent AIDS. PSI organized a team of 10 Prudence condom marketing agents in March 1992 to establish 400 nontraditional retail and 50 traditional retail and wholesale outlets for condoms. Outlets include pharmacies, restaurants, hotels, grocery stores, and nightclubs. The distributors sell the condoms at a profit. In the first 6 months, PSI distributed 2.3 million condoms. Young women want to space their children and limit the number of children, said the chief midwife for the Guinean Association for Family Well Being clinic in Conakry. Guinea's population growth rate is 2.8%, which will result in a doubling of the population in 25 years. In May 1992, Guinea's government ratified a national population policy supporting family planning. One of the primary goals is to increase contraceptive use to 25% of all couples. PSI works with the Ministry of Health and the Guinean Association for Family Well Being to integrate family planning and sexually transmitted disease prevention activities into 32 primary health care centers in Guinea's Forest Region. To combat the spread of HIV infection, PSI provides technical assistance to the National AIDS Committee to carry out AIDS information activities throughout the country, targeting the military, police, truck drivers, and students.

  16. Mind-Body Medicine in the Secondary Prevention of Coronary Heart Disease.

    Science.gov (United States)

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

    2015-11-06

    In mind-body medicine (MBM), conventional lifestyle modification measures such as dietary counseling and exercise are supplemented with relaxation techniques and psychological motivational elements. This review studied the effect of MBM on cardiac events and mortality in patients with coronary heart disease (CHD). This review is based on publications up to and including January 2015 that were retrieved by a systematic search in PubMed, the Cochrane Library, and Scopus. Randomized controlled trials of the effect of MBM programs (versus standard treatment) on cardiac events, overall mortality, and/or cardiac mortality were analyzed. Atherosclerosis, blood pressure, LDL cholesterol, and the body mass index (BMI) were chosen as secondary outcomes. Random-effects meta-analyses were performed. The risk of bias was assessed with the Cochrane tool. Twelve trials, performed on a total of 1085 patients, were included in the analysis. Significant differences between groups were found with respect to cardiac events (odds ratio [OR]: 0.38; 95% confidence interval [CI]: 0.23-0.61; p<0.01; heterogeneity [I2]: 0%), but not overall mortality (OR: 0.82; 95% CI: 0.46-1.45; p = 0.49; I2: 0%) or cardiac mortality (OR: 0.98; 95% CI: 0.43-2.25; p = 0.97; I2: 0%). Significant differences between groups were also found with respect to atherosclerosis (mean difference [MD] = -7.86% diameter stenosis; 95% CI: -15.06-[-0.65]; p = 0.03; I2: 0%) and systolic blood pressure (MD = -3.33 mm Hg; 95% CI: -5.76-[-0.91]; p<0.01; I2: 0%), but not with respect to diastolic blood pressure, LDL cholesterol, or BMI. In patients with CHD, MBM programs can lessen the occurrence of cardiac events, reduce atherosclerosis, and lower systolic blood pressure, but they do not reduce mortality. They can be used as a complement to conventional rehabilitation programs.

  17. QiShenYiQi Pills, a Compound Chinese Medicine, Prevented Cisplatin Induced Acute Kidney Injury via Regulating Mitochondrial Function

    Directory of Open Access Journals (Sweden)

    Li Zhou

    2017-12-01

    Full Text Available Nephrotoxicity is a serious adverse effect of cisplatin chemotherapy that limits its clinical application, to deal with which no effective management is available so far. The present study was to investigate the potential protective effect of QiShenYiQi Pills (QSYQ, a compound Chinese medicine, against cisplatin induced nephrotoxicity in mice. Pretreatment with QSYQ significantly attenuated the cisplatin induced increase in plasma urea and creatinine, along with the histological damage, such as tubular necrosis, protein cast, and desquamation of epithelial cells, improved the renal microcirculation disturbance as indicated by renal blood flow, microvascular flow velocity, and the number of adherent leukocytes. Additionally, QSYQ prevented mitochondrial dysfunction by preventing the cisplatin induced downregulation of mitochondrial complex activity and the expression of NDUFA10, ATP5D, and Sirt3. Meanwhile, the cisplatin-increased renal thiobarbituric acid-reactive substances, caspase9, cleaved-caspase9, and cleaved-caspase3 were all diminished by QSYQ pretreatment. In summary, the pretreatment with QSYQ remarkably ameliorated the cisplatin induced nephrotoxicity in mice, possibly via the regulation of mitochondrial function, oxidative stress, and apoptosis.

  18. Assessment of the presence and quality of osteoporosis prevention education among at-risk internal medicine patients.

    Science.gov (United States)

    Shulha, Jennifer A; Sviggum, Cortney B; O'Meara, John G; Berg, Melody L

    2014-01-01

    Appropriate calcium and vitamin D intake for the prevention of osteoporosis represents an important component of osteoporosis prevention education (OPE). We sought to assess the presence and quality of OPE among osteoporotic and at-risk inpatients. Prospective chart review plus cross-sectional interview. One academic tertiary referral medical center in Rochester, Minnesota. Adults admitted to an inpatient medicine service who were determined to be at risk for osteoporosis based on an investigator-developed screening tool or previously diagnosed with osteoporosis. Four hundred sixtyfour patients were screened, 192 patients were approached for participation, and 150 patients consented to be interviewed for the study. Source of OPE, rates of appropriate calcium intake and supplementation. OPE from a health care provider was reported by 31.3% of patients, with only one patient reporting education from a pharmacist. Self OPE and no OPE were received by 29.3% and 39.3% of patients, respectively. Appropriate overall calcium intake was found in 30.7% of patients, and only 21.3% of patients were taking an appropriate calcium salt. Patients with osteoporosis and risk factors for osteoporosis lack adequate education from health care providers regarding appropriate intake of dietary and supplemental calcium and vitamin D. A particular deficit was noted in pharmacist-provided education. Specific education targeting elemental calcium amounts, salt selection, and vitamin D intake should be provided to increase the presence of appropriate overall calcium consumption.

  19. [Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency].

    Science.gov (United States)

    Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert

    2017-01-01

    Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their

  20. Role of cardiac magnetic resonance imaging focusing on QOL and preventive medicine

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Ito, Hirotoshi; Kubota, Takao

    2003-01-01

    Cardiac magnetic resonance imaging (MRI) using fast imaging techniques has been developing quickly recently. Left ventricular function with pharmacological intervention can be evaluated using True fast imaging with steady-state precession (FISP) method. In addition, left ventricular diastolic function can be evaluated by retrospective gating with a high frame rate. Myocardial perfusion and viability can also be evaluated by first-pass imaging and delayed enhancement with Gd-DTPA. Data concerning myocardial ischemia, viability, and left ventricular function is now almost equivalent to that of myocardial SPECT and contrast echo. Additionally, coronary arterial narrowing and coronary vessel wall can be visualized with both the bright-blood and black-blood method. These methods are still currently in the research stage. The prognostic value of myocardial perfusion and ventricular function in ischemic heart disease should be established using large numbers of patients. Multi-center trials using cardiac MRI should be recommended for this purpose. Furthermore, detecting acute coronary syndrome in the emergency department can be performed with safety and accuracy. MR coronary angiography should be used not only for flow-limiting coronary stenosis but also the atherosclerotic wall region. This provides information that may predict cardiovascular risk, and facilitate further study of artherothrombosis, progression and response to therapy. It may also provide for the assessment of subclinical disease. (author)

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

    Directory of Open Access Journals (Sweden)

    Matteo Tellini

    2015-05-01

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

  2. Prevention of triplets and higher order multiples: trends in reproductive medicine.

    Science.gov (United States)

    Armour, Kim L; Callister, Lynn Clark

    2005-01-01

    In the United States and throughout the world, today's healthcare providers are challenged by the risks of multiple gestation pregnancy. Assisted reproductive technologies (ARTs) often used to treat infertility raise ethical issues including informed consent, veracity, and nonmalificence. In the United States, there is the need to improve maternal and fetal/neonatal mortality and morbidity by proposing legislation regulating ART and supporting single embryo transfers with no more than 2 such transfers. Beginning with the diagnosis of infertility, providers have a responsibility to educate, inform, and treat infertile couples. From the moment pregnancy with multiples is confirmed, these families are faced with incredible stressors including decision making on multifetal or selective reduction. Full disclosure of risks involved throughout the course of care should be discussed and documented in the record and plan of care. Currently in the United States, legislation does not regulate ART, including ovulation induction/enhancement and in vitro fertilization. Although the United States does have self-regulation via limited reporting through their professional organization and the Centers for Disease Control and Prevention, an unlimited number of embryos may be transferred. Unfortunately, many healthcare providers have not recognized the responsibility and burden placed on families and society as a whole. Lack of regulation means women may become pregnant with high order multiples, which raises serious moral and ethical issues.

  3. Herbal Medicine AC591 Prevents Oxaliplatin-Induced Peripheral Neuropathy in Animal Model and Cancer Patients

    Directory of Open Access Journals (Sweden)

    Xiaolan Cheng

    2017-06-01

    Full Text Available Oxaliplatin is clinically compelling because of severe peripheral neuropathy. The side effect can result in dosage reductions or even cessation of chemotherapy, and no effective treatments are available. AC591 is a standardized extract of Huangqi Guizhi Wuwu decoction, an herbal formula recorded in “Synopsis of the Golden Chamber” for improving limb numbness and pain. In this study, we investigated whether AC591 could protect against oxaliplatin-induced peripheral neuropathy. To clarify it, a rat model of oxaliplatin-induced peripheral neuropathy was established, and neuroprotective effect of AC591 was studied. Our results showed that pretreatment with AC591 reduced oxaliplatin-induced cold hyperalgesia, mechanical allodynia as well as morphological damage of dorsal root ganglion. Microarray analysis indicated the neuroprotective action of AC591 depended on the modulation of multiple molecular targets and pathways involved in the downregulation of inflammation and immune response. Moreover, AC591 enhanced the antitumor activity of oxaliplatin to some extent in Balb/c mice bearing CT-26 carcinoma cells. The efficacy of AC591 is also investigated in 72 colorectal cancer patients. After four cycles of treatment, the percentage of grades 1–2 neurotoxicity in AC591-treated group (n = 36 was 25%, whereas in the control group the incidence was 55.55% (P < 0.01 (n = 36. No significant differences in the tumor response rate between the two groups were found. These evidences suggested that AC591 can prevent oxaliplatin-induced neuropathy without reducing its antitumor activity, and may be a promising adjuvant to alleviate sensory symptoms in clinical practice.

  4. Preventing the aortic complications of Marfan syndrome: a case-example of translational genomic medicine

    Science.gov (United States)

    Li-Wan-Po, Alain; Loeys, Bart; Farndon, Peter; Latham, David; Bradley, Caroline

    2011-01-01

    The translational path from pharmacological insight to effective therapy can be a long one. We aim to describe the management of Marfan syndrome as a case-example of how pharmacological and genomic insights can contribute to improved therapy. We undertook a literature search for studies of Marfan syndrome, to identify milestones in description, understanding and therapy of the syndrome. From the studies retrieved we then weaved an evidence-based description of progress. Marfan syndrome shows considerable heterogeneity in clinical presentation. It relies on defined clinical criteria with confirmation based on FBN1 mutation testing. Surgical advances have prolonged life in Marfan syndrome. First-line prophylaxis of complications with β-adrenoceptor blockers became established on the basis that reduction of aortic pressure and heart rate would help. Over-activity of proteinases, first suggested in 1980, has since been confirmed by evidence of over-expression of matrix metalloproteinases (MMP), notably MMP-2 and MMP-9. The search for MMP inhibitors led to the evaluation of doxycycline, and both animal studies and small trials, provided early evidence that this widely used antimicrobial agent was useful. Identification of the importance of TGF-β led to evaluation of angiotensin II type I receptor (AT1R) blockers with highly promising results. Combination prophylactic therapy would appear rational. Pharmacological and genomic research has provided good evidence that therapy with losartan and doxycycline would prevent the aortic complications of Marfan syndrome. If on-going well designed trials confirm their efficacy, the outlook for Marfan syndrome patients would be improved considerably. PMID:21276043

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

    Science.gov (United States)

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

    2018-05-01

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

  6. Modelo de dirección estratégica para el departamento de Medicina General Integral Model of strategical management for the Department of General Comprehensive Medicine

    Directory of Open Access Journals (Sweden)

    Alcides Abad Ochoa Alonso

    2005-12-01

    Full Text Available La creciente complejidad del proceso organizacional del Departamento de Medicina General Integral, de la Facultad de Ciencias Médicas “Mariana Grajales Coello” de Holguín, evidenció la necesidad de una intervención de carácter estratégico, capaz de guiar la gestión del cambio y de facilitar la sostenibilidad de las estrategias en curso en el departamento. Valiéndose de métodos de investigación científica, como son, el dialéctico, la modelación y la triangulación, y otros propios de las ciencias de la administración, se construyó un modelo de dirección estratégica específico para este departamento. El proyecto de intervención concebido es producto del análisis crítico de los modelos de dirección estratégica estudiados, y de la introducción de momentos, procedimientos y técnicas adecuados a las condiciones del departamento. Los enfoques rectores del proceso, aplicados en el modelo construido, permiten una mayor integración entre los niveles estratégico, táctico y operativo, con el consiguiente impacto esperado sobre la eficacia y la eficiencia en el alcance de los objetivos.The increasing complexity of the organizational process of the Department of General Comprehensive Medicine of “Mariana Grajales Coello” Faculty of Medical Sciences, in Holguin , evidenced the need of an intervention of strategical character capable of guiding the change management and of facilitating the sustainability of the strategies under way in the department. By using methods of scientific research, such as the dialectic methods, modeling, triangulation and others characteristic of the management science, it was constructed a specific model of strategical management for this department.The intervention project created is the result of the critical analysis of studied strategic management models, and of the introduction of moments, procedures and techniques adjusted to the conditions of the department. The ruling approaches of the

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Preventive effect of Chinese traditional medicine-Qing-Xue granula on radiation induced lung injury in mice

    International Nuclear Information System (INIS)

    Wang Xiaozhen; Ji Wei; Jiang Heng; Zhao Lujun; Yang Weizhi; Yang Yufei; Wang Luhua

    2012-01-01

    Objective: To evaluate whether oral administration of Chinese traditional medicine, Qing-Xue granula, can prevent mouse lung injury caused by thoracic radiation. Methods: 128 BalB/C mice were divided into 4 groups: control (C) group; radiation (R) group; radiation plus high dose Qing-Xue granula (H) group and radiation plus median dose Qing-Xue granula (M) group. The H and M groups were fed 0.64 g and 0.32 g of Qing-Xue granula dissolved in 0.5 ml saline once daily for two months,which were 4 and 2 times of human dosage, respectively. Whole thorax radiation of 12 Gy was delivered with a single ventral-dorsal field with 6 MV X-ray. Group C and group R received 21 days of 0.5 ml saline feeding. Mice were sacrificed at 1, 2, 4 or 6 months after radiation. Macrophage cell count of lung lavage fluid and hydroxyproline content of left lung were assayed, and the lung fibrosis was scored according to the Ashcroft's criteria. The plasma interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) concentration were assayed with ELISA method. The One-way ANOVA was used to test the significance of any differences between groups at each time point. Results: The macrophage cell number of lung lavage fluid was significantly lower in the 1 st month in group M than in group R (2:4, q =3.92, P 0.05). The hydroxyproline content of group H was significantly lower than group R in the 1 st and 6 th months (q =3.62, 3.54, all P nd , 4 th and 6 th months (q=3.38 -4.16, all P st month (q=3.53, P 0.05). The VEGF concentration was significantly higher in group R than group C since the 2 nd month (q =3.12 - 3.78, P nd and 6 th months (q =3.08 - 3.92, all P<0.05). Conclusions: Oral Chinese traditional medicine, Qing-Xue granula, could prevent radiation induced lung fibrosis in mice, especially at high dosage. The degree of elevation of VEGF in plasma was not parallel with that of lung fibrosis. (authors)

  9. Prevention of Type 2 Diabetes with the Chinese Herbal Medicine Tianqi Capsule: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Pang, Bing; Zhang, Ying; Liu, Jing; He, Li-Sha; Zheng, Yu-Jiao; Lian, Feng-Mei; Tong, Xiao-Lin

    2017-12-01

    Prevention of the rapid growth in incidence of type 2 diabetes (T2DM) is a big challenge for clinicians. In China, many trials have indicated that Tianqi capsule, which contains several Chinese herbal medicines as part of a large healing system called traditional Chinese medicine, could decrease the incidence of T2DM. The review assessed the effectiveness of Tianqi capsule in prevention of T2DM. Seven electronic databases were searched to identify eligible trials published from the inception of the databases up until May 1, 2017. Randomized controlled trials (RCTs) of Tianqi capsule for impaired glucose tolerance (IGT) were included. Data extraction and quality assessment were performed according to the Cochrane review standards. A random or a fixed effect model was used to analyze outcomes which were expressed as risk ratios (RRs) or mean differences (MD), and I 2 statistics were used to assess heterogeneity. Six trials were identified that included 1027 subjects. Meta-analysis showed that subjects who received Tianqi capsule plus lifestyle modification (LM) were less likely to progress to T2DM compared to controls (RR 0.55, 95% CI 0.44-0.68). Subjects who received Tianqi capsule plus LM were more likely to have glucose return to normal compared to controls (RR 0.69; 95% CI 0.62-0.78); and they had reduced fasting plasma glucose (FBG) (MD - 0.35; 95% CI - 0.55 to - 0.16) and 2-h plasma glucose (2 h PG) (MD - 1.04; 95% CI - 1.75 to - 0.32). There was no statistical difference between the two groups for IGT stabilized incidence (RR 0.89; 95% CI 0.71-1.12). No obvious adverse events occurred. In patients with IGT, Tianqi capsule reduced the risk of progression to T2DM and increased the possibility of regression toward normoglycemia. As a result of the limited number of RCTs and the methodological drawbacks of the included studies, the results should be interpreted with caution.

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

    Science.gov (United States)

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

    2018-01-01

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

  11. [Peripartal mortality in an autopsy sample of the Pathologic Institute of the Department of Medicine of the Karl Marx University in Leipzig 1960-1982].

    Science.gov (United States)

    Emmrich, P; Wötzel, E

    1986-01-01

    Between 1960 and 1982 we have autopsied 88 cases of peripartal mortality in the pathological institute of the department of medicine, Karl-Marx-University of Leipzig. According to the legal instruction in the GDR we have subdivided in direct and indirect peripartal death cases (direct and indirect relation between maternal mortality and pregnancy). We have compared both the groups (1960-1969, 1970-1982) and have found: The number of cases with indirect and direct relation between maternal mortality and pregnancy is decreased markedly in the second time period. The composition within the two time groups is very different in respect to the cause of the mortality: Between 1960 and 1969 amnioticfluid embolism, thromboembolism and air embolism, furthermore preeclampsia and their consequences as well as hemorrhages sub partu and postpartum could be found. In the second time group the most frequent causes of peripartal mortality are the different forms of embolism and preeclampsia, but then cases with a indirect relation between mortality and pregnancy with diseases of the cardiopulmonary system and of the kidneys.

  12. Permeability of gloves used in nuclear medicine departments to [(99m)Tc]-pertechnetate and [(18)F]-fluorodeoxyglucose: radiation protection considerations.

    Science.gov (United States)

    Ridone, S; Matheoud, R; Valzano, S; Di Martino, R; Vigna, L; Brambilla, M

    2013-09-01

    In order to evaluate the safety of the individual protection devices, the permeability of four different types of disposable gloves, commonly used in hospitals, was tested in relation to [(99m)Tc]-pertechnetate and to [(18)F]-fluorodeoxyglucose ([(18)F]-FDG). From these radiopharmaceutical solutions, a drop was deposited on the external surface of the glove which was opened and stretched with the external surface placed upward. The smear test technique permitted to evaluate the activity onto the inner surface of the glove at different times. The smear tests were measured in a well sodium iodide detector calibrated in efficiency for (99m)Tc and (18)F. The permeability was tested on ten samples of each type of gloves and was expressed as the ratio of the activity onto the inner surface at each time interval to the activity deposited on the external surface of the glove. For each type of gloves and for each sampling time, mean value, standard deviation and percentage coefficient of variation of permeability were evaluated. One type of gloves showed a low resistance to permeation of both radiopharmaceuticals, while another one only to pertechnetate. The other gloves were good performers. The results of this study suggest to test permeability for gloves used for handling radiopharmaceuticals, before their adoption in the clinical routine. This practice will provide a more careful service of radiation protection for nuclear medicine department staff. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. Key issues to consider and innovative ideas on fall prevention in the geriatric department of a teaching hospital.

    Science.gov (United States)

    Chan, Daniel Ky; Sherrington, Cathie; Naganathan, Vasi; Xu, Ying Hua; Chen, Jack; Ko, Anita; Kneebone, Ian; Cumming, Robert

    2018-06-01

    Falls in hospital are common and up to 70% result in injury, leading to increased length of stay and accounting for 10% of patient safety-related deaths. Yet, high-quality evidence guiding best practice is lacking. Fall prevention strategies have worked in some trials but not in others. Differences in study setting (acute, subacute, rehabilitation) and sampling of patients (cognitively intact or impaired) may explain the difference in results. This article discusses these important issues and describes the strategies to prevent falls in the acute hospital setting we have studied, which engage the cognitively impaired who are more likely to fall. We have used video clips rather than verbal instruction to educate patients, and are optimistic that this approach may work. We have also explored the option of co-locating high fall risk patients in a close observation room for supervision, with promising results. Further studies, using larger sample sizes are required to confirm our findings. © 2018 AJA Inc.

  14. The First Four Years: A Synopsis of the Global Effort. Department of Defense HIV/AIDS Prevention Program (DHAPP)

    Science.gov (United States)

    2005-06-01

    international companies such as CARE International, Mobil Gas Service Corporation, and the Coca - Cola Company. Each participating agency created its own...police, and prison wardens, with a total of 35,450 per- sonnel trained. Counseling and Testing Under DHAPP sponsorship , 6 CT centers were opened and...Troops Trained To date, more than 1200 CAF troops have been trained in HIV prevention. Counseling and Testing Under DHAPP sponsorship , 1 CT

  15. Hygienic bases of professiographic assessment of dental specialties and prospects of its use in the practice of modern preventive medicine

    Directory of Open Access Journals (Sweden)

    Panchuk O.Y.

    2016-12-01

    Full Text Available Professiography of work activity is an important part of a modern system of professional orientation. In the course of research aimed at developing hygienic bases of professiographic assessment of the major dental specialties and determining prospects for its use in the practice of modern preventive medicine it was found, that in the structure of psychophysiological functions, reflecting peculiarities of higher nervous activity of the organism and necessary for successful mastery of dental specialties, professionally-important functions should be considered such things as balance and mobility of nervous processes, strength of excitation and inhibition processes, speed of differentiated visual-motor reactions and endurance of the nervous system; in the structure of psychophysiological functions that reflect features of visual sensory system of the organism – the most important indicators are visual acuity, critical rate of fusion of light nictations, differentiated linear good eye, speed of visual perception and differential light sensitivity; in the structure of psychophysiological functions, reflecting features of somatosensory analyzer of the organism – the most important their characteristics are overall coordination, combined coordination of arm movements, coordination of arms under the control of vision and coordination of movements of the fingers.

  16. A Chinese Herbal Medicine, Jia-Wei-Xiao-Yao-San, Prevents Dimethylnitrosamine-Induced Hepatic Fibrosis in Rats

    Directory of Open Access Journals (Sweden)

    Shu-Chen Chien

    2014-01-01

    Full Text Available Jia-wei-xiao-yao-san (JWXYS is a traditional Chinese herbal medicine that is widely used to treat neuropsychological disorders. Only a few of the hepatoprotective effects of JWXYS have been studied. The aim of this study was to investigate the hepatoprotective effects of JWXYS on dimethylnitrosamine- (DMN- induced chronic hepatitis and hepatic fibrosis in rats and to clarify the mechanism through which JWXYS exerts these effects. After the rats were treated with DMN for 3 weeks, serum glutamic oxaloacetic transaminase (SGOT and serum glutamic pyruvic transaminase (SGPT levels were significantly elevated, whereas the albumin level decreased. Although DMN was continually administered, after the 3 doses of JWXYS were orally administered, the SGOT and SGPT levels significantly decreased and the albumin level was significantly elevated. In addition, JWXYS treatment prevented liver fibrosis induced by DMN. JWXYS exhibited superoxide-dismutase-like activity and dose-dependently inhibited DMN-induced lipid peroxidation and xanthine oxidase activity in the liver of rats. Our findings suggest that JWXYS exerts antifibrotic effects against DMN-induced chronic hepatic injury. The possible mechanism is at least partially attributable to the ability of JWXYS to inhibit reactive-oxygen-species-induced membrane lipid peroxidation.

  17. Reported Systems Changes and Sustainability Perceptions of Three State Departments of Health Implementing Multi-Faceted Evidence-Based Fall Prevention Efforts

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2017-06-01

    Full Text Available Although the concepts of systems change and sustainability are not new, little is known about the factors associated with systems change sustaining multi-state, multi-level fall prevention efforts. This exploratory study focuses on three State Departments of Health (DOH that were awarded 5-year funding from the Centers for Disease Control and Prevention to simultaneously implement four separate yet related evidence-based fall prevention initiatives at the clinical, community, and policy level. The purpose of this study was to examine changes in partnerships and collaborative activities that occurred to accomplish project goals (examining changes in the context of “before funding” and “after funding was received”. Additionally, this study explored changes in State DOH perceptions about action related to sustainability indicators in the context of “during funding” and “after funding ends.” Findings from this study document the partnership and activity changes necessary to achieve defined fall prevention goals after funding is received, and that the importance of sustainability indicator documentation is seen as relevant during funding, but less so after the funding ends. Findings from this study have practice and research implications that can inform future funded efforts in terms of sector and stakeholder engagement necessary for initiating, implementing, and sustaining community- and clinical-based fall prevention interventions.

  18. [Physical activity as prevention and treatment resource of chronic diseases in the syllabus of Medicine and Sport Sciences at Spanish universities].

    Science.gov (United States)

    Calonge Pascual, Sergio; Casajús Mallén, José Antonio; González Gross, Marcela

    2017-07-28

    Currently, there is scientific evidence about the benefits of physical exercise over human health. The aim of this study was to review the curricula of Medicine and Sport Sciences at Spanish universities, specifically regarding the contents related to physical exercise in the promotion, prevention and treatment of non-communicable chronic diseases (NCDs). In a systematic way, all syllabus, programs and contents of the different subjects were reviewed for all Spanish universities which offer the Bachelors of Medicine and Sport Sciences. Total, compulsory and optional European Credit Transfer System (ECTS) were analyzed and added for each university. Practicum and Bachelor thesis were not considered. In the mean, Medicine studies dedicate 3.62% (2.38% mandatory and 1.20% optional) of the total 360 ECTS to these contents. In Sport Sciences studies, of the total 240 ECTS, 17.78% (9.87% mandatory and 7.92% optional) were identified as related to these areas of knowledge. Contents ranged from 36 to 4.5 ECTS in Medicine and from 48 to 28 ECTS in Sport Sciences. There is a great disparity between universities for both degrees among Spanish universities. Contents related to the efficient use of physical exercise for the prevention and treatment of non-communicable chronic diseases are scarce, especially in Medicine. Results indicate the need of increasing these contents in undergraduate studies and/or include them in Master or other programs.

  19. Study of dose levels absorbed by members of the public in the nuclear medicine departments; Estudo dos niveis de dose em individuos do publico nos servicos de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Cabral, Geovanna Oliveira de Mello

    2001-03-01

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

  20. Application of infrared thermal imaging in the study of preventing cardiovascular and cerebrovascular diseases with Chinese medicine health food

    Science.gov (United States)

    Li, Ziru; Zhang, Xusheng

    2009-08-01

    To explore the assessing technique which could objectively reflect the characteristics of Chinese medicine in the prevention of cardiovascular and cerebrovascular diseases, four balance features of infrared thermal images (ITI) corresponding to the up and down, left and right, proximal and distal balance of blood circulation of human body were studied. First, the ITI features of the middle-aged and elderly people with lipid abnormality history were compared with those of the healthy youth. It was found that the balance state of the youth was significantly better than that of the middle-aged and elderly, Pfood with the function of helping to decrease serum lipid, on the balance features. The subjects were middle-aged and elderly people with lipid abnormality history. Shengyi capsule was taken by the trial group while Xuezhikang capsule (with lovastatin as the main effective component) by the control group for 108 days. The balance features of ITI showed that Shengyi was significantly better than Xuezhikang in improving the whole body balance of blood circulation (including the up and down, left and right, proximal and distal balance). The relative efficacy rate was 81.0% for the trial group and 33.3% for the control group, there was significant difference between the two groups (P=0.002). Shengyi could effectively decrease the low density lipoprotein cholesterol (LDL-C) but the effect of Xuezhikang in decreasing total cholesterol (TC) and LDL-C was better than Shengyi. Though the lipid-lowering effect of Shengyi was not as good as Xuezhikang, ITI reflected the obvious advantage of Shengyi in improving the whole body balance of blood circulation which indicated that helping to decrease serum lipid is only part of the health function of Shengyi. The physiology and pathology basis of the influences of Shengyi on the four balance features and its relationship with the clinical outcome deserves further study. So the prospect of infrared thermal imaging is indicated as

  1. Safety: Preventive Medicine.

    Science.gov (United States)

    Kotula, John R.; Digenakis, Anthony

    1985-01-01

    Underscores the need for community colleges to practice safety within the institutions and to instruct students in workplace safety procedures and requirements. Reviews Occupational Safety and Health Act (OSHA) regulations and their impact on industry and education. Looks at the legal responsibilities of colleges for safety. (DMM)

  2. Medicine safety and children

    Science.gov (United States)

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

  3. Estimating the impact of state budget cuts and redirection of prevention resources on the HIV epidemic in 59 California local health departments.

    Science.gov (United States)

    Lin, Feng; Lasry, Arielle; Sansom, Stephanie L; Wolitski, Richard J

    2013-01-01

    In the wake of a national economic downturn, the state of California, in 2009-2010, implemented budget cuts that eliminated state funding of HIV prevention and testing. To mitigate the effect of these cuts remaining federal funds were redirected. This analysis estimates the impact of these budget cuts and reallocation of resources on HIV transmission and associated HIV treatment costs. We estimated the effect of the budget cuts and reallocation for California county health departments (excluding Los Angeles and San Francisco) on the number of individuals living with or at-risk for HIV who received HIV prevention services. We used a Bernoulli model to estimate the number of new infections that would occur each year as a result of the changes, and assigned lifetime treatment costs to those new infections. We explored the effect of redirecting federal funds to more cost-effective programs, as well as the potential effect of allocating funds proportionately by transmission category. We estimated that cutting HIV prevention resulted in 55 new infections that were associated with $20 million in lifetime treatment costs. The redirection of federal funds to more cost-effective programs averted 15 HIV infections. If HIV prevention funding were allocated proportionately to transmission categories, we estimated that HIV infections could be reduced below the number that occurred annually before the state budget cuts. Reducing funding for HIV prevention may result in short-term savings at the expense of additional HIV infections and increased HIV treatment costs. Existing HIV prevention funds would likely have a greater impact on the epidemic if they were allocated to the more cost-effective programs and the populations most likely to acquire and transmit the infection.

  4. Organizing and conducting career guidance and crime prevention among young people by means of physical culture and sports specialized university departments Internal Affairs of Ukraine.

    Directory of Open Access Journals (Sweden)

    Zakorko I.P

    2011-06-01

    Full Text Available At the present stage of social development takes on special urgency the problem of finding new means and methods of crime prevention among youth in the context of strengthening the nation's health. In our opinion, employees of the Ukrainian Interior Ministry must take a decisive role in solving these problems. One of the most effective ways to solve them is to organize youth sports schools and clubs to professionally-applied sports at the bases of relevant departments of higher educational institutions of Ministry of Internal Affairs of Ukraine, the involvement of the best specialists and trainers.

  5. A qualitative, interprofessional analysis of barriers to and facilitators of implementation of the Department of Veterans Affairs' Clostridium difficile prevention bundle using a human factors engineering approach.

    Science.gov (United States)

    Yanke, Eric; Moriarty, Helene; Carayon, Pascale; Safdar, Nasia

    2018-03-01

    Clostridium difficile infection (CDI) is increasingly prevalent, severe, and costly. Adherence to infection prevention practices remains suboptimal. More effective strategies to implement guidelines and evidence are needed. Interprofessional focus groups consisting of physicians, resident physicians, nurses, and health technicians were conducted for a quality improvement project evaluating adherence to the Department of Veterans Affairs' (VA) nationally mandated C difficile prevention bundle. Qualitative analysis with a visual matrix display identified barrier and facilitator themes guided by the Systems Engineering Initiative for Patient Safety model, a human factors engineering approach. Several themes, encompassing both barriers and facilitators to bundle adherence, emerged. Rapid turnaround time of C difficile polymerase chain reaction testing was a facilitator of timely diagnosis. Too few, poorly located, and cluttered sinks were barriers to appropriate hand hygiene. Patient care workload and the time-consuming process of contact isolation precautions were also barriers to adherence. Multiple work system components serve as barriers to and facilitators of adherence to the VA CDI prevention bundle among an interprofessional group of health care workers. Organizational factors appear to significantly influence bundle adherence. Interprofessional perspectives are needed to identify barriers to and facilitators of bundle implementation, which is a necessary first step to address adherence to bundled infection prevention practices. Published by Elsevier Inc.

  6. Contribution of radio-iodine 131 in the treatment of Grave's Basedow disease in the department of nuclear medicine of Ibn Sina Hospital in Rabat

    International Nuclear Information System (INIS)

    Mbodj, M.; Amjad, I.; Guerrouj, H.; Ben Rais, N.A.

    2009-01-01

    One hundred and twenty-nine Grave's Basedow diseases in any gender and variable age patients, coming from several cities of Morocco, were randomized in a study of radio-iodine treatment who took place at the nuclear medicine department of Ibn Sina Hospital (Rabat, Morocco) during the period (from January 2001 to December 2008). The radio-iodine treatment was a first, second or third option and radio-iodine activities delivered varied (from 222 to 555 MBq 6 to 15 mCi) according to the age, the thyroid volume, the degree of hyperthyroidism and socio-economical situation. The high amounts of 131 I were reserved especially to the patients who live far and whose socio-economic level is low with an aim of quickly obtaining an easily controllable state of hypothyroidism by a substitute treatment. The results showed that: (1) 57.36% of patients reverted to euthyroidism (n = 74) with a patient having received two 131 I cures. The second cure was justified by recurrence of hyperthyroidism after the first cure; (2) 34.88% passed in hypothyroidism (n = 45) with three patients having received two cures of 131 I, the second cure was justified by recurrence of hyperthyroidism after the first cure in two patients and by the persistence of the hyperthyroidism after the first cure for the third patient. The average time of passage in hypothyroidism was 4.5 months; (3) 7.76% had remained in hyperthyroidism after the radioactive iodine treatment. Finally, 92.24% of our patients treated by radioactive iodine had passed in euthyroidism or hypothyroidism against 7.76% whose hyperthyroidism had persisted or occurred. (authors)

  7. Voices used by nurses when communicating with patients and relatives in a department of medicine for older people-An ethnographic study.

    Science.gov (United States)

    Johnsson, Anette; Boman, Åse; Wagman, Petra; Pennbrant, Sandra

    2018-04-01

    To describe how nurses communicate with older patients and their relatives in a department of medicine for older people in western Sweden. Communication is an essential tool for nurses when working with older patients and their relatives, but often patients and relatives experience shortcomings in the communication exchanges. They may not receive information or are not treated in a professional way. Good communication can facilitate the development of a positive meeting and improve the patient's health outcome. An ethnographic design informed by the sociocultural perspective was applied. Forty participatory observations were conducted and analysed during the period October 2015-September 2016. The observations covered 135 hours of nurse-patient-relative interaction. Field notes were taken, and 40 informal field conversations with nurses and 40 with patients and relatives were carried out. Semistructured follow-up interviews were conducted with five nurses. In the result, it was found that nurses communicate with four different voices: a medical voice described as being incomplete, task-oriented and with a disease perspective; a nursing voice described as being confirmatory, process-oriented and with a holistic perspective; a pedagogical voice described as being contextualised, comprehension-oriented and with a learning perspective; and a power voice described as being distancing and excluding. The voices can be seen as context-dependent communication approaches. When nurses switch between the voices, this indicates a shift in the orientation or situation. The results indicate that if nurses successfully combine the voices, while limiting the use of the power voice, the communication exchanges can become a more positive experience for all parties involved and a good nurse-patient-relative communication exchange can be achieved. Working for improved communication between nurses, patients and relatives is crucial for establishing a positive nurse

  8. [Indications, diagnoses and quality markers in upper and lower endoscopies in 2010 and 2011 at the 1st Department of Medicine, Semmelweis University, Budapest].

    Science.gov (United States)

    Gönczi, Lóránt; Kürti, Zsuzsanna; Golovics, Petra; Végh, Zsuzsanna; Lovász, Barbara; Dorkó, Andrea; Seres, Anna; Sümegi, Liza; Menyhárt, Orsolya; Kiss, Lajos; Papp, János; Gecse, Krisztina; Lakatos, Péter László

    2016-12-01

    The aim was to assess the incidence of endoscopic findings based on the indication of the procedures in upper/lower endoscopies, and measuring quality indicators of colonoscopies at the 1st Department of Medicine, Semmelweis University, Budapest. Data of 2987 patients (male/female:1361/1626, mean age: 60.7 years(y), SD: 16.7y) between 01.01.2010 and 31.12.2011 were analyzed. Both inpatient and outpatient records were collected. Incidence of peptic ulcer disease, esophageal varices, gastric polyps and gastric cancer were 10.8%, 4.5%, 6.1%, 2.9% in upper endoscopies, respectively. In colonoscopies colorectal polyps, diverticulosis, colorectal cancer and IBD were found in 29.9%, 22.4%, 6.9%, 9.7%, respectively. In patients having upper endoscopy with GI bleeding indication, older age (p<0.001), male gender (p<0.001, OR: 1.64), acenocoumarol/heparin use (p<0,001, peptic ulcers and esophageal varices were more frequent (p<0.001, OR: 2.83 and p<0.001, OR: 2.79), while in colonoscopies colorectal cancer had higher incidence (p<0.001, OR:3.27). 81% of colonoscopies were complete. Causes of incomplete procedures were ineffective bowel preparation (38.2%), technical difficulties (25.1%) and strictures (20.5%). The endoscopic findings and quality indicators (adenoma detection rate, coecal intubation rate) were in line with that reported in published series. Orv. Hetil., 2016, 157(52), 2074-2081.

  9. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  10. Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs.

    Science.gov (United States)

    McCarthy, John F; Bossarte, Robert M; Katz, Ira R; Thompson, Caitlin; Kemp, Janet; Hannemann, Claire M; Nielson, Christopher; Schoenbaum, Michael

    2015-09-01

    The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions.

  11. Potential of Complementary and Alternative Medicine in Preventive Management of Novel H1N1 Flu (Swine Flu Pandemic: Thwarting Potential Disasters in the Bud

    Directory of Open Access Journals (Sweden)

    Rajesh Arora

    2011-01-01

    Full Text Available The emergence of novel H1N1 has posed a situation that warrants urgent global attention. Though antiviral drugs are available in mainstream medicine for treating symptoms of swine flu, currently there is no preventive medicine available. Even when available, they would be in short supply and ineffective in a pandemic situation, for treating the masses worldwide. Besides the development of drug resistance, emergence of mutant strains of the virus, emergence of a more virulent strain, prohibitive costs of available drugs, time lag between vaccine developments, and mass casualties would pose difficult problems. In view of this, complementary and alternative medicine (CAM offers a plethora of interesting preventive possibilities in patients. Herbs exhibit a diverse array of biological activities and can be effectively harnessed for managing pandemic flu. Potentially active herbs can serve as effective anti influenza agents. The role of CAM for managing novel H1N1 flu and the mode of action of these botanicals is presented here in an evidence-based approach that can be followed to establish their potential use in the management of influenza pandemics. The complementary and alternative medicine approach deliberated in the paper should also be useful in treating the patients with serious influenza in non pandemic situations.

  12. Prevalence of Needlestick Injuries, Attitude Changes, and Prevention Practices Over 12 Years in an Urban Academic Hospital Surgery Department.

    Science.gov (United States)

    Hasak, Jessica M; Novak, Christine B; Patterson, Jennifer Megan M; Mackinnon, Susan E

    2018-02-01

    Needlestick injury prevalence, protection practices, and attitudes were assessed. Current medical students were compared with 2003 data to assess any changes that occurred with engineered safety feature implementation. Risk of occupational exposure to bloodborne pathogens is elevated in the operating room particularly with surgeons in training and nurses. A cross-sectional survey was distributed to medical students (n = 358) and Department of Surgery staff (n = 247). The survey response rate was 24.8%. Needlestick injuries were reported by 38.7% of respondents (11% high risk), and the most common cause was "careless/accidental." Needlestick injury prevalence increased from medical students to residents and fellows (100%). Thirty-three percent of injured personnel had at least one unreported injury, and the most common reason was "inconvenient/too time consuming." Needlestick injury prevalence and double-glove use in medical students did not differ from 2003, and 25% of fellows reported always wearing double gloves. The true seroconversion rate for bloodborne pathogens was underestimated or unknown. The concern for contracting a bloodborne pathogen significantly decreased (65%) compared to 2003, and there were significantly less medical students with hepatitis B vaccinations (78.3%). Level of concern for contracting a bloodborne pathogen was predictive of needlestick injury. Needlestick injury and occupational exposure to bloodborne pathogens are significant hazards for surgeons and nurses. Attitudes regarding risk are changing, and the true seroconversion risk is underestimated. Educational efforts focused on needlestick injury prevalence, seroconversion rates, and double-glove perforation rates may be effective in implementing protective strategies.

  13. Traditional Chinese and western medicine for the prevention of deep venous thrombosis after lower extremity orthopedic surgery: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zhu, Shibai; Song, Yi; Chen, Xi; Qian, Wenwei

    2018-04-10

    Chinese herbal medicine has traditionally been considered to promote blood circulation to remove obstruction in the channels and clear pathogenic heat to drain dampness effects. We conducted this meta-analysis to evaluate its benefits for the prevention of deep venous thrombosis (DVT) after lower extremity orthopedic surgery. Relevant, published studies were identified using the following keywords: lower extremity orthopedic surgery, arthroplasty, joint replacement, fracture, traditional Chinese and western medicine, Chinese herbal medicine, deep venous thrombosis (DVT), and Venous thromboembolism (VTE). The following databases were used to identify the literature consisting of RCTs with a date of search of 31 May 2017: PubMed, Cochrane Library, Web of knowledge, the Chinese National Knowledge Infrastructure Database, the Chongqing VIP Database, the Chinese Biomedical Database, and the Wanfang Database (including three English and four Chinese databases). All relevant data were collected from studies meeting the inclusion criteria. The outcome variables were the incidence rate of DVT, activated partial thromboplastin time (APTT), prothrombin time (PT), and D-dimer; subcutaneous hematoma; and other reported outcomes. RevMan5.2. software was adopted for the meta-analysis. A total of 20 published studies (1862 cases) met the inclusion criteria. The experimental group, 910 patients (48.87%), received the Chinese herbal medicine or traditional Chinese and western medicine for prevention of DVT; the control group, 952 patients (51.13%), received the standard western treatment. The meta-analysis showed that traditional Chinese and western medicine therapy reduced the incidence rates of DVT significantly when compared with controls (risk ratio [RR] = 0.40; 95% CI, 0.30 to 0.54; P < 0.00001), and the D-dimer was lower in the experimental group (P = 0.01). Besides, the incidence rate of subcutaneous hematoma was lower in the experimental group (P < 0

  14. [Development of forensic thanatology through the prism of analysis of postmortem protocols collected at the Department of Forensic Medicine, Jagiellonian University].

    Science.gov (United States)

    Konopka, Tomasz

    2011-01-01

    When assessed based on the analysis of postmortem protocols, the successes of forensic thanatology appear to differ from those that might be assumed using as the foundation a review of publications and textbooks. The greatest achievements date back to as early as the 18th and 19th centuries, when the morphological changes observed in the majority of types of deaths resulting from disease-associated and traumatic causes were described. Within the past 130 years, however, or in other words, in the period when autopsy protocols were written that are today collected in the archives of the Krakow Department of Forensic Medicine, the causes and mechanisms of death became understood even when the said factors were associated with discrete postmortem changes only or no no such changes whatsoever were left. At the end of the 19th century and for a long time afterwards, a difficult problem was posed by sudden deaths, where the postmortem examinations demonstrated solely atherosclerosis and the cause of death was described as "heart palsy". As it turned out, a great portion of such deaths represented individuals with myocardial infarction; in spite of its evident macroscopic presentation, the diagnostic management of the disease was progressing very slowly. Myocardial infarction, known at least since 1912, was associated by forensic medicine with the phenomenon of sudden death only in the forties, and the ability to detect myocardial infarction in practice developed only in the fifties of the last century. The achievement of the present dissertation is the formulation of a theory ascribing such a long delay in macroscopic diagnostics of myocardial infarction to forensic medicine specialists being attached to and fond of employing the "in situ" autopsy technique, which was unfavorable from the viewpoint of heart examination, since the organ was not dissected free and removed from the body in the course of a postmortem examination. When autopsies started to concentrate on

  15. Piper betel Linn (betel vine), the maligned Southeast Asian medicinal plant possesses cancer preventive effects: time to reconsider the wronged opinion.

    Science.gov (United States)

    Rai, Manoj P; Thilakchand, Karadka Ramdas; Palatty, Princy L; Rao, Prathima; Rao, Suresh; Bhat, Harshith P; Baliga, Manjeshwar Shrinath

    2011-01-01

    Since antiquity, Piper betel Linn (betel vine; family Piperaceae) has been an important medicinal agent in the various traditional and folk systems of medicine in Southeast Asia countries. The leaves are the most valued plant part and in the past were routinely used as a chewing agent to prevent halitosis. The leaves are also supposed to harden the gum, conserve the teeth and to prevent indigestion, bronchitis, constipation, congestion, coughs and asthma. Innumerable scientific studies have validated the ethnomedicinal claims. Betel leaves are an integral component of the betel quid that consists of areca nut (Areca catechu Linn.), tobacco (Nicotiana tabacum L) and slaked lime; a highly abused agent with carcinogenic properties. Regular chewing of betel quid is associated mainly with oral cancer and detail studies with individual constituents of the quid have shown that both tobacco and areca nut are carcinogenic, while slaked lime is shown to promote the process of carcinogenesis. However unlike other constituents of the betel quid, the betel leaves devoid carcinogenic effects and on the contrary possesses cancer preventive effects including against the carcinogens present in tobacco. This review for the first time provides information on cancer preventive effects and also addresses the various mechanisms which might be involved.

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

    Science.gov (United States)

    Pal, Ranabir; Kumar, Raman

    2017-01-01

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

  17. The identification, management, and prevention of conflict with faculty and fellows: A practical ethical guide for department chairs and division chiefs.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2007-12-01

    The relationship between chairs and divisions chiefs with faculty colleagues in departments of obstetrics and gynecology has important but heretofore unexplored ethical dimensions. Based on the ethical concept of fiduciary responsibility and contractual obligations, this paper provides ethically justified practical guidance for academic physician leaders in the identification, management, and prevention of conflicts in their relationships with faculty colleagues. The framework is developed in contrast with the fiduciary-contractual dimensions of the physician-patient relationship and is articulated in terms of the ethical principles of beneficence, respect for autonomy, and justice. The distinctive nature of the academic physician leader-colleague relationship is that beneficence-based obligations and justice-based obligations to colleagues can often justifiably override autonomy-based obligations to colleagues, about which it is crucial for academic leaders to be transparent in making and implementing leadership decisions.

  18. Bullying Prevention: a Summary of the Report of the National Academies of Sciences, Engineering, and Medicine : Committee on the Biological and Psychosocial Effects of Peer Victimization: Lessons for Bullying Prevention.

    Science.gov (United States)

    Flannery, Daniel J; Todres, Jonathan; Bradshaw, Catherine P; Amar, Angela Frederick; Graham, Sandra; Hatzenbuehler, Mark; Masiello, Matthew; Moreno, Megan; Sullivan, Regina; Vaillancourt, Tracy; Le Menestrel, Suzanne M; Rivara, Frederick

    2016-11-01

    Long tolerated as a rite of passage into adulthood, bullying is now recognized as a major and preventable public health problem. The consequences of bullying-for those who are bullied, the perpetrators of bullying, and the witnesses-include poor physical health, anxiety, depression, increased risk for suicide, poor school performance, and future delinquent and aggressive behavior. Despite ongoing efforts to address bullying at the law, policy, and programmatic levels, there is still much to learn about the consequences of bullying and the effectiveness of various responses. In 2016, the National Academies of Sciences, Engineering, and Medicine published a report entitled Preventing Bullying Through Science, Policy and Practice, which examined the evidence on bullying, its impact, and responses to date. This article summarizes the report's key findings and recommendations related to bullying prevention.

  19. Lifestyle and precision diabetes medicine: will genomics help optimise the prediction, prevention and treatment of type 2 diabetes through lifestyle therapy?

    Science.gov (United States)

    Franks, Paul W; Poveda, Alaitz

    2017-05-01

    Precision diabetes medicine, the optimisation of therapy using patient-level biomarker data, has stimulated enormous interest throughout society as it provides hope of more effective, less costly and safer ways of preventing, treating, and perhaps even curing the disease. While precision diabetes medicine is often framed in the context of pharmacotherapy, using biomarkers to personalise lifestyle recommendations, intended to lower type 2 diabetes risk or to slow progression, is also conceivable. There are at least four ways in which this might work: (1) by helping to predict a person's susceptibility to adverse lifestyle exposures; (2) by facilitating the stratification of type 2 diabetes into subclasses, some of which may be prevented or treated optimally with specific lifestyle interventions; (3) by aiding the discovery of prognostic biomarkers that help guide timing and intensity of lifestyle interventions; (4) by predicting treatment response. In this review we overview the rationale for precision diabetes medicine, specifically as it relates to lifestyle; we also scrutinise existing evidence, discuss the barriers germane to research in this field and consider how this work is likely to proceed.

  20. Data sharing for prevention: a case study in the development of a comprehensive emergency department injury surveillance system and its use in preventing violence and alcohol-related harms.

    Science.gov (United States)

    Quigg, Zara; Hughes, Karen; Bellis, Mark A

    2012-10-01

    To examine emergency department (ED) data sharing via a local injury surveillance system and assess its contribution to the prevention of violence and alcohol-related harms. 6-year (2004-2010) exploratory study analysing injury attendances to one ED in the North West of England using descriptive and trend analyses. Over the 6-year period, there were 242,796 ED injury attendances, including 21,683 for intentional injuries. Compared with unintentional injury patients, intentional injury patients were more likely to be men, aged 18-34 years, live in the most deprived communities, have attended the ED at night/weekends, have been injured in a public place and have consumed alcohol prior to the injury. Detailed data collected on alcohol and violence-related ED attendances were shared with local partners to monitor local trends and inform prevention activity including targeted policing and licensing enforcement. Over the 6-year period, intentional ED injury attendances decreased by 35.6% and alcohol-related assault attendances decreased by 30.3%. The collection of additional ED data on assault details and alcohol use prior to injury, and its integration into multi-agency policy and practice, played an important role in driving local violence prevention activity. Further research is needed to assess the direct contribution ED data sharing makes to reductions in violence.

  1. Nuclear medicine

    International Nuclear Information System (INIS)

    Chamberlain, M.J.

    1986-01-01

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

  2. Knowledge of HIV Testing Guidelines Among US Internal Medicine Residents: A Decade After the Centers for Disease Control and Prevention's Routine HIV Testing Recommendations.

    Science.gov (United States)

    Dandachi, Dima; Dang, Bich N; Wilson Dib, Rita; Friedman, Harvey; Giordano, Thomas

    2018-05-01

    Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adherence to universal HIV testing in an outpatient setting. A cross-sectional survey of internal medicine residents at four residency programs in Chicago was conducted from January to March 2016. Aggregate data on HIV screening were collected from 35 federally qualified community health centers in the Chicago area after inclusion of an HIV testing best practice alert in patients' electronic medical records. Of the 192 residents surveyed, 130 (68%) completed the survey. Only 58% were aware of universal HIV screening and 49% were aware that Illinois law allows for an opt-out HIV testing strategy. Most of the residents (64%) ordered no more than 10 HIV tests in 6 months. The most frequently reported barriers to HIV testing were deferral because of urgent care issues, lack of time, and the perception that patients were uncomfortable discussing HIV testing. From July 2015 to February 2016, the average HIV testing adherence rate in the 35 health centers was 18.2%. More effort is needed to change HIV testing practices among internal medicine residents so that they will adopt this approach in their future clinical practice. Improving knowledge about HIV testing and addressing other HIV testing barriers are essential for such a successful change.

  3. Trends in hospitalised sport/leisure injuries in New South Wales, Australia--implications for the targetting of population-focussed preventive sports medicine efforts.

    Science.gov (United States)

    Finch, Caroline F; Mitchell, Rebecca; Boufous, Soufiane

    2011-01-01

    Sport/leisure injuries are a population health issue in Australia. Over 2003-2004 to 2007-2008, the rate of sport/leisure injury NSW hospitalisations was 195.5/100,000 residents. Males and children/young people had consistently highest rates of hospitalisation. There was no significant decline in rates over this period and no change in the profiles of the types of sport/leisure injuries. The extent to which effective preventive programs have been developed and implemented needs to be determined as current programs do not seem to be impacting on hospitalisation rates. Medical/health promotion agencies and sports bodies need to jointly formulate and implement policies to reduce sport/leisure injuries. This is one of the most significant challenges facing sports medicine professionals today. Copyright © 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  4. New organic forms of preventive medicine and correction of neurotic and psichosomatic disorders for personnel of the Pripyat' and Spetsatom research and production joint enterprises

    International Nuclear Information System (INIS)

    Tabachnikov, S.I.; Snizhenko, Yu.N.; Aleksandrovskij, Yu.A.; Kazakov, V.N.; Bebeshko, E.G.; Mecheret, E.L.; Rymar', I.B.; Cherenkov, V.P.; Roslyakov, V.S.; Titievskij, S.V.

    1992-01-01

    The differentiated harmonious system of new organizing forms and methods, as well as necessary preventive and medical measures, which is introduced in the MSCh-26 rehabilitation department is discussed. The Antitabak and Antibakhus programs are developed and introduced. Modifications of emotional-stress psychotherapy and tabacco dependence reflexotherapy are used. The system of rehabilitation-sanitation measures (RSM) includes 4 stage, which are: RSM organization directly in the Chernobyl' NPP dispensary (manual therapy, massage, psychotherapy reflexotherapy); RSM organization on the basis of medical-sanitary departments; RSM during interduty period at a place of residence; rehabilitation under conditions of special sanatoria

  5. [Evolutionary medicine].

    Science.gov (United States)

    Wjst, M

    2013-12-01

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

  6. Oral administration of Chinese herbal medicine during gestation period for preventing hemolytic disease of the newborn due to ABO incompatibility: A systematic review of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Huijuan Cao

    Full Text Available About 85.3% of hemolytic disease of the newborn (HDN is caused by maternal-fetal ABO blood group incompatibility. However, there is currently no recommended "best" therapy for ABO incompatibility during pregnancy.To systematically assess the safety and effectiveness of oral Chinese herbal medicine (CHM for preventing HDN due to ABO incompatibility.The protocol of this review was registered on the PROSPERO website (No. CRD42016038637.Six databases were searched from inception to April 2016. Randomized controlled trials (RCTs of CHM for maternal-fetal ABO incompatibility were included. The primary outcome was incidence of HDN. The Cochrane risk of bias tool was used to assess the methodological quality of included trials. Risk ratios (RR and mean differences with 95% confidence interval were used as effect measures. Meta-analyses using Revman 5.3 software were conducted if there were sufficient trials without obvious clinical or statistical heterogeneity available.Totally 28 RCTs involving3413 women were included in the review. The majority of the trials had unclear or high risk of bias. Our study found that the rate of HDN and the incidence of neonatal jaundice might be 70% lower in the herbal medicine group compared with the usual care group (RR from 0.25 to 0.30.After treatment with herbal medicine, women were twice as likely to have antibody titers lower than 1:64 compared with women who received usual care(RR from 2.15 to 3.14 and the umbilical cord blood bilirubin level in the herbal medicine group was 4umol/L lower than in those receiving usual care. There was no difference in Apgar scores or birthweights between the two groups.This review found very low-quality evidence that CHM prevented HDN caused by maternal-fetal ABO incompatibility. No firm conclusions can be drawn regarding the effectiveness or safety of CHM for this condition.

  7. Oral administration of Chinese herbal medicine during gestation period for preventing hemolytic disease of the newborn due to ABO incompatibility: A systematic review of randomized controlled trials.

    Science.gov (United States)

    Cao, Huijuan; Wu, Ruohan; Han, Mei; Caldwell, Patrina Ha Yuen; Liu, Jian-Ping

    2017-01-01

    About 85.3% of hemolytic disease of the newborn (HDN) is caused by maternal-fetal ABO blood group incompatibility. However, there is currently no recommended "best" therapy for ABO incompatibility during pregnancy. To systematically assess the safety and effectiveness of oral Chinese herbal medicine (CHM) for preventing HDN due to ABO incompatibility. The protocol of this review was registered on the PROSPERO website (No. CRD42016038637).Six databases were searched from inception to April 2016. Randomized controlled trials (RCTs) of CHM for maternal-fetal ABO incompatibility were included. The primary outcome was incidence of HDN. The Cochrane risk of bias tool was used to assess the methodological quality of included trials. Risk ratios (RR) and mean differences with 95% confidence interval were used as effect measures. Meta-analyses using Revman 5.3 software were conducted if there were sufficient trials without obvious clinical or statistical heterogeneity available. Totally 28 RCTs involving3413 women were included in the review. The majority of the trials had unclear or high risk of bias. Our study found that the rate of HDN and the incidence of neonatal jaundice might be 70% lower in the herbal medicine group compared with the usual care group (RR from 0.25 to 0.30).After treatment with herbal medicine, women were twice as likely to have antibody titers lower than 1:64 compared with women who received usual care(RR from 2.15 to 3.14) and the umbilical cord blood bilirubin level in the herbal medicine group was 4umol/L lower than in those receiving usual care. There was no difference in Apgar scores or birthweights between the two groups. This review found very low-quality evidence that CHM prevented HDN caused by maternal-fetal ABO incompatibility. No firm conclusions can be drawn regarding the effectiveness or safety of CHM for this condition.

  8. The Road to Excellence: : A Case Study of the Application of GMP, ISO 9001 and the EFQM Excellence Model in a Nuclear Medicine Department

    NARCIS (Netherlands)

    van Huizen, L; Ahaus, C.T.B. (Kees)

    2017-01-01

    Definitions are introduced to give insight in the field of work of Quality Management in relation to responsibilities in Nuclear Medicine and Molecular Imaging. A relation model visualizes the relationships. When working on the Road to Quality Excellence. The standards as GMP, GCP, ISO 9001 and EFQM

  9. Risk factors and disease prevalence in 3331 personal check-ups performed in preventive medicine between 2006 and 2011. cross-sectional and follow-up study.

    Science.gov (United States)

    Keipes, M; Bellucci, A; Hansen, E

    2012-01-01

    The present data results from a retrospective analysis of 3331 check-ups made in the preventive medicine department of the "ZithaKlinik", named "ZithaGesondheetsZentrum". These check-ups are done for the employee's of several firm's and institutions. According to gender and age, several tests and examinations are performed and the results are given to the person's general practitioner or another doctor of his choice. We will present a global synthesis of all the results but also a follow-up study of persons having performed 2 check-ups or more over a 5-year period. In the cross-sectional part, the analysis is done on 3331 individual check-ups (1447 woman, 1884 men). The average age is 50.3 years +/- 11.4. In the follow-up study, 478 persons (191 women, 287 men) had at least 2 (maximum 5) check-ups in the 5-year period of our observation. Initial age was 54.1 +/- 10.9 years for woman and 51.4 +/- 11.4 for men, respectively 56.4 +/- 10.9 and 53.7+/- 11.2 at their last check-up. An alarming number of persons present with a weight or obesity problem (according to age ranging from 22.0% overweight and 7.3% obese from 18-29 years, respectively 37.5% and 11.3% from 30-49 years, finally 44.0% and 20.6% in the range 50-69 years). Associated risk factors and pathologies (Hypertension, Dyslipidemia, NASH, diabetes type 2 and complete metabolic syndromes) are extremely frequent and getting more so with growing age. Furthermore, physical activity is insufficient in grossly 2/3 of the studied population. The only positive point is a tendency of decreasing tobacco use in all age groups. The follow-up study is frustrating because most of the examined criteria get worse in-between check-ups instead of getting better with changes in lifestyle in an informed population. Asymptomatic diseases or risk factors for non-communicable diseases are extremely frequent in the population examined. The follow-up data shows that huge parts of this group are not sufficiently conscientious of their

  10. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    user1

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

  11. Activity measurements using recessed ionization chambers (activity meters) as performed in the Department for Nuclear Medicine at the Hanover Medical School

    International Nuclear Information System (INIS)

    Meyer, G.J.; Matzke, K.H.; Kuehn, J.

    1992-01-01

    Recessed ionization chambers have an application in the production and dose determination of radiopharmaceuticals. The measuring instrumentation installed in the radiochemical department, service instructions, quality assurance measures and relevant practical experiences are described in brief. (DG) [de

  12. CAEP 2014 Academic Symposium: "How to make research succeed in your emergency department: How to develop and train career researchers in emergency medicine".

    Science.gov (United States)

    Perry, Jeffrey J; Snider, Carolyn E; Artz, Jennifer D; Stiell, Ian G; Shaeri, Sedigheh; McLeod, Shelley; Le Sage, Natalie; Hohl, Corinne; Calder, Lisa A; Vaillancourt, Christian; Holroyd, Brian; Hollander, Judd E; Morrison, Laurie J

    2015-05-01

    We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity. We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received. Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization. We recommend that the CAEP Academic Section create a

  13. Effectiveness of a Mentor-Implemented Violence Prevention Intervention for Assault-Injured Youth Presenting to the Emergency Department: Results of a Randomized Trial

    Science.gov (United States)

    Cheng, Tina L.; Haynie, Denise; Brenner, Ruth; Wright, Joseph L.; Chung, Shang-en; Simons-Morton, Bruce

    2008-01-01

    Context The emergency department has been described as a promising setting to initiate interventions with assault-injured youth to reduce the risk of re-injury and reactive perpetration. Efforts to intervene have received little study. Objective To assess the impact of a mentor-implemented violence prevention intervention on reducing aggression, fighting and re-injury among assault-injured youth. Design Randomized controlled trial Setting Two large urban hospital emergency departments Participants Youth age 10–15 presenting with peer assault injury were recruited and randomly assigned to intervention and comparison groups. Intervention Intervention youth received a mentor who implemented a 6 session problem-solving curriculum while parents received 3 home visits with a health educator to discuss family needs and facilitate service use and parental monitoring. The comparison group received a list of community resources with 2 follow-up phone calls to facilitate service use. Main Outcome Measures Youth and parents were interviewed at baseline and 6 months to assess attitudes about violence, risk factors, fighting and repeat injury. Results 227 families were recruited with 23% refusing participation and 4% partial interview completion. 166 families were enrolled with 87 randomized to the intervention group and 79 in the comparison group; 118 (71%) completed both youth and parent follow-up interviews and 113 had usable data. Intervention and comparison groups were not significantly different at baseline on demographics or risk factors except for increased knife carrying and less deviant peers in the intervention group. After adjustment for baseline differences, there was a trend toward significant program effect including reducing misdemeanor activity (rate ratio 0.29, confidence interval 0.08–0.98), youth-reported aggression scores (rate ratio .63, 0.4–1.00) and increasing youth self efficacy (beta=2.28, pmentor-implemented program with assault-injured youth

  14. Trichomonas vaginalis infections in department of gynecology and preventive measures%妇科阴道毛滴虫感染分析及预防措施

    Institute of Scientific and Technical Information of China (English)

    何燕妃

    2012-01-01

    OBJECTIVE To explore and analyze the status of Trichomonas vaginalis infections in department of gynecology, so as to develop preventive measures. METHODS The clinical data of outpatients in department of gynecology of our hospital from May 2010 to Apr. 2011 were collected; the age, month, and seasonal infection rates of the patients with T. Vaginalis infections were compared and analyzed for the understanding of status of T. Vaginalis infection. RESULTS A total of 1680 patients undergoing examination in gynecology clinic were enrolled in this study. T. Vaginalis infections occurred in 118 patients with the infection rate of 7. 0%. The age group of 35 has the highest infection rate, followed by age group of 40s the infections were widely distributed in spring (10. 0%), which was significantly higher than the other seasons. CONCLUSION The middle or young female adults between 35 and 45 years of age are the predominant population for T. Vaginalis infections. Keeping vulva clean and taking good healthcare are the important ways to prevent the disease.%目的 对妇科阴道毛滴虫感染情况进行分析探讨,并结合感染情况研究预防措施.方法 提取医院2010年5月-2011年4月门诊妇科检查资料,对感染阴道毛滴虫患者的年龄、月份、季节感染率进行对比分析,了解阴道毛滴虫感染情况.结果 妇科门诊进行检查的妇科患者共1680例,其中阴道毛滴虫感染者118例,感染率为7.0% ;35岁年龄组感染率较高,明显高于其他年龄组,40岁组次之;春季感染较多,为10.0%,高于其他季节.结论 妇科阴道毛滴虫感染以35~45岁中青年女性居多,保持个人外阴清洁、做好卫生保健,是预防本病的重要手段.

  15. Effectiveness of a mentor-implemented, violence prevention intervention for assault-injured youths presenting to the emergency department: results of a randomized trial.

    Science.gov (United States)

    Cheng, Tina L; Haynie, Denise; Brenner, Ruth; Wright, Joseph L; Chung, Shang-en; Simons-Morton, Bruce

    2008-11-01

    The goal was to assess the impact of a mentor-implemented, violence prevention intervention in reducing aggression, fighting, and reinjury among assault-injured youths. In a randomized, controlled trial performed in the emergency departments of 2 large urban hospitals, 10- to 15-year-old youths who presented with peer assault injuries were recruited and randomly assigned to intervention and comparison groups. In the intervention group, youths received a mentor, who implemented a 6-session problem-solving curriculum, and parents received 3 home visits with a health educator, to discuss family needs and to facilitate service use and parental monitoring. The comparison group received a list of community resources, with 2 follow-up telephone calls to facilitate service use. Youths and parents were interviewed at baseline and at 6 months, for assessment of attitudes about violence, risk factors, fighting, and repeat injury. A total of 227 families were recruited, with 23% refusing participation and 4% providing partial interview completion. A total of 166 families were enrolled, with 87 assigned to the intervention group and 79 to the comparison group; 118 (71%) completed both youth and parent follow-up interviews, and 113 had usable data. The intervention and comparison groups were not significantly different at baseline with respect to demographic features or risk factors, except for increased knife-carrying and fewer deviant peers in the intervention group. After adjustment for baseline differences, there was a trend toward significant program effects, including reduced misdemeanor activity and youth-reported aggression scores and increased youth self-efficacy. Program impact was associated with the number of intervention sessions received. A community-based, mentor-implemented program with assault-injured youths who presented to the emergency department trended in the direction of decreased violence, with reduced misdemeanors and increased self-efficacy.

  16. Creating a pro-active health care system to combat chronic diseases in Sri Lanka: the central role of preventive medicine and healthy lifestyle behaviors.

    Science.gov (United States)

    Sagner, Michael; Arena, Ross; McNeil, Amy; Brahmam, Ginnela N V; Hills, Andrew P; De Silva, H Janaka; Karunapema, R P Palitha; Wijeyaratne, Chandrika N; Arambepola, Carukshi; Puska, Pekka

    2016-10-01

    The current burden and future escalating threat of chronic diseases, constitutes the major global public health challenge. In Sri Lanka, cardiovascular diseases account for the majority of annual deaths. Data from Sri Lanka also indicate a high incidence and prevalence of pre-diabetes and diabetes; 1 in 5 adults have elevated blood sugar in Sri Lanka. It is well established that chronic diseases share four primary behavioral risk factors: 1) tobacco use; 2) unhealthy diet; 3) physical inactivity; and 4) harmful use of alcohol. Evidence has convincingly shown that replacing these behavioral risk factors with the converse, healthy lifestyle characteristics, decrease the risk of poor outcomes associated with chronic disease by 60 to 80%. In essence, prevention or reversal of these behavioral risk factors with effective healthy lifestyle programing and interventions is the solution to the current chronic disease crisis. Expert commentary: Healthy lifestyle is medicine with global applicability, including Sri Lanka and the rest of the South Asia region. This policy statement will discuss the chronic disease crisis in Sri Lanka, its current policies and action implemented to promote healthy lifestyles, and further recommendations on preventive medicine and healthy lifestyle initiatives that are needed to move forward.

  17. Security in transport, storage and disposal of radioactive materials, providing to the department of nuclear medicine in hospitals Rafael Angel Calderon Guardia, San Juan de Dios and Mexico

    International Nuclear Information System (INIS)

    Elizondo Valle, Alejandro; Jimenez Mendez, Christian; Leiton Araya, Christopher; Villalobos Rodriguez, Geovanny; Leal Vega, Olga Maritza; Lopez Gatjens, Santiago

    2010-01-01

    The security is analysed for the transport and storage of radioactive sources and the management of radioactive waste product of practices and interventions in nuclear medicine services in hospitals Calderon Guardia, San Juan de Dios and Mexico. The objective is to assess the compliance with current regulations, the effectiveness and efficiency of the same. The security and compliance with current regulations were considered related to the transport of radioactive sources by the two private companies that provide this service, from the Juan Santamaria airport customs to three hospitals evaluated. Compliance with national and international rules on storage of radioactive sources and waste materials were analyzed. For this has been studied Costa Rican law and the recommendations of international organizations related to the subject matter, in the three nuclear medicine services valued. The national and international background related to radiological accidents occurred with radioactive sources during transport, storage and waste were revised, where highlights that in most cases, these accidents occurred for breach of the regulations established. Studies in Costa Rica on radioactive waste management were analysed, and the current status of nuclear medicine services in terms of radiation safety, which helped with the investigation. The compliance and regulations were analyzed by the result of observation and interviews during development, to finally make a series of findings and provide recommendations that are considered relevant. Various variants and indicators that are defined in the theoretical framework were used; also, the strategy of methodology is described. The purpose of the work has been to provide a scientific nature, and that methodology met the objectives, offering an approach from different angles and the actors involved, and a critical and objective analysis strictly in order to contribute to public health. The research is a valuable tool that provides

  18. [Realization of the modern educational concept for the organization of the teaching and learning activities at the Department of Forensic Medicine of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation].

    Science.gov (United States)

    Pigolkin, Yu I; Lomakin, Yu V; Leonova, E N

    The modern educational concept for the organization of the teaching and learning activities (continuous, free, and open education) implies the necessity for its implementation the development and introduction of the new approaches to the work with the students. This problem should be addressed based on the use of the up-to-date technologies for education of the adult subjects. Such technologies find the increasingly wider application at the Department of Forensic Medicine of the I.M. Sechenov First Moscow State Medical University. It markedly contributes to the improvement of the quality of education.

  19. [Tumors of the 4th ventricle and the craniospinal transitional zone. Review of patients of the Neurosurgical Clinic of the Department of Medicine of the Karl Marx University].

    Science.gov (United States)

    Niebeling, H G; Fried, H; Goldhahn, W E; Skrzypczak, J; Brachmann, J; Eichler, I

    1983-01-01

    From a total of 1,028 infratentorial tumours operated on at the Neurosurgical Hospital of the Section Medicine of the Karl-Marx University Leipzig in the last 30 years, 167 tumours in the region of the 4th ventrical have been selected. Their statistical processing was carried out with respect to specific localisation, average age, kind of tumour, sex, clinical findings, duration of case history, application of instrumental diagnostic procedures and radicality of operation, success and failure. Some fundamental conclussions are drawn. A subdivision in detail will be contained in the following articles based on this material.

  20. Exploration of Islamic medicine plant extracts as powerful antifungals for the prevention of mycotoxigenic Aspergilli growth in organic silage

    DEFF Research Database (Denmark)

    Tayel, Ahmed A.; Salem, Mohammed F.; El-Tras, Wael F.

    2011-01-01

    Feed contamination with mycotoxins is a major risk factor for animals and humans as several toxins can exist as residues in meat and milk products, giving rise to carry-over to consumers via ingestion of foods of animal origin. The starting point for prevention, in this chain, is to eliminate the...

  1. [Appropriateness admissions to the Department of Internal Medicine of the Hospital de Santa Luzia (Elvas) evaluated by the AEP (Appropriateness Evaluation Protocol)].

    Science.gov (United States)

    Cordero, A; Aguila, J; Massalana, A; Escoto, V; Lopes, L; Susano, R

    2004-01-01

    The authors analyse the appropriateness admissions to the Internal Medicine ward of the Hospital de Santa Luzia (Elvas). A retrospective study was performed during 6 months of 2001, using the Appropriateness Evaluation Protocol (AEP). Non-appropriateness admissions were found in 19% (CI95%: 16-22), and this group of patients had less mean age (63 + 16 vs 69 + 16; p <0.01), and less mean days of admission (7.1 + 6 vs 9.3 + 7; p <0.01) than group with appropriateness admissions. Appropriateness admissions were mainly found in patients admitted from the emergency room (86% vs 49%; p <0.001). Most of patients with non-appropriate admissions were admitted to undergo diagnostic tests (44%; CI95%: 35-53), or to be referred to other medical centres for specialized study and/or treatment (12%; CI95%: 6-18).

  2. Travel medicine

    Science.gov (United States)

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

    2014-01-01

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

  3. An anonymous survey of psychosomatic medicine fellowship directors regarding breaches of contracts and a proposal for prevention.

    Science.gov (United States)

    Levenson, James L; Bialer, Philip

    2010-01-01

    The authors studied how often applicants accept positions at more than one program, or programs offer positions to applicants who have already signed contracts with other programs. An anonymous survey was distributed to all psychosomatic medicine fellowship program directors. It is fairly common for applicants to sign contracts for fellowship positions and then back out of the contracts. Only one program reported ever knowingly offering a contract to an applicant who had accepted a position elsewhere. Programs are divided over whether there are extenuating circumstances under which it would be acceptable to offer a position to an applicant who has already signed a contract with another program. Guidelines for fellowship programs that do not use the National Resident Match Program can improve the recruitment process.

  4. Main plants used in traditional medicine for the treatment of snake bites n the regions of the department of Antioquia, Colombia.

    Science.gov (United States)

    Vásquez, Julieta; Alarcón, Juan C; Jiménez, Silvia L; Jaramillo, Gloria I; Gómez-Betancur, Isabel C; Rey-Suárez, J Paola; Jaramillo, Karen M; Muñoz, Diana C; Marín, Daniela M; Romero, Jefferson O

    2015-07-21

    In Colombia, more than 4.000 ophidian accidents occur per year and due to the scarce distribution and limited availability of antivenom, the use of traditional medicine has been perpetuated in some of its rural communities, in which initially, those affected are treated by healers and shamans using medicinal plants in different ways. Research was conducted with renowned healers or connoisseurs of plants on the ethnobotany of ophidian accidents in five different areas and their municipalities of Antioquia: Magdalena Medio (Caracolí, Puerto Berrío); Bajo Cauca (Caucasia, Zaragoza); Nordeste (San Roque, Yalí); Norte (Gómez Plata, Valdivia); Suroeste (Ciudad Bolívar, Salgar); collecting information related to experience and time of use of plants in the treatment of these poisonings, amounts used, ways of use (beverage, bathing, ointment, chupaderas, vapors), preparation types (maceration or decoction) and treatment duration. 71 plant species were identified and collected, 49.29% of them without previous reports as antiophidian and 38.0% employed for the same purpose in other geographical areas. The leaves (24.82%), stems (11.68%) and flowers (10.95%) were found to be the most frequently employed structures in the preparation of the extracts, which are usually prepared by decoction (83.94%), maceration (6.57%). In this work, specimens lacking previous ethnobotanical reports have been found, plants used by ethnic groups from other regions of Antioquia and the world to treat snake bites; and herbaceous plants whose inhibitory activity of symptoms produced by some snake venoms, has been experimentally verified by in vivo and in vitro tests. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Lewis, C.; Arscott, T.

    2008-01-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Praveen Aggarwal

    2014-01-01

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

  8. Electrocardiogram as an important tool in Preventive & Community Medicine - A rare case report of asymptomatic non paroxysmal accelerated junctional rhythm detected on routine ECG

    Directory of Open Access Journals (Sweden)

    Raghavendra Deolalikar

    2015-03-01

    Full Text Available Fifty four year old asymptomatic employee was detected to have Inverted P waves with normal QRS complex on Electrocardiogram [ECG] during his Annual Medical Examination. The ECG reverted to normal after few days. Inverted P is suggestive of retrograde conduct of impulse from A-V Node. Case of Non Paroxysmal Accelerated Junctional Rhythm. Causes are inferior wall myocardial infarction, myocarditis or recent open heart surgery. Troponin T Test was negative, Treadmill test was negative, and 2D Echo showed 55 % ejection fraction with no regional wall motion abnormalities. It needs no treatment if underlying causes are ruled out. Case would have gone un-noticed as patient was asymptomatic, thus emphasizing the importance of ECG in preventive and community medicine.

  9. Barriers and facilitators to implementation of the institute of medicine recommendations on preventing mental, emotional, and behavioral disorders among young people.

    Science.gov (United States)

    Evans, Mary E

    2012-05-01

    The purpose of this study was to gain an understanding of the barriers and facilitators to implementation of the five overarching recommendations of the Institute of Medicine report and to consider the implications for nursing. Data were collected through use of a semi-structured interview of purposive sample of 22 key informants regarding the barriers and facilitators to implementation of the report's five major recommendations. The major barriers were competing priorities, lack of infrastructure for implementation, lack of public education regarding mental health and the effectiveness of prevention, stigma, and a paucity of facilitating factors. The facilitators were leadership, flexible resources, linkage to healthcare reform or other legislation, coordination across agencies and governmental levels, and additional research. The discussion focuses on ways of promoting facilitating factors and consideration of nursing's potential contributions in the areas of education, practice, and research. © 2012 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2017-06-01

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

  11. PHARMACOEPIDEMIOLOGICAL STUDY OF NON-STEROID ANTIINFLAMMATORY MEDICINE USE IN THE IN-PATIENT DEPARTMENT BEFORE AND AFTER THE FORMULAR SYSTEM ADOPTION

    Directory of Open Access Journals (Sweden)

    V.A. Baturin

    2008-03-01

    Full Text Available We studied the use ofnon-steroid anti-inflammatorydrugs (NSAID at the in-patient department ofcentral district hospitalwith the application ofDDD-techniques before and after the formular system adoption. After introduction of drug formular and treatment standards the use of NSAID was reduced; the physicians began to use modern drugs. Non-indicated and contraindicated NSAID were prescribed more seldom. Itwas determined that reduction of antihypertensive drugs efficiency in hypertensive patients was the main side effect of NSAID use. NSAID gastropathy occurred more seldom, and mainly in the patients receiving several NSAIDs simultaneously.

  12. Study on preventive and therapeutic effect of Chinese medicinal herbal extracts on rat with bone marrow injury induced by radiation exposure

    International Nuclear Information System (INIS)

    Guo Jun; Chen Baotian; Meng Hua; Liu Wenchao; Xie Wei; Sheng Rong

    2006-01-01

    Objective: To examine the effect of Chinese medicinal herbal extracts, Danggui (Radix angelicae sinensis), Chuanxiong (Rhizoma chuanxiong), Huangqi (Radix astragali), and Danshen (Radix salviae miltiorrhizae) on rats with bone marrow injury induced with whole-body gamma-ray exposure. Methods: Sixty male rats were randomly divided into three groups, control group, model group (irradiation only with no administration of the extracts), and drug treatment group (irradiation and administration of Chinese medicinal herbal extracts). Rats were irradiated with 6 Gy cobolt-60 gamma rays after administration of the extracts for two weeks. The number of marrow nucleate cells was counted, and VEGF and PDGF expression were measured with Western blot method on the 7th day since the irradiation. Results: Bone marrow nucleate cells and VEGF and PDGF expression in bone marrow cells in the model group were significantly lower than those in the control group (P<0.01), and these values in the drug treatment group were significantly higher than those in the model group (P<0.01 or P<0.05). Conclusion: The extracts of Chuanxiong, Danggui, Huangqi, and Danshen can be used to prevent from ration bone marrow injury in rats. (authors)

  13. Individualized prevention against hypertension based on Traditional Chinese Medicine Constitution Theory: A large community-based retrospective, STROBE-compliant study among Chinese population.

    Science.gov (United States)

    Li, Ying; Li, Xiao-Hui; Huang, Xin; Yin, Lu; Guo, Cheng-Xian; Liu, Chang; He, Yong-Mei; Liu, Xing; Yuan, Hong

    2017-11-01

    Traditional Chinese Medicine Constitution (TCMC) theory states that individuals with a biased TCMC are more likely to suffer from specific diseases. However, little is known regarding the influence of TCMC on susceptibility to hypertension. The aim of this study is to examine the possible relationship between TCMC and hypertension. Retrospective evaluation and observation were performed using the STROBE guidelines checklist. A large community-based cross-sectional study was conducted between 2009 and 2013 in Changsha, China. TCMC was assessed using a questionnaire that included 68 items. TCMC distributions and the associations of different TCMCs with hypertension risk were analyzed. In total, 144,439 subjects underwent evaluations of TCMC and blood pressure (BP). There were significant differences in the hypertension prevalence among the various TCMC groups (P medicine criteria; for example, phlegm wetness with hypertension was similar to obesity-related hypertension. Our results suggest that phlegm wetness, yin deficiency, blood stasis, and qi deficiency have different effects on the prevalence of hypertension. More attention should be paid to TCMCs associated with susceptibility to hypertension, and corresponding preventive and therapeutic treatments should be developed according to different TCMCs.

  14. Evolving trade policy and the Trans-Pacific Partnership Agreement: does it threaten Vietnam's access to medicine and its progress towards scaling up HIV prevention, treatment and care?

    Science.gov (United States)

    Linh, Nguyen Nhat; Huong, Nguyen Thanh; Thuy, Hua Thanh

    2015-01-01

    The Trans-Pacific Partnership Agreement (TPP) has undergone 18 rounds of secretive negotiation between the USA and 11 Asia-Pacific countries. Aiming at a free trade area, this multilateral trade proposal covers all aspects of commercial relations among the countries involved. Despite some anticipated positive impacts in trade, specific articles in this proposal's intellectual property and transparency chapters might negatively impact access to medicine, in general, and to antiretroviral (ARV) drugs, in particular, in Vietnam. Drawing on a desk review and qualitative in-depth interviews with 20 key informants from government, academia, hospitals and civil society, we analyse various provisions of the proposal being negotiated leaked after the 14th round of negotiations in September 2012. Findings suggest that the TPP could lead to increased monopoly protection and could limit technological advancements within the local pharmaceutical manufacturing industry, resulting in higher medicine prices in Vietnam. This outcome would have a significant impact on Vietnam's ability to achieve goals for HIV prevention, treatment and care, and create barriers to universal health-care coverage. This research provides unique evidence for Vietnam to advocate for more equitable pharmaceutical provisions in and to raise awareness of the implications of the TPP among the pharmaceutical stakeholder community in Vietnam.

  15. Traditional Medicinal Plant Extracts and Natural Products with Activity against Oral Bacteria: Potential Application in the Prevention and Treatment of Oral Diseases

    Directory of Open Access Journals (Sweden)

    Enzo A. Palombo

    2011-01-01

    Full Text Available Oral diseases are major health problems with dental caries and periodontal diseases among the most important preventable global infectious diseases. Oral health influences the general quality of life and poor oral health is linked to chronic conditions and systemic diseases. The association between oral diseases and the oral microbiota is well established. Of the more than 750 species of bacteria that inhabit the oral cavity, a number are implicated in oral diseases. The development of dental caries involves acidogenic and aciduric Gram-positive bacteria (mutans streptococci, lactobacilli and actinomycetes. Periodontal diseases have been linked to anaerobic Gram-negative bacteria (Porphyromonas gingivalis, Actinobacillus, Prevotella and Fusobacterium. Given the incidence of oral disease, increased resistance by bacteria to antibiotics, adverse affects of some antibacterial agents currently used in dentistry and financial considerations in developing countries, there is a need for alternative prevention and treatment options that are safe, effective and economical. While several agents are commercially available, these chemicals can alter oral microbiota and have undesirable side-effects such as vomiting, diarrhea and tooth staining. Hence, the search for alternative products continues and natural phytochemicals isolated from plants used as traditional medicines are considered as good alternatives. In this review, plant extracts or phytochemicals that inhibit the growth of oral pathogens, reduce the development of biofilms and dental plaque, influence the adhesion of bacteria to surfaces and reduce the symptoms of oral diseases will be discussed further. Clinical studies that have investigated the safety and efficacy of such plant-derived medicines will also be described.

  16. Essentials of Periodontal Medicine in Preventive Medicine

    OpenAIRE

    Gulati, Minkle; Anand, Vishal; Jain, Nikil; Anand, Bhargavi; Bahuguna, Rohit; Govila, Vivek; Rastogi, Pavitra

    2013-01-01

    Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer′s disease, gastrointestinal disease, prostatitis, renal diseases, which has a...

  17. [Pre-eclampsia prevention in 2018 in general population and in lupic women: At the dawn of a personalized medicine?

    Science.gov (United States)

    de Moreuil, C; Fauchais, A-L; Merviel, P; Tremouilhac, C; Le Moigne, E; Pasquier, E; Pan-Petesch, B; Lacut, K

    2018-06-19

    Pre-eclampsia prevention represents a major public health issue, as this vasculo-placental disorder generates a great burden of foeto-maternal morbi-mortality. Aspirin has proved its efficacy in primary and secondary pre-eclampsia prevention, especially when it is given at 150mg per day bedtime before 15 weeks of gestation to high-risk women. In the English trial ASPRE, high-risk women were identified by an algorithm taking into account angiogenic biomarkers ascertained at the end of first trimester of pregnancy. This article focuses on physiopathological mechanisms and risk factors of pre-eclampsia and on the interest of early angiogenic biomarkers dosing during pregnancy, for the assessment of pre-eclampsia risk. Unlike Great Britain or Israel, cost-effectiveness of this algorithm in general population has not been assessed in France. Finally, systemic lupus erythematous is at high risk of vasculo-placental disorders. Although few studies of angiogenic biomarkers dosing during lupus pregnancies identified a correlation between high sFlt1 levels at the end of first trimester and subsequent onset of severe vasculo-placental disorders, with a very good negative predictive value of sFtl1. Angiogenic biomarkers ascertainment for screening of vasculo-placental disorders in pregnant women with systemic lupus erythematous could allow targeting at best women needing an aspirin treatment and a closer monitoring. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

  18. The ability of clinical and laboratory findings to predict in-hospital death in patients with thrombotic thrombocytopenic purpura in an internal and emergency medicine department

    Directory of Open Access Journals (Sweden)

    Filippo Pieralli

    2012-01-01

    Full Text Available Introduction: Thrombotic thrombocytopenic purpura (TTP is a rare, life-threatening syndrome characterized by microangiopathic anemia, thrombocytopenia, diffuse microvascular thrombosis, and ischemia. It is associated with very low levels of ADAMTS-13. Measurement of ADAMTS-13 levels is used for diagnostic and prognostic purposes, but in every-day clinical practice, this type of analysis is not always readily available. In this retrospective study, we evaluated prognostic value of clinical and laboratory findings in patients with TTP. Materials and methods: We retrospectively investigated patients with clinically diagnosed TTP treated in a unit of Internal and Emergency Medicine (1996-2007. Clinical and laboratory findings were collected and analyzed in order to assess their ability to predict in-hospital death. Results: Twelve patients were identified (mean age 59 + 22 years; 58% were women. Five (42% died during the hospitalization, and the variables significantly associated with this outcome were: a delay between diagnosis and symptom onset (HR 1.36; 95% CI 1.04-1.78; p < 0.05; a higher severity score (HR 1.48; 95%CI 1,23-3.86; p < 0.05; hemodynamic instability with hypotension and/or shock (HR 3.35; 95%CI 3.02-9.26; p < 0.01; a higher schistocyte count on blood smear (HR 1.84; 95%CI 1.04-3.27; p < 0.05; and higher lactate values (HR 1.85; 95%CI 1.08- 3.16; p < 0.05. Conclusions: TTP is a rare and potentially fatal disease with protean manifestations. Delayed diagnosis after symptom onset is a major determinant of poor outcome. Hypotension and shock are also prognostically unfavourable. Laboratory evidence of cardiocirculatory compromise (i.e., elevated lactate levels and extension of the disease process (i.e., schistocyte count > 3 are predictive of in-hospital death, independently of the hemodynamic profile on admission.

  19. National survey on the indicators of quality in Bioethics of the SEMICYUC in the departments of Intensive Care Medicine in Spain.

    Science.gov (United States)

    López Camps, V; García García, M A; Martín Delgado, M C; Añón Elizalde, J M; Masnou Burrallo, N; Rubio Sanchiz, O; Estella García, A; Monzón Marín, J L

    2017-12-01

    Multiple interventions are performed in critical patients admitted to Intensive Care Units (ICUs). This study explores the presence in the daily practice of ICUs of elements related to the 6 bioethics quality indicators of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units, and the participation of their members in the hospital ethics committees. A multicenter observational study was carried out, using a survey exploring descriptive aspects of the ICUs, with 25 questions related to bioethics quality indicators, and assessing the participation of ICU members in the hospital ethics committees. The ICUs were classified by size (larger or smaller than 10 beds) and type of hospital (public/private-public concerted center, with/without teaching). The 68 analyzed surveys revealed: daily informing of the family (97%), carried out in the information room (82%); end-of-life care protocols (44%); life support limitation form (48.43%); and physical containment protocol (40%). Compliance with the informed consent process referred to different procedures is: tracheostomy (92%), vascular procedures (76%), and extrarenal clearance (25%). The presence of ICU members in the hospital ethics committee is currently frequent (69%). Information supplied to relatives is adequate, although there are ICUs without an information room. Compliance with the informed consent requirements of various procedures is insufficient. The participation of ICU members in the hospital ethics committees is frequent. The results obtained suggest a chance for improvement in the bioethical quality of the ICU. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  20. [Hygiene, safety and occupational medicine in Niger].

    Science.gov (United States)

    Moussa, F; Sékou, H

    1997-01-01

    The laws and rules governing hygiene, safety and medicine in the workplace in Niger were evaluated in this study. We used labour administration, health service and Social Security Department reports to review each type of professional activity and the risks associated with it. This enabled us to make recommendations to the authorities and to the organizations representing employers and staff, concerning the prevention of risks at work.

  1. Gualou Xiebai Decoction, a Traditional Chinese Medicine, Prevents Cardiac Reperfusion Injury of Hyperlipidemia Rat via Energy Modulation.

    Science.gov (United States)

    Yan, Lu-Lu; Zhang, Wei-Yang; Wei, Xiao-Hong; Yan, Li; Pan, Chun-Shui; Yu, Yang; Fan, Jing-Yu; Liu, Yu-Ying; Zhou, Hua; Han, Jing-Yan; Yao, Xin-Sheng

    2018-01-01

    Background: Gualou Xiebai Decoction (GLXB) is a classic prescription of Chinese medicine used for the treatment of cardiac problems. The present study was designed to explore the effect and mechanism of GLXB on ischemia/reperfusion (I/R) induced disorders in myocardial structure and function, focusing on the regulation of energy metabolism and the RhoA/ROCK pathway. Methods: After hyperlipidemic rat model was established by oral administration of high fat diet, the rats were treated with GLXB for 6 weeks and subjected to 30 min occlusion of the left anterior descending coronary artery (LADCA) followed by 90 min reperfusion to elicit I/R challenge. Myocardial infarct size was assessed by Evans blue-TTC staining. Myocardial blood flow (MBF) and cardiac function were evaluated. Enzyme-linked immunosorbent assay was performed to examine the content of ATP, ADP, AMP, CK, CK-MB, LDH, cTnT, cTnI, and IL-6. Double staining of F-actin and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling was conducted to assess myocardial apoptosis. Expressions of ATP synthase subunit δ (ATP 5D), and RhoA and ROCK were determined by Western blotting. Results: Administration with GLXB at high dose for 6 weeks protected heart against I/R-induced MBF decrease, myocardial infarction and apoptosis, ameliorated I/R-caused impairment of cardiac function and myocardial structure, restored the decrease in the ratio of ADP/ATP and AMP/ATP, and the expression of ATP 5D with inhibiting the expression of RhoA and ROCK. Conclusions: Treatment with GLXB effectively protects myocardial structure and function from I/R challenge, possibly via regulating energy metabolism involving inactivation of RhoA/ROCK signaling pathway.

  2. The Traditional Herbal Medicine, Dangkwisoo-San, Prevents Cerebral Ischemic Injury through Nitric Oxide-Dependent Mechanisms

    Directory of Open Access Journals (Sweden)

    Ji Hyun Kim

    2011-01-01

    Full Text Available Dangkwisoo-San (DS is an herbal extract that is widely used in traditional Korean medicine to treat traumatic ecchymosis and pain by promoting blood circulation and relieving blood stasis. However, the effect of DS in cerebrovascular disease has not been examined experimentally. The protective effects of DS on focal ischemic brain were investigated in a mouse model. DS stimulated nitric oxide (NO production in human brain microvascular endothelial cells (HBMECs. DS (10–300 μg/mL produced a concentration-dependent relaxation in mouse aorta, which was significantly attenuated by the nitric oxide synthase (NOS inhibitor L-NAME, suggesting that DS causes vasodilation via a NO-dependent mechanism. DS increased resting cerebral blood flow (CBF, alt