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Sample records for problem list medication

  1. Determinants of a successful problem list to support the implementation of the problem-oriented medical record according to recent literature.

    Science.gov (United States)

    Simons, Sereh M J; Cillessen, Felix H J M; Hazelzet, Jan A

    2016-08-02

    A problem-oriented approach is one of the possibilities to organize a medical record. The problem-oriented medical record (POMR) - a structured organization of patient information per presented medical problem- was introduced at the end of the sixties by Dr. Lawrence Weed to aid dealing with the multiplicity of patient problems. The problem list as a precondition is the centerpiece of the problem-oriented medical record (POMR) also called problem-oriented record (POR). Prior to the digital era, paper records presented a flat list of medical problems to the healthcare professional without the features that are possible with current technology. In modern EHRs a POMR based on a structured problem list can be used for clinical decision support, registries, order management, population health, and potentially other innovative functionality in the future, thereby providing a new incentive to the implementation and use of the POMR. On both 12 May 2014 and 1 June 2015 a systematic literature search was conducted. From the retrieved articles statements regarding the POMR and related to successful or non-successful implementation, were categorized. Generic determinants were extracted from these statements. In this research 38 articles were included. The literature analysis led to 12 generic determinants: clinical practice/reasoning, complete and accurate problem list, data structure/content, efficiency, functionality, interoperability, multi-disciplinary, overview of patient information, quality of care, system support, training of staff, and usability. Two main subjects can be distinguished in the determinants: the system that the problem list and POMR is integrated in and the organization using that system. The combination of the two requires a sociotechnical approach and both are equally important for successful implementation of a POMR. All the determinants have to be taken into account, but the weight given to each of the determinants depends on the organizationusing

  2. [Problem list in computer-based patient records].

    Science.gov (United States)

    Ludwig, C A

    1997-01-14

    Computer-based clinical information systems are capable of effectively processing even large amounts of patient-related data. However, physicians depend on rapid access to summarized, clearly laid out data on the computer screen to inform themselves about a patient's current clinical situation. In introducing a clinical workplace system, we therefore transformed the problem list-which for decades has been successfully used in clinical information management-into an electronic equivalent and integrated it into the medical record. The table contains a concise overview of diagnoses and problems as well as related findings. Graphical information can also be integrated into the table, and an additional space is provided for a summary of planned examinations or interventions. The digital form of the problem list makes it possible to use the entire list or selected text elements for generating medical documents. Diagnostic terms for medical reports are transferred automatically to corresponding documents. Computer technology has an immense potential for the further development of problem list concepts. With multimedia applications sound and images will be included in the problem list. For hyperlink purpose the problem list could become a central information board and table of contents of the medical record, thus serving as the starting point for database searches and supporting the user in navigating through the medical record.

  3. Automation of a problem list using natural language processing

    Directory of Open Access Journals (Sweden)

    Haug Peter J

    2005-08-01

    Full Text Available Abstract Background The medical problem list is an important part of the electronic medical record in development in our institution. To serve the functions it is designed for, the problem list has to be as accurate and timely as possible. However, the current problem list is usually incomplete and inaccurate, and is often totally unused. To alleviate this issue, we are building an environment where the problem list can be easily and effectively maintained. Methods For this project, 80 medical problems were selected for their frequency of use in our future clinical field of evaluation (cardiovascular. We have developed an Automated Problem List system composed of two main components: a background and a foreground application. The background application uses Natural Language Processing (NLP to harvest potential problem list entries from the list of 80 targeted problems detected in the multiple free-text electronic documents available in our electronic medical record. These proposed medical problems drive the foreground application designed for management of the problem list. Within this application, the extracted problems are proposed to the physicians for addition to the official problem list. Results The set of 80 targeted medical problems selected for this project covered about 5% of all possible diagnoses coded in ICD-9-CM in our study population (cardiovascular adult inpatients, but about 64% of all instances of these coded diagnoses. The system contains algorithms to detect first document sections, then sentences within these sections, and finally potential problems within the sentences. The initial evaluation of the section and sentence detection algorithms demonstrated a sensitivity and positive predictive value of 100% when detecting sections, and a sensitivity of 89% and a positive predictive value of 94% when detecting sentences. Conclusion The global aim of our project is to automate the process of creating and maintaining a problem

  4. Automation of a problem list using natural language processing

    OpenAIRE

    Meystre, Stephane; Haug, Peter J

    2005-01-01

    Abstract Background The medical problem list is an important part of the electronic medical record in development in our institution. To serve the functions it is designed for, the problem list has to be as accurate and timely as possible. However, the current problem list is usually incomplete and inaccurate, and is often totally unused. To alleviate this issue, we are building an environment where the problem list can be easily and effectively maintained. Methods For this project, 80 medica...

  5. Automatic detection of omissions in medication lists.

    Science.gov (United States)

    Hasan, Sharique; Duncan, George T; Neill, Daniel B; Padman, Rema

    2011-01-01

    Evidence suggests that the medication lists of patients are often incomplete and could negatively affect patient outcomes. In this article, the authors propose the application of collaborative filtering methods to the medication reconciliation task. Given a current medication list for a patient, the authors employ collaborative filtering approaches to predict drugs the patient could be taking but are missing from their observed list. The collaborative filtering approach presented in this paper emerges from the insight that an omission in a medication list is analogous to an item a consumer might purchase from a product list. Online retailers use collaborative filtering to recommend relevant products using retrospective purchase data. In this article, the authors argue that patient information in electronic medical records, combined with artificial intelligence methods, can enhance medication reconciliation. The authors formulate the detection of omissions in medication lists as a collaborative filtering problem. Detection of omissions is accomplished using several machine-learning approaches. The effectiveness of these approaches is evaluated using medication data from three long-term care centers. The authors also propose several decision-theoretic extensions to the methodology for incorporating medical knowledge into recommendations. Results show that collaborative filtering identifies the missing drug in the top-10 list about 40-50% of the time and the therapeutic class of the missing drug 50%-65% of the time at the three clinics in this study. Results suggest that collaborative filtering can be a valuable tool for reconciling medication lists, complementing currently recommended process-driven approaches. However, a one-size-fits-all approach is not optimal, and consideration should be given to context (eg, types of patients and drug regimens) and consequence (eg, the impact of omission on outcomes).

  6. Using an electronic prescribing system to ensure accurate medication lists in a large multidisciplinary medical group.

    Science.gov (United States)

    Stock, Ron; Scott, Jim; Gurtel, Sharon

    2009-05-01

    Although medication safety has largely focused on reducing medication errors in hospitals, the scope of adverse drug events in the outpatient setting is immense. A fundamental problem occurs when a clinician lacks immediate access to an accurate list of the medications that a patient is taking. Since 2001, PeaceHealth Medical Group (PHMG), a multispecialty physician group, has been using an electronic prescribing system that includes medication-interaction warnings and allergy checks. Yet, most practitioners recognized the remaining potential for error, especially because there was no assurance regarding the accuracy of information on the electronic medical record (EMR)-generated medication list. PeaceHealth developed and implemented a standardized approach to (1) review and reconcile the medication list for every patient at each office visit and (2) report on the results obtained within the PHMG clinics. In 2005, PeaceHealth established the ambulatory medication reconciliation project to develop a reliable, efficient process for maintaining accurate patient medication lists. Each of PeaceHealth's five regions created a medication reconciliation task force to redesign its clinical practice, incorporating the systemwide aims and agreed-on key process components for every ambulatory visit. Implementation of the medication reconciliation process at the PHMG clinics resulted in a substantial increase in the number of accurate medication lists, with fewer discrepancies between what the patient is actually taking and what is recorded in the EMR. The PeaceHealth focus on patient safety, and particularly the reduction of medication errors, has involved a standardized approach for reviewing and reconciling medication lists for every patient visiting a physician office. The standardized processes can be replicated at other ambulatory clinics-whether or not electronic tools are available.

  7. Electronic problem lists: a thematic analysis of a systematic literature review to identify aspects critical to success.

    Science.gov (United States)

    Hodge, Chad M; Narus, Scott P

    2018-05-01

    Problem list data is a driving force for many beneficial clinical tools, yet these data remain underutilized. We performed a systematic literature review, pulling insights from previous research, aggregating insights into themes, and distilling themes into actionable advice. We sought to learn what changes we could make to existing applications, to the clinical workflow, and to clinicians' perceptions that would improve problem list utilization and increase the prevalence of problems data in the electronic medical record. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to systematically curate a corpus of pertinent articles. We performed a thematic analysis, looking for interesting excerpts and ideas. By aggregating excerpts from many authors, we gained broader, more inclusive insights into what makes a good problem list and what factors are conducive to its success. Analysis led to a list of 7 benefits of using the problem list, 15 aspects critical to problem list success, and knowledge to help inform policy development, such as consensus on what belongs on the problem list, who should maintain the problem list, and when. A list of suggestions is made on ways in which the problem list can be improved to increase utilization by clinicians. There is also a need for standard measurements of the problem list, so that lists can be measured, compared, and discussed with rigor and a common vocabulary.

  8. Medical care of employees long-term sick listed due to mental health problems: a cohort study to describe and compare the care of the occupational physician and the general practitioner.

    Science.gov (United States)

    Anema, J R; Jettinghoff, K; Houtman, I; Schoemaker, C G; Buijs, P C; van den Berg, R

    2006-03-01

    To describe medical management by the general practitioner (GP) and occupational physician (OP) of workers sick listed due to mental health problems, and to determine agreement in diagnosis, main cause of sickness absence and obstacles in return to work. A cohort of 555 employees being sick listed for 12 to 20 weeks due to mental health problems was recruited and followed for 1 year. These employees were interviewed about their mental health and contacts with GP, OP, other specialists and employer. In addition, the GP and/or the OP of 72 employees were interviewed about the medical diagnosis and management. Most employees sick listed for 12-20 weeks visited their GP and OP. According to the employees most interventions applied by the GP were medical interventions, such as referral of employees and prescription of medical drugs. Working conditions were seldom discussed by the GP and work-related interventions were never applied. Most interventions applied by the OP were work-related interventions and/or contact with the employer. The OP more often talked about working conditions and conflicts. According to the employees, the communication between GP and OP only took place in 8% of the cases. Agreement in the diagnosis, main cause of sickness absence, and obstacles in return to work reported by the GPs and OPs of the same employee was poor. In addition, similarity in reported diagnosis by GP and/or OP and the employees' scores on valid questionnaires on (mental) health was limited. The lack of communication and agreement by Dutch GPs and OPs in medical diagnosis and management of employees long-term sick listed due to mental health problems are indicators of sub-optimal medical treatment and return-to-work strategies.

  9. Determinants of a successful problem list to support the implementation of the problem-oriented medical record according to recent literature

    NARCIS (Netherlands)

    Simons, S.M.; Cillessen, F.H.J.M.; Hazelzet, J.A.

    2016-01-01

    BACKGROUND: A problem-oriented approach is one of the possibilities to organize a medical record. The problem-oriented medical record (POMR) - a structured organization of patient information per presented medical problem- was introduced at the end of the sixties by Dr. Lawrence Weed to aid dealing

  10. The Space Medicine Exploration Medical Condition List

    Science.gov (United States)

    Watkins, Sharmi; Barr, Yael; Kerstman, Eric

    2011-01-01

    Exploration Medical Capability (ExMC) is an element of NASA s Human Research Program (HRP). ExMC's goal is to address the risk of the "Inability to Adequately Recognize or Treat an Ill or Injured Crewmember." This poster highlights the approach ExMC has taken to address this risk. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to define the set of medical conditions that are most likely to occur during exploration space flight missions. The list was derived from the International Space Station Medical Checklist, the Shuttle Medical Checklist, in-flight occurrence data from the Lifetime Surveillance of Astronaut Health, and NASA subject matter experts. The list of conditions was further prioritized for eight specific design reference missions with the assistance of the ExMC Advisory Group. The purpose of the SMEMCL is to serve as an evidence-based foundation for the conditions that could affect a crewmember during flight. This information is used to ensure that the appropriate medical capabilities are available for exploration missions.

  11. Automated problem list generation and physicians perspective from a pilot study.

    Science.gov (United States)

    Devarakonda, Murthy V; Mehta, Neil; Tsou, Ching-Huei; Liang, Jennifer J; Nowacki, Amy S; Jelovsek, John Eric

    2017-09-01

    An accurate, comprehensive and up-to-date problem list can help clinicians provide patient-centered care. Unfortunately, problem lists created and maintained in electronic health records by providers tend to be inaccurate, duplicative and out of date. With advances in machine learning and natural language processing, it is possible to automatically generate a problem list from the data in the EHR and keep it current. In this paper, we describe an automated problem list generation method and report on insights from a pilot study of physicians' assessment of the generated problem lists compared to existing providers-curated problem lists in an institution's EHR system. The natural language processing and machine learning-based Watson 1 method models clinical thinking in identifying a patient's problem list using clinical notes and structured data. This pilot study assessed the Watson method and included 15 randomly selected, de-identified patient records from a large healthcare system that were each planned to be reviewed by at least two internal medicine physicians. The physicians created their own problem lists, and then evaluated the overall usefulness of their own problem lists (P), Watson generated problem lists (W), and the existing EHR problem lists (E) on a 10-point scale. The primary outcome was pairwise comparisons of P, W, and E. Six out of the 10 invited physicians completed 27 assessments of P, W, and E, and in process evaluated 732 Watson generated problems and 444 problems in the EHR system. As expected, physicians rated their own lists, P, highest. However, W was rated higher than E. Among 89% of assessments, Watson identified at least one important problem that physicians missed. Cognitive computing systems like this Watson system hold the potential for accurate, problem-list-centered summarization of patient records, potentially leading to increased efficiency, better clinical decision support, and improved quality of patient care. Copyright © 2017

  12. List-Based Simulated Annealing Algorithm for Traveling Salesman Problem

    Directory of Open Access Journals (Sweden)

    Shi-hua Zhan

    2016-01-01

    Full Text Available Simulated annealing (SA algorithm is a popular intelligent optimization algorithm which has been successfully applied in many fields. Parameters’ setting is a key factor for its performance, but it is also a tedious work. To simplify parameters setting, we present a list-based simulated annealing (LBSA algorithm to solve traveling salesman problem (TSP. LBSA algorithm uses a novel list-based cooling schedule to control the decrease of temperature. Specifically, a list of temperatures is created first, and then the maximum temperature in list is used by Metropolis acceptance criterion to decide whether to accept a candidate solution. The temperature list is adapted iteratively according to the topology of the solution space of the problem. The effectiveness and the parameter sensitivity of the list-based cooling schedule are illustrated through benchmark TSP problems. The LBSA algorithm, whose performance is robust on a wide range of parameter values, shows competitive performance compared with some other state-of-the-art algorithms.

  13. Enhancement of medication recall using medication pictures and lists in telephone interviews.

    Science.gov (United States)

    Kimmel, Stephen E; Lewis, James D; Jaskowiak, Jane; Kishel, Lori; Hennessy, Sean

    2003-01-01

    To determine the effect of reading medication lists and providing medication pictures on recall of non-aspirin non-steroidal anti-inflammatory drugs (NANSAIDs) during telephone interviews in a case-control study. After a series of indication-specific questions, a list of all available NANSAIDs was read to study participants and a series of pictures was reviewed when available. Recall was defined as enhanced if a participant recalled NANSAID use only after the memory aids. Among the 1484 participants who reported NANSAID use, 94 (6.3%) recalled their NANSAID use only after the memory aids. Several groups demonstrated enhanced recall following the memory aids: men (odds ratio (OR): 1.73; 95% confidence interval (CI): 1.11, 2.69), users of non-prescription versus prescription NANSAIDs (OR 2.28; 95% CI: 1.21, 4.30), those using > 2 other medications (OR 1.69; 95% CI: 1.06, 2.69), those who did not have all of their medication containers available during the interview (OR 1.58; 95% CI: 1.03, 2.42) and cases versus controls (OR 1.90; 95% CI: 1.11, 3.28). The reading of medication names with the availability of medication photographs enhanced recall by approximately 6%. The use of this type of memory aid may reduce recall bias in case-control studies that rely on medication recall, depending on the overall prevalence of medication use and the effect size of the drug on the outcome.

  14. 20 CFR 404.1569 - Listing of Medical-Vocational Guidelines in appendix 2.

    Science.gov (United States)

    2010-04-01

    ... § 404.1569 Listing of Medical-Vocational Guidelines in appendix 2. The Dictionary of Occupational Titles... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Listing of Medical-Vocational Guidelines in appendix 2. 404.1569 Section 404.1569 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE...

  15. Characterization of Request Sequences for List Accessing Problem and New Theoretical Results for MTF Algorithm

    OpenAIRE

    Mohanty, Rakesh; Sharma, Burle; Tripathy, Sasmita

    2011-01-01

    List Accessing Problem is a well studied research problem in the context of linear search. Input to the list accessing problem is an unsorted linear list of distinct elements along with a sequence of requests, where each request is an access operation on an element of the list. A list accessing algorithm reorganizes the list while processing a request sequence on the list in order to minimize the access cost. Move-To-Front algorithm has been proved to be the best performing list accessing onl...

  16. A New Proposed Cost Model for List Accessing Problem using Buffering

    OpenAIRE

    Mohanty, Rakesh; Bhoi, Seetaya; Tripathy, Sasmita

    2011-01-01

    There are many existing well known cost models for the list accessing problem. The standard cost model developed by Sleator and Tarjan is most widely used. In this paper, we have made a comprehensive study of the existing cost models and proposed a new cost model for the list accessing problem. In our proposed cost model, for calculating the processing cost of request sequence using a singly linked list, we consider the access cost, matching cost and replacement cost. The cost of processing a...

  17. Referral letters to the emergency department: is the medication list accurate?

    LENUS (Irish Health Repository)

    McCullagh, M

    2015-02-01

    Medication errors are common when patients transfer across healthcare boundaries. This study was designed to investigate the quality of information on medicines provided by general practitioners (GPs) on emergency department (ED) referral letters. A convenience sample of referral letters to the ED of a teaching hospital was reviewed. The medication list and\\/or patient\\'s drug allergy status were noted. Medicines reconciliation including patient (or carer) interview was conducted to determine the patient\\'s actual home medication list. This was compared with the GP list and any discrepancies were identified and addressed. A total of 92 referral letters were included in the analysis of which 60 were computer-generated and 32 were hand-written. GPs provided dose and frequency of administration information in 47 (51%) of the letters sampled i.e. 44 (71%) computer-generated versus 3 (10%) hand-written; p < 0.001. In addition, the patient was taking their medicines exactly as per the GP list in 20 (22%) of cases. The patient\\'s drug allergy status was documented in 13 (14%) of the letters.

  18. Ambulatory EHR functionality: a comparison of functionality lists.

    Science.gov (United States)

    Drury, Barbara M

    2006-01-01

    There is a proliferation of lists intended to define and clarify the functionality of an ambulatory electronic health record system. These lists come from both private and public entities and vary in terminology, granularity, usability, and comprehensiveness. For example, functionality regarding a problem list includes the following possible definitions: * "Create and maintain patient-specific problem lists," from the HL7 Electronic Health Record Draft Standard for Trial Use. * "Provide a flexible mechanism for retrieval of encounter information that can be organized by diagnosis, problem, problem type," from the Bureau of Primary Health Care. * "The system shall associate encounters, orders, medications and notes with one or more problems," from the Certification Commission on Health Information Technology. * "Displays dates of problems on problem list," from COPIC Insurance Co. * "Shall automatically close acute problems using an automated algorithm," from the Physicians Foundations HIT Subcommittee. This article will compare the attributes of these five electronic health record functionality lists and their usefulness to different audiences-clinicians, application developers and payers.

  19. Lists I and II, nuclear medical diagnostics. As of January 18, 1983

    International Nuclear Information System (INIS)

    1983-01-01

    The information booklet presents the guidelines of the Federal Association of Panel Doctors, concerning the minimum equipment required for nuclear medical diagnostics practices (nuclear medical equipment guidelines), in the amended version of May 18, 1981; it also contains the list I (modern commercially available equipment) and the list II (older types of equipment). The devices specified in these lists are products of firms that are members of the ZVEI, and are in compliance with the guidelines of the Panel Doctors' Association. Combinations of older computer equipment/cameras with up-to-date equipment, also come up to the standards given in the guidelines if specifically mentioned therein. The list of manufacturers gives addresses of the manufacturers of the equipment stated in list I and II. An appendix up-dates the information to the date of October 1, 1986. (orig./HP) [de

  20. 78 FR 54731 - Update to the List of Basic Medical Supplies

    Science.gov (United States)

    2013-09-05

    ..., tape, wrist bands, documents, brochures, and graphics Non-electronic patient medical record file... DEPARTMENT OF THE TREASURY Office of Foreign Assets Control Update to the List of Basic Medical... defined as basic medical supplies. SUMMARY: The Department of the Treasury's Office of Foreign Assets...

  1. The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries.

    Science.gov (United States)

    Renom-Guiteras, Anna; Meyer, Gabriele; Thürmann, Petra A

    2015-07-01

    The aim of the study was to develop a European list of potentially inappropriate medications (PIM) for older people, which can be used for the analysis and comparison of prescribing patterns across European countries and for clinical practice. A preliminary PIM list was developed, based on the German PRISCUS list of potentially inappropriate medications and other PIM lists from the USA, Canada and France. Thirty experts on geriatric prescribing from Estonia, Finland, France, the Netherlands, Spain and Sweden participated; eight experts performed a structured expansion of the list, suggesting further medications; twenty-seven experts participated in a two-round Delphi survey assessing the appropriateness of drugs and suggesting dose adjustments and therapeutic alternatives. Finally, twelve experts completed a brief final survey to decide upon issues requiring further consensus. Experts reached a consensus that 282 chemical substances or drug classes from 34 therapeutic groups are PIM for older people; some PIM are restricted to a certain dose or duration of use. The PIM list contains suggestions for dose adjustments and therapeutic alternatives. The European Union (EU)(7)-PIM list is a screening tool, developed with participation of experts from seven European countries, that allows identification and comparison of PIM prescribing patterns for older people across European countries. It can also be used as a guide in clinical practice, although it does not substitute the decision-making process of individualised prescribing for older people. Further research is needed to investigate the feasibility and applicability and, finally, the clinical benefits of the newly developed list.

  2. Information on actual medication use and drug-related problems in older patients: questionnaire or interview?

    Science.gov (United States)

    Willeboordse, Floor; Grundeken, Lucienne H; van den Eijkel, Lisanne P; Schellevis, François G; Elders, Petra J M; Hugtenburg, Jacqueline G

    2016-04-01

    Information on medication use and drug-related problems is important in the preparation of clinical medication reviews. Critical information can only be provided by patients themselves, but interviewing patients is time-consuming. Alternatively, patient information could be obtained with a questionnaire. In this study the agreement between patient information on medication use and drug-related problems in older patients obtained with a questionnaire was compared with information obtained during an interview. General practice in The Netherlands. A questionnaire was developed to obtain information on actual medication use and drug-related problems. Two patient groups ≥65 years were selected based on general practitioner electronic medical records in nine practices; I. polypharmacy and II. ≥1 predefined general geriatric problems. Eligible patients were asked to complete the questionnaire and were interviewed afterwards. Agreement on information on medication use and drug-related problems collected with the questionnaire and interview was calculated. Ninety-seven patients participated. Of all medications used, 87.6 % (95 % CI 84.7-90.5) was reported identically in the questionnaire and interview. Agreement for the complete medication list was found for 45.4 % (95 % CI 35.8-55.3) of the patients. On drug-related problem level, agreement between questionnaire and interview was 75 %. Agreement tended to be lower in vulnerable patients characterized by ≥4 chronic diseases, ≥10 medications used and low health literacy. Information from a questionnaire showed reasonable agreement compared with interviewing. The patients reported more medications and drug-related problems in the interview than the questionnaire. Taking the limitations into account, a questionnaire seems a suitable tool for medication reviews that may replace an interview for most patients.

  3. Selected List of Books and Journals for the Small Medical Library

    Science.gov (United States)

    Brandon, Alfred N.

    2012-01-01

    This list of 358 books and 123 journals is intended as a selection aid for the small library of a hospital, medical society, clinic, or similar organization. Books and journals are arranged by subject, with the books followed by an author index, and the journals by an alphabetical title listing. PMID:23509428

  4. Improved Parallel Three-List Algorithm for the Knapsack Problem without Memory Conflicts

    Institute of Scientific and Technical Information of China (English)

    Pan Jun; Li Kenli; Li Qinghua

    2006-01-01

    Based on the two-list algorithm and the parallel three-list algorithm, an improved parallel three-list algorithm for knapsack problem is proposed, in which the method of divide and conquer, and parallel merging without memory conflicts are adopted. To find a solution for the n-element knapsack problem, the proposed algorithm needs O(23n/8) time when O(23n/8) shared memory units and O(2n/4) processors are available. The comparisons between the proposed algorithm and 10 existing algorithms show that the improved parallel three-list algorithm is the first exclusive-read exclusive-write (EREW) parallel algorithm that can solve the knapsack instances in less than O(2n/2) time when the available hardware resource is smaller than O(2n/2), and hence is an improved result over the past researches.

  5. Union list of periodicals in medical libraries of Myanmar 1980-1993

    International Nuclear Information System (INIS)

    U Kyyi-Thaung; U Aung-Myo-Min; Myunt-Nyunt-Swe, Daw.

    1994-01-01

    The abstract - the ''Union List of Periodicals in Medical Libraries of Myanmar: 1980-1993'' is published by the Department of Medical Research, Central Biomedical Library which is the National Focal Point library of Health Literature, Library and Information Services (HELLIS) network which was established since 1979 by WHO, S.E. Asia Regional Office. Other seven libraries which participate in this union list are: 1. Institute of Medicine 1, Library, Yangon; 2. Institute of Medicine 2, Library, Yangon; 3. Institute of Medicine, Library, Mandalay; 4. Institute of Dental Medicine, Library, Yangon; 5. Department of Health, Central Health Science Library, Yangon; 6. Institute of Nursing, Library, Yangon; 7. Department of Health Manpower, Library, Yangon

  6. Union list of periodicals in medical libraries of Myanmar 1980-1993

    Energy Technology Data Exchange (ETDEWEB)

    Kyyi-Thaung, U; Aung-Myo-Min, U; Myunt-Nyunt-Swe, Daw

    1994-12-31

    The abstract - the ``Union List of Periodicals in Medical Libraries of Myanmar: 1980-1993`` is published by the Department of Medical Research, Central Biomedical Library which is the National Focal Point library of Health Literature, Library and Information Services (HELLIS) network which was established since 1979 by WHO, S.E. Asia Regional Office. Other seven libraries which participate in this union list are: 1. Institute of Medicine 1, Library, Yangon; 2. Institute of Medicine 2, Library, Yangon; 3. Institute of Medicine, Library, Mandalay; 4. Institute of Dental Medicine, Library, Yangon; 5. Department of Health, Central Health Science Library, Yangon; 6. Institute of Nursing, Library, Yangon; 7. Department of Health Manpower, Library, Yangon.

  7. Learning the preferences of physicians for the organization of result lists of medical evidence articles.

    Science.gov (United States)

    O'Sullivan, D; Wilk, S; Michalowski, W; Slowinski, R; Thomas, R; Kadzinski, M; Farion, K

    2014-01-01

    Online medical knowledge repositories such as MEDLINE and The Cochrane Library are increasingly used by physicians to retrieve articles to aid with clinical decision making. The prevailing approach for organizing retrieved articles is in the form of a rank-ordered list, with the assumption that the higher an article is presented on a list, the more relevant it is. Despite this common list-based organization, it is seldom studied how physicians perceive the association between the relevance of articles and the order in which articles are presented. In this paper we describe a case study that captured physician preferences for 3-element lists of medical articles in order to learn how to organize medical knowledge for decision-making. Comprehensive relevance evaluations were developed to represent 3-element lists of hypothetical articles that may be retrieved from an online medical knowledge source such as MEDLINE or The Cochrane Library. Comprehensive relevance evaluations asses not only an article's relevance for a query, but also whether it has been placed on the correct list position. In other words an article may be relevant and correctly placed on a result list (e.g. the most relevant article appears first in the result list), an article may be relevant for a query but placed on an incorrect list position (e.g. the most relevant article appears second in a result list), or an article may be irrelevant for a query yet still appear in the result list. The relevance evaluations were presented to six senior physicians who were asked to express their preferences for an article's relevance and its position on a list by pairwise comparisons representing different combinations of 3-element lists. The elicited preferences were assessed using a novel GRIP (Generalized Regression with Intensities of Preference) method and represented as an additive value function. Value functions were derived for individual physicians as well as the group of physicians. The results show

  8. Just-in-time coding of the problem list in a clinical environment.

    Science.gov (United States)

    Warren, J. J.; Collins, J.; Sorrentino, C.; Campbell, J. R.

    1998-01-01

    Clinically useful problem lists are essential to the CPR. Providing a terminology that is standardized and understood by all clinicians is a major challenge. UNMC has developed a lexicon to support their problem list. Using a just-in-time coding strategy, the lexicon is maintained and extended prospectively in a dynamic clinical environment. The terms in the lexicon are mapped to ICD-9-CM, NANDA, and SNOMED International classification schemes. Currently, the lexicon contains 12,000 terms. This process of development and maintenance of the lexicon is described. PMID:9929226

  9. Towards a collaborative filtering approach to medication reconciliation.

    Science.gov (United States)

    Hasan, Sharique; Duncan, George T; Neill, Daniel B; Padman, Rema

    2008-11-06

    A physicians prescribing decisions depend on knowledge of the patients medication list. This knowledge is often incomplete, and errors or omissions could result in adverse outcomes. To address this problem, the Joint Commission recommends medication reconciliation for creating a more accurate list of a patients medications. In this paper, we develop techniques for automatic detection of omissions in medication lists, identifying drugs that the patient may be taking but are not on the patients medication list. Our key insight is that this problem is analogous to the collaborative filtering framework increasingly used by online retailers to recommend relevant products to customers. The collaborative filtering approach enables a variety of solution techniques, including nearest neighbor and co-occurrence approaches. We evaluate the effectiveness of these approaches using medication data from a long-term care center in the Eastern US. Preliminary results suggest that this framework may become a valuable tool for medication reconciliation.

  10. Predictors of return to work in employees sick-listed with mental health problems

    DEFF Research Database (Denmark)

    D.Nielsen, Maj Britt; Madsen, Ida E.H.; Bültmann, Ute

    2011-01-01

    Sickness absence due to mental health problems (MHPs) is increasing in several European countries. However, little is known about return to work (RTW) for employees with MHPs. This prospective study aimed to identify predictors for RTW in employees sick-listed with MHPs.......Sickness absence due to mental health problems (MHPs) is increasing in several European countries. However, little is known about return to work (RTW) for employees with MHPs. This prospective study aimed to identify predictors for RTW in employees sick-listed with MHPs....

  11. Optimizing medication safety in the home.

    Science.gov (United States)

    LeBlanc, Raeanne Genevieve; Choi, Jeungok

    2015-06-01

    Medication safety among community-dwelling older adults in the United States is an ongoing health issue impacting health outcomes, chronic disease management, and aging in place at home. This article describes a medication safety improvement project that aimed to: (1) Increase the ability of participants to manage medications, (2) Identify and make necessary medication changes, (3) Create an accurate up-to-date medication list to be available in the home, and (4) Provide communication between the primary care provider, participant, and case manager. An in-home medication assessment was completed for 25 participants using an evidence-based medication management software system. This process was used to review medications; identify medication-related problems; create a shared medication list; and convey this information to the primary care provider, case manager, and client while addressing needed medication changes. Educational interventions on management and understanding of medications were provided to participants to emphasize the correct use of medications and use of a personal medication record. Outcome improvements included provision of an accurate medication list, early identification of medication-related problems, identification of drug duplication, and identification of medication self-management challenges that can be useful for optimizing medication safety-related home healthcare and inform future interventions.

  12. Prioritizing medication safety in care of people with cancer: clinicians’ views on main problems and solutions

    Science.gov (United States)

    Car, Lorainne Tudor; Papachristou, Nikolaos; Urch, Catherine; Majeed, Azeem; Atun, Rifat; Car, Josip; Vincent, Charles

    2017-01-01

    Background Cancer care is liable to medication errors due to the complex nature of cancer treatment, the common presence of comorbidities and the involvement of a number of clinicians in cancer care. While the frequency of medication errors in cancer care has been reported, little is known about their causal factors and effective prevention strategies. With a unique insight into the main safety issues in cancer treatment, frontline staff can help close this gap. In this study, we aimed to identify medication safety priorities in cancer patient care according to clinicians in North West London using PRIORITIZE, a novel priority–setting approach. Methods The project steering group determined the scope, the context and the criteria for prioritization. We then invited North West London cancer care clinicians to identify and prioritize main causes for, and solutions to, medication errors in cancer care. Forty cancer care providers submitted their suggestions which were thematically synthesized into a composite list of 20 distinct problems and 22 solutions. A group of 26 clinicians from the initial cohort ranked the composite list of suggestions using predetermined criteria. Results The top ranked problems focused on patients’ poor understanding of treatments due to language or education difficulties, clinicians’ insufficient attention to patients’ psychological distress, and inadequate information sharing among health care providers. The top ranked solutions were provision of guidance to patients and their carers on what to do when unwell, pre–chemotherapy work–up for all patients and better staff training. Overall, clinicians considered improved communication between health care providers, quality assurance procedures (during prescription and monitoring stages) and patient education as key strategies for improving cancer medication safety. Prescribing stage was identified as the most vulnerable to medication safety threats. The highest ranked suggestions

  13. Potentially inappropriate medication in the elderly in Germany: an economic appraisal of the PRISCUS list.

    Science.gov (United States)

    Pohl-Dernick, Katharina; Meier, Florian; Maas, Renke; Schöffski, Oliver; Emmert, Martin

    2016-04-01

    Several lists of potentially inappropriate medication (PIM) for elderly patients have been developed worldwide in recent years. Those lists intend to reduce prescriptions of drugs that carry an unnecessarily high risk of adverse drug events in elderly patients. In 2010, an expert panel published the PRISCUS list for the German drug market. This study calculates the amount of drug reimbursement for PIM in Germany and potential cost effects from the perspective of statutory health insurance when these are replaced by the substitutes recommended by the PRISCUS list. Register-based data for the 30 top-selling drugs on the PRISCUS list in 2009 for patients greater than or equal to 65 years of age were provided by the Scientific Institute of the German Local Health Care Fund. We calculated the percentage of sales and defined daily doses for patients greater than or equal to 65 years of age compared with the total statutory health insurance population. Reimbursement costs for the recommended substitutions were estimated by considering different scenarios. In 2009, drug reimbursement for the 30 top-selling PIM prescribed to patients greater than or equal to 65 years of age were calculated to be €305.7 million. Prescribing the recommended substitution medication instead of PIM would lead to an increased total reimbursement cost for the German health care system ranging between from €325.9 million to €810.0 million. The results show that the substitution of PIM by medication deemed to be more appropriate for the elderly comes along with additional costs. Consequently, there is no short-term incentive for doing so from a payer perspective. Future studies have to consider the long-term effects and other sectors.

  14. Management of surgical waiting lists through a Possibilistic Linear Multiobjective Programming problem

    OpenAIRE

    Pérez Gladish, Blanca María; Arenas Parra, María del Mar; Bilbao Terol, Amelia María; Rodríguez Uria, María Victoria

    2005-01-01

    This study attempts to apply a management science technique to improve the efficiency of Hospital Administration. We aim to design the performance of the surgical services at a Public Hospital that allows the Decision-Maker to plan surgical scheduling over one year in order to reduce waiting lists. Real decision problems usually involve several objectives that have parameters which are often given by the decision maker in an imprecise way. It is possible to handle these kinds of problems ...

  15. Statistical problems in medical research

    African Journals Online (AJOL)

    STORAGESEVER

    2008-12-29

    Dec 29, 2008 ... medical research, there are some common problems in using statistical methodology which may result ... optimal combination of diagnostic tests for osteoporosis .... randomization used include stratification and minimize-.

  16. Drug-related problems identified in medication reviews by Australian pharmacists

    DEFF Research Database (Denmark)

    Stafford, Andrew C; Tenni, Peter C; Peterson, Gregory M

    2009-01-01

    OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study was to exam......OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study....... These reviews had been self-selected by pharmacists and submitted as part of the reaccreditation process to the primary body responsible for accrediting Australian pharmacists to perform medication reviews. The drug-related problems identified in each review were classified by type and drugs involved. MAIN...... OUTCOME MEASURE: The number and nature of drug-related problems identified in pharmacist-conducted medication reviews. RESULTS: There were 1,038 drug-related problems identified in 234 medication reviews (mean 4.6 (+/-2.2) problems per review). The number of problems was higher (4.9 +/- 2.0 vs. 3.9 +/- 2...

  17. 20 CFR 416.969 - Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Listing of Medical-Vocational Guidelines in... Disability and Blindness Vocational Considerations § 416.969 Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter. The Dictionary of Occupational Titles includes...

  18. Task Performance with List-Mode Data

    Science.gov (United States)

    Caucci, Luca

    This dissertation investigates the application of list-mode data to detection, estimation, and image reconstruction problems, with an emphasis on emission tomography in medical imaging. We begin by introducing a theoretical framework for list-mode data and we use it to define two observers that operate on list-mode data. These observers are applied to the problem of detecting a signal (known in shape and location) buried in a random lumpy background. We then consider maximum-likelihood methods for the estimation of numerical parameters from list-mode data, and we characterize the performance of these estimators via the so-called Fisher information matrix. Reconstruction from PET list-mode data is then considered. In a process we called "double maximum-likelihood" reconstruction, we consider a simple PET imaging system and we use maximum-likelihood methods to first estimate a parameter vector for each pair of gamma-ray photons that is detected by the hardware. The collection of these parameter vectors forms a list, which is then fed to another maximum-likelihood algorithm for volumetric reconstruction over a grid of voxels. Efficient parallel implementation of the algorithms discussed above is then presented. In this work, we take advantage of two low-cost, mass-produced computing platforms that have recently appeared on the market, and we provide some details on implementing our algorithms on these devices. We conclude this dissertation work by elaborating on a possible application of list-mode data to X-ray digital mammography. We argue that today's CMOS detectors and computing platforms have become fast enough to make X-ray digital mammography list-mode data acquisition and processing feasible.

  19. Statistical Problems In Medical Research | Okeh | East African ...

    African Journals Online (AJOL)

    Given the main role of a general practitioner as a biostatistician, I thought it would be of interest to enumerate statistical problems in assessing methods of medical diagnosis in general terms. In conducting and reporting of medical research, there are some common problems in using statistical methodology which may result ...

  20. Therminological problems in medical thermography

    International Nuclear Information System (INIS)

    Rozenfel'd, L.G.; Kolotilov, N.N.

    1988-01-01

    Some problems of medicotechnical terminology of clinical thermography are discussed. A short hystorical review of stages of the recovery of infrared rays and their medical application was given. An analysis of a number of terms is based on the rules of medical terminology and state standards. An obligatory use in literature of correct terms, mainly of the Greek and Latin origin, is proposed. Commonly used terms on the basis of modern anatomical terminology are recommended for thermogram description

  1. Therminological problems in medical thermography

    Energy Technology Data Exchange (ETDEWEB)

    Rozenfel' d, L G; Kolotilov, N N

    1988-01-01

    Some problems of medicotechnical terminology of clinical thermography are discussed. A short hystorical review of stages of the recovery of infrared rays and their medical application was given. An analysis of a number of terms is based on the rules of medical terminology and state standards. An obligatory use in literature of correct terms, mainly of the Greek and Latin origin, is proposed. Commonly used terms on the basis of modern anatomical terminology are recommended for thermogram description.

  2. The context of ethical problems in medical volunteer work.

    Science.gov (United States)

    Wall, Anji

    2011-06-01

    Ethical problems are common in clinical medicine, so medical volunteers who practice clinical medicine in developing countries should expect to encounter them just as they would in their practice in the developed world. However, as this article argues, medical volunteers in developing countries should not expect to encounter the same ethical problems as those that dominate Western biomedicine or to address ethical problems in the same way as they do in their practice in developed countries. For example, poor health and advanced disease increase the risks and decrease the potential benefits of some interventions. Consequently, when medical volunteers intervene too readily, without considering the nutritional and general health status of patients, the results can be devastating. Medical volunteers cannot assume that the outcomes of interventions in developing countries will be comparable to the outcomes of the same interventions in developed countries. Rather, they must realistically consider the complex medical conditions of patients when determining whether or not to intervene. Similarly, medical volunteers may face the question of whether to provide a pharmaceutical or perform an intervention that is below the acceptable standard of care versus the alternative of doing nothing. This article critically explores the contextual features of medical volunteer work in developing countries that differentiate it from medical practice in developed countries, arguing that this context contributes to the creation of unique ethical problems and affects the way in which these problems should be analyzed and resolved.

  3. Self-Assessment of Problem Solving Disposition in Medical Students

    Directory of Open Access Journals (Sweden)

    Silvia Lizett Olivares-Olivares

    2014-01-01

    Full Text Available Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 experts in medical education and applied to 135 registered students on the sixth year of the M.D. Physician Surgeon program at a private medical school. Cronbach’s alpha indicated an internal consistency of 0.751. The findings suggest that selected items have both homogeneity and validity. The factor analysis resulted in components that were associated with three problem-solving subcategories. The students’ perceptions are higher in the pattern recognition and application of general strategies for problem solving subcategories of the Problem solving disposition model.

  4. Programming list processes. SLIP: symmetric list processor - applications; Le traitement de listes en programmation. SLIP: langage de listes symetrique - applications

    Energy Technology Data Exchange (ETDEWEB)

    Broudin, Y [Commissariat a l' Energie Atomique, Centre d' Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France)

    1966-06-01

    Modern aspects of programming languages are essentially turned towards list processing. The ordinary methods of sequential treatment become inadequate and we must substitute list processes for them, where the cells of a group have no neighbourhood connection, but where the address of one cell is contained in the preceding one. These methods are required in 'time sharing' solving problems. They also allow us to treat new problems and to solve others in the shortest time. Many examples are presented after an abstract of the most usual list languages and a detailed study of one of them : SLIP. Among these examples one should note: locating of words in a dictionary or in a card index, treatment of non numerical symbols, formal derivation. The problems are treated in Fortran II on an IBM 7094 machine. The subroutines which make up the language are presented in an appendix. (author) [French] La programmation moderne ne se satisfait plus des methodes classiques de traitement sequentiel ni des tableaux a positions de memoire contigues. Elle tend a generaliser les methodes de listes ou les cellules d'un groupe n'ont pas de relation de voisinage, mais sont enchainees en listes, l'une donnant l'adresse machine de l'autre. Ces methodes sont indispensables en 'partage de temps' et dans les traitements en 'temps reel'. De plus, elles permettent de traiter des problemes nouveaux et d'optimiser le temps de traitement de nombreux autres. De nombreux exemples sont traites, apres un resume des langages les plus utilises et une etude plus precise d'un langage de listes: SLIP. Parmi les exemples traites signalons la recherche lexicographique, le traitement de symboles alphanumeriques, la derivation formelle. Probleme traite en Fortran II sur IBM 7094. Les sous-programmes constitutifs du langage sont fournis en annexe. (auteur)

  5. Impact of Pharmacist-Conducted Comprehensive Medication Reviews for Older Adult Patients to Reduce Medication Related Problems.

    Science.gov (United States)

    Kiel, Whitney J; Phillips, Shaun W

    2017-12-31

    Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization. The purpose of this pharmacy resident research study is to examine the impact of pharmacist-conducted geriatric medication reviews to reduce medication-related problems within a leading community health system in southwest Michigan. Furthermore, the study examines type of pharmacist interventions made during medication reviews, acute healthcare utilization, and physician assessment of the pharmacist's value. The study was conducted as a retrospective post-hoc analysis on ambulatory patients who received a CMR by a pharmacist at a primary care practice. Inclusion criteria included patients over 65 years of age with concurrent use of at least five medications who were a recent recipient of a CMR. Exclusion criteria included patients with renal failure, or those with multiple providers involved in primary care. The primary outcome was the difference in number of medication-related problems, as defined by the START and STOPP Criteria (Screening Tool to Alert doctors to Right Treatment/Screening Tool of Older Persons' Prescriptions). Secondary outcomes included hospitalizations, emergency department visits, number and type of pharmacist interventions, acceptance rate of pharmacist recommendations, and assessment of the pharmacist's value by clinic providers. There were a total of 26 patients that received a comprehensive medication review from the pharmacist and were compared to a

  6. Medical device problem reporting for the betterment of healthcare.

    Science.gov (United States)

    1998-08-01

    Given that there are nearly 5,000 individual classes of medical devices, tens of thousands of medical device suppliers, and millions of healthcare providers around the world, device-related problems are bound to happen. But effective problem reporting can help reduce or eliminate many of these problems--not only within an institution, but also potentially around the world. In this article, we trace the problem reporting process from its beginnings in the hospital to its global impact in making critical information available throughout the healthcare community.

  7. Safety problems with the use of medical equipment/devices

    NARCIS (Netherlands)

    Rademakers, C.

    2009-01-01

    In the past decennia medical technology has rapidly developed. Nowadays it plays an important role in all medical fields. It introduced technologic solutions for many medical problems and it definitely increased the possibilities in the medical field to increase the quality of life. However with

  8. [Methods for teaching problem-solving in medical schools].

    Science.gov (United States)

    Shumway, J M; Vargas, M E; Heller, L E

    1984-01-01

    The need to include in the medical curriculum instructional activities to promote the development of problem-solving abilities has been asserted at the national and international levels. In research on the mental process involved in the solution of problems in medicine, problem-solving has been defined as a hypothetical-deductive activity engaged in by experienced physicians, in which the early generation of hypotheses influences the subsequent gathering of information. This article comments briefly on research on the mental process by which medical problems are solved. It describes the methods that research has shown to be most applicable in instruction to develop problem-solving abilities, and presents some educational principles that justify their application. The "trail-following" approach is the method that has been most commonly used to study the physician's problem-solving behavior. The salient conclusions from this research are that in the problem-solving process the diagnostic hypothesis is generated very early on and with limited data; the number of hypotheses is small; the problem-solving approach is specific to the type of medical problem and case in hand; and the accumulation of medical knowledge and experience forms the basis of clinical competence. Four methods for teaching the solution of problems are described: case presentation, the rain of ideas, the nominal groups technique and decision-making consensus, the census and analysis of forces in the field, and the analysis of clinical decisions. These methods are carried out in small groups. The advantages of the small groups are that the students are active participants in the learning process, they receive formative evaluation of their performance in a setting conductive to learning, and are able to interact with their instructor if he makes proper use of the right questioning techniques. While no single problem-solving method can be useful to all students or in all the problems they encounter

  9. Medical problems of porters and trekkers in the Nepal Himalaya.

    Science.gov (United States)

    Basnyat, B; Litch, J A

    1997-05-01

    The purpose of this study was to assess the incidence of medical illness among members of trekking groups in the Nepal Himalaya. The design was a cohort study using interview and clinical examination by a single physician. The setting was the Manaslu area in the central Nepal Himalaya along a 22-day trekking route with elevations ranging from 487 m to 5100 m. Subjects were 155 members of commercial trekking groups: 102 Nepali porters, 31 Nepali trek staff, and 22 Western trekkers. We found that medical problems occurred in 45% of party members. The porter cohort contained the highest diversity and severity of illness. The relatively larger porter cohort experienced 77% of the medical problems recorded compared with 17% among Western trekkers and 6% among trek staff. The incidence of medical problems was not significantly different in the porter staff (52%) and Western trekkers (55%) and was significantly lower for the trek staff (13%). High-altitude pharyngitis/bronchitis was the most common illness in the party (12%) followed by acute mountain sickness (8%) and gastroenteritis (6%). Other conditions included anxiety (3%), cellulitis (3%), scabies (3%), snow blindness (3%), acute alcohol intoxication (2%), conjunctivitis (2%), fever (2%), lacerations (2%), and hemorrhoids (1%). Illness with infectious etiologies comprised 33% of the medical problems. The incidence of altitude illness was not significantly less in the Nepali porter staff than in the Western trekkers. Evacuation was required in 5% of party members, all from the porter group. This study should alert expedition medical providers and trip leaders of the need to be observant for and prepared to treat the frequent and diverse medical problems among the porter staff in their party, in addition to the Western members. Medical problems are common in remote mountainous areas, indicating that trip physicians should be experienced in primary care.

  10. Programming list processes. SLIP: symmetric list processor - applications

    International Nuclear Information System (INIS)

    Broudin, Y.

    1966-06-01

    Modern aspects of programming languages are essentially turned towards list processing. The ordinary methods of sequential treatment become inadequate and we must substitute list processes for them, where the cells of a group have no neighbourhood connection, but where the address of one cell is contained in the preceding one. These methods are required in 'time sharing' solving problems. They also allow us to treat new problems and to solve others in the shortest time. Many examples are presented after an abstract of the most usual list languages and a detailed study of one of them : SLIP. Among these examples one should note: locating of words in a dictionary or in a card index, treatment of non numerical symbols, formal derivation. The problems are treated in Fortran II on an IBM 7094 machine. The subroutines which make up the language are presented in an appendix. (author) [fr

  11. Ancient medical texts, modern reading problems

    Directory of Open Access Journals (Sweden)

    Maria Carlota Rosa

    2006-12-01

    Full Text Available The word tradition has a very specific meaning in linguistics: the passing down of a text, which may have been completed or corrected by different copyists at different times, when the concept of authorship was not the same as it is today. When reading an ancient text the word tradition must be in the reader's mind. To discuss one of the problems an ancient text poses to its modern readers, this work deals with one of the first printed medical texts in Portuguese, the Regimento proueytoso contra ha pestenença, and draws a parallel between it and two related texts, A moche profitable treatise against the pestilence, and the Recopilaçam das cousas que conuem guardar se no modo de preseruar à Cidade de Lixboa E os sãos, & curar os que esteuerem enfermos de Peste. The problems which arise out of the textual structure of those books show how difficult is to establish a tradition of another type, the medical tradition. The linguistic study of the innumerable medieval plague treatises may throw light on the continuities and on the disruptions of the so-called hippocratic-galenical medical tradition.

  12. Sleep-related problems in common medical conditions.

    Science.gov (United States)

    Parish, James M

    2009-02-01

    Common medical problems are often associated with abnormalities of sleep. Patients with chronic medical disorders often have fewer hours of sleep and less restorative sleep compared to healthy individuals, and this poor sleep may worsen the subjective symptoms of the disorder. Individuals with lung disease often have disturbed sleep related to oxygen desaturations, coughing, or dyspnea. Both obstructive lung disease and restrictive lung diseases are associated with poor quality sleep. Awakenings from sleep are common in untreated or undertreated asthma, and cause sleep disruption. Gastroesophageal reflux is a major cause of disrupted sleep due to awakenings from heartburn, dyspepsia, acid brash, coughing, or choking. Patients with chronic renal disease commonly have sleep complaints often due to insomnia, insufficient sleep, sleep apnea, or restless legs syndrome. Complaints related to sleep are very common in patients with fibromyalgia and other causes of chronic pain. Sleep disruption increases the sensation of pain and decreases quality of life. Patients with infectious diseases, including acute viral illnesses, HIV-related disease, and Lyme disease, may have significant problems with insomnia and hypersomnolence. Women with menopause have from insomnia, sleep-disordered breathing, restless legs syndrome, or fibromyalgia. Patients with cancer or receiving cancer therapy are often bothered by insomnia or other sleep disturbances that affect quality of life and daytime energy. The objective of this article is to review frequently encountered medical conditions and examine their impact on sleep, and to review frequent sleep-related problems associated with these common medical conditions.

  13. From cases to projects in problem-based medical education

    Directory of Open Access Journals (Sweden)

    Diana Stentoft

    2014-06-01

    Full Text Available Problem-based learning (PBL based on patient cases has become a well-established worldwide educational approach in medical education. Recent studies indicate that case-based PBL when used throughout an entire curriculum may develop into a counter-productive routine for students as well as teachers. Consequently, there is a need to develop PBL approaches further allowing students to work with more ill-defined problems and alternative learning structures. In this paper, we argue that this can be realised by introducing project-PBL into the medical curriculum, as in the medical education at Aalborg University, Denmark. We outline organisations of case- and project- PBL in the medical curriculum and present an explorative study of 116 first and second year students’ experiences working in the two settings of PBL. Results reveal that students generally rate their PBL experiences positively however, project-PBL is rated more positively than case-PBL on all parameters studied. These results invite further consideration of the differences in working with cases and projects. Two central differences are discussed; the nature of the problem as the trigger of learning and students' possibilities for directing their own learning processes. The study demonstrates that introducing project-PBL may contribute significantly in problem-based medical education. However, the need for extensive research into advantages and limitations of the combined use of case- and project-PBL is also emphasised.

  14. Problems of medical personnel deontology during radiation emergency response

    International Nuclear Information System (INIS)

    Poplavskij, K.K.; Popov, A.O.

    1990-01-01

    Problems of deontology in the process of liquidation of radiation accident consequences are considered in the article. It is noted, that shortages of ethical nature in the activities of physicians are related to insufficient qualification of medical personnel in the area of radiation medicine. Problems of medical personnel participation in the large scale propaganda activities among various groups of population are considered. 5 refs

  15. Medical social consequences of the safety problems of oncological radiology

    International Nuclear Information System (INIS)

    Pilipenko, M.Yi.; Stadnik, L.L.; Shal'opa, O.Yu.; Rigan, M.M.; Skalets'kij, Yu.M.

    2015-01-01

    Actuality of the problem of patient safety in oncoradiology in Ukraine is grounded. The results of international audit TLD (IAEA/WHO) quality during dosimetry procedures cobalt-telegamma vehicles in Ukraine are investigated, as well as legal and regulatory framework providing for the safety of radiotherapy care, scientific publications on patient safety. Methods: statistical, analytical, bibliographical, systematic approach. On the example of radiation therapy using the results of the international program of the IAEA/WHO TLD audit quality dosimetry calibration devices for remote gamma therapy in Ukraine from 1998 to 2014 the attempt to assess the extent of medical and social consequences of underestimating of medical errors in oncoradiology is made. The problems of regulatory nature of medical errors in oncoradiology are preliminary identified. The problem of medical errors in the treatment of cancer radiation methods in Ukraine is extremely important. Usually the problems of errors in oncoradiology are considered in organizational, technical, personnel and technical aspects, while medical and social consequences of problem are not covered. About 10 thousand of cancer patients in year may suffer from errors related only to dose calculation according to the optimistic variant, while the number of patients for the same period on the pessimistic case can reach 15 thousand. There are a number of legal character problems in oncoradiology related to patient safety that require clarification. The first priority for improving the safety of patients in oncoradiology is the recording and analysis of radiation therapy defects and their consequences

  16. Beers criteria for potentially inappropriate medication use in older adults.

    Science.gov (United States)

    Berryman, Sandra N; Jennings, Joy; Ragsdale, Sue; Lofton, Tiffany; Huff, Debbie Cooley; Rooker, Janet Smith

    2012-01-01

    Nurses can decrease the risk of adverse drug problems with medication review and prompt interventions. The Beers Criteria lists medications to avoid using among elderly clients. The origin of the Beers Criteria, its 2002 modification, and application in acute care settings are explained.

  17. Evaluation of problem-based learning in medical students’ education

    Directory of Open Access Journals (Sweden)

    MOHAMMAD HADI IMANIEH

    2014-01-01

    Full Text Available Introduction: In traditional medical education systems much interest is placed on the cramming of basic and clinical facts without considering their applicability in the future professional career. The aim of this study is to evaluate a novice medical training method (problem-based learning as compared to the contemporary teacher-based medical education or traditional methods. Methods: Selection of the study subjects was done through simple sampling and according to the division of medical students introduced from Medical Faculty to the Pediatrics Department with no personal involvement. 120 medical students were assigned to 8 groups of 15 students each. For four months, 4 groups were trained with traditional method and 4 other groups underwent problem-based learning method on selected subject materials. In each method, a pre-course test at the beginning and a post-course test at the end of each course were given to each group. The questionnaire used in this study as the instrument was composed of 39 questions, 37 multiple choice questions and two short answer questions. Three professors of pediatric gastroenterologist took part in the training. Two of these professors were responsible for solving task training method. The third professor used traditional teacher-centered methodology to eliminate any possible bias. Scores obtained from these tests were analyzed using paired t-test and independent t-test. P values of less than 0.05 were considered as significant. Results: The scores of the students undergoing the traditional method were 14.70±3.03 and 21.20±4.07 in the first and second test, respectively. In problembased learning, the scores were 15.82±3.29 in the first and 27.52±4.72 in the second test. There was a significant difference between the mean scores of post-course exams of the two groups (p=0.001, while no significant difference was observed between the mean scores of pre-course exams of the groups (p=0.550. Conclusion: It may be

  18. Compendium to radiation physics for medical physicists. 300 problems and solutions

    International Nuclear Information System (INIS)

    Podgorsak, Ervin B.

    2014-01-01

    Can be used in combination with other textbooks. Exercise book for graduate and undergraduate students of medical physics and engineering. Well chosen and didactically presented problems. Perfect set for learning in connection with the textbook by Podgorsak and others. Detailed derivation of results with many detailed illustrations. Fully worked-out solutions to exercises/questions. Combines exercises in radiation physics and medical physics. This exercise book contains 300 typical problems and exercises in modern physics and radiation physics with complete solutions, detailed equations and graphs. This textbook is linked directly with the textbook ''Radiation Physics for Medical Physicists'', Springer (2010) but can also be used in combination with other related textbooks. For ease of use, this textbook has exactly the same organizational layout (14 chapters, 128 sections) as the ''Radiation Physics for Medical Physicists'' textbook and each section is covered by at least one problem with solution given. Equations, figures and tables are cross-referenced between the two books. It is the only large compilation of textbook material and associated solved problems in medical physics, radiation physics, and biophysics.

  19. Problems of radiation protection at medical use of radiation equipment

    International Nuclear Information System (INIS)

    Larwin, K.

    1979-01-01

    For medical use of radiation equipment man is not only operator, but also object (patient). The question, if or how much it is necessary to expose the patient, is a medical problem and therefore not to be discussed here. For the user of medical equipments we have often special conditions. For many diagnostic applications the physician has to stay in the application room in contact with the patient. As a typical example for the problems of radiation protection there is discussed the situation on a well known fluoroscopic unit for lung and stomach examinations. (author)

  20. Characteristics of sick-listing cases that physicians consider problematic--analyses of written case reports.

    Science.gov (United States)

    Engblom, Monika; Alexanderson, Kristina; Rudebeck, Carl Edvard

    2009-01-01

    The aim was to discern common characteristics in the sick-listing cases that physicians in general practice and occupational health services find problematic. Descriptive categorization within a narrative theoretical framework. Sickness-insurance course for physicians in general practice and occupational health services. A total of 195 case reports written by 195 physicians. Main outcome measures. Categories of features regarding medical, work, and social situation as well as medical interventions. Beside age and sex, the following information was often provided: family situation, stressful life events, occupation, problem at work, considerations concerning diagnoses, medical investigations, treatments, and vocational rehabilitation measures. Two-thirds of the patients had been sickness absent for more than a year. The most common type of case reports concerned women, employed in non-qualified nursing occupations, and sick listed due to mental disorders. The most common measures taken by the physicians were referrals to psychotherapy and/or physiotherapy, and prescribing antidepressants (SSRI). Facts about alcohol habits were rarely provided in the cases. Some of the circumstances, such as prolonged sick-listing, are likely to be more or less inevitable in problematic sick-listing cases. Other circumstances, such as stress-full life events, more closely reflect what the reporting physicians find problematic. The categories identified can be regarded as markers of problematic sick-listing cases in general practice and occupational health service.

  1. Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP).

    Science.gov (United States)

    Tak, Erwin C P M; van Hespen, Ariëtte T H; Verhaak, Peter F M; Eekhof, Just; Hopman-Rock, Marijke

    2016-07-01

    Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety, depression, cognition, suspicion, loneliness, and somatisation. A draft list of indicators identified from a short review of the literature and the opinions of 22 experts was evaluated by general practitioners (GPs) and home care organisations for feasibility. It was then used by GPs and home care personnel to observe patients, who also completed validated tests for psychological disorders (General Health Questionnaire 12 item version (GHQ-12)), depression (Geriatric Depression Scale 15-item version (GDS-15)), anxiety and suspicion (Symptom Checklist-90 (SCL-90)), loneliness (University of California, Los Angeles (UCLA)), somatisation (Illness Attitude Scale (IAS)), and cognition (Mini-Mental State Examination (MMSE)). GPs and home care personnel observed 180 patients (mean age 78.4 years; 66% female) and evaluated the draft list during a regular visit. Cronbach's α was 0.87 for the draft list and ≥0.80 for the draft problem areas (loneliness and suspicion excepted). Principal component analysis identified six components (cognition, depression + loneliness, somatisation, anxiety + suspicion, depression (other signs), and an ambiguous component). Convergent validity was shown for the indicators list as a whole (using the GHQ-12), and the subscales of depression, anxiety, loneliness, cognition, and somatisation. Using pre-set agreed criteria, the list was reduced to 14 final indicators divided over five problem areas. The Observation List for mental disorders and social Problems (OLP) proved to be preliminarily valid, reliable, and feasible for use in primary and home care settings. Copyright © John Wliey & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Compendium to radiation physics for medical physicists 300 problems and solutions

    CERN Document Server

    Podgorsak, Ervin B

    2014-01-01

    This exercise book contains 300 typical problems and exercises in modern physics and radiation physics with complete solutions, detailed equations and graphs. This textbook is linked directly with the textbook "Radiation Physics for Medical Physicists", Springer (2010) but can also be used in combination with other related textbooks. For ease of use, this textbook has exactly the same organizational layout (14 chapters, 128 sections) as the "Radiation Physics for Medical Physicists" textbook and each section is covered by at least one problem with solution given. Equations, figures and tables are cross-referenced between the two books. It is the only large compilation of textbook material and associated solved problems in medical physics, radiation physics, and biophysics.

  3. CACS: Master Textbook List Helps Solve On-Going Problem.

    Science.gov (United States)

    Anderson, Robert

    1979-01-01

    The use of a master textbook list developed by the Southern California Association of College Stores (CACS) is described. The three-part program is explained and the information assimilation process, format for revising lists, procedures for implementation, and general guidelines are among areas covered. (PHR)

  4. Self-Assessment of Problem Solving Disposition in Medical Students

    OpenAIRE

    Olivares-Olivares, Silvia Lizett; López-Cabrera, Mildred Vanessa

    2014-01-01

    Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 ...

  5. PROBLEMS OF IT DEPARTMENT IN A MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    V. Ya Gelman

    2017-01-01

    Full Text Available The aim of the study is the analysis of the problems faced by heads and staff of IT departments in medical universities. Methodology and research methods. The methods involve expert estimation, analysis and generalization of practical work experience of IT departments. Results and scientific novelty. The main aspects and specifics of professional activity of IT departments of modern medical schools are designated. The approaches to the definition of the hierarchy of goals in the professional activities of the department, as well as quantitative and qualitative indicators that assess the effectiveness of their achievements are analyzed. The contradictions arising between long-term and short-term goals of the IT department are highlighted. The main challenges which heads of IT departments can deal with in the course of day-to-day management work planning are described. The problems arising in educational, educational-methodical and scientific work of department, in its economic activity, solution of personnel affairs, and aspects of material support are considered. The possible solutions to these problems are proposed. Practical significance. The results of the analysis, proposed approaches and practical recommendations will enable to better organize the work of the IT department in a medical school. The advantage of the proposed approaches consists in their versatility: with some adjustment, they can be used by other departments, regardless of the specifics and the type of educational institution.

  6. Effect of smartphone overuse on sleep problems in medical students

    Directory of Open Access Journals (Sweden)

    Pairoj Boonluksiri

    2018-05-01

    Full Text Available Background: Smartphones are used worldwide. Consequently, it does seem to be having an impact on health-related problems if overused. However, it is uncertain whether it is associated with sleep problems or poor learning. Objective: To determine the association between smartphone overuse and sleep problems in medical students as primary outcome and poor learning as secondary outcome. Methods: A cross-sectional study was conducted in 89 students having their own smartphones, at Hatyai Medical Education Centre, Thailand. The habits of using smartphone were obtained. Smartphone overuse during bedtime was defined as using longer than 1 hour according to Smartphone Addiction Scale (SAS. The primary outcome was napping in a classroom that was defined as a problem if it happened more than 20% of the time attending class. Sleep problems using Pittsburgh Sleep Quality Index (PSQI and Epworth Sleepiness Scale (ESS were obtained by self-assessment. Learning outcome measured by grade point average was the secondary outcome. Multivariable analysis was performed for the association between smartphone overuse and sleep problems. Results: Of all students, 77.5% had sleep problems and 43.6% had napped in the classroom. No personal characteristics, daily life behaviours, and physical environments were associated with sleep problems. 70.8% of all students found to over use smartphones during bedtime. The Facebook website was the most popular. Smartphone overuse was significantly associated with poor sleep quality (odds ratio= 3.46 and napping in the classroom (odds ratio=4.09 but not grade point average. Conclusion: Smartphone overuse during bedtime in medical students is associated with sleep problems but not learning achievement.

  7. The Composition of Cigarette Smoke: Problems with Lists of Tumorigens

    Directory of Open Access Journals (Sweden)

    Rodgman A

    2014-12-01

    Full Text Available Since the mid-1960s, various investigators, agencies, and institutions have disseminated lists of cigarette mainstream smoke (MSS components reported to be tumorigenic on the basis of laboratory bioassays conducted under conditions significantly different from those encountered by the smoker during exposure to the components in the cigarette MSS aerosol. Since 1990, numerous lists of cigarette MSS components, defined as significant tumorigens, have been compiled by American Health Foundation personnel, Occupational Safety and Health Administration (OSHA, Fowles and Bates, and R.J. Reynolds R&D personnel. The purpose of most of the reports was to define human risk assessment and to dissuade smokers from smoking. Various investigators and agencies have frequently cited the earlier and/or the more recent lists of tumorigenic entities. The recent compilations, involving nearly 80 MSS components, suffer from serious deficiencies including: a Use of per cigarette delivery ranges for specified components which often include analytical data from cigarettes manufactured in the 1950s and 1960s which are not comparable to lower-'tar’ yield cigarettes manufactured since the mid-1970s. b Absence of standard analytical procedures for most of the listed components. c Methodological considerations regarding bioassays used to determine tumorigenicity of the listed MSS components. d Difficulty in extrapolating in vivo bioassay data obtained by non-inhalation modes of administration of a single compound to the human smoking situation involving inhalation of a complex aerosol containing that compound. e Inhalation data inadequacies regarding the tumorigenicity of many of the components. f Several tobacco smoke components are listed despite the fact their presence has not been confirmed, their MSS level has not been defined, or their MSS level is no longer relevant. g Insufficient consideration of inhibitors of tumorigenesis and mutagenesis found in MSS. h

  8. Child and caregiver reported problems in using asthma medications and question-asking during paediatric asthma visits.

    Science.gov (United States)

    Sleath, Betsy; Carpenter, Delesha M; Beard, Ashley; Gillette, Christopher; Williams, Dennis; Tudor, Gail; Ayala, Guadalupe X

    2014-02-01

    The objectives of the study were to describe the extent to which lay caregivers and children who reported asthma medication problems asked medication questions during their medical visits. Children with asthma ages 8 through 16 years and their caregivers were recruited at five paediatric practices and their medical visits were audiotape recorded. Children were interviewed after their medical visits and caregivers completed questionnaires. A home visit was conducted 1 month later. Generalized estimating equations were used to analyse the data. Two hundred and ninety six families participated. Among those caregivers who reported asthma medication problems, only 35% had asked at least one medication question during the visit. Among children who reported asthma medication problems, only 11% had asked at least one medication question during their consultation. Caregivers and children who reported a problem with their asthma medications were significantly more likely to have asked medication questions if providers had asked more questions about control medications. Children who reported higher asthma management self-efficacy were significantly more likely to have asked an asthma medication question. Only one in three caregivers and one in 10 children who reported an asthma medication problem asked a question during their medical visits and many still reported these problems 1 month later. Pharmacists should encourage caregivers and children to report problems they may be having using their asthma medications. © 2013 Royal Pharmaceutical Society.

  9. Self-reported competency ratings of graduates of a problem-leased medical curriculum

    NARCIS (Netherlands)

    van der Molen, H. T.

    Purpose. To study the self-reports of professional competencies by graduates of a problem-based medical curriculum. Method. All graduates from a medical school and a faculty of health sciences with a problem-based curriculum were sent a questionnaire asking them to compare their own performances in

  10. Self-reported competency ratings of graduates of a problem-based medical curriculum

    NARCIS (Netherlands)

    H.G. Schmidt (Henk); H.M. van der Molen

    2001-01-01

    textabstractPurpose. To study the self-reports of professional competencies by graduates of a problem-based medical curriculum. Method. All graduates from a medical school and a faculty of health sciences with a problem-based curriculum were sent a questionnaire asking them to compare their own

  11. Nurses' perceptions and problems in the usability of a medication safety app.

    Science.gov (United States)

    Ankem, Kalyani; Cho, Sookyung; Simpson, Diana

    2017-10-16

    The majority of medication apps support medication adherence. Equally, if not more important, is medication safety. Few apps report on medication safety, and fewer studies have been conducted with these apps. The usability of a medication safety app was tested with nurses to reveal their perceptions of the graphical user interface and to discover problems they encountered in using the app. Usability testing of the app was conducted with RN-BSN students and informatics students (n = 18). Perceptions of the graphical components were gathered in pretest and posttest questionnaires, and video recordings of the usability testing were transcribed. The significance of the difference in mean performance time for 8 tasks was tested, and qualitative analysis was deployed to identify problems encountered and to rate the severity of each problem. While all participants perceived the graphical user interface as easy to understand, nurses took significantly more time to complete certain tasks. More nurses found the medication app to be lacking in intuitiveness of user interface design, in capability to match real-world data, and in providing optimal information architecture. To successfully integrate mobile devices in healthcare, developers must address the problems that nurses encountered in use of the app.

  12. Bladder Control Problems: Medications for Treating Urinary Incontinence

    Science.gov (United States)

    ... control problems, including how they work to treat urinary incontinence and possible side effects. By Mayo Clinic Staff ... a look at medications commonly prescribed to treat urinary incontinence and their possible side effects. Keep in mind ...

  13. Waiting list in a public health facility in Santiago, Chile

    Directory of Open Access Journals (Sweden)

    Alejandro Letelier

    2014-07-01

    Full Text Available Introduction Waiting lists are a well-known problem in public healthcare systems worldwide. For instance, England had over one million people in waiting lists for elective surgical procedures in 2000. Spain had over 360 000 patients in surgical waiting lists in 2007. Chile has been trying to manage waiting times through the GES (Explicit Guarantees in Healthcare plan, which was established by the Chilean government in 2005. Waiting lists for the guaranteed-care diseases in the GES plan had 380 000 patients at the beginning of 2010, and that number was reduced to zero in 2011. Internationally, there are some descriptive studies about waiting lists that focus on variables such as waiting times and number of patients in the list. In Chile, however, this type of study is lacking. Purpose This study aims to describe the characteristics of waiting lists for medical specialties between April and October 2011. It also aims to identify the components of management models in public healthcare centers, and to identify and analyze waiting-time frames of patients referred to a secondary or tertiary healthcare public center from a public primary healthcare center. Methods A descriptive cross-sectional study of the waiting list for first-time consultations for medical specialties was carried out. Referred patients were described and grouped using indicators of access to healthcare and waiting time between April and October 2011. Each consultation request or referral of a new patient was included in the waiting list and analyzed. Results There were 15 935 requests for consultations; 5 717 requests were resolved, and 8 544 were not (54% of the total requests for consultation. There was a mean waiting time of 498 days for non-resolved requests for consultation, and a mean of 141 days for resolved requests. The specialties in highest demand were orthopedic surgery and ophthalmology. The main waiting-list management processes were referral and reception of requests

  14. Medical audit on problem analysis and implementing changes at the ...

    African Journals Online (AJOL)

    Infection control and continuing medical education committees were formed where they did not exist. Conclusion/Recommendation: Hospital medical audit on problem analysis and implementation of changes in health units is highly effective in stimulating and empowering health care workers and hospital administrators to ...

  15. Revisiting the medical diagnosis problem

    DEFF Research Database (Denmark)

    Ejersbo, Lisser Rye; Leron, Uri

    2014-01-01

    in the context of probability, with special focus on one case study – the Medical Diagnosis Problem – which figures prominently in the cognitive psychology research literature and in the so-called rationality debate. Our case study involves a combination of theory, design and experiment: Using the extensive...... psychological research as a theoretical base, we design a new “bridging” task, which is on the one hand formally equivalent to the given “difficult” task, but on the other hand is much more accessible to students’ intuitions. Furthermore, this new task would serve as "stepping stone", enabling students to solve...

  16. Medical problems of survivors of nuclear war

    International Nuclear Information System (INIS)

    Abrams, H.L.; Von Kaenel, W.E.

    1981-01-01

    The nature of the medical problems that may confront survivors of a nuclear war are discussed with emphasis on infection and the spread of communicable disease. Factors which will increase the risk and severity of infection include: radiation, trauma and burns, malnutrition and starvation, dehydration, exposure, and hardship. Factors which will increase the spread of disease include: crowded shelter conditions, poor sanitation, insects, corpses, free-roaming diseased animals. Shortages of physicians, the destruction of laboratories, and the general disorganization sure to follow the attack will also contribute to the problems. The authors recommend further study in this area

  17. Medical-isotope supply hit by production problems

    Science.gov (United States)

    Gould, Paula

    2008-10-01

    A shortfall in the production of medical isotopes in Europe has forced hospitals to delay patient scans or offer alternative diagnostic tests. The problems began in August when all three nuclear reactors used to generate molybdenum-99, which then decays to form the key nuclear-imaging agent technetium-99, had to be unexpectedly shut down at the same time.

  18. Renewed roles for librarians in problem-based learning in the medical curriculum.

    Science.gov (United States)

    Mi, Misa

    2011-01-01

    Problem-based learning (PBL) is a teaching-learning process or method of instruction that is widely used in medical education curricula. Librarians play important roles as facilitators for PBL as well as guides for information resources. Involvement in PBL activities presents unique opportunities to incorporate library resources and instruction into the medical curriculum. This article reviews the problem-based learning method within the conceptual framework of the learning theory of constructivism. It describes how a medical librarian at a U.S. medical school used emerging technologies to facilitate PBL small group case discussions, guide students to quality information resources, and enhance the learning environment for the PBL process.

  19. Medication-related problem type and appearance rate in ambulatory hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Drayer Debra K

    2003-12-01

    Full Text Available Abstract Background Hemodialysis (HD patients are at risk for medication-related problems (MRP. The MRP number, type, and appearance rate over time in ambulatory HD patients has not been investigated. Methods Randomly selected HD patients were enrolled to receive monthly pharmaceutical care visits. At each visit, MRP were identified through review of the patient chart, electronic medical record, patient interview, and communications with other healthcare disciplines. All MRP were categorized by type and medication class. MRP appearance rate was determined as the number of MRP identified per month/number of months in study. The number of MRP per patient-drug exposures were determined using: {[(number of patients × (mean number of medications]/(number of months of study} /number of MRP identified. Results were expressed as mean ± standard deviation or percentages. Results Patients were 62.6 ± 15.9 years old, had 6.4 ± 2.0 comorbid conditions, were taking 12.5 ± 4.2 medications, and 15.7 ± 7.2 doses per day at baseline. Medication-dosing problems (33.5%, adverse drug reactions (20.7%, and an indication that was not currently being treated (13.5% were the most common MRP. 5,373 medication orders were reviewed and a MRP was identified every 15.2 medication exposures. Overall MRP appearance rate was 0.68 ± 0.46 per patient per month. Conclusion MRP continue to occur at a high rate in ambulatory HD patients. Healthcare providers taking care of HD patients should be aware of this problem and efforts to avoid or resolve MRP should be undertaken at all HD clinics.

  20. Educational Problems of Kermanshah Medical School: View Points of Students, Graduates and Faculty Members

    Directory of Open Access Journals (Sweden)

    soraia Siabani

    2009-07-01

    Full Text Available Background and purpose: In recent years although the number of students registering for medicines has decreased in Kermanshah University of Medical sciences parallel to other universities of medical sciences the quality of educational services has not improved the informal reports suggests that the competency of medical graduates is not satisfactory Since any intervention needs situation analysis this study was conducted to obtain viewpoints of three main groups of stockholders including faculty members, students and graduates on medical school problems and insufficiencies.Methods: In this qualitative study faculty members of medical schools, medical graduated of 2005-6, and medical students of different phases participated. With participation of these subjects Focus Group Discussion (FGD sessions were carried out. The goals of the projects were first explained for participants. In the end of each discussion session the discussions were careful transcribed. The sessions continued till the sessions get saturated. The transcript of discussion was thoroughly reviewed by researchers and codified. The problems were classified in 7 areas of management, planning, education goals, evaluation, ethics, teaching, and students.Results: The subjects believed that the most important problems in Kermanshah medical school include neglecting the student evaluation, no educational objectives or being inattentive to them, unwanted effects of pay for service plan, too much duties for interns (students, overload of medical duties and insufficiency in the number of faculty members, no rewarding system for teachers, inattention to needed outcomes, shortage of facilities for student in hospital and being negligent about mutual respect between students and teachers.Conclusion: some of the problems such as the effects of pay for service plan and insufficiency in the number of faculty members have solutions stemming beyond the university at Ministry of Health level

  1. Medical Problem-Solving: A Critique of the Literature.

    Science.gov (United States)

    McGuire, Christine H.

    1985-01-01

    Prescriptive, decision-analysis of medical problem-solving has been based on decision theory that involves calculation and manipulation of complex probability and utility values to arrive at optimal decisions that will maximize patient benefits. The studies offer a methodology for improving clinical judgment. (Author/MLW)

  2. Predictors of return to work in employees sick-listed with mental health problems : findings from a longitudinal study

    NARCIS (Netherlands)

    Nielsen, Maj Britt D.; Madsen, Ida E. H.; Bultmann, Ute; Christensen, Ulla; Diderichsen, Finn; Rugulies, Reiner

    2011-01-01

    Background: Sickness absence due to mental health problems (MHPs) is increasing in several European countries. However, little is known about return to work (RTW) for employees with MHPs. This prospective study aimed to identify predictors for RTW in employees sick-listed with MHPs. Methods:

  3. A computerised out-patient medical records programme based on the Summary Time-Oriented Record (STOR) System.

    Science.gov (United States)

    Cheong, P Y; Goh, L G; Ong, R; Wong, P K

    1992-12-01

    Advances in microcomputer hardware and software technology have made computerised outpatient medical records practical. We have developed a programme based on the Summary Time-Oriented Record (STOR) system which complements existing paper-based record keeping. The elements of the Problem Oriented Medical Record (POMR) System are displayed in two windows within one screen, namely, the SOAP (Subjective information, Objective information, Assessments and Plans) elements in the Reason For Encounter (RFE) window and the problem list with outcomes in the Problem List (PL) window. Context sensitive child windows display details of plans of management in the RFE window and clinical notes in the PL window. The benefits of such innovations to clinical decision making and practice based research and its medico-legal implications are discussed.

  4. Medical-biological problems

    International Nuclear Information System (INIS)

    1986-01-01

    The report contains data on operational and emergency staff of the Chernobyl nuclear power plant who were exposed to radiation as a consequence of the reactor accident, the size of the doses received and consequences for health. 203 persons were found to have acute radiation sickness. Of the 22 patients suffering from an extremely severe degree of acute radiation sickness, 19 died. Of the 23 patients with severe bone marrow syndrome, 7 died. For the majority of patients, clinical recovery occurred toward the end of the second month following the accident. The main harmful factor for all victims was the relatively uniform gamma- and beta-radiation effect in a dosage exceeding 1 Gy and, in the case of 35 people exceeding 4 Gy. Radiation damage to wide areas of the skin was one of the main factors contributing to the overall severe condition of the patients, and was a determining factor in the main fatal complications. A preliminary evaluation of the use of some biochemical and immunological tests in the event of accidental exposure to radiation and the methods of treatment and preliminary assessment of their effectiveness are presented. Another part of the report contains data on the doses from radiation exposure to the population of the town of Pripyat' until the time of evacuation and to the population in the 30 km zone around Chernobyl' nuclear power plant and radiation consequences of the accident for the population of different regions in the European part of the USSR, especially the problems related to the contamination of food products. The last part of the report gives some data on the organization of medical examinations of the population from the region around the Chernobyl' plant and on the long-term programmes for the medical and biological monitoring of the population and personnel

  5. Development of a provisional essential medicines list for children in Canada: consensus process.

    Science.gov (United States)

    Woods, Hannah; Oronsaye, Efosa; Bali, Anjli; Rajakulasingam, Yathavan; Lee, Taehoon; Umali, Norman; Cohen, Eyal; Finkelstein, Yaron; Offringa, Martin; Persaud, Nav

    2018-03-26

    Worldwide, many countries have developed a list of essential medicines for children to improve prescribing. We aimed to create an essential medicines list for children in Canada. We adapted the previously created preliminary list of essential medicines for adults in Canada and the WHO Model List of Essential Medicines for Children to create a provisional list of essential medicines for children in Canada. Canadian clinicians made suggestions for changes. Literature relevant to each suggestion was presented to clinician-scientists, who used a modified nominal group technique to make recommendations on the suggestions. Ontario Public Drug Programs prescription data were reviewed to identify commonly prescribed medications missing from the list. Literature relevant to these medications was shared with a clinician-scientist review panel to determine which should be added, and a revised list was developed. A total of 76 items were removed from the list of essential medicines for adults in Canada because they were not indicated for use in children or were not relevant in the Canadian health care context; 7 medications were added to the child list based on Ontario Public Drugs Programs prescribing data and clinician-scientist review. Suggestions to add, remove or substitute medications were made by peer-reviewers and resulted in removal of 1 medication and replacement of 1 medication. The process produced a provisional list of 67 essential medications for children. A provisional list of 67 essential medicines for children was created through a peer-reviewed, multistep process based on current clinical evidence, Canadian clinical practice guidelines and historical prescribing data. It is publicly posted at http://cleanmeds.ca/. The list should be further developed based on wider input and should be continuously revised based on emerging evidence of the safety and effectiveness of these medicines in all pediatric age groups. Copyright 2018, Joule Inc. or its licensors.

  6. Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements.

    Science.gov (United States)

    Flanagan, Meghan R; Foster, Carolyn C; Schleyer, Anneliese; Peterson, Gene N; Mandell, Samuel P; Rudd, Kristina E; Joyner, Byron D; Payne, Thomas H

    2016-02-01

    House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program. House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention. The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P house staff in institutional quality and safety initiatives with tangible institutional benefits. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. 75 FR 49481 - Procurement List; Additions and Deletion

    Science.gov (United States)

    2010-08-13

    ... added to the Procurement List: Services Service Type/Locations: Laundry Service, Atlanta VA Medical...: Additions to and deletion from the Procurement List. SUMMARY: This action adds services to the Procurement... disabilities and deletes a service from the Procurement List previously furnished by such agency. DATES...

  8. Effect of smartphone overuse on sleep problems in medical students

    OpenAIRE

    Pairoj Boonluksiri

    2018-01-01

    Background: Smartphones are used worldwide. Consequently, it does seem to be having an impact on health-related problems if overused. However, it is uncertain whether it is associated with sleep problems or poor learning. Objective: To determine the association between smartphone overuse and sleep problems in medical students as primary outcome and poor learning as secondary outcome. Methods: A cross-sectional study was conducted in 89 students having their own smartphones, at Hatyai...

  9. Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western maharashtra, India.

    Science.gov (United States)

    Giri, Pa; Baviskar, Mp; Phalke, Db

    2013-01-01

    Good quality sleep and adequate amount of sleep are important in order to have better cognitive performance and avoid health problems and psychiatric disorders. The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates, interns and postgraduate students of Pravara Institute of Medical Sciences (Deemed University), Loni, Maharashtra, India. Sleep habits and problems were investigated using a convenience sample of students from Pravara Institute of Medical Sciences (Deemed University), Loni, Maharashtra, India. The study was carried out during Oct. to Dec. 2011 with population consisted of total 150 medical students. A self-administered questionnaire developed based on Epworth Daytime Sleepiness Scale and Pittsburgh Sleep Quality Index was used. Data was analyzed by using Statistical Package of Social Sciences (SPSS) version 16.0. In this study, out of 150 medical students, 26/150 (17.3%) students had abnormal levels of daytime sleepiness while 20/150 (13.3%) were border line. Sleep quality in females was better than the male. Disorders related to poor sleep qualities are significant problems among medical students in our institution. Caffeine and alcohol ingestion affected sleep and there was high level of daytime sleepiness. Sleep difficulties resulted in irritability and affected lifestyle and interpersonal relationships.

  10. List manipulation in Turbo Prolog

    Directory of Open Access Journals (Sweden)

    V.Cotelea

    1995-06-01

    Full Text Available The present paper is concerned with list processing in Turbo Prolog language. It doesn't claim to be an exhaustive description of operations which can be performed upon lists. Nevertheless adduced programs are most representative, more or less known to specialists in logic programming domain. By means of examples are explained the list manipulation techniques, use of recursion, declarative comparison of predicates, analysis and fixation of acceptable prototypes and some problems of predicates' inconsistency. Index terms. Prolog, list, recursion.

  11. Design and implementation of a web-based patient portal linked to an electronic health record designed to improve medication safety: the Patient Gateway medications module

    Directory of Open Access Journals (Sweden)

    Jeffrey Schnipper

    2008-07-01

    Full Text Available In this article we describe the background, design, and preliminary results of a medications module within Patient Gateway (PG, a patient portal linked to an electronic health record (EHR. The medications module is designed to improve the accuracy of medication lists within the EHR, reduce adverse drug events and improve patient_provider communication regarding medications and allergies in several primary care practices within a large integrated healthcare delivery network. This module allows patients to view and modify the list of medications and allergies from the EHR, report nonadherence, side effects and other medication-related problems and easily communicate this information to providers, who can verify the information and update the EHR as needed. Usage and satisfaction data indicate that patients found the module easy to use, felt that it led to their providers having more accurate information about them and enabled them to feel more prepared for their forthcoming visits. Further analyses will determine the effects of this module on important medication-related outcomes and identify further enhancements needed to improve on this approach.

  12. Structured Medication Review to Improve Pharmacotherapy in People with Intellectual Disability and Behavioural Problems.

    Science.gov (United States)

    Scheifes, Arlette; Egberts, Toine C G; Stolker, Joost Jan; Nijman, Henk L I; Heerdink, Eibert R

    2016-07-01

    Polypharmacy and chronic drug use are common in people with intellectual disability and behavioural problems, although evidence of effectiveness and safety in this population is lacking. This study examined the effects of a structured medication review and aimed to improve pharmacotherapy in inpatients with intellectual disability. In a treatment facility for people with mild to borderline intellectual disability and severe behavioural problems, a structured medication review was performed. Prevalence and type of drug-related problems (DRPs) and of the recommended and executed actions were calculated. In a total of 55 patients with intellectual disability and behavioural problems, 284 medications were prescribed, in which a DRP was seen in 106 (34%). No indication/unclear indication was the most prevalent DRP (70). Almost 60% of the recommended actions were also executed. This high prevalence of DRPs is worrying. The structured medication review is a valuable instrument to optimize pharmacotherapy and to support psychiatrists in adequate prescribing of both psychotropic and somatic drugs. © 2015 John Wiley & Sons Ltd.

  13. Sick-listed employees with severe medically unexplained physical symptoms : burden or routine for the occupational health physician? A cross sectional study

    NARCIS (Netherlands)

    Hoedeman, Rob; Krol, Boudien; Blankenstein, Annette H.; Koopmans, Petra C.; Groothoff, Johan W.

    2010-01-01

    Background: The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs), and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS).

  14. [Current situations and problems of quality control for medical imaging display systems].

    Science.gov (United States)

    Shibutani, Takayuki; Setojima, Tsuyoshi; Ueda, Katsumi; Takada, Katsumi; Okuno, Teiichi; Onoguchi, Masahisa; Nakajima, Tadashi; Fujisawa, Ichiro

    2015-04-01

    Diagnostic imaging has been shifted rapidly from film to monitor diagnostic. Consequently, Japan medical imaging and radiological systems industries association (JIRA) have recommended methods of quality control (QC) for medical imaging display systems. However, in spite of its need by majority of people, executing rate is low. The purpose of this study was to validate the problem including check items about QC for medical imaging display systems. We performed acceptance test of medical imaging display monitors based on Japanese engineering standards of radiological apparatus (JESRA) X-0093*A-2005 to 2009, and performed constancy test based on JESRA X-0093*A-2010 from 2010 to 2012. Furthermore, we investigated the cause of trouble and repaired number. Medical imaging display monitors had 23 inappropriate monitors about visual estimation, and all these monitors were not criteria of JESRA about luminance uniformity. Max luminance was significantly lower year-by-year about measurement estimation, and the 29 monitors did not meet the criteria of JESRA about luminance deviation. Repaired number of medical imaging display monitors had 25, and the cause was failure liquid crystal panel. We suggested the problems about medical imaging display systems.

  15. [Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

    Science.gov (United States)

    Mehrmann, Lena; Ollenschläger, Günter

    2014-01-01

    Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care. Copyright © 2013. Published by Elsevier GmbH.

  16. Undergraduate medical student's perceptions on traditional and problem based curricula: pilot study.

    Science.gov (United States)

    Meo, Sultan Ayoub

    2014-07-01

    To evaluate and compare students' perceptions about teaching and learning, knowledge and skills, outcomes of course materials and their satisfaction in traditional Lecture Based learning versus Problem-Based Learning curricula in two different medical schools. The comparative cross-sectional questionnaire-based study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from July 2009 to January 2011. Two different undergraduate medical schools were selected; one followed the traditional curriculum, while the other followed the problem-based learning curriculum. Two equal groups of first year medical students were selected. They were taught in respiratory physiology and lung function lab according to their curriculum for a period of two weeks. At the completion of the study period, a five-point Likert scale was used to assess students' perceptions on satisfaction, academic environment, teaching and learning, knowledge and skills and outcomes of course materials about effectiveness of problem-based learning compared to traditional methods. SPSS 19 was used for statistical analysis. Students used to problem-based learning curriculum obtained marginally higher scores in their perceptions (24.10 +/- 3.63) compared to ones following the traditional curriculum (22.67 +/- 3.74). However, the difference in perceptions did not achieve a level of statistical significance. Students following problem-based learning curriculum have more positive perceptions on teaching and learning, knowledge and skills, outcomes of their course materials and satisfaction compared to the students belonging to the traditional style of medical school. However, the difference between the two groups was not statistically significant.

  17. Medical and psychological problems faced by young Australian gap year travellers.

    Science.gov (United States)

    Furuya-Kanamori, Luis; Mills, Deborah; Sheridan, Sarah; Lau, Colleen

    2017-09-01

    Gap year travellers can potentially be exposed to many infectious diseases and other travel-related health problems including injuries and psychological problems. Currently, there is little information on health and wellbeing of this particular group of travellers. Participants were recruited from an organization that specialized in organising international gap year placements. Gap year travellers were asked to complete a pre-departure survey on demographics, placement destination and duration, previous travel experience, hobbies, risk taking behaviour, anticipated problems during the placement, and pre-travel preparations. After the placement, participants were asked to complete a post-trip survey on their experiences, problems, health issues, and medical treatment required. The 88 and 34 gap year travellers aged 17-23 years completed pre- and post-placement surveys respectively. The duration of placements ranged from 3 to 12 months. Psychological stressors were frequently reported [ n = 26 (76.5%) felt home sick; n = 18 (52.9%) experienced culture shock; n = 17 (50.0%) had difficulty communicating with the locals]. The majority of participants (91.2%) tried to work out a solution for the stressor on their own. Twenty-eight (82.4%) participants reported medical problems during their placement; the most common problems were sunburn ( n = 19; 55.9%), respiratory infections ( n = 15; 44.1%), weight change ( n = 14; 41.2%), and diarrhoea/food poisoning ( n = 13; 38.2%). Three participants (3.4%) were admitted to hospital; for a muscle injury, head injury and skin infection after getting a tribal tattoo. Psychological stressors were common, but most did not seek help. Some medical problems encountered during their placement may have been preventable with improved pre-departure preparation. Gap year, pre-departure, preparation. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e

  18. Use of information technology for medication management in residential care facilities: correlates of facility characteristics.

    Science.gov (United States)

    Bhuyan, Soumitra S; Chandak, Aastha; Powell, M Paige; Kim, Jungyoon; Shiyanbola, Olayinka; Zhu, He; Shiyanbola, Oyewale

    2015-06-01

    The effectiveness of information technology in resolving medication problems has been well documented. Long-term care settings such as residential care facilities (RCFs) may see the benefits of using such technologies in addressing the problem of medication errors among their resident population, who are usually older and have numerous chronic conditions. The aim of this study was two-fold: to examine the extent of use of Electronic Medication Management (EMM) in RCFs and to analyze the organizational factors associated with the use of EMM functionalities in RCFs. Data on RCFs were obtained from the 2010 National Survey of Residential Care Facilities. The association between facility, director and staff, and resident characteristics of RCFs and adoption of four EMM functionalities was assessed through multivariate logistic regression. The four EMM functionalities included were maintaining lists of medications, ordering for prescriptions, maintaining active medication allergy lists, and warning of drug interactions or contraindications. About 12% of the RCFs adopted all four EMM functionalities. Additionally, maintaining lists of medications had the highest adoption rate (34.5%), followed by maintaining active medication allergy lists (31.6%), ordering for prescriptions (19.7%), and warning of drug interactions or contraindications (17.9%). Facility size and ownership status were significantly associated with adoption of all four EMM functionalities. Medicaid certification status, facility director's age, education and license status, and the use of personal care aides in the RCF were significantly associated with the adoption of some of the EMM functionalities. EMM is expected to improve the quality of care and patient safety in long-term care facilities including RCFs. The extent of adoption of the four EMM functionalities is relatively low in RCFs. Some RCFs may strategize to use these functionalities to cater to the increasing demands from the market and also to

  19. Preparing foundation-year students for medical studies in a problem-based learning environment

    DEFF Research Database (Denmark)

    Du, Xiangyun; Massoud, Walid; Al-Banna, Nadia Ali

    2016-01-01

    Purpose: To contribute to the field of preparing new students for their medical studies and to investigate how foundation-year medical students perceive the progression of appropriate learning skills for studying in a PBL medical curriculum via the support of a course aiming at facilitating...... students with these skills. Methods: A 10-point scale online questionnaire consisting of 20 questions was used for data collection. 50 out of the 59 (19 males and 31 females) students responded and self-evaluated a list of learning skills according to the course objectives before and after the course....... Cronbach's alpha was used to test for internal consistency and reliability of the collected data and Principal Component Exploratory Factor Analysis was performed. Paired t-test was used to examine differences between pre- and post-analysis data. Results: The internal consistency of the questionnaire...

  20. Problems associated with the organization and planning of medical aid for radiation accident casualties

    International Nuclear Information System (INIS)

    Jammet, H.P.

    1977-01-01

    Problems associated with the organization and planning of medical treatment for radiation accident casualties are considered for different types of radiation accident: whole-body or partial irradiation, external or internal contamination and small or large numbers of cases. The problems posed are ones of competence, urgency and capacity; on the diagnostic side there is the problem of evaluating the exposure or contamination and assessing the resultant damage, while on the treatment side the questions of first aid, conventional treatment and specialized treatment have to be considered. The solutions envisaged involve organization at the local and national levels and planning of medical treatment by skilled, multidisciplinary medical teams. (author)

  1. Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base.

    Science.gov (United States)

    McCoy, Allison B; Wright, Adam; Rogith, Deevakar; Fathiamini, Safa; Ottenbacher, Allison J; Sittig, Dean F

    2014-04-01

    Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications being encoded in particular terminologies. Crowdsourcing represents one approach to generating robust knowledge bases across a variety of terminologies, but more sophisticated approaches are necessary to improve accuracy and reduce manual data review requirements. We sought to develop and evaluate a clinician reputation metric to facilitate the identification of appropriate problem-medication pairs through crowdsourcing without requiring extensive manual review. We retrieved medications from our clinical data warehouse that had been prescribed and manually linked to one or more problems by clinicians during e-prescribing between June 1, 2010 and May 31, 2011. We identified measures likely to be associated with the percentage of accurate problem-medication links made by clinicians. Using logistic regression, we created a metric for identifying clinicians who had made greater than or equal to 95% appropriate links. We evaluated the accuracy of the approach by comparing links made by those physicians identified as having appropriate links to a previously manually validated subset of problem-medication pairs. Of 867 clinicians who asserted a total of 237,748 problem-medication links during the study period, 125 had a reputation metric that predicted the percentage of appropriate links greater than or equal to 95%. These clinicians asserted a total of 2464 linked problem-medication pairs (983 distinct pairs). Compared to a previously validated set of problem-medication pairs, the reputation metric achieved a specificity of 99.5% and marginally improved the sensitivity of previously described knowledge bases. A

  2. Application of EGS and ETRAN to Problems in Medical Physics and Dosimetry

    CERN Document Server

    Nelson, W R

    1980-01-01

    The author looks at a few applications of Monte Carlo programs to problems of interest in medical physics and dosimetry. In particular, two areas are considered: 1) bremsstrahlung production from medical accelerators; 2) photon dosimetry at medium to low energies. (16 refs) .

  3. Resident and parental perceptions of adolescent problems and family communications in a low socioeconomic population.

    Science.gov (United States)

    Hawley, L E; Shear, C L; Stark, A M; Goodman, P R

    1984-11-01

    This cross-sectional survey of a low socioeconomic patient group was designed to determine the prevalence and severity of parentally perceived behavioral problems in adolescents as well as to investigate the correlation between such problems and single parenting, family communications, and medical care delivered. The sample population consisted of 79 parents and 121 teenagers selected from a family practice center. The medical record and telephone interview were the sources of information. Results include a parental perception of a high prevalence of problems with school grades (48 percent), school attendance (38 percent), and household problems (chores and sibling rivalry). Of low prevalence but high severity were perceived problems related to suicidal ideation, running away, sexual activity, and gang membership. Single-parent homes had a threefold higher incidence of behavioral problems, a greater degree of communication, and a lower use of community resources than two-parent families. None of the approximately 400 perceived behavioral problems listed by parents was found in the family physicians' master problem list. The results indicate the need for physician education of low socioeconomic and single-parent patients with regard to communication and coping style. In addition, it appears that training programs should provide more education in the care of adolescents.

  4. The cost of problem-based vs traditional medical education.

    Science.gov (United States)

    Mennin, S P; Martinez-Burrola, N

    1986-05-01

    It is generally accepted that teachers' salaries are a major factor in the cost of medical education. Little is known about the effects of curriculum on teaching time. A comparison of teaching time devoted to each of two different medical education curricula is presented. In a traditional teacher-centered, subject-oriented curriculum, 61% of the total teaching effort expended by twenty-two teachers took place in the absence of students, i.e. in preparation for student contact. Only 39% of the effort devoted by these teachers to medical education took place in the presence of students. In a problem-based, student-centered curriculum which focuses upon small-group tutorial learning and early extended primary care experience in a rural community setting, 72% of the total teaching effort devoted to medical education was spent with students and only 28% was spent in preparation for student contact. Overall, there were no differences in the total amount of teaching time required by each of the two curricular approaches to medical education. There were, however, major differences in how teachers spent their teaching time.

  5. Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs.

    Science.gov (United States)

    McCoy, A B; Wright, A; Krousel-Wood, M; Thomas, E J; McCoy, J A; Sittig, D F

    2015-01-01

    Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging. We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record. We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision. The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%. We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across healthcare settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes.

  6. [A model list of high risk drugs].

    Science.gov (United States)

    Cotrina Luque, J; Guerrero Aznar, M D; Alvarez del Vayo Benito, C; Jimenez Mesa, E; Guzman Laura, K P; Fernández Fernández, L

    2013-12-01

    «High-risk drugs» are those that have a very high «risk» of causing death or serious injury if an error occurs during its use. The Institute for Safe Medication Practices (ISMP) has prepared a high-risk drugs list applicable to the general population (with no differences between the pediatric and adult population). Thus, there is a lack of information for the pediatric population. The main objective of this work is to develop a high-risk drug list adapted to the neonatal or pediatric population as a reference model for the pediatric hospital health workforce. We made a literature search in May 2012 to identify any published lists or references in relation to pediatric and/or neonatal high-risk drugs. A total of 15 studies were found, from which 9 were selected. A model list was developed mainly based on the ISMP one, adding strongly perceived pediatric risk drugs and removing those where the pediatric use was anecdotal. There is no published list that suits pediatric risk management. The list of pediatric and neonatal high-risk drugs presented here could be a «reference list of high-risk drugs » for pediatric hospitals. Using this list and training will help to prevent medication errors in each drug supply chain (prescribing, transcribing, dispensing and administration). Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  7. Agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases

    Directory of Open Access Journals (Sweden)

    Fathelrahman Ahmed I

    2009-09-01

    Full Text Available Abstract Background The main objective of the present study was to evaluate the agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases. Methods Cross-sectional sample of 100 poisoning cases consecutively admitted to the Hospital Pulau Pinang, Malaysia during the period from September 2003 to February 2004 were studied. Data on health and socioeconomic problems were collected both by self-administered questionnaire and from medical records. Agreement between the two sets of data was assessed by calculating the concordance rate, Kappa (k and PABAK. McNemar statistic was used to test differences between categories. Results Data collected by questionnaire and medical records showed excellent agreement on the "marital status"; good agreements on "chronic illness", "psychiatric illness", and "previous history of poisoning"; and fair agreements on "at least one health problem", and "boy-girl friends problem". PABAK values suggest better agreements' measures. Conclusion There were excellent to good agreements between questionnaire and medical records on the marital status and most of the health problems and fair to poor agreements on the majority of socioeconomic problems. The implications of those findings were discussed.

  8. 77 FR 29596 - Procurement List Proposed Additions

    Science.gov (United States)

    2012-05-18

    .../Location: Laundry Service, Veterans Administration Medical Center (VAMC), (offsite: 1809 W 2nd Avenue... Additions to the Procurement List. SUMMARY: The Committee is proposing to add products and services to the... identified in this notice will be required to procure the products and services listed below from nonprofit...

  9. Impact of supply problems of preservative-free glaucoma medications on patients and hospital staff.

    Science.gov (United States)

    Shah, Shima; Theodossiades, Julia; Chapman, Kristin; Murdoch, Ian

    2015-03-01

    Glaucoma is a chronic ocular disease, which is usually managed with long-term daily medical therapy, in the form of eye drops. Patients who are intolerant to preservatives in topical medicines require preservative-free versions. From early 2011 patients attending Moorfields Eye Hospital, London, UK, started to report recurring problems with the supply of the following preservative-free glaucoma medications: Timolol 0.25% (Timoptol 0.25%, MSD UK); Dorzolamide (Trusopt, MSD UK); Dorzolamide and Timolol 0.5% (Cosopt, MSD UK). This study investigates the impact of the supply problems of these medications at Moorfields Eye Hospital from a patient, administrative and clinical perspective. Information was sought by interviewing both patients and hospital staff, and by a retrospective case note review between April 2010 and May 2013. Many hospital roles, both administrative and clinical, were involved in attempting to resolve the impact of the supply problems. All staff reported a considerable increase in their workload. At the peak of the problem, the glaucoma secretaries received about 150 enquiries per week. A review of 83 sets of patient notes, retrieved from a random sample of 125 patients, showed that 22% encountered a supply problem. Of these, more than one-third attended Moorfields Eye Hospital Accident & Emergency (A&E) for repeat supplies and 89% eventually had their medication changed. In telephone interviews with 39 of a random sample of 50 patients (a subset of the 83 notes retrieved), 59% of the interviewees reported a supply problem. Of these, one-third attended Moorfields Eye Hospital A&E for repeat supplies and half eventually required an alternative medication. Some patients reported going to considerable lengths to obtain ongoing supplies in the community. This study shows that medication supply problems can have a major impact on patients and hospital services. Supply problems occur across many fields of medicine and with increasing frequency. The

  10. Overseas listing location and capital structure

    Institute of Scientific and Technical Information of China (English)

    Peixin Li; Baolian Wang

    2014-01-01

    Purpose-A significant number of Chinese companies are listed overseas.The authors aim to examine whether overseas locations affect their financing decision,specifically their capital structure choice.Design/methodology/approach-Most of the Chinese overseas listed companies are listed in the USA and Hong Kong.As the institutional quality of the USA is better than Hong Kong,the authors,therefore,choose to build the hypotheses from the “law and finance” literature.Specifically,the authors argue that the better institutional environment of the USA can mitigate the information asymmetry problem and the agency problem of financing via equity.Consequently,firms listed in the USA will rely more on equity and have lower leverage ratio.The difference in leverage ratio of US listed and Hong Kong listed companies should be larger when the marginal benefit of better information environment is larger.Findings-Referring to various data sources,the authors construct a comprehensive list of overseas listed companies in the USA and Hong Kong.The authors collect the accounting and stock performance information from Datastream/Worldscope and the equity offering data from Global New Issue database.The empirical findings provide strong support of the hypotheses:the leverage is 15 percent lower for US listed companies than the Hong Kong listed companies;the results are stronger when the firms face more severe information asymmetry problem;the stock price reacts less negatively for seasoned equity offering in the USA than in Hong Kong.Practical implications-Most of the Chinese companies decided to be listed overseas because they cannot be listed in the Mainland Chinese stock exchanges.One of the most important motivation is to access to external capital to support firm growth.As the main channel of external financing in the overseas markets is equity since debt is still mainly domestically based,one implication of this paper is that Chinese companies can gain better access to external

  11. New fuzzy support vector machine for the class imbalance problem in medical datasets classification.

    Science.gov (United States)

    Gu, Xiaoqing; Ni, Tongguang; Wang, Hongyuan

    2014-01-01

    In medical datasets classification, support vector machine (SVM) is considered to be one of the most successful methods. However, most of the real-world medical datasets usually contain some outliers/noise and data often have class imbalance problems. In this paper, a fuzzy support machine (FSVM) for the class imbalance problem (called FSVM-CIP) is presented, which can be seen as a modified class of FSVM by extending manifold regularization and assigning two misclassification costs for two classes. The proposed FSVM-CIP can be used to handle the class imbalance problem in the presence of outliers/noise, and enhance the locality maximum margin. Five real-world medical datasets, breast, heart, hepatitis, BUPA liver, and pima diabetes, from the UCI medical database are employed to illustrate the method presented in this paper. Experimental results on these datasets show the outperformed or comparable effectiveness of FSVM-CIP.

  12. New Fuzzy Support Vector Machine for the Class Imbalance Problem in Medical Datasets Classification

    Directory of Open Access Journals (Sweden)

    Xiaoqing Gu

    2014-01-01

    Full Text Available In medical datasets classification, support vector machine (SVM is considered to be one of the most successful methods. However, most of the real-world medical datasets usually contain some outliers/noise and data often have class imbalance problems. In this paper, a fuzzy support machine (FSVM for the class imbalance problem (called FSVM-CIP is presented, which can be seen as a modified class of FSVM by extending manifold regularization and assigning two misclassification costs for two classes. The proposed FSVM-CIP can be used to handle the class imbalance problem in the presence of outliers/noise, and enhance the locality maximum margin. Five real-world medical datasets, breast, heart, hepatitis, BUPA liver, and pima diabetes, from the UCI medical database are employed to illustrate the method presented in this paper. Experimental results on these datasets show the outperformed or comparable effectiveness of FSVM-CIP.

  13. Study of Sleep Habits and Sleep Problems Among Medical Students ...

    African Journals Online (AJOL)

    characteristics, psychiatric illness, and some types of physical illness. ... to poor sleep qualities are significant problems among medical students in our institution. Caffeine and .... prepare for post graduation and also get to play a role (albeit a.

  14. Mediators for internalizing problems in adolescents of parents with chronic medical condition

    NARCIS (Netherlands)

    Sieh, D.S.; Oort, F.J.; Visser-Meily, J.M.A.; Meijer, A.M.

    2014-01-01

    Parents’ chronic medical condition (CMC) is related to internalizing problem behavior in adolescents. Following the transactional stress and coping (TSC) model of Hocking and Lochman, our study examines whether the effect of illness and demographic parameters on the child’s internalizing problems is

  15. Medical education and cognitive continuum theory: an alternative perspective on medical problem solving and clinical reasoning.

    Science.gov (United States)

    Custers, Eugène J F M

    2013-08-01

    Recently, human reasoning, problem solving, and decision making have been viewed as products of two separate systems: "System 1," the unconscious, intuitive, or nonanalytic system, and "System 2," the conscious, analytic, or reflective system. This view has penetrated the medical education literature, yet the idea of two independent dichotomous cognitive systems is not entirely without problems.This article outlines the difficulties of this "two-system view" and presents an alternative, developed by K.R. Hammond and colleagues, called cognitive continuum theory (CCT). CCT is featured by three key assumptions. First, human reasoning, problem solving, and decision making can be arranged on a cognitive continuum, with pure intuition at one end, pure analysis at the other, and a large middle ground called "quasirationality." Second, the nature and requirements of the cognitive task, as perceived by the person performing the task, determine to a large extent whether a task will be approached more intuitively or more analytically. Third, for optimal task performance, this approach needs to match the cognitive properties and requirements of the task. Finally, the author makes a case that CCT is better able than a two-system view to describe medical problem solving and clinical reasoning and that it provides clear clues for how to organize training in clinical reasoning.

  16. Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs

    Science.gov (United States)

    Wright, A.; Krousel-Wood, M.; Thomas, E. J.; McCoy, J. A.; Sittig, D. F.

    2015-01-01

    Summary Background Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging. Objective We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record. Methods We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision. Results The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%. Conclusions We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across healthcare settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes. PMID:26171079

  17. Distribution of Problems, Medications and Lab Results in Electronic Health Records: The Pareto Principle at Work.

    Science.gov (United States)

    Wright, Adam; Bates, David W

    2010-01-01

    BACKGROUND: Many natural phenomena demonstrate power-law distributions, where very common items predominate. Problems, medications and lab results represent some of the most important data elements in medicine, but their overall distribution has not been reported. OBJECTIVE: Our objective is to determine whether problems, medications and lab results demonstrate a power law distribution. METHODS: Retrospective review of electronic medical record data for 100,000 randomly selected patients seen at least twice in 2006 and 2007 at the Brigham and Women's Hospital in Boston and its affiliated medical practices. RESULTS: All three data types exhibited a power law distribution. The 12.5% most frequently used problems account for 80% of all patient problems, the top 11.8% of medications account for 80% of all medication orders and the top 4.5% of lab result types account for all lab results. CONCLUSION: These three data elements exhibited power law distributions with a small number of common items representing a substantial proportion of all orders and observations, which has implications for electronic health record design.

  18. Quality Assessment of Medical Apps that Target Medication-Related Problems.

    Science.gov (United States)

    Loy, John Shiguang; Ali, Eskinder Eshetu; Yap, Kevin Yi-Lwern

    2016-10-01

    The advent of smartphones has enabled a plethora of medical apps for disease management. As of 2012, there are 40,000 health care-related mobile apps available in the market. Since most of these medical apps do not go through any stringent quality assessment, there is a risk of consumers being misinformed or misled by unreliable information. In this regard, apps that target medication-related problems (MRPs) are not an exception. There is little information on what constitutes quality in apps that target MRPs and how good the existing apps are. To develop a quality assessment tool for evaluating apps that target MRPs and assess the quality of such apps available in the major mobile app stores (iTunes and Google Play). The top 100 free and paid apps in the medical categories of iTunes and Google Play stores (total of 400 apps) were screened for inclusion in the final analysis. English language apps that targeted MRPs were downloaded on test devices to evaluate their quality. Apps intended for clinicians, patients, or both were eligible for evaluation. The quality assessment tool consisted of 4 sections (appropriateness, reliability, usability, privacy), which determined the overall quality of the apps. Apps that fulfilled the inclusion criteria were classified based on the presence of any 1 or more of the 5 features considered important for apps targeting MRPs (monitoring, interaction checker, dose calculator, medication information, medication record). Descriptive statistics and Mann-Whitney tests were used for analysis. Final analysis was based on 59 apps that fulfilled the study inclusion criteria. Apps with interaction checker (66.9%) and monitoring features (54.8%) had the highest and lowest overall qualities. Paid apps generally scored higher for usability than free apps (P = 0.006) but lower for privacy (P = 0.003). Half of the interaction checker apps were unable to detect interactions with herbal medications. Blood pressure and heart rate monitoring apps

  19. Factors affecting residency rank-listing: A Maxdiff survey of graduating Canadian medical students

    Directory of Open Access Journals (Sweden)

    Forgie Melissa

    2011-08-01

    Full Text Available Abstract Background In Canada, graduating medical students consider many factors, including geographic, social, and academic, when ranking residency programs through the Canadian Residency Matching Service (CaRMS. The relative significance of these factors is poorly studied in Canada. It is also unknown how students differentiate between their top program choices. This survey study addresses the influence of various factors on applicant decision making. Methods Graduating medical students from all six Ontario medical schools were invited to participate in an online survey available for three weeks prior to the CaRMS match day in 2010. Max-Diff discrete choice scaling, multiple choice, and drop-list style questions were employed. The Max-Diff data was analyzed using a scaled simple count method. Data for how students distinguish between top programs was analyzed as percentages. Comparisons were made between male and female applicants as well as between family medicine and specialist applicants; statistical significance was determined by the Mann-Whitney test. Results In total, 339 of 819 (41.4% eligible students responded. The variety of clinical experiences and resident morale were weighed heavily in choosing a residency program; whereas financial incentives and parental leave attitudes had low influence. Major reasons that applicants selected their first choice program over their second choice included the distance to relatives and desirability of the city. Both genders had similar priorities when selecting programs. Family medicine applicants rated the variety of clinical experiences more importantly; whereas specialty applicants emphasized academic factors more. Conclusions Graduating medical students consider program characteristics such as the variety of clinical experiences and resident morale heavily in terms of overall priority. However, differentiation between their top two choice programs is often dependent on social/geographic factors

  20. Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP).

    NARCIS (Netherlands)

    Tak, E.C.P.M.; Hespen, A.T.H. van; Verhaak, P.F.M.; Eekhof, J.; Hopman-Rock, M.

    2016-01-01

    Objective: Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety,

  1. Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP)

    NARCIS (Netherlands)

    Tak, E.C.P.M.; Hespen, A.T.H. van; Verhaal, P.F.M.; Eekhof, J.; Hopman-Rock, M.

    2016-01-01

    Objective: Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety,

  2. Radiology and radiation protection. Present-day problems

    International Nuclear Information System (INIS)

    Andrieu, L.

    1978-01-01

    With the development of nuclear energy the present-day problems of radioprotection are studied in the light of new radiobiological knowledge. The following points are analysed in turn: radioprotection norms, the notion of acceptable risk; influence of dose rate and fractionation; the low-dose problem; relative biological effectiveness (RBE) and quality factor (Q.F.); the biological problem of long-term effects. The genetic risk due to accepted radioprotection norms is estimated. The part played by radioprotection organisations is underlined, with emphasis on the fact that radioactivity is the most strictly and effectively regulated of all industrial inconveniences. It is pointed out that medical irradiation is not subject to the legislations and regulations listed [fr

  3. Medication use in children with asthma: not a child size problem.

    Science.gov (United States)

    Grover, Charu; Armour, Carol; Asperen, Peter Paul Van; Moles, Rebekah; Saini, Bandana

    2011-12-01

    The global burden of pediatric asthma is high. Governments and health-care systems are affected by the increasing costs of childhood asthma--in terms of direct health-care costs and indirect costs due to loss of parental productivity, missed school days, and hospitalizations. Despite the availability of effective treatment, the current use of medications in children with asthma is suboptimal. The purpose of this review is to scope the empirical literature to identify the problems associated with the use of pediatric asthma medications. The findings will help to design interventions aiming to improve the use of asthma medications among children. A literature search using electronic search engines (i.e., Medline, International Pharmaceutical Abstracts (IPA), PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) and the search terms "asthma," "children," and "medicines" (and derivatives of these keywords) was conducted. The search terms were expanded to include emergent themes arising out of search findings. Content themes relating to parents, children themselves, health-care professionals, organizational systems, and specific medications and devices were found. Within these themes, key issues included a lack of parental knowledge about asthma and asthma medications, lack of information provided to parents, parental beliefs and fears, parental behavioral problems, the high costs of medications and devices, the child's self-image, the need for more child responsibility, physician nonadherence to prescribing guidelines, "off-label" prescribing, poor understanding of teachers, lack of access to educational resources, and specific medications. These key issues should be taken into account when modifying the development of educational tools. These tools should focus on targeting the children themselves, the parent/carers, the health-care professionals, and various organizational systems.

  4. Classifying IS Project Problems

    DEFF Research Database (Denmark)

    Munk-Madsen, Andreas

    2006-01-01

    The literature contains many lists of IS project problems, often in the form of risk factors. The problems sometimes appear unordered and overlapping, which reduces their usefulness to practitioners as well as theoreticians. This paper proposes a list of criteria for formulating project problems...

  5. Teaching Biochemistry at a Medical Faculty with a Problem-Based Learning System.

    Science.gov (United States)

    Rosing, Jan

    1997-01-01

    Highlights the differences between classical teaching methods and problem-based learning. Describes the curriculum and problem-based approach of the Faculty of Medicine at the Maastricht University and gives an overview of the implementation of biochemistry in the medical curriculum. Discusses the procedure for student assessment and presents…

  6. How primary health care physicians make sick listing decisions: The impact of medical factors and functioning

    Directory of Open Access Journals (Sweden)

    Svärdsudd Kurt

    2008-01-01

    Full Text Available Abstract Background The decision to issue sickness certification in Sweden for a patient should be based on the physician's assessment of the reduction of the patient's work capacity due to a disease or injury, not on psychosocial factors, in spite of the fact that they are known as risk factors for sickness absence. The aim of this study was to investigate the influence of medical factors and functioning on sick listing probability. Methods Four hundred and seventy-four patient-physician consultations, where sick listing could be an option, in general practice in Örebro county, central Sweden, were documented using physician and patient questionnaires. Information sought was the physicians' assessments of causes and consequences of the patients' complaints, potential to recover, diagnoses and prescriptions on sick leave, and the patients' view of their family and work situation and functioning as well as data on the patients' former and present health situation. The outcome measure was whether or not a sickness certificate was issued. Multivariate analyses were performed. Results Complaints entirely or mainly somatic as assessed by the physician decreased the risk of sick listing, and complaints resulting in severe limitation of occupational work capacity, as assessed by the patient as well as the physician, increased the risk of sick listing, as did appointments for locomotor complaints. The results for patients with infectious diseases or musculoskeletal diseases were partly similar to those for all diseases. Conclusion The strongest predictors for sickness certification were patient's and GP's assessment of reduced work capacity, with a striking concordance between physician and patient on this assessment. When patient's complaints were judged to be non-somatic the risk of sickness certification was enhanced.

  7. Dialog about Psychosocial Issues in Problem-Based Learning Sessions in Medical Education

    Science.gov (United States)

    Adams, Nancy E.

    2016-01-01

    The purpose of this qualitative case study was two-fold: to investigate the dialog about psychosocial aspects of health care in problem based learning (PBL) groups in a single medical school; and to describe the factors that learners and PBL facilitators identify as influencing dialog about these issues in PBL groups. Medical education is a…

  8. Development and evaluation of a computer-based medical work assessment programme

    Directory of Open Access Journals (Sweden)

    Spallek Michael

    2008-12-01

    Full Text Available Abstract Background There are several ways to conduct a job task analysis in medical work environments including pencil-paper observations, interviews and questionnaires. However these methods implicate bias problems such as high inter-individual deviations and risks of misjudgement. Computer-based observation helps to reduce these problems. The aim of this paper is to give an overview of the development process of a computer-based job task analysis instrument for real-time observations to quantify the job tasks performed by physicians working in different medical settings. In addition reliability and validity data of this instrument will be demonstrated. Methods This instrument was developed in consequential steps. First, lists comprising tasks performed by physicians in different care settings were classified. Afterwards content validity of task lists was proved. After establishing the final task categories, computer software was programmed and implemented in a mobile personal computer. At least inter-observer reliability was evaluated. Two trained observers recorded simultaneously tasks of the same physician. Results Content validity of the task lists was confirmed by observations and experienced specialists of each medical area. Development process of the job task analysis instrument was completed successfully. Simultaneous records showed adequate interrater reliability. Conclusion Initial results of this analysis supported the validity and reliability of this developed method for assessing physicians' working routines as well as organizational context factors. Based on results using this method, possible improvements for health professionals' work organisation can be identified.

  9. 76 FR 78248 - Procurement List; Addition and Deletions

    Science.gov (United States)

    2011-12-16

    .... Service Type/Location: Laundry Service, Stratton Medical Center, 113 Holland Ave, Albany, NY. [[Page 78249...: Addition to and Deletions from the Procurement List. SUMMARY: This action adds a service to the Procurement... disabilities, and deletes products and services from the Procurement List previously furnished by such agencies...

  10. Medication management and practices in prison for people with mental health problems: a qualitative study

    OpenAIRE

    Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

    2009-01-01

    Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore ...

  11. #DDOD: Establishment Registration & Device Listing

    Data.gov (United States)

    U.S. Department of Health & Human Services — SUMMARY DDOD use case to request means on consolidating multiple data sources (MDR, PMA, 510(k), R&L) in order to build a list of all marketed medical devices....

  12. Medical support of children’s sports: Topical problems

    Directory of Open Access Journals (Sweden)

    L. A. Balykova

    2017-01-01

    Full Text Available The paper discusses the most topical issues of medical support of children and adolescents engaged in physical exercises and sports. Much attention is paid to different views on the etiology, pathogenesis, diagnosis, and principles of therapy of pathological transformation of the heart in child athletes. The problem of sudden cardiac death in sports and the possibility of a relationship between connective tissue dysplasia and its development are touched upon. Electrocardiographic and morphological criteria for cardiac maladaptation in athletes are discussed. The problem of early and accessible diagnosis and Russia’s tactics for the diagnosis of health changes in athletes and approaches to their prevention and treatment are covered. Different ways to prevent the pathological transformation of the cardiovascular system in athletes and sudden cardiac death as its extreme manifestation are discussed.

  13. Evaluation of Medication-related Self-care Skills in Patients With Cystic Fibrosis.

    Science.gov (United States)

    Lewis, Kelsey Lackey; John, Barnabas; Condren, Michelle; Carter, Sandra M

    2016-01-01

    BACKGROUND: As the life expectancy of patients with cystic fibrosis (CF) increases, the focus on ensuring success with medication therapies is increasingly important. The ability of patients to autonomously manage medications and related therapies is poorly described in the literature. OBJECTIVE: The goal of this project was to assess the level of medication-related knowledge and self-care skills in patients with CF. METHODS: This project took place in a Cystic Fibrosis Foundation accredited affiliate center. Eighty-nine patients between the ages of 6 and 60 were eligible to participate based on inclusion and exclusion criteria. Pharmacists administered a 16-item questionnaire and detailed medication history during clinic visits from January through May 2014. RESULTS: Forty-five patients 6 to 41 years old participated in the study. The skills most often performed independently were preparing nebulizer treatments (85%) and telling someone if they feel their medicines are causing a problem (89%). Skills least often performed were carrying a medication list (82%) and bringing a medication list to appointments (76%). In respondents 21 years of age and older, less than 75% of respondents were involved with obtaining financial resources, maintaining equipment, carrying a medication list, or rinsing their mouth after using inhaled medicines. Participants were able to provide drug name, dose, and frequency of use for pancreatic enzymes and azithromycin 37% and 24% of the time, respectively. CONCLUSIONS: In the population surveyed, many medication-related skills had not been acquired by early adulthood. Assessing and providing education for medication-related self-care skills at all ages are needed.

  14. An interactive problem-solving approach to teach traumatology for medical students.

    Science.gov (United States)

    Abu-Zidan, Fikri M; Elzubeir, Margaret A

    2010-08-13

    We aimed to evaluate an interactive problem-solving approach for teaching traumatology from perspectives of students and consider its implications on Faculty development. A two hour problem-solving, interactive tutorial on traumatology was structured to cover main topics in trauma management. The tutorial was based on real cases covering specific topics and objectives. Seven tutorials (5-9 students in each) were given by the same tutor with the same format for fourth and fifth year medical students in Auckland and UAE Universities (n = 50). A 16 item questionnaire, on a 7 point Likert-type scale, focusing on educational tools, tutor-based skills, and student-centered skills were answered by the students followed by open ended comments. The tutorials were highly ranked by the students. The mean values of educational tools was the highest followed by tutor-centered skills and finally student-centered skills. There was a significant increase of the rating of studied attributes over time (F = 3.9, p = 0.004, ANOVA). Students' open ended comments were highly supportive of the interactive problem-solving approach for teaching traumatology. The interactive problem-solving approach for tutorials can be an effective enjoyable alternative or supplement to traditional instruction for teaching traumatology to medical students. Training for this approach should be encouraged for Faculty development.

  15. The agency problem and medical acting: an example of applying economic theory to medical ethics.

    Science.gov (United States)

    Langer, Andreas; Schröder-Bäck, Peter; Brink, Alexander; Eurich, Johannes

    2009-03-01

    In this article, the authors attempt to build a bridge between economic theory and medical ethics to offer a new perspective to tackle ethical challenges in the physician-patient encounter. They apply elements of new institutional economics to the ethically relevant dimensions of the physician-patient relationship in a descriptive heuristic sense. The principal-agent theory can be used to analytically grasp existing action problems in the physician-patient relationship and as a basis for shaping recommendations at the institutional level. Furthermore, the patients' increased self-determination and modern opportunities for the medical laity to inform themselves lead to a less asymmetrical distribution of information between physician and patient and therefore require new interaction models. Based on the analysis presented here, the authors recommend that, apart from the physician's necessary individual ethics, greater consideration should be given to approaches of institutional ethics and hence to incentive systems within medical ethics.

  16. Prevalence of drug-related problems in self-medication in Danish community pharmacies

    Directory of Open Access Journals (Sweden)

    Bente Frøkjær

    2012-01-01

    Full Text Available Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this. Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems. Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies. Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines. Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner. Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect

  17. Prevalence of drug-related problems in self-medication in Danish community pharmacies

    Directory of Open Access Journals (Sweden)

    Charlotte Rossing

    2012-01-01

    Full Text Available Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this.Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems.Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies.Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines.Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner.Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect, unintended

  18. Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain.

    Science.gov (United States)

    Cranford, James A; Arnedt, J Todd; Conroy, Deirdre A; Bohnert, Kipling M; Bourque, Carrie; Blow, Frederic C; Ilgen, Mark

    2017-11-01

    To examine the prevalence and correlates of sleep problems in a sample of medical cannabis patients. Adults ages 21 and older (N=801,M age=45.8) who were seeking medical cannabis certification (either for the first time or as a renewal) for chronic pain at medical cannabis clinics in southern Michigan completed baseline measures of cannabis use, sleep, pain, and other related constructs. Over half of the sample (59%) met criteria for past 1-month sleep disturbance, defined as at least one sleep problem occurring on 15 or more nights in the past month. Most participants (86%) reported that sleep problems were due to their current pain. Approximately 80% of participants reported using cannabis in the past 6 months to improve sleep and, among these participants, cannabis was rated as helpful for improving sleep. Sleep-related cannabis side effects were rare (35%), but sleep-related cannabis withdrawal symptoms were relatively common (65%). Statistically significant correlates of past 1-month sleep disturbance included a) being female, b) being white, c) being on disability, d) not having a medical cannabis card, and e) frequency of using cannabis to help sleep. Sleep problems are highly prevalent and frequent in medical cannabis patients and are closely tied to pain. Sleep-related cannabis withdrawal symptoms are relatively common but their clinical relevance is unknown. The association between frequency of cannabis use to help sleep with higher odds of sleep problems will need to be clarified by longitudinal studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. An analysis of medical students’ reflective essays in problem-based learning

    Directory of Open Access Journals (Sweden)

    Jihyun Si

    2018-03-01

    Full Text Available Purpose This study aimed to explore students’ learning experience in problem-based learning (PBL particularly in terms of what they learned and how they learned in one Korean medical school by analyzing their reflective essays with qualitative research methods. Methods This study included 44 first-year medical students. They took three consecutive PBL courses and wrote reflective essays 3 times anonymously on the last day of each course. Their reflective essays were analyzed using an inductive content analysis method. Results The coding process yielded 16 sub-categories and these categories were grouped into six categories according to the distinctive characteristics of PBL learning experience: integrated knowledge base, clinical problem solving, collaboration, intrinsic motivation, self-directed learning, and professional attitude. Among these categories, integrated knowledge base (34.68% and professional attitude (2.31% were the categories mentioned most and least frequently. Conclusion The findings of this study provide an overall understanding of the learning experience of Korean medical students during PBL in terms of what they learned and how they learned with rich descriptive commentaries from their perspectives as well as several thoughtful insights to help develop instructional strategies to enhance the effectiveness of PBL.

  20. The effects of problem-based learning during medical school on physician competency: a systematic review.

    Science.gov (United States)

    Koh, Gerald Choon-Huat; Khoo, Hoon Eng; Wong, Mee Lian; Koh, David

    2008-01-01

    Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.

  1. Refinement of the distress management problem list as the basis for a holistic therapeutic conversation among UK patients with cancer.

    Science.gov (United States)

    Brennan, James; Gingell, Polly; Brant, Heather; Hollingworth, William

    2012-12-01

    Originally devised in the USA, the Distress Thermometer is being deployed in many cancer settings in the UK. It is commonly used with a Problem List (PL), which has never been validated with a UK population. This study aimed to refine the PL items based upon the concerns of a sample of UK patients attending a regional cancer centre. Existing versions of the PL were scrutinised by a focus group comprising five ex-patients, six health care staff and two academics. This group considered the intelligibility, ambiguity and redundancy of items, sometimes making alternative suggestions or pooling items. The resulting 46 candidate items were sent to 735 patients with mixed cancer, asking them to endorse items that had been 'a source of concern or distress' during their recently finished treatment. We used multivariate logistic regression to evaluate the association between the prevalence of problems and patient characteristics. In this study, 395 (53%) people responded. 'Fatigue, exhaustion or extreme tiredness' (70%), 'worry, fear or anxiety' (45%) and 'sleep problems' (38%) were the most frequently endorsed items. Items not appearing on the original PL were commonly endorsed such as 'memory or concentration' (30%) and 'loneliness or isolation' (15%), suggesting that they should be routinely included in the Distress Thermometer Problem List. The current study offers a more comprehensive PL, on the basis of actual patients' concerns, using words that are understood by UK patients. The reluctance of some patients to volunteer their concerns suggests that screening for distress should be undertaken within the context of a structured conversation. Copyright © 2011 John Wiley & Sons, Ltd.

  2. Active teaching-learning methodologies: medical students' views of problem-based learning

    Directory of Open Access Journals (Sweden)

    José Roberto Bittencourt Costa

    Full Text Available The prevailing undergraduate medical training process still favors disconnection and professional distancing from social needs. The Brazilian Ministries of Education and Health, through the National Curriculum Guidelines, the Incentives Program for Changes in the Medical Curriculum (PROMED, and the National Program for Reorientation of Professional Training in Health (PRO-SAÚDE, promoted the stimulus for an effective connection between medical institutions and the Unified National Health System (SUS. In accordance to the new paradigm for medical training, the Centro Universitário Serra dos Órgãos (UNIFESO established a teaching plan in 2005 using active methodologies, specifically problem-based learning (PBL. Research was conducted through semi-structured interviews with third-year undergraduate students at the UNIFESO Medical School. The results were categorized as proposed by Bardin's thematic analysis, with the purpose of verifying the students' impressions of the new curriculum. Active methodologies proved to be well-accepted by students, who defined them as exciting and inclusive of theory and practice in medical education.

  3. A snapshot of residents in medical oncology in Turkey: A Nationwide survey on profile and key problems

    Directory of Open Access Journals (Sweden)

    Erdinc Nayir

    2016-04-01

    Conclusion: Recognition of the subspecialty residents who are the future of medical oncology, and determination of their needs, and problems will contribute to the development of recommendations for their solution. In our country their main problems are medical conscription, inadequate education, and burnout.

  4. National Coal Board Medical Service annual report 1981-82

    Energy Technology Data Exchange (ETDEWEB)

    1983-01-01

    Sections report on: medical examinations and consultations; protection from health hazards, such as pneumoconiosis and other prescribed diseases; problems such as vitamin D in miners' blood, Legionnaires' disease, rehabilitation and physiotherapy, high pressure injection injuries, pump packing; National Coal Board (Coal Products) Ltd.; injuries and treatment; and nursing service. A list of staff and their publications and a supplement on occupational toxicology are included.

  5. Medics on the Move South Africa: Access to Medical Words

    Directory of Open Access Journals (Sweden)

    Kris Van de Poel

    2013-12-01

    Full Text Available South African medical students who are Cuban-trained and therefore Spanish- speaking, on their return to South Africa need to learn medical vocabulary, terminology, and appropriate interactional discourse in the two major languages of English and Afrikaans, in order to be able to practise professional medicine effectively and efficiently. Indeed, their language problems are further compounded by differences in medical equipment and in medical practices between Cuba and South Africa. To meet these particular students’ needs and provide a communication support tool, the concept of a paper-based pocket-size multi-lingual illustrated dictionary was introduced as an additional component in a blended learning approach, to complement online materials called MoM-SA. The dictionary, to which students are invited to add material, has word lists in English, Afrikaans and Spanish, and offers links to the online materials. Students can add terminology, translations into other African languages and images, so that the dictionary grows and reflects the everyday needs of the students, who, at the same time, become co-owners of the dictionary; thus, process has become content and, as a result, learner motivation has increased.

  6. Problems on Divisibility of Binomial Coefficients

    Science.gov (United States)

    Osler, Thomas J.; Smoak, James

    2004-01-01

    Twelve unusual problems involving divisibility of the binomial coefficients are represented in this article. The problems are listed in "The Problems" section. All twelve problems have short solutions which are listed in "The Solutions" section. These problems could be assigned to students in any course in which the binomial theorem and Pascal's…

  7. Benefits and problems in implementation for integrated medical information system

    International Nuclear Information System (INIS)

    Park, Chang Seo; Kim, Kee Deog; Park, Hyok; Jeong, Ho Gul

    2005-01-01

    Once the decision has been made to adopt an integrated medical information system (IMIS), there are a number of tissues to overcome. Users need to be aware of the impact the change will make on end users and be prepared to address issues that arise before they become problems. The purpose of this study is to investigate the benefits and unexpected problems encountered in the implementation of IMIS and to determine a useful framework for IMIS. The Yonsei University Dental Hospital is steadily constructing an IMIS. The vendor's PACS software, Piview STAR, supports transactions between workstations that are approved to integrating the health care enterprise (IHE) with security function. It is necessary to develop an excellent framework that is good for the patient, health care provider and information system vendors, in an expert, efficient, and cost-effective manner. The problems encountered with IMIS implementation were high initial investments, delay of EMR enforcement, underdevelopment of digital radiographic appliances and software and insufficient educational training for users. The clinical environments of dental IMIS is some different from the medical situation. The best way to overcome these differences is to establish a gold standard of dental IMIS integration, which estimates the cost payback. The IHE and its technical framework are good for the patient, the health care provider and all information systems vendors.

  8. Feasibility of a self-administered survey to identify primary care patients at risk of medication-related problems

    Directory of Open Access Journals (Sweden)

    Makowsky MJ

    2014-02-01

    Full Text Available Mark J Makowsky,1 Andrew J Cave,2 Scot H Simpson1 1Faculty of Pharmacy and Pharmaceutical Sciences, 2Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada Background and objectives: Pharmacists working in primary care clinics are well positioned to help optimize medication management of community-dwelling patients who are at high risk of experiencing medication-related problems. However, it is often difficult to identify these patients. Our objective was to test the feasibility of a self-administered patient survey, to facilitate identification of patients at high risk of medication-related problems in a family medicine clinic. Methods: We conducted a cross-sectional, paper-based survey at the University of Alberta Hospital Family Medicine Clinic in Edmonton, Alberta, which serves approximately 7,000 patients, with 25,000 consultations per year. Adult patients attending the clinic were invited to complete a ten-item questionnaire, adapted from previously validated surveys, while waiting to be seen by the physician. Outcomes of interest included: time to complete the questionnaire, staff feedback regarding impact on workflow, and the proportion of patients who reported three or more risk factors for medication-related problems. Results: The questionnaire took less than 5 minutes to complete, according to the patient's report on the last page of the questionnaire. The median age (and interquartile range of respondents was 57 (45–69 years; 59% were women; 47% reported being in very good or excellent health; 43 respondents of 100 had three or more risk factors, and met the definition for being at high risk of a medication-related problem. Conclusions: Distribution of a self-administered questionnaire did not disrupt patients, or the clinic workflow, and identified an important proportion of patients at high risk of medication-related problems. Keywords: screening tool, pharmacists, primary

  9. Sonography and hypotension: a change to critical problem solving in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Amini R

    2016-01-01

    Full Text Available Richard Amini, Lori A Stolz, Nicholas C Hernandez, Kevin Gaskin, Nicola Baker, Arthur Barry Sanders, Srikar AdhikariDepartment of Emergency Medicine, University of Arizona Medical Center, College of Medicine, University of Arizona, Tucson, AZ, USAStudy objectives: Multiple curricula have been designed to teach medical students the basics of ultrasound; however, few focus on critical problem-solving. The objective of this study is to determine whether a theme-based ultrasound teaching session, dedicated to the use of ultrasound in the management of the hypotensive patient, can impact medical students’ ultrasound education and provide critical problem-solving exercises.Methods: This was a cross-sectional study using an innovative approach to train 3rd year medical students during a 1-day ultrasound training session. The students received a 1-hour didactic session on basic ultrasound physics and knobology and were also provided with YouTube hyperlinks, and links to smart phone educational applications, which demonstrated a variety of bedside ultrasound techniques. In small group sessions, students learned how to evaluate patients for pathology associated with hypotension. A knowledge assessment questionnaire was administered at the end of the session and again 3 months later. Student knowledge was also assessed using different clinical scenarios with multiple-choice questions.Results: One hundred and three 3rd year medical students participated in this study. Appropriate type of ultrasound was selected and accurate diagnosis was made in different hypotension clinical scenarios: pulmonary embolism, 81% (95% CI, 73%–89%; abdominal aortic aneurysm, 100%; and pneumothorax, 89% (95% CI, 82%–95%. The average confidence level in performing ultrasound-guided central line placement was 7/10, focused assessment with sonography for trauma was 8/10, inferior vena cava assessment was 8/10, evaluation for abdominal aortic aneurysm was 8/10, assessment for

  10. Tracks to a Medical Diagnosis: Expertise Differences in Visual Problem Solving

    NARCIS (Netherlands)

    Jaarsma, Thomas; Boshuizen, Els; Jarodzka, Halszka; Nap, Marius; Verboon, Peter; Van Merriënboer, Jeroen

    2018-01-01

    This study focuses on the visual problem-solving process of clinical pathologists. Its aim is to find expertise-related differences in the temporal arrangement of this process, with a special focus on the orientation phase. A theoretical model of the visual diagnostic process of medical specialists

  11. Medication management and practices in prison for people with mental health problems: a qualitative study.

    Science.gov (United States)

    Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

    2009-10-20

    Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely to be doubly vulnerable because of inconsistencies in substance

  12. Documenting clinical performance problems among medical students: feedback for learner remediation and curriculum enhancement

    Directory of Open Access Journals (Sweden)

    Brian E. Mavis

    2013-07-01

    Full Text Available Introduction: We operationalized the taxonomy developed by Hauer and colleagues describing common clinical performance problems. Faculty raters pilot tested the resulting worksheet by observing recordings of problematic simulated clinical encounters involving third-year medical students. This approach provided a framework for structured feedback to guide learner improvement and curricular enhancement. Methods: Eighty-two problematic clinical encounters from M3 students who failed their clinical competency examination were independently rated by paired clinical faculty members to identify common problems related to the medical interview, physical examination, and professionalism. Results: Eleven out of 26 target performance problems were present in 25% or more encounters. Overall, 37% had unsatisfactory medical interviews, with ‘inadequate history to rule out other diagnoses’ most prevalent (60%. Seventy percent failed because of physical examination deficiencies, with missing elements (69% and inadequate data gathering (69% most common. One-third of the students did not introduce themselves to their patients. Among students failing based on standardized patient (SP ratings, 93% also failed to demonstrate competency based on the faculty ratings. Conclusions: Our review form allowed clinical faculty to validate pass/fail decisions based on standardized patient ratings. Detailed information about performance problems contributes to learner feedback and curricular enhancement to guide remediation planning and faculty development.

  13. Problem based learning in medical education: theory, rationale, process and implications for pakistan.

    Science.gov (United States)

    Baig, Lubna A

    2006-09-01

    Historically, lectures were the medium to transfer cognitive information to the learners in medical education. Apprenticeship training, labs, bedside teaching, tutorials etc. were used to impart psychomotor and affective skills. It was assumed that the learner will assimilate all this knowledge and will be competent to apply this learning in practical life. Problem-based learning (PBL) emerged due to problems in building the appropriate competencies in the medical graduates and is a relatively newer mode of transfer of knowledge. This paper will deal with problem-based learning which took the world with storm in the 80's and most institutions in the world started using different variants of PBL. This paper attempts to define and explore the theoretical basis and historical background of PBL. The paper will systematically review literature and argue about the advantages and disadvantages of PBL and the implications of its implementation in Pakistan.

  14. Pharmacotherapeutic Problems and Pharmacist Interventions in a Medical Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Tae Yun Park

    2015-05-01

    Full Text Available Background: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. Methods: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. Results: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%, followed by parenteral/enteral nutritional support (n = 228, 18.1%, the provision of drug information (n = 228, 18.1%, and advice regarding pharmacokinetics (n = 118, 9.3%. Antimicrobial agents (n = 516, 42.6% were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%. Conclusions: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.

  15. Teaching medical students to discern ethical problems in human clinical research studies.

    Science.gov (United States)

    Roberts, Laura Weiss; Warner, Teddy D; Green Hammond, Katherine A; Brody, Janet L; Kaminsky, Alexis; Roberts, Brian B

    2005-10-01

    Investigators and institutional review boards are entrusted with ensuring the conduct of ethically sound human studies. Assessing ethical aspects of research protocols is a key skill in fulfilling this duty, yet no empirically validated method exists for preparing professionals to attain this skill. The authors performed a randomized controlled educational intervention, comparing a criteria-based learning method, a clinical-research- and experience-based learning method, and a control group. All 300 medical students enrolled at the University of New Mexico School of Medicine in 2001 were invited to participate. After a single half-hour educational session, a written posttest of ability to detect ethical problems in hypothetical protocol vignettes was administered. The authors analyzed responses to ten protocol vignettes that had been evaluated independently by experts. For each vignette, a global assessment of the perceived significance of ethical problems and the identification of specific ethical problems were evaluated. Eighty-three medical students (27%) volunteered: 50 (60%) were women and 55 (66%) were first- and second-year students. On global assessments, the criteria-focused group perceived ethical problems as more significant than did the other two groups (p evaluation skills. This work supports the potential value of empirically derived methods for preparing professionals to discern ethical aspects of human studies.

  16. Protection of Bulgarian population in medical radiation diagnostic science after 1950. Some basic problems

    International Nuclear Information System (INIS)

    Ingilizova, Kr.

    2000-01-01

    The report presents summarized data on frequency and structure of X-ray and nuclear medical examinations carried out in Bulgaria during the period 1950-1995. The effective and the collective effective dose are calculated. Some on the basic problems concerning the protection of Bulgarian population during medical exposure are outlined

  17. EFFECTIVENESS OF PROBLEM BASED LEARNING AS A STRATEGY TO FOSTER PROBLEM SOLVING AND CRITICAL REASONING SKILLS AMONG MEDICAL STUDENTS.

    Science.gov (United States)

    Asad, Munazza; Iqbal, Khadija; Sabir, Mohammad

    2015-01-01

    Problem based learning (PBL) is an instructional approach that utilizes problems or cases as a context for students to acquire problem solving skills. It promotes communication skills, active learning, and critical thinking skills. It encourages peer teaching and active participation in a group. It was a cross-sectional study conducted at Al Nafees Medical College, Isra University, Islamabad, in one month duration. This study was conducted on 193 students of both 1st and 2nd year MBBS. Each PBL consists of three sessions, spaced by 2-3 days. In the first session students were provided a PBL case developed by both basic and clinical science faculty. In Session 2 (group discussion), they share, integrate their knowledge with the group and Wrap up (third session), was concluded at the end. A questionnaire based survey was conducted to find out overall effectiveness of PBL sessions. Teaching through PBLs greatly improved the problem solving and critical reasoning skills with 60% students of first year and 71% of 2nd year agreeing that the acquisition of knowledge and its application in solving multiple choice questions (MCQs) was greatly improved by these sessions. They observed that their self-directed learning, intrinsic motivation and skills to relate basic concepts with clinical reasoning which involves higher order thinking have greatly enhanced. Students found PBLs as an effective strategy to promote teamwork and critical thinking skills. PBL is an effective method to improve critical thinking and problem solving skills among medical students.

  18. Making Capability Lists: Philosophy versus Democracy

    NARCIS (Netherlands)

    Claassen, R.J.G.

    2011-01-01

    The article discusses a fundamental problem that has to be faced if the general capability approach is to be developed in the direction of a theory of justice: the selection and justification of a list of capabilities. The democratic solution to this problem (defended by Amartya Sen) is to leave the

  19. Sick-listed employees with severe medically unexplained physical symptoms: burden or routine for the occupational health physician? A cross sectional study

    Directory of Open Access Journals (Sweden)

    Koopmans Petra C

    2010-11-01

    Full Text Available Abstract Background The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs, and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS. Third objective was to determine which disease-, patient-, doctor- and practice-related factors are associated with the difficulties and needs of the OHPs. Methods In this cross-sectional study, 43 participating OHPs from 5 group practices assessed 489 sick-listed employees with and without severe MUPS. The OHPs filled in a questionnaire about difficulties concerning sickness certification tasks, consultation time, their needs with regard to consultation with or referral to a psychiatrist or psychologist, and communication with GPs. The OHPs also completed a questionnaire about their personal characteristics. Results OHPs only experienced task difficulties in employees with severe MUPS in relation to their communication with the treating physician. This only occured in cases in which the OHP attributed the physical symptoms to somatoform causes. If they attributed the physical symptoms to mental causes, the OHPs reported a need to consultate a psychiatrist about the diagnosis and treatment. Conclusions OHPs experience few difficulties with their sickness certification tasks and consultation load concerning employees with severe MUPS. However, they encounter problems if the diagnostic uncertainties of the treating physician interfere with the return to work process. OHPs have a need for psychiatric expertise whenever they are uncertain about the psychiatric causes of a delayed return to work process. We recommend further training programs for OHPs. They should also have more opportunity for consultation and referral to a psychiatrist, and their communication with treating physicians should be improved.

  20. The efficacy and usefulness of problem based learning in undergraduate medical school education of radiation oncology

    International Nuclear Information System (INIS)

    Uchino, Minako; Itazawa, Tomoko; Someya, Masanori; Nakamura, Satoaki

    2007-01-01

    The Japanese Association for Therapeutic Radiation Oncology (JASTRO) holds a seminar for medical students every summer, which has developed into a joint program with a session addressing radiation treatment planning. To clarify this topic for medical students, we have incorporated Problem Based Learning skills into the session. Not only has the students' comprehension improved but the instructors have also found this teaching experience valuable and productive in advancing their own clinical skills. Our experience suggests that the application of this Problem Based Learning session for radiation treatment planning in undergraduate medical school education has proven to be effective. (author)

  1. A Selected List of Urban, Environmental and Social Problem Gaming/Simulations. Revised Edition.

    Science.gov (United States)

    Steinwachs, Barbara

    This revised list includes games/simulations for all age levels, though often most applicable at the secondary through adult levels. In her reviews of available products, the author limited her listings to those games/simulations which are useful for educational purposes and which focus directly on social concerns relative to urban and…

  2. Non-medical influences on medical decision-making.

    Science.gov (United States)

    McKinlay, J B; Potter, D A; Feldman, H A

    1996-03-01

    The influence of non-medical factors on physicians' decision-making has been documented in many observational studies, but rarely in an experimental setting capable of demonstrating cause and effect. We conducted a controlled factorial experiment to assess the influence of non-medical factors on the diagnostic and treatment decisions made by practitioners of internal medicine in two common medical situations. One hundred and ninety-two white male internists individually viewed professionally produced video scenarios in which the actor-patient, presenting with either chest pain or dyspnea, possessed various balanced combinations of sex, race, age, socioeconomic status, and health insurance coverage. Physician subjects were randomly drawn from lists of internists in private practice, hospital-based practice, and HMO's, at two levels of experience. The most frequent diagnoses for both chest pain and dyspnea were psychogenic origin and cardiac problems. Smoking cessation was the most frequent treatment recommendation for both conditions. Younger patients (all other factors being the same) were significantly more likely to receive the psychogenic diagnosis. Older patients were more likely to receive the cardiac diagnosis for chest pain, particularly if they were insured. HMO-based physicians were more likely to recommend a follow-up visit for chest pain. Several interactions of patient and physician factors were significant in addition to the main effects. The variability in decision-making evidenced by physicians in this experiment was not entirely accounted for by strictly rational Bayesian inference (the common prescriptive model for medical decision-making), in-as-much as non-medical factors significantly affected the decisions that they made. There is a need to supplement idealized medical schemata with considerations of social behavior in any comprehensive theory of medical decision-making.

  3. [Medical data security in medico-legal opinioning].

    Science.gov (United States)

    Susło, Robert; Swiatek, Barbara

    2005-01-01

    Medical data security can be approached in medico-legal opinioning in three main situations: security of medical data, on which the opinion should be based, opinioning itself and whether the medical data security was properly ensured and ensuring medical data security during medico-legal opinion giving. The importance of medical data security, during collecting, processing and storing, as well in medical as in legal institutions, is of major importance for the possibility of providing a proper medico-legal opinion. Theoretically speeking, it is possible to give a proper medico-legal opinion using incorrect data, but the possibility is low. When the expert is given improper, unreadable, incomplete or even bogus in part or in the whole medical data it is extremely possible, that he fails in giving his opinion. The term "medical data" was defined and subsequently there was a brief review of medical data storing methods made and specific threats bound with them, based on modern literature. The authors also pointed out possible methods of preventing the threats. They listed Polish as well as international regulations and laws concerning the problem, accenting the importance of preserving medical data for the purposes of medico-legal opinioning.

  4. List of reports in reactor safety research by BMFT, EPRI, JSTA, and USNRC

    International Nuclear Information System (INIS)

    1981-05-01

    This list reviews reports from the Federal Republic of Germany, from the United States of America and from Japan concerning special problems in the field of reactor safety research. The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Program of BMFT, reporting organisation. The list of reports appears quarterly. (orig./HP) [de

  5. The documentation of health problems in relation to prescribed medication in people with profound intellectual and multiple disabilities

    NARCIS (Netherlands)

    van der Heide, D. C.; van der Putten, A. A. J.; van den Berg, P. B.; Taxis, K.; Vlaskamp, C.

    Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed.

  6. The top-cited articles in medical education: a bibliometric analysis.

    Science.gov (United States)

    Azer, Samy A

    2015-08-01

    To identify and examine the characteristics of the 50 top-cited articles in medical education. Two searches were conducted in the Web of Knowledge database in March 2014: a search of medical education journals in the category "Education, Scientific Discipline" (List A) and a keyword search across all journals (List B). Articles identified were reviewed for citation count, country of origin, article type, journal, authors, and publication year. Both lists included 56 articles, not 50, because articles with the same absolute number of citations shared the same rank. The majority of List A articles were published in Academic Medicine (34; 60.7%) and Medical Education (16; 28.6%). In List B, 27 articles (48.2%) were published in medical education journals, 19 (33.9%) in general medicine and surgery journals, and 10 (17.9%) in higher education and educational psychology journals. Twenty-six articles were included in both lists, with different rankings. Reviews and articles constituted the majority of articles; there were only 8 research papers in List A and 13 in List B. Articles mainly originated from the United States, Canada, the Netherlands, and the United Kingdom. The majority were published from 1979 to 2007. There was no correlation between year and citation count. The finding that over half of List B articles were published in nonmedical education journals is consistent with medical education's integrated nature and subspecialty breadth. Twenty of these articles were among their respective non-medical-education journals' 50 top-cited papers, showing that medical education articles can compete with subject-based articles.

  7. Medication management and practices in prison for people with mental health problems: a qualitative study

    Directory of Open Access Journals (Sweden)

    Rogers Anne

    2009-10-01

    Full Text Available Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS. Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. Methods The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Results and Discussion Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely

  8. Effect of training problem-solving skill on decision-making and critical thinking of personnel at medical emergencies

    Science.gov (United States)

    Heidari, Mohammad; Shahbazi, Sara

    2016-01-01

    Background: The aim of this study was to determine the effect of problem-solving training on decision-making skill and critical thinking in emergency medical personnel. Materials and Methods: This study is an experimental study that performed in 95 emergency medical personnel in two groups of control (48) and experimental (47). Then, a short problem-solving course based on 8 sessions of 2 h during the term, was performed for the experimental group. Of data gathering was used demographic and researcher made decision-making and California critical thinking skills questionnaires. Data were analyzed using SPSS software. Results: The finding revealed that decision-making and critical thinking score in emergency medical personnel are low and problem-solving course, positively affected the personnel’ decision-making skill and critical thinking after the educational program (P problem-solving in various emergency medicine domains such as education, research, and management, is recommended. PMID:28149823

  9. Predictors of prescribed medication use for depression, anxiety, stress, and sleep problems in mid-aged Australian women.

    Science.gov (United States)

    Schofield, Margot J; Khan, Asaduzzaman

    2014-11-01

    The study examined prevalence of self-reported use of medication recommended or prescribed by a doctor for depression, anxiety, stress, and sleep problems; and modelled baseline factors that predicted use over 3 years for each condition. Analyses were undertaken on the 2001 and 2004 surveys of mid-aged women in the Australian Longitudinal Study on Women's Health. Dependent variables were self-reported use in past 4 weeks of medications recommended or prescribed by a doctor for depression, anxiety, stress, or sleep problems in 2001 and 2004. Generalized Estimating Equations (GEE) were used to predict medication use for each condition over 3 years. Prevalence of prescribed medication use (2001, 2004) for each condition was depression (7.2, 8.9 %), anxiety (7.4, 9.0 %), stress (4.8, 5.7 %), and sleep problems (8.7, 9.5 %). Multivariable analyses revealed that odds of medication use across 3 years in all four conditions were higher for women with poorer mental and physical health, using hormone replacement therapy (HRT), or having seen a counsellor; and increased over time for depression, anxiety, and stress models. Medication use for depression was also higher for overweight/obese women, ex-smokers, and unmarried. Medication use for anxiety was higher for unmarried and non-working/low occupational women. Medication use for stress was higher for non-working women. Additional predictors of medication for sleep were surgical menopause, and area of residence. Self-reported use of prescribed medication for four mental health conditions is increased over time after controlling for mental and physical health and other variables. Research needs to explore decision-making processes influencing differential rates of psychoactive medication use and their relationship with health outcomes.

  10. [Child-pedestrian injuries inflicted in the road traffic accidents as a forensic medical problem].

    Science.gov (United States)

    Savenkova, E N; Efimov, A A

    The road traffic accidents are known to make the greatest contribution to the overall structure of pediatric traumatism with the fatal outcome. The problem of pediatric traumatism remains on top of its relevancy despite numerous administrative, legal, technical, and financial measures taken at the government level in an attempt to reduce the mortality rate associated with the child-pedestrian injuries inflicted in the road traffic accidents. The objective of the present study was to summarize and interpret the results published in the scientific literature concerning child-pedestrian injuries inflicted in the road traffic accidents with special reference to the age of the victims and the type of the injury. The analysis of the publications of the domestic and foreign authors has demonstrated that the available data of interest remain to be systematized and that the forensic medical aspects of the problem in question are poorly represented in these materials. It was shown that forensic medical expertises of child-pedestrian injuries inflicted in the road traffic accidents are frequently carried out without taking into consideration the peculiar anatomical and physiological features of the child's organism. The available data concerning the mechanisms and evaluation of severe injuries inflicted to the children in the road traffic accidents are insufficient for the development of the algorithms for the relevant adequate forensic medical expertise. In the light of these findings, the problem of the child-pedestrian injuries inflicted in the road traffic accidents takes on new significance when considered in the context of pediatric traumatism. There is evidently the growing necessity to formulate the universal database containing systematized objective information for the development of new methods of forensic medical expertise for the elucidation of the mechanisms of road traffic injuries inflicted to the children of different age groups depending on the type of the

  11. Benefit of Problem-Based Learning for Psychosocial Medicine: first experiences at the medical faculty of berne

    OpenAIRE

    Laederach-Hofmann, Kurt; Stadelmann, Barbara; Isenschmid, Bettina

    2005-01-01

    Aim: Presentation of skills and knowledge of medical students in psychiatry or psychosocial medicine in basic study (year 1 to 3) after the introduction of a problem oriented learning curriculum at the Medical Faculty of Berne.Method: Description of the curriculum with the different teaching units, and the evaluation by means of formative tools used by students and tutors.Results: With reference to qualitative comparison students of the problem based learning track showed a better preparation...

  12. Investigation of medical board reports of disability due to mental health problems

    Directory of Open Access Journals (Sweden)

    Mesut Yildiz

    2016-06-01

    Conclusion: We think that this report might be helpful for regulations related to disabled people, and might guide adult psychiatric services for patients who present to medical boards for disability due to mental health problems. [Cukurova Med J 2016; 41(2.000: 253-258

  13. Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record.

    Science.gov (United States)

    Wright, Adam; Sittig, Dean F; McGowan, Julie; Ash, Joan S; Weed, Lawrence L

    2014-01-01

    Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software--over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done. 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.

  14. Organisational fundamentals of medical care in catastrophes

    International Nuclear Information System (INIS)

    Ahnefeld, F.W.

    1983-01-01

    The author presents definitions, considerations, and fundamentals of discussion. He starts by listing the institutions, equipment and traning required for medical care and life-saving services in cases of emergency. A central coordination service for medical care and life saving is proposed. The present situation is reviewed, future needs are stated, and the necessary components of a medical service are listed. (DG) [de

  15. Assessing Personality and Mood With Adjective Check List Methodology: A Review

    Science.gov (United States)

    Craig, Robert J.

    2005-01-01

    This article addresses the benefits and problems in using adjective check list methodology to assess personality. Recent developments in this assessment method are reviewed, emphasizing seminal adjective-based personality tests (Gough's Adjective Check List), mood tests (Lubin's Depressive Adjective Test, Multiple Affect Adjective Check List),…

  16. Are survivors who report cancer-related financial problems more likely to forgo or delay medical care?

    Science.gov (United States)

    Kent, Erin E; Forsythe, Laura P; Yabroff, K Robin; Weaver, Kathryn E; de Moor, Janet S; Rodriguez, Juan L; Rowland, Julia H

    2013-10-15

    Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. The authors identified cancer survivors diagnosed as adults (n=1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%-34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all Pfinancial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. Copyright © 2013 American Cancer Society.

  17. Are Survivors Who Report Cancer-Related Financial Problems More Likely to Forgo or Delay Medical Care?

    Science.gov (United States)

    Kent, Erin E.; Forsythe, Laura P.; Yabroff, K. Robin; Weaver, Kathryn E.; de Moor, Janet S.; Rodriguez, Juan L.; Rowland, Julia H.

    2015-01-01

    BACKGROUND Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. METHODS The authors identified cancer survivors diagnosed as adults (n = 1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. RESULTS Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%–34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all Pfinancial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. PMID:23907958

  18. Problems of overcoming medical consequences of nuclear tests at the former Semipalatinsk test site (STS)

    International Nuclear Information System (INIS)

    Devyatko, V.N.

    1997-01-01

    Tests conducted for many years resulted in large radioactive contamination of Semipalatinsk, East Kazakhstan, Pavlodar and Karaganda regions. About 1,5 million people underwent multiple acute and chronic influence of small ionizing radiation doses basically.In this connection Ministry of Heals Protection and Social Protection Organizations are worried about the problem of recovering and rehabilitating the population of the above regions. to solve these problems Ministry of Health Protection Republic of Kazakhstan established Scientific Research Institutes of Medicine and Ecology in Semipalatinsk and regional Medical and Diagnostic Center in Kurchatov. With the help of regional Administrations there were created medical centers: diagnostic, children's, recovering, ophthalmological, of motherhood and childhood protection. Work on creating State National Medical Registration for people who underwent influence of ionizing radiation is being performed

  19. Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study.

    Science.gov (United States)

    Borst, Jorien M; Frings-Dresen, Monique H W; Sluiter, Judith K

    2016-11-01

    A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems among Dutch medical students and, second, to study which study-related and personal factors present a risk of these mental health problems. A 1-year prospective longitudinal study was performed among medical students of two medical faculties in the Netherlands (n=951). Health problems and study-related and personal factors were measured with an online questionnaire. Mental health problems were assessed by depression and/or anxiety symptoms (BSI-DEP and BSI-ANG). Univariate and multivariate hierarchical logistic regression analyses were performed to examine which of the study-related and personal factors predict mental health problems. At follow-up, 36%, 28% and 48% of the medical students reported symptoms of depression, anxiety and mental health problems, respectively. The incidence between 2010 and 2011 for depression was 20%, 17% for anxiety and 25% for mental health problems. Students who are worried about their own health during medical education are at an increased risk of future mental health problems (OR 2.0 [1.3-2.9], p=0.00). Excessive drinking behavior is a protective factor in this study (OR 0.7 [0.5-0.9], p=0.02). This study shows that only two out of nine factors are significantly associated with mental health problems among Dutch medical students, one risk factor and one protective factor.

  20. Trained student pharmacists’ telephonic collection of patient medication information: Evaluation of a structured interview tool

    Science.gov (United States)

    Margolis, Amanda R.; Martin, Beth A.; Mott, David A.

    2016-01-01

    Objective To determine the feasibility and fidelity of student pharmacists collecting patient medication list information using a structured interview tool and the accuracy of documenting the information. The medication lists were used by a community pharmacist to provide a targeted medication therapy management (MTM) intervention. Design Descriptive analysis of patient medication lists collected via telephone interviews. Participants 10 trained student pharmacists collected the medication lists. Intervention Trained student pharmacists conducted audio-recorded telephone interviews with 80 English-speaking community dwelling older adults using a structured interview tool to collect and document medication lists. Main outcome measures Feasibility was measured using the number of completed interviews, the time student pharmacists took to collect the information, and pharmacist feedback. Fidelity to the interview tool was measured by assessing student pharmacists’ adherence to asking all scripted questions and probes. Accuracy was measured by comparing the audio recorded interviews to the medication list information documented in an electronic medical record. Results On average it took student pharmacists 26.7 minutes to collect the medication lists. The community pharmacist said the medication lists were complete and that having the medication lists saved time and allowed him to focus on assessment, recommendations, and education during the targeted MTM session. Fidelity was high with an overall proportion of asked scripted probes of 83.75% (95%CI: 80.62–86.88%). Accuracy was also high for both prescription (95.1%, 95%CI: 94.3–95.8%) and non-prescription (90.5%, 95%CI: 89.4–91.4%) medications. Conclusion Trained student pharmacists were able to use an interview tool to collect and document medication lists with a high degree of fidelity and accuracy. This study suggests that student pharmacists or trained technicians may be able to collect patient medication

  1. Trained student pharmacists' telephonic collection of patient medication information: Evaluation of a structured interview tool.

    Science.gov (United States)

    Margolis, Amanda R; Martin, Beth A; Mott, David A

    2016-01-01

    To determine the feasibility and fidelity of student pharmacists collecting patient medication list information using a structured interview tool and the accuracy of documenting the information. The medication lists were used by a community pharmacist to provide a targeted medication therapy management (MTM) intervention. Descriptive analysis of patient medication lists collected with telephone interviews. Ten trained student pharmacists collected the medication lists. Trained student pharmacists conducted audio-recorded telephone interviews with 80 English-speaking, community-dwelling older adults using a structured interview tool to collect and document medication lists. Feasibility was measured using the number of completed interviews, the time student pharmacists took to collect the information, and pharmacist feedback. Fidelity to the interview tool was measured by assessing student pharmacists' adherence to asking all scripted questions and probes. Accuracy was measured by comparing the audio-recorded interviews to the medication list information documented in an electronic medical record. On average, it took student pharmacists 26.7 minutes to collect the medication lists. The community pharmacist said the medication lists were complete and that having the medication lists saved time and allowed him to focus on assessment, recommendations, and education during the targeted MTM session. Fidelity was high, with an overall proportion of asked scripted probes of 83.75% (95% confidence interval [CI], 80.62-86.88%). Accuracy was also high for both prescription (95.1%; 95% CI, 94.3-95.8%) and nonprescription (90.5%; 95% CI, 89.4-91.4%) medications. Trained student pharmacists were able to use an interview tool to collect and document medication lists with a high degree of fidelity and accuracy. This study suggests that student pharmacists or trained technicians may be able to collect patient medication lists to facilitate MTM sessions in the community pharmacy

  2. Sonography and hypotension: a change to critical problem solving in undergraduate medical education.

    Science.gov (United States)

    Amini, Richard; Stolz, Lori A; Hernandez, Nicholas C; Gaskin, Kevin; Baker, Nicola; Sanders, Arthur Barry; Adhikari, Srikar

    2016-01-01

    Multiple curricula have been designed to teach medical students the basics of ultrasound; however, few focus on critical problem-solving. The objective of this study is to determine whether a theme-based ultrasound teaching session, dedicated to the use of ultrasound in the management of the hypotensive patient, can impact medical students' ultrasound education and provide critical problem-solving exercises. This was a cross-sectional study using an innovative approach to train 3rd year medical students during a 1-day ultrasound training session. The students received a 1-hour didactic session on basic ultrasound physics and knobology and were also provided with YouTube hyperlinks, and links to smart phone educational applications, which demonstrated a variety of bedside ultrasound techniques. In small group sessions, students learned how to evaluate patients for pathology associated with hypotension. A knowledge assessment questionnaire was administered at the end of the session and again 3 months later. Student knowledge was also assessed using different clinical scenarios with multiple-choice questions. One hundred and three 3rd year medical students participated in this study. Appropriate type of ultrasound was selected and accurate diagnosis was made in different hypotension clinical scenarios: pulmonary embolism, 81% (95% CI, 73%-89%); abdominal aortic aneurysm, 100%; and pneumothorax, 89% (95% CI, 82%-95%). The average confidence level in performing ultrasound-guided central line placement was 7/10, focused assessment with sonography for trauma was 8/10, inferior vena cava assessment was 8/10, evaluation for abdominal aortic aneurysm was 8/10, assessment for deep vein thrombus was 8/10, and cardiac ultrasound for contractility and overall function was 7/10. Student performance in the knowledge assessment portion of the questionnaire was an average of 74% (SD =11%) at the end of workshop and 74% (SD =12%) 3 months later (P=0.00). At our institution, we

  3. Lecturing skills as predictors of tutoring skills in a problem-based medical curriculum

    OpenAIRE

    Kassab, Salah; Hassan,Nahla; Abu-Hijleh,Marwan; P Sequeira,Reginald

    2016-01-01

    Salah Eldin Kassab,1 Nahla Hassan,1 Marwan F Abu-Hijleh,2 Reginald P Sequeira3 1Department of Medical Education, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 2College of Medicine, Qatar University, Doha, Qatar; 3College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain Purpose: Recruitment of tutors to work in problem-based learning (PBL) programs is challenging, especially in that most of them are graduated from discipline-based programs. ...

  4. The Association between Sleep Problems, Sleep Medication Use, and Falls in Community-Dwelling Older Adults: Results from the Health and Retirement Study 2010

    Science.gov (United States)

    2016-01-01

    Background. Very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls among community-dwelling older adults. The objective of this study was to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. Methods. The study population comprised a nationally representative sample of noninstitutionalized older adults participating in the 2010 Health and Retirement Study. Proportion of adults reporting sleep problems, sleep medication use, and fall was calculated. Multiple logistic regression models were constructed to examine the impact of sleep problems and sleep medication use on the risk of falls after controlling for covariates. Results. Among 9,843 community-dwelling older adults, 35.8% had reported a fall and 40.8% had reported sleep problems in the past two years. Sleep medication use was reported by 20.9% of the participants. Older adults who do have sleep problems and take sleep medications had a significant high risk of falls, compared to older adults who do not have sleep problems and do not take sleep medications. The other two groups also had significantly greater risk for falls. Conclusion. Sleep problems added to sleep medication use increase the risk of falls. Further prospective studies are needed to confirm these observed findings. PMID:27547452

  5. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem

    Directory of Open Access Journals (Sweden)

    Williams PAH

    2015-07-01

    Full Text Available Patricia AH Williams, Andrew J Woodward eHealth Research Group and Security Research Institute, Edith Cowan University, Perth, WA, Australia Abstract: The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. Keywords: cybersecurity, security, safety, wireless, risk, medical devices

  6. Effort--reward imbalance and medically certified absence for mental health problems: a prospective study of white-collar workers.

    Science.gov (United States)

    Ndjaboué, R; Brisson, C; Vézina, M; Blanchette, C; Bourbonnais, R

    2014-01-01

    Little is known about the effects of psychosocial work factors on objectively assessed mental health problems leading to medically certified absence. Only one study has evaluated the prospective effects of effort-reward imbalance (ERI) at work with regards to this outcome. The present study aimed to evaluate the effects of ERI on the incidence of medically certified absence for mental health problems. The study included 2086 white-collar workers (63.3% women) employed in public organisations in Quebec city. Participants were followed over a 9-year period. Medical absences from work were collected from employers' files and psychosocial factors were measured using the ERI questionnaire. Cox regression models were used to estimate the incidence of certified sickness absence due to mental health problems that lasted 5 workdays or more, while controlling for confounders. Workers exposed to ERI had a higher risk of a first spell of medically certified absence for mental health problems (HR=1.38, 95% CI 1.08 to 1.76) compared with unexposed workers. Low reward was significantly associated with a high risk among men (HR=2.80, 95% CI 1.34 to 5.89) but not in women. (HR=1.24, 95% CI 0.90 to 1.73). Effort at work had no effect on certified absence. All these effects were adjusted for potential confounders. ERI and low reward at work were prospectively associated with medically certified absence for mental health problems. These effects seem to differ by gender. Primary prevention that is aimed at reducing these stressors should be considered to help reduce the incidence of such severe mental health problems.

  7. Attitude and perception of undergraduate medical students toward the problem-based learning in Chitwan Medical College, Nepal

    Directory of Open Access Journals (Sweden)

    Yadav RL

    2018-05-01

    Full Text Available Ram Lochan Yadav,1 Rano Mal Piryani,2 Gopendra Prasad Deo,3 Dev Kumar Shah,1 Laxmi Kumari Yadav,4 Md Nazrul Islam1 1Department of Physiology, Chitwan Medical College, Bharatpur, Nepal; 2Department of Internal Medicine and Health Professional Educational Research Center (HPERC, Chitwan Medical College, Bharatpur, Nepal; 3Department of Anaesthesiology and Critical Care, Chitwan Medical College, Bharatpur, Nepal; 4Department of Microbiology, Chitwan Medical College, Bharatpur, Nepal Background: Problem-based learning (PBL was introduced into Basic Medical Sciences early in the 1980s at Tribhuvan University (TU, Nepal, followed by other universities where didactic lecture method was still followed as the main teaching strategy. Despite gaining its popularity worldwide as integrated teaching learning method, PBL is not given importance in Nepal. This study aimed to assess the attitude and perceptions of undergraduate medical students regarding learning outcomes of PBL and to know their views about role and qualities of effective tutors for its successful implementation.Methods: This descriptive study was based on a self-administered questionnaire. The first part of the questionnaire measured students’ perception and attitude toward benefits of PBL and the second part measured students’ perception about role of PBL tutor. Bachelor of Medicine and Bachelor of Surgery (MBBS first year (2014/2015 academic year students at Chitwan Medical College, TU, were asked to express their opinions about the importance of learning outcomes by rating each statement on a five-point Likert scale and the responses were combined into three categorical variables: “agree” (strongly agree plus agree, “neutral”, and “disagree” (strongly disagree plus disagree. Data were analyzed using SPSS version 21.0.Results: Approximately 85.5% participants agreed that PBL is an interesting method of teaching learning. Most of them (86.7% accepted that PBL is an

  8. LazySorted: A Lazily, Partially Sorted Python List

    Directory of Open Access Journals (Sweden)

    Naftali Harris

    2015-06-01

    Full Text Available LazySorted is a Python C extension implementing a partially and lazily sorted list data structure. It solves a common problem faced by programmers, in which they need just part of a sorted list, like its middle element (the median, but sort the entire list to get it. LazySorted presents them with the abstraction that they are working with a fully sorted list, while actually only sorting the list partially with quicksort partitions to return the requested sub-elements. This enables programmers to use naive "sort first" algorithms but nonetheless attain linear run-times when possible. LazySorted may serve as a drop-in replacement for the built-in sorted function in most cases, and can sometimes achieve run-times more than 7 times faster.

  9. National priorities list sites: Delaware, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  10. National priorities list sites: Oklahoma, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  11. National priorities list sites: Wisconsin, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  12. National priorities list sites: Wyoming, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  13. What language is your doctor speaking? Facing the problems of translating medical documents into English

    Directory of Open Access Journals (Sweden)

    Mićović Dragoslava

    2013-01-01

    Full Text Available What is translation - a craft, an art, a profession or a job? Although one of the oldest human activities, translation has not still been fully defined, and it is still young in terms of an academic discipline. The paper defines the difference between translation and interpreting and then attempts to find the answer to the question what characteristics, knowledge and skills a translator must have, particularly the one involved in court translation, and where his/her place in the communication process (both written and oral communication is. When translating medical documentation, a translator is set within a medical language environment as an intermediary between two doctors (in other words, two professionals in the process of communication which would be impossible without him, since it is conducted in two different languages. The paper also gives an insight into types of medical documentation and who they are intended for. It gives practical examples of the problems faced in the course of translation of certain types of medical documentation (hospital discharge papers, diagnoses, case reports,.... Is it possible to make this kind of communication between professionals (doctors standardized, which would subsequently make their translation easier? Although great efforts are made in Serbia regarding medical language and medical terminology, the conclusion is that specific problems encountered by translators can hardly be overcome using only dictionaries and translation manuals.

  14. Problem Patron Manual.

    Science.gov (United States)

    Brown, Marion, Comp.; And Others

    This document presents guidelines for handling disruptive behavior in the Schenectady County Public Library (New York). Specific responses are listed for dealing with questions about library selection policy and sudden patron illness or injury. Also listed are responses to problem situations involving angry or irate patrons, assault or physically…

  15. Sexual dysfunction and the underlying medical problems in post-menopausal women

    Directory of Open Access Journals (Sweden)

    Soheila Nazarpour

    2016-02-01

    Full Text Available Background: Sexual dysfunction could be under the influence of some underlying medical problems. The purpose of this study is to examine the relationship between medical problems and sexual function in post-menopausal women. Methods: This is a community-based, descriptive-correlation study of 405 post-menopausal women residing in Chalus and Nowshahr cities, North of Iran, aged 40 to 65 years old from October 2013 to May 2014. A multistage, randomized sampling was conducted. The data was acquired through interviews using the Female Sexual Function Index (FSFI questionnaire and a researcher-made questionnaire, and was analyzed using descriptive and analytical tests such as multiple linear regression and logistic regression models. Results: 51.4% of the subjects had medical conditions. Cardiovascular disorders were the most common diseases among the subjects. 61% of the women were suffering from female sexual dysfunction (FSD. Sexual dysfunction in patients with medical conditions was significantly higher (P= 0.037. Scores of arousal (P= 0.000, orgasm (P= 0.018, and satisfaction (P= 0.026, as well as the FSFI total score (P= 0.005, were significantly lower in subjects with cardiovascular disorders. Scores of desire (P= 0.001, arousal (P= 0.006, lubrication (P= 0.010, orgasm (P= 0.004, and satisfaction (P= 0.022, as well as the FSFI total score (P= 0.017, were significantly lower in subjects with diabetes. Scores of pain were significantly lower in subjects with musculoskeletal disorders (P= 0.041, they experienced more pain during intercourse. In domains of arousal (P= 0.030, satisfaction (P= 0.040, and pain (P= 0.044, the scores of those taking antihypertensive medications were significantly lower than the scores of the rest of the subjects. Scores of desire (P= 0.001, arousal (P= 0.006, orgasm (P= 0.006, and satisfaction (P= 0.048, as well as the FSFI total score (P= 0.006, were significantly lower in those taking antidiabetic drugs. And lastly

  16. List of reports on reactor safety research by the BMFT and the USNRC

    International Nuclear Information System (INIS)

    1977-05-01

    This list reviews reports from the Federal Republic of Germany and from the United States of America concerning special problems in the field of Reactor Safety Research which have been collected in the Gesellschaft fuer Reaktorsicherheit. The list pursues the following order: Country of origin, problem area concerned according to the Reactor Safety Research Program of BMFT, reporting organisation. The list or reports appears quarterly. This edition contains all reports as registered from January through March 1977. (orig./HK) [de

  17. Building large collections of Chinese and English medical terms from semi-structured and encyclopedia websites.

    Science.gov (United States)

    Xu, Yan; Wang, Yining; Sun, Jian-Tao; Zhang, Jianwen; Tsujii, Junichi; Chang, Eric

    2013-01-01

    To build large collections of medical terms from semi-structured information sources (e.g. tables, lists, etc.) and encyclopedia sites on the web. The terms are classified into the three semantic categories, Medical Problems, Medications, and Medical Tests, which were used in i2b2 challenge tasks. We developed two systems, one for Chinese and another for English terms. The two systems share the same methodology and use the same software with minimum language dependent parts. We produced large collections of terms by exploiting billions of semi-structured information sources and encyclopedia sites on the Web. The standard performance metric of recall (R) is extended to three different types of Recall to take the surface variability of terms into consideration. They are Surface Recall (R(S)), Object Recall (R(O)), and Surface Head recall (R(H)). We use two test sets for Chinese. For English, we use a collection of terms in the 2010 i2b2 text. Two collections of terms, one for English and the other for Chinese, have been created. The terms in these collections are classified as either of Medical Problems, Medications, or Medical Tests in the i2b2 challenge tasks. The English collection contains 49,249 (Problems), 89,591 (Medications) and 25,107 (Tests) terms, while the Chinese one contains 66,780 (Problems), 101,025 (Medications), and 15,032 (Tests) terms. The proposed method of constructing a large collection of medical terms is both efficient and effective, and, most of all, independent of language. The collections will be made publicly available.

  18. A comparison between the effectiveness of PBL and LBL on improving problem-solving abilities of medical students using questioning

    DEFF Research Database (Denmark)

    He, Yunfeng; Du, Xiangyun; Toft, Egon

    2018-01-01

    of problem-based learning (PBL) and lecture-based learning in improving the questioning abilities of medical students (N = 104) was assessed by a modified 20-question task. In this task, the participants were asked to identify target pictures by asking questions, the problem-solving process of which......In daily patient-history taking and diagnosis practice, doctors ask questions to gather information from patients and narrow down diagnostic hypotheses. Training medical students to be efficient problem solvers through the use of questioning is therefore important. In this study, the effectiveness....... This finding suggests that PBL curricula may help improve the questioning strategies of medical students and help them diagnose more efficiently in future diagnosis practice....

  19. List of reports from BMFT, CEA, EPRI, JSTA and USNRC concerning reactor safety research

    International Nuclear Information System (INIS)

    1982-02-01

    This list reviews reports from the Federal Republic of Germany, from France from Japan and from the United States of America concerning special problems in the field of reactor safety research. According to the cooperation in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig.) [de

  20. An Optimization Model for Product Placement on Product Listing Pages

    Directory of Open Access Journals (Sweden)

    Yan-Kwang Chen

    2014-01-01

    Full Text Available The design of product listing pages is a key component of Website design because it has significant influence on the sales volume on a Website. This study focuses on product placement in designing product listing pages. Product placement concerns how venders of online stores place their products over the product listing pages for maximization of profit. This problem is very similar to the offline shelf management problem. Since product information sources on a Web page are typically communicated through the text and image, visual stimuli such as color, shape, size, and spatial arrangement often have an effect on the visual attention of online shoppers and, in turn, influence their eventual purchase decisions. In view of the above, this study synthesizes the visual attention literature and theory of shelf-space allocation to develop a mathematical programming model with genetic algorithms for finding optimal solutions to the focused issue. The validity of the model is illustrated with example problems.

  1. Constructivist, Problem-Based Learning Does Work: A Meta-Analysis of Curricular Comparisons Involving a Single Medical School

    Science.gov (United States)

    Schmidt, Henk G.; van der Molen, Henk T.; te Winkel, Wilco W. R.; Wijnen, Wynand H. F. W.

    2009-01-01

    Effects of problem-based learning as reported in curricular comparison studies have been shown to be inconsistent over different medical schools. Therefore, we decided to summarize effects of a single well-established problem-based curriculum rather than to add up sometimes-conflicting findings from different problem-based curricula. Effect sizes…

  2. Evaluating learning among undergraduate medical students in schools with traditional and problem-based curricula.

    Science.gov (United States)

    Meo, Sultan Ayoub

    2013-09-01

    This study aimed to assess knowledge and skills in a respiratory physiology course in traditional versus problem-based learning (PBL) groups in two different medical schools. Two different undergraduate medical schools were selected for this study. The first medical school followed the traditional [lecture-based learning (LBL)] curriculum, and the second medical school followed the PBL curriculum. Sixty first-year male medical students (30 students from each medical school) volunteered; they were apparently healthy and of the same age, sex, nationality, and regional and cultural background. Students were taught respiratory physiology according to their curriculum for a period of 2 wk. At the completion of the study period, knowledge was measured based on a single best multiple-choice question examination, and skill was measured based on the objective structured practical examination in the lung function laboratory (respiratory physiology). A Student's t-test was applied for the analysis of the data, and the level of significance was set at P schools.

  3. Progress report - list of reports from BMFT, CEA, EPRI, JSTA and USNRC reactor safety research

    International Nuclear Information System (INIS)

    1982-10-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special problems in the field of reactor safety research. The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  4. Can You Teach a Teen New Tricks? Problem Solving Skills Training Improves Oral Medication Adherence in Pediatric Patients with Inflammatory Bowel Disease Participating in a Randomized Trial.

    Science.gov (United States)

    Greenley, Rachel N; Gumidyala, Amitha P; Nguyen, Eve; Plevinsky, Jill M; Poulopoulos, Natasha; Thomason, Molly M; Walter, Jennifer G; Wojtowicz, Andrea A; Blank, Ellen; Gokhale, Ranjana; Kirschner, Barbara S; Miranda, Adrian; Noe, Joshua D; Stephens, Michael C; Werlin, Steven; Kahn, Stacy A

    2015-11-01

    Medication nonadherence is associated with higher disease activity, greater health care utilization, and lower health-related quality of life in pediatric inflammatory bowel diseases (IBD). Problem solving skills training (PSST) is a useful tool to improve adherence in patients with chronic diseases but has not been fully investigated in IBD. This study assessed feasibility, acceptability, and preliminary efficacy of PSST in pediatric IBD. Recruitment occurred during outpatient clinic appointments. After completion of baseline questionnaires, families were randomized to a treatment group or wait-list comparison group. The treatment group received either 2 or 4 PSST sessions. Youth health-related quality of life was assessed at 3 time points, and electronic monitoring of oral medication adherence occurred for the study duration. Seventy-six youth (ages 11-18 years) on an oral IBD maintenance medication participated. High retention (86%) and treatment fidelity rates (95%) supported feasibility. High satisfaction ratings (mean values ≥4.2 on 1-5 scale) supported intervention acceptability. Modest increases in adherence occurred after 2 PSST sessions among those with imperfect baseline adherence (d = 0.41, P 0.05). Phone-delivered PSST was feasible and acceptable. Efficacy estimates were similar to those of lengthier interventions conducted in other chronic illness populations. Older adolescents benefited more from the intervention than their younger counterparts.

  5. Medication problems are frequent and often serious in a Danish emergency department and may be discovered by clinical pharmacists

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Thisted, Anette Rehn; Olsen, Inger

    2012-01-01

    Transferring a patient from one health-care sector to another implies a risk of medication errors. It is of interest to evaluate whether a specialist in clinical pharmacy is beneficial for the patients in the emergency departments (ED). The aim of the present study was to report the incidence, ca......, categories and seriousness of medication problems discovered by clinical pharmacists in an ED and to evaluate if it is possible for pharmacists to identify those groups of patients who are most at risk of medication problems....

  6. A shared computer-based problem-oriented patient record for the primary care team.

    Science.gov (United States)

    Linnarsson, R; Nordgren, K

    1995-01-01

    1. INTRODUCTION. A computer-based patient record (CPR) system, Swedestar, has been developed for use in primary health care. The principal aim of the system is to support continuous quality improvement through improved information handling, improved decision-making, and improved procedures for quality assurance. The Swedestar system has evolved during a ten-year period beginning in 1984. 2. SYSTEM DESIGN. The design philosophy is based on the following key factors: a shared, problem-oriented patient record; structured data entry based on an extensive controlled vocabulary; advanced search and query functions, where the query language has the most important role; integrated decision support for drug prescribing and care protocols and guidelines; integrated procedures for quality assurance. 3. A SHARED PROBLEM-ORIENTED PATIENT RECORD. The core of the CPR system is the problem-oriented patient record. All problems of one patient, recorded by different members of the care team, are displayed on the problem list. Starting from this list, a problem follow-up can be made, one problem at a time or for several problems simultaneously. Thus, it is possible to get an integrated view, across provider categories, of those problems of one patient that belong together. This shared problem-oriented patient record provides an important basis for the primary care team work. 4. INTEGRATED DECISION SUPPORT. The decision support of the system includes a drug prescribing module and a care protocol module. The drug prescribing module is integrated with the patient records and includes an on-line check of the patient's medication list for potential interactions and data-driven reminders concerning major drug problems. Care protocols have been developed for the most common chronic diseases, such as asthma, diabetes, and hypertension. The patient records can be automatically checked according to the care protocols. 5. PRACTICAL EXPERIENCE. The Swedestar system has been implemented in a

  7. [Problems in integrative postgraduate medical training of physicians at anthroposophic hospitals in Germany and Switzerland].

    Science.gov (United States)

    Heusser, Peter; Eberhard, Sabine; Weinzirl, Johannes; Orlow, Pascale; Berger, Bettina

    2014-01-01

    Anthroposophic hospitals provide integrative medical care by complementing conventional (CON) with anthroposophic medicine (AM). They teach integrative medicine in postgraduate medical training (PGMT). In a first evaluation of PGMT quality in AM, we analyzed the problems of this training from the perspectives of trainers and trainees. We conducted an anonymous cross-sectional full survey of all trainee and trainer physicians at the 15 AM hospitals in Germany (DE) and Switzerland (CH) with questionnaires of the Swiss Institute of Technology (ETH) Zürich, complemented by a module for AM. We also conducted descriptive statistics for questions with answering scales as well as calculations of group differences (two-tailed Mann-Whitney U test) and a qualitative content analysis (Mayring) of free text answers related to the problem analysis. The response rate in DE embraced 89 out of 215 (41.39%) surveyed trainees and 78 out of 184 (42.39%) trainers; in CH, the response rate comprised 19 out of 25 (76%) trainees and 22 out of 30 (73.33%) trainers. Free text answers related to problem analysis in DE and CH were given by 16 out of 108 (14.8%) trainees and by 20 out of 100 (20%) trainers, overall. Perceived main problems include work overload; shortcomings in work organization; delimitation of competences; interprofessional cooperation; financial resources (trainers); wages (trainees DE); practical relevance of AM (trainees and trainers in DE); professional or didactic competence of trainers; lack of interest in AM (trainees); problems with learning and practicing AM; no curriculum for postgraduate medical training in AM; tensions between AM and CON. Explanations for the differences between DE and CH include larger departments and the DRG system in DE, but also better structural conditions for AM PGMT in CH. Main problems of PGMT in AM include not only non-specific and systemic aspects, but also AM-specific issues. In order to develop a basis for concrete problem solving

  8. Contraception in women with medical problems

    Science.gov (United States)

    Dhanjal, Mandish K

    2008-01-01

    Women with medical disease have a higher incidence of maternal mortality compared with healthy women, with cardiac disease now being the most common cause of maternal death in the UK. A handful of medical conditions exist where pregnancy is not recommended due to mortality rates approaching 50%. It is imperative that such women have the most reliable methods of contraception available. Contraceptive agents may themselves affect medical disease, or may interact with medications used by such women. There may be a range of contraceptive agents suitable for each medical condition. The contraceptive selected should be tailored to suit the individual. The following points should be considered when deciding on the most appropriate contraceptive agent: efficacy, thrombotic risk (oestrogen containing contraceptives), arterial risks (oestrogen containing contraceptives), infective risk (e.g. insertion of intrauterine device [IUD]), vagal stimulation (e.g. insertion of IUD, ESSURE®), bleeding risks with patients on anticoagulants, interaction with concomitant drugs, effects of anaesthesia and ease of use. This review aims to cover the different contraceptive agents available and the best ones to use for certain medical illnesses. PMID:27582790

  9. National Coal Board Medical Service annual report 1980-1981

    Energy Technology Data Exchange (ETDEWEB)

    1982-01-01

    Sections report on: medical examinations and consultations; protection from health hazards such as pneumoconiosis and other prescribed diseases; problems such as vitamin D in the blood of miners, Legionaires' disease, Perthe's disease, rehabilitation and physiotherapy, chemical hazards, public health and hygiene, noise, and the use of visual display units; diseases from coal products such as in coke and tar manufacture; first aid services, morphia, and nursing service; and back pain in the mining industry. A list of staff and their publications is also included.

  10. QTL list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...Policy | Contact Us QTL list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  11. Marker list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...Database Site Policy | Contact Us Marker list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  12. EXPANSION OF TURBO PROLOGUE PROGRAMMING SYSTEM BY PREDICATES FOR LIST PROCESSING

    Directory of Open Access Journals (Sweden)

    A. T. Kovalkov

    2008-01-01

    Full Text Available Lists are considered as a main data structure in logic Turbo Prologue programming language. However the language does not contain in-set predicates (procedures for list processing. In order to facilitate a problem programming process where lists are used it is proposed to apply a Turbo Prologue version that has a set of predicates in the form of recursive rules for executing frequently repeated operations with lists such as unification of lists, italicization and deletion of some list elements, sorting-out, list reversing and many others. The modified version contains a reference to new input predicates. The proposed Turbo Prologue version is easily expanded by new rules. Usage of this version makes programmer’s work easier and promotes development of new programs where it is necessary to work with lists.

  13. Property Testing on Linked Lists

    DEFF Research Database (Denmark)

    Afshani, Peyman; Matulef, Kevin; Wilkinson, Bryan Thomas

    2013-01-01

    We define a new property testing model for algorithms that do not have arbitrary query access to the input, but must instead traverse it in a manner that respects the underlying data structure in which it is stored. In particular, we consider the case when the underlying data structure is a linked...... list, and the testing algorithm is allowed to either sample randomly from the list, or walk to nodes that are adjacent to those already visited. We study the well-known monotonicity testing problem in this model, and show that (n13) queries are both necessary and sufficient to distinguish whether...... a list is sorted (monotone increasing) versus a constant distance from sorted. Our bound is strictly greater than the (logn) queries required in the standard testing model, that allows element access indexed by rank, and strictly less than the (n12) queries required by a weak model that only allows...

  14. General practitioners' views on (long-term) prescription and use of problematic and potentially inappropriate medication for oldest-old patients-A qualitative interview study with GPs (CIM-TRIAD study).

    Science.gov (United States)

    Pohontsch, Nadine Janis; Heser, Kathrin; Löffler, Antje; Haenisch, Britta; Parker, Debora; Luck, Tobias; Riedel-Heller, Steffi G; Maier, Wolfgang; Jessen, Frank; Scherer, Martin

    2017-02-17

    Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM. As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list). The interview guideline included generic and patient-specific questions. Interviews were digitally recorded and transcribed verbatim. We content analyzed the interviews using deductive and inductive category development. The majority of the general practitioners were not aware of the PRISCUS list. Agents deemed potentially inappropriate from the general practitioners' point of view and the PRISCUS list are not completely superimposable. General practitioners named their criteria to identify appropriate medication for elderly patients (e.g. renal function, cognitive state) and emphasized the importance of monitoring. We identified prescription- (e.g. benzodiazepines on alternative private prescription), medication- (e.g. subjective perception that PIM has no alternative), general practitioner- (e.g. general practitioner relies on specialists), patient- (e.g. "demanding high-user", positive subjective benefit-risk-ratio) and system-related aspects (e.g. specialists lacking holistic view, interface problems) related to the (long term) use of PIM. While the PRISCUS list does not seem to play a decisive role in general practice, general practitioners are well aware of risks associated with PIM. Our study identifies some starting points for a safer handling of PIM, e.g. stronger dissemination of the PRISCUS list, better compensation of

  15. Combined Use of the Rationalization of Home Medication by an Adjusted STOPP in Older Patients (RASP) List and a Pharmacist-Led Medication Review in Very Old Inpatients: Impact on Quality of Prescribing and Clinical Outcome.

    Science.gov (United States)

    Van der Linden, Lorenz; Decoutere, Liesbeth; Walgraeve, Karolien; Milisen, Koen; Flamaing, Johan; Spriet, Isabel; Tournoy, Jos

    2017-02-01

    Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. Our objective was to evaluate the effect of a pharmacist intervention, consisting of the application of the Rationalization of home medication by an Adjusted STOPP in older Patients (RASP) list and a pharmacist-led medication review on polypharmacy, the quality of prescribing, and clinical outcome in geriatric inpatients. A monocentric, prospective controlled trial was undertaken at the geriatric wards of a large university hospital. Pharmacists applied the RASP list to the drugs reconciled on admission and additionally performed an expert-based medication review, upon which recommendations were provided to the treating physicians. The primary outcome was the composite endpoint of drug discontinuation and dose reduction of drugs taken on admission. Secondary outcomes included RASP-identified potentially inappropriate medications (PIMs), the number of Emergency Department (ED) visits and quality of life (QOL) registered up to 3 months after discharge. On average, patients (n = 172) took 10 drugs on admission and were 84.5 years (standard deviation 4.8) of age. More drugs were discontinued or reduced in dose in the intervention group {control vs.intervention:median (interquartile range [IQR]) 3 (2-5) vs. 5 (3-7); p < 0.001}. More PIMs were discontinued in the intervention group, leading to less PIM at discharge [control vs.intervention:median (IQR) 2 (1-3) vs. 0.5 (0-1); p < 0.001]. No signal of harm was seen, and a significant improvement of QOL and less ED visits without hospitalization were observed. The combined intervention safely reduced drug use in very old inpatients and outperformed usual geriatric care. An increased QOL was seen, as well as a trend towards less ED visits. ClinicalTrials.gov Identifier: NCT01513265.

  16. "Chase CRP", "Review patient": Improving the Quality of Weekend Medical Handover at a London Teaching Hospital.

    Science.gov (United States)

    Saifuddin, Aamir; Magee, Lucia; Barrett, Rachael

    2015-01-01

    Clinical handover has been identified as a "major preventable cause of harm" by the Royal College of Physicians (RCP). Whilst working at a London teaching hospital from August 2013, we noted substandard weekend handover of medical patients. The existing pro forma was filled incompletely by day doctors so it was difficult for weekend colleagues to identify unwell patients, with inherent safety implications. Furthermore, on-call medical staff noted that poor accessibility of vital information in patients' files was affecting acute clinical management. We audited the pro formas over a six week period (n=83) and the Friday ward round (WR) entries for medical inpatients over two weekends (n=84) against the RCP's handover guidance. The results showed poor documentation of several important details on the pro formas, for example, ceiling of care (4%) and past medical history (PMH) (23%). Problem lists were specified on 62% of the WR entries. We designed new handover pro formas and 'Friday WR sheets' to provide prompts for this information and used Medical Meetings and emails to explain the project's aims. Re-audit demonstrated significant improvement in all parameters; for instance, PMH increased to 52% on the pro formas. Only 10% of Friday WR entries used our sheet. However, when used, outcomes were much better, for example, problem list documentation increased to 100%. In conclusion, our interventions improved the provision of crucial information needed to prioritise and manage patients over the weekend. Future work should further highlight the importance of safe handover to all doctors to induce a shift in culture and optimise patient care.

  17. Pet Problems at Home: Pet Problems in the Community.

    Science.gov (United States)

    Soltow, Willow

    1984-01-01

    Discusses problems of pets in the community, examining the community's role related to disruptive pets and pet overpopulation. Also discusses pet problems at home, offering advice on selecting a pet, meeting a pet's needs, and disciplining pets. Includes a list of books, films/filmstrips, teaching materials, and various instructional strategies.…

  18. List of BMFT, USNRC, EPRI, and STA reports on reactor safety research

    International Nuclear Information System (INIS)

    1980-07-01

    This list reviews reports from the Federal Republic of Germany, from the United States of America and from Japan concerning special problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the United States Nuclear Regulatory Commission (USNRC), the Electric Power Research Institute (EPRI), and the Japan Science and Technology Agency (JSTA) these reports are available in the Gesellschaft fuer Reaktorsicherheit. The list pursues the following order : Country of origin, problem area concerned, according to the Reactor Safety Research Program of BMFT, reporting organisation. The list of reports appears quarterly. (orig./HP) [de

  19. 12 CFR 41.32 - Sharing medical information with affiliates.

    Science.gov (United States)

    2010-01-01

    ... individualized list or description based on the payment transactions of the consumer for medical products or services; or (3) An aggregate list of identified consumers based on payment transactions for medical... activities described in section 18B of the model Privacy of Consumer Financial and Health Information...

  20. National priorities list sites: New York, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  1. National priorities list sites: North Carolina, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  2. National priorities list sites: New Mexico, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  3. Update on Research and Application of Problem-Based Learning in Medical Science Education

    Science.gov (United States)

    Fan, Chuifeng; Jiang, Biying; Shi, Xiuying; Wang, Enhua; Li, Qingchang

    2018-01-01

    Problem-based learning (PBL) is a unique form of pedagogy dedicated to developing students' self-learning and clinical practice skills. After several decades of development, although applications vary, PBL has been recognized all over the world and implemented by many medical schools. This review summarizes and updates the application and study of…

  4. Experience of Problem-Based Learning in Nursing Education at Kaohsiung Medical University

    Directory of Open Access Journals (Sweden)

    Fan-Hao Chou

    2009-05-01

    Full Text Available Nursing education must keep up with the rapidly changing medical landscape to support the competences of nurses in the areas of critical thinking, problem solving, and creativity. Problem-based learning (PBL provides an appropriate strategy for nursing education innovation. Nursing curricula based on PBL remain in the growing stage in Taiwan. Kaohsiung Medical University introduced PBL into nursing education in 2002. The critical events in the process included: (1 nurturing key tutors; (2 using PBL teaching methods in an elective course—Oncology Nursing, and designing a new elective course—Symposiums Regarding Clinical Cases; (3 holding conferences inside and outside the school to promote PBL teaching methods; (4 linking e-learning and PBL teaching methods; (5 conducting PBL research; (6 establishing a committee of PBL, objective structured clinical examination, and teaching material review for the College of Nursing; and (7 setting up a required course—Nursing Ethics. We now have 12 key tutors in the College of Nursing. We have also completed two studies to evaluate the ability of students and to explore the experience of tutors. From our studies, we know that PBL can increase learner abilities in self-directed learning, critical thinking, and PBL performance. The approach helps students to cope with the changing medical landscape. Furthermore, tutors and teachers develop adequate PBL teaching skills. Based on the experience above, we believe that we are on the right path in terms of continuing tutor development, gradually increasing the number of PBL courses, and undertaking further research to promote PBL methods in Taiwan.

  5. List of reports in reactor safety research by BMFT, USNRC, EPRI and JSTA

    International Nuclear Information System (INIS)

    1981-01-01

    This list reviews reports from the Federal Republic of Germany, from the United States of America and from Japan concerning special problems in the field of Reactor Safety research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the United States Nuclear Regulatory Commission (USNRC), the Electric Power Research Institute (EPRI), and the Japan Science and Technology Agency (JSTA) these reports are available in the Gesellschaft fuer Reaktorsicherheit. The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Program of BMFT, reporting organisation. The list of reports appears quarterly. (orig.) [de

  6. Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study.

    Science.gov (United States)

    Tudor Car, Lorainne; Papachristou, Nikolaos; Gallagher, Joseph; Samra, Rajvinder; Wazny, Kerri; El-Khatib, Mona; Bull, Adrian; Majeed, Azeem; Aylin, Paul; Atun, Rifat; Rudan, Igor; Car, Josip; Bell, Helen; Vincent, Charles; Franklin, Bryony Dean

    2016-11-16

    Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. We used a novel priority-setting method for identifying and ranking patient safety problems and solutions called PRIORITIZE. We invited 500 North West London primary care clinicians to complete an open-ended questionnaire to identify three main problems and solutions relating to medication error in primary care. 113 clinicians submitted responses, which we thematically synthesized into a composite list of 48 distinct problems and 45 solutions. A group of 57 clinicians randomly selected from the initial cohort scored these and an overall ranking was derived. The agreement between the clinicians' scores was presented using the average expert agreement (AEA). The study was conducted between September 2013 and November 2014. The top three problems were incomplete reconciliation of medication during patient 'hand-overs', inadequate patient education about their medication use and poor discharge summaries. The highest ranked solutions included development of a standardized discharge summary template, reduction of unnecessary prescribing, and minimisation of polypharmacy. Overall, better communication between the healthcare provider and patient, quality assurance approaches during medication prescribing and monitoring, and patient education on how to use their medication were considered the top priorities. The highest ranked suggestions received the strongest agreement among the clinicians, i.e. the highest AEA score. Clinicians identified a range of suggestions for better medication management, quality assurance procedures and patient education. According to clinicians, medication errors can be largely prevented with feasible and affordable interventions. PRIORITIZE is a new, convenient, systematic, and replicable method

  7. Learning styles, academic achievement, and mental health problems among medical students in Thailand.

    Science.gov (United States)

    Paiboonsithiwong, Salilthip; Kunanitthaworn, Natchaya; Songtrijuck, Natchaphon; Wongpakaran, Nahathai; Wongpakaran, Tinakon

    2016-01-01

    This study aimed to investigate the prevalence of various learning styles among medical students and their correlations with academic achievement and mental health problems in these students. This study was conducted among 140 first-year medical students of Chiang Mai University, Thailand in 2014. The participants completed the visual-aural-read/write-kinesthetic (VARK) questionnaire, the results of which can be categorized into 4 modes, corresponding to how many of the 4 types are preferred by a respondent. The 10-item Perceived Stress Scale (PSS-10) and the 21-item Outcome Inventory (OI-21) were also used. The participants' demographic data, grade point average (GPA), and scores of all measurements are presented using simple statistics. Correlation and regression analysis were employed to analyze differences in the scores and to determine the associations among them. Sixty percent of the participants were female. The mean age was 18.86±0.74 years old. Quadmodal was found to be the most preferred VARK mode (43.6%). Unimodal, bimodal, and trimodal modes were preferred by 35%, 12.9%, and 18.6% of the participants, respectively. Among the strong unimodal learners, visual, aural, read/write, and kinesthetic preferences were reported by 4.3%, 7.1%, 11.4%, and 12.1% of participants, respectively. No difference was observed in the PSS-10, OI-anxiety, OI-depression, and OI-somatization scores according to the VARK modes, although a significant effect was found for OI-interpersonal (F=2.788, P=0.043). Moreover, neither VARK modes nor VARK types were correlated with GPA. The most preferred VARK learning style among medical students was quadmodal. Learning styles were not associated with GPA or mental health problems, except for interpersonal problems.

  8. Learning styles, academic achievement, and mental health problems among medical students in Thailand

    Directory of Open Access Journals (Sweden)

    Salilthip Paiboonsithiwong

    2016-10-01

    Full Text Available Purpose This study aimed to investigate the prevalence of various learning styles among medical students and their correlations with academic achievement and mental health problems in these students. Methods This study was conducted among 140 first-year medical students of Chiang Mai University, Thailand in 2014. The participants completed the visual-aural-read/write-kinesthetic (VARK questionnaire, the results of which can be categorized into 4 modes, corresponding to how many of the 4 types are preferred by a respondent. The 10-item Perceived Stress Scale (PSS-10 and the 21-item Outcome Inventory (OI-21 were also used. The participants’ demographic data, grade point average (GPA, and scores of all measurements are presented using simple statistics. Correlation and regression analysis were employed to analyze differences in the scores and to determine the associations among them. Results Sixty percent of the participants were female. The mean age was 18.86±0.74 years old. Quadmodal was found to be the most preferred VARK mode (43.6%. Unimodal, bimodal, and trimodal modes were preferred by 35%, 12.9%, and 18.6% of the participants, respectively. Among the strong unimodal learners, visual, aural, read/write, and kinesthetic preferences were reported by 4.3%, 7.1%, 11.4%, and 12.1% of participants, respectively. No difference was observed in the PSS-10, OI-anxiety, OI-depression, and OI-somatization scores according to the VARK modes, although a significant effect was found for OI-interpersonal (F=2.788, P=0.043. Moreover, neither VARK modes nor VARK types were correlated with GPA. Conclusion The most preferred VARK learning style among medical students was quadmodal. Learning styles were not associated with GPA or mental health problems, except for interpersonal problems.

  9. 76 FR 14942 - Procurement List; Additions and Deletions

    Science.gov (United States)

    2011-03-18

    ... DFAC. Service Type/Location: Laundry & Dry Cleaning Service, F.E. Warren, AFB, WY. NPA: Goodwill... Service Type/Location: Laundry Service, Atlanta VA Medical Center, Decatur, GA. NPA: GINFL Services, Inc...: Additions to and deletions from the Procurement List. SUMMARY: This action adds services to the Procurement...

  10. A descriptive study of medical educators' views of problem-based learning

    Directory of Open Access Journals (Sweden)

    Dennick Reg

    2009-11-01

    Full Text Available Abstract Background There is a growing amount of literature on the benefits and drawbacks of Problem-Based Learning (PBL compared to conventional curricula. However, it seems that PBL research studies do not provide information rigorously and formally that can contribute to making evidence-based medical education decisions. The authors performed an investigation aimed at medical education scholars around the question, "What are the views of medical educators concerning the PBL approach?" Methods After framing the question, the method of data collection relied on asking medical educators to report their views on PBL. Two methods were used for collecting data: the questionnaire survey and an online discussion forum. Results The descriptive analysis of the study showed that many participants value the PBL approach in the practice and training of doctors. However, some participants hold contrasting views upon the importance of the PBL approach in basic medical education. For example, more than a third of participants (38.5% had a neutral stance on PBL as a student-oriented educational approach. The same proportion of participants also had a neutral view of the efficiency of traditional learning compared to a PBL tutorial. The open-ended question explored the importance of faculty development in PBL. A few participants had negative perceptions of the epistemological assumptions of PBL. Two themes emerged from the analysis of the forum repliers: the importance of the faculty role and self-managed education. Conclusion Whilst many participants valued the importance of the PBL approach in the practice and training of doctors and agreed with most of the conventional descriptions of PBL, some participants held contrasting views on the importance of the PBL approach in undergraduate medical education. However there was a strong view concerning the importance of facilitator training. More research is needed to understand the process of PBL better.

  11. CRAYFISH AND ITS CULTURE IN UKRAINE. THEMATIC REFERENCES LIST

    Directory of Open Access Journals (Sweden)

    I. Hrytsyniak

    2014-09-01

    Full Text Available Purpose. To compile a thematic references list on the problems of biology, physiology, pathology and crayfish breeding in Ukraine. Methodology. As the search base for the realization of the purpose was the scientific library stock of the Institute of Fisheries NAAS. The methods that have been preferred were both integrated and selective. Findings. We prepared a thematic reference list of the main scientific works, such as collections of scientific papers, proceedings of international scientific conferences, articles and candidate’s thesis abstracts on the biology of crustaceans and their cultivation in Ukraine, including the literature sources since 1958. The bibliography contains 37 publications of the Institute of Fisheries NAAS scientific library stock, in alphabetical order, and described according to DSTU GOST 7.1:2006 «System of standards on information, librarianship and publishing. Bibliographic entry. Bibliographic description. General requirements and rules». Practical value. The list may be helpful for experts, scientists, students, who are interested in problems of crayfish biology and culture.

  12. Registered plant list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...the Plant DB link list in simple search page) Genome analysis methods Presence or... absence of Genome analysis methods information in this DB (link to the Genome analysis methods information ...base Site Policy | Contact Us Registered plant list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  13. Estimating costs in the economic evaluation of medical technologies.

    Science.gov (United States)

    Luce, B R; Elixhauser, A

    1990-01-01

    The complexities and nuances of evaluating the costs associated with providing medical technologies are often underestimated by analysts engaged in economic evaluations. This article describes the theoretical underpinnings of cost estimation, emphasizing the importance of accounting for opportunity costs and marginal costs. The various types of costs that should be considered in an analysis are described; a listing of specific cost elements may provide a helpful guide to analysis. The process of identifying and estimating costs is detailed, and practical recommendations for handling the challenges of cost estimation are provided. The roles of sensitivity analysis and discounting are characterized, as are determinants of the types of costs to include in an analysis. Finally, common problems facing the analyst are enumerated with suggestions for managing these problems.

  14. Benefit of Problem-Based Learning for Psychosocial Medicine: first experiences at the medical faculty of berne

    Directory of Open Access Journals (Sweden)

    Laederach-Hofmann, Kurt

    2005-04-01

    Full Text Available Aim: Presentation of skills and knowledge of medical students in psychiatry or psychosocial medicine in basic study (year 1 to 3 after the introduction of a problem oriented learning curriculum at the Medical Faculty of Berne.Method: Description of the curriculum with the different teaching units, and the evaluation by means of formative tools used by students and tutors.Results: With reference to qualitative comparison students of the problem based learning track showed a better preparation of the different teaching units than did traditional students. Moreover, compared to classical teaching, students in problem based learning rated the commitment of the teachers higher. The formative results showed a better adherence to the teaching modules, a higher effort in self learning and a higher interest in psychological or psychiatric learning items.Discussion: The higher commitment of teachers and the explicit structuring of the teaching contents in psychiatry and psychosocial medicine showed positive effects in the learning strategy of students. Beside the fact that exams have been adapted to the new curriculum one can assume that the learning style has changed. This might be a result of the better learning environment in the new curriculum. However, there is not clear how and to what extent these changes will remain active until the final exams of the medical curriculum when psychosocial contents will be reexamined.Conclusions: The intense commitment of the teachers and the better structuring of the subject matter may lead to a better integration of psychosocial and psychiatric issues into the medical curriculum.

  15. EUROPEAN TERATOLOGY INFORMATION SERVICE: EXPERIENCE, PROBLEMS AND PERSPECTIVES

    Directory of Open Access Journals (Sweden)

    A.V. Ostrovskaya

    2007-01-01

    Full Text Available Congenital malformations are still the important medical and social issue. They take the second place among the reasons for the infant mortality and cause up to 18,3% of disablement cases among the children. Exogenous factors, effecting the growing fetus, are very essential along with the genetic matters among the reasons for the congenital malformations. The importance of information on the teratogenic potential of the medications is acknowledged by the doctors from various countries. The article outlines the information on entis activity — European network of teratology information services — a non profit organization, rendering consulting services to the pregnant women and medical staff, regarding the embryo and fetotoxic actions of the medications. The authors highlight the history of entis, its objectives, principles of operation and consulting algorithm and list the basic scientific publications by the entis members for the recent years. The article deals with the most obvious problems, which the organization members face, first of all — the quality of the information they receive. The authors also provide the substantiation for the necessity to develop such an information service in Russia and express hope for the successful development of the entis subsidiary they formed in Moscow.Key words: congenital malformations, medications, pregnancy, embryotoxicity.

  16. Teaching biochemistry to medical students in Singapore--from organic chemistry to problem-based learning.

    Science.gov (United States)

    Khoo, H E

    2005-07-01

    The medical faculty in the National University of Singapore started in 1905 but the Chair in Biochemistry was only established in 1927. For many years the biochemistry course consisted of the teaching of the organic chemistry of substances of physiological importance, nutrition, metabolism and hormones. In 1961, clinical biochemistry was introduced and in the 1980s, genetics and molecular biology were included. By then, most of the organic chemistry content had been removed as greater emphasis was placed on clinical correlation. Laboratory classes consisted of mock glucose tolerance tests and the measurement of various enzymes. By the 1990s, students were no longer interested in such practical classes, so a bold decision was made around 1995 to remove laboratory classes from the curriculum. Unfortunately, this meant that the medical students who might have been interested in laboratory work could no longer do such work. However, the new curriculum in 1999 gave the department an opportunity to offer a laboratory course as an elective for interested students. This new curriculum adopted an integrated approach with Genetics being taught as part of Paediatrics, and a new module (Structural and Cell Biology) comprising aspects of cell biology and biochemistry was introduced. This module is currently taught by staff from Anatomy, Physiology and Biochemistry. Some biochemistry content is now incorporated into the clinical problem scenarios of problem-based learning such as jaundice, diabetes mellitus, anorexia nervosa, etc. So the evolution of teaching biochemistry to medical students in Singapore has paralleled worldwide trends and moved from the didactic teaching of organic chemistry of biomolecules to problem-based learning using clinical cases.

  17. [Problems in organization of medical criminological registration and personality identification for subjects occupationally exposed to life risk].

    Science.gov (United States)

    Shcherbakov, V V

    2000-01-01

    The paper discusses problems in organization of identification studies under conditions of mass deaths as exemplified by forensic medical records of medical criminological identification studies of subjects killed during war conflict in Chechnya. The evolution of the organization model of identification studies is shown transformation of organization philosophy, formation of expert algorithms, formalization and technologic realization of expert solutions.

  18. Female Directors and Firm Performance: Evidence from UK Listed Firms

    Directory of Open Access Journals (Sweden)

    Pananda Pasaribu

    2017-08-01

    Full Text Available The impact of female directors on firm performance has lacked consistency in the previously conducted empirical studies, which may be due to the endogeneity problem, or certain characteristics (i.e. governance, industry, competition. This study examines the relationship between female directors and firm performance by addressing those problems. This study analyses all non-financial UK listed firms during the period 2004-2012 and employs several econometric models. The regression results indicate that there is little evidence that female directors have a positive and strong relationship with firm performance. But, further analysis reports that the UK’s small listed firms experience a positive significant effect, because small firms do not suffer from the problem of over-monitoring and they have more flexibility in composing their boards of directors.

  19. The system evaluation for report writing skills of summary by HGA-SVM with Ontology: Medical case study in problem based learning

    Science.gov (United States)

    Yenaeng, Sasikanchana; Saelee, Somkid; Samai, Wirachai

    2018-01-01

    The system evaluation for report writing skills of summary by Hybrid Genetic Algorithm-Support Vector Machines (HGA-SVM) with Ontology of Medical Case Study in Problem Based Learning (PBL) is a system was developed as a guideline of scoring for the facilitators or medical teacher. The essay answers come from medical student of medical education courses in the nervous system motion and Behavior I and II subject, a third year medical student 20 groups of 9-10 people, the Faculty of Medicine in Prince of Songkla University (PSU). The audit committee have the opinion that the ratings of individual facilitators are inadequate, this system to solve such problems. In this paper proposes a development of the system evaluation for report writing skills of summary by HGA-SVM with Ontology of medical case study in PBL which the mean scores of machine learning score and humans (facilitators) score were not different at the significantly level .05 all 3 essay parts contain problem essay part, hypothesis essay part and learning objective essay part. The result show that, the average score all 3 essay parts that were not significantly different from the rate at the level of significance .05.

  20. Medical marijuana: California update.

    Science.gov (United States)

    James, J S

    1996-08-23

    The Cannabis Buyers' Club in San Francisco remains closed after it was raided by the office of California Attorney General Dan Lungren. Many individuals with serious illnesses such as AIDS and cancer are without safe access to medical marijuana to relieve the symptoms of their diseases. The need for access to medicinal marijuana, the return of the confiscated confidential medical records held at the buyers' club, and the passage of California Proposition 215 in the November election, which allows for the legitimate use of marijuana for medical purposes are of immediate concern. Since the raid, the Cannabis Buyers' Club has denied charges that it sold marijuana to teenagers, saying the drug was sold to a teen's mother, an undercover narcotics officer. However, the club admitted to sales to non-medical individuals who used fraudulent documents in order to obtain the drug and acknowledges the need to tighten procedures. Individuals may be able to obtain marijuana at other buyers' clubs if they have documentation of a medical need. While literature on the medical use of marijuana is lacking, the Federal government continues to block any efforts toward medical research on this issue. A list of other cannabis buyers' clubs in California is included, as well as a list of organizations working for Proposition 215.

  1. Curricular priorities for business ethics in medical practice and research: recommendations from Delphi consensus panels.

    Science.gov (United States)

    DuBois, James M; Kraus, Elena M; Gursahani, Kamal; Mikulec, Anthony; Bakanas, Erin

    2014-11-15

    No published curricula in the area of medical business ethics exist. This is surprising given that physicians wrestle daily with business decisions and that professional associations, the Institute of Medicine, Health and Human Services, Congress, and industry have issued related guidelines over the past 5 years. To fill this gap, the authors aimed (1) to identify the full range of medical business ethics topics that experts consider important to teach, and (2) to establish curricular priorities through expert consensus. In spring 2012, the authors conducted an online Delphi survey with two heterogeneous panels of experts recruited in the United States. One panel focused on business ethics in medical practice (n = 14), and 1 focused on business ethics in medical research (n = 12). Panel 1 generated an initial list of 14 major topics related to business ethics in medical practice, and subsequently rated 6 topics as very important or essential to teach. Panel 2 generated an initial list of 10 major topics related to business ethics in medical research, and subsequently rated 5 as very important or essential. In both domains, the panel strongly recommended addressing problems that conflicts of interest can cause, legal guidelines, and the goals or ideals of the profession. The Bander Center for Medical Business Ethics at Saint Louis University will use the results of the Delphi panel to develop online curricular resources for each of the highest rated topics.

  2. Managing sleep problems using non-prescription medications and the role of community pharmacists: older adults' perspectives.

    Science.gov (United States)

    Abraham, Olufunmilola; Schleiden, Loren J; Brothers, Amanda L; Albert, Steven M

    2017-12-01

    To examine older adults' perspectives regarding managing sleep problems through selection and use of non-prescription sleep aids, and the role of pharmacists. Telephone interviews were conducted from May to June 2015 with 116 individuals aged ≥60 years in Pittsburgh, Pennsylvania. Participants reported in a previous survey to have used at least one non-prescription sleep aid in the past 30 days and were willing to participate in a follow-up interview. Interview guides were designed to elicit perspectives of sleep problems, selection and use of non-prescription sleep aids, and consultation with healthcare professionals. Interview transcripts underwent content analysis. Four themes emerged as follows: experiences with sleep problems, selection of non-prescription sleep aids, non-prescription sleep aid use and interactions with healthcare professionals. Over half of participants reported using a non-prescription sleep aid for >1 year, were satisfied with its use and perceived it improved sleep quality. Participants commonly used an antihistamine-only sleep aid; 36% of participants self-recommended their sleep aid; and 16% of participants consulted healthcare professionals. Few participants read medication dosage labels (22%), side effects or warnings (19%), and many reported they disregarded directions. Participants did not typically consult pharmacists about sleep problems (65%) but perceived that they could assist with medication concerns. Although most participants had favourable perceptions of non-prescription sleep aids, older adults may be inappropriately using non-prescription sleep aids to self-manage sleep problems by frequently disregarding medication labels and directions for safe use. Also, few older adults are discussing their sleep aid selection and use with pharmacists. © 2017 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.

  3. The Role of Argumentation in Hypothetico-Deductive Reasoning during Problem-Based Learning in Medical Education: A Conceptual Framework

    Science.gov (United States)

    Ju, Hyunjung; Choi, Ikseon

    2018-01-01

    One of the important goals of problem-based learning (PBL) in medical education is to enhance medical students' clinical reasoning--hypothetico-deductive reasoning (HDR) in particular--through small group discussions. However, few studies have focused on explicit strategies for promoting students' HDR during group discussions in PBL. This paper…

  4. Benefits from Funding the MSD Engineering List: A Fiscal Year 1999 Case Study

    National Research Council Canada - National Science Library

    Gehrich, David

    2004-01-01

    Every year the Air Force Material Command (AFMC) funds the MSD Engineering list. The projects on the list are submitted by the Air Logistic Centers in order to address problems with the maintainability or reliability of a reparable part...

  5. List of reports on reactor safety research from BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1984-10-01

    The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  6. Medical judgement analogue studies with applications to spaceflight crew medical officer.

    Science.gov (United States)

    McCarroll, Michele L; Ahmed, Rami A; Schwartz, Alan; Gothard, Michael David; Atkinson, Steven Scott; Hughes, Patrick; Brito, Jose Cepeda; Assad, Lori; Myers, Jerry; George, Richard L

    2017-10-01

    The National Aeronautics and Space Administration (NASA) developed plans for potential emergency conditions from the Exploration Medical Conditions List. In an effort to mitigate conditions on the Exploration Medical Conditions List, NASA implemented a crew medical officer (CMO) designation for eligible astronauts. This pilot study aims to add knowledge that could be used in the Integrated Medical Model. An analogue population was recruited for two categories: administrative physicians (AP) representing the physician CMOs and technical professionals (TP) representing the non-physician CMOs. Participants completed four medical simulations focused on abdominal pain: cholecystitis (CH) and renal colic (RC) and chest pain: cardiac ischaemia (STEMI; ST-segment elevation myocardial infarction) and pneumothorax (PX). The Medical Judgment Metric (MJM) was used to evaluate medical decision making. There were no significant differences between the AP and TP groups in age, gender, race, ethnicity, education and baseline heart rate. Significant differences were noted in MJM average rater scores in AP versus TP in CH: 13.0 (±2.25), 4.5 (±0.48), p=<0.001; RC: 12.3 (±2.66), 4.8 (±0.94); STEMI: 12.1 (±3.33), 4.9 (±0.56); and PX: 13.5 (±2.53), 5.3 (±1.01), respectively. There could be a positive effect on crew health risk by having a physician CMO. The MJM demonstrated the ability to quantify medical judgement between the two analogue groups of spaceflight CMOs. Future studies should incorporate the MJM in a larger analogue population study to assess the medical risk for spaceflight crewmembers.

  7. List of reports in the field of reactor safety research sponsored by BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1986-04-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning single problems in the field of Reactor Safety Research. The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Program of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  8. List of reports in the field of reactor safety research sponsored by BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1986-02-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special problems in the field of reactor safety research. The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  9. [Medical problems of musicians].

    Science.gov (United States)

    van de Wiel, Albert; Rietveld, Boni

    2010-01-01

    Most individuals enjoy making music, but pleasure may be diminished by physical complaints. The most common complaints in musicians include injuries of the upper part of the body including the shoulder and spine, skin disorders and hearing problems. Injuries are not so much related to the extent of rehearsing and playing but are mostly the result of a wrong position and misuse of the instrument. Adequate preparation before playing and professional coaching to avoid injuries or to detect problems at an early stage are exceptions rather than the rule. Because of the large number of amateur and professional musicians in the Netherlands, music medicine deserves a more prominent role.

  10. A qualitative study of health problems, risk factors, and prevention among Emergency Medical Service workers.

    Science.gov (United States)

    Dropkin, Jonathan; Moline, Jacqueline; Power, Paul M; Kim, Hyun

    2015-01-01

    Risk factors among Emergency Medical Service (EMS) workers are difficult to characterize and inconsistencies remain about their main health problems. To identify main work-related health problems among EMS workers in the United States; identify risk factors at the organizational, task, and exposure level; identify prevention strategies; examine these issues between participants (EMS workers and supervisors). Two types of qualitative research methods based on grounded theory were used: in-depth interviews with emergency medical technicians/paramedics (EMS workers) and focus groups (EMS workers and supervisors). Most participants reported similar health problems (musculoskeletal injuries) and the task related to these injuries, patient handling. Participants also reported similar physical exposures (ascending stairs with patients and patient weight). For organization/psychosocial factors, participants agreed that fitness, wages, breaks, and shift scheduling were linked with injuries, but overall, perceptions about these issues differed more than physical exposures. Lack of trust between EMS workers and supervisors were recurrent concerns among workers. However, not all organizational/psychosocial factors differed. EMS workers and supervisors agreed pre-employment screening could reduce injuries. Participants identified micro- and macro-level prevention opportunities. The grounded theory approach identified workers' main health problems, and the organizational factors and exposures linked with them. Perceptions about work organization/psychosocial exposures appeared more diverse than physical exposures. Prevention among all participants focused on mechanized equipment, but EMS workers also wanted more organizational support.

  11. List of reports from reactor safety research of BMFT, USNRC, EPRI and JSTA

    International Nuclear Information System (INIS)

    1979-01-01

    This list reviews reports from the Federal Republic of Germany, from the USA and from Japan concerning special problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the USNRC, the Electric Power Research Institute (EPRI), and the Japan Science and Technology Agency (JSTA) these reports are available in the Gesellschaft fuer Reaktorsicherheit. The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Program of BMFT, reporting organisation. The list of reports appears quarterly. Requests for reports should be adressed to GRS, Forschungsbetreuung. Contractual view points have to be considered for the distribution of the reports. (orig./HP) [de

  12. List of reports from reactor safety research of BMFT, USNRC, EPRI and JSTA

    International Nuclear Information System (INIS)

    1978-12-01

    This list reviews reports from the Federal Republic of Germany, from the USA and from Japan concerning special problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the USNRC, the Electric Power Research Institute (EPRI), and the Japan Science and Technology Agency (JSTA) these reports are available in the Gesellschaft fuer Reaktorsicherheit. The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Program of BMFT, reporting organisation. The list of reports appears quarterly. Requests for reports should be addressed to GRS, Forschungsbetreuung. Contractual view points have to be considered for the distribution of the reports. (orig./HP) [de

  13. List of reactor safety research reports from BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1982-07-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special Problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technologie Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these Reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Program of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  14. Defining Medical Capabilities for Exploration Missions

    Science.gov (United States)

    Hailey, M.; Antonsen, E.; Blue, R.; Reyes, D.; Mulcahy, R.; Kerstman, E.; Bayuse, T.

    2018-01-01

    Exploration-class missions to the moon, Mars and beyond will require a significant change in medical capability from today's low earth orbit centric paradigm. Significant increases in autonomy will be required due to differences in duration, distance and orbital mechanics. Aerospace medicine and systems engineering teams are working together within ExMC to meet these challenges. Identifying exploration medical system needs requires accounting for planned and unplanned medical care as defined in the concept of operations. In 2017, the ExMC Clinicians group identified medical capabilities to feed into the Systems Engineering process, including: determining what and how to address planned and preventive medical care; defining an Accepted Medical Condition List (AMCL) of conditions that may occur and a subset of those that can be treated effectively within the exploration environment; and listing the medical capabilities needed to treat those conditions in the AMCL. This presentation will discuss the team's approach to addressing these issues, as well as how the outputs of the clinical process impact the systems engineering effort.

  15. 77 FR 31335 - Procurement List; Proposed Additions and Deletion

    Science.gov (United States)

    2012-05-25

    .... Services Service Type/Location: Laundry and Dry Cleaning Service, Buckley Air Force Base Lodging & Medical... products and services to the Procurement List that will be furnished by nonprofit agencies employing persons who are blind or have other severe disabilities, and deletes a service previously provided by such...

  16. Job requirements compared to medical school education: differences between graduates from problem-based learning and conventional curricula.

    Science.gov (United States)

    Schlett, Christopher L; Doll, Hinnerk; Dahmen, Janosch; Polacsek, Ole; Federkeil, Gero; Fischer, Martin R; Bamberg, Fabian; Butzlaff, Martin

    2010-01-14

    Problem-based Learning (PBL) has been suggested as a key educational method of knowledge acquisition to improve medical education. We sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements. Graduates from all German medical schools who graduated between 1996 and 2002 were eligible for this study. Graduates self-assessed nine competencies as required at their day-to-day work and as taught in medical school on a 6-point Likert scale. Results were compared between graduates from a PBL-based curriculum (University Witten/Herdecke) and conventional curricula. Three schools were excluded because of low response rates. Baseline demographics between graduates of the PBL-based curriculum (n = 101, 49% female) and the conventional curricula (n = 4720, 49% female) were similar. No major differences were observed regarding job requirements with priorities for "Independent learning/working" and "Practical medical skills". All competencies were rated to be better taught in PBL-based curriculum compared to the conventional curricula (all p learning/working" (Delta + 0.57), "Psycho-social competence" (Delta + 0.56), "Teamwork" (Delta + 0.39) and "Problem-solving skills" (Delta + 0.36), whereas "Research competence" (Delta--1.23) and "Business competence" (Delta--1.44) in the PBL-based curriculum needed improvement. Among medical graduates in Germany, PBL demonstrated benefits with regard to competencies which were highly required in the job of physicians. Research and business competence deserve closer attention in future curricular development.

  17. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem.

    Science.gov (United States)

    Williams, Patricia Ah; Woodward, Andrew J

    2015-01-01

    The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat.

  18. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem

    Science.gov (United States)

    Williams, Patricia AH; Woodward, Andrew J

    2015-01-01

    The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. PMID:26229513

  19. Union Listing via OCLC's Serials Control Subsystem.

    Science.gov (United States)

    O'Malley, Terrence J.

    1984-01-01

    Describes library use of Conversion of Serials Project's (CONSER) online national machine-readable database for serials to create online union lists of serials via OCLC's Serial Control Subsystem. Problems in selection of appropriate, accurate, and authenticated records and prospects for the future are discussed. Twenty sources and sample records…

  20. Applications of the Monte Carlo simulation in dosimetry and medical physics problems

    International Nuclear Information System (INIS)

    Rojas C, E. L.

    2010-01-01

    At the present time the computers use to solve important problems extends to all the areas. These areas can be of social, economic, of engineering, of basic and applied science, etc. With and appropriate handling of computation programs and information can be carried out calculations and simulations of real models, to study them and to solve theoretical or application problems. The processes that contain random variables are susceptible of being approached with the Monte Carlo method. This is a numeric method that, thanks to the improvements in the processors of the computers, it can apply in many tasks more than what was made in the principles of their practical application (at the beginning of the decade of 1950). In this work the application of the Monte Carlo method will be approached in the simulation of the radiation interaction with the matter, to investigate dosimetric aspects of some problems that exist in the medical physics area. Also, contain an introduction about some historical data and some general concepts related with the Monte Carlo simulation are revised. (Author)

  1. Shift Work and Related Health Problems among Medical and Diagnostic Staff of the General Teaching Hospitals Affiliated to Shiraz University of Medical Sciences, 2012

    Directory of Open Access Journals (Sweden)

    Zahra Sajjadnia

    2015-07-01

    Full Text Available Introduction:Today, shift work is considered as a necessity in many jobs and for some 24-hour services the use of shift-work is growing. However, shift work can lead to physiological and psycho-social problems for shift workers. This study aimed to determine the effects of shift work on the associated health problems, together with the demographic and job characteristics underlying the problems, among the medical and diagnostic staff of the general teaching hospitals affiliated to Shiraz University of Medical Sciences in 2012. Method:This study was an applied, cross-sectional and descriptive-analytical one. The study employed a sample of 205 employees from the medical and diagnostic staff using stratified sampling proportional to the size and simple random sampling methods. Data were collected using the Survey of Shift workers (SOS questionnaire, validity and reliability of which have already been confirmed. Finally, the collected data were analyzed using SPSS 16.0 software through ANOVA, Chi-square, Independent-Samples T-Test, as well as Pearson Correlation Coefficient. A P<0.05 was considered statistically significant. Results: The results showed that among the demographic and job characteristics studied, the individual, family and social problems had significant associations with work schedules, shift work and job satisfaction. In addition, there were significant associations between musculoskeletal disorders and the satisfaction of shift work; cardiovascular disorders and marital status and occupation; digestive disorders and the work schedules; sleep disorders and the satisfaction of shift work; musculoskeletal disorders, cardiovascular disorders and sleep disorders and age, job experience and shift work experience. And finally, there were significant associations among sleep disorders and age, job experience and the shift work experience. Conclusion: Based on the findings of this study, demographic characteristics such as age, marital

  2. What bothers the sick-listed employee with severe MUPS?

    NARCIS (Netherlands)

    Hoedeman, R.; Blankenstein, A. H.; Koopmans, P. C.; Groothoff, J. W.

    Aims: The aim of this study was to explore what employees with severe medically unexplained physical symptoms (MUPS) experience as causes of distress with regard to employees with mild or no MUPS. Methods: This study is an additional analysis of a cross-sectional study in which 486 sick-listed

  3. List memory in young adults with language learning disability.

    Science.gov (United States)

    Sheng, Li; Byrd, Courtney T; McGregor, Karla K; Zimmerman, Hannah; Bludau, Kadee

    2015-04-01

    The purpose of this study was to characterize the verbal memory limitations of young adults with language learning disability (LLD). Sixteen young adults with LLD and 34 age- and education-matched controls with typical language participated in a Deese-Roediger-McDermott (DRM; Deese, 1959; Roediger & McDermott, 1995) list recall experiment. Participants listened to 12-item word lists that converged on a nonpresented critical item (e.g., rain) semantically (umbrella, drench, weather, hail), phonologically (train, main, ran, wren), or dually in a hybrid list (umbrella, train, drench, main) and recalled words in no particular order. Group comparisons were made on veridical recall (i.e., words that were presented) and false recall of nonpresented critical items. Recall performance was analyzed by list type and list position to examine potential differences in the quality of memorial processes. The LLD group produced fewer veridical recalls than the controls. Both groups demonstrated list type and list position effects in veridical recall. False recall of the critical items was comparable in the 2 groups and varied by list type in predictable ways. Young adults with LLD have verbal memory limitations characterized by quantitatively low levels of accurate recall. Qualitative patterns of recall are similar to those of unaffected peers. Therefore, the memory problem is characterized by limited capacity; memorial processes appear to be intact.

  4. Preliminary list of plant invaders in Montenegro

    Directory of Open Access Journals (Sweden)

    Stešević, D.

    2010-12-01

    Full Text Available Due to the fact that Invasive alien species (IAS are considered to be the second cause of global biodiversity loss after direct habitat destruction and have adverse environmental, economic and social impacts from the local level upwards, in last decades investigations of alien flora of Montenegro are intensified. In this paper we are presenting a preliminary list of IAS, with the aim to provide a basic data on IAS in Montenegro, to enable future monitoring and to draw attention on the problems which expansion of IAS is bringing with itself. The list consists of 50 plant taxa species and supspecies level.

  5. [The problems of professional competence in the complementary professional forensic medical expertise programs of advanced training and professional requalification].

    Science.gov (United States)

    Shadymov, A B; Fominykh, S A; Dik, V P

    This article reports the results of the analysis of the new tendencies and normatives of the working legislation in the field of additional professional education in the speciality of «forensic medical expertise» and the application of the competency-based approach to the training of specialists in the framework of professional requalification and advanced training programs. Special attention is given to the problems of organization of the educational process and the elaboration of additional training programs based on the competency approach to the training of specialists at the Department of Forensic Medicine and Law with the professor V.N. Kryukov Course of Advanced Professional Training and Professional Requalification of Specialists at the state budgetary educational Institution of higher professional education «Altai State Medical University», Russian Ministry of Health. The study revealed the problems pertaining to the development of professional competencies in the framework of educational programs for the professional requalification and advanced training in the speciality «forensic medical expertise». The authors propose the legally substantiated approaches to the solution of these problems.

  6. Promotion of Problem Solving Skills by Using Metacognitive-based Instruction in Students of Kermanshah University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    yahya safari

    2017-06-01

    Full Text Available Background and objective: Studies have indicated that metacognitive strategies control and direct cognitive strategies. Thus, application of metacognitive and cognitive strategies together is essential for successful learning to happen. The present study was conducted to examine the effect of metacognitive-oriented instruction on development of problem solving skills in students of Kermanshah University of Medical Sciences. Materials and Methods: This study was a quasi-experimental research with pretest/posttest and control group design. The study sample included the students of Kermanshah University of Medical Sciences (n=4283 in the academic year of 2013-2014. A total number of 40 students were selected through convenient sampling method as the study sample. The samples were randomly placed in experimental and control groups. For the experimental group, problem solving skills were taught based on metacognitive strategies in 8 sessions, each session for 1 and half hours. For the control group, however, problem solving skills were taught through conventional teaching method. The instrument for data collection was Heppner’s problem solving inventory (1988 whose validity and reliability were confirmed previously. Data were analyzed by descriptive statistics, mean and standard deviation, and the hypotheses were tested through t-test. Results: The results of the posttest showed that the total mean of scores for problem solving skills in the experimental group (99.75 was higher than that of the control group (26.800 (p<0.0001. This difference was significant in the case of confidence, approach/avoidance and personal control components (p<0.0001. Moreover, the mean of students’ scores was not significant in terms of gender and major. Conclusion: Given the positive effect of metacognitive strategies on the students’ performance and the necessity of teaching metacognition for the sake of academic achievement, these strategies are recommended to be

  7. List of reports on reactor safety research from BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1985-01-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special Problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l' Energie Atomique (CEA), the Japan Science and Technologie Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these Reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  8. List of reports on reactor safety research from BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1985-08-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special problems in the field of reactor safety research. According to the cooperation of the Federal Ministry for Research and Technology (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available from the Society for Reactor Safety (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Program of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  9. List of reports concerning reactor safety research from BMFT, CEA, EPRI, JSTA, and USNRC

    International Nuclear Information System (INIS)

    1982-12-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technologie Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these Reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  10. Perceptions among general medical practitioners toward implementation of medication reconciliation program for patients discharged from hospitals in Penang, Malaysia.

    Science.gov (United States)

    Hassali, Mohamed Azmi Ahmad; Al-Haddad, Mahmoud; Shafie, Asrul Akmal; Tangiisuran, Balamurugan; Saleem, Fahad; Atif, Muhammad; Al-Qazaz, Harith

    2012-06-01

    This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia. A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry. A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers. General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.

  11. Listings.

    Science.gov (United States)

    1994-12-07

    Nursing Standard regrets that it is no longer able to take listings over the telephone because of unprecedented demand. Readers are reminded that the listings section is for the use of charitable and professional organisations, unions and health authorities to publicise forthcoming events. Listings should contain all relevant details and be posted or faxed to Susan Blood-worth, Nursing Standard, Viking House, 17-19 Peterborough Road, Harrotc. Middlesex HA 1 2AX. Fax: 081-423 3867.

  12. National priorities list sites: The United States Territories, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  13. [The set of wearable medical equipment for medical and nursing teams].

    Science.gov (United States)

    Efimenko, N a; Valevskii, V V; Lyutov, V V; Makhnovskii, A I; Sorokin, S I; Blinda, I V

    2015-06-01

    The kit is designed in accordance with the list of the first medical aid procedures and syndromic standards of emergency medical care providing. The kit contains modern local hemostatic agents, vent tubes, cricothyrotomy, needles to eliminate pneumothorax, portable oxygen machine, sets for intravenous and intraosseous infusion therapy, collapsible plastic tires, anti-shock pelvic girdle, and other medical products and pharmaceuticals. As containers used backpack and trolley bag on wheels camouflage colours. For the convenience and safety of the personnel of the vest is designed discharge to be converted in the body armour.

  14. Teaching nutrition to medical students: a community-based problem-solving approach.

    Science.gov (United States)

    Bhattacharji, S; Joseph, A; Abraham, S; Muliyil, J; John, K R; Ethirajan, N

    1990-01-01

    This paper presents a community-based problem-solving educational programme which aims at teaching medical and other health science students the importance of nutrition and its application. Through community surveys students assess the nutritional status of children under five using different anthropometric methods. They understand the cultural beliefs and customs related to food fads and the reasons for them. They also acquire the skill to educate the community using the information gathered. They use epidemiological methods such as case control study to find associations between malnutrition and other causative factors. Feedback from students has been positive and evaluation of students' knowledge before and after the programme has shown significant improvement.

  15. Interprofessional, simulation-based technology-enhanced learning to improve physical health care in psychiatry: The recognition and assessment of medical problems in psychiatric settings course.

    Science.gov (United States)

    Akroyd, Mike; Jordan, Gary; Rowlands, Paul

    2016-06-01

    People with serious mental illness have reduced life expectancy compared with a control population, much of which is accounted for by significant physical comorbidity. Frontline clinical staff in mental health often lack confidence in recognition, assessment and management of such 'medical' problems. Simulation provides one way for staff to practise these skills in a safe setting. We produced a multidisciplinary simulation course around recognition and assessment of medical problems in psychiatric settings. We describe an audit of strategic and design aspects of the recognition and assessment of medical problems in psychiatric settings course, using the Department of Health's 'Framework for Technology Enhanced Learning' as our audit standards. At the same time as highlighting areas where recognition and assessment of medical problems in psychiatric settings adheres to these identified principles, such as the strategic underpinning of the approach, and the means by which information is collected, reviewed and shared, it also helps us to identify areas where we can improve. © The Author(s) 2014.

  16. Discrepancies in listed adverse drug reactions in pharmaceutical product information supplied by the regulatory authorities in Denmark and the USA

    DEFF Research Database (Denmark)

    Eriksson, Robert; Aagaard, Lise; Jensen, Lars Juhl

    2014-01-01

    as ADRs listed only in one country or listed with different frequencies. We analyzed PIs for 40 separate drugs from ten therapeutic groups and assigned the 4003 identified ADRs to System Organ Classes (Medical Dictionary for Regulatory Activities [MedDRA] terminology). Less than half of listed ADRs (n...

  17. Design and Development of Virtual Reality Simulation for Teaching High-Risk Low-Volume Problem-Prone Office-Based Medical Emergencies

    Science.gov (United States)

    Lemheney, Alexander J.

    2014-01-01

    Physicians' offices are not the usual place where emergencies occur; thus how staff remains prepared and current regarding medical emergencies presents an ongoing challenge for private practitioners. The very nature of low-volume, high-risk, and problem-prone medical emergencies is that they occur with such infrequency it is difficult for staff to…

  18. [The Results of Self-Assessment by Medical Organizations Their Correspondence to Proposals (Practical Recommendations) of the Roszdravnadzor Concerning Organization of Internal Control of Quality and Safety of Medical Activity].

    Science.gov (United States)

    Ivanov, I V; Shvabsky, O R; Minulin, I B

    2017-11-01

    The article presents the analysis of the results of internal audits (self-rating) in medical organizations implemented on the basis of Proposals (practical guidelines) of the Roszdravnadzor concerning organization of inner control of quality and safety of medical activities in medical organization (hospital). The self-rating was implemented by the medical organizations themselves according the common criteria of the Proposals as provided the following plan: planning of self-rating, collection and processing of data, application of self-rating, analysis of obtained results, preparation of report. The article uses the results of self-rating of medical organizations corresponding to following criteria: profile of activity-multi-field hospital-number of beds more than 350-state property. The self-rating was implemented according to 11 basic parts of the Proposals. The criteria were developed for every part. The evaluation lists developed on the basis of the given Proposals permitted to medical organizations to independently establish problems in their activities. Within the framework of implemented self-rating medical organizations mentioned the directions of activity related to personnel management, identification of personality of patient, support of epidemiological and surgical safety as having significant discrepancies with the Proposals and requiring implementation of improvement measures.

  19. How patients can improve the accuracy of their medical records.

    Science.gov (United States)

    Dullabh, Prashila M; Sondheimer, Norman K; Katsh, Ethan; Evans, Michael A

    2014-01-01

    Assess (1) if patients can improve their medical records' accuracy if effectively engaged using a networked Personal Health Record; (2) workflow efficiency and reliability for receiving and processing patient feedback; and (3) patient feedback's impact on medical record accuracy. Improving medical record' accuracy and associated challenges have been documented extensively. Providing patients with useful access to their records through information technology gives them new opportunities to improve their records' accuracy and completeness. A new approach supporting online contributions to their medication lists by patients of Geisinger Health Systems, an online patient-engagement advocate, revealed this can be done successfully. In late 2011, Geisinger launched an online process for patients to provide electronic feedback on their medication lists' accuracy before a doctor visit. Patient feedback was routed to a Geisinger pharmacist, who reviewed it and followed up with the patient before changing the medication list shared by the patient and the clinicians. The evaluation employed mixed methods and consisted of patient focus groups (users, nonusers, and partial users of the feedback form), semi structured interviews with providers and pharmacists, user observations with patients, and quantitative analysis of patient feedback data and pharmacists' medication reconciliation logs. (1) Patients were eager to provide feedback on their medications and saw numerous advantages. Thirty percent of patient feedback forms (457 of 1,500) were completed and submitted to Geisinger. Patients requested changes to the shared medication lists in 89 percent of cases (369 of 414 forms). These included frequency-or dosage changes to existing prescriptions and requests for new medications (prescriptions and over-the counter). (2) Patients provided useful and accurate online feedback. In a subsample of 107 forms, pharmacists responded positively to 68 percent of patient requests for

  20. Prevalence, associated factors and impact of loneliness and interpersonal problems on internet addiction: A study in Chiang Mai medical students.

    Science.gov (United States)

    Simcharoen, Sutapat; Pinyopornpanish, Manee; Haoprom, Pattaraporn; Kuntawong, Pimolpun; Wongpakaran, Nahathai; Wongpakaran, Tinakon

    2018-01-01

    Internet addiction is common among medical students, and the prevalence is higher than the general population. Identifying and creating solutions for this problem is important. The aim of this study was to examine the prevalence and associated factors, particularly loneliness and interpersonal problems among Chiang Mai medical students. Of 324 first to sixth year medical students, 56.8% comprised females with a mean age of 20.88 (SD 1.8). All completed questionnaires related to the objectives and activities of internet use, the Young Internet Addiction Test, the UCLA loneliness scale, and the Interpersonal Problems Inventory were employed to identify internet addiction. In all, 36.7% of the subjects exhibited internet addiction, mostly at mild level. Amount of time used daily, loneliness and interpersonal problems were strong predictors (beta = 0.441, p < 0.05, beta = 0.219, p < 0.001 and beta = 0.203 p < 0.001, respectively), whereas age and sex were not. All objectives of using internet contributed to the variance of internet addiction score. For internet activities, only non-academic or studying contributed. The final model accounted for 42.8% of total variance of the internet addiction score. Even though most addiction was at a mild level, careful strategies should be applied to better understand the situation. Along with a screening for potential internet addiction among medical students, attention should be paid to identifying those who experience loneliness and interpersonal problems, because both are strong predictors that can be improved by a variety of appropriate intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Organization of accident medical service in emergency situations in the system of Federal administration board for medical-biological and emergency problems at the Ministry of public health and medical industry of Russia

    International Nuclear Information System (INIS)

    Parfenova, L.N.

    1995-01-01

    Federal Administration Board for medical-biological problems at the Ministry of Public Health and Medical Industry of Russia, in accordance with the entrusted functions, provides medical-sanitary service for the workers of the branches of industry with especially dangerous labour conditions. For these purpose, there is functioning in its system a network of therapeutic-prophylactic, sanitary, scientific-research, educational and other establishments. A high degree of accident danger of the attended industrial plants determines the state policy of organizations and administrations as well as scientific-practical establishments of the Federal Administration Board in respect of elaboration and introduction of a complex of measures which would enable to guarantee the safe functioning of the plants. All sub-administration establishments have the necessary structures, settle the questions of liquidation of medical-sanitary after-effects of accidents at the attended plants, and are regarded to be the organizations of specialized emergency medical aid of the Federal Administration Board

  2. Twelve Tips for teaching medical professionalism at all levels of medical education.

    Science.gov (United States)

    Al-Eraky, Mohamed Mostafa

    2015-01-01

    Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.

  3. License - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...t list, Marker list, QTL list, Plant DB link & Genome analysis methods © Satoshi ... Policy | Contact Us License - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  4. DisLexList

    DEFF Research Database (Denmark)

    2013-01-01

    DisLexList is a simple analysis script for the generation of lists of lexemes in discourses, and may be used as a tool in discourse analysis (critical and otherwise). DisLexList is, in its current state, able to generate simple word lists and lexeme list based on output from VISL's flat structure...

  5. From primary care to public health: using Problem-based Learning and the ecological model to teach public health to first year medical students.

    Science.gov (United States)

    Hoover, Cora R; Wong, Candice C; Azzam, Amin

    2012-06-01

    We investigated whether a public health-oriented Problem-Based Learning case presented to first-year medical students conveyed 12 "Population Health Competencies for Medical Students," as recommended by the Association of American Medical Colleges and the Regional Medicine-Public Health Education Centers. A public health-oriented Problem-Based Learning case guided by the ecological model paradigm was developed and implemented among two groups of 8 students at the University of California, Berkeley-UCSF Joint Medical Program, in the Fall of 2010. Using directed content analysis, student-generated written reports were coded for the presence of the 12 population health content areas. Students generated a total of 29 reports, of which 20 (69%) contained information relevant to at least one of the 12 population health competencies. Each of the 12 content areas was addressed by at least one report. As physicians-in-training prepare to confront the challenges of integrating prevention and population health with clinical practice, Problem-Based Learning is a promising tool to enhance medical students' engagement with public health.

  6. A Comparison between the Effectiveness of PBL and LBL on Improving Problem-Solving Abilities of Medical Students Using Questioning

    Science.gov (United States)

    He, Yunfeng; Du, Xiangyun; Toft, Egon; Zhang, Xingli; Qu, Bo; Shi, Jiannong; Zhang, Huan; Zhang, Hui

    2018-01-01

    In daily patient-history taking and diagnosis practice, doctors ask questions to gather information from patients and narrow down diagnostic hypotheses. Training medical students to be efficient problem solvers through the use of questioning is therefore important. In this study, the effectiveness of problem-based learning (PBL) and lecture-based…

  7. Medical Optimization Network for Space Telemedicine Resources

    Science.gov (United States)

    Shah, R. V.; Mulcahy, R.; Rubin, D.; Antonsen, E. L.; Kerstman, E. L.; Reyes, D.

    2017-01-01

    INTRODUCTION: Long-duration missions beyond low Earth orbit introduce new constraints to the space medical system such as the inability to evacuate to Earth, communication delays, and limitations in clinical skillsets. NASA recognizes the need to improve capabilities for autonomous care on such missions. As the medical system is developed, it is important to have an ability to evaluate the trade space of what resources will be most important. The Medical Optimization Network for Space Telemedicine Resources was developed for this reason, and is now a system to gauge the relative importance of medical resources in addressing medical conditions. METHODS: A list of medical conditions of potential concern for an exploration mission was referenced from the Integrated Medical Model, a probabilistic model designed to quantify in-flight medical risk. The diagnostic and treatment modalities required to address best and worst-case scenarios of each medical condition, at the terrestrial standard of care, were entered into a database. This list included tangible assets (e.g. medications) and intangible assets (e.g. clinical skills to perform a procedure). A team of physicians working within the Exploration Medical Capability Element of NASA's Human Research Program ranked each of the items listed according to its criticality. Data was then obtained from the IMM for the probability of occurrence of the medical conditions, including a breakdown of best case and worst case, during a Mars reference mission. The probability of occurrence information and criticality for each resource were taken into account during analytics performed using Tableau software. RESULTS: A database and weighting system to evaluate all the diagnostic and treatment modalities was created by combining the probability of condition occurrence data with the criticalities assigned by the physician team. DISCUSSION: Exploration Medical Capabilities research at NASA is focused on providing a medical system to

  8. Problems of postgraduate medical training in Nigeria.

    Science.gov (United States)

    Ike, S O

    2004-01-01

    Postgraduate medical training in Nigeria has been in dire straits for about two decades now. That it has continued to survive, is a tribute to the average resident doctor who has become immunized, and who has grown a thick skin of armour, as well the spirit of altruism of the medical teachers--consultants (young and old), who despite odds, have kept their focus clear, above the murky waters of national distraction and daunting socio economic challenges. A review of relevant literature on medical education in Nigeria was undertaken by manual library search. This paper x-rays the strong points that have still prevailed to hold the rudiments and ideals of postgraduate medical training in a viable position up to date. It discusses the weaknesses and threats--potential and real--to the training programme. This paper attempts to search, and actually hopes, for silver lining in the Nigerian sky as possible solution lifelines that may yet re-engineer the programme.

  9. Lists A and B of X-ray equipment. As of July 1, 1984

    International Nuclear Information System (INIS)

    1984-01-01

    The lists A and B of X-ray equipment present the guidelines for X-ray device, as of December 10, 1983, that are defined in the guidelines for radiology and nuclear medicine of the Federal Association of Panel Doctors. In list A, the equipment categories of up-to-date, commercially available X-ray device are given, whereas list B classifies older equipment, both types available from manufacturers who are members of the ZVEI association. Since the categories of application II and III have been made, specifiying the equipment still in use and applicable within a given transitional period in existing medical establishments, but which may not be applied in new establishments. The list of manufacturers gives the addresses of the firms supplying the equipment described in Lists A and B, which have been compiled according to the requirements set by the Federal Association of Panel Doctors. (orig.) [de

  10. Evaluation of a Computerized Problem-Oriented Medical Record in a Hospital Department: Does it Support Daily Clinical Practice?

    DEFF Research Database (Denmark)

    Bossen, Claus

    2007-01-01

    led to more time spent documenting clinical work, fragmentation of patient situation into separate problems, and lack of overview.Conclusion: The problem-oriented method for structuring a computerized medical record may provide a description of how physicians think or ought to think, but does...... not adequately support complex clinical work. While the CPOMR can be used for patients with few, simple problems who are admitted for only a short time, the CPOMR is not useful for patients with a complex set of problems or for patients admitted for longer periods of time. This is in accordance with criticism...

  11. Apps and Mobile Support Services in Canadian Academic Medical Libraries

    Directory of Open Access Journals (Sweden)

    Tess Grynoch

    2016-12-01

    Full Text Available Objective: To examine how Canadian academic medical libraries are supporting mobile apps, what apps are currently being provided by these libraries, and what types of promotion are being used. Methods: A survey of the library websites for the 17 medical schools in Canada was completed. For each library website surveyed, the medical apps listed on the website, any services mentioned through this medium, and any type of app promotion events were noted. When Facebook and Twitter accounts were evident, the tweets were searched and the past two years of Facebook posts scanned for mention of medical apps or mobile services/events. Results: All seventeen academic medical libraries had lists of mobile medical apps with a large range in the number of medical relevant apps (average=31, median= 23. A total of 275 different apps were noted and the apps covered a wide range of subjects. Five of the 14 Facebook accounts scanned had posts about medical apps in the past two years while 11 of the 15 Twitter accounts had tweets about medical apps. Social media was only one of the many promotional methods noted. Outside of the app lists and mobile resources guides, Canadian academic medical libraries are providing workshops, presentations, and drop-in sessions for mobile medical apps. Conclusion: While librarians cannot simply compare mobile services and resources between academic medical libraries without factoring in a number of other circumstances, librarians can learn from mobile resources strategies employed at other libraries, such as using research guides to increase medical app literacy.

  12. List of reports from the BMFT, CEA, EPRI, JSTA and USNRC concerning reactor safety research

    International Nuclear Information System (INIS)

    1981-09-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special Problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Energie Atomique (CEA) the Japan Science and Technology Agency (JSTA) the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Saftety Research Program of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  13. Color blindness defect and medical laboratory technologists: unnoticed problems and the care for screening.

    Science.gov (United States)

    Dargahi, Hossein; Einollahi, Nahid; Dashti, Nasrin

    2010-01-01

    Color-blindness is the inability to perceive differences between some color that other people can distinguish. Using a literature search, the results indicate the prevalence of color vision deficiency in the medical profession and its on medical skills. Medical laboratory technicians and technologists employees should also screen for color blindness. This research aimed to study color blindness prevalence among Hospitals' Clinical Laboratories' Employees and Students in Tehran University of Medical Sciences (TUMS). A cross-sectional descriptive and analytical study was conducted among 633 TUMS Clinical Laboratory Sciences' Students and Hospitals' Clinical Laboratories' Employees to detect color-blindness problems by Ishihara Test. The tests were first screened with certain pictures, then compared to the Ishihara criteria to be possible color defective were tested further with other plates to determine color - blindness defects. The data was saved using with SPSS software and analyzed by statistical methods. This is the first study to determine the prevalence of color - blindness in Clinical Laboratory Sciences' Students and Employees. 2.4% of TUMS Medical Laboratory Sciences Students and Hospitals' Clinical Laboratories' Employees are color-blind. There is significant correlation between color-blindness and sex and age. But the results showed that there is not significant correlation between color-blindness defect and exposure to chemical agents, type of job, trauma and surgery history, history of familial defect and race. It would be a wide range of difficulties by color blinded students and employees in their practice of laboratory diagnosis and techniques with a potentially of errors. We suggest color blindness as a medical conditions should restrict employment choices for medical laboratory technicians and technologists job in Iran.

  14. Medication reconciliation is a prerequisite for obtaining a valid medication review

    DEFF Research Database (Denmark)

    Bjeldbak-Olesen, Mette; Danielsen, Anja Gadsbølle; Tomsen, Dorthe Vilstrup

    2013-01-01

    The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors.......The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors....

  15. Professional development of medical students: problems and promises.

    Science.gov (United States)

    Wear, D

    1997-12-01

    Observers and critics of the medical profession, both within and without, urge that more attention be paid to the moral sensibilities, the characters, of medical students. Passing on particular moral values and actions to physicians has always been an essential core of medical training, and this call for renewal is not new in modern medicine. Some of the structures and characteristics of modern medical education, however, often work directly against the professionalism that the education espouses. For example, medical students are socialized into a hierarchy that has broad implications for relations among health care professionals, other health care workers, and patients, and academic medicine has not promoted and taught critical reflection about the values and consequences of this hierarchy. Further, behind the formal curriculum lies the "hidden curriculum" of values that are unconsciously or half-consciously passed on from the faculty and older trainees. Two resources for thinking anew about professional development for medical students are feminist standpoint theory and critical multicultural theory, each of which raises important and fundamental questions about defining the role of medicine in society and the role of the physician in medicine. The author discusses these two theories and their implications for medical education, showing how they can be used to move discussions of professional development into analysis of the widespread social consequences of how a society organizes its health care and into critical reflection on the nature of medical knowledge.

  16. Analysis of medication adherence-related notes from a service-oriented community pharmacy.

    Science.gov (United States)

    Witry, Matthew; Parry, Rachel; McDonough, Randal; Deninger, Michael

    2017-07-15

    Medication nonadherence is a significant public health problem. Community pharmacists are positioned to intervene, however, the process is not well understood. To classify and quantify the reasons for nonadherence documented by community pharmacists. A retrospective content analysis of pharmacist notes related to nonadherence at a service oriented community pharmacy in the Midwest United States. Notes from the site's dispensing custom documentation software were obtained from September 1, 2014 through February 28, 2015 that were labeled "compliance", either prompted by proportion of days covered calculations or entered as a drug therapy problem. A code list was iterated for the notes based on the literature and by reading the notes and generating descriptive codes. A reliability analysis was calculated for two coders. Notes were coded, check-coded, and discrepancies were resolved using a consensus process. Frequencies were calculated for each code and representative text was selected. Pharmacists documented 3491 notes as part of their continuous medication monitoring process. Nineteen codes were developed. The reliability for the coders had a Cohen's Kappa of 0.749. The majority of notes (61.4%) documented the pharmacist evaluated the refill and had no concerns or would continue to follow. Also documented were specific reasons for out of range PDCs not indicative of a nonadherence problem. Only 2.2% of notes specifically documented a nonadherence problem, such as forgetfulness or cost. While pharmacists encountered many false positive nonadherence alerts, following up with patients led to hundreds of discussions and clarifications about how patients use their medications at home. These results suggest a small minority of late refills are judged by pharmacists as indicative of an adherence problem, contrary to the prevailing literature. Pharmacists may benefit from modifying their approach to nonadherence interviewing and documentation as they seek to address

  17. [Medical assessment of occupational disability (preparation of a list of occupational diseases with the colaboration of scientific societies)].

    Science.gov (United States)

    Jardón-Dato, E

    Amongst the financial benefits given by the Social Security Service, that of disability benefit is one of the most important. To determine the right to obtain this and the amount due, it is necessary to have administrative certification of the existence of this disability, the cause of it and the degree (partial, total, absolute or great disability). Therefore medical assessment is essential. The medical assessors of the Disability Tribunals of the Instituto Nacional de la Seguridad Social are responsible for medical assessment. It is necessary for these doctors to understand all types of disorders and useful for them to have methodology at their disposal for each of the different disorders. Also, lack of official criteria for evaluation, due to the variety of situations which may arise, make unification difficult. We aim to devise criteria for evaluation of the diagnosis, by means of the tests and investigations necessary, their evaluation and the symptoms of each disorder which may cause problems (deficiencies) in the individual person, when carrying out his work (determining which tests and investigations allow this to be shown). Neurology is one of the specialities which offers the greatest difficulty to nonspecialists. This is due to the evaluation of complementary tests used and the subjectivity of some defects. In this paper, we aim to report these difficulties in order to promote collaboration between medical assessors and Neurology specialists.

  18. Collaborative diagramming during problem based learning in medical education: Do computerized diagrams support basic science knowledge construction?

    NARCIS (Netherlands)

    de Leng, Bas; Gijlers, Aaltje H.

    2015-01-01

    Aim: To examine how collaborative diagramming affects discussion and knowledge construction when learning complex basic science topics in medical education, including its effectiveness in the reformulation phase of problem-based learning. Methods: Opinions and perceptions of students (n = 70) and

  19. Manual for medical problems of radiation protection

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    The manual deals comprehensively and topically with the theoretical and practical fundamentals of radiation protection of the population considering the present knowledge in the fields of radiobiology and radiation protection medicine. The subject is covered under the following headings: (1) physics of ionizing radiations, (2) biological radiation effects, (3) the acute radiation syndrome, (4) medical treatment of the acute radiation syndrome, (5) combined radiation injuries, and (6) prophylaxis and therapy of injuries caused by fission products of nuclear explosions. The book is of interest to medical doctors, medical scientists, and students in medicine who have to acquire special knowledge in the field of radiation protection and it is of value as a reference book in daily routine

  20. National priorities list sites: Puerto Rico and Virgin Islands, 1992

    International Nuclear Information System (INIS)

    1992-12-01

    The publication provides general Superfund background information and descriptions of activities at each State National Priorities List (NPL) site. It clearly describes what the problems are, what EPA and others participating in site cleanups are doing, and how the nation can move ahead in solving these serious problems. Compiles site summary fact sheets on each State site being cleaned up under the Superfund Program

  1. Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

    Directory of Open Access Journals (Sweden)

    Rachel Root, PharmD, MS

    2012-01-01

    Full Text Available Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system.Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist’s medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM follow-up.Adult patients with a predicted diagnosis-related group (DRG of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85% received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25% receiving MTM follow-up, 26 (65% completing a primary care visit after their first hospital discharge, and 23 (58% receiving a home care visit.Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system.

  2. List of reports of BMFT, CEA, EPRI, JSTA and USNRC in the field of reactor safety research

    International Nuclear Information System (INIS)

    1984-04-01

    The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  3. [Medicalization of life at the GP level: Where are we headed to?].

    Science.gov (United States)

    Cerecedo Pérez, M Jesús; Tovar Bobo, Margarita; Rozadilla Arias, Aurora

    2013-12-01

    The power of medicine has lately enhanced the idea of medicalizing any aspects of life that can be perceived as medical problems. Medicine sometimes creates false needs and there is nowadays an increasing number of situations are medicalized with the pretext of treating fake diseases such as spring fatigue, shyness o natural biological processes like menopause. Despite the better life conditions, we now attend more people that complain about discomfort that may have more to do with «feeling sick» than with authentic disease. There is an endless list: sadness, hyperactive children, anorexia, bulimia, vigorexia or problematic teenagers, amongst others. In this article we revise some interventions that, contribute to promote these situations also from the own doctor's office. Everyday adversity acquires today the status of disease, hence the remarkable increase in these consultations in the diverse sanitary services. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  4. Employing UMLS for generating hints in a tutoring system for medical problem-based learning.

    Science.gov (United States)

    Kazi, Hameedullah; Haddawy, Peter; Suebnukarn, Siriwan

    2012-06-01

    While problem-based learning has become widely popular for imparting clinical reasoning skills, the dynamics of medical PBL require close attention to a small group of students, placing a burden on medical faculty, whose time is over taxed. Intelligent tutoring systems (ITSs) offer an attractive means to increase the amount of facilitated PBL training the students receive. But typical intelligent tutoring system architectures make use of a domain model that provides a limited set of approved solutions to problems presented to students. Student solutions that do not match the approved ones, but are otherwise partially correct, receive little acknowledgement as feedback, stifling broader reasoning. Allowing students to creatively explore the space of possible solutions is exactly one of the attractive features of PBL. This paper provides an alternative to the traditional ITS architecture by using a hint generation strategy that leverages a domain ontology to provide effective feedback. The concept hierarchy and co-occurrence between concepts in the domain ontology are drawn upon to ascertain partial correctness of a solution and guide student reasoning towards a correct solution. We describe the strategy incorporated in METEOR, a tutoring system for medical PBL, wherein the widely available UMLS is deployed and represented as the domain ontology. Evaluation of expert agreement with system generated hints on a 5-point likert scale resulted in an average score of 4.44 (Spearman's ρ=0.80, p<0.01). Hints containing partial correctness feedback scored significantly higher than those without it (Mann Whitney, p<0.001). Hints produced by a human expert received an average score of 4.2 (Spearman's ρ=0.80, p<0.01). Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Prescription data improve the medication history in primary care

    DEFF Research Database (Denmark)

    Glintborg, Bente; Andersen, S K; Poulsen, H E

    2010-01-01

    Incomplete medication lists increase the risk of medication errors and adverse drug effects. In Denmark, dispensing data and pharmacy records are available directly online to treating physicians. We aimed (1) to describe if use of pharmacy records improved the medication history among patients co...

  6. [Deontology of the medical expert].

    Science.gov (United States)

    Raszeja, S

    1995-09-01

    The authority of prosecuting organ to choose the expert, set his task and verify the following opinion is defined. The qualities of the medical expert and his duties are described, referring to: -his expertise; -his morality; -his ability to issue an independent (objective) opinion. Detailed rules, which can be ascribed to a specific medical expert's deontological code, are listed and explained.

  7. 78 FR 18837 - Revised Medical Criteria for Evaluating Visual Disorders

    Science.gov (United States)

    2013-03-28

    ... updating our regulations is to address advances in medical technology and terminology. We have removed the... Medical Criteria for Evaluating Visual Disorders AGENCY: Social Security Administration. ACTION: Final..., Office of Medical Listings Improvement, Social Security Administration, 6401 Security Boulevard...

  8. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg, Pharm.D.

    2010-01-01

    Full Text Available Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic.Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation.Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting.

  9. Patterns of Self-Medication Behavior for Oral Health Problems Among Adults Living in Riyadh, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Arwa Aldeeri

    2018-02-01

    Full Text Available Abstract: Self-medication is a widespread behavior worldwide. It is defined as the practice of self-diagnosis and drug prescription without proper professional consultation. Aim: To determine the prevalence and predictors of self-medication for oral health problems among adults living in Riyadh city. Methods: A cross-sectional study based on a structured close-ended questionnaire was distributed among adults visiting shopping malls in all different five regions of Riyadh. A two-stage sampling technique was used: cluster and simple random sampling. The questionnaire was composed of two main sections: demographic characteristics and questions assessing the behavior of self-medication. Results: The prevalence of self-medication was found to be 63.25%, with a higher prevalence among females than males. Gender and nationality were significantly associated with self-medication. Salt in hot water locally (52.57% and acetaminophen (47.43%, a type of an analgesic, were, systemically, the most frequently used. Pharmacy shops were the main source of these medicaments (66.01%. Similarly, the advice for using them was mainly given by pharmacists (53.36%. Lack of time was claimed to be the main reason for practicing self-medication (54.55% with abscess, toothache, and gingival bleeding being the main predictors. Conclusions: Self-medication was found to be a common practice among the population of Riyadh city.

  10. Medication documentation in a primary care network serving North Carolina medicaid patients: results of a cross-sectional chart review

    Directory of Open Access Journals (Sweden)

    Olson Matthew D

    2012-08-01

    Full Text Available Abstract Background Medical records that do not accurately reflect the patient’s current medication list are an open invitation to errors and may compromise patient safety. Methods This cross-sectional study compares primary care provider (PCP medication lists and pharmacy claims for 100 patients seen in 8 primary care practices and examines the association of congruence with demographic, clinical, and practice characteristics. Medication list congruence was measured as agreement of pharmacy claims with the entire PCP chart, including current medication list, visit notes, and correspondence sections. Results Congruence between pharmacy claims and the PCP chart was 65%. Congruence was associated with large chronic disease burden, frequent PCP visits, group practice, and patient age ≥45 years. Conclusion Agreement of medication lists between the PCP chart and pharmacy records is low. Medication documentation was more accurate among patients who have more chronic conditions, those who have frequent PCP visits, those whose practice has multiple providers, and those at least 45 years of age. Improved congruence among patients with multiple chronic conditions and in group practices may reflect more frequent visits and reviews by providers.

  11. Psychosocial problems of clinical students in the University of Ibadan Medical School.

    Science.gov (United States)

    Omokhodion, F O; Gureje, O

    2003-03-01

    A cross sectional study was carried out among medical students in the University of Ibadan to identify their socio economic and psychological problems. Three hundred and sixteen students, 159 males and 157 females participated in the study. The questionnaire, which was self-administered, sought information about sources of financial support, type of accommodation, use of recreational facilities, smoking and drinking habits and sources of stress and insecurity on the campus. The GHQ-12 was used to assess their mental status. Ninety-four percent of students were sponsored by their parents. Average monthly income as pocket money ranged from N800-N15,000. Sixty-three (20%) reported that their pocket money was inadequate and 11 (3.5%) engage in business ventures to supplement their income. Two hundred and fifty-seven (81%) live on the campus, 11 (3.5%) were current smokers and 54 (18%) were current drinkers. Stealing and lack of money were the commonest causes of insecurity on the campus. Lack of money, fear of failure of examinations, family problems and broken relationships were reported as causes of depression among this study population. GHQ scores ranged from 1 to 9 using a cut-off point of 3 scores, 38 students (12.0%) were categorised as having traits of poor mental health. GHQ scores were not associated with age, sex, smoking or drinking status or students' assessment of the adequacy of their pocket money. However, living off campus and poor self-perception were associated with poor mental health (p < 0.01). Counseling services should be provided in the medical school to assist students to handle issues that constitute a source of stress in their psychosocial environment.

  12. The list of prohibited substances and methods in sport: structure and review process by the world anti-doping agency.

    Science.gov (United States)

    Mazzoni, Irene; Barroso, Osquel; Rabin, Olivier

    2011-11-01

    The List of Prohibited Substances and Methods (the List) is the International Standard that determines what is prohibited in sport in- and out-of-competition. The official text of the List is produced by the World Anti-Doping Agency (WADA), the international independent organization responsible for promoting, coordinating and monitoring the fight against doping in sport. The drafting of the annual List is a highly interactive and consultative process involving scientific and medical experts in anti-doping, sport federations and governments. In this article, the elements that compose the List as well as the process behind its annual revision and update are presented.

  13. Download - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...t_db_link_en.zip (36.3 KB) - 6 Genome analysis methods pgdbj_dna_marker_linkage_map_genome_analysis_methods_... of This Database Site Policy | Contact Us Download - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  14. Employees Sick-Listed with Mental Disorders : Who Returns to Work and When?

    NARCIS (Netherlands)

    Roelen, C. A. M.; Norder, G.; Koopmans, P. C.; van Rhenen, W.; van der Klink, J. J. L.; Bultmann, U.

    Purpose To investigate return to work (RTW) in employees sick-listed with mental disorders classified according to the International Classification of Diseases (ICD). Methods Sickness absences (SA) medically certified as emotional disturbance (ICD-10 R45) or mental and behavioral disorders (ICD-10

  15. Medical students' preferences for problem-based learning in relation to culture and personality: a multicultural study.

    Science.gov (United States)

    Holen, Are; Manandhar, Kedar; Pant, Devendra S; Karmacharya, Biraj M; Olson, Linda M; Koju, Rajendra; Mansur, Dil I

    2015-07-19

    The aim of this study was to explore positive and negative preferences towards problem-based learning in relation to personality traits and socio-cultural context. The study was an anonymous and voluntary cross-sectional survey of medical students (N=449) in hybrid problem-based curricula in Nepal, Norway and North Dakota. Data was collected on gender, age, year of study, cohabitation and medical school. The PBL Preference Inventory identified students' positive and negative preferences in relation to problem-based learning; the personality traits were detected by the NEO Five-Factor Inventory. The determinants of the two kinds of preferences were analyzed by hierarchical multiple linear regressions. Positive preferences were mostly determined by personality; associations were found with the traits Extra-version, Openness to experience, Conscientiousness and Neuroticism; the first three are related to sociability, curiosity and orderliness, the last, to mental health. The learn-ing environments of such curricula may be supportive for some and unnerving for others who score high on Neuroticism. Negative preferences were rather determined by culture, but also, they correlated with Neuroticism and Conscientiousness. Negative preferences were lower among females and students living in symmetrical relationships. Some high on Conscientiousness disliked group work, and the negative correlation with Agreeableness indicated that less sociable students were not predisposed to this kind of learning activity. Preferences related to problem-based learning were significantly and independently determined both by personality traits and culture. More insights into the nature of students' preferences may guide aspects of curriculum modifications and the daily facilitation of groups.

  16. Deciding medical problems in radiation protection for thirty years in the Boris Kidric Institute - Experimental and epidemiological experiences

    Energy Technology Data Exchange (ETDEWEB)

    Stojanovic, D; Milivojevic, K; Trajkovic, M [Institute of Nuclear Sciences Boris Kidric, Vinca, Beograd (Serbia and Montenegro)

    1989-07-01

    This paper deals with some research work carried out in the Medical Protection Laboratory of the Boris Kidric Institute of Nuclear Sciences - Vinca. Four research fields have been chosen: the analysis of contribution of collaborators Medical Protection Laboratory on symposium Yugoslav Radiation Protection Association (IRPA); from 1963 to 1989 years; the appearance on the meeting IAEA, International seminars, symposium and Congress, including European and international congress IRPA with presentation the most important obtained results; the activity in the frame research projects and contribution for solving important problems in the field of medical aspects of radiation protection in developing and applicable research; the survey current and practical trends in the future (author)

  17. Deciding medical problems in radiation protection for thirty years in the Boris Kidric Institute - Experimental and epidemiological experiences

    International Nuclear Information System (INIS)

    Stojanovic, D.; Milivojevic, K.; Trajkovic, M.

    1989-01-01

    This paper deals with some research work carried out in the Medical Protection Laboratory of the Boris Kidric Institute of Nuclear Sciences - Vinca. Four research fields have been chosen: the analysis of contribution of collaborators Medical Protection Laboratory on symposium Yugoslav Radiation Protection Association (IRPA); from 1963 to 1989 years; the appearance on the meeting IAEA, International seminars, symposium and Congress, including European and international congress IRPA with presentation the most important obtained results; the activity in the frame research projects and contribution for solving important problems in the field of medical aspects of radiation protection in developing and applicable research; the survey current and practical trends in the future (author)

  18. Female Directors and Firm Performance: Evidence from UK Listed Firms

    OpenAIRE

    Pasaribu, Pananda

    2017-01-01

    The impact of female directors on firm performance has lacked consistency in the previously conducted empirical studies, which may be due to the endogeneity problem, or certain characteristics (i.e. governance, industry, competition). This study examines the relationship between female directors and firm performance by addressing those problems. This study analyses all non-financial UK listed firms during the period 2004-2012 and employs several econometric models. The regression results indi...

  19. [Medical student curriculum in psychiatry in Poland].

    Science.gov (United States)

    Bilikiewicz, A

    1999-01-01

    The author describes present medical student curricula in psychiatry in Polish medical schools based on the questionnaire sent to all the lecturers of the subject in Poland. The questionnaire contained questions concerning the schedule of lectures, seminars and classes (the list of topics) as well as the number of hours of the forms of activities like interpersonal training, discussion groups, internship, etc. We also asked on which year of studies the course in psychiatry took place. The questionnaire included our request to describe the level of integration of psychiatry and other pre-clinical and clinical subjects as well as to enclose a recommended reading list (handbooks and other items of literature). The last question dealt with the problem of assessment of lectures and classes by students. The results of the questionnaire reveal great differences in the curricula of psychiatry in various schools in Poland. The differences lie both in the courses and the number of hours devoted to teaching psychiatry (in most schools it was 120 hours or less). In 7 schools students learn psychiatry in the 6th i.e. the last year of their studies. In 2 schools lectures in psychiatry are given in the th year. In Kraków and Gdańsk the courses in psychiatry consist of 150 and 160 hours respectively. The author proposes unification of the curricula in psychiatry concerning both the number of hours of classes and lectures, and topics as well as introducing the diagnostic and classifying criteria ICD-10 (WHO) since Poland is going to join EU.

  20. Relative accuracy and availability of an Irish National Database of dispensed medication as a source of medication history information: observational study and retrospective record analysis.

    LENUS (Irish Health Repository)

    Grimes, T

    2013-01-27

    WHAT IS KNOWN AND OBJECTIVE: The medication reconciliation process begins by identifying which medicines a patient used before presentation to hospital. This is time-consuming, labour intensive and may involve interruption of clinicians. We sought to identify the availability and accuracy of data held in a national dispensing database, relative to other sources of medication history information. METHODS: For patients admitted to two acute hospitals in Ireland, a Gold Standard Pre-Admission Medication List (GSPAML) was identified and corroborated with the patient or carer. The GSPAML was compared for accuracy and availability to PAMLs from other sources, including the Health Service Executive Primary Care Reimbursement Scheme (HSE-PCRS) dispensing database. RESULTS: Some 1111 medication were assessed for 97 patients, who were median age 74 years (range 18-92 years), median four co-morbidities (range 1-9), used median 10 medications (range 3-25) and half (52%) were male. The HSE-PCRS PAML was the most accurate source compared to lists provided by the general practitioner, community pharmacist or cited in previous hospital documentation: the list agreed for 74% of the medications the patients actually used, representing complete agreement for all medications in 17% of patients. It was equally contemporaneous to other sources, but was less reliable for male than female patients, those using increasing numbers of medications and those using one or more item that was not reimbursable by the HSE. WHAT IS NEW AND CONCLUSION: The HSE-PCRS database is a relatively accurate, available and contemporaneous source of medication history information and could support acute hospital medication reconciliation.

  1. Online medical books: their availability and an assessment of how health sciences libraries provide access on their public Websites.

    Science.gov (United States)

    MacCall, Steven L

    2006-01-01

    The objective of this study was to determine the number and topical range of available online medical books and to assess how health sciences libraries were providing access to these resources on their public Websites. The collection-based evaluative technique of list checking was used to assess the number and topical range of online medical books of the six largest publishers. Publisher inventory lists were downloaded over a two-day period (May 16-17, 2004). Titles were counted and compared with the 2003 Brandon/Hill list. A sample of health sciences libraries was subsequently derived by consulting the 2004 "Top Medical Schools-Research" in U.S. News & World Report. Bibliographic and bibliothecal access methods were evaluated based on an inspection of the publicly available Websites of the sample libraries. Of 318 currently published online medical books, 151 (47%) were Brandon/Hill titles covering 42 of 59 Brandon/Hill topics (71%). These 151 titles represented 22% (N = 672) of the Brandon/Hill list, which further broke down as 52 minimal core, 41 initial purchase, and 58 other recommended Brandon/Hill titles. These numbers represented 50%, 28%, and 12%, respectively, of all Brandon/Hill titles corresponding to those categories. In terms of bibliographic access, 20 of 21 of sampled libraries created catalog records for their online medical books, 1 of which also provided analytical access at the chapter level, and none provided access at the chapter section level. Of the 21 libraries, 19 had library Website search engines that provided title-level access and 4 provided access at the chapter level and none that at the chapter section level. For bibliothecal access, 19 of 21 libraries provided title-level access to medical books, 8 of which provided classified and alphabetic arrangements, 1 provided a classified arrangement only, and 10 provided an alphabetic arrangement only. No library provided a bibliothecal arrangement for medical book chapters or chapter

  2. List of reports on reactor safety research of BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1984-07-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special problems in the field of reactor safety research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. Requests for reports should be addressed to GRS, Forschungsbetreuung. Contractual points of view have to be considered for the distribitution of the reports. (orig.) [de

  3. Monte Carlo Particle Lists: MCPL

    DEFF Research Database (Denmark)

    Kittelmann, Thomas; Klinkby, Esben Bryndt; Bergbäck Knudsen, Erik

    2017-01-01

    A binary format with lists of particle state information, for interchanging particles between various Monte Carlo simulation applications, is presented. Portable C code for file manipulation is made available to the scientific community, along with converters and plugins for several popular...... simulation packages. Program summary: Program Title: MCPL. Program Files doi: http://dx.doi.org/10.17632/cby92vsv5g.1 Licensing provisions: CC0 for core MCPL, see LICENSE file for details. Programming language: C and C++ External routines/libraries: Geant4, MCNP, McStas, McXtrace Nature of problem: Saving...

  4. Monte Carlo methods for top-k personalized PageRank lists and name disambiguation

    NARCIS (Netherlands)

    Avrachenkov, Konstatin; Litvak, Nelli; Nemirovsky, Danil; Smirnova, Elena; Sokol, Marina

    We study a problem of quick detection of top-k Personalized PageRank lists. This problem has a number of important applications such as finding local cuts in large graphs, estimation of similarity distance and name disambiguation. In particular, we apply our results to construct efficient algorithms

  5. Automation and adaptation: Nurses’ problem-solving behavior following the implementation of bar coded medication administration technology

    Science.gov (United States)

    Holden, Richard J.; Rivera-Rodriguez, A. Joy; Faye, Héléne; Scanlon, Matthew C.; Karsh, Ben-Tzion

    2012-01-01

    The most common change facing nurses today is new technology, particularly bar coded medication administration technology (BCMA). However, there is a dearth of knowledge on how BCMA alters nursing work. This study investigated how BCMA technology affected nursing work, particularly nurses’ operational problem-solving behavior. Cognitive systems engineering observations and interviews were conducted after the implementation of BCMA in three nursing units of a freestanding pediatric hospital. Problem-solving behavior, associated problems, and goals, were specifically defined and extracted from observed episodes of care. Three broad themes regarding BCMA’s impact on problem solving were identified. First, BCMA allowed nurses to invent new problem-solving behavior to deal with pre-existing problems. Second, BCMA made it difficult or impossible to apply some problem-solving behaviors that were commonly used pre-BCMA, often requiring nurses to use potentially risky workarounds to achieve their goals. Third, BCMA created new problems that nurses were either able to solve using familiar or novel problem-solving behaviors, or unable to solve effectively. Results from this study shed light on hidden hazards and suggest three critical design needs: (1) ecologically valid design; (2) anticipatory control; and (3) basic usability. Principled studies of the actual nature of clinicians’ work, including problem solving, are necessary to uncover hidden hazards and to inform health information technology design and redesign. PMID:24443642

  6. 12 CFR 717.32 - Sharing medical information with affiliates.

    Science.gov (United States)

    2010-01-01

    ...) An individualized list or description based on the payment transactions of the consumer for medical products or services; or (3) An aggregate list of identified consumers based on payment transactions for... activities described in section 18B of the model Privacy of Consumer Financial and Health Information...

  7. Rethinking medical humanities.

    Science.gov (United States)

    Chiapperino, Luca; Boniolo, Giovanni

    2014-12-01

    This paper questions different conceptions of Medical Humanities in order to provide a clearer understanding of what they are and why they matter. Building upon former attempts, we defend a conception of Medical Humanities as a humanistic problem-based approach to medicine aiming at influencing its nature and practice. In particular, we discuss three main conceptual issues regarding the overall nature of this discipline: (i) a problem-driven approach to Medical Humanities; (ii) the need for an integration of Medical Humanities into medicine; (iii) the methodological requirements that could render Medical Humanities an effective framework for medical decision-making.

  8. Patients' and clinicians' experiences of holistic needs assessment using a cancer distress thermometer and problem list: A qualitative study.

    Science.gov (United States)

    Biddle, Lucy; Paramasivan, Sangeetha; Harris, Susan; Campbell, Rona; Brennan, James; Hollingworth, William

    2016-08-01

    Psychosocial needs assessment is recommended for patients undergoing cancer treatment, but trials of effectiveness of assessment tools provide mixed results. This qualitative study aimed to understand how such tools are experienced by patients and clinicians in order to optimise use in the future. Qualitative interviews were used in a mixed-methods sequential design following a randomised controlled trial of needs assessment using the Distress Thermometer and Problem List (DT&PL), and explored patients' and clinicians' evaluations of the needs assessment process. Benefits of needs assessment using the DT&PL included the potential to detect hidden distress, allow opportunity for distress to be discussed, and to deliver outcomes to address problems. However, effectiveness and patient willingness to report all forms of distress could be hindered by: clinicians feeling ill-equipped to deal with 'non-physical' distress and patients questioning their appropriateness to do so; time constraints; insufficient support services and referral guidelines; inappropriate timing; and lack of follow-up. The benefits of a holistic needs assessment cannot be realised without matching time and frequency of administration to the dynamic nature of distress during cancer, and making changes to the context of delivery - for instance, providing protected time, increasing referral options and clinician training. Significant investment is needed to optimise potential benefits for patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Lecturing skills as predictors of tutoring skills in a problem-based medical curriculum

    Directory of Open Access Journals (Sweden)

    Kassab SE

    2016-01-01

    Full Text Available Salah Eldin Kassab,1 Nahla Hassan,1 Marwan F Abu-Hijleh,2 Reginald P Sequeira3 1Department of Medical Education, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 2College of Medicine, Qatar University, Doha, Qatar; 3College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain Purpose: Recruitment of tutors to work in problem-based learning (PBL programs is challenging, especially in that most of them are graduated from discipline-based programs. Therefore, this study aims at examining whether lecturing skills of faculty could predict their PBL tutoring skills. Methods: This study included evaluation of faculty (n=69 who participated in both tutoring and lecturing within particular PBL units at the College of Medicine and Medical Sciences (CMMS, Arabian Gulf University, Bahrain. Each faculty was evaluated by medical students (n=45±8 for lecturing and 8±2 for PBL tutoring using structured evaluation forms based on a Likert-type scale (poor to excellent. The prediction of tutoring skills using lecturing skills was statistically analyzed using stepwise linear regression. Results: Among the parameters used to judge lecturing skills, the most important predictor for tutoring skills was subject matter mastery in the lecture by explaining difficult concepts and responding effectively to students' questions. Subject matter mastery in the lecture positively predicted five tutoring skills and accounted for 25% of the variance in overall effectiveness of the PBL tutors (F=22.39, P=0.000. Other important predictors for tutoring skills were providing a relaxed class atmosphere and effective use of audiovisual aids in the lecture. Conclusion: Predicting the tutoring skills based on lecturing skills could have implications for recruiting tutors in PBL medical programs and for tutor training initiatives. Keywords: PBL, tutor, tutoring skills, lecturing skills

  10. ClinicalCodes: an online clinical codes repository to improve the validity and reproducibility of research using electronic medical records.

    Science.gov (United States)

    Springate, David A; Kontopantelis, Evangelos; Ashcroft, Darren M; Olier, Ivan; Parisi, Rosa; Chamapiwa, Edmore; Reeves, David

    2014-01-01

    Lists of clinical codes are the foundation for research undertaken using electronic medical records (EMRs). If clinical code lists are not available, reviewers are unable to determine the validity of research, full study replication is impossible, researchers are unable to make effective comparisons between studies, and the construction of new code lists is subject to much duplication of effort. Despite this, the publication of clinical codes is rarely if ever a requirement for obtaining grants, validating protocols, or publishing research. In a representative sample of 450 EMR primary research articles indexed on PubMed, we found that only 19 (5.1%) were accompanied by a full set of published clinical codes and 32 (8.6%) stated that code lists were available on request. To help address these problems, we have built an online repository where researchers using EMRs can upload and download lists of clinical codes. The repository will enable clinical researchers to better validate EMR studies, build on previous code lists and compare disease definitions across studies. It will also assist health informaticians in replicating database studies, tracking changes in disease definitions or clinical coding practice through time and sharing clinical code information across platforms and data sources as research objects.

  11. Database Description - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ... QTL list, Plant DB link & Genome analysis methods Alternative name - DOI 10.18908/lsdba.nbdc01194-01-000 Cr...ers and QTLs are curated manually from the published literature. The marker information includes marker sequences, genotyping methods... Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  12. Medical Terminology: Root Words. Health Occupations Education Module.

    Science.gov (United States)

    Temple Univ., Philadelphia, PA. Div. of Vocational Education.

    This module on medical terminology (root words) is one of 17 modules designed for individualized instruction in health occupations education programs at both the secondary and postsecondary levels. This module consists of an introduction to root words, a list of resources needed, procedures for using the module, a list of terminology used in the…

  13. Sources of pre-admission medication information: observational study of accuracy and availability.

    LENUS (Irish Health Repository)

    Fitzsimons, Michelle

    2011-12-01

    To identify the accessibility of sources of pre-admission medication (PAM) information, to quantify agreement between the PAM list and the \\'gold-standard\\' PAM list (GS-PAML) and to categorise disagreements.

  14. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg

    2010-06-01

    Full Text Available Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic. Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation. Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting. Type: Original Research

  15. 75 FR 71632 - Revised Medical Criteria for Evaluating Mental Disorders

    Science.gov (United States)

    2010-11-24

    ... Revised Medical Criteria for Evaluating Mental Disorders AGENCY: Social Security Administration. ACTION... comments on any other aspects of the proposed listings for mental disorders that we receive during this... our mental disorders listings: Definitions we provide for the terms ``marked'' and ``extreme'' that...

  16. Plant DB link - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...e Site Policy | Contact Us Plant DB link - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  17. The effects of using concept mapping as an artifact to engender metacognitive thinking in first-year medical students' problem-based learning discussions: A mixed-methods investigation

    Science.gov (United States)

    Shoop, Glenda Hostetter

    Attention in medical education is turning toward instruction that not only focuses on knowledge acquisition, but on developing the medical students' clinical problem-solving skills, and their ability to critically think through complex diseases. Metacognition is regarded as an important consideration in how we teach medical students these higher-order, critical thinking skills. This study used a mixed-methods research design to investigate if concept mapping as an artifact may engender metacognitive thinking in the medical student population. Specifically the purpose of the study is twofold: (1) to determine if concept mapping, functioning as an artifact during problem-based learning, improves learning as measured by scores on test questions; and (2) to explore if the process of concept mapping alters the problem-based learning intragroup discussion in ways that show medical students are engaged in metacognitive thinking. The results showed that students in the problem-based learning concept-mapping groups used more metacognitive thinking patterns than those in the problem-based learning discussion-only group, particularly in the monitoring component. These groups also engaged in a higher level of cognitive thinking associated with reasoning through mechanisms-of-action and breaking down complex biochemical and physiologic principals. The students disclosed in focus-group interviews that concept mapping was beneficial to help them understand how discrete pieces of information fit together in a bigger structure of knowledge. They also stated that concept mapping gave them some time to think through these concepts in a larger conceptual framework. There was no significant difference in the exam-question scores between the problem-based learning concept-mapping groups and the problem-based learning discussion-only group.

  18. Simple solution to the medical instrumentation software problem

    Science.gov (United States)

    Leif, Robert C.; Leif, Suzanne B.; Leif, Stephanie H.; Bingue, E.

    1995-04-01

    Medical devices now include a substantial software component, which is both difficult and expensive to produce and maintain. Medical software must be developed according to `Good Manufacturing Practices', GMP. Good Manufacturing Practices as specified by the FDA and ISO requires the definition and compliance to a software processes which ensures quality products by specifying a detailed method of software construction. The software process should be based on accepted standards. US Department of Defense software standards and technology can both facilitate the development and improve the quality of medical systems. We describe the advantages of employing Mil-Std-498, Software Development and Documentation, and the Ada programming language. Ada provides the very broad range of functionalities, from embedded real-time to management information systems required by many medical devices. It also includes advanced facilities for object oriented programming and software engineering.

  19. Solution-focused intervention for sick listed employees with psychological problems or muscle skeletal pain: a randomised controlled trial [ISRCTN39140363

    Directory of Open Access Journals (Sweden)

    Hagen Kare B

    2006-03-01

    Full Text Available Abstract Background Long-term sick leave has been of concern to politicians and decision-makers in Norway for several years. In the current study we assess the efficacy of a solution-focused follow-up for sick-listed employees. Methods Employees on long-term sick leave due to psychological problems or muscle skeletal pain (n = 703 were invited to participate in the project. Following self-recruitment, 103 were randomly allocated to receive solution-focused follow-up (n = 53 or "treatment as usual" (n = 50. The intervention was integrated within the regular follow up of six social security offices and organised as eight weekly solution focused work sessions. Effectiveness was measured by rate of return to work and health related quality of life (SF-36. Results Intention to treat analysis showed no significant differences between the two groups for any of the outcome measures. Secondary analysis, comparing those who attended at least 50% of the sessions with the control group revealed a significant difference in favour of the active intervention group in the SF-36 subscale of mental health (Effect Size 0.56, p = 0.05. When comparing the subgroup of participants with psychological problems there was a significant difference in mental health in favour of the intervention group (Effect Size 0.71, p = 0.041. Conclusion A voluntary solution-focused intervention offered by social-security offices is no more effective than regular follow up for employees on long-term sick leave due to psychological problems or muscle skeletal pain.

  20. Preferred drug lists: Potential impact on healthcare economics

    Directory of Open Access Journals (Sweden)

    Kimberly Ovsag

    2008-04-01

    Full Text Available Kimberly Ovsag, Sabrina Hydery, Shaker A MousaPharmaceutical Research Institute at Albany College of Pharmacy, Albany, New York, USAObjectives: To analyze the implementation of Medicaid preferred drug lists (PDLs in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare.Methods: We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included “drug lists,” “prior authorization,” “prior approval,” and “Medicaid.” We added terms such as “influence use of other healthcare services,” “quality of care,” and “overall economic impact.” We mainly used primary sources.Results: Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a the potential for PDLs to influence the utilization of other healthcare services, (b criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c the effect of PDL implementation on compliance to new regimens, (d the potential effects of restricting medication availability on quality of care, (e administrative costs associated with PDLs, and (f satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact.Conclusions: The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care.Keywords: preferred drug lists, medicaid, healthcare costs, managed care

  1. Predictive gene lists for breast cancer prognosis: A topographic visualisation study

    Directory of Open Access Journals (Sweden)

    Lowe David

    2008-04-01

    Full Text Available Abstract Background The controversy surrounding the non-uniqueness of predictive gene lists (PGL of small selected subsets of genes from very large potential candidates as available in DNA microarray experiments is now widely acknowledged 1. Many of these studies have focused on constructing discriminative semi-parametric models and as such are also subject to the issue of random correlations of sparse model selection in high dimensional spaces. In this work we outline a different approach based around an unsupervised patient-specific nonlinear topographic projection in predictive gene lists. Methods We construct nonlinear topographic projection maps based on inter-patient gene-list relative dissimilarities. The Neuroscale, the Stochastic Neighbor Embedding(SNE and the Locally Linear Embedding(LLE techniques have been used to construct two-dimensional projective visualisation plots of 70 dimensional PGLs per patient, classifiers are also constructed to identify the prognosis indicator of each patient using the resulting projections from those visualisation techniques and investigate whether a-posteriori two prognosis groups are separable on the evidence of the gene lists. A literature-proposed predictive gene list for breast cancer is benchmarked against a separate gene list using the above methods. Generalisation ability is investigated by using the mapping capability of Neuroscale to visualise the follow-up study, but based on the projections derived from the original dataset. Results The results indicate that small subsets of patient-specific PGLs have insufficient prognostic dissimilarity to permit a distinction between two prognosis patients. Uncertainty and diversity across multiple gene expressions prevents unambiguous or even confident patient grouping. Comparative projections across different PGLs provide similar results. Conclusion The random correlation effect to an arbitrary outcome induced by small subset selection from very high

  2. Psychosocial problems of pre-clinical students in the University of Ibadan Medical School.

    Science.gov (United States)

    Omokhodion, F O

    2003-06-01

    Recent changes in the psychosocial environment of the university campus such as the steep rise in student numbers, the high cost of living standards and the increase in violence and cult activities has prompted the need to assess the impact of these changes on the students. A cross sectional study was carried out among pre-clinical medical students to identify their psychosocial problems. A self-administered questionnaire was used to collect information about socio-demographic variables including age, sex, sources of financial support, type of accommodation, smoking and drinking habits and use of recreational facilities. Causes of insecurity and depression among students were also recorded. The General Health Questionnaire GHQ-12 was used to assess their mental health status. One hundred and seventy-six students responded to the enquiry, 94 males (53%) and 80 females (45%). One hundred and thirty-seven (79%) live on the campus while 37 (21%) live off campus. Only 9 of the students (5%) were smokers and 28 (16%) were drinkers. Monthly pocket money ranged from Naira 1,000 to Naira 25,000. Forty-one (23%) thought their pocket money was adequate, 92 (52%) thought it was fair and 39 (22%) thought it was inadequate. Causes of insecurity on the campus were cultism 34 (19%), lack of money 27 (15%), lack of textbooks 13 (7%) and stealing 10 (6%). Causes of depression include fear of failure of examinations, 62 (35%), lack of money, 48 (27%) and family problems 17 (10%). Mental health scores ranged from 1 to 10. Using a cut off point of 3 to delineate those with traits of poor mental health, 35 (21%) fell into the category 15 boys and 20 girls. Mean mental health score were higher for females, those living on campus, smokers and drinkers but this was not statistically significant. Fear of failure of examinations, cultism and lack of money are major concerns among medical students on the main university campus. Counselling services should be provided to assist students with

  3. Problem-solving ability and repetition of deliberate self-harm: a multicentre study.

    Science.gov (United States)

    McAuliffe, Carmel; Corcoran, Paul; Keeley, Helen S; Arensman, Ella; Bille-Brahe, Unni; De Leo, Diego; Fekete, Sandor; Hawton, Keith; Hjelmeland, Heidi; Kelleher, Margaret; Kerkhof, Ad J F M; Lönnqvist, Jouko; Michel, Konrad; Salander-Renberg, Ellinor; Schmidtke, Armin; Van Heeringen, Kees; Wasserman, Danuta

    2006-01-01

    While recent studies have found problem-solving impairments in individuals who engage in deliberate self-harm (DSH), few studies have examined repeaters and non-repeaters separately. The aim of the present study was to investigate whether specific types of problem-solving are associated with repeated DSH. As part of the WHO/EURO Multicentre Study on Suicidal Behaviour, 836 medically treated DSH patients (59% repeaters) from 12 European regions were interviewed using the European Parasuicide Study Interview Schedule (EPSIS II) approximately 1 year after their index episode. The Utrecht Coping List (UCL) assessed habitual responses to problems. Factor analysis identified five dimensions--Active Handling, Passive-Avoidance, Problem Sharing, Palliative Reactions and Negative Expression. Passive-Avoidance--characterized by a pre-occupation with problems, feeling unable to do anything, worrying about the past and taking a gloomy view of the situation, a greater likelihood of giving in so as to avoid difficult situations, the tendency to resign oneself to the situation, and to try to avoid problems--was the problem-solving dimension most strongly associated with repetition, although this association was attenuated by self-esteem. The outcomes of the study indicate that treatments for DSH patients with repeated episodes should include problem-solving interventions. The observed passivity and avoidance of problems (coupled with low self-esteem) associated with repetition suggests that intensive therapeutic input and follow-up are required for those with repeated DSH.

  4. Medical physics education after the ISCO listing of the profession - Quo Vadis?

    International Nuclear Information System (INIS)

    Tabakov, S.

    2012-01-01

    The inclusion of Medical Physics in the International Standard Classification of Occupations (ISCO-08) underlines the increased significance of the profession. This opens new horizons, but also challenges in front of the profession. One of these is the need for re-organisation of the medical physics education. Some Universities already open under-graduate (BSc) courses on medical physics in order to accommodate the increased volume of professional knowledge. The paper discusses briefly the background of this trend and presents the urgent need of a wide professional discussion on the matter. (author)

  5. Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review.

    Science.gov (United States)

    Mekonnen, Alemayehu B; Alhawassi, Tariq M; McLachlan, Andrew J; Brien, Jo-Anne E

    2018-03-01

    Medication errors and adverse drug events are universal problems contributing to patient harm but the magnitude of these problems in Africa remains unclear. The objective of this study was to systematically investigate the literature on the extent of medication errors and adverse drug events, and the factors contributing to medication errors in African hospitals. We searched PubMed, MEDLINE, EMBASE, Web of Science and Global Health databases from inception to 31 August, 2017 and hand searched the reference lists of included studies. Original research studies of any design published in English that investigated adverse drug events and/or medication errors in any patient population in the hospital setting in Africa were included. Descriptive statistics including median and interquartile range were presented. Fifty-one studies were included; of these, 33 focused on medication errors, 15 on adverse drug events, and three studies focused on medication errors and adverse drug events. These studies were conducted in nine (of the 54) African countries. In any patient population, the median (interquartile range) percentage of patients reported to have experienced any suspected adverse drug event at hospital admission was 8.4% (4.5-20.1%), while adverse drug events causing admission were reported in 2.8% (0.7-6.4%) of patients but it was reported that a median of 43.5% (20.0-47.0%) of the adverse drug events were deemed preventable. Similarly, the median mortality rate attributed to adverse drug events was reported to be 0.1% (interquartile range 0.0-0.3%). The most commonly reported types of medication errors were prescribing errors, occurring in a median of 57.4% (interquartile range 22.8-72.8%) of all prescriptions and a median of 15.5% (interquartile range 7.5-50.6%) of the prescriptions evaluated had dosing problems. Major contributing factors for medication errors reported in these studies were individual practitioner factors (e.g. fatigue and inadequate knowledge

  6. List of reports in the field of reactor safety research of BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1990-05-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning single problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programme of the BMFT, reporting organization. The list of reports appears quarterly. (orig.) [de

  7. List of reports in the field of reactor safety research from BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1991-08-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning single problems in the field of reactor safety research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Program of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  8. List of reports in the field of reactor safety research of BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1990-02-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning single problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig.) [de

  9. List of reports in the field of reactor safety research of BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1989-05-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning single problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programme of the BMFT, reporting organization. The list of reports appears quarterly. (orig.) [de

  10. List of reports in the field of reactor safety research of BMFT, CEA, EPRI, JSTA und USNRC

    International Nuclear Information System (INIS)

    1989-11-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning single problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commissariat a l'Engergie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programme of the BMFT, reporting organization. The list of reports appears quarterly. (orig.) [de

  11. List of reports of BMFT, CEA, EPRI, JSTA and USNRC in the field of reactor safety research

    International Nuclear Information System (INIS)

    1985-04-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning special problems in the field of Reactor Safety Research. According to the cooperation of the Bundesminister fuer Forschung und Technologie (BMFT) with the Commisariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electrical Power Research Institute (EPRI) and the United States Nuclear Regulatory Commision, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quaterly. (orig./HP) [de

  12. Discordant Documentation of Obesity Body Mass Index and Obesity Diagnosis in Electronic Medical Records

    Directory of Open Access Journals (Sweden)

    Jennifer T. Fink

    2014-11-01

    Full Text Available Purpose: This study examined concordance between presence of obesity body mass index (BMI, defined as BMI ≥ 30, in the patient’s electronic medical record (EMR and a documented diagnosis of obesity. Methods: We conducted a retrospective review of the EMR in a large health care system for a 1-year period (2012. A total of 397,313 patients met the study criteria of having at least one physician visit, being at least 18 years of age, and not being pregnant. Of those, 158,327 (40% had a recorded BMI ≥ 30. We examined the EMR of these obese patients to determine whether a diagnosis of obesity was recorded, and whether demographics or comorbid diagnoses impacted the likelihood of a recorded obesity diagnosis. Results: Obesity appeared on the EMR problem list for only 35% of patients with BMI ≥ 30. Obesity diagnosis was documented more frequently in women, middle-aged patients and blacks. The presence of some comorbidities (e.g. sleep apnea, hypertension, diabetes led to significantly more frequent diagnosis of obesity. There was a significant positive association between the number of comorbid diagnoses per patient and an obesity diagnosis appearing on the problem list. Conclusions: Obesity remains underrecorded in the EMR problem list despite the presence of obesity BMI in the EMR. Patient demographics and comorbidities should be considered when identifying best practices for weight management. New practices should be patient-centered and consider cultural context as well as the social and physical resources available to patients – all crucial for enacting systems change in a true accountable care environment.

  13. Local Search Approaches in Stable Matching Problems

    Directory of Open Access Journals (Sweden)

    Toby Walsh

    2013-10-01

    Full Text Available The stable marriage (SM problem has a wide variety of practical applications, ranging from matching resident doctors to hospitals, to matching students to schools or, more generally, to any two-sided market. In the classical formulation, n men and n women express their preferences (via a strict total order over the members of the other sex. Solving an SM problem means finding a stable marriage where stability is an envy-free notion: no man and woman who are not married to each other would both prefer each other to their partners or to being single. We consider both the classical stable marriage problem and one of its useful variations (denoted SMTI (Stable Marriage with Ties and Incomplete lists where the men and women express their preferences in the form of an incomplete preference list with ties over a subset of the members of the other sex. Matchings are permitted only with people who appear in these preference lists, and we try to find a stable matching that marries as many people as possible. Whilst the SM problem is polynomial to solve, the SMTI problem is NP-hard. We propose to tackle both problems via a local search approach, which exploits properties of the problems to reduce the size of the neighborhood and to make local moves efficiently. We empirically evaluate our algorithm for SM problems by measuring its runtime behavior and its ability to sample the lattice of all possible stable marriages. We evaluate our algorithm for SMTI problems in terms of both its runtime behavior and its ability to find a maximum cardinality stable marriage. Experimental results suggest that for SM problems, the number of steps of our algorithm grows only as O(n log(n, and that it samples very well the set of all stable marriages. It is thus a fair and efficient approach to generate stable marriages. Furthermore, our approach for SMTI problems is able to solve large problems, quickly returning stable matchings of large and often optimal size, despite the

  14. Determining risk factors for internalizing problem behavior: the Screening Instrument for Adolescents of Parents with Chronic Medical Condition

    NARCIS (Netherlands)

    Sieh, D.S.; Oort, F.J.; Visser-Meily, J.M.A.; Meijer, A.M.

    2013-01-01

    A large body of evidence suggests that the risk for adjustment difficulties in children of parents with a chronic medical condition (CMC) depend on a number of demographic, illness-related, child adaptational, and family characteristics. In particular, internalizing problems are common in children

  15. Lecturing skills as predictors of tutoring skills in a problem-based medical curriculum.

    Science.gov (United States)

    Kassab, Salah Eldin; Hassan, Nahla; Abu-Hijleh, Marwan F; Sequeira, Reginald P

    2016-01-01

    Recruitment of tutors to work in problem-based learning (PBL) programs is challenging, especially in that most of them are graduated from discipline-based programs. Therefore, this study aims at examining whether lecturing skills of faculty could predict their PBL tutoring skills. This study included evaluation of faculty (n=69) who participated in both tutoring and lecturing within particular PBL units at the College of Medicine and Medical Sciences (CMMS), Arabian Gulf University, Bahrain. Each faculty was evaluated by medical students (n=45±8 for lecturing and 8±2 for PBL tutoring) using structured evaluation forms based on a Likert-type scale (poor to excellent). The prediction of tutoring skills using lecturing skills was statistically analyzed using stepwise linear regression. Among the parameters used to judge lecturing skills, the most important predictor for tutoring skills was subject matter mastery in the lecture by explaining difficult concepts and responding effectively to students' questions. Subject matter mastery in the lecture positively predicted five tutoring skills and accounted for 25% of the variance in overall effectiveness of the PBL tutors (F=22.39, P=0.000). Other important predictors for tutoring skills were providing a relaxed class atmosphere and effective use of audiovisual aids in the lecture. Predicting the tutoring skills based on lecturing skills could have implications for recruiting tutors in PBL medical programs and for tutor training initiatives.

  16. Medical problems of survivors of nuclear war: Infection and the spread of communicable disease

    International Nuclear Information System (INIS)

    Abrams, H.L.; VonKaenel, W.E.

    1984-01-01

    The nature of the medical problems produced by the aftermath of nuclear war is discussed. The survivors of nuclear war will live without the social structure needed to assure food, water, and shelter. They will experience malnutrition, exposure, and fatigue, which are all favorable to infection and the epidemic spread of communicable disease. The authors analyze the problem of infectious illness in the postattack period, assuming the 6,559 megaton attack scenario used by the Federal Emergency Management Agency. A particular contribution of this analysis is that it is based on government technical reports that describe the available computer modeling of postattack conditions. Such simulations allow a semiquantitative estimate of deaths due to infection. They estimate that postattack infectious disease mortality will be 25%. These studies are not accessible to the general reader and are difficult for health professionals to interpret

  17. Medical Tests for Prostate Problems

    Science.gov (United States)

    ... walnut-shaped gland that is part of the male reproductive system. It has two or more lobes, or sections, ... treating problems of the urinary tract and the male reproductive system. Abdominal Ultrasound Ultrasound uses a device, called a ...

  18. Effectiveness of problem based learning as an instructional tool for acquisition of content knowledge and promotion of critical thinking among medical students.

    Science.gov (United States)

    Tayyeb, Rakhshanda

    2013-01-01

    To assess effectiveness of PBL as an instructional tool in clinical years to improve learning of undergraduate students in terms of acquisition of content knowledge, critical thinking and problem solving skills through problem based learning and traditional way of teaching. Quasi-experimental study. Fatima Jinnah Medical College for Women, Lahore, from October 2009 to April 2010. Final year medical students attending Obstetrics and Gynaecology and Surgery rotations were inducted as participants in this study. Two batches of 50 students each attended Gynaecology rotation and two batches attended Surgery rotation, i.e. 100 students in each. Each batch was divided into two groups i.e. A and B of 25 students each. Group-A learnt through traditional teaching, involving bedside teaching and lectures in wards and Group-B learnt relevant clinical knowledge through a modified PBL process. Content knowledge was tested by MCQs testing recall while clinical reasoning and problem were assessed by MCQs testing analysis and critical thinking. Intra-group comparison of mean scores of pre and post-test scores was done using paired sample t-tests while for intergroup comparison of mean scores was done through independent sample t-test. Teaching through traditional method significantly improved content knowledge, (p = 0.001) but did not considerably improve clinical reasoning and problem solving skills (p = 0.093) whereas, content knowledge of students who studied through PBL remained the same (p = 0.202) but there was marked improvement in their clinical reasoning and problem solving skills (p = critical thinking and problem solving skills among medical students.

  19. Utility of an Algorithm to Increase the Accuracy of Medication History in an Obstetrical Setting.

    Science.gov (United States)

    Corbel, Aline; Baud, David; Chaouch, Aziz; Beney, Johnny; Csajka, Chantal; Panchaud, Alice

    2016-01-01

    In an obstetrical setting, inaccurate medication histories at hospital admission may result in failure to identify potentially harmful treatments for patients and/or their fetus(es). This prospective study was conducted to assess average concordance rates between (1) a medication list obtained with a one-page structured medication history algorithm developed for the obstetrical setting and (2) the medication list reported in medical records and obtained by open-ended questions based on standard procedures. Both lists were converted into concordance rate using a best possible medication history approach as the reference (information obtained by patients, prescribers and community pharmacists' interviews). The algorithm-based method obtained a higher average concordance rate than the standard method, with respectively 90.2% [CI95% 85.8-94.3] versus 24.6% [CI95%15.3-34.4] concordance rates (phistory in our obstetric population, without using substantial resources. Its implementation is an effective first step to the medication reconciliation process, which has been recognized as a very important component of patients' drug safety.

  20. How doctors learn: the role of clinical problems across the medical school-to-practice continuum.

    Science.gov (United States)

    Slotnick, H B

    1996-01-01

    The author proposes a theory of how physicians learn that uses clinical problem solving as its central feature. His theory, which integrates insights from Maslow, Schön, Norman, and others, claims that physicians-in-training and practicing physicians learn largely by deriving insights from clinical experience. These insights allow the learner to solve future problems and thereby address the learner's basic human needs for security, affiliation, and self-esteem. Ensuring that students gain such insights means that the proper roles of the teacher are (1) to select problems for students to solve and offer guidance on how to solve them, and (2) to serve as a role model of how to reflect on the problem, its solution, and the solution's effectiveness. Three principles guide instruction within its framework for learning: (1) learners, whether physicians-in-training or practicing physicians, seek to solve problems they recognize they have; (2) learners want to be involved in their own learning; and (3) instruction must both be time-efficient and also demonstrate the range of ways in which students can apply what they learn. The author concludes by applying the theory to an aspect of undergraduate education and to the general process of continuing medical education.

  1. Library of problem-oriented programs for solving problems of atomic and nuclear physics

    International Nuclear Information System (INIS)

    Kharitonov, Yu.I.

    1976-01-01

    The Data Centre of the Leningrad Institute of Nuclear Physics (LIYaF) is working on the establishment of a library of problem-oriented computer programs for solving problems of atomic and nuclear physics. This paper lists and describes briefly the programs presently available to the Data Centre. The descriptions include the program code numbers, the program language, the translator for which the program is designed, and the program scope

  2. Prescription data improve the medication history in primary care

    DEFF Research Database (Denmark)

    Glintborg, Bente; Andersen, S K; Poulsen, H E

    2010-01-01

    Incomplete medication lists increase the risk of medication errors and adverse drug effects. In Denmark, dispensing data and pharmacy records are available directly online to treating physicians. We aimed (1) to describe if use of pharmacy records improved the medication history among patients...... consulting their general practitioner and (2) to characterise inconsistencies between the medication history reported by the patient and the general practitioner's recordings....

  3. Placebo Problem In Acupuncture Studies and Interventions to Increase Report Quality

    Directory of Open Access Journals (Sweden)

    H. Volkan Acar

    2012-07-01

    Full Text Available Studies for acupuncture that has been used as a medical therapeutic method for thousands of years in Far East, is being increased in Western world. In parallel to this increase, there raised several methodologic problems. The most important one of these is the choice of control procedure. If a valid and credible control method has not been chosen, these ‘placebo acupuncture’ or ‘sham acupuncture’ controls could make a negative impact on the study results. In this paper, these different sham acupuncture methods are dis-cussed to find an optimal control procedure. The second major problem which was encountered with acupuncture studies is related with the reporting of interventions. Like CONSORT checklist in conventional medicine, STRICTA recommendations list is prepared for the controlled acupuncture trials. In conclusion, to choose a valid and credible control procedure and to follow CONSORT checklist and STRICTA recommendations will improve the quality of acupuncture studies.

  4. Job requirements compared to medical school education: differences between graduates from problem-based learning and conventional curricula

    Directory of Open Access Journals (Sweden)

    Federkeil Gero

    2010-01-01

    Full Text Available Abstract Background Problem-based Learning (PBL has been suggested as a key educational method of knowledge acquisition to improve medical education. We sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements. Methods Graduates from all German medical schools who graduated between 1996 and 2002 were eligible for this study. Graduates self-assessed nine competencies as required at their day-to-day work and as taught in medical school on a 6-point Likert scale. Results were compared between graduates from a PBL-based curriculum (University Witten/Herdecke and conventional curricula. Results Three schools were excluded because of low response rates. Baseline demographics between graduates of the PBL-based curriculum (n = 101, 49% female and the conventional curricula (n = 4720, 49% female were similar. No major differences were observed regarding job requirements with priorities for "Independent learning/working" and "Practical medical skills". All competencies were rated to be better taught in PBL-based curriculum compared to the conventional curricula (all p Conclusion Among medical graduates in Germany, PBL demonstrated benefits with regard to competencies which were highly required in the job of physicians. Research and business competence deserve closer attention in future curricular development.

  5. [Medical manuscripts in the library of the Deontology Department of the Ankara University Medical School].

    Science.gov (United States)

    Arda, B

    1998-01-01

    At every academical platform on medical history and its instruction, lack of Turkish medical historiography is mainly emphasized. There are two main factors determining the situation: 1-There isn't any comprehensive Turkish medical history textbook. 2-There are difficulties in reaching the primary sources in this field. Everybody agrees with the importance of reaching medical manuscripts easily and reading and evaluating them in medical history. For this reason, it is important to know where we can find them. In this article, medical manuscripts which are available in the library of the Deontology Department of Ankara University Medical School are introduced. The manuscripts have been listed in alphabetical order of the authors' name. The bibliographic items, such as the size, writing style, and type of paper used, are mentioned.

  6. Retrofitting Listed Buildings

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2011-01-01

    The paper presents a case study where the energy demand for a listed building constructed in 1900 is reduced. Many older buildings are listed and have restrictions that include the entire building or that include only its exterior. For the building presented, only its exterior facade is listed. T...

  7. A Problem Assisted Course Delivery for Occupational Health Students' Improved Learning: An Experience of Using Problems and Real Cases

    Directory of Open Access Journals (Sweden)

    Seyedeh Negar Assadi

    2016-05-01

    Full Text Available Background and Purpose: Problem based medical education had been useful in education of medical sciences students. The objective is the determination of effects of problem based medical education on occupational health students' learning.Methods: This study was a semi-experimental study. By using the curriculum of Ministry of Health, occupational toxicology course had been taught based on a problem based plan for group A, then students' grades or data had been analyzed by SPSS 16, mean, standard deviation, t-test with P<0.05.Results: The total grade of occupational toxicology in group A (with problem based medical education was 18.03±1.84 and in group B (regular education, it was 17.60±1.72 with t=0.852 and P=0.398 had not significant differences. The specific lessons such as cadmium and allergic disorders were promoted and its mean grades were more in group A than B.Conclusions: Problem based medical education was helpful in learning of some chapters of occupational toxicology.Keywords: PROBLEM BASED MEDICAL EDUCATION, OCCUPATIONAL TOXICOLOGY, MEDICAL SCIENCES EDUCATION, OCCUPATIONAL HEALT

  8. Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors

    Directory of Open Access Journals (Sweden)

    Polonsky WH

    2016-07-01

    Full Text Available William H Polonsky,1,2 Robert R Henry2,3 1Behavioral Diabetes Institute, San Diego, 2University of California, San Diego, 3Center for Metabolic Research, VA San Diego Healthcare System, San Diego, CA, USA Abstract: At least 45% of patients with type 2 diabetes (T2D fail to achieve adequate glycemic control (HbA1c <7%. One of the major contributing factors is poor medication adherence. Poor medication adherence in T2D is well documented to be very common and is associated with inadequate glycemic control; increased morbidity and mortality; and increased costs of outpatient care, emergency room visits, hospitalization, and managing complications of diabetes. Poor medication adherence is linked to key nonpatient factors (eg, lack of integrated care in many health care systems and clinical inertia among health care professionals, patient demographic factors (eg, young age, low education level, and low income level, critical patient beliefs about their medications (eg, perceived treatment inefficacy, and perceived patient burden regarding obtaining and taking their medications (eg, treatment complexity, out-of-pocket costs, and hypoglycemia. Specific barriers to medication adherence in T2D, especially those that are potentially modifiable, need to be more clearly identified; strategies that target poor adherence should focus on reducing medication burden and addressing negative medication beliefs of patients. Solutions to these problems would require behavioral innovations as well as new methods and modes of drug delivery. Keywords: glycemic control, HbA1c, hypoglycemia, medication adherence, psychosocial, type 2 diabetes

  9. Simulation-Based Medical Education Is No Better than Problem-Based Discussions and Induces Misjudgment in Self-Assessment

    Science.gov (United States)

    Wenk, Manuel; Waurick, Rene; Schotes, David; Wenk, Melanie; Gerdes, Christina; Van Aken, Hugo K.; Popping, Daniel M.

    2009-01-01

    Simulation-based teaching (SBT) is increasingly used in medical education. As an alternative to other teaching methods there is a lack of evidence concerning its efficacy. The aim of this study was to evaluate the potency of SBT in anesthesia in comparison to problem-based discussion (PBD) with students in a randomized controlled setting.…

  10. Bibliography of Recent Books on Creativity and Problem Solving: Supplement 31.

    Science.gov (United States)

    Stievater, Susan M.

    1993-01-01

    This bibliography lists approximately 55 books on creativity and problem solving, published in 1992 and 1993. For each listing, bibliographic information is provided along with one or more subject descriptor terms. (JDD)

  11. Update History of This Database - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available List Contact us PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods ...B link & Genome analysis methods English archive site is opened. 2012/08/08 PGDBj... Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods is opened. About This...ate History of This Database - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  12. Medication cost problems among chronically ill adults in the US: did the financial crisis make a bad situation even worse?

    Directory of Open Access Journals (Sweden)

    Piette JD

    2011-04-01

    Full Text Available John D Piette1, Ann Marie Rosland1, Maria J Silveira1, Rodney Hayward1, Colleen A McHorney21Ann Arbor VA Healthcare System, Ann Arbor, MI, USA; 2US Outcomes Research, Merck and Co, Inc, North Wales, PA, USAAbstract: A national internet survey was conducted between March and April 2009 among 27,302 US participants in the Harris Interactive Chronic Illness Panel. Respondents reported behaviors related to cost-related medication non-adherence (CRN and the impacts of medication costs on other aspects of their daily lives. Among respondents aged 40–64 and looking for work, 66% reported CRN in 2008, and 41% did not fill a prescription due to cost pressures. More than half of respondents aged 40–64 and nearly two-thirds of those in this group who were looking for work or disabled reported other impacts of medication costs, such as cutting back on basic needs or increasing credit card debt. More than one-third of respondents aged 65+ who were working or looking for work reported CRN. Regardless of age or employment status, roughly half of respondents reporting medication cost hardship said that these problems had become more frequent in 2008 than before the economic recession. These data show that many chronically ill patients, particularly those looking for work or disabled, reported greater medication cost problems since the economic crisis began. Given links between CRN and worse health, the financial downturn may have had significant health consequences for adults with chronic illness.Keywords: medication adherence, cost-of-care, access to care, chronic disease

  13. Career listings.

    Science.gov (United States)

    1994-01-12

    Nursing Standard regrets that it is no longer able to take listings over the telephone because of unprecedented demand. Readers are reminded that the listings section is for the use of charitable and professional organisations, unions and health authorities to publicise forthcoming events.

  14. Integrative Review of Mobile Phone Contacts and Medication Adherence in Severe Mental Illness.

    Science.gov (United States)

    Bright, Cordellia E

    Poor medication adherence is a significant problem in individuals with severe mental illness (SMI). About 50% of people with SMI become nonadherent to treatment in the first month following discharge from the hospital. This study examined literature in the past decade (2006-2016) on the use of mobile phone contacts in individuals with SMI to improve medication adherence post hospital discharge. This integrative review used the search terms texting, text messaging, SMS, cell/mobile phone, medication adherence, medication compliance, and mental illness. Databases (CINAHL, PubMed, PsycINFO, and Scopus) and manual searching of reference lists were done. The main inclusion criteria were the use of mobile phone contacts on medication adherence in individuals with SMI. Adults 18 years and older, studies conducted from 2006 to 2016, and studies conducted in English were also criteria for inclusion. Only five studies met criteria for inclusion. Outcomes from the review showed that mobile phone contacts have been used to improve medication adherence in individuals with SMI and able to provide the four types of social support (instrumental, informational, emotional, and, appraisal). When phone contacts especially text messaging was used as an adjunct to other interventions, it yielded better medication adherence than when used alone. However, results on medication adherence rates were mixed in participants on both psychiatric and nonpsychiatric medications. Although mobile phone contacts are a promising tool to enhance medication adherence after hospital discharge, its effectiveness to increase medication adherence in this population remains inconclusive.

  15. List of reports in the field of reactor safety research sponsored by BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1987-05-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning single problems in the field of reactor safety research. According to the cooperation of the Federal Minister for Research and Technology (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  16. List of reports in the field of reactor safety research sponsored by BMFT, CEA, EPRI, JSTA and USNRC

    International Nuclear Information System (INIS)

    1987-02-01

    This list reviews reports from the Federal Republic of Germany, from France, from Japan and from the United States of America concerning single problems in the field of reactor safety research. According to the cooperation of the Federal Minister for Research and Technology (BMFT) with the Commissariat a l'Energie Atomique (CEA), the Japan Science and Technology Agency (JSTA), the Electric Power Research Institute (EPRI) and the United States Nuclear Regulatory Commission, these reports are available in the Gesellschaft fuer Reaktorsicherheit (GRS). The list pursues the following order: Country of origin, problem area concerned, according to the Reactor Safety Research Programm of the BMFT, reporting organization. The list of reports appears quarterly. (orig./HP) [de

  17. Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study

    NARCIS (Netherlands)

    Borst, Jorien M.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2016-01-01

    A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems

  18. Rasch Analysis of Professional Behavior in Medical Education

    Science.gov (United States)

    Lange, R.; Verhulst, S. J.; Roberts, N. K.; Dorsey, J. K.

    2015-01-01

    The use of students' "consumer feedback" to assess faculty behavior and improve the process of medical education is a significant challenge. We used quantitative Rasch measurement to analyze pre-categorized student comments listed by 385 graduating medical students. We found that students differed little with respect to the number of…

  19. Retail Shopping Lists

    DEFF Research Database (Denmark)

    Schmidt, Marcus

    2012-01-01

    categories. An association between the frequency of a brand's appearance on lists and the amount of money spent on advertising the brand could not be found. A strong link between brands, prices and store names is revealed. Price in the majority of cases refers to brands rather than to product categories......The paper addresses consumers' shopping lists. The current study is based on a survey of 871 lists collected at retail grocery stores. Most items on shopping lists appear on the product category level rather than the brand level. The importance of the brand level varies considerably across product...

  20. Variation in clinical coding lists in UK general practice: a barrier to consistent data entry?

    Science.gov (United States)

    Tai, Tracy Waize; Anandarajah, Sobanna; Dhoul, Neil; de Lusignan, Simon

    2007-01-01

    Routinely collected general practice computer data are used for quality improvement; poor data quality including inconsistent coding can reduce their usefulness. To document the diversity of data entry systems currently in use in UK general practice and highlight possible implications for data quality. General practice volunteers provided screen shots of the clinical coding screen they would use to code a diagnosis or problem title in the clinical consultation. The six clinical conditions examined were: depression, cystitis, type 2 diabetes mellitus, sore throat, tired all the time, and myocardial infarction. We looked at the picking lists generated for these problem titles in EMIS, IPS, GPASS and iSOFT general practice clinical computer systems, using the Triset browser as a gold standard for comparison. A mean of 19.3 codes is offered in the picking list after entering a diagnosis or problem title. EMIS produced the longest picking lists and GPASS the shortest, with a mean number of choices of 35.2 and 12.7, respectively. Approximately three-quarters (73.5%) of codes are diagnoses, one-eighth (12.5%) symptom codes, and the remainder come from a range of Read chapters. There was no readily detectable consistent order in which codes were displayed. Velocity coding, whereby commonly-used codes are placed higher in the picking list, results in variation between practices even where they have the same brand of computer system. Current systems for clinical coding promote diversity rather than consistency of clinical coding. As the UK moves towards an integrated health IT system consistency of coding will become more important. A standardised, limited list of codes for primary care might help address this need.

  1. Historical review of the List of Occupational Diseases recommended by the International Labour organization (ILO)

    Science.gov (United States)

    2013-01-01

    The list of occupational diseases established in the international and national legal system has played important roles in both prevention of and compensation for workers’ diseases. This report reviewed the historical development in the ILO list of occupational diseases and suggested implications of the trends. Since the first establishment of the ILO list of occupational diseases in 1925, the list has played a key role in harmonizing the development of policies on occupational diseases at the international level. The three occupational diseases (anthrax, lead poisoning, and mercury poisoning) in the first ILO list of occupational diseases, set up in 1925 as workmen’s compensation convention represented an increase of occupational diseases from the Industrial Revolution. Until the 1960s, 10 occupational diseases had been representative compensable occupational diseases listed in Convention No. 121, which implies that occupational diseases in this era were equated to industrial poisoning. Since 1980, with advancements in diagnostic techniques and medical science, noise-induced hearing loss, and several bronchopulmonary diseases have been incorporated into the ILO occupational list. Since 2002, changes in the structure of industries, emerging new chemicals, and advanced national worker’s compensation schemes have provoked the ILO to revise the occupational disease list. A new format of ILO list appended in Recommendation 194 (R194) was composed of two dimensions (causes and diseases) and subcategories. Among 50 member states that had provided their national lists of occupational diseases, until 2012 thirty countries were found to have the list occupational diseases having similar structure to ILO list in R194. PMID:24472440

  2. Historical review of the List of Occupational Diseases recommended by the International Labour organization (ILO).

    Science.gov (United States)

    Kim, Eun-A; Kang, Seong-Kyu

    2013-08-05

    The list of occupational diseases established in the international and national legal system has played important roles in both prevention of and compensation for workers' diseases. This report reviewed the historical development in the ILO list of occupational diseases and suggested implications of the trends. Since the first establishment of the ILO list of occupational diseases in 1925, the list has played a key role in harmonizing the development of policies on occupational diseases at the international level. The three occupational diseases (anthrax, lead poisoning, and mercury poisoning) in the first ILO list of occupational diseases, set up in 1925 as workmen's compensation convention represented an increase of occupational diseases from the Industrial Revolution. Until the 1960s, 10 occupational diseases had been representative compensable occupational diseases listed in Convention No. 121, which implies that occupational diseases in this era were equated to industrial poisoning. Since 1980, with advancements in diagnostic techniques and medical science, noise-induced hearing loss, and several bronchopulmonary diseases have been incorporated into the ILO occupational list. Since 2002, changes in the structure of industries, emerging new chemicals, and advanced national worker's compensation schemes have provoked the ILO to revise the occupational disease list. A new format of ILO list appended in Recommendation 194 (R194) was composed of two dimensions (causes and diseases) and subcategories. Among 50 member states that had provided their national lists of occupational diseases, until 2012 thirty countries were found to have the list occupational diseases having similar structure to ILO list in R194.

  3. Dealing with sickness certification – a survey of problems and strategies among general practitioners and orthopaedic surgeons

    Directory of Open Access Journals (Sweden)

    Nilsson Gunnar

    2007-10-01

    Full Text Available Abstract Background In order to get sickness benefit a sick-listed person need a medical certificate issued by a physician; in Sweden after one week of self-certification. Physicians experience sick-listing tasks as problematic and conflicts may arise when patients regard themselves unable to work due to complaints that are hard to objectively verify for the physician. Most GPs and orthopaedic surgeons (OS deal regularly with sick-listing issues in their daily practice. The aim of this study was to explore perceived problems and coping strategies related to tasks of sickness certification among general practitioners (GP and orthopaedic surgeons (OS. Methods A cross-sectional study about sickness certification in two Swedish counties, with 673 participating GPs and 149 OSs, who answered a comprehensive questionnaire. Frequencies together with crude and adjusted (gender and working years Odds ratios were calculated. Results A majority of the GPs and OSs experienced problems in sickness certification every week. To assess the patient's work ability, to handle situations when they and the patient had different opinions about the need for sickness absence, and to issue prolongation certificates when the previous was issued by another physician were reported as problematic by a majority in both groups. Both GPs and OSs prolonged sickness certifications due to waiting times in health care or at Social Insurance Office (SIO. To handle experienced problems they used different strategies; OSs issued sickness certificates without personal appointment more often than the GPs, who on the other hand reported having contact with SIO more often than the OSs. A higher rate of GPs experienced support from management and had a common strategy for handling sickness certification at the clinic than the OSs. Conclusion Most GPs and OSs handled sickness certification weekly and reported a variety of problems in relation to this task, generally GPs to a higher extent

  4. Registries Help Moms Measure Medication Risks

    Science.gov (United States)

    ... in the case of the North American Antiepileptic Drug Pregnancy Registry, which studies the effects of drugs for ... is taking. For example, the North American Antiepileptic Drug Pregnancy Registry website lists more than 30 medications being ...

  5. Validation of the MedUseQ: A Self-Administered Screener for Older Adults to Assess Medication Use Problems.

    Science.gov (United States)

    Berman, Rebecca L; Iris, Madelyn; Conrad, Kendon J; Robinson, Carrie

    2018-01-01

    Older adults taking multiple prescription and nonprescription drugs are at risk for medication use problems, yet there are few brief, self-administered screening tools designed specifically for them. The study objective was to develop and validate a patient-centered screener for community-dwelling older adults. In phase 1, a convenience sample of 57 stakeholders (older adults, pharmacists, nurses, and physicians) participated in concept mapping, using Concept System® Global MAX TM , to identify items for a questionnaire. In phase 2, a 40-item questionnaire was tested with a convenience sample of 377 adults and a 24-item version was tested with 306 older adults, aged 55 and older, using Rasch methodology. In phase 3, stakeholder focus groups provided feedback on the format of questionnaire materials and recommended strategies for addressing problems. The concept map contained 72 statements organized into 6 conceptual clusters or domains. The 24-item screener was unidimensional. Cronbach's alpha was .87, person reliability was acceptable (.74), and item reliability was high (.96). The MedUseQ is a validated, patient-centered tool targeting older adults that can be used to assess a wide range of medication use problems in clinical and community settings and to identify areas for education, intervention, or further assessment.

  6. 78 FR 76507 - Revised Medical Criteria for Evaluating Cancer (Malignant Neoplastic Diseases)

    Science.gov (United States)

    2013-12-17

    ... include updating the medical terminology in the listings. For example, we would replace the term ``Hodgkin... Revised Medical Criteria for Evaluating Cancer (Malignant Neoplastic Diseases); Proposed Rule #0;#0...

  7. Medical standards for radiation workers

    International Nuclear Information System (INIS)

    Rae, S.

    1977-01-01

    The Council of the European Communities in its Directive of June 1, 1976 has laid down revised basic safety standards for the health protection of the general public and workers against the danger of ionising radiation. The Directive requires each Member State of the Community 'for the guidance of medical practitioners.....to draw up a list, which need not be exhaustive, of the criteria which should be taken into account when judging a worker's fitness to be exposed to ionising radiation'. Medical officers with current responsibility for radiation workers in the U.K. therefore met recently for informal exploratory discussion at the National Radiological Protection Board's headquarters, and an account is given of the views expressed there about the composition of the required 'list', and the possibility of standardizing the procedure adopted. Consideration was given to the objectives of medical examinations, the form of examination, and specific conditions which may give rise to difficulty in making a fitness assessment. These conditions are skin abnormalities, blood abnormalities, cataract, pregnancy, and psychological and psychiatric conditions. It was concluded that the medical examination of radiation workers, including blood examinations, are of value to the extent that they form part of any good general occupational health practice. The promulgation of the Euratom Directive has provided an opportunity for reviewing and standardising procedures for medical surveillance in the light of current knowledge concerning average occupational radiation doses and dose-response relationships. (U.K.)

  8. PROBLEMS IN TOPOLOGICAL GRAPH THEORY : QUESTIONS I CAN'T ANSWER

    OpenAIRE

    Archdeacon, Dan

    1999-01-01

    This paper describes my Problems in Topological Graph Theory, which can be accessed through the world-wide-web at http: //www.emba .uvm.edu/~arcceack/problems/problems.html This list of problems is constantly being revised; the interested reader is encouraged to submit additions and updates.

  9. [Medication reconciliation: an innovative experience in an internal medicine unit to decrease errors due to inacurrate medication histories].

    Science.gov (United States)

    Pérennes, Maud; Carde, Axel; Nicolas, Xavier; Dolz, Manuel; Bihannic, René; Grimont, Pauline; Chapot, Thierry; Granier, Hervé

    2012-03-01

    An inaccurate medication history may prevent the discovery of a pre-admission iatrogenic event or lead to interrupted drug therapy during hospitalization. Medication reconciliation is a process that ensures the transfer of medication information at admission to the hospital. The aims of this prospective study were to evaluate the interest in clinical practice of this concept and the resources needed for its implementation. We chose to include patients aged 65 years or over admitted in the internal medicine unit between June and October 2010. We obtained an accurate list of each patient's home medications. This list was then compared with medication orders. All medication variances were classified as intended or unintended. An internist and a pharmacist classified the clinical importance of each unintended variance. Sixty-one patients (mean age: 78 ± 7.4 years) were included in our study. We identified 38 unintended discrepancies. The average number of unintended discrepancies was 0.62 per patient. Twenty-five patients (41%) had one or more unintended discrepancies at admission. The contact with the community pharmacist permitted us to identify 21 (55%) unintended discrepancies. The most common errors were the omission of a regularly used medication (76%) and an incorrect dosage (16%). Our intervention resulted in order changes by the physician for 30 (79%) unintended discrepancies. Fifty percent of the unintended variances were judged by the internist and 76% by the pharmacist to be clinically significant. The admission to the hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  10. Quantum algorithms for the ordered search problem via semidefinite programming

    International Nuclear Information System (INIS)

    Childs, Andrew M.; Landahl, Andrew J.; Parrilo, Pablo A.

    2007-01-01

    One of the most basic computational problems is the task of finding a desired item in an ordered list of N items. While the best classical algorithm for this problem uses log 2 N queries to the list, a quantum computer can solve the problem using a constant factor fewer queries. However, the precise value of this constant is unknown. By characterizing a class of quantum query algorithms for the ordered search problem in terms of a semidefinite program, we find quantum algorithms for small instances of the ordered search problem. Extending these algorithms to arbitrarily large instances using recursion, we show that there is an exact quantum ordered search algorithm using 4 log 605 N≅0.433 log 2 N queries, which improves upon the previously best known exact algorithm

  11. Can anonymous posters on medical forums be reidentified?

    Science.gov (United States)

    Bobicev, Victoria; Sokolova, Marina; El Emam, Khaled; Jafer, Yasser; Dewar, Brian; Jonker, Elizabeth; Matwin, Stan

    2013-10-03

    Participants in medical forums often reveal personal health information about themselves in their online postings. To feel comfortable revealing sensitive personal health information, some participants may hide their identity by posting anonymously. They can do this by using fake identities, nicknames, or pseudonyms that cannot readily be traced back to them. However, individual writing styles have unique features and it may be possible to determine the true identity of an anonymous user through author attribution analysis. Although there has been previous work on the authorship attribution problem, there has been a dearth of research on automated authorship attribution on medical forums. The focus of the paper is to demonstrate that character-based author attribution works better than word-based methods in medical forums. The goal was to build a system that accurately attributes authorship of messages posted on medical forums. The Authorship Attributor system uses text analysis techniques to crawl medical forums and automatically correlate messages written by the same authors. Authorship Attributor processes unstructured texts regardless of the document type, context, and content. The messages were labeled by nicknames of the forum participants. We evaluated the system's performance through its accuracy on 6000 messages gathered from 2 medical forums on an in vitro fertilization (IVF) support website. Given 2 lists of candidate authors (30 and 50 candidates, respectively), we obtained an F score accuracy in detecting authors of 75% to 80% on messages containing 100 to 150 words on average, and 97.9% on longer messages containing at least 300 words. Authorship can be successfully detected in short free-form messages posted on medical forums. This raises a concern about the meaningfulness of anonymous posting on such medical forums. Authorship attribution tools can be used to warn consumers wishing to post anonymously about the likelihood of their identity being

  12. 12 CFR 571.32 - Sharing medical information with affiliates.

    Science.gov (United States)

    2010-01-01

    ... based on the payment transactions of the consumer for medical products or services; or (3) An aggregate list of identified consumers based on payment transactions for medical products or services. (c... activities described in section 18B of the model Privacy of Consumer Financial and Health Information...

  13. The Museum of Science and Industry Basic List of Children's Science Books 1973-1984.

    Science.gov (United States)

    Richter, Bernice; Wenzel, Duane

    Children's science books are listed under these headings: animals; astronomy; aviation and space; biography; careers; earth sciences; encyclopedias and reference books; environment and conservation; fiction; general science; life sciences; marine life; mathematics and computer science; medical and health sciences; physics and chemistry; plant…

  14. The Motivation of Judicial Judgments in Demands of Medications in the Context of the Crisis of Bourgeois Legality

    Directory of Open Access Journals (Sweden)

    Ariadi Sandrini Rezende

    2015-12-01

    Full Text Available The provision of free medicines to the population for the treatment of diseases is regulated by Decree No. 7,508/2011, which created the National List of Essential Medicines. A problem occurs when it is asked how judges should proceed in demands of medication when the drugs desired are not in the list. It is necessary to confront the dogma that law is the law and, therefore, to demonstrate the requirements that the contemporary legal phenomenon requires for the foundations of judicial decisions when them talk about social rights. It is depicted the rise of the idea of legality within the bourgeois state. Three problems that led to the crisis of this political model of law are exposed. It is shown the process of constitucionalization of the social rights with the reform of the liberal state and, therefore, the consolidation of the desire to control the legislative political power and the legality. It is exposed how the judicial activity can consolidate the reform initiated by the constitutionalization of social rights when obstacles imposed against its effectiveness are exceeded by the judge. It will be shown the anachronism of merely loyalist decisions which deny provisionses in judicial demands of medications based on dogmas of nineteenth-century liberal state. It will be exposed the needs of serious judicial decisions which wonder about the role of the welfare state and judicial activity in the contemporary context.

  15. Medical Physics: Forming and testing solutions to clinical problems.

    Science.gov (United States)

    Tsapaki, Virginia; Bayford, Richard

    2015-11-01

    According to the European Federation of Organizations for Medical Physics (EFOMP) policy statement No. 13, "The rapid advance in the use of highly sophisticated equipment and procedures in the medical field increasingly depends on information and communication technology. In spite of the fact that the safety and quality of such technology is vigorously tested before it is placed on the market, it often turns out that the safety and quality is not sufficient when used under hospital working conditions. To improve safety and quality for patient and users, additional safeguards and related monitoring, as well as measures to enhance quality, are required. Furthermore a large number of accidents and incidents happen every year in hospitals and as a consequence a number of patients die or are injured. Medical Physicists are well positioned to contribute towards preventing these kinds of events". The newest developments related to this increasingly important medical speciality were presented during the 8th European Conference of Medical Physics 2014 which was held in Athens, 11-13 September 2014 and hosted by the Hellenic Association of Medical Physicists (HAMP) in collaboration with the EFOMP and are summarized in this issue. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. Surfing the Net: Children + Problem Solving = Giftedness. How Can Ill-Structured Problems Take Advantage of a Child's Natural Curiosity?

    Science.gov (United States)

    Berger, Sandra

    2000-01-01

    This article discusses using a Problem-Based Learning (PBL) curriculum to engage gifted learners. The benefits of PBL are described and a list of seven useful Web sites that explain PBL and provide examples of problems that can be used to excite gifted children about learning is provided. (CR)

  17. Merging Problem-Based Learning with Simulation-Based Learning in the Medical Undergraduate Curriculum: The PAIRED Framework for Enhancing Lifelong Learning

    Science.gov (United States)

    Koh, Jansen

    2016-01-01

    Lifelong learning is an essential trait that is expected of every physician. The CanMeds 2005 Physician Competency Framework emphasizes lifelong learning as a key competency that physicians must achieve in becoming better physicians. However, many physicians are not competent at engaging in lifelong learning. The current medical education system is deficient in preparing medical students to develop and carry out their own lifelong learning curriculum upon graduation. Despite understanding how physicians learn at work, medical students are not trained to learn while working. Similarly, although barriers to lifelong learning are known, medical students are not adequately skilled in overcoming these barriers. Learning to learn is just as important, if not more, as acquiring the skills and knowledge required of a physician. The medical undergraduate curriculum lacks a specific learning strategy to prepare medical students in becoming an adept lifelong learner. In this article, we propose a learning strategy for lifelong learning at the undergraduate level. In developing this novel strategy, we paid particular attention to two parameters. First, this strategy should be grounded on literature describing a physician’s lifelong learning process. Second, the framework for implementing this strategy must be based on existing undergraduate learning strategies to obviate the need for additional resources, learner burden, and faculty time. In this paper, we propose a Problem, Analysis, Independent Research Reporting, Experimentation Debriefing (PAIRED) framework that follows the learning process of a physician and serves to synergize the components of problem-based learning and simulation-based learning in specifically targeting the barriers to lifelong learning. PMID:27446767

  18. Virtual microscopy system at Chinese medical university: an assisted teaching platform for promoting active learning and problem-solving skills.

    Science.gov (United States)

    Tian, Yanping; Xiao, Wengang; Li, Chengren; Liu, Yunlai; Qin, Maolin; Wu, Yi; Xiao, Lan; Li, Hongli

    2014-04-09

    Chinese medical universities typically have a high number of students, a shortage of teachers and limited equipment, and as such histology courses have been taught using traditional lecture-based formats, with textbooks and conventional microscopy. This method, however, has reduced creativity and problem-solving skills training in the curriculum. The virtual microscope (VM) system has been shown to be an effective and efficient educational strategy. The present study aims to describe a VM system for undergraduates and to evaluate the effects of promoting active learning and problem-solving skills. Two hundred and twenty-nine second-year undergraduate students in the Third Military Medical University were divided into two groups. The VM group contained 115 students and was taught using the VM system. The light microscope (LM) group consisted of 114 students and was taught using the LM system. Post-teaching performances were assessed by multiple-choice questions, short essay questions, case analysis questions and the identification of structure of tissue. Students' teaching preferences and satisfaction were assessed using questionnaires. Test scores in the VM group showed a significant improvement compared with those in the LM group (p 0.05); however, there were notable differences in the mean score rate of case analysis questions and identification of structure of tissue (p effects of the VM system in terms of additional learning resources, critical thinking, ease of communication and confidence. The VM system is an effective tool at Chinese medical university to promote undergraduates' active learning and problem-solving skills as an assisted teaching platform.

  19. A computed room temperature line list for phosphine

    Science.gov (United States)

    Sousa-Silva, Clara; Yurchenko, Sergei N.; Tennyson, Jonathan

    2013-06-01

    An accurate and comprehensive room temperature rotation-vibration transition line list for phosphine (31PH3) is computed using a newly refined potential energy surface and a previously constructed ab initio electric dipole moment surface. Energy levels, Einstein A coefficients and transition intensities are computed using these surfaces and a variational approach to the nuclear motion problem as implemented in the program TROVE. A ro-vibrational spectrum is computed, covering the wavenumber range 0-8000 cm-1. The resulting line list, which is appropriate for temperatures up to 300 K, consists of a total of 137 million transitions between 5.6 million energy levels. Several of the band centres are shifted to better match experimental transition frequencies. The line list is compared to the most recent HITRAN database and other laboratorial sources. Transition wavelengths and intensities are generally found to be in good agreement with the existing experimental data, with particularly close agreement for the rotational spectrum. An analysis of the comparison between the theoretical data created and the existing experimental data is performed, and suggestions for future improvements and assignments to the HITRAN database are made.

  20. CRC Handbook of Medical Physics, vol. 3

    International Nuclear Information System (INIS)

    Waggener, R.G.; Kereiakes, J.G.; Shalek, R.J.

    1984-01-01

    In this work, the care and testing of measurement and diagnostic instruments are described in detail. Difficulties encountered with therapeutic and diagnostic calibrations are explored and solutions are suggested. VOLUME III Physics Teaching for Radiologic Technologists, Physics Teaching for Diagnostic Radiology Residents, Physics Teaching for Nuclear Medicine Residents, Physics Teaching for Radiotherapy Residents, Degree Programs in Medical Physics, Radiobiology Teaching, Non-Degree Medical Physics Training and American Board of Radiology Certifications, Radioactivity and Production of Medical Isotopes, Practical Medical Physics Consulting, Radiologic Terminology, Nuclear Medicine Imaging Techniques, Description of Radiotherapy Procedures, Medical Applications of Ultrasonography and Thermography, Glossary of Medical and Anatomical Terms Used in Medical Physics, Equipment List for Medical Physics and Acquisition Priority. Bibliography of Reference Materials. Index

  1. Medication Errors - A Review

    OpenAIRE

    Vinay BC; Nikhitha MK; Patel Sunil B

    2015-01-01

    In this present review article, regarding medication errors its definition, medication error problem, types of medication errors, common causes of medication errors, monitoring medication errors, consequences of medication errors, prevention of medication error and managing medication errors have been explained neatly and legibly with proper tables which is easy to understand.

  2. 12 CFR 222.32 - Sharing medical information with affiliates.

    Science.gov (United States)

    2010-01-01

    ... payment transactions of the consumer for medical products or services; or (3) An aggregate list of identified consumers based on payment transactions for medical products or services. (c) Exceptions. A person... in section 18B of the model Privacy of Consumer Financial and Health Information Regulation issued by...

  3. 12 CFR 334.32 - Sharing medical information with affiliates.

    Science.gov (United States)

    2010-01-01

    ... payment transactions of the consumer for medical products or services; or (3) An aggregate list of identified consumers based on payment transactions for medical products or services. (c) Exceptions. A person... in section 18B of the model Privacy of Consumer Financial and Health Information Regulation issued by...

  4. Priority of the genus name Clostridium Prazmowski 1880 (Approved Lists 1980) vs Sarcina Goodsir 1842 (Approved Lists 1980) and the creation of the illegitimate combinations Clostridium maximum (Lindner 1888) Lawson and Rainey 2016 and Clostridium ventriculi (Goodsir 1842) Lawson and Rainey 2016 that may not be used.

    Science.gov (United States)

    Tindall, B J

    2016-11-01

    In a recent publication that attempts to deal with the growing problem of taxa being added to the genus Clostridium that are outside of Clostridium (16S rRNA) group I, a solution is proposed that seeks to limit the genus Clostridium Prazmowski 1880 (Approved Lists 1980) to a small number of species 'related' to the type species, Clostridium butyricum Prazmowski 1880 (Approved Lists 1980). It has been proposed that this genus should also include members of the genus Sarcina Goodsir 1842 (Approved Lists 1980), Sarcinamaxima Lindner 1888 (Approved Lists 1980) and Sarcinaventriculi Goodsir 1842 (Approved Lists 1980), the latter being the nomenclatural type of the genus Sarcina Goodsir 1842 (Approved Lists 1980). In making proposals to treat the genus name Sarcina Goodsir 1842 (Approved Lists 1980) as a synonym of ClostridiumPrazmowski 1880 (Approved Lists 1980), reference is made to the wording of the International Code of Nomenclature of Bacteria. However, while that wording is factually correct, other parts of the Code are relevant to this issue and clearly indicate that the proposed course of action is not sanctioned by texts that have not been directly made reference to. Rather than avoiding confusion it has been contributed to, and it is necessary to document where the problems lie.

  5. PROBLEM OF SUPPORTING THE VERSIONS OF DISTANCE EDUCATION SYSTEM MOODLE IN THE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    Andrii V. Semenets

    2014-01-01

    Full Text Available Moodle is one of the open-source software learning management system using to support an educational process. The problem of updating the outdated Moodle versions is studied in the article. It is shown a successful implementation of a modified version on the basis of I. Ya. Horbachevsky Ternopil State Medical University. The step-by-step manual of the updating and a new server migration process are described. Examples of the application of the virtualization techniques and version control system to the SDE Moodle system administration tasks solving are presented. The SDE Moodle server optimization and customization recommendations are also given.

  6. Potentially inappropriate medicines in elderly hospitalised patients according to the EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol.

    Science.gov (United States)

    Mucalo, Iva; Hadžiabdić, Maja Ortner; Brajković, Andrea; Lukić, Sonja; Marić, Patricia; Marinović, Ivana; Bačić-Vrca, Vesna

    2017-08-01

    The aim of this study was to measure the prevalence of potentially inappropriate medications (PIMs) by using the EU(7)-PIM list, STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) version 2 criteria and the new comprehensive protocol. This prospective study involved a sample of 276 consecutive elderly patients discharged from the university teaching hospital. Age, gender, diagnoses, medication history and medicines at discharge were recorded. The main outcome measure was the prevalence of PIMs according to each set of criteria: EU(7)-PIM list, STOPP version 2 criteria and comprehensive protocol. The median patient age (range) was 74 (65-92) years. The median number of prescribed medications was 7 (1-17). STOPP identified 393 PIMs affecting 190 patients (69%), EU(7)-PIM list identified 330 PIMs in 184 patients (66.7%) whilst the comprehensive protocol identified 134 PIMs in 102 patients (37%). STOPP version 2 criteria identified significantly more PIMs per patient than the other two protocols (p comprehensive protocol and was found as a more sensitive tool for PIM detection.

  7. "Political co-authorships" in medical science journals.

    Science.gov (United States)

    Johal, Jaspreet; Loukas, Marios; Oskouian, Rod J; Tubbs, R Shane

    2017-09-01

    The issue of co-author relationships on medical sciences journal publications has become more pronounced as advances in technology have enabled collaboration across countries and institutions to occur much more efficiently. These relationships often have underlying political motivations and outcomes, including career advancement, attempting to increase prestige of a project, and maintaining research grants. Some authors may be listed as senior or honorary authors despite offering little or no contribution to the original research project. This may be done in an effort to enhance the gravitas of a research project, and attain publication in a highly regarded medical journal. The current review covers the topic of political co-authorship and germane literature and lists strategies to combat this phenomenon. Such co-authorship practices corrupt the integrity of the research process as they attempt to bypass the safeguard that medical journals and institutions have put in place to prevent fraud and falsification. A number of strategies have been proposed to combat the practice of co-authorship, but it may ultimately be an unavoidable feature of contemporary medical research publishing that is difficult to police. Clin. Anat. 30:831-834, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  8. Natural personal care products-analysis of ingredient lists and legal situation.

    Science.gov (United States)

    Klaschka, Ursula

    2016-01-01

    Many natural substances are classified as dangerous substances according to the European regulation on classification and labelling. Are they used in natural personal care products today? One hundred ingredient lists were analyzed to find this out. All products with natural substances contained dangerous natural substances or they contained natural substances, for which the information about their classification as dangerous substances is not available. 54 natural substances quoted in the ingredient lists were found to be classified, with 37 substances being classified due to hazardous effects for skin and eyes. However, the most frequently used natural substances are not classified as dangerous. Natural substances are multi-constituent compounds, leading to two main problems in personal care products: the potential interactions of a multitude of substances and the fact that dangerous constituents are not disclosed in the ingredient lists. For example, the fragrance allergens citral, farnesol, limonene, and linalool are frequent components of the natural substances employed. In addition, 82 products listed allergenic fragrance ingredients as single substances in their ingredient lists. Recommendations for sensitive skin in a product's name do not imply that the '26 fragrance allergens' are omitted. Furthermore, 80 products listed 'parfum'/'aroma', and 50 products listed ethanol. The data show that the loopholes for natural substances and for personal care products in the present European chemical legislation (e.g. the exception for classification and labelling of cosmetic products and the exception for information transfer in the supply chain) are not in line with an adequate consumer and environmental protection.

  9. Some problems in differential geometry and topology

    International Nuclear Information System (INIS)

    Donaldson, S K

    2008-01-01

    This does not attempt to be a systematic overview or to present a comprehensive list of problems. We outline some questions in three different areas which seem interesting to the author. Experts will learn little that is new; our goal is to give some picture of the fields for non-specialists. (open problem)

  10. Mary's Story: A Curriculum for Teaching Medical Terminology.

    Science.gov (United States)

    Pennsylvania State Univ., University Park. Inst. for the Study of Adult Literacy.

    This packet of materials for a class on medical terminology consists of a collection of stories with highlighted vocabulary, teacher's guide, and student's guide. The materials teach medical terms in a series of stories about a woman named Mary Consola. Each story begins with a list of word parts that will be learned; after the story, new word…

  11. A Bibliography of Books Dealing With the Problems of Older Children (Grades 3-12).

    Science.gov (United States)

    Sacco, Margaret

    Books for children that deal with the real problems of children in grades 3 to 12 are listed in this bibliography. The books are concerned with many social problems such as racial inequality, poverty, adult hypocrisy, desertion, broken homes, drugs, alcohol, sex, mental illness, and death. The entries are listed alphabetically by author. Each…

  12. Problem Gambling and Delinquent Behaviours Among Adolescents: A Scoping Review.

    Science.gov (United States)

    Kryszajtys, David T; Hahmann, Tara E; Schuler, Andrée; Hamilton-Wright, Sarah; Ziegler, Carolyn P; Matheson, Flora I

    2018-02-22

    Despite many studies indicating an association between problem gambling and delinquent behaviours among adolescents, there has been no effort to systematically analyze the state of the literature on this relationship. To fill this gap, we conducted a scoping review of the literature published between 2000 and 2016 on problem gambling and delinquent behaviours among adolescents. We searched twelve databases and reviewed reference lists to identify eligible studies. Search terms included a combination of medical subject headings and keywords for gambling, youth, and delinquency, which were combined with the Boolean operator "AND". 1795 studies were identified through the literature search. Nine studies were eligible for inclusion. All of the studies were conducted in North America, with primarily male participants, and most of the data were cross-sectional. No qualitative studies met the inclusion criteria. Screening tools used to measure problem gambling were inconsistent, making comparisons across studies difficult. We found a consistent moderate to strong association between problem gambling and delinquent behaviour. Only one study presented associations by socio-economic status and none considered gender, sex or ethnic differences. Studies in the review showed that problem gambling is associated with both violent and non-violent behaviours among adolescents. These associations may suggest that problem gambling and delinquent behaviours have common risk factors and reflect a syndrome of risky behaviours best targeted through prevention and treatment that is holistic and considers the context in which the youth is situated. Further research is warranted to better understand the relationship between problem gambling and delinquent behaviours.

  13. Sources of Stress and Coping Strategies among Undergraduate Medical Students Enrolled in a Problem-Based Learning Curriculum

    Directory of Open Access Journals (Sweden)

    Samira S. Bamuhair

    2015-01-01

    Full Text Available Background. Medical education is rated as one of the most difficult trainings to endure. Throughout their undergraduate years, medical students face numerous stressors. Coping with these stressors requires access to a variety of resources, varying from personal strengths to social support. We aimed to explore the perceived stress, stressors, and coping strategies employed by medical students studying in a problem-based learning curriculum. Methodology. This is a cross-sectional study of randomly selected medical students that explored demographics, perceived stress scale, sources of stress, and coping strategies. Results. Of the 378 medical students that participated in the study, males were 59.3% and females 40.7%. Nearly 53% of the students often felt stressed, and a third felt that they could not cope with stress. Over 82% found studying stressful and 64.3% were not sleeping well. Half of the students reported low self-esteem. Perceived stress scores were statistically significantly high for specific stressors of studying in general, worrying about future, interpersonal conflict, and having low self-esteem. Coping strategies that were statistically significantly applied more often were blaming oneself and being self-critical, seeking advice and help from others, and finding comfort in religion. Female students were more stressed than males but they employ more coping strategies as well. Conclusions. Stress is very common among medical students. Most of the stressors are from coursework and interpersonal relationships. Low self-esteem coupled with self-blame and self-criticism is quite common.

  14. Medical slang in British hospitals.

    Science.gov (United States)

    Fox, Adam T; Fertleman, Michael; Cahill, Pauline; Palmer, Roger D

    2003-01-01

    The usage, derivation, and psychological, ethical, and legal aspects of slang terminology in medicine are discussed. The colloquial vocabulary is further described and a comprehensive glossary of common UK terms provided in appendix. This forms the first list of slang terms currently in use throughout the British medical establishment.

  15. Medical devices made into weapons by prisoners: an unrecognized risk.

    Science.gov (United States)

    Hayden, J W; Laney, C; Kellermann, A L

    1995-12-01

    The alteration of a knee immobilizer into a sharp weapon by a prisoner prompted us to survey neighboring penal institutions to determine the frequency of such events. We mailed a nine-item survey to all detention facilities in Tennessee, Arkansas, and Mississippi. A second survey was sent to nonresponding institutions 6 weeks after the initial mailing. The Regional Medical Center at Memphis, the designated facility for evaluation and treatment of prisoners from the county jail and state penitentiary. Survey respondents included 25 state penitentiaries, 31 county jails, 1 state minimum-security facility, 1 state maximum-security facility, 1 work-release center, 1 county detention center for drunken-driving offenders, and 1 federal penitentiary. Of the 81 institutions surveyed, 77% responded to one of the two mailings. Forty percent responded in the affirmative when asked whether stolen or unauthorized medical equipment from outside their institutions had been discovered among inmates. When respondents were questioned as to whether medical equipment, prescribed or not, had been used or altered in a criminal manner, 34% responded "yes." Medications and medical appliances were listed in the responses. A survey of 81 local and neighboring penal institutions in a three-state area revealed that the illicit use of medicine and medical devices by prisoners is a legitimate safety concern of prison personnel and health care workers when medical care for inmates must be sought outside the security of their institutions. The modification of medical equipment into weapons by incarcerated patients, although clearly recognized as a security and safety problem by police authorities, appears to be unappreciated by health care workers providing episodic care to inmates.

  16. List of the reports from reactor safety research of the BMFT and USNRC

    International Nuclear Information System (INIS)

    1977-02-01

    This list presents a survey of reports from the FRG and USA issued on special problems of reactor safety research. The problems include emergency core cooling, the containment during loss of coolant, core meltdown, component safety, external impacts, risk and reliability, quality assurance, fission product transport, radiation exposure, as well as the LWR, HTR and the fast sodium-cooled reactor in general. (orig./HK) [de

  17. The STAPL pList

    KAUST Repository

    Tanase, Gabriel

    2010-01-01

    We present the design and implementation of the stapl pList, a parallel container that has the properties of a sequential list, but allows for scalable concurrent access when used in a parallel program. The Standard Template Adaptive Parallel Library (stapl) is a parallel programming library that extends C++ with support for parallelism. stapl provides a collection of distributed data structures (pContainers) and parallel algorithms (pAlgorithms) and a generic methodology for extending them to provide customized functionality. stapl pContainers are thread-safe, concurrent objects, providing appropriate interfaces (e.g., views) that can be used by generic pAlgorithms. The pList provides stl equivalent methods, such as insert, erase, and splice, additional methods such as split, and efficient asynchronous (non-blocking) variants of some methods for improved parallel performance. We evaluate the performance of the stapl pList on an IBM Power 5 cluster and on a CRAY XT4 massively parallel processing system. Although lists are generally not considered good data structures for parallel processing, we show that pList methods and pAlgorithms (p-generate and p-partial-sum) operating on pLists provide good scalability on more than 103 processors and that pList compares favorably with other dynamic data structures such as the pVector. © 2010 Springer-Verlag.

  18. An Observational Study to Evaluate the Usability and Intent to Adopt an Artificial Intelligence-Powered Medication Reconciliation Tool.

    Science.gov (United States)

    Long, Ju; Yuan, Michael Juntao; Poonawala, Robina

    2016-05-16

    Medication reconciliation (the process of creating an accurate list of all medications a patient is taking) is a widely practiced procedure to reduce medication errors. It is mandated by the Joint Commission and reimbursed by Medicare. Yet, in practice, medication reconciliation is often not effective owing to knowledge gaps in the team. A promising approach to improve medication reconciliation is to incorporate artificial intelligence (AI) decision support tools into the process to engage patients and bridge the knowledge gap. The aim of this study was to improve the accuracy and efficiency of medication reconciliation by engaging the patient, the nurse, and the physician as a team via an iPad tool. With assistance from the AI agent, the patient will review his or her own medication list from the electronic medical record (EMR) and annotate changes, before reviewing together with the physician and making decisions on the shared iPad screen. In this study, we developed iPad-based software tools, with AI decision support, to engage patients to "self-service" medication reconciliation and then share the annotated reconciled list with the physician. To evaluate the software tool's user interface and workflow, a small number of patients (10) in a primary care clinic were recruited, and they were observed through the whole process during a pilot study. The patients are surveyed for the tool's usability afterward. All patients were able to complete the medication reconciliation process correctly. Every patient found at least one error or other issues with their EMR medication lists. All of them reported that the tool was easy to use, and 8 of 10 patients reported that they will use the tool in the future. However, few patients interacted with the learning modules in the tool. The physician and nurses reported the tool to be easy-to-use, easy to integrate into existing workflow, and potentially time-saving. We have developed a promising tool for a new approach to

  19. Problem-based learning and radiology

    International Nuclear Information System (INIS)

    Thurley, P.; Dennick, R.

    2008-01-01

    The Royal College of Radiologists recently published documents setting out guidelines to improve the teaching of radiology to medical students. These included recommendations that clinicians who teach radiology should be aware of newer educational techniques, such as problem-based learning, and should be involved in the development of curricula and assessment in medical schools. This review aims to introduce the educational theories behind problem-based learning and describe how a problem-based learning tutorial is run. The relevance of problem-based learning to radiology and the potential advantages and disadvantages are discussed

  20. Perspectives of unemployed workers with mental health problems: barriers to and solutions for return to work

    NARCIS (Netherlands)

    Audhoe, Selwin S.; Nieuwenhuijsen, Karen; Hoving, Jan L.; Sluiter, Judith K.; Frings-Dresen, Monique H. W.

    2018-01-01

    To evaluate the barriers to and solutions for return to work (RTW) from the perspective of unemployed workers who were sick-listed due to mental health problems. We conducted semi-structured interviews with 25 sick-listed unemployed workers with mental health problems. Qualitative data analysis was

  1. Internet-delivered cognitive-behavioural therapy for concerned significant others of people with problem gambling: study protocol for a randomised wait-list controlled trial.

    Science.gov (United States)

    Magnusson, Kristoffer; Nilsson, Anders; Hellner Gumpert, Clara; Andersson, Gerhard; Carlbring, Per

    2015-12-09

    About 2.3% of the adult population in Sweden are considered to suffer from problem gambling, and it is estimated that only 5% of those seek treatment. Problem gambling can have devastating effects on the economy, health and relationship, both for the individual who gambles and their concerned significant other (CSO). No empirically supported treatment exists for the CSOs of people with problem gambling. Consequently, the aim of this study is to develop and evaluate a programme aimed at CSOs of treatment-refusing problem gamblers. The programme will be based on principles from cognitive behavioural therapy (CBT) and motivational interviewing. To benefit as many CSOs as possible, the programme will be delivered via the internet with therapist support via encrypted email and short weekly conversations via telephone. This will be a randomised wait-list controlled internet-delivered treatment trial. A CBT programme for the CSOs of people with problem gambling will be developed and evaluated. The participants will work through nine modules over 10 weeks in a secure online environment, and receive support via secure emails and over the telephone. A total of 150 CSOs over 18 years of age will be included. Measures will be taken at baseline and at 3, 6 and 12 months. Primary outcomes concern gambling-related harm. Secondary outcomes include the treatment entry of the individual who gambles, the CSO's levels of depression, anxiety, as well as relationship satisfaction and quality of life. The protocol has been approved by the regional ethics board of Stockholm, Sweden. This study will add to the body of knowledge on how to protect CSOs from gambling-related harm, and how to motivate treatment-refusing individuals to seek professional help for problem gambling. NCT02250586. 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/

  2. A comparison of course-related stressors in undergraduate problem-based learning (PBL) versus non-PBL medical programmes.

    Science.gov (United States)

    Lewis, Alexander D; Menezes, Darryl A Braganza; McDermott, Helen E; Hibbert, Louise J; Brennan, Sarah-Louise; Ross, Elizabeth E; Jones, Lisa A

    2009-09-13

    Medical students report high levels of stress related to their medical training as well as to other personal and financial factors. The aim of this study is to investigate whether there are differences in course-related stressors reported by medical students on undergraduate problem-based learning (PBL) and non-PBL programmes in the UK. A cross-sectional study of second-year medical students in two UK medical schools (one PBL and one non-PBL programme) was conducted. A 16-question self-report questionnaire, derived from the Perceived Medical Student Stress Scale and the Higher Education Stress Inventory, was used to measure course-related stressors. Following univariate analysis of each stressor between groups, multivariate logistic regression was used to determine which stressors were the best predictors of each course type, while controlling for socio-demographic differences between the groups. A total of 280 students responded. Compared to the non-PBL students (N = 197), the PBL students (N = 83) were significantly more likely to agree that: they did not know what the faculty expected of them (Odds Ratio (OR) = 0.38, p = 0.03); there were too many small group sessions facilitated only by students resulting in an unclear curriculum (OR = 0.04, p academic subjects of interest (OR = 0.40, p = 0.02). They were significantly more likely to disagree that: there was a lack of encouragement from teachers (OR = 3.11, p = 0.02); and that the medical course fostered a sense of anonymity and feelings of isolation amongst students (OR = 3.42, p = 0.008). There are significant differences in the perceived course-related stressors affecting medical students on PBL and non-PBL programmes. Course designers and student support services should therefore tailor their work to minimise, or help students cope with, the specific stressors on each course type to ensure optimum learning and wellbeing among our future doctors.

  3. Light ion linacs for medical applications

    International Nuclear Information System (INIS)

    Bradbury, J.N.; Knapp, E.A.; Nagle, D.E.

    1975-01-01

    Recent advances in linear accelerator technology point to the feasibility of designing and developing practical medical linacs for producing protons, neutrons, or π mesons for the radiation therapy of cancer. Additional uses of such linacs could include radioisotope production and charged particle radiography. For widespread utilization medical linacs must exhibit reasonable cost, compactness, reliability, and simplicity of operation. Possible extensions of current accelerator technology which might provide these characteristics are discussed in connection with linac design, fabrication techniques, materials, power sources, injectors, and particle collection and delivery systems. Parameters for a medical proton linac for producing pions are listed. (U.S.)

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

    Science.gov (United States)

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

    2013-01-01

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

  5. Medical Computational Thinking

    DEFF Research Database (Denmark)

    Musaeus, Peter; Tatar, Deborah Gail; Rosen, Michael A.

    2017-01-01

    Computational thinking (CT) in medicine means deliberating when to pursue computer-mediated solutions to medical problems and evaluating when such solutions are worth pursuing in order to assist in medical decision making. Teaching computational thinking (CT) at medical school should be aligned...

  6. Inflammation Thread Runs across Medical Laboratory Specialities

    Directory of Open Access Journals (Sweden)

    Urs Nydegger

    2016-01-01

    Full Text Available We work on the assumption that four major specialities or sectors of medical laboratory assays, comprising clinical chemistry, haematology, immunology, and microbiology, embraced by genome sequencing techniques, are routinely in use. Medical laboratory markers for inflammation serve as model: they are allotted to most fields of medical lab assays including genomics. Incessant coding of assays aligns each of them in the long lists of big data. As exemplified with the complement gene family, containing C2, C3, C8A, C8B, CFH, CFI, and ITGB2, heritability patterns/risk factors associated with diseases with genetic glitch of complement components are unfolding. The C4 component serum levels depend on sufficient vitamin D whilst low vitamin D is inversely related to IgG1, IgA, and C3 linking vitamin sufficiency to innate immunity. Whole genome sequencing of microbial organisms may distinguish virulent from nonvirulent and antibiotic resistant from nonresistant varieties of the same species and thus can be listed in personal big data banks including microbiological pathology; the big data warehouse continues to grow.

  7. Medical Students' Knowledge about Alcohol and Drug Problems: Results of the Medical Council of Canada Examination

    Science.gov (United States)

    Kahan, Meldon; Midmer, Deana; Wilson, Lynn; Borsoi, Diane

    2006-01-01

    Purpose: To determine knowledge of a national sample of medical students about substance withdrawal, screening and early intervention, medical and psychiatric complications of addiction, and treatment options. Methods: Based on learning objectives developed by medical faculty, twenty-two questions on addictions were included in the 1998 Canadian…

  8. A comparison of course-related stressors in undergraduate problem-based learning (PBL versus non-PBL medical programmes

    Directory of Open Access Journals (Sweden)

    Ross Elizabeth E

    2009-09-01

    Full Text Available Abstract Background Medical students report high levels of stress related to their medical training as well as to other personal and financial factors. The aim of this study is to investigate whether there are differences in course-related stressors reported by medical students on undergraduate problem-based learning (PBL and non-PBL programmes in the UK. Method A cross-sectional study of second-year medical students in two UK medical schools (one PBL and one non-PBL programme was conducted. A 16-question self-report questionnaire, derived from the Perceived Medical Student Stress Scale and the Higher Education Stress Inventory, was used to measure course-related stressors. Following univariate analysis of each stressor between groups, multivariate logistic regression was used to determine which stressors were the best predictors of each course type, while controlling for socio-demographic differences between the groups. Results A total of 280 students responded. Compared to the non-PBL students (N = 197, the PBL students (N = 83 were significantly more likely to agree that: they did not know what the faculty expected of them (Odds Ratio (OR = 0.38, p = 0.03; there were too many small group sessions facilitated only by students resulting in an unclear curriculum (OR = 0.04, p Conclusion There are significant differences in the perceived course-related stressors affecting medical students on PBL and non-PBL programmes. Course designers and student support services should therefore tailor their work to minimise, or help students cope with, the specific stressors on each course type to ensure optimum learning and wellbeing among our future doctors.

  9. List Decoding of Algebraic Codes

    DEFF Research Database (Denmark)

    Nielsen, Johan Sebastian Rosenkilde

    We investigate three paradigms for polynomial-time decoding of Reed–Solomon codes beyond half the minimum distance: the Guruswami–Sudan algorithm, Power decoding and the Wu algorithm. The main results concern shaping the computational core of all three methods to a problem solvable by module...... Hermitian codes using Guruswami–Sudan or Power decoding faster than previously known, and we show how to Wu list decode binary Goppa codes....... to solve such using module minimisation, or using our new Demand–Driven algorithm which is also based on module minimisation. The decoding paradigms are all derived and analysed in a self-contained manner, often in new ways or examined in greater depth than previously. Among a number of new results, we...

  10. Compliance with therapy in patients with chronic hepatitis C: associations with psychiatric symptoms, interpersonal problems, and mode of acquisition.

    Science.gov (United States)

    Kraus, M R; Schäfer, A; Csef, H; Faller, H; Mörk, H; Scheurlen, M

    2001-10-01

    Tolerance of interferon-a therapy for hepatitis C is often poor and medication is expensive. Compliance with diagnostic procedures and, even more important, with medical treatment is obviously critical to minimize the rate of dropouts and to maximize cost efficiency. Moreover, a good concordance with scheduled follow-ups is important for early recognition and treatment of interferon-associated side effects. Therefore, we investigated psychiatric symptoms, interpersonal problems, different modes of acquisition, and sociodemographic factors in HCV-infected patients as possible predictor variables of good versus poor compliance. In a longitudinal study, 74 patients with chronic hepatitis C (CHC) who fulfilled the criteria for treatment with interferon (IFN)-alpha-2b with or without ribavirin were investigated prospectively to identify those at risk for poor compliance during IFN medication. To assess predictive factors, we used both IIP-C (Inventory of Interpersonal Problems) and SCL-90-R (Symptom Check List 90 Items Revised) as psychometric instruments. Sociodemographic and somatic variables as well as compliance during IFN therapy were also evaluated. Poor compliance before or during medication was demonstrated by 23% (N = 17) of HCV patients. Sociodemographic factors and mode of acquisition, particularly former intravenous drug (IVD) abuse were not significantly linked with compliance. Logistic regression analysis demonstrated that the subgroup of patients with compliance problems was best identified by both pretherapeutic psychiatric symptoms and interpersonal problems. Predictive value was best and significant for anger-hostility (P = 0.009), intrusive (P = 0.014), depression (P = 0.015), and phobic anxiety (P = 0.049). Adopting this statistical prediction model, sensitivity was 47.1%, but specificity reached 98.3%. In total, 86.5% of cases were classified correctly. In situations of unclear indication for IFN therapy, psychological variables assessment of before

  11. Medical students' self-efficacy in problem-based learning and its relationship with self-regulated learning.

    Science.gov (United States)

    Demirören, Meral; Turan, Sevgi; Öztuna, Derya

    2016-01-01

    Problem-based learning (PBL) is most commonly used in medical education to enhance self-regulated learning (SRL) skills. Self-efficacy beliefs affect students' motivation through self-regulatory processes. The purpose of this study is to examine the relationship between medical students' self-reported SRL skills and their self-efficacy in PBL. A cross-sectional study was conducted with second (286; 83.1%) and third (275; 80.2%) year students at the Ankara University School of Medicine. The SRL perception (SRLP) scale and self-efficacy for problem-based learning (SPBL) scale were used in the study. The SRLP subscales were positively correlated with the SPBL subscales. There was a weak but meaningful correlation between the subscales of SRLP (with the exception of the lack of self-directedness scale) and the subscales of SPBL and the students' views on benefiting from PBL. The female students' mean score was higher for the 'planning and goal setting' subscale of SRLP (p=0.017), and the second-year students' mean score was higher than that of the third-year students for the 'lack of self-directedness' subscale of SRLP (p=0.001) with small effect sizes (Cohen's d is 0.17 and 0.27). There was no statistically significant difference between the year and subscales of SPBL. With regard to gender, the female students had higher scores than the male students on the 'responsibility' subscale of SPBL (p=0.003; Cohen's d=0.26). The study showed that medical students used SRL skills and believed in their ability to learn effectively in the PBL context and demonstrated the relationship between SRL skills and self-efficacy beliefs. Monitoring students' development in these skills and giving them feedback could be beneficial for the cognitive achievement of students with learning difficulties and insufficient study skills. Further studies need to be undertaken to investigate issues such as the curriculum, learning environment, individual differences, and how these can affect the

  12. Medical students’ self-efficacy in problem-based learning and its relationship with self-regulated learning

    Science.gov (United States)

    Demirören, Meral; Turan, Sevgi; Öztuna, Derya

    2016-01-01

    Background Problem-based learning (PBL) is most commonly used in medical education to enhance self-regulated learning (SRL) skills. Self-efficacy beliefs affect students’ motivation through self-regulatory processes. The purpose of this study is to examine the relationship between medical students’ self-reported SRL skills and their self-efficacy in PBL. Methods A cross-sectional study was conducted with second (286; 83.1%) and third (275; 80.2%) year students at the Ankara University School of Medicine. The SRL perception (SRLP) scale and self-efficacy for problem-based learning (SPBL) scale were used in the study. Results The SRLP subscales were positively correlated with the SPBL subscales. There was a weak but meaningful correlation between the subscales of SRLP (with the exception of the lack of self-directedness scale) and the subscales of SPBL and the students’ views on benefiting from PBL. The female students’ mean score was higher for the ‘planning and goal setting’ subscale of SRLP (p=0.017), and the second-year students’ mean score was higher than that of the third-year students for the ‘lack of self-directedness’ subscale of SRLP (p=0.001) with small effect sizes (Cohen's d is 0.17 and 0.27). There was no statistically significant difference between the year and subscales of SPBL. With regard to gender, the female students had higher scores than the male students on the ‘responsibility’ subscale of SPBL (p=0.003; Cohen's d=0.26). Conclusions The study showed that medical students used SRL skills and believed in their ability to learn effectively in the PBL context and demonstrated the relationship between SRL skills and self-efficacy beliefs. Monitoring students’ development in these skills and giving them feedback could be beneficial for the cognitive achievement of students with learning difficulties and insufficient study skills. Further studies need to be undertaken to investigate issues such as the curriculum, learning

  13. Medical students’ self-efficacy in problem-based learning and its relationship with self-regulated learning

    Directory of Open Access Journals (Sweden)

    Meral Demirören

    2016-03-01

    Full Text Available Background: Problem-based learning (PBL is most commonly used in medical education to enhance self-regulated learning (SRL skills. Self-efficacy beliefs affect students’ motivation through self-regulatory processes. The purpose of this study is to examine the relationship between medical students’ self-reported SRL skills and their self-efficacy in PBL. Methods: A cross-sectional study was conducted with second (286; 83.1% and third (275; 80.2% year students at the Ankara University School of Medicine. The SRL perception (SRLP scale and self-efficacy for problem-based learning (SPBL scale were used in the study. Results: The SRLP subscales were positively correlated with the SPBL subscales. There was a weak but meaningful correlation between the subscales of SRLP (with the exception of the lack of self-directedness scale and the subscales of SPBL and the students’ views on benefiting from PBL. The female students’ mean score was higher for the ‘planning and goal setting’ subscale of SRLP (p=0.017, and the second-year students’ mean score was higher than that of the third-year students for the ‘lack of self-directedness’ subscale of SRLP (p=0.001 with small effect sizes (Cohen's d is 0.17 and 0.27. There was no statistically significant difference between the year and subscales of SPBL. With regard to gender, the female students had higher scores than the male students on the ‘responsibility’ subscale of SPBL (p=0.003; Cohen's d=0.26. Conclusions: The study showed that medical students used SRL skills and believed in their ability to learn effectively in the PBL context and demonstrated the relationship between SRL skills and self-efficacy beliefs. Monitoring students’ development in these skills and giving them feedback could be beneficial for the cognitive achievement of students with learning difficulties and insufficient study skills. Further studies need to be undertaken to investigate issues such as the curriculum

  14. 78 FR 59623 - Emergency Medical Equipment

    Science.gov (United States)

    2013-09-27

    ... accordance with the FAA master minimum equipment list does not adversely affect aviation safety. This action... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Parts 121 and 135 [Docket No... inoperative Emergency Medical Kit (EMK) or automated external defibrillator (AED). A copy of Master Minimum...

  15. Academic satisfaction among traditional and problem based learning medical students. A comparative study.

    Science.gov (United States)

    Albarrak, Ahmed I; Mohammed, Rafiuddin; Abalhassan, Mohammed F; Almutairi, Nasser K

    2013-11-01

    To evaluate the academic satisfaction and importance among traditional learning (TL) and problem based learning (PBL) medical students, and to further evaluate the areas of concern in the academic education from the student's point of view. A cross sectional study was conducted at the College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia from May to June 2012. The survey questionnaires were self-administered and consisted of mainly 6 sections: teaching, learning, supervision, course organization, information technology (IT) facilities, and development of skills. A total of 92 TL (males: 66 [71.7%]; females: 26 [28.3%]), and 108 PBL (males: 84 [77.8%]; females: 24 [22.1%]), with a mean age of 21.3 +/- 1.3 (TL), and 20.7 +/- 1.0 (PBL) were included in the study. The overall satisfaction rate was higher in the PBL students when compared with TL students in: teaching (84.7%/60.3%); learning (81.4%/64.5%); supervision (80%/51.5%); course organization (69.3%/46.9%); IT facilities (74.0%/58.9%); and development of skills (79.1%/53.9%). There was statistical significance difference in academic satisfaction comparing both groups of students (pdisadvantages of the traditional system. The PBL was potentially considered a successful method in enhancing medical education.

  16. CRNL library serials list

    International Nuclear Information System (INIS)

    Alburger, T.P.

    1982-04-01

    A list of 1900 serial publications (periodicals, society transactions and proceedings, annuals and directories, indexes, newspapers, etc.) is presented with volumes and years held by the Main Library. This library is the largest in AECL as well as one of the largest scientific and technical libraries in North America, and functions as a Canadian resource for nuclear information. A main alphabetical list is followed by broad subject field lists representing research interests, and lists of abstract and index serials, general bibliographic serials, conference indexes, press releases, English translations, and original language journals

  17. Protecting the health of medical students on international electives in low-resource settings.

    Science.gov (United States)

    Johnston, Niall; Sandys, Nichola; Geoghegan, Rosemary; O'Donovan, Diarmuid; Flaherty, Gerard

    2018-01-01

    Increasingly, medical students from developed countries are undertaking international medical electives in developing countries. Medical students understand the many benefits of these electives, such as the opportunity to develop clinical skills, to gain insight into global health issues and to travel to interesting regions of the world. However, they may be much less aware of the risk to their health and wellbeing while abroad. Compounding this problem, medical students may not seek advice from travel medicine practitioners and often receive inadequate or no information from their medical school prior to departure. The PubMed database was searched for relevant literature relating to the health of medical elective students. Combinations of the following key words were used as search terms: 'international health elective', 'medical student' and 'health risks'. Articles were restricted to those published in English from 1997 through June 2017. A secondary review of the reference lists of these articles was performed. The grey literature was also searched for relevant material. This narrative literature review outlines the risks of clinical electives in resource-poor settings which include exposure to infectious illness, trauma, sexual health problems, excessive sun exposure, mental health issues and crime. Medical students may mitigate these health risks by being informed and well prepared for high-risk situations. The authors provide evidence-based travel advice which aims to improve pre-travel preparation and maximize student traveller safety. A safer and more enjoyable elective may be achieved if students follow road safety advice, take personal safety measures, demonstrate cultural awareness, attend to their psychological wellbeing and avoid risk-taking behaviours. This article may benefit global health educators, international elective coordinators and travel medicine practitioners. For students, a comprehensive elective checklist, an inventory of health kit

  18. Flexible but boring: medical students' perceptions of a career in general practice.

    Science.gov (United States)

    Koehler, Nicole; McMenamin, Christine

    2016-07-01

    Australia will continue to face a general practitioner (GP) shortage unless a significant number of medical students make general practice their chosen career. Perceptions regarding general practice may influence career choices. Thus this study investigated what Australian medical students perceived to be the advantages and disadvantages of pursuing a career in general practice via an anonymous online survey. Fifty-one students indicated general practice to be their first ranked career preference, 200 indicated a career other than general practice, and 106 were undecided. Two-hundred and two students reported having been on a GP placement, whereas 88 students had not. Flexibility, continuity of patient care and work-life balance were the three most common stated advantages to pursuing a career in general practice whereas general practice being boring, poorly paid, and of low prestige were the three most common disadvantages stated. Some disadvantages stated by those with a non-GP preference were not stated by those with a GP preference (e.g. lack of procedural skills, lack of career advancement opportunities). Students with more than 80 h of GP placement experience were more likely to list the advantages of work-life balance and a diversity of problems/illnesses/patients than those with no placement experience but were also more likely to list the disadvantage of low prestige. Negative stereotypes regarding general practice continue to exist which may influence students' career choices.

  19. Medical Student Attitudes about Mental Illness: Does Medical-School Education Reduce Stigma?

    Science.gov (United States)

    Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep

    2012-01-01

    Background: Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mental illness, as compared with…

  20. Charting the landscape of priority problems in psychiatry, part 1: classification and diagnosis.

    Science.gov (United States)

    Stephan, Klaas E; Bach, Dominik R; Fletcher, Paul C; Flint, Jonathan; Frank, Michael J; Friston, Karl J; Heinz, Andreas; Huys, Quentin J M; Owen, Michael J; Binder, Elisabeth B; Dayan, Peter; Johnstone, Eve C; Meyer-Lindenberg, Andreas; Montague, P Read; Schnyder, Ulrich; Wang, Xiao-Jing; Breakspear, Michael

    2016-01-01

    Contemporary psychiatry faces major challenges. Its syndrome-based disease classification is not based on mechanisms and does not guide treatment, which largely depends on trial and error. The development of therapies is hindered by ignorance of potential beneficiary patient subgroups. Neuroscientific and genetics research have yet to affect disease definitions or contribute to clinical decision making. In this challenging setting, what should psychiatric research focus on? In two companion papers, we present a list of problems nominated by clinicians and researchers from different disciplines as candidates for future scientific investigation of mental disorders. These problems are loosely grouped into challenges concerning nosology and diagnosis (this Personal View) and problems related to pathogenesis and aetiology (in the companion Personal View). Motivated by successful examples in other disciplines, particularly the list of Hilbert's problems in mathematics, this subjective and eclectic list of priority problems is intended for psychiatric researchers, helping to re-focus existing research and providing perspectives for future psychiatric science. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Acronym master list

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

    This document is a master list of acronyms and other abbreviations that are used by or could be useful to, the personnel at Los Alamos National Laboratory. Many specialized and well-known abbreviations are not included in this list.

  2. Bioethics and transnational medical travel: India,"medical tourism," and the globalisation of healthcare.

    Science.gov (United States)

    Runnels, Vivien; Turner, Leigh

    2011-01-01

    Health-related travel, also referred to as "medical tourism" is historically well-known. Its emerging contemporary form suggests the development of a form of globalised for-profit healthcare. Medical tourism to India, the focus of a recent conference in Canada, provides an example of the globalisation of healthcare. By positioning itself as a low-cost, high-tech, fast-access and high-quality healthcare destination country, India offers healthcare to medical travellers who are frustrated with waiting lists and the limited availability of some procedures in Canada. Although patients have the right to travel and seek care at international medical facilities, there are a number of dimensions of medical tourism that are disturbing. The diversion of public investments in healthcare to the private sector, in order to serve medical travellers, perversely transfers public resources to international patients at a time when the Indian public healthcare system fails to provide primary healthcare to its own citizens. Further, little is known about patient safety and quality care in transnational medical travel. Countries that are departure points as well as destination countries need to carefully explore the ethical, social, cultural, and economic consequences of the growing phenomenon of for-profit international medical travel.

  3. Discipline--Still Number One on the Administrator's List of Problems.

    Science.gov (United States)

    Bartosh, Fred, Jr.; Barilla, John

    1985-01-01

    Describes the components of a discipline record system that can improve understanding of where, when, and why problems occur and what methods prove successful for handling them. Also identifies a number of factors that affect the success of discipline conferences between administrators and the parents of misbehaving students. (PGD)

  4. Appreciation of learning environment and development of higher-order learning skills in a problem-based learning medical curriculum.

    Science.gov (United States)

    Mala-Maung; Abdullah, Azman; Abas, Zoraini W

    2011-12-01

    This cross-sectional study determined the appreciation of the learning environment and development of higher-order learning skills among students attending the Medical Curriculum at the International Medical University, Malaysia which provides traditional and e-learning resources with an emphasis on problem based learning (PBL) and self-directed learning. Of the 708 participants, the majority preferred traditional to e-resources. Students who highly appreciated PBL demonstrated a higher appreciation of e-resources. Appreciation of PBL is positively and significantly correlated with higher-order learning skills, reflecting the inculcation of self-directed learning traits. Implementers must be sensitive to the progress of learners adapting to the higher education environment and innovations, and to address limitations as relevant.

  5. Top-Cited Articles in Problem-Based Learning: A Bibliometric Analysis and Quality of Evidence Assessment.

    Science.gov (United States)

    Azer, Samy A

    2017-04-01

    The aims of this study were to identify characteristics of the top-cited articles in problem-based learning (PBL) and assess the quality of evidence provided by these articles. The most frequently cited articles on PBL were searched in April 2015 in the Science Citation Index Expanded database (List A) and Google Scholar database (List B). Eligible articles identified were reviewed for key characteristics. The Oxford Centre for Evidence-Based Medicine guidelines were used in assessing the level of evidence. The number of citations varied (62 to 923 on List A and 218 to 2,859 on List B). Countries that contributed the majority of articles in both lists were the United States, Netherlands, United Kingdom, and Canada. No significant correlations were found between number of citations and number of years since published (p=0.451), number of authors (p=0.144), females in authorship (p=0.189), non-medical authors (p=0.869), number of institutions (p=0.452), and number of grants (p=0.143), but a strong correlation was found with number of countries involved (p=0.007). Application of the Oxford hierarchy of evidence showed that 36 articles were at levels 4 and 5 of evidence. This study found that research articles represented approximately one-third of PBL articles assessed and reported mainly on questionnaire-based studies. The most highly cited articles occupied top-ranking positions in the journals in which they were published. The lower level of evidence observed in most top-cited articles may reflect the significance of innovative ideas or content of these articles. These findings have implications for dental educators and dental researchers.

  6. Analysis of current situation of information disclosure of listed companies on GEM

    Directory of Open Access Journals (Sweden)

    Zhirong Shen

    2017-03-01

    Full Text Available In the afternoon on October 23th, 2009, GEM was officially launched in our country. Due to the lack of experience in the market supervision, information disclosure violations frequently occurred. In April 2015, Shenzhen Stock Exchange puts forward morning information disclosure system to strengthen the reform of information disclosure system. Therefore, this paper deeply focuses on the current situation of information disclosure violations on GEM for the purpose of attracting more attention to the problems. Through studying the information disclosure violations of the listed companies on GEM from 2011 to September 30th, 2015, this paper divides the violations into the following four types: false record, misleading statement, material misstatement and delayed disclosure. On the other hand, we find that these types of violations are concurrent. From this discussion, we may safely draw the conclusion that the information disclosure of listed companies on GEM has the problem of untruthfulness, incorrectness, incompleteness and delay.

  7. An experimental comparison of some heuristics for cardinality constrained bin packing problem

    Directory of Open Access Journals (Sweden)

    Maja Remic

    2012-01-01

    Full Text Available Background: Bin packing is an NPhard optimization problem of packing items of given sizes into minimum number of capacitylimited bins. Besides the basic problem, numerous other variants of bin packing exist. The cardinality constrained bin packing adds an additional constraint that the number of items in a bin must not exceed a given limit Nmax. Objectives: Goal of the paper is to present a preliminary experimental study which demostrates adaptations of the new algorithms to the general cardinality constrained bin packing problem. Methods/Approach: Straightforward modifications of First Fit Decreasing (FFD, Refined First Fit (RFF and the algorithm by Zhang et al. for the bin packing problem are compared to four cardinality constrained bin packing problem specific algorithms on random lists of items with 0%, 10%, 30% and 50% of large items. The behaviour of all algorithms when cardinality constraint Nmax increases is also studied. Results: Results show that all specific algorithms outperform the general algorithms on lists with low percentage of big items. Conclusions: One of the specific algorithms performs better or equally well even on lists with high percentage of big items and is therefore of significant interest. The behaviour when Nmax increases shows that specific algorithms can be used for solving the general bin packing problem as well.

  8. The Association Between the STOPP/START Criteria and Gastro-Intestinal Track Bleedings in Elderly Patients

    NARCIS (Netherlands)

    Veldhuis, Anouk; Sent, Danielle; Bruin-Huisman, Linette; Beers, Erna; Abu-Hanna, Ameen

    2017-01-01

    Potentially inappropriate prescribing is a common problem, especially in elderly care. To tackle this problem, Irish medical experts have developed a list of criteria when medication should be added or omitted based upon the patient's physical condition and medication use, known as the STOPP and

  9. PROBLEMS OF GENERAL PRACTICE IN RURAL CALIFORNIA

    Science.gov (United States)

    Carey, Hollis L.; Andrews, Carroll B.

    1949-01-01

    Medical care for rural populations is an important problem facing the medical profession nationally and locally. The mechanism for solution lies in the existing American Medical Association and California Medical Association committees on rural medical service and further development of “local health councils.” Additional emphasis on training of physicians for general practice is essential through medical school graduate and postgraduate periods. The problem of providing additional adequately equipped and staffed hospitals must receive much consideration. Recognizing that passiveness invites aggressive non-medical agencies to foster bureaucratic dictation inimical to the practice of medicine, the rural physician must act through medical and community organizations to correct weaknesses in the structure of medical practice. PMID:18116230

  10. Towards a Uniform European Education for Medical Physicists

    International Nuclear Information System (INIS)

    Christofides, S.

    2008-01-01

    The European Federation of Organisations in Medical Physics (EFOMP) mission and objectives are briefly presented. The most attention is given to the education and training activities of the EFOMP. Revised EFOMP recommendations on Education, Training and CPD of Medical Physicists and Policy Statements are listed. In order for Medical Physics to be recognised by the European Union as a profession some future activities like Bologna Declaration process, continuous professional development, European Network for Medical Physics training Schools, actions for the harmonisation of the Education and Training of the Medical Physicist in Europe in accordance with EU Directive 2005/36/EC and EU Recommendation 2008/C 111/01 are also discussed

  11. Ownership patterns and control of top 100 Malaysian listed companies

    Directory of Open Access Journals (Sweden)

    Che-Ahmad Ayoib B

    2017-01-01

    Full Text Available The incentive of this study stems from the significance of protecting minority shareholders’ rights. It analyses the most dominant ownership structure practices within listed firms in Bursa Malaysia (BM, in which controlling shareholders (CSs hold control on many firms despite relatively small portion of investment. Malaysian firms are characterised by high levels of concentrated ownership with families owning more than 70% of the listed firms in BM [9]. This study finds that the separation between cash flow rights (real investment and control rights (voting rights for Top 100 Malaysian listed firms is accomplished through pyramidal ownership and golden share arrangements. Hence, the divergence between cash flow rights (CFRs and voting rights (VRs exacerbates Type II Agency problem. This study calls for future studies in the area of accounting and finance to introduce and operationalise new measurement of Type II Agency Cost in order to better understand the agency conflicts within this unique market. It also better explains the state of the minority shareholders in the BM.

  12. Resolving embarrassing medical conditions with online health information.

    Science.gov (United States)

    Redston, Sarah; de Botte, Sharon; Smith, Carl

    2018-06-01

    Reliance on online health information is proliferating and the Internet has the potential to revolutionize the provision of public health information. The anonymity of online health information may be particularly appealing to people seeking advice on 'embarrassing' health problems. The purpose of this study was to investigate (1) whether data generated by the embarrassingproblems.com health information site showed any temporal patterns in problem resolution, and (2) whether successful resolution of a medical problem using online information varied with the type of medical problem. We analyzed the responses of visitors to the embarrassingproblems.com website on the resolution of their problems. The dataset comprised 100,561 responses to information provided on 77 different embarrassing problems grouped into 9 classes of medical problem over an 82-month period. Data were analyzed with a Bernoulli Generalized Linear Model using Bayesian inference. We detected a statistically important interaction between embarrassing problem type and the time period in which data were collected, with an improvement in problem resolution over time for all of the classes of medical problem on the website but with a lower rate of increase in resolution for urinary health problems and medical problems associated with the mouth and face. As far as we are aware, this is the first analysis of data of this nature. Findings support the growing recognition that online health information can contribute to the resolution of embarrassing medical problems, but demonstrate that outcomes may vary with medical problem type. The results indicate that building data collection into online information provision can help to refine and focus health information for online users. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. [Development of medical tourism in Georgia. Problems and prospectiv (review)].

    Science.gov (United States)

    Gerzmava, O; Lomtadze, L; Kitovani, D; Kadjrishvili, M

    2011-10-01

    Medical tourism is the movement of patients through a global network of health services. Medical tourists seek affordable healthcare on a timely basis in a variety of destination nations. The expansion of global medical services has sparked immense economic growth in developing nations and has created a new market for advertising access to care. Beyond offering a unique untapped market of services, medical tourism has invited a host of liability, malpractice and ethical concerns. The explosion of off-shore "mini-surgical" vacations will surely incite global unification and increased access, quality and affordability of care. Medical tourism is a dynamic subset of global health care that incorporates a variety of services, procedures and venues of care. Health insurance coverage, the impact on domestic and global markets, and the use of international standards of care will be examined in combination with quality, access and cost parameters. The global nature of medical tourism invites a variety of legal and ethical issues and calls for an organizational body to monitor this new phenomenon. Finally, the future implications of the globalization of health services and systems will be discussed.

  14. Depression, financial problems and other reasons for suspending medical studies, and requested support services: findings from a qualitative study.

    Science.gov (United States)

    Soh, Nerissa; Ma, Colleen; Lampe, Lisa; Hunt, Glenn; Malhi, Gin; Walter, Garry

    2012-12-01

    This study aimed to qualitatively explore medical students' reasons for suspending, or thinking of suspending, their studies and the types of support services they request. Data were collected through an anonymous online survey. Medical students' responses to open-ended questions were analyzed thematically. Responses were received from 475 students. Financial problems, doubts as to whether medicine was the right vocation, and depression were the most commonly reported themes. Students endorsed a wide range of other pressures and concerns, barriers to obtaining assistance, and also suggested solutions and services to address their concerns. Medical students' financial concerns and potential depressive symptoms should be addressed by university and faculty support services. Government financial support mechanisms for students should also be reviewed. Students' suggestions of the types of services and their location must be borne in mind when allocating resources.

  15. Developing an integrated framework of problem-based learning and coaching psychology for medical education: a participatory research.

    Science.gov (United States)

    Wang, Qing; Li, Huiping; Pang, Weiguo; Liang, Shuo; Su, Yiliang

    2016-01-05

    Medical schools have been making efforts to develop their own problem-based learning (PBL) approaches based on their educational conditions, human resources and existing curriculum structures. This study aimed to explore a new framework by integrating the essential features of PBL and coaching psychology applicable to the undergraduate medical education context. A participatory research design was employed. Four educational psychology researchers, eight undergraduate medical school students and two accredited PBL tutors participated in a four-month research programme. Data were collected through participatory observation, focus groups, semi-structured interviews, workshop documents and feedback surveys and then subjected to thematic content analysis. The triangulation of sources and member checking were used to ensure the credibility and trustworthiness of the research process. Five themes emerged from the analysis: current experience of PBL curriculum; the roles of and relationships between tutors and students; student group dynamics; development of self-directed learning; and coaching in PBL facilitation. On the basis of this empirical data, a systematic model of PBL and coaching psychology was developed. The findings highlighted that coaching psychology could be incorporated into the facilitation system in PBL. The integrated framework of PBL and coaching psychology in undergraduate medical education has the potential to promote the development of the learning goals of cultivating clinical reasoning ability, lifelong learning capacities and medical humanity. Challenges, benefits and future directions for implementing the framework are discussed in this paper.

  16. Can Hybrid Educational Activities of Team and Problem Based Learning Program be Effective for Japanese Medical Students?

    Science.gov (United States)

    Iwata, Kentaro; Doi, Asako

    2017-11-10

    The purpose of this study is to investigate the medical students'perceptions of the Hybrid Educational Activities between team based learning (TBL) and problem based learning (PBL) Program (HEATAPP), a novel educational program that combines characteristics of PBL and TBL. A five-day HEATAPP on infectious diseases was provided to 4th year medical students at Kobe University School of Medicine, Kobe, Japan. After the program, a focus group discussion was held among 6 medical students who participated in HEATAPP. We qualitatively analyzed the recorded data to delineate the effectiveness of, and the perceptions on, HEATAPP. Some students considered HEATAPP being effective as an active learning, and in developing questions. However, some students found active learning difficult to execute, since they were so familiar with passive learning such as lectures and examinations. They also found it difficult to identify important points by reading authentic textbooks on given issues, particularly English textbooks. Even though active learning and group discussion are underscored as important in medicine, some Japanese medical students may be reluctant to shift towards these since they are so used to passive learning since childhood. English language is another barrier to active learning. The introduction of active learning in the earlier stages of education might be an effective solution. Teachers at medical schools in Japan should be mindful of the students'potentially negative attitudes towards active learning, which is claimed to be successful in western countries.

  17. Cognitive Medical Multiagent Systems

    OpenAIRE

    Barna Iantovics

    2010-01-01

    The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System) was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems...

  18. [The early medical textbooks in Korea: medical textbooks published at Je Joong Won-Severance Hospital Medical School].

    Science.gov (United States)

    Park, H W

    1998-01-01

    Kwang Hye Won(Je Joong Won), the first western hospital in Korea, was founded in 1885. The first western Medical School in Korea was open in 1886 under the hospital management. Dr. O. R. Avison, who came to Korea in 1893, resumed the medical education there, which was interrupted for some time before his arrival in Korea. He inaugurated translating and publishing medical textbooks with the help of Kim Pil Soon who later became one of the first seven graduates in Severance Hospital Medical School. The first western medical textbook translated into Korean was Henry Gray's Anatomy. However, these twice-translated manuscripts were never to be published on account of being lost and burnt down. The existing early anatomy textbooks, the editions of 1906 and 1909, are not the translation of Gray's Anatomy, but that of Japanese anatomy textbook of Gonda. The remaining oldest medical textbook in Korean is Inorganic Materia Medica published in 1905. This book is unique among its kind that O. R. Avison is the only translator of the book and it contains the prefaces of O. R. Avison and Kim Pil Soon. The publication of medical textbook was animated by the participation of other medical students, such as Hong Suk Hoo and Hong Jong Eun. The list of medical textbooks published includes almost all the field of medicine. The medical textbooks in actual existence are as follows: Inorganic Materia Medica (1905), Inorganic Chemistry (1906), Anatomy I (1906), Physiology (1906), Diagnostics I (1906), Diagnostics II (1907), Obstetrics (1908), Organic Chemistry (1909), Anatomy (1909), and Surgery (1910).

  19. MEDICAL DIAGNOSTICS BY MICROSTRUCTURAL ANALYSIS OF BIOLOGICAL LIQUID DRIED PATTERNS AS A PROBLEM OF BIOINFORMATICS

    Directory of Open Access Journals (Sweden)

    Petr Vladimirovich Lebedev-Stepanov, Dr.

    2018-02-01

    Full Text Available Motivation: It is important to develop the high-precision computerized methods for medical rapid diagnostic which is generalizing the unique clinical experience obtained in the past decade as specialized solutions for diagnostic problems of control of specific diseases and, potentially, for a wide health monitoring of virtually healthy population, identify the reserves of human health and take the actions to prevent of these reserves depletion. In this work we present one of the new directions in bioinformatics, i.e. medical diagnostics by automated expert system on basis of morphology analysis of digital image of biological liquid dried pattern. Results: Proposed method is combination of bioinformatics and biochemistry approaches for obtaining diagnostic information from a morphological analysis of standardized dried patterns of biological liquid sessile drop. We have carried out own research in collaboration with medical diagnostic centers and formed the electronic database for recognition the following types of diseases: candidiasis; neoplasms; diabetes mellitus; diseases of the circulatory system; cerebrovascular disease; diseases of the digestive system; diseases of the genitourinary system; infectious diseases; factors relevant to the work; factors associated with environmental pollution; factors related to lifestyle. The laboratory setup for diagnostics of the human body in pathology states is developed. The diagnostic results are considered. Availability: Access to testing the software can be obtained on request to the contact email below.

  20. Parental Financial Support and the Financial and Family Problems of College Freshmen

    Science.gov (United States)

    Bunnett, Nancy Hubbell

    1975-01-01

    Freshmen completed the Mooney Problem Check List and reported how much financial support their parents provided. The relationship between parents' support and finances, living conditions, and employment problems was highly significant, with women reporting more financial problems than men. (Author)

  1. The Christmas list

    CERN Multimedia

    James Gillies

    2010-01-01

    List making seems to be among mankind’s favourite activities, particularly as the old year draws to a close and the new one begins. It seems that we all want to know what the top 100 annoying pop songs are, who are the world’s most embarrassing people and what everyone’s been watching on TV. The transition from 2009 to 2010 was no different, but some of the latest batch of lists have a few surprising entries. According to the Global Language Monitor, ‘twitter’ was the top word of 2009. No surprises there, but ‘hadron’ came in at number 8 on the list. ‘King of pop’ was top phrase, according to the same source, but ‘god particle’ came in at number 10. And while ‘Barack Obama’ was the name of the year, ‘Large Hadron Collider’ came in at number four. The Global Language Monitor was not the only organization whose lists included particle physics references. &ls...

  2. Comparing the Long-Term Retention of a Physiology Course for Medical Students with the Traditional and Problem-Based Learning

    Science.gov (United States)

    Pourshanazari, A. A.; Roohbakhsh, A.; Khazaei, M.; Tajadini, H.

    2013-01-01

    The rapid improvements in medical sciences and the ever-increasing related data, however, require novel methods of instruction. One such method, which has been given less than due attention in Iran, is problem-based learning (PBL). In this study, we aimed to evaluate the impact of study skills and the PBL methods on short and long-term retention…

  3. Problem-solving intervention for caregivers of children with mental health problems.

    Science.gov (United States)

    Gerkensmeyer, Janis E; Johnson, Cynthia S; Scott, Eric L; Oruche, Ukamaka M; Lindsey, Laura M; Austin, Joan K; Perkins, Susan M

    2013-06-01

    Building Our Solutions and Connections (BOSC) focused on enhancing problem-solving skills (PSS) of primary caregivers of children with mental health problems. Aims were determining feasibility, acceptability, and effect size (ES) estimates for depression, burden, personal control, and PSS. Caregivers were randomized to BOSC (n=30) or wait-list control (WLC) groups (n=31). Data were collected at baseline, post-intervention, and 3 and 6 months post-intervention. Three-months post-intervention, ES for burden and personal control were .07 and .08, respectively. ES for depressed caregivers for burden and personal control were 0.14 and 0.19, respectively. Evidence indicates that the intervention had desired effects. Published by Elsevier Inc.

  4. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ... (HPSAs) as of April 1, 2012, available on the Health Resources and Services Administration (HRSA) Web... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Lists of... Resources and Services Administration, Department of Health and Human Services. ACTION: Notice. SUMMARY...

  5. Medical service plans in academic medical centers.

    Science.gov (United States)

    Siegel, B

    1978-10-01

    Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.

  6. Prescribing of pain medication in palliative care. A survey in general practice

    NARCIS (Netherlands)

    Borgsteede, Sander D.; Deliens, Luc; Zuurmond, Wouter W. A.; Schellevis, François G.; Willems, Dick L.; van der Wal, Gerrit; van Eijk, Jacques Th M.

    2009-01-01

    Purpose To examine what pain and adjuvant medication is prescribed in palliative care patients at home in The Netherlands. Methods In a nationwide, representative, prospective study in general practice in The Netherlands, prescribed medication was registered in 95 general practices with a listed

  7. Prescribing of pain medication in palliative care: a survey in general practice.

    NARCIS (Netherlands)

    Borgsteede, S.D.; Deliens, L.; Zuurmond, W.W.A.; Schellevis, F.; Willems, D.L.; Wal, G. van der; Eijk, J.T.M. van

    2009-01-01

    PURPOSE: To examine what pain and adjuvant medication is prescribed in palliative care patients at home in The Netherlands. METHODS: In a nationwide, representative, prospective study in general practice in The Netherlands, prescribed medication was registered in 95 general practices with a listed

  8. Naval Medical Research and Development Strategic Plan

    Science.gov (United States)

    2008-03-01

    the strategic planning program for action. The pros and cons of the current NMR&D organization structure, management support funding, and officer...Distribution List D-4 Naval Medical Research and Development Strategic Plan March 2008 SWE Naval Surface Warfare Enterprise SWOT Strengths

  9. Teaching pharmacology to medical students in an integrated problem-based learning curriculum:an Australian perspective

    Institute of Scientific and Technical Information of China (English)

    Owen L WOODMAN; Agnes E DODDS; Albert G FRAUMAN; Mosepele MOSEPELE

    2004-01-01

    The world-wide move away from the didactic teaching of single disciples to integrated Problem-based Learning (PBL) curricula in medical education has posed challenges for the basic sciences. In this paper we identify two major challenges. The first challenge is the need to describe a core disciplinary curriculum that can be articulated and mapped onto the new structure. We illustrate how the British Pharmacological Society (BPS) Guidelines are used to evaluate the curriculum coverage in the medical course at The University of Melbourne. The second challenge is to ensure that foundational concepts are given adequate emphasis within the new structure, and in particular, that students have the opportunity to pursue these concepts in their self-directed learning. We illustrate one approach to teaching important pharmacological concepts in an integrated curriculum with a case study from the first year curriculum at The University of Melbourne. Finally, we propose the features of an integrated curriculum that facilitates the learning of basic pharmacology in a situation where PBL and integration sets the curriculum framework.

  10. A smart medication recommendation model for the electronic prescription.

    Science.gov (United States)

    Syed-Abdul, Shabbir; Nguyen, Alex; Huang, Frank; Jian, Wen-Shan; Iqbal, Usman; Yang, Vivian; Hsu, Min-Huei; Li, Yu-Chuan

    2014-11-01

    The report from the Institute of Medicine, To Err Is Human: Building a Safer Health System in 1999 drew a special attention towards preventable medical errors and patient safety. The American Reinvestment and Recovery Act of 2009 and federal criteria of 'Meaningful use' stage 1 mandated e-prescribing to be used by eligible providers in order to access Medicaid and Medicare incentive payments. Inappropriate prescribing has been identified as a preventable cause of at least 20% of drug-related adverse events. A few studies reported system-related errors and have offered targeted recommendations on improving and enhancing e-prescribing system. This study aims to enhance efficiency of the e-prescribing system by shortening the medication list, reducing the risk of inappropriate selection of medication, as well as in reducing the prescribing time of physicians. 103.48 million prescriptions from Taiwan's national health insurance claim data were used to compute Diagnosis-Medication association. Furthermore, 100,000 prescriptions were randomly selected to develop a smart medication recommendation model by using association rules of data mining. The important contribution of this model is to introduce a new concept called Mean Prescription Rank (MPR) of prescriptions and Coverage Rate (CR) of prescriptions. A proactive medication list (PML) was computed using MPR and CR. With this model the medication drop-down menu is significantly shortened, thereby reducing medication selection errors and prescription times. The physicians will still select relevant medications even in the case of inappropriate (unintentional) selection. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. 77 FR 60704 - Medical Devices; Availability of Safety and Effectiveness Summaries for Premarket Approval...

    Science.gov (United States)

    2012-10-04

    ... regulations provide that FDA publish a quarterly list of available safety and effectiveness summaries of PMA...-0638] Medical Devices; Availability of Safety and Effectiveness Summaries for Premarket Approval... Administration (FDA) is publishing a list of premarket approval applications (PMAs) that have been approved. This...

  12. Assessment of the use of xerogenic medications for chronic medical and dental conditions among adult day health participants.

    Science.gov (United States)

    Lam, Annie; Kiyak, Asuman; Gossett, Allison M; McCormick, Lawrence

    2009-10-01

    To describe the health conditions, dental problems, and use of xerogenic medications among dental patients in adult day health (ADH) centers. Cross-sectional descriptive study. ADH centers in King County, Washington. ADH clients who were patients of a mobile dental service. Pharmacist-conducted chart reviews and in-person medication reviews with patients. Demographic description, mean numbers of medical and dental problems, medications, xerogenic medications used per subject, and identification of xerogenic medications by therapeutic class. At five sites, 97 patients were interviewed (average age 73.8 +/- 11.8 years, 61% female); ethnicities included: Asian-American (37.1%), Caucasian (30.9%), Russian (29%), and African-American (3%). Mean numbers of chronic health problems, medications, and xerogenic medications per patient were 5.2 +/- 2.7, 10.9 +/- 4.4, and 3.3 +/- 1.8, respectively. Antidepressants were the most commonly used xerogenic medication, followed by antipsychotics, antiemetics, analgesics, and antihistamines. Among 74 patients who received dental treatment, 33 (44.6%) wore dentures. Among 58 patients with teeth, a mean number of 2.8 dental problems per patient was identified. Dental caries (51.7%) was the most prevalent problem, followed by periodontitis (29.3%), soft tissue lesions (10.3%), gingivitis (5.2%), and candidiasis (3.4%). Multiple systemic diseases, use of multiple xerogenic medications, and poor oral health were prevalent among the ADH clients in this study. However, self-reports of dry mouth were unrelated to number of xerogenic medications or oral conditions. Further research is needed to determine the association between self-reported dry mouth, chronic health conditions, use of xerogenic medications, tooth loss, and/or denture use.

  13. Medical Issues: Breathing

    Science.gov (United States)

    ... Information Packets Equipment Pool Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily Life At ... curesma.org > support & care > living with sma > medical issues > breathing Breathing Breathing problems are the most common ...

  14. What can we learn from problem-based learning tutors at a graduate entry medical school? A mixed method approach.

    Science.gov (United States)

    O Doherty, Diane; Mc Keague, Helena; Harney, Sarah; Browne, Gerard; McGrath, Deirdre

    2018-05-04

    Problem-based learning (PBL) has been adopted by many medical schools as an innovative method to deliver an integrated medical curriculum since its inception at McMaster University (Dornan et al., Med Educ 39(2):163-170, 2005; Finucane et al., Med Educ 35(1):56-61, 2001; Barrows, Tutorials in problem-based learning: A new direction in teaching the health professions, 1984). The student experience in PBL has been explored in detail (Merriam, New Directions for Adult and Continuing Education 89: 3-13, 2001; Azer, Kaohsiung J Med Sci 25(5): 240-249, 2009; Boelens et al., BMC Med Ed 15(1): 84, 2015; Dolmans et al., Med Teach 24(2):173-180, 2002; Lee et al., Med Teach 35(2): e935-e942, 2013) but the tutors who facilitate PBL have valuable insight into how PBL functions and this aspect has not been extensively researched. The integrated curriculum for years 1 and 2 at the Graduate Entry Medical School at the University of Limerick is delivered though problem-based learning (PBL). This programme requires collaborative teamwork between students and the tutors who facilitate small-group tutorial sessions. All PBL tutors at GEMS are medically qualified, with the majority (68%) currently working in clinical practice. A mixed-methods approach was adopted, utilising two surveys and follow-up focus groups to fully understand the tutor experience. Thirty-three tutors took part in two online surveys with a response rate of 89%. Thirteen tutors participated in two focus groups. Descriptive analysis was completed on survey data and thematic analysis on focus group discussions which highlighted five main themes. Tutors reported challenges with managing group dynamics, development of confidence in tutoring with experience and a willingness to learn from peers to improve practice. Findings are in keeping with previously published work. Results also identified several less commonly discussed issues impacting student engagement in PBL including the use of mobile device technology

  15. Course Resource Lists.

    Science.gov (United States)

    England, Robert G.

    The Mountain-Plains Course Resource List is presented by job title for 26 curriculum areas. For each area the printed materials, audiovisual aids, and equipment needed for the course are listed. The 26 curriculum areas are: mathematics skills, communication skills, office education, lodging services, food services, marketing and distribution,…

  16. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ..., available on the Health Resources and Services Administration (HRSA) Web site at http://bhpr.hrsa.gov... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Lists of... Resources and Services Administration, HHS. ACTION: Notice. SUMMARY: This notice advises the public of the...

  17. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ..., available on the Health Resources and Services Administration (HRSA) Web site at http://www.hrsa.gov... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Lists of... Resources and Services Administration, HHS. ACTION: Notice. SUMMARY: This notice advises the public of the...

  18. A comprehensive model for diagnosing the causes of individual medical performance problems: skills, knowledge, internal, past and external factors (SKIPE).

    Science.gov (United States)

    Norfolk, Tim; Siriwardena, A Niroshan

    2013-01-01

    This discussion paper describes a new and comprehensive model for diagnosing the causes of individual medical performance problems: SKIPE (skills, knowledge, internal, past and external factors). This builds on a previous paper describing a unifying theory of clinical practice, the RDM-p model, which captures the primary skill sets required for effective medical performance (relationship, diagnostics and management), and the professionalism that needs to underpin them. The SKIPE model is currently being used, in conjunction with the RDM-p model, for the in-depth assessment and management of doctors whose performance is a cause for concern.

  19. Order of 22 June 1970 listing work requiring special medical surveillance

    International Nuclear Information System (INIS)

    1970-01-01

    In the framework of the protection of workers, this Order provides that physicians responsible for medical surveillance of personnel engaged in work involving the utilization of X-rays and radioactive substances must calculate such control on the basis of one hour per month for every ten persons. (NEA) [fr

  20. [Current problems of deontology].

    Science.gov (United States)

    Dimov, A S

    2010-01-01

    The scope of knowledge in medical ethics continues to extend. Deontology as a science needs systematization of the accumulated data. This review may give impetus to classification of problems pertaining to this important area of medical activity.

  1. Premium Collection and the Problem of Voluntary Enrolment in China’s New Rural Cooperative Medical System

    Directory of Open Access Journals (Sweden)

    Armin Müller

    2016-01-01

    Full Text Available In late 2002, the Chinese government launched an initiative to extend the coverage of health insurance in rural China with the New Rural Cooperative Medical System (NRCMS. It covered all of rural China by 2008 and is being continuously adapted and developed. This study explores two conflicting goals in the policy design: universal coverage and voluntary enrolment. Local governments often faced the problem that only insufficient numbers of villagers were enrolling voluntarily. They developed different strategies to cope with it: Complementary outpatient reimbursement via medical savings accounts (MSAs effectively transferred villagers’ premiums back to them, thus making the NRCMS more attractive. Adapting the premium-collection process to the local context or utilising collusive practices allowed them to pay premiums on behalf of the villagers from the insurance funds. These strategies undermine the effectiveness of the NRCMS as a risk-pooling mechanism, facilitate latent coverage gaps and turn it into a tax-funded service.

  2. Medics on the Move South Africa: Access to Medical Words

    OpenAIRE

    Kris Van de Poel; Christine Fourie; Karen Seberechts

    2013-01-01

    South African medical students who are Cuban-trained and therefore Spanish- speaking, on their return to South Africa need to learn medical vocabulary, terminology, and appropriate interactional discourse in the two major languages of English and Afrikaans, in order to be able to practise professional medicine effectively and efficiently. Indeed, their language problems are further compounded by differences in medical equipment and in medical practices between Cuba and South Africa. To meet t...

  3. Modified task-based learning program promotes problem-solving capacity among Chinese medical postgraduates: a mixed quantitative survey.

    Science.gov (United States)

    Tian, Yanping; Li, Chengren; Wang, Jiali; Cai, Qiyan; Wang, Hanzhi; Chen, Xingshu; Liu, Yunlai; Mei, Feng; Xiao, Lan; Jian, Rui; Li, Hongli

    2017-09-07

    Despite great advances, China's postgraduate education faces many problems, for example traditional lecture-based learning (LBL) method provides fewer oppotunities to apply knowledge in a working situation. Task-based learning (TBL) is an efficient strategy for increasing the connections among skills, knowledge and competences. This study aimed to evaluate the effect of a modified TBL model on problem-solving abilities among postgraduate medical students in China. We allocated 228 first-year postgraduate students at Third Military Medical University into two groups: the TBL group and LBL group. The TBL group was taught using a TBL program for immunohistochemistry. The curriculum consisted of five phases: task design, self-learning, experimental operations, discussion and summary. The LBL group was taught using traditional LBL. After the course, learning performance was assessed using theoretical and practical tests. The students' preferences and satisfaction of TBL and LBL were also evaluated using questionnaires. There were notable differences in the mean score rates in the practical test (P 80) in the TBL group was higher than that in the LBL group. We observed no substantial differences in the theoretical test between the two groups (P > 0.05). The questionnaire results indicated that the TBL students were satisfied with teaching content, teaching methods and experiment content. The TBL program was also beneficial for the postgraduates in completing their research projects. Furthermore, the TBL students reported positive effects in terms of innovative thinking, collaboration, and communication. TBL is a powerful educational strategy for postgraduate education in China. Our modified TBL imparted basic knowledge to the students and also engaged them more effectively in applying knowledge to solve real-world issues. In conclusion, our TBL established a good foundation for the students' future in both medical research and clinical work.

  4. 78 FR 17415 - Medical Devices; Availability of Safety and Effectiveness Summaries for Premarket Approval...

    Science.gov (United States)

    2013-03-21

    ... its decision. The regulations provide that FDA publish a quarterly list of available safety and..., FDA-2012-M-1183, and FDA-2012-M-1184] Medical Devices; Availability of Safety and Effectiveness.... SUMMARY: The Food and Drug Administration (FDA) is publishing a list of premarket approval applications...

  5. Reactor operations Brookhaven medical research reactor, Brookhaven high flux beam reactor informal monthly report

    International Nuclear Information System (INIS)

    Hauptman, H.M.; Petro, J.N.; Jacobi, O.

    1995-04-01

    This document is the April 1995 summary report on reactor operations at the Brookhaven Medical Research Reactor and the Brookhaven High Flux Beam Reactor. Ongoing experiments/irradiations in each are listed, and other significant operations functions are also noted. The HFBR surveillance testing schedule is also listed

  6. Information from the MEDICAL SERVICE

    CERN Multimedia

    Safety Commission

    2008-01-01

    The CERN infirmary (ground floor, Building 57) is open from 8.00 a.m. to 5.30 p.m. every working day. It is open for emergencies only between 12.30 and 1.30 p.m., to allow the nurses to take their lunch breaks. The Medical Service only gives first-level medical treatment and under no circumstances can it take the place of your family doctor. A list of doctors, dentists and other health professionals in the Pay de Gex and Meyrin can be consulted on the Medical Service’s regularly updated web page: http://sc-me.web.cern.ch/sc-me/ In the event of an emergency on the CERN site, the first number to call is 74444.

  7. 78 FR 37927 - List of Approved Spent Fuel Storage Casks: MAGNASTOR® System

    Science.gov (United States)

    2013-06-25

    ...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... ADAMS Search.'' For problems with ADAMS, please contact the NRC's Public Document Room (PDR) reference... not have a significant economic impact on a substantial number of small entities. This final rule...

  8. Prioritising interventions against medication errors

    DEFF Research Database (Denmark)

    Lisby, Marianne; Pape-Larsen, Louise; Sørensen, Ann Lykkegaard

    errors are therefore needed. Development of definition: A definition of medication errors including an index of error types for each stage in the medication process was developed from existing terminology and through a modified Delphi-process in 2008. The Delphi panel consisted of 25 interdisciplinary......Abstract Authors: Lisby M, Larsen LP, Soerensen AL, Nielsen LP, Mainz J Title: Prioritising interventions against medication errors – the importance of a definition Objective: To develop and test a restricted definition of medication errors across health care settings in Denmark Methods: Medication...... errors constitute a major quality and safety problem in modern healthcare. However, far from all are clinically important. The prevalence of medication errors ranges from 2-75% indicating a global problem in defining and measuring these [1]. New cut-of levels focusing the clinical impact of medication...

  9. Medical Students' Perception of Problem Areas in Anatomy ...

    African Journals Online (AJOL)

    The ranges of problems were extensive; neuro-anatomy in gross anatomy, slide review in histology, and cardiovascular embryology were amongst the most highlighted areas of concern. Most students attributed the problems in gross anatomy to difficulty with accessing the area during dissection and inability to grasp the ...

  10. Truebounded, Overbounded, or Underbounded? Scientists’ Personal Publication Lists versus Lists Generated through Bibliographic Information Services

    Directory of Open Access Journals (Sweden)

    Isabelle Dorsch

    2018-02-01

    Full Text Available A truebounded publication list of a scientific author consists of exactly all publications that meet two criteria: (1 they are formally published (e.g., journal article or proceeding paper; (2 they have scientific, scholarly, or academic content. A publication list is overbounded if it includes documents which do not meet the two criteria (such as novels; a publication list is underbounded if it is incomplete. Are authors’ personal publication lists, found on their personal sites on the Internet or in institutional repositories, truebounded, overbounded, or underbounded? And are the respective publication lists generated through bibliographic information services truebounded, overbounded, or underbounded? As case studies, publications of nine International Society of Scientometrics and Informetrics (ISSI Committee members (published between 2007 and 2016 were collected to create preferably complete personal publication lists according to the two criteria. We connect the “relative visibility of an author” with the concepts of truebounded, overbounded, and underbounded publication lists. The authors’ relative visibility values were determined for the information services Web of Science (WoS, Scopus, and Google Scholar and compared to the relative visibility of the authors’ personal publication lists. All results of the bibliographic information services are underbounded. Relative visibility is highest in Google Scholar, followed by Scopus and WoS.

  11. Open Access Publishing in the Field of Medical Informatics.

    Science.gov (United States)

    Kuballa, Stefanie

    2017-05-01

    The open access paradigm has become an important approach in today's information and communication society. Funders and governments in different countries stipulate open access publications of funded research results. Medical informatics as part of the science, technology and medicine disciplines benefits from many research funds, such as National Institutes of Health in the US, Wellcome Trust in UK, German Research Foundation in Germany and many more. In this study an overview of the current open access programs and conditions of major journals in the field of medical informatics is presented. It was investigated whether there are suitable options and how they are shaped. Therefore all journals in Thomson Reuters Web of Science that were listed in the subject category "Medical Informatics" in 2014 were examined. An Internet research was conducted by investigating the journals' websites. It was reviewed whether journals offer an open access option with a subsequent check of conditions as for example the type of open access, the fees and the licensing. As a result all journals in the field of medical informatics that had an impact factor in 2014 offer an open access option. A predominantly consistent pricing range was determined with an average fee of 2.248 € and a median fee of 2.207 €. The height of a journals' open access fee did not correlate with the height of its Impact Factor. Hence, medical informatics journals have recognized the trend of open access publishing, though the vast majority of them are working with the hybrid method. Hybrid open access may however lead to problems in questions of double dipping and the often stipulated gold open access.

  12. Brazilian medical students’ perceptions of expert versus non-expert facilitators in a (non problem-based learning environment

    Directory of Open Access Journals (Sweden)

    Lucélio B. Couto

    2015-04-01

    Full Text Available Background: In problem-based learning (PBL, the facilitator plays an important role in guiding the student learning process. However, although content expertise is generally regarded as a useful but non-essential prerequisite for effective PBL facilitation, the perceived importance of content knowledge may be subject to cultural, contextual, and/or experiential influences. Aim: We sought to examine medical students’ perceptions of subject-matter expertise among PBL facilitators in a region of the world (Brazil where such active learning pedagogies are not widely used in university or pre-university settings. Results: Of the 252 Brazilian medical students surveyed, significantly (p≤0.001 greater proportions viewed content expert facilitators to be more effective than their non-expert counterparts at building knowledge (95% vs. 6%, guiding the learning process (93% vs. 7%, achieving cognitive learning (92% vs. 18%, generating learning goals (87% vs. 15%, and motivating self-study (80% vs. 15%. Discussion/conclusion: According to Brazilian medical students, subject-matter expertise among PBL facilitators is essential to the learning process. We believe this widespread perception is due, in large part, to the relative lack of prior educational exposure to such pedagogies.

  13. Developing and Evaluating Medical Humanities Problem-Based Learning Classes Facilitated by the Teaching Assistants Majored in the Liberal Arts

    Science.gov (United States)

    Tseng, Fen-Yu; Shieh, Jeng-Yi; Kao, Tze-Wah; Wu, Chau-Chung; Chu, Tzong-Shinn; Chen, Yen-Yuan

    2016-01-01

    Abstract Although medical humanities courses taught by teachers from nonmedical backgrounds are not unusual now, few studies have compared the outcome of medical humanities courses facilitated by physicians to that by teaching assistants majored in the liberal arts. The objectives of this study were to (1) analyze the satisfaction of medical students with medical humanities problem-based learning (PBL) classes facilitated by nonmedical teaching assistants (TAF) majored in the liberal arts, and those facilitated by the attending physicians (APF) and (2) examine the satisfaction of medical students with clinical medicine-related and clinical medicine-unrelated medical humanities PBL classes. A total of 123 medical students, randomly assigned to 16 groups, participated in this study. There were 16 classes in the course: 8 of them were TAF classes; and the others were APF classes. Each week, each group rotated from 1 subject of the 16 subjects of PBL to another subject. All of the 16 groups went through all the 16 subjects in the 2013 spring semester. We examined the medical students’ satisfaction with each class, based on a rating score collected after each class was completed, using a scale from 0 (the lowest satisfaction) to 100 (the highest satisfaction). We also conducted multivariate linear regression analysis to examine the association between the independent variables and the students’ satisfaction. Medical students were more satisfied with the TAF (91.35 ± 7.75) medical humanities PBL classes than APF (90.40 ± 8.42) medical humanities PBL classes (P = 0.01). Moreover, medical students were more satisfied with the clinical medicine-unrelated topics (92.00 ± 7.10) than the clinical medicine-related topics (90.36 ± 7.99) in the medical humanities PBL course (P = 0.01). This medical humanities PBL course, including nonmedical subjects and topics, and nonmedical teaching assistants from the liberal arts as class facilitators, was

  14. Medication therapy management and complex patients with disability: a randomized controlled trial.

    Science.gov (United States)

    Chrischilles, Elizabeth A; Doucette, William; Farris, Karen; Lindgren, Scott; Gryzlak, Brian; Rubenstein, Linda; Youland, Kelly; Wallace, Robert B

    2014-02-01

    Drug therapy problems, adverse drug events (ADEs), and symptom burden are high among adults with disabilities. To compare the effects of a modified medication therapy management (MTM) program within a self-efficacy workshop versus the workshop alone or usual care on symptom burden among adults with activity limitations. Three-group randomized controlled trial among adults (age 40 and older) with self-reported activity limitations in community practice. 8 weekly Living Well With a Disability (LWD) 2-hour workshop sessions with and without a collaborative medication management (CMM) module. mean number of moderate to very severe symptoms from a list of 11 physical and mental symptoms. Process measures: changes in medication regimens and self-reported ADEs. general linear mixed models (continuous outcomes) and generalized estimating equations (categorical outcomes). Participants had high symptom burden, low physical health, and took many medications. There was a significant increase in ADE reporting in the LWD + CMM group relative to the other 2 groups (Study group × Time P = .014), and there were significantly more changes in medication regimens in the LWD + CMM group (P = .013 LWD only vs LWD + CMM). The oldest third of participants had significantly fewer mean symptoms but received more intense CMM. There was no difference between the LWD-only, LWD + CMM, and usual care groups in symptom burden over time. Pharmacist MTM practices and MTM guidelines may need to be modified to affect symptom burden in a population with physical activity limitations.

  15. Medical marijuana.

    OpenAIRE

    Marmor, J B

    1998-01-01

    Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several...

  16. How often does the operating list follow the planned order? An analysis of elective maxillofacial operating lists.

    Science.gov (United States)

    Islam, Shofiq; Taylor, Christopher J; Ahmed, Siddiq; Ormiston, Ian W; Hayter, Jonathan P

    2015-12-01

    The authors explored consistency of the observed running order in operating sequence compared with prior scheduled listing. We analysed potential variables felt to be predictive in the chances of a patient having their procedure as previously scheduled. Data were retrospectively collected for a consecutive group of patients who underwent elective maxillofacial procedures over a four week period. The consistency of scheduled and observed running order was documented. We considered four independent variables (original list position, day of week, morning or afternoon list, seniority of surgeon) and analysed their relationship to the probability of a patient undergoing their operation as per listing. Logistic regression analysis was used to determine significant associations between predictor variables with an altered list order. Data were available for 35 lists (n = 133). 49% of lists were found to run according to prior given order, the remainder subject to some alteration. Logistic regression analysis showed a statistically significant association between original scheduled position and day of week, with list position consistency. Patients listed first were twelve times more likely to have their operation as listed compared to those placed fourth (OR 12.7, 95% CI 3.7-43, p lists at the start of a week were subject to less alteration (p lists showed some alteration to the previously printed order. It appears that being first on an elective list offers the greatest guarantee that a patient will have their operation as per prior schedule. It may be reasonable for clinicians to be mindful of potential operating list alterations when preparing their patients for elective surgery. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  17. Applying STOPP Guidelines in Primary Care Through Electronic Medical Record Decision Support: Randomized Control Trial Highlighting the Importance of Data Quality.

    Science.gov (United States)

    Price, Morgan; Davies, Iryna; Rusk, Raymond; Lesperance, Mary; Weber, Jens

    2017-06-15

    Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly. We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non-academic) primary care practices. We conducted a mixed-method, pragmatic, cluster, randomized control trial in research naïve primary care practices. Phase 1: In the randomized controlled trial, 40 fully automated STOPP rules were implemented as EMR alerts during a 16-week intervention period. The control group did not receive the 40 STOPP rules (but received other alerts). Participants were recruited through the OSCAR EMR user group mailing list and in person at user group meetings. Results were assessed by querying EMR data PIPs. EMR data quality probes were included. Phase 2: physicians were invited to participate in 1-hour semi-structured interviews to discuss the results. In the EMR, 40 STOPP rules were successfully implemented. Phase 1: A total of 28 physicians from 8 practices were recruited (16 in intervention and 12 in control groups). The calculated PIP rate was 2.6% (138/5308) (control) and 4.11% (768/18,668) (intervention) at baseline. No change in PIPs was observed through the intervention (P=.80). Data quality probes generally showed low use of problem list and medication list. Phase 2: A total of 5 physicians participated. All the participants felt that they were aware of the alerts but commented on workflow and presentation challenges. The calculated PIP rate was markedly less than the expected rate found in literature (2.6% and 4.0% vs 20% in literature). Data quality probes highlighted issues related to completeness of data in areas of the EMR used for PIP reporting and by the decision support such as problem and medication lists. Users also highlighted areas for better integration of STOPP guidelines with

  18. Using Everyday Materials To Promote Problem Solving in Toddlers.

    Science.gov (United States)

    Segatti, Laura; Brown-DuPaul, Judy; Keyes, Tracy L.

    2003-01-01

    Outlines benefits of and skills involved in problem solving. Details how an environment rich in materials that foster cause-and-effect or trial-and-error explorations promote cognitive development among toddlers. Offers examples of problem-solving experiences and lists materials for use in curriculum planning. Describes the teacher' role as one of…

  19. Lists of semi-dwarf cereal stocks

    International Nuclear Information System (INIS)

    1984-01-01

    The lists are prepared in relation to the Co-ordinated Research Programme. At the first Research Co-ordination Meeting on evaluation of cereal semi-dwarf mutants for cross breeding, March 1981, programme participants were requested to list semi-dwarf mutants available at their institutes including also non-induced semi-dwarf stocks being used in cross-breeding programme for short stature. List-I is prepared from such lists provided by programme participants. Further it was requested to name breeders and institutes providing characteristics of the listed semi-dwarf stocks. List-II gives that information. In the List-I: Parents of semi-dwarf stocks derived from cross breeding, are shown in brackets. In column ''Culm length'', figures are in cm and those of parent cultivars are shown in brackets

  20. Outpatients flow management and ophthalmic electronic medical records system in university hospital using Yahgee Document View.

    Science.gov (United States)

    Matsuo, Toshihiko; Gochi, Akira; Hirakawa, Tsuyoshi; Ito, Tadashi; Kohno, Yoshihisa

    2010-10-01

    General electronic medical records systems remain insufficient for ophthalmology outpatient clinics from the viewpoint of dealing with many ophthalmic examinations and images in a large number of patients. Filing systems for documents and images by Yahgee Document View (Yahgee, Inc.) were introduced on the platform of general electronic medical records system (Fujitsu, Inc.). Outpatients flow management system and electronic medical records system for ophthalmology were constructed. All images from ophthalmic appliances were transported to Yahgee Image by the MaxFile gateway system (P4 Medic, Inc.). The flow of outpatients going through examinations such as visual acuity testing were monitored by the list "Ophthalmology Outpatients List" by Yahgee Workflow in addition to the list "Patients Reception List" by Fujitsu. Patients' identification number was scanned with bar code readers attached to ophthalmic appliances. Dual monitors were placed in doctors' rooms to show Fujitsu Medical Records on the left-hand monitor and ophthalmic charts of Yahgee Document on the right-hand monitor. The data of manually-inputted visual acuity, automatically-exported autorefractometry and non-contact tonometry on a new template, MaxFile ED, were again automatically transported to designated boxes on ophthalmic charts of Yahgee Document. Images such as fundus photographs, fluorescein angiograms, optical coherence tomographic and ultrasound scans were viewed by Yahgee Image, and were copy-and-pasted to assigned boxes on the ophthalmic charts. Ordering such as appointments, drug prescription, fees and diagnoses input, central laboratory tests, surgical theater and ward room reservations were placed by functions of the Fujitsu electronic medical records system. The combination of the Fujitsu electronic medical records and Yahgee Document View systems enabled the University Hospital to examine the same number of outpatients as prior to the implementation of the computerized filing system.