Full Text Available Abstract Background Jurisdictional drug information systems are being implemented in many regions around the world. British Columbia, Canada has had a provincial medication dispensing record, PharmaNet, system since 1995. Little is known about how accurately PharmaNet reflects actual medication usage. Methods This prospective, multi-centre study compared pharmacist collected Best Possible Medication Histories (BPMH to PharmaNet profiles to assess accuracy of the PharmaNet profiles for patients receiving a BPMH as part of clinical care. A review panel examined the anonymized BPMHs and discrepancies to estimate clinical significance of discrepancies. Results 16% of medication profiles were accurate, with 48% of the discrepant profiles considered potentially clinically significant by the clinical review panel. Cardiac medications tended to be more accurate (e.g. ramipril was accurate >90% of the time, while insulin, warfarin, salbutamol and pain relief medications were often inaccurate (80–85% of the time. 1215 sequential BPMHs were collected and reviewed for this study. Conclusions The PharmaNet medication repository has a low accuracy and should be used in conjunction with other sources for medication histories for clinical or research purposes. This finding is consistent with other, smaller medication repository accuracy studies in other jurisdictions. Our study highlights specific medications that tend to be lower in accuracy.
Prah Ruger, Jennifer
The summer 2014 Ebola virus outbreak in Western Africa illustrates global health's striking inequalities. Globalisation has also increased pandemics, and disparate health system conditions mean that where one falls ill or is injured in the world can mean the difference between quality care, substandard care or no care at all, between full recovery, permanent ill effects and death. Yet attention to the normative underpinnings of global health justice and distribution remains, despite some important exceptions, inadequate in medical ethics, bioethics and political philosophy. We need a theoretical foundation on which to build a more just world. Provincial globalism (PG), grounded in capability theory, offers a foundation; it provides the components of a global health justice framework that can guide implementation. Under PG, all persons possess certain health entitlements. Global health justice requires progressively securing this health capabilities threshold for every person. 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.
Full Text Available Thomas Bender’s 2009 essay “Can National History Be De-Provincialized? U.S. History Textbook Controversies in the 1940s and 1990s,” originally published in Contexts: The Journal of Educational Media, Memory, and Society, asks the important question of how a nation-specific curriculum in history—that is, how “American” history itself—can be taught with the least influence of political factions and the least interference of commercial factors, in light of the fact that both elements, the political and the commercial, have played a role in the construction of the US history textbook. Bender’s essay demonstrates the complexity of the problem as multiple stakeholders seek to control, limit, or promote particular elements of the narratives of US history. Professional historians, Bender argues, like history itself, have “no responsibility to supply comfort”—that is, no role in promoting nationalism or American exceptionalism—yet he also warns that, due to changes in the textbook industry, they also may have little role in determining what is finally published. Bender’s essay, which specifically discusses the impact of political conditions—World War II, for example—on the daily practice of teaching and writing about history, serves as an insightful reminder of the complexity and vulnerability of a nation’s memory.
Wong, Roger Y; Chen, Luke; Dhadwal, Gurbir; Fok, Mark C; Harder, Ken; Huynh, Hanh; Lunge, Ryan; Mackenzie, Mark; Mckinney, James; Ovalle, William; Rauniyar, Pooja; Tse, Luke; Villanyi, Diane
As distributed undergraduate and postgraduate medical education becomes more common, the challenges with the teaching and learning process also increase. To collaboratively engage front line teachers in improving teaching in a distributed medical program. We recently conducted a contest on teaching tips in a provincially distributed medical education program and received entries from faculty and resident teachers. Tips that are helpful for teaching around clinical cases at distributed teaching sites include: ask "what if" questions to maximize clinical teaching opportunities, try the 5-min short snapper, multitask to allow direct observation, create dedicated time for feedback, there are really no stupid questions, and work with heterogeneous group of learners. Tips that are helpful for multi-site classroom teaching include: promote teacher-learner connectivity, optimize the long distance working relationship, use the reality television show model to maximize retention and captivate learners, include less teaching content if possible, tell learners what you are teaching and make it relevant and turn on the technology tap to fill the knowledge gap. Overall, the above-mentioned tips offered by front line teachers can be helpful in distributed medical education.
Finn, Michael A; Stark, James F
The Cruelty to Animals Act 1876 was an important but ambiguous piece of legislation. For researchers it stymied British science, yet ensured that vivisection could continue under certain restrictions. For anti-vivisection protestors it was positive proof of the influence of their campaigns, yet overly deferent to Britain's scientific elite. In previous accounts of the Act and the rise of anti-vivisectionism, scientific medicine central to these debates has been treated as monolithic rather than a heterogeneous mix of approaches; and this has gone hand-in-hand with the marginalizing of provincial practices, as scholarship has focused largely on the 'Golden Triangle' of London, Oxford and Cambridge. We look instead at provincial research: brain studies from Wakefield and anthrax investigations in Bradford. The former case elucidates a key role for specific medical science in informing the anti-vivisection movement, whilst the latter demonstrates how the Act affected the particular practices of provincial medical scientists. It will be seen, therefore, how provincial medical practices were both influential upon, and profoundly affected by, the growth of anti-vivisectionism and the passing of the Act. This paper emphasises how regional and varied medico-scientific practices were central to the story of the creation and impact of the Cruelty to Animals Act. Copyright © 2014 Elsevier Ltd. All rights reserved.
Laughlin, John S.
Traces the development of basic radiation physics that underlies much of today's medical physics and looks separately at the historical development of two major subfields of medical physics: radiation therapy and nuclear medicine. Indicates that radiation physics has made important contributions to solving biomedical problems in medical…
Ice, R D
Radionuclide production for medical use originally was incidental to isotope discoveries by physicists and chemists. Once the available radionuclides were identified they were evaluated for potential medical use. Hevesy first used 32P in 1935 to study phosphorous metabolism in rats. Since that time, the development of cyclotrons, linear accelerators, and nuclear reactors have produced hundreds of radionuclides for potential medical use. The history of medical radionuclide production represents an evolutionary, interdisciplinary development of applied nuclear technology. Today the technology is represented by a mature industry and provides medical benefits to millions of patients annually.
Full Text Available [english] The focus of the current issue 1-2/2012 of GMS Medizin – Bibliothek – Information is on medical history literature. In six articles special collections and recent projects of medical history libraries in Berlin, Hamburg, Heidelberg, Leipzig, Vienna and Zurich are presented. The authors in this issue are Melanie Scholz & Vera Seehausen (From Augusta to Klingsor, from Luise to Benjamin – past, present and future of the library of the Institute of the History of Medicine in Berlin, Alexandra Veith (Library of the Institute for History of Medicine and Ethics of Medicine, Heidelberg, Melanie Kintzel, Meike Knittel & Tanja Krutky (Historic collections of the Medical Library of the University of the University Medical Center Hamburg-Eppendorf and their deacidification, Dagmar Geithner (Library of the Karl Sudhoff Institute for the History of Medicine and Science, Leipzig – a Historical Review, Harald Albrecht, Bruno Bauer & Walter Mentzel (The Josephinian Library and the medical-historic stock of the University Library of the Medical University of Vienna and Monika Huber & Ursula Reis (Library of the Institute and Museum of the History of Medicine Zurich.[german] Schwerpunktthema der aktuellen Ausgabe 1-2/2012von GMS Medizin – Bibliothek – Information ist medizinhistorische Literatur. In sechs Beiträgen werden Bestände und aktuelle Projekte medizinhistorischer Bibliotheken in Berlin, Hamburg, Heidelberg, Leipzig, Wien und Zürich vorgestellt. Verfasst wurden die Beiträge der Schwerpunktausgabe von Melanie Scholz & Vera Seehausen (Von August zu Klingsor, von Luise zu Benjamin – Vergangenheit, Gegenwart und Zukunft der Bibliothek des Instituts für Geschichte der Medizin in Berlin, Melanie Kintzel, Meike Knittel & Tanja Krutky (Medizinhistorische Buchbestände am Universitätsklinikum Hamburg-Eppendorf und ihre Entsäuerung, Ara Veith (Bibliothek des Instituts für Geschichte und Ethik der Medizin in Heidelberg, Dagmar Geithner
Joseli Maria Nunes Mendonça
Full Text Available This article revisits two established themes in the historiography of Paraná: immigration and colonization. Studies dedicated to these themes had a general tendency to focus on the narrow relationship between these two historical experiences, appointing that, in Paraná, colonization was made effective by means of small land owners of foreign origin (the colonials who farmed their land for general supply agriculture. Using sources that have also been largely explored by researchers of regional history – reports from province presidents and legislation – but prioritizing a less-studied period – the years 1850 and 1860 – and presenting questions related to the definition of public politics for the recently-constituted province, the research made evident that the proletarianization was a common experience for the immigrants in that period and that the so-called “nationals” were fundamental agents in the colonization projects then being implemented. The article, therefore, shows the problems of the synonymy constituted by the historiography between the words immigration and colonization, giving evidence to a context of ruptures, indeterminations and multiple expectations.
Full Text Available [Purpose/significance] The National Natural Science Foundation of China (NSFC is one of the most important channels to support basic research in China. Competition for funding by the NSFC has been a very important indicator to measure the basic research level of various province and scientific research institutions. [Method/process] By combing and analyzing the status quo of NSFC in medical science, it is helpful to narrow the provincial gap and improve the basic research of medical science in China. Based on the project information of NSFC and previous scholars’ research, the paper update the index of basic research competitiveness, and analyzes project number and project funding of medical science during 2006-2016. At the same time, the competitiveness of medical science basic research and its changing trend in 31 provinces of China are analyzed. [Result/conclusion] The result shows that, in recent years, China’s basic scientific research has greatly improved, but there is a large gap between the provinces.
Martin Luther achieved great success in religious reformation, though he was said to have suffered from many kinds of diseases during his lifetime. Unfortunately, however, his medical history has never been reported in Japan. Since the second half of his thirties, he was suffering from severe constipation, causing hemorrhoids and anal prolapse. At the beginning of his forties he had vertigo, tinnitis and headaches, which were the signs of chronic purlent otitis media and ended in left otorrhea and pyorrhea of the left mastoiditis. Nearly at the same time, he started to suffer from anginal pain, colic and dysuria due to urinary uric acid stones, gout and left leg ulcer, which were all caused by metabolic syndromes. The last 1/3 of his life was affected by the shadow of diseases, and his religious activities were frequently disturbed. He died from myocardial infarction at the age 63, in February 1546.
Full Text Available This case study focus upon Swedish provincial doctors as practitioners in a sparsely populated medical district in Sweden 1881-1920, and their positions as state’s medical experts in a period when the first steps towards a welfare state were taken. The question to be answered is how the doctors themselves looked upon their possibilities to promote public health in the Swedish countryside? The study shows that the provincial doctors for sure identified themselves as representatives of the Swedish state, medical science and modernisation, and that they agreed upon their own importance in the crusade of bringing modern welfare to the Swedish countryside. In practice, though, their possibilities to implementation and influence seem to have been limited – something that the doctors were well aware of. The explanation is probably lack of confidence, as a result of the doctors’ tendency to distance themselves from the simple, ignorant and reactionary locals.
Rezansoff, Stefanie N; Moniruzzaman, Akm; Fazel, Seena; McCandless, Lawrence; Somers, Julian M
Preliminary evidence suggests that adherence to antipsychotic medication reduces criminal recidivism among patients diagnosed with schizophrenia. However, existing studies operationalize antipsychotic adherence as a binary variable (usually using a threshold of ≥80%), which does not reflect the prevalence of suboptimal adherence in real-world settings. The purpose of the current analysis was to investigate the association between successive ordinal levels of antipsychotic adherence and criminal recidivism in a well-defined sample of offenders diagnosed with schizophrenia (n = 11462). Adherence was measured using the medication possession ratio (MPR) and analyzed as a time-dependent covariate in multivariable regression models. Data were drawn from linked, comprehensive diagnostic, pharmacy and justice system records, and individuals were followed for an average of 10 years. Adjusted rate ratios (ARR) and confidence intervals (CI) are reported. Overall mean MPR was 0.41. Increasing levels of antipsychotic adherence were not associated with progressively lower rates of offending. However, when compared to the reference group (MPR ≥ 80%) all lower adherence levels were significantly associated (P recidivism. Future research addressing functional outcomes of antipsychotic adherence should conceptualize adherence as an incremental independent variable. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.
Dec 2, 2009 ... The history of diseases of the circulatory system forms one of the most interesting chapters in medical ... CHRONICLES OF MEDICAL HISTORY IN AFRICA. PIONEERS OF HEART SURGERY: FROM ..... in arteriovascuscular diseases and in 1982 reported the experience in vascular surgery at Ibadan.
Ding, Jingmei; Hu, Xuejun; Zhang, Xianzhi; Shang, Lei; Yu, Min; Chen, Huoliang
The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants. The inputs and outputs of most provincial medical service systems increased gradually from 2009 to 2014. Overall, the eastern region allocated more human and capital resources than the other two regions, and produced more than 50% of the total outpatient and emergency room visits, whereas the western region produced more inpatient services (about 30% of the total volume of inpatient services) according to the distribution of the population. The average efficiency scores of the provincial medical systems in China's mainland were 0.895, 0.927, 0.929, 0.963, 0.977 and 0.968 from 2009 to 2014, with a slight average improvement of 1.60%. The efficiency score of each provincial medical service system varied greatly from one another: Tibet (1.475 ± 0.057) performed extremely well, whereas several others including Heilongjiang (0.579 ± 0.001) performed poorly. Furthermore, the proportion of high-class medical facilities was negatively associated with efficiency, whereas the proportion of the vulnerable population, the per capita Gross Domestic Product, the proportion of the illiterate population and the improvement of primary health care had positive effects on efficiency. Inequity in health resources allocation and service provision existed across the regions, but not all the gaps have begun to narrow since 2009. The difference of efficiency was great among provincial medical service systems
The teaching in medical history at the University of Oslo, Norway, is given as an integrated part of the student training for practical work in health care and community health. I summarize here the underlying argumentation and the teaching experiences, concluding that this is felt as an effective way to convey relevant medical historical knowledge and skills to the future doctors.
Alberti, S J
Edinburgh has a wealth of medical collections, thanks not only to its role in the Enlightenment and the diaspora of graduates from the large medical school, but also to recent developments in medical heritage. Concentrating on the collections of the University of Edinburgh's Anatomy Department and Surgeons' Hall Museums at the Royal College of Surgeons of Edinburgh, this paper charts the complex and connected histories of the material culture of anatomy, pathology and surgery in the city. What roles did museums play, from their 18th century origins to their 21st century resurgence, and who used them?
Medical history is the objective process of the development of medicine. Medicine historiography is the recording, interpretation and comments of this process. Historiography of medicine is often called medical history. By subject attribute, historiography of medicine belongs to history and could be divided into study on specific medical historiography (the objective ibeing medical history), historical materials on medicine (the objective is to offer reliable materials for specific medical historiography) and study on medical historiography (the objective being mthe historiography of medicine itself).
van Diermen, D E; Brand, H S; Vissink, A
A patient's medical history is a vital part of his or her dental history and increases the dentist's awareness of diseases and medication which might interfere with the patient's dental treatment. This article describes the essential characteristics of a solid medical history, according to the Dutch Guidelines for Dental Education published in 1997. In future the importance of patients' medical histories will increase along with the number of medically complex patients who visit the dental general practice.
Surgical abortion has been provided liberally in Australia since the early 1970s, mainly in privately owned specialist clinics. The introduction of medical abortion, however, was deliberately obstructed and consequently significantly delayed when compared to similar countries. Mifepristone was approved for commercial import only in 2012 and listed as a government subsidised medicine in 2013. Despite optimism from those who seek to improve women's access to abortion, the increased availability of medical abortion has not yet addressed the disadvantage experienced by poor and non-metropolitan women. After telling the story of medical abortion in Australia, this paper considers the context through which it has become available since 2013. It argues that the integration of medical abortion into primary health care, which would locate abortion provision in new settings and expand women's access, has been constrained by the stigma attached to abortion, overly cautious institutionalised frameworks, and the lack of public health responsibility for abortion services. The paper draws on documentary sources and oral history interviews conducted in 2013 and 2015. Copyright © 2015 Elsevier Inc. All rights reserved.
King, C. R.
The history of medicine is always written from the basis of the historian. Contemporary historiography provides an understanding of the major methods of historical analysis and their influences on the writing of medical history. Medical history in the 20th century has emphasized the historiographic methods of the history of great men, historicism, social history, and intellectual history. Each methodology has inherent biases that influence the historian's analysis of the past. Understanding the historian's biases provides the reader important tools for the interpretation of medical history. PMID:1933068
Brown, E W; Kimball, R G
A questionnaire, designed to elicit information about the training, experience, and medical history of adolescent powerlifters, was administered to 71 contestants entered in the 1981 Michigan Teenage Powerlifting Championship. The average subject had participated in 4.1 workouts per week for 17.1 months. Each workout lasted an average of 99.2 minutes. The population sustained 98 powerlifting injuries which caused a discontinuance of training for a total of 1,126 days. The incidence and severity of pain in 13 regions of the body, as well as the site and type of powerlifting injury, were investigated. The low back region was shown to be the site with the greatest number of injuries (49). This region also had the highest percent of subjects recording an elevated occurrence and level of pain associated with powerlifting.
Gabrielle L Procopio
Full Text Available Background: Clear processes to facilitate medication reconciliation in a hospital setting are still undefined. The observation unit allows for a high patient turnover rate, where obtaining accurate medication histories is critical. Objectives: The objective of this study was to assess the ability of pharmacists and student pharmacists to identify discrepancies in medication histories obtained at triage in observation patients. Methods: Pharmacists and student pharmacists obtained a medication history for each patient placed in observation status. Patients were excluded if they were unable to provide a medication history and family, caregiver, or community pharmacy was also unable to provide the history. A comparison was made between triage and pharmacy collected medication histories to identify discrepancies. Results: A total of 501 medications histories were collected, accounting for 3213 medication records. There were 1176 (37% matched medication records and 1467 discrepancies identified, including 808 (55% omissions, 296 (20.2% wrong frequency, 278 (19% wrong dose, 51 (3.5% discontinued, and 34 (2.3% wrong medication. There was an average of 2.9 discrepancies per patient profile. In all, 76 (15% of the profiles were matched. The median time to obtain a medication history was 4 min (range: 1–48 min. Conclusion: Pharmacy collected medication histories in an observation unit identify discrepancies that can be reconciled by the interdisciplinary team.
Honore, Russel L; Boslego, David V
The Provincial Reconstruction Team (PRT) training mission completed by First U.S. Army in April 2006 was a joint Service effort to meet a requirement from the combatant commander to support goals in Afghanistan...
Glintborg, Bente; Andersen, S K; Poulsen, H E
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....
Cimrin, A H; Sevinc, C; Kundak, I; Ellidokuz, H; Itil, O
To evaluate occupational history taking, as a detailed occupational history is the most effective means for proper diagnosis of occupational illness. In order to determine the attitudes of 66 physicians working in Dokuz Eylül Medical Faculty Hospital about taking occupational history, 269 patient records were examined. It was detected that 43.9% of physicians took no occupational history from any of their patients. Occupational history was obtained from 81.8% of the patients in clinics where standard examination forms were in regular use. We found that physicians were not in the habit of taking occupational histories.
Glintborg, Bente; Andersen, S K; Poulsen, H E
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...
Full Text Available Abstract: The beginnings of university studies of medicine in Ljubljana, and wartime interruptions. – One hundred years of anesthesia on the European continent as part of the surgeon’s work and responsibility. – The organization of health service (1942–1945 within the partisan resistance struggle. – Clandestine partisan hospitals. The wounded, the staff, the physicians. – Wartime anesthesia: an overview and perspectives. – SVPB Franja: a description. The efforts invested so far for the recognition of this war memorial as a UNESCO World Heritage Site. – From the 1982 International Symposium on the History of Modern Anesthesia to ISHA – the international society for the history of anesthesia.
... mtDNA Resources Help Me Understand Genetics Share: Email Facebook Twitter Home Help Me Understand Genetics Inheriting Genetic Conditions Why is it important to know my family medical history? Why is it important to know my family ...
Excerpts of his London era first published on the occasion of the Karl Marx testimonials of 1983 gave rise to extend the memory of the fundamental achievements of Karl Marx to medico-historical aspects. In this case Karl Marx paid special attention to the working and living conditions of the working class and an analysis of his adequate statements and records shows multifarious details which give a research basis also for the history of medicine. Marx and Engels had friendly contacts with several physicians who shared the opinions of the two classics: their way of life is shown in the most important points.
Takaki, Ronald T.
Discusses the history of the admission of African Americans at the Harvard Medical School and the racial prejudice that followed. The author reveals how Harvard medical students of the time believed that blacks were intellectually inferior and that having black students at the school would devalue the school and their diplomas. (GR)
Miranda C, Marcelo
Edgar Allan Poe, one of the best American storytellers and poets, suffered an episodic behaviour disorder partially triggered by alcohol and opiate use. Much confusion still exists about the last days of his turbulent life and the cause of his death at an early age. Different etiologies have been proposed to explain his main medical problem, however, complex partial seizures triggered by alcohol, poorly recognized at the time when Poe lived, seems to be one of the most acceptable hypothesis, among others discussed.
Round, W H; Jafari, S; Kron, T; Azhari, H A; Chhom, S; Hu, Y; Mauldon, G F; Cheung, K Y; Kuppusamy, T; Pawiro, S A; Lubis, L E; Soejoko, D S; Haryanto, F; Endo, M; Han, Y; Suh, T S; Ng, K H; Luvsan-Ish, A; Maung, S O; Chaurasia, P P; Jafri, S M A; Farrukh, S; Peralta, A; Toh, H J; Sarasanandarajah, S; Shiau, A C; Krisanachinda, A; Suriyapee, S; Vinijsorn, S; Nguyen, T C
The history of medical physics in Asia-Oceania goes back to the late nineteenth century when X-ray imaging was introduced, although medical physicists were not appointed until much later. Medical physics developed very quickly in some countries, but in others the socio-economic situation as such prevented it being established for many years. In others, the political situation and war has impeded its development. In many countries their medical physics history has not been well recorded and there is a danger that it will be lost to future generations. In this paper, brief histories of the development of medical physics in most countries in Asia-Oceania are presented by a large number of authors to serve as a record. The histories are necessarily brief; otherwise the paper would quickly turn into a book of hundreds of pages. The emphasis in each history as recorded here varies as the focus and culture of the countries as well as the length of their histories varies considerably.
Jones, David S; Greene, Jeremy A; Duffin, Jacalyn; Harley Warner, John
Historians of medicine have struggled for centuries to make the case for history in medical education. They have developed many arguments about the value of historical perspective, but their efforts have faced persistent obstacles, from limited resources to curricular time constraints and skepticism about whether history actually is essential for physicians. Recent proposals have suggested that history should ally itself with the other medical humanities and make the case that together they can foster medical professionalism. We articulate a different approach and make the case for history as an essential component of medical knowledge, reasoning, and practice. History offers essential insights about the causes of disease (e.g., the non-reductionistic mechanisms needed to account for changes in the burden of disease over time), the nature of efficacy (e.g., why doctors think that their treatments work, and how have their assessments changed over time), and the contingency of medical knowledge and practice amid the social, economic, and political contexts of medicine. These are all things that physicians must know in order to be effective diagnosticians and caregivers, just as they must learn anatomy or pathophysiology. The specific arguments we make can be fit, as needed, into the prevailing language of competencies in medical education. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com.
The Museum and Library of History of Medicine celebrated the 700th anniversary of the foundation of the University of Rome "La Sapienza" with an exhibition of images and documents recalling the history of the medical faculty. Dissecting tools and surgical instruments testify to the long history of anatomical and surgical studies and to the great worth of the teachers at Rome University. Documents, archival papers, books and pictures document the historical inheritance of the Medical School in Rome.
Ajdukovic, Maja; Crook, Meredith; Angley, Christopher; Stupans, Ieva; Soulsby, Natalie; Doecke, Christopher; Anderson, Barbara; Angley, Manya
The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED). The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demographic groups when pharm...
of nationalist political propaganda, in effect – is analysed, and it is suggested that while it is certainly suffused with patriotic rhetoric (such as the occasion demanded), Rung nevertheless at the same time took the opportunity to incorporate a number of significant international musical influences, notably...... from Felicien David’s symphonic ode, Le désert, Meyerbeer’s Les huguenots and from the vocal music of the Italian renaissance. These influences are interpreted as indicative of an international outlook, differing quite markedly from that of his internationally renowned contemporary, Niels W. Gade...... of cosmopolitanism and provincialism in relation to music is developed with reference to Franz Liszt, who in the context of this article comes to function as a sort of ‘cosmopolitan’ mirror image of the ‘provincial’ Danish composer, Henrik Rung (1807-1871). Rung’s work Slaget ved Fredericia (1850) – a piece...
Stewart, Michael R.; Fogg, Sarah M.; Schminke, Brandon C.; Zackula, Rosalee E.; Nester, Tina M.; Eidem, Leslie A.; Rosendale, James C.; Ragan, Robert H.; Bond, Jack A.; Goertzen, Kreg W.
Abstract Background/Objective: Medication reconciliation at transitions of care decreases medication errors, hospitalizations, and adverse drug events. We compared inpatient medication histories and reconciliation across disciplines and evaluated the nature of discrepancies. Methods: We conducted a prospective cohort study of patients admitted from the emergency department at our 760-bed hospital. Eligible patients had their medication histories conducted and reconciled in order by the admitting nurse (RN), certified pharmacy technician (CPhT), and pharmacist (RPh). Discharge medication reconciliation was not altered. Admission and discharge discrepancies were categorized by discipline, error type, and drug class and were assigned a criticality index score. A discrepancy rating system systematically measured discrepancies. Results: Of 175 consented patients, 153 were evaluated. Total admission and discharge discrepancies were 1,461 and 369, respectively. The average number of medications per participant at admission was 8.59 (1,314) with 9.41 (1,374) at discharge. Most discrepancies were committed by RNs: 53.2% (777) at admission and 56.1% (207) at discharge. The majority were omitted or incorrect. RNs had significantly higher admission discrepancy rates per medication (0.59) compared with CPhTs (0.36) and RPhs (0.16) (P < .001). RPhs corrected significantly more discrepancies per participant than RNs (6.39 vs 0.48; P < .001); average criticality index reduction was 79.0%. Estimated prevented adverse drug events (pADEs) cost savings were $589,744. Conclusions: RPhs committed the fewest discrepancies compared with RNs and CPhTs, resulting in more accurate medication histories and reconciliation. RPh involvement also prevented the greatest number of medication errors, contributing to considerable pADE-related cost savings. PMID:25477614
Hastrup, J L; Phillips, S M; Vullo, K; Kang, G; Slomka, L
Compared 309 youths ages 11 to 15 years and their parents with respect to their comprehension of terms for seven common medical disorders: heart attack, stroke, atherosclerosis, ulcer, hypertension, diabetes, and cancer. For two thirds of the adolescent sample, accuracy of reporting of these disorders among the parents and grandparents was assessed. Results indicated considerable variation among disorders with respect to both comprehension of terms and accuracy of family health history. Adolescents' age was a major predictor of knowledge of medical terms (r = .41). Age was not related to accuracy of family health information. Consonant with this finding, adolescents' level of accuracy regarding family health history was generally similar to that of previous adult samples, suggesting that family health information is acquired and retained at an early age. Adolescents were more accurate concerning parents' compared with grandparents' history of hypertension.
Fletcher, Oscar J; Hooper, Billy E; Schoenfeld-Tacher, Regina
The Journal of Veterinary Medical Education (JVME), with the leadership of seven editors and two interim editors, grew from 33 pages of mostly news and commentary to become the premier source for information exchange in veterinary medical education. The first national publication of the Association of American Veterinary Medical Colleges (AAVMC) was a 21-page newsletter published in December 1973. This one-time newsletter was followed by volume 1, issue 1 of JVME, published in spring 1974 and edited by William W. Armistead. Richard Talbot was the second and longest serving editor, and under his leadership, JVME grew in the number and quality of papers. Lester Crawford and John Hubbell served as interim editors, maintaining quality and keeping JVME on track until a new editor was in place. Robert Wilson, Billy Hooper, Donal Walsh, Henry Baker, and the current editor, Daryl Buss, are major contributors to the success of JVME. The early history of the journal is described by Billy Hooper and followed by a brief history of the periods of each of the editors. This history concludes with objective and subjective evaluations of the impacts of JVME.
An audit comparing the discrepancies between a verbal enquiry, a written history, and an electronic medical history questionnaire: a suggested medical history/social history form for clinical practice.
In everyday practice, dentists are confronted with an increasing number of patients with complex medical problems. There is divergence of opinion among dentists regarding how to obtain a thorough medical\\/social history.
Full Text Available This special issue intends to show the potential of medical history to contribute to major historical debates, e.g. on the rise of the welfare state. Together the articles in this issue make clear that medical history, for the twentieth century even more so than for earlier periods, is strongly embedded in social, cultural and political history. The second goal of the special issue is methodological. It aims to highlight the conceptual work being done by medical historians in oral history, digital history and the study of material culture. These methodologies allow them to expand the range of actors in the medical field: architects, missionaries, ‘laypersons’, advertisers and drug users all extend the medical field beyond the established categories of ‘doctor’ and ‘patient’. Through their eyes, the particularities of twentieth-century health care become clear: the strong presence of mass media and public opinion, the role of international organisations and the redefining of patients as citizen-consumers entitled to health care. Vervagende grenzen: naar een medische geschiedenis van de twintigste eeuwDit themanummer wil het potentieel van de medische geschiedenis tonen om bij te dragen tot belangrijke historische vraagstukken, zoals de opkomst van de welvaartstaat. De artikelen in dit nummer maken duidelijk dat de medische geschiedenis – voor de twintigste eeuw meer nog dan voor vroegere tijdvakken – nauw verbonden is met de sociale, culturele en politieke geschiedenis. De tweede doelstelling van dit nummer is van methodologische aard. Het wil de conceptuele vernieuwingen van medisch historici op het terrein van de mondelinge geschiedenis, de digitale geschiedenis en de studie van materiële cultuur onder de aandacht brengen. Dankzij deze methodologieën komen nieuwe actoren in beeld: architecten, missionarissen, ‘leken’, adverteerders en druggebruikers – actoren die het medische veld verruimen, voorbij de traditionele
The health informatics profession in Bosnia and Herzegovina has relatively long history. Thirty five years from the introduction of the first automatic manipulation of data, thirty years from the establishment of Society for Medical Informatics BiH, twenty years from the establishment of the Scientific journal "Acta Informatica Medica (Acta Inform Med", indexed in PubMed, PubMed Central Scopus, Embase, etc.), twenty years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina, ten years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article is eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.
Lerner, B H
Although clinicians without a sense of history may not be condemned to repeat the past, the historical record offers many informative lessons. For one thing, history demonstrates the changing nature of scientific knowledge; current understandings of health and disease may prove as ephemeral as earlier discarded theories. In addition, history reminds us that social and cultural factors influence how physicians diagnose and treat various medical conditions. When attempting to teach the history of medicine at academic medical centers, instructors should be innovative as opposed to comprehensive. Students and residents are likely to find recent historical issues to be more relevant, particularly when such material can be integrated into the existing curriculum. Provocative topics include depictions of medicine in old Hollywood films, the contributions made by famous physicians at one's own institution, and historical debates over controversial events, such as the Tuskegee syphilis study and the use of lobotomy in mental institutions in the 1950s.
In the early nineteenth century, geology was a new but rapidly growing science, in the provinces and among the gentlemen scientists of London, Oxford and Cambridge. Industry, particularly mining, often motivated local practical geologists, and the construction of canals and railways exposed the strata for all to see. The most notable of the early practical men of geology was the mineral surveyor William Smith; his geological map of England and Wales, published in 1815, was the first of its kind. He was not alone. The contributions of professional men, and the provincial societies with which they were connected, are sometimes underestimated in the history of geology.
Ajdukovic, Maja; Crook, Meredith; Angley, Christopher; Stupans, Ieva; Soulsby, Natalie; Doecke, Christopher; Anderson, Barbara; Angley, Manya
The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED). The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Twenty four participants were classified as 'language barrier'; 12 participants were from residential aged care facilities, and 64 participants were classified as 'general'. The number of correctly recorded medications was lowest in the 'language barrier' group (13.8%) compared with 18% and 19.6% of medications for 'general' patients and patients from residential aged care facilities respectively. Seven of the patients (29.2%) with 'language barrier'; 1 from a residential aged care facility (8.3%) and 13 of the (20.3%) patients from the 'general' category were suspected as having a medication related ED presentation. This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation.
Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED. The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. Methods: The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Results: Twenty four participants were classified as ‘language barrier’; 12 participants were from residential aged care facilities, and 64 participants were classified as ‘general’. The number of correctly recorded medications was lowest in the ‘language barrier’ group (13.8% compared with 18% and 19.6% of medications for ‘general’ patients and patients from residential aged care facilities respectively. Seven of the patients (29.2% with ‘language barrier’; 1 from a residential aged care facility (8.3% and 13 of the (20.3% patients from the ‘general’ category were suspected as having a medication related ED presentation. Conclusion: This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation.
The history of medical physics in Japan dates back to the mid-1950's when radioisotope sources such as cobalt-60 were initiated into hospitals. In 1961, a total of about 30 medical physics researchers created a sub-committee of medical physics under the Japan Radiological Society (JRS), which flourished throughout the decade, and the number of members exceeded to more than 200 in 1970. Although there were great advances in medical technologies, the number of members of the medical physics community did not grow for the next two decades from 1980 to 2000. Then, the JRS began to officially recognize medical physicists as a professional group in 1987. Qualifications of candidacy for the examination included having the education equivalent of a Bachelor of Science/Engineering and being a member of the JRS. For the first official examination, 70 medical physicists were approved by the JRS. As of 2013, there are currently 700 medical physicists, however, the number of practicing clinical medical physicists remains only about 150. The main reason for this limited number of medical physicists is that the certification is not recognized as a national license and therefore is challenging to find professional employment as qualified medical personnel at hospitals. (author)
Radoï, Loredana; Paget-Bailly, Sophie; Guida, Florence; Cyr, Diane; Menvielle, Gwenn; Schmaus, Annie; Carton, Matthieu; Cénée, Sylvie; Sanchez, Marie; Guizard, Anne-Valérie; Trétarre, Brigitte; Stücker, Isabelle; Luce, Danièle
International audience; BACKGROUND: The aim of this study was to evaluate the role of family history of cancer and personal history of other medical conditions in the aetiology of the oral cavity cancer in France. METHODS: We used data from 689 cases of oral cavity squamous cell carcinoma and 3481 controls included in a population-based case--control study, the ICARE study. Odds-ratios (ORs) associated with family history of cancer and personal medical conditions and their 95% confidence inte...
von Engelhardt, D
The current interest in philosophical questions and ethical aspects of medicine turns attention towards the past and obtains suggestions and perspectives from previous descriptions and interpretations of sickness, therapy, and the relation between the patient and physician. Culture as therapy and therapy as culture are fundamental challenges for the present; physician, patient, and society, i.e., humans and humane medicine, need this dialogue, which should also be constitutive for teaching history of medicine. Through the separation of the natural sciences and the humanities, modern progress of medicine has produced many benefits but has, at the same time, raised many problems. Negative consequences of this development exist not only for the patient, but also for his personal environment and for the physician. In the course of modern history, there have been several reactions aimed at overcoming these one-sided tendencies: in the Renaissance, in the epoch of Romanticism and Idealism, and at the beginning and the end of the 19th century. This article outlines, with historical examples and contemporary reflections, the concept of teaching history of medicine in the perspective of "medical humanities".
Macfarlane, T V
The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer.
Kim, Sun Chil; Kim, Jung Min
The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS (Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented con-siderations in the process of development. So we have developed MIH (Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. The program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images
Duarte, C M
This article describes the organizational characteristics of the UNIMED medical cooperative in Brazil. After an overview of UNIMED's share in the current health plan market, the author analyzes its organizational structure, historical evolution, and contractual regimen with member physicians, including the formula used to calculate the payment schedule for physician services. The plan currently includes 367 local member cooperatives, operating in over 80% of Brazil's counties, with 41% of existing physicians to serve 7% of the population. The organization's history began with local cooperatives and subsequently federations, the confederation, and other companies in the group. The organizational design and dynamics favor a high degree of decentralization and autonomy, subordination of all components in the system to the physician cooperative command, and the occurrence of internal disputes and conflicts between individual interests and those of the organization.
Majumdar, Sisir K
"Time present and time past are both perhaps present in time future and time future contained in time past".--Thomas Steams Eliot (1888-1965), Noble Literature Laureate, 1948. History and evolution of the concept of Medical Ethics is the classical example of this poetic expression. Virtually, every human society has some forces of myth to explain the origin of morality. Indian ethics was philosophical from its very birth. In the Vedas (1500 B.C.), ethics was an integral aspect of philosophical and religious speculation about the nature of reality. The Vedas says how people ought to live and is the oldest philosophical literature in the world. It was the first account of philosophical ethics in human history. The old Testament of (c. 200 B.C.) the Hebrew Bible (Greek--ta biblia--"the books") gives account of God giving the Ten Commandments--the oral and written Law engraved on tablets of Stone to Moses around 13th century B.C. on Mount Sinai (Arabic--Gebel Musa) the Mountain near the tip of the Sinai Peninsula in West Asia.
Ovallath, Sujith; Deepa, P
The clinical syndrome of parkinsonism was identified in ancient India even before the period of Christ and was treated methodically. The earliest reference to bradykinesia dates to 600 bc. Evidences prove that as early as 300 bc, Charaka proposed a coherent picture of parkinsonism by describing tremor, rigidity, bradykinesia, and gait disturbances as its components. The scenario was further developed by Madhava, Vagbhata, and Dalhana all through history. The 15th-century classic "Bhasava rajyam" introduced the term kampavata, which may be regarded as an ayurvedic analogue of parkinsonism. The pathogenesis of kampavata centered on the concept of imbalance in the vata factor, which controls psychomotor activities. The essential element in therapy was the administration of powdered seed of Mucuna pruriens, or atmagupta, which as per reports, contains 4%-6% of levodopa. In addition to proving the existence and identification of parkinsonism in ancient India, the study points to the significance of ancient Indian Sanskrit works in medical history. Copyright © 2013 Movement Disorder Society.
Full Text Available Images of provincial rural life are often key symbols in the construction of national identities, even in highly urbanized wealthy nations. Some 60 percent of the Canadian population lives in just four urban concentrations around Toronto, Montreal, Vancouver, and the Calgary-Edmonton corridor and a very significant proportion consists of immigrants, many of them from Asia, Africa, the Caribbean and South America. Canada is still a dominion within the British Commonwealth but everyday metropolitan life in Canada is far more diverse and international than the historic connections to Britain, or France, might suggest. Nonetheless, it is the provincial hinterlands and rural regions that are most often used to imagine Canada and Canadians.
Gabriel, Meghan Hufstader; Smith, Jaime Y; Sow, Max; Charles, Dustin; Joseph, Seth; Wilkins, Tricia Lee
To document national trends of electronic medication history use in the ambulatory setting and describe the characteristics and predicting factors of providers who regularly use medication history transaction capabilities through their e-prescribing systems. The study used provider-initiated medication history data requests, electronically sent over an e-prescribing network from all 50 states and the District of Columbia. Data from 138,000 prescribers were evaluated using multivariate analyses from 2007 to 2013. Medication history use showed significant growth, increasing from 8 to 850 million history requests during the study period. Prescribers on the network for histories more often than those in large and small cities, these findings were not significant in multivariate analyses. Providers in orthopedic surgery and internal medicine had a higher likelihood of more requests than family practice prescribers, with 12% and 7% higher likelihood, respectively. Early adopters of e-prescribing have remained medication history users and have continually increased their volume of requests for medication histories. Despite the fact that the use of medication histories through e-prescribing networks in the ambulatory care setting has not been encouraged through federal incentive programs, there has been substantial growth in the use of medication histories offered through e-prescribing networks. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Faruque, F. S.; Finley, R. W.
Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, "Airs, Waters, Places", yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient's medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient's "Geographic Medical History". In order to accomplish this we need information on: a) relevant spatiotemporal environmental variables, and b) location of the individual in that person's dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual's location can be tracked in real time if
McKenzie, D; Pifalo, V
The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.
The oral history helps researchers to fill the gap in historical documents in research on the contemporary history of medicine in Korea. More and more studies in history of contemporary medicine in Korea have come out using oral history of doctors and patients. Based upon the author's research on development of neurosurgery in late 20th century Korea, this paper discusses how to apply oral history to contemporary history of medicine, focusing on oral history of doctors in Korea. In this paper the author describes how to do and use oral history of key doctors and medical scientists in the contemporary history of medicine in Korea. The oral history can be a powerful tool to complement the written documents as following. First, from their interview, doctors and medical scientists often provide valuable information which historians cannot get from documents and written sources. As intelligent interviewees, they not only understand the purpose of research but also help actively the historianresearcher- interviewer. Second, the oral history facilitates further searches and often it leads to more findings of informants, and written and image material. More often than not, doctors and medical scientists do their own research on the topic and provide the historian with valuable historical source material from their laboratories, bedsides, family and friends. Third, interviews with medical scientists and oral material produced by doctors and medical scientists helped the researcher to understand and interpret the papers and written documents. Fourth, the subjective stories told by the medical scientists provide perspectives and historical source as narrative truth. Before a historian attempts to use the oral material as complementary historial evidence, he or she needs to cross-check the validity and of objectivity of the oral material. Oral material is produced through bidirectional intersubjective interaction between the interviewer and interviewee, and critical reflection
The philosophy of science yields 3 important functions in the teaching of medical history. Firstly, by analyzing the development of medicine from the perspective of philosophy, we can integrate medical history into the history of human thought and clearly show the close connection between the development of humanity and the development of medical science. Secondly, philosophical analysis on the general rules of scientific discoveries involved in medical history can help medical students to understand the methodology in the research of sciences in history. Thirdly, philosophy of science offers new dimensions for understanding the relationship between medicine and the society. By making use of the relevant theory in scientific philosophy to explore the relationship between medicine and the society, the nature of medicine and the social nature and function of science can be further understood by medical students so as to exert an active role in the research and clinical work in the future.
Full Text Available Longjing Medial College, established in Longjing, Yanbian, China on September 12, 1945, existed for about 1 year and 6 months until it was renamed as the Medical Department of Dongbei Junzheng Daxue Jilin Fenxiao in April 1947. However, there are only few records and studies on Longjing Medical College in Yanbian as well as in Korea. In order to fill the gap, this study attempted to restore the history of Longjing Medical College built in Yanbian, China immediately after the liberation. In particular, it analyzed how and why the Longjing Medical College was founded and operated, and which relations the college had with the post-war medical educational institutions, focusing on the ‘disconnection’ and ‘continuity’ in the historical sense. Since the establishment of Manchukuo, the Japanese colonial government had made it a major “frontier” and actively promoted the mass migration of Japanese and Koreans. For them, the government also set up three Exploitation Medical Schools in 1940. As a part of these three institutions, Longjing Exploitation Medical School educated more than 150 students by 1945, of which about one third was Korean. After the liberation, the Longjing Educational Alliance decided to pursue the return-movement of the Longjing Exploitation Medical School and took over the institution. On September 12, 1945, Longjing Medical College opened at the school site of Longjing Exploitation Medical School. Longjing Medical College was founded by people who had ‘the perspective of Korean nationality’ in an atmosphere where the ‘ethnicity’ of the Koreans exercised considerable power. Nevertheless, in 1946, when the Chinese Civil War began and the Yanbian region became an important base of the Chinese Communist Party, the Party began to expand and strengthen their influences in the region. Accordingly, the operation rights of Longjing Medical College were transferred to the Yanbian Administrative offices of Supervision and
Moon, Mira; Shin, Young-Jeon
Longjing Medial College, established in Longjing, Yanbian, China on September 12, 1945, existed for about 1 year and 6 months until it was renamed as the Medical Department of Dongbei Junzheng Daxue Jilin Fenxiao in April 1947. However, there are only few records and studies on Longjing Medical College in Yanbian as well as in Korea. In order to fill the gap, this study attempted to restore the history of Longjing Medical College built in Yanbian, China immediately after the liberation. In particular, it analyzed how and why the Longjing Medical College was founded and operated, and which relations the college had with the post-war medical educational institutions, focusing on the 'disconnection' and 'continuity' in the historical sense. Since the establishment of Manchukuo, the Japanese colonial government had made it a major "frontier" and actively promoted the mass migration of Japanese and Koreans. For them, the government also set up three Exploitation Medical Schools in 1940. As a part of these three institutions, Longjing Exploitation Medical School educated more than 150 students by 1945, of which about one third was Korean. After the liberation, the Longjing Educational Alliance decided to pursue the return-movement of the Longjing Exploitation Medical School and took over the institution. On September 12, 1945, Longjing Medical College opened at the school site of Longjing Exploitation Medical School. Longjing Medical College was founded by people who had 'the perspective of Korean nationality' in an atmosphere where the 'ethnicity' of the Koreans exercised considerable power. Nevertheless, in 1946, when the Chinese Civil War began and the Yanbian region became an important base of the Chinese Communist Party, the Party began to expand and strengthen their influences in the region. Accordingly, the operation rights of Longjing Medical College were transferred to the Yanbian Administrative offices of Supervision and Government of Jirinsheng which were the
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Full Text Available User authentication has been widely used by biometric applications that work on unique bodily features, such as fingerprints, retina scan, and palm vessels recognition. This paper proposes a novel concept of biometric authentication by exploiting a user’s medical history. Although medical history may not be absolutely unique to every individual person, the chances of having two persons who share an exactly identical trail of medical and prognosis history are slim. Therefore, in addition to common biometric identification methods, medical history can be used as ingredients for generating Q&A challenges upon user authentication. This concept is motivated by a recent advancement on smart-card technology that future identity cards are able to carry patents’ medical history like a mobile database. Privacy, however, may be a concern when medical history is used for authentication. Therefore in this paper, a new method is proposed for abstracting the medical data by using attribute value taxonomies, into a hierarchical data tree (h-Data. Questions can be abstracted to various level of resolution (hence sensitivity of private data for use in the authentication process. The method is described and a case study is given in this paper.
F. S. Faruque
Full Text Available Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes and lifestyle of the patient (behaviour, but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, “Airs, Waters, Places”, yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient’s medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient’s “Geographic Medical History”. In order to accomplish this we need information on: a relevant spatiotemporal environmental variables, and b location of the individual in that person’s dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual’s location
Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to hospital. Accurate medication histories are vital in optimising health outcomes and have been shown to reduce mortality rates. This study aimed to examine the accuracy of medication histories taken in the Emergency Department of the Royal Adelaide Hospital. Medication histories recorded by medical staff were compared to those elicited by a pharmacy researcher. The study, conducted over a six-week period, included 100 patients over the age of 70, who took five or more regular medications, had three or more clinical co-morbidities and/or had been discharged from hospital in three months prior to the study. Following patient interviews, the researcher contacted the patient’s pharmacist and GP for confirmation and completion of the medication history. Out of the 1152 medications recorded as being used by the 100 patients, discrepancies were found for 966 medications (83.9%. There were 563 (48.9% complete omissions of medications. The most common discrepancies were incomplete or omitted dosage and frequency information. Discrepancies were mostly medications that treated dermatological and ear, nose and throat disorders but approximately 29% were used to treat cardiovascular disorders. This study provides support for the presence of an Emergency Department pharmacist who can compile a comprehensive and accurate medication history to enhance medication management along the continuum of care. It is recommended that the patient’s community pharmacy and GP be contacted for clarification and confirmation of the medication history.
The emergence and the evolution of the idea has been followed for a professional organization of the Bulgarian doctors, the bearers of the idea being pointed out - personal and group. On the background of the existing already organization of the doctors in medical societies in Sofia, Plovdiv, Rousse, Lovech, Razgrad and others the efforts and the merits are emphasized of the Bulgarian medical society - Sofia and the Plovdiv medical society to convene the First medical convention and the foundation of the Bulgarian medical union. The formation of the major communities as to ideas is followed among the doctors and the emergence of the opposition among them.
Medical education and training in Australia comprises four phases: basic education, prevocational training, vocational training and continuing professional development. Between the 1860s and 1960s, eight medical schools were established in Australia, admitting school leavers to courses comprised of preclinical, paraclinical and clinical phases. Between the 1970s and the 1990s, two innovative new schools were established and all schools made major reforms to student selection, curricula and teaching, learning and assessment methods. Since 2000, student numbers expanded rapidly, both in existing medical schools and in eight new schools established to meet workforce demands, particularly in the rural sector. Prevocational training, first introduced as a compulsory internship year in the 1930s, has undergone reform and extension to subsequent years of junior doctor training through the agency of health departments and postgraduate medical education councils. Vocational training and continuing professional development, delivered by 15 specialist medical colleges, has evolved since the 1930s from a focus on specialist care of individual patients to include broader professional attributes required to manage complex health care systems. The Australian Medical Council began accreditation of basic medical education in 1985 and its remit now extends to all phases of medical education and training. With national governance of the entire system of medical education and training now achieved, mechanisms exist for flexible integration of all phases of medical education to meet the local and global challenges facing Australia's medical workforce.
Stevens, Rosemary A
Charles E. Rosenberg has had a major influence in defining the history of medicine as a field. However, critics who focus on his leadership or "school" in terms of defined scholarly perspectives, including those of social history and the framing of disease, offer inadequate descriptions of the messages, breadth, and scope of his scholarly work as a whole. Shoehorning the history of medicine into prescribed patterns in order to build a more unitary discipline would weaken rather than strengthen the field and is not in the Rosenberg tradition.
Huang, Simin; Xu, Peng; Feng, Lie; Lu, Chunting; Yang, Jing
History taking is an extremely important skill for medical students to master. In China, medical students usually have opportunities to practise this skill on real patients after they have learned diagnostics and basic relevant theoretical knowledge. Today, however, several factors, such as increased enrolment of medical students and the need to…
Corbel, Aline; Baud, David; Chaouch, Aziz; Beney, Johnny; Csajka, Chantal; Panchaud, Alice
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 (pprocess, which has been recognized as a very important component of patients' drug safety.
As adopted by the 1997 ... disciplines of modern medical sciences over the centuries is exciting, interesting and thoughtful2. Formal ... 300 BC, Hippocrates and Aristotle wrote about dentistry including the eruption pattern of teeth. These.
Hirnsperger, Hans; Mundschütz, Reinhard; Sonneck, Gernot
Beginning with Freudian psychoanalysis and the Zürich school of psychiatry, which in the early 20th century were the first to call for studies in medical psychology at universities, the article traces the path to the institutionalization of medical psychology in Austria especially in Vienna. Particular attention is devoted to the Academic Society for Medical Psychology (Akademischer Verein für Medizinische Psychologie) which held lectures and courses at the University of Vienna from 1926 to 1938. The Society can thus be viewed as a predecessor of the foundation of the institutes for medical psychology and psychotherapeutic clinics, starting in the late 1960s and continuing into the early 1980s.
IN THIS ARTICLE THE ACTUAL AND RELATIVE COSTS OF TUITION AT 3 Ontario medical schools are traced over the past 150 years. In addition, the factors that led to Ontario's nearly 4-decade experiment in private medical education (and to its eventual demise) are presented. In relative terms, tuition was stable for over a century, then declined (after 1960) as government support rose. Access to medical training for students from middle-income families may also have improved steadily until the late 1980s. Because there is no shortage of people wanting to become doctors, there seems to be no limit to the price that could be set for a medical education. The recent hikes in tuition have outstripped inflation and may be reducing accessibility to restrictive levels, similar to those that prevailed in the 19th century. The author invites readers to question current trends. PMID:11202668
In this article the actual and relative costs of tuition at 3 Ontario medical schools are traced over the past 150 years. In addition, the factors that led to Ontario's nearly 4-decade experiment in private medical education (and to its eventual demise) are presented. In relative terms, tuition was stable for over a century, then declined (after 1960) as government support rose. Access to medical training for students from middle-income families may also have improved steadily until the late 1980s. Because there is no shortage of people wanting to become doctors, there seems to be no limit to the price that could be set for a medical education. The recent hikes in tuition have outstripped inflation and may be reducing accessibility to restrictive levels, similar to those that prevailed in the 19th century. The author invites readers to question current trends.
Fetterolf, Donald; Brodie, Bridget
The American College of Medical Quality is a national organization of health care professionals who are interested in the advancement of medical quality as a field. Composed primarily of doctorate-level individuals in medicine, dentistry, and podiatry, it also includes affiliate members in preprofessional training as well as nursing. Origins of the organization date to 1973, when it was first called the American College of Utilization Review Physicians. It is formally recognized by the American Medical Association and holds a seat in its House of Delegates. The College views the advancement of medical quality as a field of study within itself and offers multiple venues for self-education, testing, and professional networking for its members. Recently, rising national awareness of quality in health care as a field of endeavor has elevated enrollment levels and increased interest in the organization.
M. Coolman (Marianne); C.J.M. de Groot (Christianne); V.W.V. Jaddoe (Vincent); A. Hofman (Albert); H. Raat (Hein); E.A.P. Steegers (Eric)
textabstractObjective: In this study, we assessed the validity of maternally self-reported history of preeclampsia. Study Design and Setting: This study was embedded in the Generation R Study, a population-based prospective cohort study. Data were obtained from prenatal questionnaires and one
. K. P. MOKHOBo, M.B., B.CH., F.c.P. (S.A.), Physician, .... history unnecessary or objectionable, namely, cultural prejudice and late presentation. ... tural outlook must provide the mirror through which the clinical picture is viewed. The success of ...
Lanier, Yzette; Castellanos, Ted; Barrow, Roxanne Y; Jordan, Wilbert C; Caine, Virginia; Sutton, Madeline Y
Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts.
Day, B.; Waitzkin, H.
Since World War II, individual physicians and medical organizations in the US have cooperated with the federal government in preparing for nuclear war. While most physicians have maintained a neutral stance, a minority have resisted federal policies. Health professionals participated actively at the wartime laboratories that developed the atomic bomb and in the medical research that followed Hiroshima and Nagasaki. Professional organizations helped with civil defense planning for nuclear conflict during the Cold War of the late 1950s and early 1960s. Medical resistance to nuclear war began in the same period, gained wide attention with the growth of Physicians for Social Responsibility in the early 1960s, declined during the Vietnam War, and vastly increased in the early 1980s. Activism by health professionals usually has responded to government policies that have increased the perceived risk of nuclear conflict. The recent return of civil defense planning has stimulated opposition in medical circles. Ambiguities of medical professionalism limit the scope of activism in the nuclear arena. These ambiguities concern the interplay of organized medicine and government, tensions between science and politics, and the difficulties of day-to-day work in medicine while the arms race continues
Morrison, Adrian R
Scientists frequently disagree on the interpretation of data. Such disagreements follow an informal set of rules, where one assumes that the contestants are honestly engaged even though biases may cloud their minds. A new group of individuals with medical training operates under a different set of rules, however: any statement or argument may be used to support the animal rightists' contention that using animals to advance human medicine is wrong. These "medical scientists" pervert the scientific discourse in which most of us engage. Their fabrications are egregious. They take legitimate scientists' statements out of context, construct statements out of larger passages to twist arguments in their favor, and cite works that actually are contrary to their arguments for effect. This essay reveals the distortions by a number of such medically trained individuals that I and several colleagues have uncovered.
Introduction: Medical history in Sudan is far from being complete. There are no reliable records. Attempt to write on the projects and development of history of TB in the Sudan is a difficult task. Objective: To study and trace the progress of TB in Sudan during the last century through their historical development. Design: A ...
Edrissian, Gholamhossein; Rokni, Mohammad Bagher; Mohebali, Mehdi; Nateghpour, Mehdi; Mowlavi, Gholamreza; Bahadori, Moslem
Parasites and parasitic diseases have been prevalent in Iran according to Iranian ancient scholars and physicians' inscriptions dating back to 865-1496. Some protozoan diseases such as malaria and cutaneous leishmaniasis have been introduced by clinical manifestations and helminthic infections by size and morphology of the worms. Scientific studies of Parasitology started in Iran from 1833, first by foreign physicians and continued from 1909 by Iranian researchers. The pioneer medical parasitologists of Iran were Dr N. Ansari and Dr. Sh. Mofidi who established the Department of Medical Parasitology in the School of Medicine, University of Tehran, 1939. Afterward, a considerable number of researchers and professors of parasitology have been active in training and research works in the fields of medical parasitology throughout the entire nation. At present, some significant parasitic diseases such as bilharsiasis and dracunculiasis are more or less eradicated and malaria is in the elimination phase. The prevalence of most helminthic infections has considerably decreased. Most of the departments of medical Parasitology in Iran are active in training MD, MSPH and PhD students. The Iranian Society of Parasitology established in 1994 is active with many eligible members and its creditable publication, the Iranian Journal of Parasitology, published seasonally since 2006. From 1833, when the scientific studies of Parasitology have started in Iran up to 2013, many researchers have been done on various fields of medical Parasitology and parasitic diseases in Iran and 2517 papers in English and 1890 papers in Persian have been published in national and international scientific journals. In addition, more than 420 books related in the field of medical parasitology field have been published in Persian language.
Willfors, C; Carlsson, T; Anderlid, B-M; Nordgren, A; Kostrzewa, E; Berggren, S; Ronald, A; Kuja-Halkola, R; Tammimies, K; Bölte, S
The environmental contributions to autism spectrum disorder (ASD) and their informative content for diagnosing the condition are still largely unknown. The objective of this study was to investigate associations between early medical events and ASD, as well as autistic traits, in twins, to test the hypothesis of a cumulative environmental effect on ASD risk. A total of 80 monozygotic (MZ) twin pairs (including a rare sample of 13 twin pairs discordant for clinical ASD) and 46 dizygotic (DZ) twin pairs with varying autistic traits, were examined for intra-pair differences in early medical events (for example, obstetric and neonatal factors, first year infections). First, differences in early medical events were investigated using multisource medical records in pairs qualitatively discordant for ASD. The significant intra-pair differences identified were then tested in relation to autistic traits in the remaining sample of 100 pairs, applying generalized estimating equations analyses. Significant association of the intra-pair differences in the MZ pairs were found for the cumulative load of early medical events and clinical ASD (Z=-2.85, P=0.004) and autistic traits (β=78.18, P=0.002), as well as infant dysregulation (feeding, sleeping abnormalities, excessive crying and worriedness), when controlling for intelligence quotient and attention deficit hyperactivity disorder comorbidity. The cumulative load of early medical events in general, and infant dysregulation in particular, may index children at risk of ASD owing to non-shared environmental contributions. In clinical practice, these findings may facilitate screening and early detection of ASD.
Full Text Available Introduction: Family history of hypertension in medical students is an important, non-modifiable risk factor for hypertension in future. Aim: To determine the prevalence of sustained hypertension in young asymptomatic medical students with a parental history of hypertension. Materials and Methods: A cross-sectional study was conducted in a medical college of Dehradun. A total of 104 medical students with parental history of hypertension (Group A and 100 medical students without a parental history of hypertension (Group B were included. Electronically blood pressures were recorded on two separate occasions at an interval of 15 days. Comparison was done using Chi-square test/Likelihood ratio, Un-paired t-test and ANCOVA. Results: Overall, Group A had significantly higher percentage of prehypertensive (56.7% and hypertensive (17.3% students as compared to Group B which were 19% and 1%, respectively. Group A students had significantly higher Systolic Blood Pressure (SBP and Diastolic Blood Pressure (DBP as compared to Group B, even after controlling for the differences in Body Mass Index (BMI and gender (p<0.001. Conclusion: Hypertension was significantly higher in asymptomatic, healthy medical students with parental history of hypertension as compared to those with normotensive parents. We need to orient medical students to improve their knowledge, attitude and lifestyle practices early in life to prevent, treat hypertension and prevent its subsequent morbidity and mortality.
Hasman, Arie; Mantas, John; Zarubina, Tatyana
This contribution presents the development of medical informatics education in Europe. It does not discuss all developments that took place. Rather it discerns several themes that indicate the progress in the field, starting from the initiation phase to the final quality control phase. PMID:24648617
, scant attention has been paid to the psychological processes that underpin mental toughness. Objectives: To explore the relationship between mindfulness and mental toughness among provincial adolescent female hockey players.
Seebacher, C; Blaschke-Hellmessen, Renate; Kielstein, P
After the Second World War the development of medical mycology in Germany had taken a very different course in the east and west parts depending on the political division. In this respect our contribution deals with the situation in the former German Democratic Republic. Efficient mycological centres were founded step by step almost in all medical universities on the basis of the mycological laboratories in dermatological hospitals competent for diagnostic work, but also for teaching and scientific research. In this context biologists were the main stay of mycology, they finally were integrated to the same degree in the universities like physicians. The effectiveness of the Gesellschaft für Medizinische Mykologie der DDR (GMM), its board of directors and its working groups as well as the topics of human and animal mycology during this period are described. Especially the merger of the GMM with the Deutschsprachige Mykologische Gesellschaft after the reunification of Germany without problems and the kind co-operation of Prof. Dr. Johannes Müller during this procedure are emphasized.
Wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region because of the laxity of the peritoneal attachments. Many patients with wandering spleen are asymptomatic, hence the condition can be discovered only by abdominal examination or at a hospital emergency department if a patient is admitted to hospital because of severe abdominal pain, vomiting or obstipation. This article aims to provide a historical overview of wandering spleen diagnostics and surgical treatment supplemented with an analyses of articles on wandering spleen included in the PubMed database. One of the first clinical descriptions of a wandering spleen was written by Józef Dietl in 1854. The next years of vital importance are 1877 when A. Martin conducted the first splenectomy and in 1895 when Ludwik Rydygier carried out the first splenopexy to immobilize a wandering spleen. Since that time various techniques of splenectomy and splenopexy have been developed. Introducing medical technologies was a watershed in the development and treatment of wandering spleen, which is confirmed by the PubMed database. Despite the increased number of publications medical literature shows that a wandering spleen still remains a misdiagnosed condition, especially among children.
Chetlen, Alison L; Mendiratta-Lala, Mishal; Probyn, Linda; Auffermann, William F; DeBenedectis, Carolynn M; Marko, Jamie; Pua, Bradley B; Sato, Takashi Shawn; Little, Brent P; Dell, Carol M; Sarkany, David; Gettle, Lori Mankowski
Simulation is a promising method for improving clinician performance, enhancing team training, increasing patient safety, and preventing errors. Training scenarios to enrich medical student and resident education, and apply toward competency assessment, recertification, and credentialing are important applications of simulation in radiology. This review will describe simulation training for procedural skills, interpretive and noninterpretive skills, team-based training and crisis management, professionalism and communication skills, as well as hybrid and in situ applications of simulation training. A brief overview of current simulation equipment and software and the barriers and strategies for implementation are described. Finally, methods of measuring competency and assessment are described, so that the interested reader can successfully implement simulation training into their practice. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.
For millennia, a red face has been a handicap in social relations, mainly because of the associated bias against alcoholics. The color red is also the color of emotion, betrayal of the person who blushes. Since the color red is one of the main characteristics of rosacea, it contributes to the bad reputation this disorder has, which is therefore the subject of a pressing therapeutic demand, principally in women. Nineteenth-century French novelists such as Balzac and later Proust, admirably described blotchy, red, or sanguine faces, which always announced a difficult, violent temperament, or was simply the mark of the laboring class. The color red remains ambivalent today, on the one hand denoting blood and life and on the other suffering, shame, and death. The history of dermatology shows that the semiology of rosacea was very well described in the earliest reports, notably those written in the Middle Ages. The term "acne rosacea" appeared in Bateman's writings, who made it a clinical form of acne. This confusion lasted throughout the nineteenth century. It was not until Hebra in Austria and Darier in France that the differential diagnosis was clearly made between acne and rosacea. A "couperosis" previously referred to the entire range of the disease, particularly the papules and pustules, and it was not until the twentieth century that the current meaning of rosacea progressively gained ground: this term today designates facial telangiectasia, whether or not it is associated with a characteristic redness. Copyright © 2011 Elsevier Masson SAS. All rights reserved.
This assessment of provincial government performance on climate change is intended as a 'baseline' prior to the implementation of the National Implementation Strategy on Climate Change, (NIS) scheduled to be signed by the federal and provincial Ministers of Energy and Environment in Quebec City in October 2000. Participants are also expected to agree on a 'First Business Plan' for the NIS at that same meeting, including identification of measures each of the provincial governments plan to institute to address climate change issues over the next two to three years. The report is based on performance of government activity in climate change in Alberta, British Columbia, Saskatchewan, Ontario and Quebec , the five provinces that together account for 89 per cent of Canada's total GHG emissions, against the greenhouse gas emission measures identified by the various provincial governments on various occasions over the past 10 years. Nine areas of potential activity to address climate change with a total of 38 criteria were used. Each criterion was used to determine whether or not a provincial government has implemented a specific measure that will likely be an integral component of a national effort to address climate change. The nine categories forming the base of the assesment were: transportation, electricity generation,buildings, industry, readiness to facilitate emissions trading, 'own house in order' other sources of GHG, promoting GHG reduction technology development, and enhancing awareness and public education. All provincial governments received a very poor, failing grade . (The 'best': British Columbia with 30.5 per cent; the 'worst': Saskatchewan with 20.5 per cent). The report characterizes the last 10 years as 'the lost decade' with respect to government action on the issue of climate change. It points out that time is running out; provincial governments have to make the effort to be part of the solution to climate change, or they will have solutions
For millennia, a red face has been a handicap in social relations, mainly because of the associated bias against alcoholics. The color red is also the color of emotion, betrayal of the person who blushes. Since the color red is one of the main characteristics of rosacea, it contributes to the bad reputation this disorder has, which is therefore the subject of a pressing therapeutic demand, principally in women. Nineteenth-century French novelists such as Balzac and later Proust, admirably described blotchy, red, or sanguine faces, which always announced a difficult, violent temperament, or was simply the mark of the laboring class. The color red remains ambivalent today, on the one hand denoting blood and life and on the other suffering, shame, and death. The history of dermatology shows that the semiology of rosacea was very well described in the earliest reports, notably those written in the Middle Ages. The term "acne rosacea" appeared in Bateman's writings, who made it a clinical form of acne. This confusion lasted throughout the nineteenth century. It was not until Hebra in Austria and Darier in France that the differential diagnosis was clearly made between acne and rosacea. A "couperosis" previously referred to the entire range of the disease, particularly the papules and pustules, and it was not until the twentieth century that the current meaning of rosacea progressively gained ground: this term today designates facial telangiectasia, whether or not it is associated with a characteristic redness. Rosacea is a conspicuous disease, since the lesions involve the central portion of the face.Among the many manifestations of rosacea, redness is the most characteristic . Copyright © 2011 Elsevier Masson SAS. All rights reserved.
Rowland, Stephen M.
Provides background material and laboratory procedures for an activity which requires students to compare (in quantitative terms) fossils from 10 localities and to objectively define provinces, regions, and realms. These paleobiogeographic relationships are then used to reconstruct the drift histories of the three continents on which the 10…
This essay explores the multiple sites where disability appears in the history of medicine and suggests ways in which medical historians can self-consciously incorporate a disability perspective into their own work. Just as medical historians have much to learn from disability historians, disability historians could benefit from looking more closely at the history of medicine. While disability cannot (and should not) be reduced to disease, the fact remains that some forms of disability are brought about by disease processes, and some require daily regimes of home health care, therapy, and pain management. How the disabled have interacted with health care institutions, caretakers, and the medical establishment is too significant to be written out of its history.
Schulz, Stefan; Woestmann, Barbara; Huenges, Bert; Schweikardt, Christoph; Schäfer, Thorsten
Objectives: It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE) - or the lack thereof - has on the judgement of these subjects. Methods: From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). Results: 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Conclusion: Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative
Taylor, Simone; Welch, Susan; Harding, Andrew; Abbott, Leonie; Riyat, Baljit; Morrow, Mel; Lawrence, Dona; Rodda, Sheridan; Heward, Sarah
Clinical handover and obtaining best possible medication histories (BPMH) at transition points in care are key patient safety pri-orities. This study aimed to determine the accuracy of medication histories documented on general practitioner (GP) referral letters for patients referred to emergency departments. This was a multicentre prospective observational study in eight emergency departments. Patients taking ≥1 regular medication, referred to the emergency department with a GP letter and seen by a pharmacist were included. GP medication regimens were compared with BPMH documented by the emergency department pharmacist. Of the GP letters (total 414), 361 (87%) had one or more discrepancies in the patients' regular medications and 62% had one or more regular medication discrepancies of moderate-high significance. Omission of medication was more prevalent in hand-written letters (P DISCUSSION: GP referral letters should not be used in isolation to determine the medication regimen taken before an emergency department presentation. Interventions are indicated to improve awareness and accuracy of medication documentation.
Weisshaar, E; König, A; Diepgen, T L; Eckart, W U
Pruritus (itching) as a disease state and especially as a disease symptom has been object of medical and scientific descriptions and examinations in all epochs since the antiquity and in different cultural periods. Antiquity was dominated by observations and descriptions but during the course of medical history and particularly since the establishment of dermatology, more and more emphasis has been placed on classification and etiologic research.
Hu, A H; Wan, S M
History of Famous Family in Xin'an includes abundant information and important value of the medical cultural history, including the medical family, medical ethics and the number of the famous doctors and its distribution, the medical books and its outline the medical ethics, the diseases. As for the 115 famous doctors recorded in this book, Shexian county owns the most while Jixi county owns the least, and of the average number of famous doctors among the 10, 000 local people, Yixian county owns the most while Xiuning county owns the least. History of Famous Family in Xin'an includes 26 medical books, ranging from medical literature study, gynecological treatment, external medical treatment, diagnosis and treatment of pediatric diseases, ancient medical case records, medical education, acu-moxibustion and summary of other medical experiences. The book also demonstrates the noble morality of doctors, development of doctor' family, and records of paralytic stroke, epistaxis, tuberculous consumptive diseases, furunculosis, dystocia and some infectious diseases.
Sun, Xiaoqi; An, Haizhong; Liu, Xiaojia
Global economic system is a huge network formed by national subnetworks that contains the provincial networks. As the second largest world economy, China has "too big to fail" impact on the interconnected global economy. Detecting the critical sectors and vital linkages inside Chinese economic network is meaningful for understanding the origin of this Chinese impact. Different from tradition network research at national level, this paper focuses on the provincial networks and inter-provincial network. Using Chinese inter-regional input-output table to construct 30 provincial input-output networks and one inter-provincial input-output network, we identify central sectors and vital linkages, as well as analyze economic structure similarity. Results show that (1) Communication Devices sector in Guangdong and that in Jiangsu, Transportation and Storage sector in Shanghai play critical roles in Chinese economy. (2) Advanced manufactures and services industry occupy the central positions in eastern provincial economies, while Construction sector, Heavy industry, and Wholesale and Retail Trades sector are influential in middle and western provinces. (3) The critical monetary flow paths in Chinese economy are Communication Devices sector to Communication Devices sector in Guangdong, Metals Mining sector to Iron and Steel Smelting sector in Henan, Communication Devices sector to Communication Devices sector in Jiangsu, as well as Petroleum Mining sector in Heilongjiang to Petroleum Processing sector in Liaoning. (4) Collective influence results suggest that Finance sector, Transportation and Storage sector, Production of Electricity and Heat sector, and Rubber and Plastics sector in Hainan are strategic influencers, despite being weakly connected. These sectors and input-output relations are worthy of close attention for monitoring Chinese economy.
Full Text Available This paper investigates the effect of provincial corruption on the performance of local development bank, specifically to the profitability and credit quality. We use the data of 26 local development banks in 2012 and 2013. For the provincial corruption measurement we use “Public Institution Openness Index”. Results of this study are first, corruption significantly has a negative effect on the profitability of local development bank. Second, corruption doesn’t affect the credit quality of local development bank. These results are expected to enrich the within country corruption effect to the economic studies, particularly to the local development bank which is infrequently investigated.
Canfield, Dennis V; Salazar, Guillermo J; Lewis, Russell J; Whinnery, James E
.... This database was searched to identify all pilots found positive for medications used to treat cardiovascular, psychological, or neurological conditions over the period 1 Jan 1993 through 31 Dec 2003...
Luttjeboer, F.; Verhoeve, H. R.; van Dessel, H. J.; van der Veen, F.; Mol, B. W. J.; Coppus, S. F. P. J.
Guidelines recommend diagnostic laparoscopy in subfertile women with known co-morbidities in their medical history. Aggregated evidence underpinning these recommendations is, however, currently lacking. The objective of this study was to perform a systematic review and meta-analysis of the available
Schmidt, Josef M
As a paradigmatic case study of the origin, spread, and development of medical systems, this paper investigates the 200-years history of homeopathy from different perspectives of medical history. On the basis of new research on Samuel Hahnemann (1755-1843), first, a concise and critical overview on the principles, explanations, and implications of his doctrine is presented. The historical, conceptual, and social background of the founder of homeopathy is then elaborated in terms of history of medicine, science, philosophy, sociology, culture, and ideas, as well as theory of science, theory of communication, and sociology of science. The process of the world wide spread of homeopathy is examined from different points of view, ranging from history of heroes, institutions, professionalisation, politics, economics, religion, and organisations to history of patients, perception, and semiotics. Finally, a comparative approach to the different development and status of homeopathy in different countries results in the extraction of a set of crucial variables, such as charismatic personage, influential patronage, economic sponsorship, political protection, media support, and patients' demand, which might explane a major part of these differences. Eventually, the notorious splits of homeopathy's doctrine suggest the idea that--in analogy to theory of evolution--a variety of concurrent strains (rather than one monolithic block) of a doctrine may prove to be a kind of advantage for survival. In conclusion, acceptance and relevance of medical systems are determined by many factors. Since external ones are usually outweighing internal ones, medical history may offer a broader and more comprehensive understanding of the dynamics of their spread and development than clinical trials and scientific objection alone.
Kaproncszay, Katalin; Magyar, László András; Putnam, Constance E
Objectives: The 170-year history of the library of the Royal Society of Medicine in Budapest illustrates both that political and cultural context matter and that “medical” libraries, if they survive, in due course become primarily “medical history” libraries. Methods: Two of the authors are on the staff of the Semmelweis Medical History Library; the third is a US scholar who makes frequent use of the library. Together, they avail themselves of archival and published materials—and personal experience with the collection—to establish the context that produced the original library, trace its evolution, and describe its present-day incarnation. Results: A tale of transformation emerges that reflects how collections are likely to change. The authors present events and individuals in the life of the Royal Society's library and paint a picture of the value of today's Semmelweis Medical History Library. Unique treasures in the collection are described. Conclusion: The story told here is of how a particular nineteenth-century library became a twenty-first–century institution. The authors establish its peculiarly Hungarian context and potential value to librarians and historians from outside Hungary. The overall message is that general medical libraries everywhere are perforce likely to become medical historical libraries over time. PMID:21243053
Kathryn van Boom
The results of the current study indicate that mindfulness is significantly and positively correlated with not only global mental toughness, but also with confidence, constancy and control. This suggests that as mindfulness increases among provincial female hockey players, so does their general level of mental toughness.
Erika E. Reid
Full Text Available There is little written about the history of women in dermatology. In this paper, we summarize the information obtained from archival records from the Woman’s Medical College of Pennsylvania, one of the first medical schools for women, where several of the early prominent women in dermatology obtained their medical degrees and practiced. Among others, graduates include Rose Hirschler, MD, and Margaret Gray Wood, MD. The school and its graduates made important contributions to dermatology and to the advancement of women in the field. The history of women in dermatology is not well documented, and this historical research provides background in the biographies of pioneering women in an effort to preserve and honor their important work.
Monekosso, G L
Developments in medical education in Sub-Saharan Africa over the past 100 years have been characterized by the continent's unique history. During the first half of the 20th century, the Europeans effectively installed medical education in their African colonies. The years 1950 to 1960 were distinguished by successful movements for independence, with new governments giving priority to medical education. By 1980, there were 51 medical schools in Sub-Saharan Africa. The period from 1975 to 1990 was problematic both politically and economically for Sub-Saharan Africa, and medical schools did not escape the general difficulties. War, corruption, mounting national debts, and political instability were characteristics of this period. In many countries, maintaining medical school assets--faculty members, buildings, laboratories, libraries--became difficult, and emigration became the goal of many health professionals. In contrast, the past 20 years have seen rapid growth in the number of medical schools in Sub-Saharan Africa. Economic growth and political stability in most Sub-Saharan African countries augur well for investment in health systems strengthening and in medical education. There are, nonetheless, major problem areas, including inadequate funding, challenges of sustainability, and the continuing brain drain. The 20th century was a time of colonialism and the struggle for independence during which medical education did not advance as quickly or broadly as it did in other regions of the world. The 21st century promises a different history, one of rapid growth in medical education, leading to better care and better health for the people of Africa.
Abi Raad, Vanda; Raad, Kareem; Daaboul, Yazan; Korjian, Serge; Asmar, Nadia; Jammal, Mouin; Aoun Bahous, Sola
With the adoption of the English language in medical education, a gap in clinical communication may develop in countries where the native language is different from the language of medical education. This study investigates the association between medical education in a foreign language and students' confidence in their history-taking skills in their native language. This cross-sectional study consisted of a 17-question survey among medical students in clinical clerkships of Lebanese medical schools. The relationship between the language of medical education and confidence in conducting a medical history in Arabic (the native language) was evaluated (n = 457). The majority (88.5%) of students whose native language was Arabic were confident they could conduct a medical history in Arabic. Among participants enrolled in the first clinical year, high confidence in Arabic history-taking was independently associated with Arabic being the native language and with conducting medical history in Arabic either in the pre-clinical years or during extracurricular activities. Among students in their second clinical year, however, these factors were not associated with confidence levels. Despite having their medical education in a foreign language, the majority of students in Lebanese medical schools are confident in conducting a medical history in their native language.
Vanda Abi Raad
Full Text Available Abstract Background With the adoption of the English language in medical education, a gap in clinical communication may develop in countries where the native language is different from the language of medical education. This study investigates the association between medical education in a foreign language and students’ confidence in their history-taking skills in their native language. Methods This cross-sectional study consisted of a 17-question survey among medical students in clinical clerkships of Lebanese medical schools. The relationship between the language of medical education and confidence in conducting a medical history in Arabic (the native language was evaluated (n = 457. Results The majority (88.5% of students whose native language was Arabic were confident they could conduct a medical history in Arabic. Among participants enrolled in the first clinical year, high confidence in Arabic history-taking was independently associated with Arabic being the native language and with conducting medical history in Arabic either in the pre-clinical years or during extracurricular activities. Among students in their second clinical year, however, these factors were not associated with confidence levels. Conclusions Despite having their medical education in a foreign language, the majority of students in Lebanese medical schools are confident in conducting a medical history in their native language.
Pusey, Damien; Smith, Lisette; Zeman, Elaine M.; Adams, Robert
During the last century, the creation and implementation of board certification has had a powerful impact on the medical community. Board certification has helped to shape the scope and practice of medical professionals and the care they provide, as well as to influence the way the health insurance industry sets standards for reimbursement. One profession that offers board certification to its members is medical dosimetry. The Medical Dosimetrist Certification Board exam has been administered since 1988 and its content covers a broad spectrum of information from the radiation therapy sciences. The exam has strict application requirements and is rather difficult to pass. Those who pass the exam can then call themselves Certified Medical Dosimetrists. For data purposes of this study, several members of the dosimetry community were solicited to participate in a survey regarding the exam's content and history, and to provide relevant statistical data. Currently 2,177 medical dosimetrists are board certified, with an additional 1,500 estimated to be working without certification. Although board certification is not currently required to practice medical dosimetry, new legislation known as the CARE Bill could change this. The CARE Bill, if passed, would mandate nationwide compulsory licensure and/or certification for medical dosimetrists and other medical professionals who want to work in radiation-related health care. Health maintenance organizations and other insurance carriers may likewise require certification for reimbursement purposes
Full Text Available The study involves the determination of Provincial Logistics Capability for South African provinces. Provincial Logistic Capability (PLC) is the effectiveness and efficiency of a province in facilitating logistics activities both within the province...
Abraham-Inpijn, Luzi; Russell, Gordon; Abraham, Didi A.; Baeckman, Nils; Baum, Erika; Bullon-Fernandez, Philip; Declerck, Dominique; Fricain, Jean-Christophe; Georgelin, Marie; Karlsson, Karl O.; Lamey, Philip J.; Link-Tsatsouli, Iris; Rigo, Orsolya
Objective. The objective of this study was to produce a standardized medical risk-related history (MRRH) in order to identify the medically compromised patient (MCP) attending the general dental practitioner for treatment, to develop such a history (EMRRH), and to validate it in dental practices in
matters of medical history.” ~Surg. B.L Wright, MC, USN THE GROG 13 32. Ibid. 33. Goosby, Eric. "TB the Forgotton Global Health Threat." The Hill, June 9...2015. (http://thehill.com/blogs/congress-blog/ healthcare/244367-tb-the-forgotten- global -health-threat, accessed on December 27th, 2015) Wright’s Way...all excesses of animal appetites and the selection of climate must be carried out.” homeless population.31 Over its 14-year history as a Navy
Oral manifestation of HIV/AIDS in a Kenyan provincial hospital. F. M. A. Butt, M. L. Chindia, V. P. Vaghela, K. Mandalia. Abstract. (East African Medical Journal 2001 78 (8): 398-401). Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
Fiona G Kouyoumdjian
Full Text Available Substance use and substance use disorders are common in people who experience detention or incarceration in Canada, and opioid agonist treatment (OAT may reduce the harms associated with substance use disorders. We aimed to define current physician practice in provincial correctional facilities in Ontario with respect to prescribing OAT and to identify potential barriers and facilitators to prescribing OAT.We invited all physicians practicing in the 26 provincial correctional facilities for adults in Ontario to participate in an online survey.Twenty-seven physicians participated, with representation from most correctional facilities in Ontario. Of participating physicians, 52% reported prescribing methadone and 48% reported prescribing buprenorphine/naloxone to patients in provincial correctional facilities. Nineteen percent of participants reported initiating methadone treatment and 11% reported initiating buprenorphine/naloxone for patients in custody. Participants identified multiple barriers to initiating OAT in provincial correctional facilities including concerns about medication diversion and safety, concerns about initiating treatment in patients who are not currently using opioids, lack of linkage with community-based providers and the Ministry of Community Safety and Correctional Services policy. Identified facilitators to initiating OAT were support from institutional health care staff and administrative staff, adequate resources for program delivery and access to linkage with community-based OAT providers.This study identifies opportunities to improve OAT programs and to improve access to OAT for persons in provincial correctional facilities in Ontario.
Wright, A; Wright, D; Ispas, C A; Poon, L C; Nicolaides, K H
To define the contribution of maternal variables that influence the measured mean arterial pressure (MAP) in screening for pregnancy complications. Maternal characteristics and medical history were recorded, and MAP was measured, in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6 weeks, 19 + 0 to 24 + 6 weeks and 30 + 0 to 34 + 6 weeks or 35 + 0 to 37 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths at ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of MAP were determined from linear mixed-effects multiple regression analysis. MAP was measured in 75 841 cases in the first trimester, 30 447 in the second trimester and 31 673 in the third trimester. Significant independent contributions to MAP were provided by gestational age, maternal age, weight, height, Afro-Caribbean racial origin, cigarette smoking, family history of pre-eclampsia (PE), history of PE in the previous pregnancy, interpregnancy interval, chronic hypertension and diabetes mellitus. The effects of some variables were similar, and for others differed, in the three different trimesters. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured MAP and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed PE and in those without this complication. A model was fitted to express the measured MAP as MoMs after adjustment for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Partin, Clyde; Kushner, Howard I; Horton, Mary E Kollmer
Well-intentioned attempts by the Senate Finance Committee to improve the content and quality of continuing medical education (CME) offerings had the unanticipated consequence of decimating academically oriented history of medicine conferences. New guidelines intended to keep CME courses free of commercial bias from the pharmaceutical industry were worded in a fashion that caused CME officials at academic institutions to be reluctant to offer CME credit for history of medicine gatherings. At the 2013 annual conference of the American Association for the History of Medicine, we offered a novel solution for determining CME credit in line with current guidelines. We asked attendees to provide narrative critiques for each presentation for which they desired CME credit. In this essay, we evaluate the efficacy of this approach.
Maas, Matthew B; Naidech, Andrew M; Kim, Minjee; Batra, Ayush; Manno, Edward M; Sorond, Farzaneh A; Prabhakaran, Shyam; Liotta, Eric M
We evaluated whether reduced platelet activity detected by point-of-care (POC) testing is a better predictor of hematoma expansion and poor functional outcomes in patients with intracerebral hemorrhage (ICH) than a history of antiplatelet medication exposure. Patients presenting with spontaneous ICH were enrolled in a prospective observational cohort study that collected demographic, clinical, laboratory, and radiographic data. We measured platelet activity using the PFA-100 (Siemens AG, Germany) and VerifyNow-ASA (Accumetrics, CA) systems on admission. We performed univariate and adjusted multivariate analyses to assess the strength of association between those measures and (1) hematoma growth at 24 hours and (2) functional outcomes measured by the modified Rankin Scale (mRS) at 3 months. We identified 278 patients for analysis (mean age 65 ± 15, median ICH score 1 [interquartile range 0-2]), among whom 164 underwent initial neuroimaging within 6 hours of symptom onset. Univariate association with hematoma growth was stronger for antiplatelet medication history than POC measures, which was confirmed in multivariable models (β 3.64 [95% confidence interval [CI] 1.02-6.26], P = .007), with a larger effect size measured in the under 6-hour subgroup (β 7.20 [95% CI 3.35-11.1], P < .001). Moreover, antiplatelet medication history, but not POC measures of platelet activity, was independently associated with poor outcome at 3 months (mRS 4-6) in the under 6-hour subgroup (adjusted OR 3.6 [95% CI 1.2-11], P = .023). A history of antiplatelet medication use better identifies patients at risk for hematoma growth and poor functional outcomes than POC measures of platelet activity after spontaneous ICH. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.
This paper reports on medical history from the end of the Edo period to the present and development of studies on infectious diseases, especially medical mycology including systemic fungal diseases. With the inflow of Dutch studies at the end of the Edo period and the adoption of European, mainly German, medicine in the Meiji Restoration, Japanese medical studies gradually developed. However, evolution in the medical field as well as other scientific fields was prevented during the 2nd World War. After the War, there was marked progress in scientific fields and medical research made strong advances. In the past 20 years, basic fungal studies and clinical fungal diseases, especially clinical analysis, clinical diagnosis and treatment of systemic fungal infections have progressed. The level in this field is now equivalent to or higher than that in European countries. Further development is necessary, however, to relieve patients suffering from systemic fungal infections. Members of the Japanese Association of Medical Mycology must be leaders among international medical mycologists.
Full Text Available Many forms of biometrics have been proposed and studied for biometrics authentication. Recently researchers are looking into longitudinal pattern matching that based on more than just a singular biometrics; data from user’s activities are used to characterise the identity of a user. In this paper we advocate a novel type of authentication by using a user’s medical history which can be electronically stored in a biometric security card. This is a sequel paper from our previous work about defining abstract format of medical data to be queried and tested upon authentication. The challenge to overcome is preserving the user’s privacy by choosing only the useful features from the medical data for use in authentication. The features should contain less sensitive elements and they are implicitly related to the target illness. Therefore exchanging questions and answers about a few carefully chosen features in an open channel would not easily or directly expose the illness, but yet it can verify by inference whether the user has a record of it stored in his smart card. The design of a privacy preserving model by backward inference is introduced in this paper. Some live medical data are used in experiments for validation and demonstration.
Shin, Young-Jeon; Park, Se-Hong
borderlands or frontiers of Joseon Korea, China, and Japan, where the history of the three nations met and intermingled with one another. He was a biochemist and researcher, practicing physician and medical professor of the era under Japanese Rule and the one following it. In modern Korean medicine, his life is viewed as a history of the borders, or a transnational legacy going beyond individual history of Korea, China, and Japan.
Medical education research is a maturing field of inquiry that derives theoretical perspectives from many domains. Yet while such theoretical diversity holds the promise of rich paradigmatic writing and debate, too often medical education researchers do not place their work in a historical or cultural context, giving the impression that they have somehow unearthed universal 'truths' about medical education. This paper introduces some of the key 'histories' of medical education from the contexts of Anglophone Canada and the USA following a review of major works in the history of medical education. There are many and conflicting histories of medical education in North America that can be classified according to different socio-historical paradigms. To avoid the error of over-generalisation, a much greater effort must be made to include historical, sociological, economic and other social science perspectives in the design, interpretation and application of medical education research.
Ng, C J; McCarthy, S A
Taking a sexual history and discussing sexual health issues with patients form an important part of a medical consultation. These specific communication skills can be acquired through various teaching methods. This paper describes the communication skill workshops conducted for undergraduate medical students on how to talk to patients about sex. 198 medical students participated in a series of workshops conducted in the University of Malaya in 2001-2002. Pre- and post-workshop evaluations of the programme were carried out to find out the students' difficulties and to assess the usefulness of the workshop. The workshop consisted of a short lecture, role-plays and discussion. Only 34% of the participants had received some informal training during their clinical years. The main barriers encountered were gender and age differences, language and choice of words, patients and doctors feeling shy, and cultural differences. The workshop was felt to be useful (mean score 4.38, maximum 5.0), most students felt comfortable during the workshop (mean score 4.10, maximum 5.0) and there was significant improvement in the "comfort level" when talking to patients about sex after attending the workshop (P Gender, language and cultural differences were the main barriers in taking a sexual history and discussing sexual health issues among the medical students. Communication workshop was felt to be a useful and comfortable method of learning these specific.
Changizi Ashtiyani, Saeed; Cyrus, Ali
Abu Bakr Mohammad Ibn Zakariya Razi, known in the west as Rhazes (865 to 925 AD), was born in the ancient city of Rayy, near Tehran, Iran. He was a renowned physician in medical history and not only followed Hippocrates and Galen, but also greatly extended the analytical approach of his predecessors. Based on the existing documents, he was known as the most distinguished character in the world of medicine up to the 17th century. A great number of innovations and pioneering works in the medical science have been recorded in the name of Rhazes. His fundamental works in urology as part of his research in the realm of medicine have remained unknown. Pathophysiology of the urinary tract, venereal diseases, and kidney and bladder calculi are among his main interests in this field. He also purposed and developed methods for diagnosis and treatment of kidney calculi for the first time in medical history. He also presented a very exact and precise description of neuropathic bladder followed by vertebral fracture. He advanced urine analysis and studied function and diseases of the kidneys. Rhazes recommendations for the prevention of calculi are quite scientific and practical and in accordance with current recommendations to avoid hypercalciuria and increased saturation of urine. Rhazes was not only one of the most important Persian physician-philosophers of his era, but for centuries, his writings became fundamental teaching texts in European medical schools. Some important aspects of his contributions to medicine are reviewed.
Alexej von Jawlensky (1864-1941), one of the most important expressionist painters and a member the artist group "The Blue Four", suffered from severe rheumatoid arthritis. He was the first painter in the twentieth century to create extensive series of paintings especially of human faces. The medical history of Jawlensky as documented in his letters, is a harrowing document of a great artist who suffered from rheumatoid arthritis at a time when medical treatment was limited to physical therapy, pain medication and other relatively ineffective modalities, including the unnecessary extraction of teeth. Jawlensky's disease was characterized by a rapidly progressive course with severe pain, rapid onset of disability and ending up with complete immobilization and paralysis for several years until his death.The artistic processing and sublimation of his illness and suffering resulting in a series of over 1,000 small format meditations are the impressive and touching example of creative coping with rheumatoid arthritis. The meditations are unique in the history of art and often compared with icons. However, knowing the medical condition of Jawlensky these paintings can also be seen as metaphors of suffering and in each image the great physical and mental effort is reflected in the artistic details. Therefore, his art agent Galka E. Scheyer formulated in a letter to him: "You are the painter of the human soul. I know of no other modern painter of the human soul."
Drummond, Rachel; Gall, John A M
Suspected child physical abuse, sexual abuse and neglect are not uncommon presentations. As part of the assessment of these cases, a forensic medical history may be taken. This forensic history is used not only to determine the steps necessary to address the child's wellbeing but also to direct the forensic examination. Currently, there is no clear consensus on whether or not a forensic medical history should consistently be considered an integral element within the paediatric forensic evaluation. This study examines the value derived by the medical practitioner taking a forensic medical history rather than relying on hearsay evidence when a child presents for an assessment. A retrospective review of paediatric cases seen by the Victorian Forensic Paediatric Medical Service (VFPMS) between 2014 and 2015 was undertaken. 274 forensic case reports were reviewed and the data was entered into an Excel spread sheet and analysed using chi squared tests within STATA ® . With increasing age of the child, a forensic medical history is significantly more likely to be taken. Additional information is made available to the medical practitioner what would otherwise have been provided if the medical practitioner relied only on the interview conducted by the police. Discrepancies observed between the official third parties (police or child protection) report of what a child has said and what the child says to the medical practitioner decrease with age, as do discrepancies observed between the child's version of events and a third party's (eg. parents, caregivers, friends) version of events. The study showed that by taking a forensic medical history from the child additional information can be obtained. Further, that there is a value in the examining medical practitioner taking a forensic medical history from children in cases of child physical and sexual abuse and neglect. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Yu, Mu Xue; Jiang, Xiao Yun; Li, Yi Juan; Shen, Zhen Yu; Zhuang, Si Qi; Gu, Yu Fen
The effect of using standardized parent training history-taking on the quality of medical records and communication skills among pediatric interns was determined. Fifth-year interns who were undertaking a pediatric clinical practice rotation were randomized to intervention and control groups. All of the pediatric interns received history-taking training by lecture and bedside teaching. The pediatric interns in the intervention group also received standardized parent history-taking training. The following two outcome measures were used: the scores of medical records, which were written by the pediatric interns after history-taking from real parents of pediatric patients; and the communication assessment tool (CAT) assessed by real parents. The general information, history of present illness (HPI), past medical history, personal history, family history, diagnosis, diagnostic analysis, and differential diagnosis scores in the intervention group were significantly higher than the control group (p history-taking is effective in improving the quality of medical records by pediatric interns. Standardized parent training history-taking is a superior teaching tool for clinical reasoning ability, as well as communication skills in clinical pediatric practice.
Wright, David; Syngelaki, Argyro; Akolekar, Ranjit; Poon, Leona C; Nicolaides, Kypros H
The purpose of this study was to develop a model for preeclampsia based on maternal demographic characteristics and medical history. This was a screening study of 120,492 singleton pregnancies at 11-13 weeks' gestation, including 2704 pregnancies (2.2%) that experienced preeclampsia. A survival-time model for the gestational age at delivery with preeclampsia was developed from variables of maternal characteristics and history. This approach assumes that, if the pregnancy was to continue indefinitely, all women would experience preeclampsia and that whether they do so or not before a specified gestational age depends on competition between delivery before or after development of preeclampsia. A 5-fold cross validation study was conducted to compare the performance of the new model with the National Institute for Health and Clinical Excellence (NICE) guidelines. In the new model, increased risk for preeclampsia, with a consequent shift in the Gaussian distribution of the gestational age at delivery with preeclampsia to the left, is provided by advancing maternal age, increasing weight, Afro-Caribbean and South Asian racial origin, medical history of chronic hypertension, diabetes mellitus and systemic lupus erythematosus or antiphospholipid syndrome, family history and personal history of preeclampsia, and conception by in vitro fertilization. The risk for preeclampsia decreases with increasing maternal height and in parous women with no previous preeclampsia; in the latter, the protective effect, which is related inversely to the interpregnancy interval, persists beyond 15 years. At a screen-positive rate of 11%, as defined by NICE, the new model predicted 40%, 48%, and 54% of cases of total preeclampsia and preeclampsia requiring delivery at preeclampsia. Such estimation of the a priori risk for preeclampsia is an essential first step in the use of Bayes theorem to combine maternal factors with biomarkers for the continuing development of more effective methods of
Ikiz, Mehmet Alper; Cetin, Ibrahim Ilker; Ekici, Filiz; Güven, Alev; Değerliyurt, Aydan; Köse, Gülşen
Syncope is a transient loss of consciousness as a result of global cerebral hypoperfusion. It is generally benign but may be a sign of pathology. The purpose of this study was to analyze the frequency of syncope due to cardiac, neurocardiogenic, neurologic, situational, psychiatric, and other causes and make a differential diagnosis of syncope types according to detailed medical history and further investigations. We examined prospectively 268 children presented to pediatric polyclinics as well as cardiology and neurology departments (age range, 1-18 years) with a primary complaint of syncope for the study. Cardiac syncope was diagnosed in 12 patients, neurocardiogenic syncope in 232, neurologic syncope in 9, psychiatric syncope in 9, situational in 4, and benign paroxysmal positional vertigo in 2. The neurologic syncope group consists of patients diagnosed with epilepsy after evaluation. Eight patients in the cardiac syncope group were found to have diseases such as long QT syndrome, and the remaining patients had hypertrophic cardiomyopathy, atrioventricular nodal reentry tachycardia, ventricular tachycardia, and a second-degree heart block that can cause sudden death. In conclusion, syncope is a common problem in childhood that requires hospitalization. Because it may be the first finding of an underlying malignant cardiac or neurologic disease, clinicians must be very careful during medical evaluation. An electrocardiogram and a medical history including the details of the event, chronic diseases, and familial diseases are among the most important steps for the right diagnosis and prognosis. Instead of a routine procedure, further diagnostic workup should be directed according to medical history for high yield. Convulsive movements may be defined in all types of syncope related with cerebral hypoxia, and this may lead to a misdiagnosis of seizure by the clinician.
When comic books rose to mass popularity in the early 1940s, one segment of the industry specialized in "true adventures," with stories about real people from the past and the present--in contrast to competing books that offered fantasy, science fiction, superheroes, detectives and crime, funny people, or funny animals. This study examines the figures from both medical history and twentieth-century medicine who were portrayed as heroes and role models in these comic books: first, to call attention to this very popular, if unknown, genre of medical history, and second, to illustrate how medical history was used at that time to popularize scientific and medical ideas, to celebrate the achievements of medical research, to encourage medical science as a career choice, and to show medicine as a humane and noble enterprise. The study explains how these medical history stories were situated in American popular culture more generally, and how the graphic power of comic books successfully conveyed both values and information while also telling a good story. Attention to this colorful genre of popular medical history enriches our picture of the mid-twentieth-century public's enthusiasm for medical progress.
Steinke, Hubert; Lang, Yves
Research councils, universities and funding agencies are increasingly asking for tools to measure the quality of research in the humanities. One of their preferred methods is a ranking of journals according to their supposed level of internationality. Our quantitative survey of seventeen major journals of medical history reveals the futility of such an approach. Most journals have a strong national character with a dominance of native language, authors and topics. The most common case is a paper written by a local author in his own language on a national subject regarding the nineteenth or twentieth century. American and British journals are taken notice of internationally but they only rarely mention articles from other history of medicine journals. Continental European journals show a more international review of literature, but are in their turn not noticed globally. Increasing specialisation and fragmentation has changed the role of general medical history journals. They run the risk of losing their function as international platforms of discourse on general and theoretical issues and major trends in historiography, to international collections of papers. Journal editors should therefore force their authors to write a more international report, and authors should be encouraged to submit papers of international interest and from a more general, transnational and methodological point of view. PMID:22028500
Steinke, Hubert; Lang, Yves
Research councils, universities and funding agencies are increasingly asking for tools to measure the quality of research in the humanities. One of their preferred methods is a ranking of journals according to their supposed level of internationality. Our quantitative survey of seventeen major journals of medical history reveals the futility of such an approach. Most journals have a strong national character with a dominance of native language, authors and topics. The most common case is a paper written by a local author in his own language on a national subject regarding the nineteenth or twentieth century. American and British journals are taken notice of internationally but they only rarely mention articles from other history of medicine journals. Continental European journals show a more international review of literature, but are in their turn not noticed globally. Increasing specialisation and fragmentation has changed the role of general medical history journals. They run the risk of losing their function as international platforms of discourse on general and theoretical issues and major trends in historiography, to international collections of papers. Journal editors should therefore force their authors to write a more international report, and authors should be encouraged to submit papers of international interest and from a more general, transnational and methodological point of view.
Wong, Angela T T; Nguyen, Caroline T
In this clinical report, we describe the medical history, diagnosis and prosthodontic treatment of a 61-year-old man with a previous history of oral cancer. Loss of a full upper denture and severe erosion of his teeth prompted the patient to seek treatment at the dental clinic at the British Columbia Cancer Agency. Although he stated that he was being treated for a sleeping disorder, hospital records revealed multiple recent admissions for alcoholism and depression. The patient's limited finances prevented complex restoration of worn lower dentition; thus, definitive treatment consisted of extraction of teeth with a poor prognosis, removal of a glandular odontogenic cyst and fabrication of a full maxillary prosthesis and a removable mandibular cast-metal overlay.
Manuel Lucena Salmoral
Full Text Available El acontecimiento más sobresaliente del patriarcado de don Fernando Arias de Ugarte, en el que hubo muchos notables, fue el Primer Concilio Provincial del Nuevo Reino de Granada, celebrado en el año 1623. Cumplió así una vieja aspiración de los arzobispos santafereños y la obligación impuesta en el Concilio de Trento, por lo que resulta incomprensible lo historiado por don José Antonio Plaza quien, al referirse a este hecho, dice lo siguiente...
Greenlee, Jessica L; Mosley, Angela S; Shui, Amy M; Veenstra-VanderWeele, Jeremy; Gotham, Katherine O
Depression is commonly associated with autism spectrum disorder (ASD) across the life span. We sought to identify medical and behavioral problems associated with a history of a parent-reported diagnosis of depression in a large sample of school-aged children and adolescents with ASD. A sample of 1272 participants (aged 6-17 years; mean [SD]: 9.56 [2.79] years) from the Autism Speaks Autism Treatment Network consortium were divided into "ever-depressed" (n = 89) and "nondepressed" (n = 1183) groups on the basis of caregiver endorsement of children's current or previous diagnoses of depression. In total, 7.0% of children with ASD (4.8% of those aged 6-12 years and 20.2% of those aged 13-17 years) were reported to have a history of a depression diagnosis. Positive depression history was associated with greater chronological age, higher IQ, and Asperger disorder diagnosis. After controlling for age, IQ, and within-spectrum categorical diagnosis, the ever-depressed group exhibited significantly greater rates of seizure disorders (odds ratio = 2.64) and gastrointestinal problems (odds ratio = 2.59) and trend-level differences in aggression, somatic complaints, and social impairments. The groups did not differ in autism severity, repetitive behaviors, sleep problems, eating problems, self-injurious behavior, or current intervention use. Co-occurring depression is a particularly common problem in higher-functioning older children within the Autism Treatment Network. Our findings indicate that children with ASD and a history of a depression diagnosis are more likely to also have co-occurring medical problems, although the presence and direction of causality is unclear. Copyright © 2016 by the American Academy of Pediatrics.
Miller, R A
The INTERNIST-1/Quick Medical Reference (QMR) diagnostic decision support project spans four decades, from 1971-onward. This paper describes the history of the project and details insights gained of relevance to the general clinical and informatics communities.
Haring, C.M.; Cools, B.M.; Gurp, P.J.M. van; Meer, J.W.M. van der; Postma, C.T.
BACKGROUND: During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students' clinical reasoning abilities, especially during history taking. METHODS: A
Luiz Ernesto de Almeida Troncon
Full Text Available CONTEXT AND OBJECTIVE: Overall ratings (ORs of competence, given by expert physicians, are increasingly used in clinical skills assessments. Nevertheless, the influence of specific components of competence on ORs is incompletely understood. The aim here was to investigate whether ORs for medical student history-taking competence are influenced by performance relating to communication skills, completeness of questioning and asking contentdriven key questions. DESIGN AND SETTING: Descriptive, quantitative study at Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Thirty-six medical students were examined in a 15-station high-stake objective structured clinical examination (OSCE. At four stations devoted to history-taking, examiners filled out checklists covering the components investigated and independently rated students’ overall performance using a five-point scale from 1 (poor to 5 (excellent. Physician ratings were aggregated for each student. Nonparametric correlations were made between ORs. RESULTS: ORs presented significant correlations with checklist scores (Spearman’s rs = 0.38; p = 0.02 and OSCE general results (rs = 0.52; p < 0.001. Scores for "communication skills" tended to correlate with ORs (rs = 0.31, but without reaching significance (p = 0.06. Neither the scores for "completeness" (rs = 0.26; p = 0.11 nor those for "asking key questions" (rs = 0.07; p = 0.60 correlated with ORs. CONCLUSIONS: Experts’ overall ratings for medical student competence regarding history-taking is likely to encompass a particular dimension, since ratings were only weakly influenced by specific components of performance.
Murata, Yutaka; Wada, Mikio; Kawashima, Atsushi; Kagawa, Keizo
A 37-year-old woman presented with fever and rigor after experiencing respiratory symptoms the previous week that had resolved within a few days. On presentation, her neck was swollen along the right sternocleidomastoid muscle, and chest CT showed pulmonary septic embolisms. Lemierre's syndrome was strongly suspected based on the patient's medical history and physical findings. Further examination revealed venous thrombus, and Fusobacterium necrophorum was later isolated from blood cultures. Antibiotics for anaerobes were administered before a final diagnosis was made, and the patient's symptoms thereafter improved. A rapid diagnosis is essential, since Lemierre's syndrome can be fatal with a diagnostic delay.
Cloyes, Kristin G; Berry, Patricia H; Martz, Kim; Supiano, Katherine
Increasing numbers of prisoners in the United States are dying from age-related and chronic illnesses while incarcerated. This study is among the first to document characteristics of a population of prison hospice patients. Retrospective review of medical records for all patients admitted to the Louisiana State Penitentiary prison hospice program between January 1, 2004, and May 31, 2012 (N = 79) examined demographics, medical history, hospice diagnosis, length of stay, and end-of-life symptom prevalence on admission and during final 72 hours before death. Resulting data were contrasted with community-based end-of-life care study data, demonstrating a unique clinical profile of this group. As prisons consider adopting programs to meet the growing need for inmate end-of-life care, more research concerning the particular characteristics and unique needs of prison hospice patients will inform these efforts. © The Author(s) 2015.
Edmonson, James M
The Dittrick Museum of Medical History pursues an educational mission as being part of a major research university. While the Dittrick dates to 1899 as a historical committee of the Cleveland Medical Library Association, it first affiliated with Case Western Reserve University in 1966, and became a department of the College of Arts and Sciences of CWRU in 1998. The Dittrick maintains a museum exhibition gallery that is open to the public free of charge, and museum staff provide guided tours on appointment. Much of the teaching and instruction at the Dittrick is conducted by university professors; their classes meet in the museum and use museum resources in the form of artifacts, images, archives, and rare books. Class projects using Dittrick collections may take the form of research papers, exhibitions, and online presentations. Dittrick staff assist in these classes and are available to help researchers use museum resources.
Full Text Available Provincial education supervisors visit primary schools twice a year. Especially, since the aim of supervision is to provide guidance to the teachers during the first visit, teachers could be able to discuss with the supervisors openly the professional assistance they need and the difficulties they face at school. Provincial education supervisors have the skills to be listening to teachers' needs, interests and ideas is an effective tool for understanding. In the research, according to teacher views, provincal education supervisors’ listening skills are analyzed depending on some variables primary school teachers and their principals have. The research is in the general survey model. The study population consists of 24614 teachers working in Konya in 2011-2012 academic years. The study sample consists of randomly selected 251 primary school principals and 882 primary school teachers. The research tries to determine whether the teachers’ and the principals’ educational background, professional seniority, branch, duty and gender affect their perception on the provincal education supervisors’ listening skills
It was not Dutch settlers nor British colonizers who introduced public and community health practice in north-eastern South Africa but medical doctors of the Swiss mission in southern Africa. While the history of medical knowledge transfer into 19th-20th century Africa emphasises colonial powers, this paper shows how countries without colonies contributed to expand western medical cultures, including public health. The Swiss took advantage of the local authorities' negligence, and implemented their own model of medicalization of African societies, understood as the way of improving health standards. They moved from a tolerated hospital-centred medicine to the practice of community health, which was uncommon at the time. Elim hospital's physicians moved back boundaries of segregationist policies, and sometime gave the impression of being involved in the political struggle against Apartheid. Thus, Swiss public health activities could later be seen as sorts of seeds that were planted and would partly reappear in 1994 with the ANC-projected national health policy.
Through the combination of manual retrieval and computerized retrieval, medical records of acupuncture-moxibustion in The Twenty-Four Histories were collected. Acupuncture cases from the Spring and Autumn Period (770-476 B.C.) to the end of the Ming Dynasty (1368-1644)were retrieved. From the medical records of acupuncture-moxibustion in Chinese official history books, it can be found that systematic diseases or emergent and severe diseases were already treated by physicians with the combination of acupuncture and medicine as early as in the Spring and Autumn Period as well as the Warring States Period(475-221 B.C.). CANG Gong, a famous physician of the Western Han Dynasty (206 B. C.-A. D. 24), cured diseases by selecting points along the running courses of meridians where the illness inhabited, which indicates that the theory of meridians and collaterals was served as a guide for clinical practice as early as in the Western Han Dynasty. Blood letting therapy, which has surprising effect, was often adopted by physicians of various historical periods to treat diseases. And treatment of diseases with single point was approved to be easy and effective.
The invention of a new form of hot-air bath in Blarney, Ireland in 1856, variously known in its lifetime as the Roman-Irish or Turkish Bath, acted as the starting point for a the production of a globalised therapeutic landscape. Tracking the diffusion of the Roman-Irish bath template from its local invention in Ireland to a global reach across the Victorian world and recognizing its place within a wider hydrotherapeutic history, this paper frames that diffusion as a valuable empirical addition to assemblage theory. The specific empirical history of the spread of the Roman-Irish/Turkish bath idea is drawn from primary archival and secondary historical sources. It is then discussed and, drawing from work on assemblage theory, analyzed against three broad themes: mobile networks, socio-material practices and contested emergence. The emergent relational geographies of the Roman-Irish Bath identify important roles for the diffusion and transformation of specific medical settings, identities and functions. These were linked in turn to competing social-healing pathways wherein bodies were technologically and morally managed, to produce a more inhabited form of therapeutic assemblage. In all cases the differential diffusion of the bath idea, it's shifting and fractured material forms and multiple inhabitations and discourses were contested and mobile and spoke to an assemblage approach which has ripe potential for exploration across a range of medical/health geography settings. Copyright © 2014 Elsevier Ltd. All rights reserved.
"Corporate memory" is important in many areas of medical physics, but especially so in the area of economics. To appreciate where medical physics currently resides in the reimbursement arena, it is imperative that we know from whence we came. This talk will trace the history of medical physics reimbursement, chiefly in the area of radiation oncology since most of our reimbursement codes appear in that clinical specialty. We will begin with the initiation of the Harvard RBRVS system and the effect it had on our field. Subsequently, we will trace the impact of new technological advances in the field and how, at each juncture, the reimbursement associated with these advances directly impacted our employment opportunities and salaries. Although much of the operations of the three chief panels associated with health care reimbursement, the Current Procedural Terminology (CPT) Editorial Panel, the Relative-Value Update Committee (RUC) and the Centers for Medicare and Medicaid Services (CMS) are confidential in nature, the history of how these panels operate and their impact on how health care is reimbursed is important to our field. For those of us who have labored in this arena over the years, there are successes and failures as new procedures in radiation oncology were taken for reimbursement consideration, initially by the Joint Economics Committee of ACR and ASTRO, and later by ASTRO in collaboration with AAPM. These will be discussed in a general sense to avoid confidentiality breaches. As we progressed from the use of CT planning images with 3D conventional therapy, brachytherapy -high and low dose rate systems, IMRT planning and delivery (with concomitant plan verification work) to the latest procedures of SRS and SBRT with Image Guided Radiation Therapy (IGRT), each procedure has its own story surrounding how its reimbursement was developed. Where no confidentiality issues are involved, the stories behind the scenes will be discussed as these procedures were
Clement, Christopher H.
Canada has one of the broadest and most mature nuclear industries in the world, and is a world leader in uranium mining, and in the production of medical radioisotopes. The Canadian nuclear industry also includes: uranium milling, refining, and fuel fabrication facilities; nuclear generating stations; research reactors and related facilities; waste management facilities; and the use of radioactive materials in medicine and industry. Regulation of this broad and dynamic industry is a complex and challenging task. Canada has a cooperative system for the regulation of ionizing radiation protection covering federal, provincial, territorial, and military jurisdictions. A Federal/Provincial/Territorial Radiation Protection Committee (FPTRPC) exists to aid in cooperation between the various agencies. Their mandate encompasses regulation and guidance on all aspects of radiation protection: federal and provincial; NORM and anthropogenic; ionizing and non-ionizing. The Canadian Nuclear Safety Commission (CNSC) is the federal nuclear regulator whose mandate includes radiation protection regulation of most occupational and public exposures. The CNSC does not regulate medical (patient) exposures, some aspects of NORM, or military applications. Provincial authorities are the primary regulators with respect to doses to patients and occupational doses arising from X-rays. Health Canada plays a role in X-ray device certification, development of national guidance (e.g. on radon) and direct regulation of certain federal facilities. NORM is regulated provincially, with varying regulatory mechanisms across the provinces and territories. Radiation protection regulation for National Defence and the Canadian Armed Forces is performed by the Director General Nuclear Safety. This paper gives an overview of the structure of the regulation of ionizing radiation protection in Canada, and shares lessons learned, particularly with respect to the usefulness of the FPTRPC in helping coordinate and
Frijlink, Jan Hilco
From data, gathered by the author and his students, during a wolf study in Algonquin Provincial Park, Canada, six kills of white-tailed deer by wolf packs are described. Case histories are reconstructed by means of interpreting tracks. In one case a wolf was also killed, this animal turned out to
There are few historical studies about the sex education of Australian youth. Drawing on a range of sources, including the oral histories of 40 women and men who attended two single-sex, selective high schools in a provincial Australian city (Newcastle, New South Wales) in the 1930s-1950s, this paper explores the adolescent experience of sex…
Liao, Hua; Liu, Yanan; Gao, Yixuan; Hao, Yu; Ma, Xiao-Wei; Wang, Kan
In China, more than 80% electricity comes from coal which dominates the CO2 emissions. Residential electricity demand forecasting plays a significant role in electricity infrastructure planning and energy policy designing, but it is challenging to make an accurate forecast for developing countries. This paper forecasts the provincial residential electricity consumption of China in the 13th Five-Year-Plan (2016-2020) period using panel data. To overcome the limitations of widely used predication models with unreliably prior knowledge on function forms, a robust piecewise linear model in reduced form is utilized to capture the non-deterministic relationship between income and residential electricity consumption. The forecast results suggest that the growth rates of developed provinces will slow down, while the less developed will be still in fast growing. The national residential electricity demand will increase at 6.6% annually during 2016-2020, and populous provinces such as Guangdong will be the main contributors to the increments.
The efforts being made to include Aboriginal communities in land use planning in British Columbia are discussed. British Columbia is in the midst of historic changes with respect to land and resource allocation, use and management. Historic trends in land use allocation and management are contrasted with land use planning and resource management of today. The impact of provincial government moves to double park space within the province, and the Protected Areas Strategy initiative will have on the natural gas and petroleum industry is discussed. New efforts being made to include First Nations directly in land use planning discussions in ways that do not prejudice treaty negotiations, are reviewed. Creation of a new Oil and Gas Commission in the Fort St. John area, is cited as the most recent example of the interconnections between First Nations communities and other public and industry stakeholders in land use planning in the province
Chang, Chien-Kai; Ho, Mary Wen-Reng; Chien, Sarina Hui-Lin
People go beyond the inferences afforded by a person's observable features to make guesses about personality traits or even social memberships such as political affiliations. The present study extended Hu et al. (2016) to further investigate the influence of provincial appearance on differentiating KMT (Kuomintang) and DPP (Democratic Progressive Party) candidates by headshot photos with three experiments. In Experiment 1 (Membership categorization task), participants categorized the photos from the pilot study (where the difference between the perceived age of KMT and DPP candidates was reduced) and divided into four blocks by their perceived age. We found that participants were able to distinguish KMT from DPP candidates significantly better than chance, even when the perceived age difference between the two parties was minimized. In Experiment 2 (Trait rating task), we asked young and middle-aged adults to rate six traits on candidate's photos. We found that "provincial appearance" is the core trait differentiating the two parties for both young and older participants, while "facial maturity" is another trait for older participants only. In Experiment 3 (Double categorization task), we asked participants to categorize the photos from the Exp. 1 on their membership (KMT or DPP) and on provincial appearance (mainlander or native Taiwanese) in two separate sessions. Results showed that young adults were likely to use the "provincial appearance" as the main characteristic cue to categorize candidates' political membership. In sum, our study showed that Taiwanese adults could categorize the two parties by their headshot photos when age cue was eliminated. Moreover, provincial appearance was the most critical trait for differentiating between KMT and DPP candidates, which may reflect a piece of significant history during the development of the two parties.
Full Text Available People go beyond the inferences afforded by a person’s observable features to make guesses about personality traits or even social memberships such as political affiliations. The present study extended Hu et al. (2016 to further investigate the influence of provincial appearance on differentiating KMT (Kuomintang and DPP (Democratic Progressive Party candidates by headshot photos with three experiments. In Experiment 1 (Membership categorization task, participants categorized the photos from the pilot study (where the difference between the perceived age of KMT and DPP candidates was reduced and divided into four blocks by their perceived age. We found that participants were able to distinguish KMT from DPP candidates significantly better than chance, even when the perceived age difference between the two parties was minimized. In Experiment 2 (Trait rating task, we asked young and middle-aged adults to rate six traits on candidate’s photos. We found that “provincial appearance” is the core trait differentiating the two parties for both young and older participants, while “facial maturity” is another trait for older participants only. In Experiment 3 (Double categorization task, we asked participants to categorize the photos from the Exp. 1 on their membership (KMT or DPP and on provincial appearance (mainlander or native Taiwanese in two separate sessions. Results showed that young adults were likely to use the “provincial appearance” as the main characteristic cue to categorize candidates’ political membership. In sum, our study showed that Taiwanese adults could categorize the two parties by their headshot photos when age cue was eliminated. Moreover, provincial appearance was the most critical trait for differentiating between KMT and DPP candidates, which may reflect a piece of significant history during the development of the two parties.
Demidovich, Mark; Kolko, David J; Bukstein, Oscar G; Hart, Jonathan
Abstract Objective: This study examines the characteristics of 96 children with attention-deficit/hyperactivity disorder (ADHD) and their families who refused a recommendation for medication as part of their treatment for disruptive disorders. The ADHD cases were taken from a sample of 139 youth (age 6-11) who were recruited for a clinical trial that compared the administration of a modular psychosocial treatment in an outpatient clinic or community settings. Medication management was an optional treatment module for children with ADHD in both conditions. Children who were (vs. were not) taking medication at intake, and children who accepted (vs. refused) medication recommendations during the study were compared on diagnostic and clinical measures related to child, school, parent, and family domains of functioning. Parents of 30% of the children refused study medication for ADHD. Parental medication acceptability and intake correlated highly with both medication history and study refusal of medication. Increased parental self-efficacy and emotional support for their youth correlated with medication refusal. No demographics and few child or school factors were associated with medication refusal. Medication use was associated with reductions in some key ADHD symptoms, but did not affect disruptive behaviors as did the psychosocial interventions. Medication refusers remain poorly understood but certain correlates, such as parental self-efficacy, parental emotional support for their youth, and medication acceptability, warrant further evaluation.
Utilisation of Antenatal Services at the Provincial Hospital, Mongomo, Guinea Equatoria. AAG Jimoh. Abstract. This prospective study was carried out to evaluate the utilisation of antenatal care at the Provincial Specialist Hospital, Mongomo, Guinea Equatoria, paying close attention to the confounding factors affecting ...
Yang, Feng; Zhu, Ling
Mr. MA Ji-xing has devoted himself into the study of acupuncture medical history for more than 70 years. As a result, a great work of Zhenjiuxue Tongshi (see text), History of Acupuncture-Moxibustion) has been completed. The author has expensively studied for history of acupuncture medicine in time and space. Base on abundant historical materials, deliberate textual research as well as strategically situated academic view, it is considered as a masterpiece of acupuncture on real significance. It is worthwhile to note that the book has a systematic and profound explanation on Bian-stone therapy, unearthed literature relics of acupuncture, the bronze figure or illustration of acupoint as well as special topics of Japan and Korea acupuncture history. Filled several gaps of the field, and explored some significant new paths of study, it laid the groundwork for the profound study and unscramble of traditional acupuncture theory as well as the investigation of the academic history, which is considered to have a profound and persistent influence. The careful sorting and profound digging of many distinguish thoughts and methods of Mr. MA Ji-xing in the study of acupuncture medical history has significant meaning in references and enlightenment of the future research on acupuncture medical history.
Liang, Wen-Chen; Wang, Chen-Hua; Chou, Po-Ching; Chen, Wan-Zi; Jong, Yuh-Jyh
Duchenne muscular dystrophy (DMD) is the most common hereditary muscular dystrophy and caused by DMD gene mutation. In addition to progressive proximal muscle weakness, respiratory, orthopedic, and gastrointestinal complications are often observed in DMD. The natural history of patients with DMD in Taiwan has not been reported thus far. Medical records of 39 patients who received a diagnosis of DMD between 1999 and 2016 at Kaohsiung Medical University Hospital were reviewed. The diagnosis of DMD was confirmed through muscle biopsy or DMD genetic analysis. The mean onset age and mean follow-up period were 2.75 years and 6.76 years, respectively. Seventeen patients (43.5%) had a family history of DMD. The mean full intelligence quotient of the patients was 71.08, and the mean age of walking ability loss was 9.7 years (25 patients). The mean onset age of respiratory insufficiency was 10.64 years with a decline rate of 5.18% per year (25 patients). The mean onset age of cardiomyopathy was 14.69 years (seven patients). The mean onset age of scoliosis was 13.29 years with a progression rate of 11.48° per year (14 patients). Eleven (28.2%) and eight (20.5%) patients had deletions and duplications of DMD, respectively. Fourteen patients (35.9%) had point mutations or small deletions or insertions. Five patients received only multiplex ligation-dependent probe amplification (MLPA) analysis and exhibited neither deletion nor duplication. No mutation was identified in one patient through both MLPA and exon sequencing. The clinical phenotypes and disease course in our cohort were consistent with that reported in previous studies. However, the proportion of point mutations or small deletions or insertions in our study was considerably higher than that in reports from other populations. Cardiac ejection fraction was found not a reliable biomarker for identifying cardiac problems, discovering a better parameter is necessary. Copyright © 2017. Published by Elsevier B.V.
Newcomb, Patricia; Canclini, Sharon; Cauble, Denise; Raudonis, Barbara; Golden, Paulette
In spite of the acknowledged importance of collecting family health information, methods of collecting, organizing, and storage of pedigree data are not uniformly utilized in practice, though several electronic tools have been developed for the purpose. Using electronic tools to gather health information may empower individuals to take responsibility in managing their family health history. The purpose of this study was to describe the feasibility and outcomes of introducing small groups to the My Family Health Portrait tool in faith-based communities using faith community nurses (FCNs). This pilot project adopted a mixed methods approach to assess the potential of an educational intervention delivered by FCNs for increasing the use of electronic technologies for organizing and storing family health histories among the general public. Treatment and control groups were recruited from four faith-based communities in north Texas using a parallel-groups quasi-experimental design. Qualitative data were gleaned from field notes made by investigators interacting with FCNs and observing their teaching. A majority of respondents believed that knowing one's health history and passing it on to family and medical personnel is important. Those receiving face-to-face instruction on the electronic tool were significantly more likely to have written down family health information than the control group who received only an informational handout (χ(2) = 5.96, P = .015). Barriers to teaching about and using the electronic tool included FCNs' lack of facility with computers in the educational context and FCN and respondent mistrust of electronic storage for family health information. © The Author(s) 2014.
Full Text Available Provincial governments seem to consider it only natural to finance public infrastructure using debt. There is a standard arsenal of arguments used to justify the practice, to the point where there are scarcely any political voices willing to dissent from the tradition. Financing a bridge or school with debt is like a family buying a house, goes one common rationalization, or like a business taking out a loan for equipment. Others argue that infrastructure investment can stimulate the economy and pays for itself over time. Another justification insists that it is only fair for future generations to shoulder some of the burden of infrastructure purchased today, since they will continue to enjoy it after living generations are gone. Still another holds that debt financing infrastructure offers the necessary smoothing of the tax rate over time. These arguments are widely repeated and accepted as these arguments are, but under closer scrutiny they hold almost no water at all. On the contrary, the economic analysis casts doubts on financing infrastructure using debt. If provinces want to build more roads, bridges, schools, airports, hospitals, and other infrastructure, they would do taxpayers a much bigger favour by financing it through current income. Building a government hospital is not the same as a couple taking out a home mortgage; that couple cannot increase its revenues the way a government can through higher taxes, and that couple has an earning life cycle (rising until the earners are in their mid-50s, and then declining until their income is largely comprised of public and private pensions and savings. Businesses primarily fund new investments using retained earnings; their use of debt is motivated largely by tax incentives that allow interest deductibility. Neither of these are reasonable comparisons for a government’s financing rationale. The fiscal stimulus argument is weak to begin with, as the timing of infrastructure spending is
Eduardo L De Vito
Full Text Available In the last few years, great expectations have risen in the society concerning the eventual therapeutic usefulness of compounds derived from the cannabis plant. It is well known that these compounds are being used in treating certain health conditions, either through medical prescription or self-administration. Extreme opinions range from believing that it is a harmful and dangerous drug to sustaining that it is a panacea. However, the sheer existence of an endocannabinoid system in the brain compels us to study its dimensions and derivations thoroughly. It is expected that controversies and knowledge gaps will be clarified within the framework of this new law. Prohibitionism should not be a category of analysis. Regardless of the therapeutic effects of cannabinoid compounds, demonstrated or to be demonstrated, there are already severe restrictions on their use, which mirror the still existing restrictions to the use of opioids (drugs of definite utility but on which a huge taboo persists. This review presents the first Argentine law on the medical use of cannabis. Milestones in the history of marijuana at the national level are pointed out, which are inextricably linked to world trends either in favor or against prohibition. The current status of the use of cannabis oil in the country and evidences for its therapeutic value are also analyzed. Evidences on its therapeutic value are also analyzed as well as the current status of the use of cannabis oil in our country.
Popular approach to the history of medicine rests on naive assumptions that: 1) only the present state of medical knowledge can be counted as scientific and only those elements of the former knowledge and practice which fitted the body of contemporary science should be regarded by the historians of medicine (presentism); 2) medical sciences, like the other natural sciences, portray natural phenomena as they really are (naturalism); 3) progress in sciences consists of cumulative growth of information and explanation. The twentieth century philosophical critique of science revealed that none of these assumptions were true. Empirical facts, which are taken as a basis for any true knowledge, are dependent on the presumed theories; theories are intertwined into a broader socio-cultural context; theory-changing processes are caused by social factors rather than by the theoretical content. Therefore, it is a common task of historians of medicine and philosophers of science to reveal all theoretical and cultural premises on which our comprehension of the contemporary medicine is founded.
Frisse, Mark E; Tang, Lianhong; Belsito, Anne; Overhage, J Marc
We describe our early experience with use in emergency department settings of a standards-based medication history service integrated into a health information exchange (HIE). The service sends queries from one Exchange's emergency department interface both to a local ambulatory care system and to the medication hub services provided by a second HIE. This second HIE in turn sends requests to SureScripts and returns histories for incorporation into the first Exchange's clinical interface. The service caches all requests to avoid costly duplicate query charges and maintains an account of queries, registered users, charges, and results obtained. Usage may be increasing as additional retail pharmacy data become available. Early results suggest that research and development emphasis requirements will of necessity shift from obtaining prescription medication history to finding new means to ensuring effective use.
Alexandra Lelia Dima
Full Text Available Adherence to medications is an important indicator of the quality of medication management and impacts on health outcomes and cost-effectiveness of healthcare delivery. Electronic healthcare data (EHD are increasingly used to estimate adherence in research and clinical practice, yet standardization and transparency of data processing are still a concern. Comprehensive and flexible open-source algorithms can facilitate the development of high-quality, consistent, and reproducible evidence in this field. Some EHD-based clinical decision support systems (CDSS include visualization of medication histories, but this is rarely integrated in adherence analyses and not easily accessible for data exploration or implementation in new clinical settings. We introduce AdhereR, a package for the widely used open-source statistical environment R, designed to support researchers in computing EHD-based adherence estimates and in visualizing individual medication histories and adherence patterns. AdhereR implements a set of functions that are consistent with current adherence guidelines, definitions and operationalizations. We illustrate the use of AdhereR with an example dataset of 2-year records of 100 patients and describe the various analysis choices possible and how they can be adapted to different health conditions and types of medications. The package is freely available for use and its implementation facilitates the integration of medication history visualizations in open-source CDSS platforms.
While accepting medical "pluralism" as a historical reality, as an intrinsic value inherent in any medical system, and as an ideal or desired goal that any multicultural society ought to achieve, this paper argues the need to go beyond the liberal pluralist tendencies that have dominated the debate so far. It holds that while documenting or dealing with the "co-existence" of varied medical traditions and practices, we must not ignore or underplay issues of power, domination and hegemony and must locate our work in a larger historical, social and political context. With this perspective, and based essentially on Assembly proceedings, private papers, official documents and archival materials from the first half of the 20th-century, this paper identifies three major streams in the nationalist discourse in India: conformity, defiance and the quest for an alternative. It shows that while the elements of conformity to biomedicine and its dominance remained more pronounced and emphatic, those of defiance were conversely weak and at times even apologetic. The quest for alternatives, on the other hand, although powerful and able to build trenchant civilizational and institutional critique of modern science and medicine, could never find adequate space in the national agenda for social change. The paper further holds that although the "cultural authority" and hegemony of biomedicine over indigenous science and knowledge were initiated by the colonial state, they were extended by the mainstream national leaderships and national governments with far more extensive and profound implications and less resistance. In light of the growing global networking of "traditional", "complementary" and "alternative" health systems on the one hand and the hegemonic and homogenizing role and presence of multilateral organizations (such as the World Bank and IMF) in shaping national health policies on the other, such insights from history become extraordinarily important.
Tang, Stella S.; Jaward, Leanna; Ward, Kristen; Parikh, Sagar V.; Bostwick, Jolene R.
Objectives To improve treatment of patients with depression, a new pilot service project involving student pharmacists who would conduct medication reconciliation and review of antidepressant treatment history was created and evaluated. Experimental design A prospective study conducted at the University of Michigan Depression Center. Principal observations From an initial sample of 78 referrals, 41 subjects were reached by phone, with 34 completing medication reconciliation and antidepressant treatment history. Of the 34 patients, 25 (73.5%) had at least one discrepancy identified in their medication list, resulting in 164 medication changes in the electronic medical record (EMR). A total of 105 past antidepressant trials were documented in the 34 individuals, with 34 (32.4%) trials found to be inadequate. Thirteen (38.2%) patients reported failure to respond to two different antidepressants from different classes. All 34 patients participated well in the phone calls and were willing to consult a pharmacist at their upcoming clinic visit. Conclusions A student pharmacist pilot was feasible, identified many discrepancies in the medication record, and identified important medication treatment history in patients with depression in advance of the clinic visit. The project provides support for a specialized role for student pharmacists and demonstrates that interprofessional care can contribute to improved treatment of depression. PMID:28626270
This is a brief summary and a personal reflection on Anne Luise Kirkengen's PhD thesis "Embodiment of sexual boundary violations in childhood". It is written to encourage other clinicians to familiarise themselves with this original and important study. It has high relevance for every clinician who is ever confronted with patients that present medical histories that are "diffuse" or unexplainable according to traditional medical knowledge.
Keifenheim, Katharina Eva; Petzold, Ernst Richard; Junne, Florian; Erschens, Rebecca Sarah; Speiser, Natalie; Herrmann-Werner, Anne; Zipfel, Stephan; Teufel, Martin
Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups. Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students' self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students' most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients' emotional demands appropriately. By the end of the course, students' self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student-patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.
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.
Selim Bedri Benek
Full Text Available The Seljuks built up so many medical buildings and darüssifas in lots of cities, and gave importance to medicina as well as the other branches of science. They provided great contributions to the development of modern medicine with darüssifas and medical centers by the treatment they applied as well as health care. Music therapy was applied with certain methods in these health centers where mental and spiritual diseases were tried to be treated. Sivas Divrigi Darüssifa, amongst the first ones in this concept and continued its existence until today, has an important place in terms of our medical history.
... and international bodies as well as the military. Provincial Reconstruction Teams (PRTs), as employed in Afghanistan, are used as a vehicle to examine the wide range of activities necessary for Nation Building...
In the middle of the 14th century, most towns in German-speaking territories and beyond massacred their Jewish communities. Thousands of Jews were burnt, often connected with accusations of well-poisoning. Medical and socio-historical literature usually attributes these massacres to the anxiety created by the Black Death, which was sweeping over Europe during this period. This article argues that there is no direct link between the massacres and the plague. How other researchers showed before, far from acts of plague-terrified, frenzied mobs, the massacres were the carefully planned and executed work of the Christian local governments. In addition, the slaughtering of Jews began long before the Black Death broke out in Europe. No relation can be found between the intensity of the disease and the violence of the murderers, even though there were wide regional differences. Causes of the persecutions other than the effects of plague seem evident, mainly religious fears fueled by the Church, financial profit, and political interests. This article wants to draw the attention to a myth in the history of medicine, the myth of the plague as the main cause of the massacres in the 14th century. It also raises the question, whether the plague as a trigger for the massacres really was a basic requirement.
Schmidt, Simone; Duangdala, Phouvieng; Saysanasongkham, Bounnack; Sabir, Hemmen; Brenner, Sebastian; Schmid, Manuel; Kuehn, Thomas; Hoehn, Thomas
The aim of this study was to identify the causes and incidences of neonatal diseases and deaths in five provincial hospitals in People's Democratic Republic of Laos retrospectively for the years 2010-12. Data of neonatal patients were collected before a 3-year-training program for medical and nursing staff involved in the care of newborn infants in the provincial and associated district hospitals. In the years 2010-12, a total of 1673 neonatal patients were treated in the provincial hospitals. The reasons of treatment were as follows: 48% infections, 17% complications of prematurity, 14% intrapartum-related complications and 9% other, not categorized diseases. The average mortality rate in all hospitals was 6.5%. The main causes of death were complications because of prematurity, infectious diseases and asphyxia. These data could be the basis for any teaching program aimed at reducing neonatal mortality. Furthermore, they enable an evaluation of the ongoing teaching program. © The Author . Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Full Text Available Background . Robert Fortuine provided basic medical care to Alaska Native people, chronicled the Health Aspects of Arctic Exploration and through a number of influential publications, was the first to thoroughly document and analyse Alaska's Medical History. This overview of his published work will provide the reader with a detailed overview, so that they can begin to explore Dr. Fortuine's many published works in more detail. Objective . This review will explore Alaska's Medical History and the Health Aspects of Arctic Exploration through the research files and the 10 most significant publications of Dr. Robert Fortuine. Design . Review of Dr. Fortuine's major works and the master bibliography has over 3,000 references and 81 subjects. The master bibliography is a merger of 55 separate bibliographies, which provides a wealth of bibliographic information. This paper will describe his 10 most significant publications, 2 of which began as a journal issue. Results . Dr. Fortuine was a prolific writer throughout his career, publishing 134 articles and books. He wrote papers and books on Alaska's medical history, tuberculosis and health care delivery from Russian–America through the Public Health Service efforts in the territory and then the State of Alaska. The master bibliography has over 3,000 references and 81 subjects. This list has a significant number of entries for tuberculosis with almost one-third of the entries including this heading. Others dwell on the history of “pre-contact” health, the history of Alaska Native health care, the history of the Alaska Department of Health, especially the tuberculosis programme, the role of the US Public Health Service and traditional medicine. He completely reviewed every Governors’ and the US Surgeon General's reports in regard to Alaska content. This paper describes his 10 most significant publications. Conclusions . Robert Fortuine's published works offer a wealth of information and insight
Rugulies, R; Thielen, K; Nygaard, E
A study was undertaken to investigate whether job insecurity predicts incident use of antidepressant medication and whether the association is modified by a history of prolonged unemployment.......A study was undertaken to investigate whether job insecurity predicts incident use of antidepressant medication and whether the association is modified by a history of prolonged unemployment....
LoSasso, Alisa Alfonsi; Lamberton, Courtney E; Sammon, Mary; Berg, Katherine T; Caruso, John W; Cass, Jonathan; Hojat, Mohammadreza
To examine whether an intervention on proper use of electronic medical records (EMRs) in patient care could help improve medical students' empathic engagement, and to test the hypothesis that the training would reduce communication hurdles in clinical encounters. Seventy third-year medical students from the Sidney Kimmel Medical College at Thomas Jefferson University were randomly divided into intervention and control groups during their six-week pediatric clerkship in 2012-2013. The intervention group received a one-hour training session on EMR-specific communication skills, including discussion of EMR use, the SALTED mnemonic and technique (Set-up, Ask, Listen, Type, Exceptions, Documentation), and role-plays. Both groups completed the Jefferson Scale of Empathy (JSE) at the clerkship's start and end. At clerkship's end, faculty and standardized patients (SPs) rated students' empathic engagement in SP encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and their history-taking and communication skills. Faculty mean ratings on the JSPPPE, history-taking skills, and communication skills were significantly higher for the intervention group than the control group. SP mean ratings on history-taking skills were significantly higher for the intervention group than the control group. Both groups' JSE mean scores increased pretest to posttest, but the changes were not significant. The intervention group's posttest JSE mean score was higher than the control group's, but the difference was not significant. The findings suggest that a simple intervention providing specialized training in EMR-specific communication can improve medical students' empathic engagement in patient care, history-taking skills, and communication skills.
Full Text Available Against the background of global warming, China has vowed to meet a series of carbon emissions reduction targets and plans to launch a national carbon emissions rights trading market by 2017. Therefore, from the provincial value chain perspective, using input-output tables from China in 2002, 2007, and 2010, this study constructs models to calculate the CO2 emissions responsibility of each province under the production, consumption, and value capture principles, respectively. Empirical results indicate that Shandong, Hebei, Jiangsu, Guangdong, and Henan bear the most responsibility for CO2 emissions under the three principles in China, while Hainan and Qinghai have the least responsibility. However, there is a great difference in the proportion of carbon emissions responsibility for each province during the same period under different principles or different periods under the same principle. For consumption-oriented areas such as Beijing, Tianjin, Zhejiang, Shanghai, and Guangdong, the production principle is more favorable, and the consumption principle is more beneficial for production-oriented provinces such as Hebei, Henan, Liaoning, Shanxi, Inner Mongolia, and Shaanxi. However, the value capture principle strikes a compromise of the CO2 emissions responsibility of each province between the production and consumption principles, and it shares the CO2 emissions responsibility based on the actual value captured by each province in the provincial value chain. The value capture principle is conducive to the fair and reasonable division of CO2 emissions rights of each province by sectors, as well as the construction of a standardized carbon emissions rights trading market.
Bolt, Timo C
Over the past half century, medicine has evolved into 'informational medicine'. Physicians today no longer necessarily have to possess specialist knowledge, but have to know how to access this knowledge. This means that it is important that they do not just 'grab' for loose bits of information, but systematically and judiciously search for relevant knowledge. Medical-historical insights could be helpful, alongside critical-appraisal skills. Medical knowledge has a certain structure that has developed historically under the influence of assumptions (some implicit), presuppositions and social forces and interests. By exposing this underlying structure, medical history provides an overview of and insight into relationships within medical knowledge and practice. Now in particular, in the current age of information and disinformation, there is a great need for such 'overviews'. This offers opportunities for the revitalization of the 'Historical perspective' section in the Dutch Journal of Medicine (NTvG), especially if this section evolves into a shared platform for physicians and historians.
Dr Yamila de Armas has occupied an array of posts since finishing her residency in family medicine in her home province of Cienfuegos in 1992. She has served as a family doctor; polyclinic, municipal and provincial health director; medical school dean; and twice vice minister of public health. But few would doubt her toughest job is the one she has now: deputy director of the Havana City Provincial Health Department, in charge of medical services for the 2.2 million people living in Cuba's complex, sprawling capital. It was here in 2002-2003 that the program was launched to repair, refurbish and expand the country's nearly 500 community polyclinics. Key to the effort was equipping these facilities with a broader range of new and upgraded medical technology. Dr de Armas offers MEDICC Review her reflections on the results five years later.
Full Text Available Background: Communication is a process that allows us to interact with other people. Medical professionals need to possess good communication skills for history taking, diagnosis, and treatment. Communicative skills are hardly taught in medical schools of India. The students are expected to learn them on their own. To address this issue, we introduced communicative skills training (CST for medical interns. Objective: Primary – To determine the effectiveness of CST in improving history taking on sensitive issues by medical interns. Secondary – To improve patients' satisfaction through improved communicative skills. Materials and Methods: This was a randomized control study carried out on medical interns at Jamnagar. The interns were randomized to either Group A or Group B. Intervention in the form of CST was given to Group A while Group B was control. The topic of CST was “eliciting sexual history.” Assessment of participants was done by pre- and post-intervention objective structured clinical examination. For ethical reasons, Group B was also given CST by experts after completion of our study but their results were not included for analysis. Results: Although mean scores increased in both the groups, (from 6.4 to 13.4 in the intervention group and from 6.5 to 7.5 in controls, the percent increase was much larger in the intervention group than controls (109% vs. 15%. Students gave a positive feedback to CST. Opinion of teachers was favoring CST. Among the patients allotted to intervention group, 83% were satisfied. Conclusion: CST imparted to medical interns helps in improving doctor–patient relationship.
Written as a response to a conference exhibition of medical illustrations of reproduction, this article considers the gains of an interdisciplinary study of medical illustration to both historians and medics. The article insists that we should not only be attuned to the cultural work that such representations perform but also that such illustrations are the product of material medical practices and the often humane impulses that drive them.
By applying a multi-regional input–output model, the study compares the provincial responsibility for carbon emissions and provincial carbon multipliers in China under seven responsibility-allocating principles, including three basic principles, the production, income and consumption principles, and four shared responsibility principles, the income-weighted, consumption weighted, comprehensive, and weighted comprehensive principles. Empirical results indicate that carbon multipliers of provinces under these principles are significantly different from one another. The carbon multipliers of provinces with higher ratios of carbon intensive sectors in their outputs are also larger. At the same time, the carbon multipliers of the same sector in the provinces are significantly different from one another. Changing the principle causes significant changes in the responsibility for carbon emissions of some provinces, but only slight changes in the responsibilities of some other provinces. However, the responsibilities of provinces with large economic sizes (output) are always the largest, whereas provinces with the smallest economic sizes are always the smallest regardless of the principles. Further, this study proposes a series of regional policies for carbon mitigation according to provincial carbon multipliers and responsibility allocation features under the different principles. - Highlights: • We link regional environmental responsibility to seven benefit principles. • We analyze provincial responsibility for carbon emissions in China. • We also report provincial carbon multipliers under different principles. • We compare the seven principles from the regional perspective. • Policy implications of the study are discussed.
... history including vaccination history, previous and current illnesses or conditions that may affect..., including the validity of the methodology and assumptions used; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection...
Rocca, Walter A.; Yawn, Barbara P.; St. Sauver, Jennifer L.; Grossardt, Brandon R.; Melton, L. Joseph
The Rochester Epidemiology Project (REP) has maintained a comprehensive medical records linkage system for nearly half a century for almost all persons residing in Olmsted County, Minnesota. Herein, we provide a brief history of the REP before and after 1966, the year in which the REP was officially established. The key protagonists before 1966 were Henry Plummer, Mabel Root, and Joseph Berkson, who developed a medical records linkage system at Mayo Clinic. In 1966, Leonard Kurland established collaborative agreements with other local health care providers (hospitals, physician groups, and clinics [primarily Olmsted Medical Center]) to develop a medical records linkage system that covered the entire population of Olmsted County, and he obtained funding from the National Institutes of Health to support the new system. In 1997, L. Joseph Melton III addressed emerging concerns about the confidentiality of medical record information by introducing a broad patient research authorization as per Minnesota state law. We describe how the key protagonists of the REP have responded to challenges posed by evolving medical knowledge, information technology, and public expectation and policy. In addition, we provide a general description of the system; discuss issues of data quality, reliability, and validity; describe the research team structure; provide information about funding; and compare the REP with other medical information systems. The REP can serve as a model for the development of similar research infrastructures in the United States and worldwide. PMID:23199802
Chatzopoulos, Georgios S; Wolff, Larry F
The aim of this study was to examine any potential association between demographic characteristics, socioeconomic status, dental insurance, and medical and tobacco history between patients that received endodontic treatment or extraction and implant treatment in a university dental clinic. Dental charts of patients who received root canal treatment and implant therapy were retrieved from the University of Minnesota School of Dentistry records. Age at the time of the procedure, gender, medical history, tobacco use, dental insurance status, zip code, and type of treatment provided were recorded. Patients who had both treatment modalities were excluded from the analysis. A total of 8,540 records of patients with a mean age of 50.66 years who have received either endodontic treatment (73.6%) or implant therapy (26.4%) were included. A statistically significant (P implant treatment as related to age, socioeconomic status, high blood pressure, asthma, thyroid disorders, arthritis, artificial joint, osteoporosis, depression, anxiety, cancer, and cancer treatment. Nonsmokers were significantly more likely to select a treatment plan with implants rather than an endodontic therapy. Within the limitations of this retrospective study, demographic parameters, insurance status, smoking, and medical history significantly affected the treatment selection between implant and endodontic treatment in a university setting.
Tayyar, A; Guerra, L; Wright, A; Wright, D; Nicolaides, K H
To define the contribution of maternal variables that influence the measured uterine artery pulsatility index (UtA-PI) in screening for pregnancy complications. Maternal characteristics and medical history were recorded, and UtA-PI was measured, in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6 weeks, 19 + 0 to 24 + 6 weeks and 30 + 0 to 34 + 6 weeks or 35 + 0 to 37 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths at ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of UtA-PI were determined from linear mixed-effects multiple regression. UtA-PI was measured in 90 484 cases in the first trimester, 66 862 cases in the second trimester and 33 470 cases in the third trimester of pregnancy. Significant independent contributions to UtA-PI were provided by gestational age, maternal age, weight, racial origin and a history of pre-eclampsia (PE) in the previous pregnancy. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured UtA-PI and express the values as multiples of the median (MoM). The model was shown to provide an adequate fit of MoM values for all covariates both in pregnancies that developed PE and in those that did not. A model was fitted to express the measured UtA-PI as MoMs after adjustment for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Full Text Available This article aims to describe the training and medical licensing system (uieop for becoming a physician officer (uigwan during Korea’s Goryeo Dynasty (918-1392. In the Goryeo Dynasty, although no license was necessary to provide medical services to the common people, there was a licensing examination to become a physician officer. No other national licensing system for healthcare professionals existed in Korea at that time. The medical licensing examination was administered beginning in 958. Physician officers who passed the medical licensing examination worked in two main healthcare institutions: the Government Hospital (Taeuigam and Pharmacy for the King (Sangyakguk. The promotion and expansion of medical education differed depending on the historical period. Until the reign of King Munjong (1046-1083, medical education as a path to licensure was encouraged in order to increase the number of physician officers qualifying for licensure by examination; thus, the number of applicants sitting for the examination increased. However, in the late Goryeo Dynasty, after the officer class of the local authorities (hyangri showed a tendency to monopolize the examination, the Goryeo government limited the examination applications by this group. The medical licensing examination was divided into two parts: medicine and ‘feeling the pulse and acupuncture’ (jugeumeop. The Goryeo Dynasty followed the Chinese Dang Dynasty’s medical system while also taking a strong interest in the Chinese Song Dynasty’s ideas about medicine.
Smedby, Karin E; Sampson, Joshua N; Turner, Jennifer J; Slager, Susan L; Maynadié, Marc; Roman, Eve; Habermann, Thomas M; Flowers, Christopher R; Berndt, Sonja I; Bracci, Paige M; Hjalgrim, Henrik; Weisenburger, Dennis D; Morton, Lindsay M
The etiology of mantle cell lymphoma (MCL), a distinctive subtype accounting for 2%-10% of all non-Hodgkin lymphoma, is not known. We investigated associations with self-reported medical history, lifestyle, family history, and occupational risk factors in a pooled analysis of 557 patients with MCL and 13766 controls from 13 case-control studies in Europe, North America, and Australia. Odds ratios (ORs) and 95% confidence intervals (CIs) associated with each exposure were examined using multivariate logistic regression models. The median age of the MCL patients was 62 years and 76% were men. Risk of MCL was inversely associated with history of hay fever (OR = 0.63, 95% CI = 0.48 to 0.82), and the association was independent of other atopic diseases and allergies. A hematological malignancy among first-degree relatives was associated with a twofold increased risk of MCL (OR = 1.99, 95% CI = 1.39 to 2.84), which was stronger in men (OR = 2.21, 95% CI = 1.44 to 3.38) than women (OR = 1.61, 95% CI = 0.82 to 3.19). A modestly increased risk of MCL was also observed in association with ever having lived on a farm (OR = 1.40, 95% CI = 1.03 to 1.90). Unlike some other non-Hodgkin lymphoma subtypes, MCL risk was not statistically significantly associated with autoimmune disorders, tobacco smoking, alcohol intake, body mass index, or ultraviolet radiation. The novel observations of a possible role for atopy and allergy and farm life in risk of MCL, together with confirmatory evidence of a familial link, suggest a multifactorial etiology of immune-related environmental exposures and genetic susceptibility. These findings provide guidance for future research in MCL etiology. Published by Oxford University Press 2014.
Golden, Janet; Abel, Emily K
Drawing on a large cache of letters to John and Frances Gunther after the death of their son as well as memoirs and fiction by bereaved parents, this essay challenges the assumptions of secularization that infuse histories of twentieth-century American medicine. Many parents who experienced the death of children during the postwar period relied heavily on religion to help make sense of the tragedies medicine could not prevent. Parental accounts included expression of belief in divine intervention and the power of prayer, gratitude for God's role in minimizing suffering, confidence in the existence of an afterlife, and acceptance of the will of God. Historians seeking to understand how parents and families understood both the delivery of medical care and the cultural authority of medical science must integrate an understanding of religious experiences and faith into their work. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
The average length of hospital stay was 3 days. Of the inguinal ... on hernia disease with reference to prevalence, pattern and management at a provincial general hospital in Kenya. Methods. After obtaining permission from the hospital administration, we .... financial constraint on hospitals, length of hospital stay and enable ...
Fast bowlers with a front-on bowl- ing action are more susceptible to an injury of the shoulder.10. The presence of an imbalance between the agonist and antagonist groups is one of the major risk factors for devel-. ORIGINAL RESEARCH ARTICLE. Shoulder injuries in provincial male fast bowlers — predisposing factors.
Aim To determine the etiology and outcome of pediatric burns (0-12 years). Design A retrospective study of burn victims hospitalized at the Rift Valley Provincial General Hospital, Nakuru, Kenya from April 2004 to March 2007. Method Charts of all children hospitalized for burn injury were reviewed for patient demographics, ...
Objective. To determine the incidence and nature of injury patterns in elite cricketers over two seasons. Methods. Physiotherapists and/or doctors working with 4 provincial teams completed a questionnaire for each cricketer who presented with an injury during the 2004 - 2005 (S1) and 2005 - 2006 (S2) cricket seasons.
Background: Injuries related to motorcycles contribute significantly to the number of road traffic injuries This study was aimed at determining the pattern of injuries caused by motorcycle crash among patients seen at Kakamega provincial hospital in Kenya... Methods: This was a cross sectional study which was conducted in ...
At link level it was possible to synchronise the upgraded network with the financial asset registry in order to gauge the current state of the provincial roads within Gauteng, and to identify those that are in need of attention and/or rehabilitation to optimise efficiency and safety. This approach can be standardised throughout the ...
The context of the study is the concern over declining provincial road conditions due to insufficient government funding for road maintenance. The roads are used by a wide variety of commercial and private interests that contribute a broad range of axle loads. There is no information available on the use of these roads, nor ...
van Klinken, G.; Berenschot, W.
The post-1998 surge in local politics has moved the provincial town back to centre stage. This book examines the Indonesian middle class (now 43%!) up close in the place where its members are most at home: the town. Middle Indonesia generates national political forces, yet it is neither particularly
The purpose of the study was to determine the current situation regarding the implementation of mental skills training (MST) programmes by netball coaches. A total of 265 South African provincial netball players from 28 teams and their respective coaches (n=28) participated in the study. Despite the fact that 89.90%
Khorashad, Behzad S; Roshan, Ghasem M; Reid, Alistair G; Aghili, Zahra; Hiradfar, Mehran; Afkhamizadeh, Mozhgan; Talaei, Ali; Aarabi, Azadeh; Ghaemi, Nosrat; Taghehchian, Negin; Saberi, Hedieh; Farahi, Nazanin; Abbaszadegan, Mohammad Reza
To report sexual orientation, relationship status and medical history of Iranian people with Differences of Sex Development (DSD) who were raised female. Our participants consisted of nineteen 46,XY individuals with Complete Androgen Insensitivity Syndrome (CAIS) and eighteen 46,XX individuals with Congenital Adrenal Hyperplasia (CAH) who were raised as females and older than 13years. As well as their relationship status and detailed medical history, an expert psychiatrist assessed their sexual orientation by a semi-structured psychiatric interview with them and, where applicable, their parents. Five percent of CAH participants and 42% of CAIS participants were in a relationship, which was significantly different. All CAH individuals had been diagnosed at birth; 89% of CAIS had been diagnosed after puberty and due to primary amenorrhea and 11% were diagnosed in childhood due to inguinal hernia. Genital reconstructive surgery had been performed in 100% of CAH participants and 37% of CAIS. Regarding sexual contact experiences and sexual fantasies (androphilic, gynephilic or both), no significant differences were found. However, CAH females had significantly more gynephilic dreams (P=0.045). This study, notable as one of the rare from a non-western culture, described sexual, medical and socioeconomic status of 46,XX CAH and 46,XY CAIS individuals living in Iran. Although broadly in line with previous findings from Western cultures, Iranian CAH individuals had fewer romantic relationships, but in contrast to previous studies their sexual orientation was only different from CAIS in the contents of sexual dreams. Copyright © 2016 Elsevier Inc. All rights reserved.
Karkov, Louise Lindved; Schytte-Hansen, Simon; Nørgaard, Lotte Stig
Objective The aim of this study was to clarify the number and type of discrepancies between four medication sources as well as their potential clinical significance to the patient. Method The study was conducted as a cross-sectional study comprising all patients hospitalised with hip fractures...... in the Orthopaedic Surgery Ward at Amager Hospital. Data were collected from four sources. All information was counted, and the potential clinical significance of discrepancies was evaluated on a five-point scale. The four sources are: patients, the Personal Electronic Medication Profile (PEM), the general...... sources. Results A total of 69 medications were registered for nine patients or an average of 7.7 medications per patient. 10.1 discrepancies per patient and 1.3 discrepancies per drug were registered. Two discrepancies were assessed as having potentially lethal clinical significance. Forty...
Coulter, Dwight B.
The history of veterinary homeopathy, its future and implications are discussed. The need for investigation into the validity of both allopathic and homeopathic claims is stressed and it is suggested that maintenance of quality is the key factor in any approach. (BH)
Idris, Badrisyah; Sayuti, Sani; Abdullah, Jafri Malin
Universiti Sains Malaysia is the only institution in Malaysia which incorporates all fields of the neurosciences under one roof. The integration of basic and clinical neurosciences has made it possible for this institution to become an excellent academic and research centre. This article describes the history, academic contributions and scientific progress of neurosciences at Universiti Sains Malaysia.
Schochow, Maximilian; Steger, Florian
Institutes of the history of medicine, the theory of medicine, and medical ethics at German institutions of higher learning have created various e-learning options that are based on different learning platforms and tailored to the specific curricular needs of individual teaching. Up to now no valid data has been available about the types of such e-learning options as well as possibilities of future developments thanks to coordinated cooperation among the different institutes. Of 31 German institutes of the history and theory of medicine and medical ethics that were asked to fill out a questionnaire, 30 answered, which equals a return rate of 97 per cent. The questionnaire was completed between July and August 2012 using a telephone survey. Available to students online, digitally interactive teaching tools have boomed in the course of the last few years at German institutes of the history of medicine, the theory of medicine, and medical ethics. This trend is also reflected in a willingness of more than half of the respective departments (67 per cent) to expand their e-learning options on the basis of previous experience. The offered e-learning systems are accepted very well by the students. 57 per cent of the institutes stated, that 90-100 per cent of the students use the offered systems regularly. E-learning courses for terminology are offered particularly often, this is also reflected in the intended extension of these courses by the majority of institutes which plan to expand their e-learning systems. This article discusses the results of a comprehensive empirical survey about e-learning. It illustrates ways in which individual German institutes plan to expand their e-learning options in the future. Finally, specific proposals for cooperation among institutions (not just online) are introduced, the purpose of which is to produce synergy in e-learning.
Full Text Available Background: Institutes of the history of medicine, the theory of medicine, and medical ethics at German institutions of higher learning have created various e-learning options that are based on different learning platforms and tailored to the specific curricular needs of individual teaching. Up to now no valid data has been available about the types of such e-learning options as well as possibilities of future developments thanks to coordinated cooperation among the different institutes.Methods: Of 31 German institutes of the history and theory of medicine and medical ethics that were asked to fill out a questionnaire, 30 answered, which equals a return rate of 97 per cent. The questionnaire was completed between July and August 2012 using a telephone survey.Results: Available to students online, digitally interactive teaching tools have boomed in the course of the last few years at German institutes of the history of medicine, the theory of medicine, and medical ethics. This trend is also reflected in a willingness of more than half of the respective departments (67 per cent to expand their e-learning options on the basis of previous experience. The offered e-learning systems are accepted very well by the students. 57 per cent of the institutes stated, that 90-100 per cent of the students use the offered systems regularly. E-learning courses for terminology are offered particularly often, this is also reflected in the intended extension of these courses by the majority of institutes which plan to expand their e-learning systems.Conclusions: This article discusses the results of a comprehensive empirical survey about e-learning. It illustrates ways in which individual German institutes plan to expand their e-learning options in the future. Finally, specific proposals for cooperation among institutions (not just online are introduced, the purpose of which is to produce synergy in e-learning.
Bredaki, F E; Sciorio, C; Wright, A; Wright, D; Nicolaides, K H
To define the contribution of maternal variables which influence the measured level of maternal serum alpha-fetoprotein (AFP) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum AFP was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of AFP were determined from a linear mixed-effects multiple regression. Serum AFP was measured in 17 071 cases in the first trimester, 8583 in the second trimester and 8607 in the third trimester. Significant independent contributions to serum AFP were provided by gestational age, maternal weight, racial origin, gestational age at delivery and birth-weight Z-score of the neonate of the previous pregnancy and interpregnancy interval. Cigarette smoking was found to significantly affect serum AFP in the first trimester only. The machine used to measure serum AFP was also found to have a significant effect. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum AFP and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this pregnancy complication. A model was fitted to express measured serum AFP across the three trimesters of pregnancy as MoMs, after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Pyle, G F
This paper is a personal commentary on the contributions of noted medical historian K. David Patterson. The eightieth anniversary of the onset of the Great Influenza Pandemic of 1918-19 serves as a reminder of his contributions. His works on slavery and disease in Africa, influenza diffusion and the history of cholera and other diseases periodically appeared in Social Science and Medicine. With a publishing career that lasted from 1971 to 1996, his enduring contributions include revised estimates of mortality in Africa during the influenza pandemic of 1918-1919.
Bardon, Jean; Picard, Fabien; Barbou, Franck; Varenne, Olivier; Vivien, Benoît
Spontaneous coronary artery dissection (SCAD) is an uncommon disease. We report the case of a 50 year-old woman with a past medical history of aneurysmal subarachnoid hemorrhage, presenting with acute chest pain and diffuse ST segment elevation on ECG. Coronary angiogram revealed a SCAD of the left anterior descending coronary artery. The association between cerebral aneurysms and SCAD should trigger providers concern for fibromuscular dysplasia. We hereby report on a rare and atypical case involving the relationship between fibromuscular dysplasia and SCAD.
The Salernitan School of Medicine was founded in the late 10th century as a loose association of medical teachers. The period before the middle 13th century was divided into three phases. In the early phase, before the end of 11th century, "practica" books were written, utilizing extant ancient literature, Arabic medical treatises were translated into Latin, and the medical text "Articella" was compiled. In the high phase before the end of the 12th century, the "Articella" was commented upon and new pharmacopeia and practica books were written. In the late phase before the middle of the 13th century, physicians who graduated from Salerno were active in various countries in Europe. After the middle of the 13th century the school developed organizations and rules, became a university at the end of 16th century, and was closed in 1811. The Salernitan school produced "Articella", which pioneered in theoretical medical education, and produced "practica", which dealt with both local diseases from head to foot and systemic fever diseases, and it continued until the end of 18th century. The two major disciplines of medical education before the end of 18th century, theoretica and practica, were derived from Salerno.
Chisolm, Deena J.; Scribano, Philip V.; Purnell, Tanjala S.; Kelleher, Kelly J.
Children in out-of-home placements (foster children) often undergo multiple placement changes while under the care of child protective services. This instability can result in lack of health care continuity and poor health outcomes. This brief describes the development of a medical history profile, or passport, developed from Medicaid administrative data. A purposive sample of 25 youths was provided from a county child protective services agency. The patients were systematically matched with data from the state Medicaid agency. Using Medicaid claims/encounter data we generated health care profiles that provided information on historical use of ambulatory care, diagnoses, providers seen, medications used, and inpatient admissions. Profiles were however limited by missing provider information and non-specific diagnostic coding. Despite these limitations, Medicaid data-based profiles show the potential to be a cost efficient method for improving continuity of care for children in out-of-home placement. PMID:19648702
Robert Burns's poem, Death and Doctor Hornbook, 1785, tells of the drunken narrator's late night encounter with Death. The Grim Reaper is annoyed that ‘Dr Hornbook’, a local schoolteacher who has taken to selling medications and giving medical advice, is successfully thwarting his efforts to gather victims. The poet fears that the local gravedigger will be unemployed but Death reassures him that this will not be the case since Hornbook kills more than he cures. Previous commentators have regarded the poem as a simple satire on amateur doctoring. However, it is here argued that, if interpreted in the light of the exoteric and inclusive character of 18th century medical knowledge and practice, the poem is revealed to have a much broader reference as well as being more subtle and morally ambiguous. It is a satire on 18th century medicine as a whole.
In Poland, medical embryology (both scientific research and teaching of the subject) has traditionally involved Chairs of Histology and Embryology rather than Obstetrics and Gynecology. Before World War II, the most buoyant centers for embryological research among the five universities at the time (in Warsaw, Krakow, Poznan, Lvov and Vilnius), were the Chairs of Embryology and Histology at Medical Faculties of the Jagiellonian University in Krakow and the University of Vilnius. After World War II, eleven Medical Academies (Universities of Medicine) came into being (Warsaw, Krakow, Poznan, Lodz, Gdansk, Bialystok, Bydgoszcz, Szczecin, Wroclaw, Katowice and Lublin). They conduct scientific research on normal development of the human embryo as well as teratology studies. In the XX century, eminent medicine-related embryologist included professors Emil Godlewski Jr., Stanislaw Hiller and Stefan Baginski.
Kulikowski, Casimir A; Mihalas, George; Greenes, Robert; Yacubsohn, Valerio; Park, Hyeoun-Ae
The IMIA History Working Group has as its first goal the editing of a volume of contributions from pioneers and leaders in the field of biomedical and health informatics (BMHI) to commemorate the 50th anniversary of IMIA's predecessor IFIP-TC4. This paper describes how the IMIA History WG evolved from an earlier Taskforce, and has focused on producing the edited book of original contributions. We describe its proposed outline of objectives for the personal stories, and national and regional society narratives, together with some comments on the evolution of Medinfo meeting contributions over the years, to provide a reference source for the early motivations of the scientific, clinical, educational, and professional changes that have influenced the historical course of our field.
Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history
Phytogeographic reconstructions have been published for most Paleozoic series since the Pr??i??doli??, but there have been few attempts to synthesize this data into a comprehensive review of the characteristics and causes of the changing phytogeographic patterns for the whole Paleozoic history of the vascular flora. Existing floristic analyses have been compiled in this manuscript and the resulting data are used to reconstruct the evolution of floristic provinces since the Silurian. The earliest plant fossil records indicate that provinciality was characteristic of terrestrial vascular plant distributions right from the beginning of terrestrial colonization by vascular plants. This interpretation differs markedly from the views of many workers who still maintain that pre-Upper Carboniferous floras were uniform and cosmopolitan in distribution. Three of the four major phytogeographic units, i.e. Angara, Euramerica, and Gondwana, can be recognized in the earliest fossil floras. The fourth unit, Cathaysia, differentiated from Euramerica during the late Upper Carboniferous. Phytogeographic differentiation occurs in direct response to climatic gradients and physiographic barriers. As these gradients and barriers change, provincial boundaries expand and contract, fragment, reassemble and reassort. Phytogeographic units are dynamic through time. ?? 1996 Elsevier Science B.V. All rights reserved.
Martin, Hugo; Ocana, F.; Scoles, R.
The evolution of social and political events in the province of Cordoba after the Law 8157 of 1992, that establishes the provincial nuclear policy, are analysed as well as the recent sanction and veto of the Law 8775, which creates the provincial Nuclear Regulatory Authority. The authors conclude that is necessary and convenient to enforce provincial nuclear regulations and controls
Full Text Available Introduction: Taking patients' history and doing physical examinations help physicians to diagnose correctly and treat accordingly. There are several factors which may affect the quality of taking patients' history. This study aims to assess determinants of taking patients' history from the viewpoint of the students of Birjand Medical School. Methods: This descriptive study was carried out in 2010-2011 on all 137 medical trainees and interns studying at Birjand Medical School. To determine the students’ attitudes towards history taking and to evaluate their performance a questionnaire and a check-list were used, respectively. The data analyzed using SPSS software. Descriptive-deductive statistics (T-test were applied on the data. Results: The average score of the motivational factors was more than the preventive factors. Among the motivational factors, the statement “taking patient history is a basis of proper diagnosis and treatment” (3.58 and among the preventive factors the statement “taking patient history just to evade responsibility”(2.57had the highest scores. Moreover, there was a significant difference between the performance of trainees and interns in taking and recording patients’ history (P<0.005. Conclusion: Although the students held a positive attitude toward taking patients' history, they didn’t have satisfactory performance in recording disease symptoms, diagnosis and treatment plans this entails more attention. Observation of trainers on the process of history taking may help.
Chatterjee, Pranab; Chandra, Shivika; Biswas, Tamoghna
Daniel Carrion, a sixth-year medical student, died while investigating the effects of self-inoculation of the causative organism of Oroya Fever and Bartonellosis and thereby contributed to understanding of the disease before the organisms had been identified. © The Author(s) 2014.
Patsatsi, Aikaterini; Vyzantiadis, Timoleon-Achilleas; Chrysomallis, Fotis; Devliotou-Panagiotidou, Despina; Sotiriadis, Dimitrios
Bullous pemphigoid (BP) is an autoimmune bullous disease that mainly affects elderly patients. In this retrospective study, in a series of patients with BP, data on systemic medications were collected in order to investigate a possible association with active BP. Thirty-four patients with BP were studied in two groups. Group A contained patients who were receiving systemic medications and group B contained patients receiving no medications. All sera were examined by immunoassay for the possible existence of anti-BP180NC16a and anti-BP230, prior to the initiation of steroid treatment. Patients were of a similar age in both groups (P = 0.07). Anti-BP180NC16a autoantibodies were detected in 80% of patients in group A and in 14% of patients in group B. Anti-BP230 autoantibodies were detected in 25% of patients in group A and in 50% of patients in group B. Levels of circulating anti-BP180NC16a autoantibodies were statistically significantly higher in group A than in group B (P = 0.04). Patients who were receiving systemic medications seemed to be more susceptible to the development of BP. Should we consider drug exposure as one of the reasons for the increased prevalence of BP in the elderly? It is important to be more vigilant with this category of patients in order to provide an early diagnosis of the disease.
Wright, D; Papadopoulos, S; Silva, M; Wright, A; Nicolaides, K H
To define the contribution of maternal variables which influence the measured level of maternal serum free β-human chorionic gonadotropin (β-hCG) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum free β-hCG was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of free β-hCG were determined from a linear mixed-effects multiple regression. Serum free β-hCG was measured in 94 985 cases in the first trimester, 7879 in the second trimester and 8424 in the third trimester. Significant independent contributions to serum free β-hCG were provided by gestational age, maternal weight, age and racial origin, cigarette smoking, method of conception, diabetes mellitus and family history of pre-eclampsia (PE) in the mother of the patient. The effects of some variables were similar and those for others differed in each trimester. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum free β-hCG and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates both in pregnancies that developed PE and in those without this pregnancy complication. A model was fitted to express measured serum free β-hCG across the three trimesters of pregnancy as MoMs after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Libster, Martha M
During the mid 19th century, herbal remedies were the platform for a major health reform movement in America known as the Botanical Medical Movement (BMM). A number of histories have been written on the BMM from the perspectives of physicians and pharmacists. This article describes the history of nurse-herbalism during the period and the impact that Shaker nurses, in particular, had on the BMM. The article traces the history and findings of a triangulated case study. Shaker nurses used herbs extensively in their caring and curing practices. They applied the botanical remedies recommended by BMM leaders. The nurses were also expert herbal medicine makers who used their own remedies in patient care. The Shaker infirmary was the nurses' behind-the-scenes research and development laboratory for the Shaker herbal cottage industry, which ultimately developed into an international, entrepreneurial endeavor. The Shaker infirmary was the nurses' organized proving ground for the implementation of the botanical health reforms of the mid 19th century. The nurse-herbalists' contribution to the promotion and production of herbal remedies had a significant impact on the success of botanical health reform in America.
Francisco, C; Wright, D; Benkő, Z; Syngelaki, A; Nicolaides, K H
A survival-time regression model for gestational age at delivery with pre-eclampsia (PE) in singleton pregnancy, using maternal demographic characteristics and medical history, was reported previously. The objective of this study was to extend this model to dichorionic (DC) and monochorionic (MC) twin pregnancy. The study population included 1789 DC and 430 MC twin pregnancies and 93 297 singleton pregnancies. A survival-time model for gestational age at delivery with PE was developed from variables of maternal characteristics and medical history. The risk of PE with delivery pregnancies was determined and compared with that in singleton pregnancies. In singleton pregnancies comprising women of Caucasian racial origin, mean weight of 69 kg at 12 weeks' gestation, mean height of 164 cm, nulliparous, with spontaneous conception, no family history of PE and no history of diabetes mellitus, systemic lupus erythematosus or antiphospholipid syndrome, the mean of the Gaussian distribution of gestational age at delivery with PE was 55 weeks. In DC twins with PE, mean gestational age at delivery was shifted to the left by 8.2 (95% CI, 7.2-9.1) weeks and in MC twins it was shifted to the left by 10.0 (95% CI, 8.5-11.4) weeks. The risk of delivery with PE occurring at, or before, a specified gestational age is given by the area under the fitted distribution curve. For a reference population with the above characteristics, the estimated risk of PE history has been developed for estimation of patient-specific risks for PE in DC and MC twin pregnancy. Such estimation of the a-priori risk for PE is an essential first step in the use of Bayes' theorem to combine maternal factors with biomarkers for the continuing development of more effective methods of screening for the disease. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
This article presents one of the earliest clinical photographs in the history of surgery in Iran. The picture was taken around 1919 (1297 of the Iranian solar calendar) in Tabriz, Iran. It shows the post-operative care of two amputees by the surgical team, the surgical instruments and the method of applied anesthesia. The patients were Iranian Gendarmerie soldiers who lost their limbs to frostbite. The surgeries were performed by Dr. Ali Roshdi in Gendarmerie Hospital in Tabriz. This photograph cleverly demonstrates the coconscious endeavor of the surgical team to treat and save lives of patients in about a century ago in Tabriz, Iran.
Maccabe, Andrew T; Crawford, Lester; Heider, Lawrence E; Hooper, Billy; Mann, Curt J; Pappaioanou, Marguerite
The mission of the Association of American Veterinary Medical Colleges (AAVMC) is to advance the quality of academic veterinary medicine. Founded in 1966 by the 18 US colleges of veterinary medicine and 3 Canadian colleges of veterinary medicine then in existence, the AAVMC is celebrating 50 years of public service. Initially, the AAVMC comprised the Council of Deans, the Council of Educators, and the Council of Chairs. In 1984, the tri-cameral structure was abandoned and a new governing structure with a board of directors was created. In 1997, the AAVMC was incorporated in Washington, DC and a common application service was created. Matters such as workforce issues and the cost of veterinary medical education have persisted for decades. The AAVMC is a champion of diversity in the veterinary profession and a strong advocate for One Health. The AAVMC has adopted a global perspective as more international colleges of veterinary medicine have earned COE accreditation and become members.
George M. Weisz
Full Text Available Medicine in the Middle Ages was, and ever since remained, one of the main preoccupations of the professionally restricted Jews. One of the medical dynasties on the Iberian Peninsula was the Bueno (Bonus family. Following the expulsion of the Jews from Spain and their spread in Europe, these Iberian physicians became successful everywhere—just as the Buenos were in the Netherlands.
Harding, Clifford V; Akabas, Myles H; Andersen, Olaf S
Physician-scientists are needed to continue the great pace of recent biomedical research and translate scientific findings to clinical applications. MD-PhD programs represent one approach to train physician-scientists. MD-PhD training started in the 1950s and expanded greatly with the Medical Scientist Training Program (MSTP), launched in 1964 by the National Institute of General Medical Sciences (NIGMS) at the National Institutes of Health. MD-PhD training has been influenced by substantial changes in medical education, science, and clinical fields since its inception. In 2014, NIGMS held a 50th Anniversary MSTP Symposium highlighting the program and assessing its outcomes. In 2016, there were over 90 active MD-PhD programs in the United States, of which 45 were MSTP supported, with a total of 988 trainee slots. Over 10,000 students have received MSTP support since 1964. The authors present data for the demographic characteristics and outcomes for 9,683 MSTP trainees from 1975-2014. The integration of MD and PhD training has allowed trainees to develop a rigorous foundation in research in concert with clinical training. MSTP graduates have had relative success in obtaining research grants and have become prominent leaders in many biomedical research fields. Many challenges remain, however, including the need to maintain rigorous scientific components in evolving medical curricula, to enhance research-oriented residency and fellowship opportunities in a widening scope of fields targeted by MSTP graduates, to achieve greater racial diversity and gender balance in the physician-scientist workforce, and to sustain subsequent research activities of physician-scientists.
Lonnée, Herman A; Madzimbamuto, Farai; Erlandsen, Ole R M; Vassenden, Astrid; Chikumba, Edson; Dimba, Rutenda; Myhre, Arne K; Ray, Sunanda
Cesarean delivery is the most common surgical procedure in low- and middle-income countries, so provision of anesthesia services can be measured in relation to it. This study aimed to assess the type of anesthesia used for cesarean delivery, the level of training of anesthesia providers, and to document the availability of essential anesthetic drugs and equipment in provincial, district, and mission hospitals in Zimbabwe. In this cross-sectional survey of 8 provincial, 21 district, and 13 mission hospitals, anesthetic providers were interviewed on site using a structured questionnaire adapted from standard instruments developed by the World Federation of Societies of Anaesthesiologists and the World Health Organization. The anesthetic workforce for the hospitals in this survey constituted 22% who were medical officers and 77% nurse anesthetists (NAs); 55% of NAs were recognized independent anesthetic providers, while 26% were qualified as assistants to anesthetic providers and 19% had no formal training in anesthesia. The only specialist physician anesthetist was part time in a provincial hospital. Spinal anesthesia was the most commonly used method for cesarean delivery (81%) in the 3 months before interview, with 19% general anesthesia of which 4% was ketamine without airway intubation. The mean institutional cesarean delivery rate was 13.6% of live births, although 5 district hospitals were table tilt or wedge, and insufficient blood supplies. Postoperative analgesia management was reported inadequate. This study identified areas where anesthetic provision and care could be improved. Provincial hospitals, where district/mission hospitals refer difficult cases, did not have the higher level anesthesia expertise required to manage these cases. More intensive mentorship and supervision from senior clinicians is essential to address the shortcomings identified in this survey, such as the implementation of evidence-based safe practices, supply chain failures, high
Ariffin, Farnaza; Chin, Ken Lee; Ng, ChirkJenn; Miskan, Maizatullifah; Lee, Verna KarMun; Isa, Mohammad Rodi
Sexual history training during undergraduate education is essential for preparing future doctors to handle patients' sexual health concerns. The purpose of this study was to assess the attitudes and perceptions of final-year medical students in Malaysia toward sexual history taking and the training they receive from their medical schools. The study used a cross-sectional survey of 379 final-year medical students from three medical schools in Malaysia. Students were asked to rate their attitudes and perceptions regarding training on taking sexual histories using a newly developed questionnaire with good internal consistency (Cronbach's alpha = 0.73). Ethics approval was obtained from the relevant medical schools, and the statistical analysis was conducted using SPSS, Version 20.0. The mean age of participants was 23.58 ± 0.65 SD. Participants reported high interest in sexual health and felt it was important for doctors to know how to take a sexual history (95%). Among the participants, only half felt comfortable in taking sexual histories from patients. The participants identified cultural and religious differences between the doctor and the patient as a potential barrier for discussing sexual health. Participants were aware of their own practice and ability, as well as their limitations, in taking sexual histories. Less than half (46%) felt that the training they received adequately prepared them to take sexual histories. This study identified gaps in sexual health training among medical schools in Malaysia. The delivery of sexual health education program should incorporate confidence building and to make students feel comfortable to take sexual histories from patients. The barrier caused by differences in culture or religion between a doctor and a patient may be overcome through cross cultural and cultural competency training. This is important for multi-faith, multi cultural societies such as Malaysia and other similar countries.
Hui, A C; Wong, S M
Ludwig van Beethoven had a number of medical conditions, including deafness and chronic liver disease, for which there are contemporary descriptions. An autopsy was performed on the day after his death. Physicians and historians have tried to reinterpret original sources to determine the causes of his deafness and systemic illnesses. We have reviewed the differential diagnoses that have been proposed by otologists and physicians. Clinical and post-mortem findings point to renal papillary necrosis and liver cirrhosis of unknown aetiology. In the absence of further histological examination, there is no definitive answer to the cause of his deafness and gastro-intestinal symptoms.
Marta, Monica Mihaela
Given the current importance of publishing medical research articles in high-impact international journals, this article briefly presents key moments in the evolution of this reporting genre for a better understanding of the diachronic changes that have shaped it into a highly useful tool for creating and spreading knowledge, as well as for establishing academic hierarchies at both individual and institutional level. Therefore, focus will be placed not only on the evolution of its structure and purpose, but also on issues such as knowledge construction, knowledge claims, writer-reader interaction and the appropriate writing conventions and rhetorical strategies required for successful scientific communication.
An empirical investigation refutes the popular conception that excessive drug usage was a widespread social phenomenon in the Weimar Republic. Although physicians warned the public and politicians of a "cocaine wave" that threatened the public health, there is no evidence that indicates a significant increase of cocaine use during the twenties. The decisive cause for this moral panic was caused instead by the disease pattern of "Cocainism". The addiction carried the imprint of an infectious disease and would destroy the body, the will, and the civic life of its victims. According to medical doctrine, chronic cocaine consumption also produced the tendency towards deviant sexual activities and criminal activity. For this reason, the use of this substance was in particular linked to deviant social milieus like the so-called Bohemian or demimonde. However, historical sources in fact show that it was primarily a problem of the medical professions. Against the background of the desperate political, social and economic situation in Germany after the First World War, physicians regarded cocaine and morphine addictions as a threat to the hoped for political and biological renewal of the nation.
Tsiakkas, A; Duvdevani, N; Wright, A; Wright, D; Nicolaides, K H
To define the contribution of maternal variables which influence the measured level of maternal serum placental growth factor (PlGF) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum levels of PlGF were measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 or 35 + 0 to 37 + 6 weeks' gestation. For women delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history important in the prediction of PlGF were determined from a linear mixed-effects multiple regression. Serum levels of PlGF were measured in 38,002 cases in the first trimester, 10,281 in the second trimester and 12,392 in the third trimester. Significant independent contributions to serum PlGF were provided by gestational age, maternal age, weight and racial origin, cigarette smoking, diabetes mellitus, and gestational age at delivery and birth-weight Z-score of the neonate in the previous pregnancy. The machine used to measure serum PlGF was also found to have a significant effect. Allowing for other factors, the effect of maternal age on PlGF changed over the three trimesters, whereas other variables had constant effects over the three trimesters. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured serum PlGF and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this complication. A model was fitted to express the measured level of maternal serum PlGF across the three trimesters of pregnancy as MoMs, after adjusting for variables of maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG
Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation
Bronner, Karen; Mesters, Ilse; Weiss-Meilnik, Ahuva; Geva, Ravit; Rozner, Guy; Strul, Hana; Inbar, Moshe; Halpern, Zamir; Kariv, Revital
Individuals with a family history of colorectal cancer (CRC), have a two-to-five-fold increased lifetime risk to develop CRC. Thus, they are particularly likely to benefit from adherence to medical recommendations for CRC prevention. Despite this increased risk, previous studies have shown an underutilization of colonoscopy for screening and a paucity of data on lifestyle habits that could enhance colonoscopy rates in this population. The primary aims were (a) to assess CRC screening patterns and lifestyle choices among siblings and children of CRC patients, (b) to ascertain discrepancies between actual behavior and medical recommendations, and (c) to identify family members with multiple unhealthy lifestyle habits. The secondary aim was to test for possible associations between utilization rates for CRC screening and other preventive health services. A cross-sectional study was conducted among 318 first-degree relatives (FDRs) of 164 CRC patients treated at the Tel Aviv Sourasky Medical Center. Interviews were conducted with a structured questionnaire. There was significant underutilization of colonoscopy for screening with only 73 FDRs (23.0%) adhering to the recommended screening schedule. This rate was slightly improved (N = 58, 31.9%) among subjects aged 40 years and above, although it was still far below the optimum. A similar result (N = 70, 21.7%) was observed for other cancer screening tests and routine medical check-ups. A significant association (P preventive health services, and adherence to CRC screening recommendations. CRC screening is significantly underutilized among FDRs of CRC patients. FDRs who do not comply with CRC screening guidelines, lead unhealthy lifestyles, and avoid other cancer screening tests are at increased risk and should be addressed specifically in future interventions.
Several pathogenic fungi and cases related to Japanese medical mycologists were reviewed. Trichosporon inkin (as Sarcinomyces inkin) was reported as a pathogen of scrotal lesion by Oho in 1921, and Trichosporon asahii was isolated from generalized keratotic lesions in 1922 by Akagi in Japan. They were once included in Trichophyton beigelii, but then based on revision using DNA molecular technology, were returned to their original names.Microsporum ferrugineum was reported by Ota as a causative dermatophyte of tinea capitis in Japan and surrounding areas. It was once classified under the genus Trichophyton, but after the discovery of characteristic rough-walled macroconidia belonging to genus Microsporum, the fungus was again assigned to the original name.
An emblem represents the identity of an organization. Through the emblem of an organization, they differentiate the members from others and reinforce the membership, homogeneity, and pride. It is also a tool that an organization officially publicizes its mission and values. The symbol designed by Cho, Byungduk was announced as the first emblem of Korean Medical Association (KMA) on October 31st 1947. His design work has the caduceus with the Taeguk sign on the top, the symbol of Korea, and the Red Cross in the background including the name, 'KMA'. Since then, the emblem was revised three times: in 1964, 1973, and 1995. The current symbol is based on the design of the first one. Although Asklepian, the single serpent-entwined staff of Asklepios, is the one known as the symbol of medicine, this emblem takes the caduceus of Hermes who is the patron god of merchants, thieves, and travelers. The mistake comes from the unawareness of the distinction between the caduceus of Asklepios and Hermes. Moreover, it proves that U. S. Army Medical Corps (USAMC) heavily influenced the reconstruction of Korean health care system including KMA. The USAMC has used the symbol of caduceus since 1902. In 1947, the year that the first emblem of KMA was established, Southern part of Korea was governed by the United States Military Government (USMG, 1945-1948). The current emblem of KMA brings up a question whether we should continue to use the symbol that was taken from USMAC in the historical period of USMG governance. Celebrating 100th anniversary year of KMA, KMA needs to re-evaluate the appropriateness of the KMA symbol.
Gallego Riestra, Sergio; Riaño Galán, Isolina
There is an increasing request by patients or their representatives not to have some data registered in their clinical history or if such data exists to be deleted. Without doubt, this is so because such clinical data is accessed by various professionals who in most cases are not directly involved in caring for such patients. On the other hand, such data is copied and iteratively and unnecessary reproduced in various discharge reports and others forms. The problem arises when such controversial data refer to particularly sensitive clinical aspects such as assisted reproduction techniques, which invades personal and family privacy. Therefore, the question is who determines what data should be recorded in the medical records and according to what criteria should be taken that decision? Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Tosteson, A N A; Do, T P; Wade, S W; Anthony, M S; Downs, R W
During the first year of Prospective Observational Scientific Study Investigating Bone Loss Experience (POSSIBE US), many women transitioned (i.e., discontinued or switched) from their baseline osteoporosis medication. Participants not on stable therapy at entry, with side effects, and with poor physical status were at higher risk of transitioning. Understanding factors associated with persistence may lead to improved outcomes. Postmenopausal osteoporosis (PMO) medication use patterns may differ by treatment history and drug class. We describe these patterns among patients in primary care settings using patient-reported data. Data from 3,006 participants of the POSSIBLE US were used to estimate the probability of a baseline PMO medication transition (i.e., discontinuation or switch) and hazard ratios (HRs) for predictors of these transitions. One year after study entry, the probability of persisting with a baseline medication was 66% (95% CI: 64-68%). After adjusting for age and osteoporosis diagnosis, factors at entry independently associated with a higher risk of baseline medication transition were treatment status cohort, side effect severity, and OPAQ-SV physical function score. Compared to participants stable on therapy at entry, others had a higher risk, ranging from HR = 1.59 (95% CI: 1.36-1.85) for those new to therapy to HR = 2.00 (95% CI: 1.27-3.15) for those who recently augmented therapy at entry. Participants reporting moderate (HR = 1.31, 95% CI: 1.09-1.57) or severe (HR = 1.88, 95% CI: 1.49-2.39) side effects had a higher risk than those not reporting side effects. Participants reporting Osteoporosis Assessment Questionnaire-Short Version physical function scores in the lowest tertile had a higher risk (HR = 1.27, 95% CI: 1.07-1.52) than those reporting scores in the highest tertile. Baseline osteoporosis medication transitions were common in the first year of POSSIBLE US. Participants not on stable therapy at entry, or who reported severe side
Vedin, Tomas; Svensson, Sebastian; Edelhamre, Marcus; Karlsson, Mathias; Bergenheim, Mikael; Larsson, Per-Anders
Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of adults with head trauma over a 1-year period to identify clinical features predicting intracranial hemorrhage. Medical record data have been collected retrospectively in adult patients with traumatic brain injury. A total of 1638 patients over a period of 384 days were reviewed, and 33 parameters were extracted. Patients with high-energy multitrauma managed with ATLS™ were excluded. The analysis was done with emphasis on patient history, clinical findings, and epidemiological traits. Logistic regression and descriptive statistics were applied. Median age was 58 years (18-101, IQR 35-77). High age, minor head injury, new neurological deficits, and low trauma energy level correlated with intracranial hemorrhage. Patients younger than 59 years, without anticoagulation or antiplatelet therapy who suffered low-energy trauma, had no intracranial hemorrhages. The hemorrhage frequency in the entire cohort was 4.3% (70/1638). In subgroup taking anticoagulants, the frequency of intracranial hemorrhage was 8.6% (10/116), and in the platelet-inhibitor subgroup, it was 11.8% (20/169). This study demonstrates that patients younger than 59 years with low-energy head trauma, who were not on anticoagulants or platelet inhibitors could possibly be discharged based on patient history. Maybe, there is no need for as extensive medical examination as currently recommended. These findings merit further studies.
Kim, Sun hyung; Kim, Dal Rea
Young-Jo, 83 years old, was the longest lived king of the Chosun Dynasty. Seungjeongwon Ilgi gives more detail about the diseases and prescriptions of Young-Jo. We could close look at what the Annals of the Chosun Dynasty just described that king received medical attention. In inspecting Jung-Jo`s constitution, to examine his medical history is very important. Yong-jo had a weak constitution, but he was always concerned about health care. Youn-jo complained of colic syndrom and heart fire when young; ascris and shoulder pain since middle age; severe fatigue and gait disturbance caused by edema in his latter years. During his last 20 years, he had taken and resorted to Ken-GongTang, the reason was not psychological disposion, but physical disease. Also, Yong-Jo's condition just before death could be assumed in Seungjeongwon Ilgi and Jonhyeongak Ilgi. According to continuous complaints such as edema of the lower limbs, faint(lethargy) and eating disorder caused by abnormal rising of GI (anorexia), we could presume that the cause of death was uremia. In addition, it has significance to correct feasible misconceaption about the cause of death grounded on The Annals of the Chosun Dynasty.
The retrospective comparative analysis of the following three groups is presented: control group composed of 100 somatically healthy pregnant women; 592 pregnant women with recurrent pregnancy loss complicated with placental dysfunction in the past medical history - the 1st group; and 592 pregnant women with recurrent pregnancy loss without placental dysfunction in the past medical history - the 2nd group. The fetal cardiotocography was analyzed with determination of non-stress test, fetus ultrasound investigation; the fetus biophysical profile was determined; the fates of the current pregnancy and childbearing and the state of the newborn infant were studied; using the statistical analysis, the risk factors affecting the progression of placental dysfunction in women with recurrent pregnancy loss in the past medical history were discovered.
directly declared to him. Lastly, in ministry time of Dr. Farhadi in 2001 this major was initiated for the first time in Iran University of Medical Sciences. The present report was addressed to the education guideline of emergency medicine at Shahid Beheshti University of Medical Sciences besides evaluating the formation history of emergency medicine discipline in Iran.
Nguyen Thi Nguyet
Full Text Available This paper focuses on the evaluation of the impact of the fiscal policy on the growth of Vietnam at the provincial level. A fiscal policy plays a huge role in a national economy. Policy-makers often use flexible fiscal and monetary policies to achieve the overall goal of economic growth. In order to assess the impact of the fiscal policy instruments on economic growth, integrated analyses combined with quantitative analyses are used in the paper so as to find the relationship between the key expenditure items. The government has an impact on economic growth. The results and methodology will elicit quantitative approaches in policy reviews.
This study evaluated the acceptance of using computers to take a medical history by rural Arkansas patients. Sex, age, race, education, previous computer experience and owning a computer were used as variables. Patients were asked a series of questions to rate their comfort level with using a computer to take their medical history. Comfort ratings ranged from 30 to 45, with a mean of 36.8 (SEM = 0.67). Neither sex, race, age, education, owning a personal computer, nor prior computer experience had a significant effect on the comfort rating. This study helps alleviate one of the concerns--patient acceptance--about the increasing use of computers in practicing medicine.
Kim, Yeon-Yong; Park, Jong Heon; Kang, Hee-Jin; Lee, Eun Joo; Ha, Seongjun; Shin, Soon-Ae
The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.
Full Text Available Objectives The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Methods Data from self-reported questionnaires that assessed an individual’s history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Results Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Conclusions Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.
Premkumar, Ashish; Raad, Kareem; Haidar, Mona H
The critiques leveled towards medical humanitarianism by the social sciences have yet to be felt in medical education. The elevation of biological suffering, at the detriment of sociopolitical contextualization, has been shown to clearly impact both acute and long-term care of individuals and communities. With many medical students spending a portion of their educational time in global learning experiences, exposure to humanitarianism and its consequences becomes a unique component of biomedical education. How does the medical field reconcile global health education with the critiques of humanitarianism? This paper argues that the medical response to humanitarian reason should begin at the level of a social history. Using experiential data culled from fieldwork with Palestinian and Syrian refugees in Lebanon, the authors argue that an expanded social history, combined with knowledge derived from the social sciences, can have significant clinical implications. The ability to contextualize an individual's disease and life within a complex sociopolitical framework means that students must draw on disciplines as varied as anthropology, sociology, and political history to further their knowledge base. Moreover, situating these educational goals within the framework of physician advocacy can build a strong base in medical education from both a biomedical and activist perspective.
Baty, B.J.; Blackburn, B.L.; Carey, J.C. [Univ. of Utah School of Medicine, Salt Lake City, UT (United States)
The natural history of trisomy 18 and trisomy 13 was investigated using data derived from parent questionnaires and medical records from 98 families with an index case of trisomy 18 and 32 families with an index case of trisomy 13. Data are presented on pregnancy, delivery, survival, medical complications, immunizations, growth, cause of death, cytogenetics, and recurrence risk. Half of the trisomy 18 babies were delivered by C-section. Fetal distress was a factor in half, and the only reason in a third of C-section deliveries. One minute Apgar scores were significantly lower in C-section and breech deliveries. There were more small-for-gestational-age babies than in the general population, but most of the low-birth-weight newborns were small for gestational age, unlike the general population. Survival in this group of children was better than in other studies due to ascertainment bias. There were more girls than boys at all ages for both conditions, and the sex ratio decreased with time. Growth curves for length, weight, head circumference, and weight vs height are provided. Long-term survival did not appear to be due to mosaicism. There were no adverse reactions attributable to immunizations. At age 1 year there was an average of approximately 2 operations per living child. The authors report the second case of successful major cardiac surgery in a trisomy 18 child. Almost 70% of deaths were attributed to cardiopulmonary arrest. The sibling recurrence risk for trisomy 18 or trisomy 13 was 0.55%. 86 refs., 5 figs., 5 tabs.
Klein, Wouter; Pieters, Toine
The history of the introduction of exotic therapeutic drugs in early modern Europe is usually rife with legend and obscurity and Peruvian bark is a case in point. The famous antimalarial drug entered the European medical market around 1640, yet it took decades before the bark was firmly established
exceeds incoming migrants. Young people under 35 showed the highest rate of willingness to leave the region – 57.6 % of respondents, which arouses concern about the region’s future as this cohort capable of developing the region is the target of all plans about boosting the regional image, and these people are not going to cast in their lot with the Volgograd region. For the moment, we can point out that the region shows poor attractiveness for the main target groups in the region, which encumbers the formation of the region’s image and regional identity, indicates negative tendencies and implies great effort on the part of management entities if they want to change the situation in the Volgograd region. Our study revealed the main trends in building a positive image of the region and changing the local context; these are traditional (centre of war and history memorials – 38 % of respondents, industrial – 46.0 % of respondents, tourism – 26.8 % of respondents, and innovative (centre for training and education – 35.5 %, centre for culture – 37.9 % of respondents. The regional image and local context do not change spontaneously; they are rather a product of conscious, well-regulated conceptualization, a product of artificially organized public reflection and projection. According to the surveyed people residing in the region, the region’s development and change in local context can be helped along by such factors as “active cooperation of the authorities and business – 49.3 % of respondents; “honesty among regional and municipal officials – 38.6 % of respondents; “safety of business operations” – 34.3 % of respondents; “presence of a regional strategy that meets the region’s needs” – 33.9 % of respondents; “social and tax benefits” – 33.0 % of respondents; “the people should be informed about the project of regional development and take part in them” – 26.8 % of respondents. Revealing the factors that determine the local
A review was conducted by the British Columbia Energy Council to assess the economic and social impacts of the export of long-term firm electricity to the USA and the distribution of these impacts. The objectives of, and the differences between, benefit-cost and socio-economic impact analysis are discussed as they apply to potential electricity export projects. Provincial export project review requirements (project justification, environmental impacts, socio-economic impact assessment) and proposed legislative changes are first reviewed. The concepts and objectives of value added, economic rent, opportunity costs, economic (benefit-cost) analysis, and socio-economic impact analysis are explained. Employment issues including unemployed labor, employment benefits, and regional and occupational considerations are then discussed, as well as transfers to various levels of government in the form of taxes, subsidies, resource royalties, and depletion costs. 8 refs., 4 tabs
Full Text Available Islamic symbols have flourished in the public spaces of Indonesian provincial towns after Suharto. This phenomenon has occurred in parallel with the significant shifts in the social, economic and political fields, which is tied to the mounting impact of Islamization, social mobility, economic growth, and democratization occurring among town people. It is as if we see a parallel move between Islamization, modernization, globalization and democratization. Key concepts associated with these trends are appropriated with those rooted in tradition and local culture to inform the whole dynamics of Indonesian provincial towns today. The key player in this process is the new middle class, who look to Islam for inspiration both to claim distinction and social status and to legitimize their consumptive lifestyle. They are newly pious who act as active negotiators between the global and the local as well as the cosmopolitan centre and the hinterland. They also play a pivotal role as an agency that liberalizes religion from its traditionally subservient, passive and docile posture by turning it into a source of moral legitimacy and distinction to represent a modern form of life. Given its intimate relationship with locality, tradition, modernity as well as globalization, Islam has increasingly assumed a greater importance for local politics. Political elites have used Islamic symbols for the instrumental purpose of extending their political legitimacy and mobilizing constituency support, in a political environment of open competition and increased public participation in decision making. In this process religious symbols have irrefutably been distanced from their religious moorings and narrow, Islamist understandings, in favor of pragmatic political purposes. Keywords: Islamic symbols, middle class, globalization, lifestyle, local politics
Wang, J Y; Ko, Y C; Wang, J W; Jan, L C; Chang, F M; Lin, K C
Even more restrictive regulations and reimbursement limits seem to be a very heavy burden and stress for most provincial hospitals, especially after the National Health Insurance System has been introduced. The purpose of this project to find a better, universal direction for these hospitals through three steps: 1) Using different financial and accounting ratio indexes to evaluate the general business performance of each hospital. 2) Taking a comprehensive questionnaire with senior managers of each hospital to know their concepts and attitudes concerning external environment and internal operation. 3) Comparing data's correlation and differentiation to ascertain better trends for future operation for all hospitals. The database for this project comes from two resources: 1) Government finance and budget reports of 22 provincial hospitals for the 1994 accounting calendar year. 2) The results of questionnaires returned by 274 senior managers of hospitals, and analysis of these by chi-square test. Through statistical comparison, a number of conclusions can be made: 1) Most hospitals have better operation efficiency if any professional hospital administrator is working for them. 2) The hospital with more comprehensive personnel system shows better business performance. 3) The hospital with routine and formal financial analysis reports always has better business performance. 4) The hospital with poor operational efficiency tends to get rid of restriction or limitation from government's system. 5) The hospital with good operational efficiency has more confidence and desire to improve and change. 6) The hospital with poor operational efficiency is more dependent on outside support from government. 7) The hospital with better business performance has more concern about the impact of malpractice around the hospital. In short, a hospital with poor business efficiency always has more pessimistic attitude and tends to rely on outside resource support. On the other hand, a
Full Text Available This paper presents the CSIR’s contribution to technical advances in the approach to provincial spatial planning in South Africa. It demonstrates the CSIR’s involvement in conducting the national Provincial Growth and Development Strategy Assessment...
The aim of the study is to determine the attitudes of employees of Provincial Directorates of National Education and school administrators towards strategic planning. The research was designed as a survey model study. The population of the research consisted of employees of Provincial Directorate of National Education of Kutahya and school…
Freedman, Stephen B; Lee, Bonita E; Louie, Marie; Pang, Xiao-Li; Ali, Samina; Chuck, Andy; Chui, Linda; Currie, Gillian R; Dickinson, James; Drews, Steven J; Eltorki, Mohamed; Graham, Tim; Jiang, Xi; Johnson, David W; Kellner, James; Lavoie, Martin; MacDonald, Judy; MacDonald, Shannon; Svenson, Lawrence W; Talbot, James; Tarr, Phillip; Tellier, Raymond; Vanderkooi, Otto G
Each year in Canada there are 5 million episodes of acute gastroenteritis (AGE) with up to 70% attributed to an unidentified pathogen. Moreover, 90% of individuals with AGE do not seek care when ill, thus, burden of disease estimates are limited by under-diagnosing and under-reporting. Further, little is known about the pathogens causing AGE as the majority of episodes are attributed to an "unidentified" etiology. Our team has two main objectives: 1) to improve health through enhanced enteric pathogen identification; 2) to develop economic models incorporating pathogen burden and societal preferences to inform enteric vaccine decision making. This project involves multiple stages: 1) Molecular microbiology experts will participate in a modified Delphi process designed to define criteria to aid in interpreting positive molecular enteric pathogen test results. 2) Clinical data and specimens will be collected from children aged 0-18 years, with vomiting and/or diarrhea who seek medical care in emergency departments, primary care clinics and from those who contact a provincial medical advice line but who do not seek care. Samples to be collected will include stool, rectal swabs (N = 2), and an oral swab. Specimens will be tested employing 1) stool culture; 2) in-house multiplex (N = 5) viral polymerase chain reaction (PCR) panel; and 3) multi-target (N = 15) PCR commercially available array. All participants will have follow-up data collected 14 days later to enable calculation of a Modified Vesikari Scale score and a Burden of Disease Index. Specimens will also be collected from asymptomatic children during their well child vaccination visits to a provincial public health clinic. Following the completion of the initial phases, discrete choice experiments will be conducted to enable a better understanding of societal preferences for diagnostic testing and vaccine policy. All of the results obtained will be integrated into economic models. This study is collecting novel
Annisa; Zain, LH; Loesnihari, R.
Hepatitis B virus (HBV) is one of the most contagious pathogens where the risk of exposure is very high among health care workers, especially students in the clerkship. This study describes the protection status by measuring anti-HBs level, history of vaccination, and history of HBV infection in medical students.Forty-four (44) students over 18 years old were randomly selected, interviewed for their vaccination history and then had their blood serum taken for anti-HBs and anti-HBc examinations to determine the protectivity and history of infection.There were 81.8% students without a protective anti-HBs level. Before starting their clerkship, 18.2% students received thevaccination, and only one-fourth formed protective antibody level above 10mIU/mL. Seventeen (38.6%) students had been exposed to HBV(positive anti-HBc), and only six of them showed protective anti-HBs level. None of the students that received vaccine underwent a post-vaccination serological test (PVST) to determine their immune response. These results indicated the vulnerability of medical students to the risk of HBV transmission while performing medical care. With the high incidence of HBV transmission, educational institutions are encouraged to make provisions for vulnerable students to receive a booster and an adequate PVST before their clerkship.
Two groups of black-and-white photographs are found in medical rare book rooms and the collections of historically minded physicians. They were created by artists Hiller and Sarra to bring medical history to life for members of the health professions and, to some extent, for a wider public. These were not didactic illustrations for a textbook, but elegant scenes of great figures from Antiquity to the nineteenth century, evocation not documentation even though they were based on research. As pieces of fine art, cherished in portfolios or framed on the wall, the quality prints were intended to stimulate curiosity about the achievements of the figures portrayed. While familiar to some archivists and librarians, these photographs have received almost no attention in the scholarship of medical history. Only one short article examined them in 1983. In recent years these photographers have been given new consideration by scholars of advertising and photography. Using those works and primary sources, this article expands both men's biographies, and it explores their working methods, their artistry, and their achievements. An appreciation of these photographs enlarges our understanding of the place of medical history in American culture during the first half of the twentieth century. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Pashkovskiĭ, R D
Military-medical examination is a part of medical service of the Armed Forces of the Russian Federation and plays a significant role in recruiting military troops with healthy, physically vigorous soldiers, in saving and improving of health of military personnel, in undertaking prophylaxis and therapeutic measures, in solving social problems of servicemen and their families. Military-medical examination board of Eastern Command plays a significant role in the system of military-medical examination of the Armed Forces of the Russian Federation. The article is devoted to the history of formation and development of military-medical examination in the Far East depending on aims and goals of military-medical service at different stages of military formation. Eastern Command dated back to the Civil War, has changed its organization, boundaries, structure and name many times. According these changes many new military-medical departments, including military-medical examination board, were reorganized, disbanded and created. Various military-medical commissions alternating or working simultaneously at different military units were created in the Far East.
Kaphingst, Kimberly A; Goodman, Melody; Pandya, Chintan; Garg, Priyanka; Stafford, Jewel; Lachance, Christina
Family history contributes to risk for many common chronic diseases. Little research has investigated patient factors affecting communication of this information. 1061 adult community health center patients were surveyed. We examined factors related to frequency of discussions about family health history (FHH) with family members and doctors. Patients who talked frequently with family members about FHH were more likely to report a family history of cancer (p =.012) and heart disease (p history of heart disease (p = .011), meet physical activity recommendations (p = .022), seek health information frequently in newspapers (p history of some diseases, those not meeting physical activity recommendations, and those who do not frequently seek health information may not have ongoing FHH discussions. Interventions are needed to encourage providers to update patients' family histories systematically and assist patients in initiating FHH conversations in order to use this information for disease prevention and control. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Full Text Available agenda. This review will inter alia include the Constitutional precepts on provincial government, Provincial Growth and Development Strategy Guidelines, Harmonisation and Alignment proposals, Demarcation policies and processes, and Cabinet Declarations. 3...
Kimmel, Mary; Hess, Edward; Roy, Patricia S; Palmer, Jennifer Teitelbaum; Meltzer-Brody, Samantha; Meuchel, Jennifer M; Bost-Baxter, Emily; Payne, Jennifer L
We sought to determine clinical predictors of postpartum depression (PPD), including the role of medication, in a sample of women followed prospectively during and after pregnancy. Women with a history of mood disorder were recruited and evaluated during each trimester and 1 week, 1 month, and 3 months postpartum. DSM-IV criteria for a major depressive episode were assessed by a psychiatric interview at each time point. Sixty-three women with major depression and 30 women with bipolar disorder entered the study and 75.4 % met DSM-IV criteria for a MDE during pregnancy, postpartum, or both. We modeled depression in a given time period (second trimester, third trimester, or 1 month postpartum) as a function of medication use during the preceding period (first, second, or third trimester). The odds of being depressed for those who did not use medication in the previous period was approximately 2.8 times that of those who used medication (OR 2.79, 95 % CI 1.38-5.66, p = 0.0048). Of 38 subjects who were psychiatrically well during the third trimester, 39.5 % (N = 15) met the criteria for a MDE by 4 weeks postpartum. In women who developed PPD, there was a high rate of a family history of PPD (53.3 %) compared to women who did not develop PPD (11.8 %, p = 0.02). While the use of psychiatric medications during pregnancy reduced the odds of being depressed overall, the use of psychiatric medications during pregnancy may not protect against PPD in women at high risk, particularly those with a family history of PPD.
Carmichael, Mark G; Zacher, Lisa L
A 58-year-old woman presented with chronic cough felt to be multifactorial secondary to asthma, gastroesophageal reflux disease, and chronic sinusitis. Additional medical history included obstructive sleep apnea, type 2 diabetes, and hypertension. She had a 40- year history of tobacco use, but quit 10 years ago. Her examination was significant for obesity and cobble stoning of the oropharynx. Pulmonary function testing and arterial blood gases were unrevealing. Chest films were normal. High-resolution computed tomography revealed multiple focal lucencies in a mosaic pattern consistent with air trapping and small airways disease. Bronchoscopy revealed normal airways and a noninflammatory bronchoalveolar lavage. Transbronchial biopsies revealed inflammatory infiltrates of the peribronchiolar interstitium. Lung biopsy revealed pulmonary neuroendocrine cell hyperplasia with tumorlets that stained positive for neuroendocrine tissue. We present the case of a woman with chronic cough, multiple medical problems, and pulmonary neuroendocrine cell hyperplasia with tumorlets.
Full Text Available The national census data during 1995 and 2000 and during 2005 and 2010 are selected in this paper to make an analysis of the spatio-temporal characteristics of the inter-provincial population migration in China. In addition, the general regression model, the extension regression model considering the historical dependent variable and the spatial lag model are established based on the gravity model to make the regression model on China’s inter-provincial population migration over two periods of time. The results show that: (1 the inter-provincial population migration increases rapidly in size with strong geographical proximity; (2 China’s inter-provincial population migration is still in the primary stage of the general process of population migration. In other words, the inter-provincial population emigration and immigration levels have increased greatly with the economic development; (3 Statistically, the inter-provincial population migration is negatively correlated with the level of economic development in the emigrant place and the migration distance and positively correlated with the level of economic development in the immigrant place and the population scale in the emigrant and immigrant places; and (4 The spatio-temporal factor is an important explanatory variable of population migration. The introduction of the historical dependent variable and the spatial lag factor can improve the regression effect of the gravity model greatly, and the historical variable and the spatial factor have strong explanatory power for the inter-provincial population migration.
Márquez-Rodas, Iván; López-Trabada, Daniel; Rupérez Blanco, Ana Belén; Custodio Cabello, Sara; Peligros Gómez, María Isabel; Orera Clemente, María; Calvo, Felipe A; Martín, Miguel
Identification of patients at risk of hereditary cancer is an essential component of oncology practice, since it enables clinicians to offer early detection and prevention programs. However, the large number of hereditary syndromes makes it difficult to take them all into account in daily practice. Consequently, the National Cancer Institute (NCI) has suggested a series of criteria to guide initial suspicion. It was the aim of this study to assess the perception of the risk of hereditary cancer according to the NCI criteria in our medical oncology service. We retrospectively analyzed the recordings of the family history in new cancer patients seen in our medical oncology service from January to November 2009, only 1 year before the implementation of our multidisciplinary hereditary cancer program. The family history was recorded in only 175/621 (28%) patients. A total of 119 (19%) patients met 1 or more NCI criteria (1 criterion, n = 91; 2 criteria, n = 23; 3 criteria, n = 4; and 4 criteria, n = 1), and only 14 (11.4%) patients were referred to genetic counseling. This study shows that few clinicians record the family history. The perception of the risk of hereditary cancer is low according to the NCI criteria in our medical oncology service. These findings can be explained by the lack of a multidisciplinary hereditary cancer program when the study was performed. Copyright © 2012 S. Karger AG, Basel.
Marco Cobus Pretorius
Full Text Available Problems experienced with website usability can prevent users from accessing and adopting technology, such as e-Government. At present, a number of guidelines exist for e-Government website user experience (UX design; however, the effectiveness of the implementation of these guidelines depends on the expertise of the website development team and on an organisation’s understanding of UX. Despite the highlighted importance of UX, guidelines are rarely applied in South African e-Government website designs. UX guidelines cannot be implemented if there is a lack of executive support, trained staff, budget and user-centred design processes. The goal of this research is to propose and evaluate a methodology (called the “Institutionalise UX in Government (IUXG methodology” to institutionalise UX in South African Provincial Governments (SAPGs. The Western Cape Government in South Africa was used as a case study to evaluate the proposed IUXG methodology. The results show that the IUXG methodology can assist SAPGs to establish UX as standard practice and improve the UX maturity levels.
Truong Van Canh
Full Text Available Sustainable development is zeitgeist of our age. It is one kind of development that in this trajectory humanity can create a stable and developed socio-economic foundations, conserve environment and therefore able to continue for a long time. Using indicators is one of the best ways to monitor and measure the progress toward sustainable development. In this paper we have proposed the way to create indicators for measuring provincial sustainable development index in Vietnam. We firstly made a framework of elements for economic, social and environmental component and compiled a list of indicators of 20 national and international agencies in the world. We then applied the SMART framework (Specific, Measurable, Achievable, Relevant, and Time-related to choose indicators which will be relevant for Vietnam and put them back to the elements. We then have 39 relevant indicators with 12 indicators for economy, 17 indicators for social and 10 indicators for environmental component. Finally, we have established the way to determine the worst and best value for each indicator from available data for countries in the world.
Truong, Van Canh; Lisowski, Andrzej
Sustainable development is zeitgeist of our age. It is one kind of development that in this trajectory humanity can create a stable and developed socio-economic foundations, conserve environment and therefore able to continue for a long time. Using indicators is one of the best ways to monitor and measure the progress toward sustainable development. In this paper we have proposed the way to create indicators for measuring provincial sustainable development index in Vietnam. We firstly made a framework of elements for economic, social and environmental component and compiled a list of indicators of 20 national and international agencies in the world. We then applied the SMART framework (Specific, Measurable, Achievable, Relevant, and Time-related) to choose indicators which will be relevant for Vietnam and put them back to the elements. We then have 39 relevant indicators with 12 indicators for economy, 17 indicators for social and 10 indicators for environmental component. Finally, we have established the way to determine the worst and best value for each indicator from available data for countries in the world.
Kelstrup, Anne Mette; Juillerat, Pascal; Korzenik, Joshua
Internet-based surveys provide a potentially important tool for Inflammatory Bowel Disease (IBD) research. The advantages include low cost, large numbers of participants, rapid study completion and less extensive infrastructure than traditional methods. The aim was to determine the accuracy of patient self-reporting in internet-based IBD research and identify predictors of greater reliability. 197 patients from a tertiary care center answered an online survey concerning personal medical history and an evaluation of disease specific knowledge. Self-reported medical details were compared with data abstracted from medical records. Agreement was assessed by kappa (κ) statistics. Participants responded correctly with excellent agreement (κ=0.96-0.97) on subtype of IBD and history of surgery. The agreement was also excellent for colectomy (κ=0.88) and small bowel resection (κ=0.91), moderate for abscesses and fistulas (κ=0.60 and 0.63), but poor regarding partial colectomy (κ=0.39). Time since last colonoscopy was self-reported with better agreement (κ=0.84) than disease activity. For disease location/extent, moderate agreements at κ=69% and 64% were observed for patients with Crohn's disease and ulcerative colitis, respectively. Subjects who scored higher than the average in the IBD knowledge assessment were significantly more accurate about disease location than their complementary group (74% vs. 59%, p=0.02). This study demonstrates that IBD patients accurately report their medical history regarding type of disease and surgical procedures. More detailed medical information is less reliably reported. Disease knowledge assessment may help in identifying the most accurate individuals and could therefore serve as validity criteria. Internet-based surveys are feasible with high reliability about basic disease features only. However, the participants in this study were engaged at a tertiary center, which potentially leads to a bias and compromises generalization to
Klein, Wouter; Pieters, Toine
The history of the introduction of exotic therapeutic drugs in early modern Europe is usually rife with legend and obscurity and Peruvian bark is a case in point. The famous antimalarial drug entered the European medical market around 1640, yet it took decades before the bark was firmly established in pharmaceutical practice. This article argues that the history of Peruvian bark can only be understood as the interplay of its trajectories in science, commerce, and society. Modern research has mostly focused on the first of these, largely due to the abundance of medico-historical data. While appreciating these findings, this article proposes to integrate the medical trajectory in a richer narrative, by drawing particular attention to the acculturation of the bark in commerce and society. Although the evidence we have for these two trajectories is still sketchy and disproportionate, it can nevertheless help us to make sense of sources that have not yet been an obvious focus of research. Starting from an apparently isolated occurrence of the drug in a letter, this article focuses on Paris as the location where medical and public appreciation of the bark took shape, by exploring several contexts of knowledge circulation and medical practice there. These contexts provide a new window on the early circulation of knowledge of the bark, at a time when its eventual acceptance was by no means certain. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Full Text Available Pneumonia is a common cause of paediatric hospitalisations. Aim: The aim of the study was to assess the hospitalisation structure of a non-specialised paediatric unit as well as to perform a thorough evaluation of paediatric patients hospitalised due to pneumonia. Attention was also paid to recent changes in the clinical picture of pneumonia. Material and methods: A retrospective analysis of medical records of children treated in the paediatric unit of the Janusz Korczak Provincial Specialist Hospital between 2011 and 2012, with particular emphasis on patients hospitalised due to pneumonia (ICD-10 codes J12–J18, was performed. Results: Pneumonia accounted for 12.7% of all hospitalisations in the non-specialised paediatric unit between 2011 and 2012; most of hospitalisations occurred during the winter and early spring months, with a peak incidence in March. Bronchial obstruction occurred in 39.9% of cases, mainly in infants. Extensive inflammatory lesions were noted in X-ray reports in only 26% of patients; inflammatory lesions were mostly described as interstitial lesions or patchy densities in the pulmonary hilar region in other cases. X-ray images were interpreted as normal in up to 24.6% of children, which did not reflect the typical auscultatory changes. Cefuroxime sodium was the most commonly used first-line antibiotic (51.5%, followed by macrolides (34%, including macrolides in combination with β-lactam antibiotics in 26% of cases, and third-generation cephalosporins (25.7%. Conclusions: Lower respiratory diseases, mainly pneumonia often accompanied by bronchial obstruction, were the most common cause of paediatric hospitalisations in the paediatric unit of the provincial hospital. Interstitial lesions and perihilar densities seem to be the most typical radiological image in children. Adjustment of antibiotic therapy to the current guidelines and recommendations allows better treatment
Kreshak, Allyson A; Wardi, Gabriel; Tomaszewski, Christian A
Emergency Department (ED) medication lists (ML) are considered inaccurate based on previous comparisons of ED ML with patients' self-reporting of medications and reviews of patients' pharmacy and medical records. To determine the accuracy of ED ML using mass spectrometry analysis of urine samples. This was a prospective observational study conducted at an urban tertiary care university hospital. Convenience sampling of patients who underwent ED triage was done. Included were patients 18 years or older who were capable of providing informed consent and who reported use of at least one medication. Excluded were patients unable to consent, prisoners, non-English-speaking patients, and patients unwilling or unable to provide a urine sample. Mass spectrometry analysis was performed on enrolled patients' urine, and their ED triage ML were recorded. Urinalysis results were compared to ED triage ML. Concordance between respective ED triage ML and urinalysis results was determined. Medications were grouped by medication class. The top five discrepant medication classes were identified. There were 100 patients enrolled; 21 patients, although eligible, did not provide a urine sample and were excluded, and one patient withdrew. Mean age was 51 years, and 54 patients were male. Twenty-two medication classes were identified. No patient had 100% concordance of ED triage ML and urinalysis results. Opioid analgesic, sedative hypnotics, cardiac, psychiatric, and nonopioid analgesic medications were the top discrepant medication classes. ED triage ML obtained by patient recall are inaccurate when compared to medications detected in urine using mass spectrometry analysis. Copyright © 2015 Elsevier Inc. All rights reserved.
Buykx, Penny; Ritter, Alison; Loxley, Wendy; Dietze, Paul
Medication overdose is a common method of non-fatal self-harm. Previous studies have established which mental health disorders are commonly associated with the behaviour (affective, substance use, anxiety and personality disorders) and which medications are most frequently implicated (benzodiazepines, antidepressants, antipsychotics and non-opioid…
National Aeronautics and Space Administration — This data set contains the national and provincial boundaries of Ecuador as well as the boundaries of two national parks: the Cuyabeno Wildlife Reserve and the...
National Aeronautics and Space Administration — ABSTRACT: This data set contains the national and provincial boundaries of Ecuador as well as the boundaries of two national parks: the Cuyabeno Wildlife Reserve and...
L'etat, C'est Moi: Why provincial Intra-governmental disputes in Shout Africa remain ungoverned by the final constitution and the Intergovernmental Relations Framework Act - and how we can best resolve them.
Shang, Mei; Dong, Rui; Fu, Yujie; Hao, Wentao
As a pillar industry of the national economy, the damage to the environment by construction industry can not be ignored. In the context of low carbon development, identifying the main driving factors for the carbon emission of the provincial construction industry are the key for the local government to formulate the development strategy for construction. In the paper, based on the Kaya factor decomposition method, the carbon intensity of the energy structure, energy intensity and the impact of the construction output on the carbon emission of provincial construction industry are studied, and relevant suggestions for low carbon development of provincial construction industry are proposed. The conclusion of this paper provides a theoretical basis for the early realization of low-carbon development in China’s provincial construction industry.
Fazeli Farsani, Soulmaz; Souverein, Patrick C; van der Vorst, Marja M J; Mantel-Teeuwisse, Aukje K; Knibbe, Catherijne A J; de Boer, Anthonius
There is a highly variable asymptomatic period of beta cell destruction prior to the clinical presentation of type1 diabetes. It is not well known what triggers type 1 diabetes to become a clinically overt disease. This explorative study aimed to identify the association between disease history/medication use and the clinical manifestation of type 1 diabetes. An explorative case control study was conducted in the Dutch PHARMO Record Linkage System. Cases (n = 1,107) were younger than 25 years and had at least 2 insulin prescriptions between 1999 and 2009. For each case, up to 4 controls (without any prescription for the glucose lowering medications (n = 4,424)) were matched by age and sex. Conditional logistic regression analysis was used to evaluate the association between disease history/medication use in the year prior to the diagnosis of type 1 diabetes and clinical manifestation of this disease. Type1 diabetes was significantly associated with a history of mental disorder (odds ratio (OR) 8.0, 95% confidence interval (CI) 1.5-43.7), anemia (OR 5.1, 95% CI 1.1-22.9), and disease of digestive system (OR 2.6, 95% CI 1.2-5.5). The following drug exposures were significantly associated with the clinical manifestation of type 1 diabetes: "systemic hormonal preparations" (OR 1.7, 95% CI 1.1-2.6), medications for "blood and blood forming organs" (OR 1.6, 95% CI 1.1-2.6), "alimentary tract and metabolism" (OR 1.3, 95% CI 1.1-1.6), and "anti-infectives for systemic use" (OR 1.2, 95% CI 1.01-1.4). Our explorative study demonstrated that in the year prior to the presentation of type 1 diabetes in children and young adults, hospitalization for a diverse group of diseases and drug exposures were significantly more prevalent compared with age- and sex-matched diabetes-free controls.
The prevalence of burnout and depression in medical doctors working in the Cape Town Metropolitan Municipality community healthcare clinics and district hospitals of the Provincial Government of the Western Cape: a cross-sectional study.
Independence: Military Attitudes , Policies, and Practice, 1763-1789 (New York: The Macmillan Company, 1971), 1. 18 Carr, Seeds of Discontent, 2... attitude , was the primary reason British officers viewed provincial soldiers as inferior to British regulars. The thoughts and statements by British... abortive attempt at Oswego, provincial forces won the first great victory of the French and Indian War. Four of the Rhode Island companies, under
Full Text Available The article presents the results of sociological study carried out to obtain a general model of ideas, expectations and preferences of provincial students in their attitude to higher education. The received results are presented in the form of diagrams. Provides a general interpretation of the data and on their basis are proposed recommendations for development marketing strategy and campaign to attract university entrants to the provincial university.
di Liberto, Alexander; Endrikat, Jan; Frohn, Sandra; Solomayer, Erich; Ertan, Kubilay
Serious fetal malformations and/or chromosome aberrations detected by modern diagnostic tools in early pregnancy require discussions on induced abortion with pregnant women. Competent counseling includes prediction of the time needed for the whole abortion process. In an attempt to refine our predictions, we evaluated the impact of 11 medical history and clinical variables on time to delivery. We performed a retrospective chart analysis on 79 women submitted for pre-term abortion because of fetal anomalies. Abortion was induced by vaginal application of misoprostol (prostaglandine E1, Cytotec™, Pfizer, New York, USA). We investigated 11 medical history and clinical variables for their impact on the percentage of women delivering within 24 hours (primary endpoint) and on the mean induction-delivery time interval (secondary endpoint). Fifty-three percent (42/79) of women delivered within 24 hours; 83.6% (66/79) delivered within 48 hours. A total of 83.3% of women with a history of late abortion delivered within 24 hours, whereas 50.7% without this history did. Mean induction-delivery time interval was 12.3 hours versus 35.5 hours, respectively. For history of early abortion, the figures were 65.2% versus 48.2% for delivery within 24 hours and 15.6 hours versus 32.5 hours for mean induction-delivery time interval. Current weight of fetus >500 g, weight of last previous newborn of ≤3500 g, previous pregnancies, premature rupture of membranes, and an elevated CRP of >0.5 mg/dL also cut time to delivery. Surprisingly, maternal and gestational age had no remarkable or consistent impact on the mean induction-delivery time interval. None of the differences reached statistical significance. Eighty-three percent of women needed 1000 μg or less for successful delivery. Neither variables of medical history nor specific clinical variables allow for precise prediction of time to delivery in the second trimester. Certain parameters, however, show a trend to reduce the
McCauley, Jenna L; Amstadter, Ananda B; Danielson, Carla Kmett; Ruggiero, Kenneth J; Kilpatrick, Dean G; Resnick, Heidi S
The current study examined prevalence and correlates of non-medical use of prescription drugs (NMUPD), with particular emphasis on lifetime history of rape and PTSD as risk associates. Interviews conducted via telephone using Computer-Assisted Telephone Interviewing technology, resulting in a nationally representative sample of 3001 non-institutionalized, civilian, English or Spanish speaking women (aged 18-86 years) residing in households with a telephone. Demographic characteristics, rape history, general health/mental health, and substance abuse variables were assessed. NMUPD was assessed by asking if, in the past year, participants had misused a prescription drug. Multivariable logistic regressions were conducted for each theoretically derived predictor set. Significant predictors from each set then entered into final multivariable logistic regression to determine significant predictors of past-year NMUPD. NMUPD was endorsed by 5.5% of the sample (n=164). Final multivariable model showed that Lifetime Posttraumatic Stress Disorder, other forms of substance use/abuse, and a history of drug or alcohol facilitated rape were significantly associated with increased likelihood of NMUPD. Risk reduction efforts targeting non-medical prescription drug use among women who have experienced traumatic events and/or abuse substances are warranted. Trauma-focused interventions for drug or alcohol facilitated rape victims should include treatment or prevention modules that specifically address NMUPD.
The "Universal Declaration of Human Rights" and the "Geneva Declaration" by the World Medical Association, both in 1948, were preceded by the foundation of the United Nations in New York (1945), the World Medical Association in London (1946) and the World Health Organization in Geneva (1948). After the end of World War II the community of nations strove to achieve and sustain their primary goals of peace and security, as well as their basic premise, namely the health of human beings. All these associations were well aware of the crimes by medicine, in particular by the accused Nazi physicians at the Nuremberg Doctors Trial (1946/47, sentence: August 1947). During the first conference of the World Medical Association (September 1947) issues of medical ethics played a major role: and a new document was drafted concerning the values of the medical profession. After the catastrophe of the War and the criminal activities of scientists, the late 1940s saw increased scrutiny paid to fundamental questions of human rights and medical ethics, which are still highly relevant for today's medicine and morality. The article focuses on the development of medical ethics and human rights reflected in the statement of important persons, codes and institutions in the field.
Full Text Available Changes are rapidly occur in this world, especially developments in the field of information and communication technology. Man must be able to adjust quickly to keep up. Developments in information and communication technology has made it easier for people in work. Utilization of information and communication technology are expected to make work performed by humans is more effective and efficient. National Library of Indonesia mandated by Law No. 43 of 2007 as an adviser to all types of libraries throughout Indonesia. In carrying out the task, the National Library should coordinate with local government including the provincial government, represented by the provincial library which can be said to represent the provincial government in the affairs of the library. National Library of Indonesia in coordination with the provincial library has been facilitated by information and communication technology such as telephone, fax and internet. In addition, coordination can also be done through conventional correspondency or direct face to face. This study tried to define which communication system that is commonly used by the National Library of Indonesia when coordinating with the provincial library and the reasons that lie behind them. The method used in this research is descriptive with a participatory approach, the researchers and respondents are equal and shared a mutual cooperation. This research indicates that face-to-face coordination is more preferred, because face-to-face coordination offers a social and economical benefit. Keywords: library, national library, provincial library, utilization technology
Bryce, Elizabeth; Islam, Saiful; Nelson, Becky; Gamage, Bruce; Wilson, Robin; Welsh, Petra; Han, Guanghong
The British Columbia Provincial Hand Hygiene Working Group was formed in September 2010 and tasked with the development and implementation of a provincial hand hygiene (HH) program for health care. As part of an evaluation of the provincial HH program, qualitative key informant interviews of program developers, senior administrators, and field workers were performed from December 2011 to March 2012 (phase 1) and again in April to June 2013 (phase 2). The following 5 broad themes were identified: (1) the provincial HH program became a platform for cooperation; (2) standardization (of HH audits and program components) strengthened and provided credibility to the provincial HH program; (3) quality results and good communication enabled a learning process that resulted in positive change management; (4) with ownership came pride and program success; and (5) management support and infrastructure is needed to sustain a positive culture change. Positive behavior change for HH can be achieved on a provincial scale through a program that is standardized, has mandated components, is well communicated, owned by the frontline workers, and receives sustained support from senior management. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
Nauta, Russell J
Despite a quarter century of discourse since a sentinel event in New York City raised the question of appropriate oversight for graduate medical education, many questions remain unanswered. Even with the Accreditation Council for Graduate Medical Education rules in place, some opportunity remains to examine handoff methodology, the relationship of duty hours to education, and the impact of fatigue on resident performance. Neurophysiologic adjuncts applied concomitantly to evaluation of didactic performance offer promise for data-driven definition of the optimal shift. Concurrently, the merits of specialty-specific oversight of graduate medical education remain under active consideration. Copyright © 2012 Elsevier Inc. All rights reserved.
Leven, K H
Research in ancient medical history, Greek and Roman as well as Mesopotamian and Egyptian, is usually done by philologically trained scholars; the ability to read texts in their original language is fundamental (though not sufficient) for any substantial work. There is, however, in such works the notion that something may be missing in fully understanding medicine of a certain time and culture. Does a medical historian of ancient medicine need, in addition to his philological and historical skills, a medical education? And in what way is a 'medical approach' to ancient medicine useful? Is it possible to stand at the bedside of a Hippocratic patient as a clinician or reconstruct the 'pathocoenosis', as Mirko D. Grmek (+ 2000) coined it, of ancient Greece? The present paper outlines the problem of applying present medical knowledge to ancient sources and touches on the topic of primary perception of disease and illness. An important aspect is that disease entities change in their socio-cultural setting. Examples ranging from the supposed Lupus erythematodes of the Assyrian king Esarhaddon to cases in the Hippocratic Epidemiae and plague descriptions of Greek authors illustrate the problem of retrospective diagnosis.
Spanjer, J.; Krol, B.; Popping, R.; Groothoff, J.W.; Brouwer, Sandra
Objective: To investigate whether the provision of detailed information on participation and activity limitations, compared with medical information alone, influences the assessment of work limitations by physicians. Methods: Three groups each of 9 insurance physicians used written interview reports
Romeijn, N.; Borgers, A.J.F.; Fliers, E.; Alkemade, A.; Bisschop, P.H.; Van Someren, E.J.
The hypothalamus is crucially involved in the circadian timing of the sleep-wake rhythm, yet also accommodates the most important thermoregulatory neuronal network. We have shown before that adults with pituitary insufficiency and history of chiasm compression due to a tumor with suprasellar
Romeijn, N.; Borgers, A.J.; Fliers, E.; Alkemade, A.; Bisschop, P.H.; van Someren, E.J.W.
The hypothalamus is crucially involved in the circadian timing of the sleep-wake rhythm, yet also accommodates the most important thermoregulatory neuronal network. We have shown before that adults with pituitary insufficiency and history of chiasm compression due to a tumor with suprasellar
provincial line directorates are generally uninvolved in these activities. Although a development project may benefit a particular province, core...provincial plans to be delegated to provincial line directorates, with the provincial directorates accountable for the use of funds to the parent
Schildmann, Jan; Bruns, Florian; Hess, Volker; Vollmann, Jochen
Objective: "History, Theory, Ethics of Medicine" (German: "Geschichte, Theorie, Ethik der Medizin", abbreviation: GTE) forms part of the obligatory curriculum for medical students in Germany since the winter semester 2003/2004. This paper presents the results of a national survey on the contents, methods and framework of GTE teaching. Methods: Semi-structured questionnaire dispatched in July 2014 to 38 institutions responsible for GTE teaching. Descriptive analysis of quantitative data and content analysis of free-text answers. Results: It was possible to collect data from 29 institutes responsible for GTE teaching (response: 76%). There is at least one professorial chair for GTE in 19 faculties; two professorial chairs or professorships remained vacant at the time of the survey. The number of students taught per academic year ranges from 350. Teaching in GTE comprises an average of 2.18 hours per week per semester (min: 1, max: 6). Teaching in GTE is proportionally distributed according to an arithmetic average as follows: history: 35.4%, theory 14.7% and ethics 49.9%. Written learning objectives were formulated for GTE in 24 faculties. The preferred themes of teaching in history, theory or ethics which according to respondents should be taught comprise a broad spectrum and vary. Teaching in ethics (79 from a max. of 81 possible points) is, when compared to history (61/81) and theory (53/81), attributed the most significance for the training of medical doctors. Conclusion: 10 years after the introduction of GTE the number of students and the personnel resources available at the institutions vary considerably. In light of the differences regarding the content elicited in this study the pros and cons of heterogeneity in GTE should be discussed.
Tsiakkas, A; Duvdevani, N; Wright, A; Wright, D; Nicolaides, K H
To define the contribution of maternal variables which influence the measured level of maternal serum soluble fms-like tyrosine kinase-1 (sFlt-1) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum sFlt-1 was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 or 35 + 0 to 37 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of sFlt-1 were determined from a linear mixed-effects multiple regression. Serum sFlt-1 was measured in 7066 cases in the first trimester, 8078 in the second trimester and 10,464 in the third trimester. Significant independent contributions to serum sFlt-1 were provided by gestational age, maternal weight, racial origin, cigarette smoking, birth-weight Z-score of the neonate in the previous pregnancy and interpregnancy interval. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum sFlt-1 and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this pregnancy complication. A model was fitted to express measured serum sFlt-1 across the three trimesters of pregnancy as MoMs, after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Full Text Available AbstractThe effect of changes in rates of mortality, fertility, and migration depend not only on the age specific patterns and levels of these rates, but on the age structure of the population. In orderto remove the influences of the age structure and concentrate on the impact of the demographic rates themselves, a common practice is to analyze the influences of the rates for a standard age structure. This paper adapts the general approach of using a standard age structure to a stationary population equivalent (SPE model, and analyzes current population change, using the SPE model, for provinces of Canada. Below-replacement fertility levels are only partially offset by net immigration. The SPE model evidences the decrease in the eventual provincial populations brought about by the below replacement fertility. Out-migration for some provincesto other areas of Canada accentuates their eventual population decreases.RésuméLes effets des changements des taux de mortalité, fécondité, et de migration dépendent non seulement des modèles par âge et des niveaux de ces taux, mais aussi de la structure par âge de la population. Pour éliminer les influences de la structure par âge et se concentrer sur les effets des taux démographiques mêmes, une pratique courante est d’analyser les influences des taux par une structure par âge de norme. Cet article adapte l’approche générale de la structure parâge à un modèle de population stationnaire équivalente (PSE. Cet article analyse les changements de population, en utilisant le modèle de PSE, dans les provinces canadiennes. Le taux de fécondité inférieur au seuil de reproduction de la population n’est que légèrement compensé par l’immigration nette. Le modèle de PSE démontre le déclin des populations provinciales éventuelles causé par le taux de fécondité inférieur au seuil de reproduction de la population. Le taux d’émigration entre certaines provinces et reste du
Gracious, Barbara; Abe, Naomi; Sundberg, Jane
Over-the-counter (OTC) and prescription medication abuse has been rapidly increasing, yet publications on OTC abuse in adolescents are limited. We present a brief literature review and a novel report of antihistamine dependence emerging after admission in an adolescent, subsequently treated with naltrexone. This case highlights the need to take a thorough history of OTC, herbal, and prescription drug use from parents and patients separately and repeatedly, at initial presentation, and again if withdrawal symptoms emerge. General strategies for combating OTC and prescription abuse are given.
Maeshiro, Masao; Izutsu, Satoru; Connolly, Kathleen Kihmm
The University of Hawai'i (UH) has been collaborating with Okinawa Prefectural Chubu Hospital for over 46 years. This collaboration started as a post-World War II effort to increase the physician workforce. At the initiation of the US Army and State Department, the University of Hawai'i was recruited, in cooperation with the government of the Ryukyus and USCAR, to initiate a US style postgraduate clinical training program. The Postgraduate Medical Training Program of University of Hawai'i at Okinawa Chubu Hospital introduced a style of training similar to that in the US by offering a rotating internship. The initial contract had UH establish and run the Postgraduate Medical Training Program of University of Hawaii at Okinawa Central Hospital. After Okinawa's reversion to Japan, under a new contract, UH physicians participated as consultants by providing lectures at "grand rounds" and guidance to faculty, staff, and students. To date, 895 physicians have completed the University of Hawai'i Postgraduate Medical Training Program with 74 currently training. Approximately 662 (74%) of the trainees have remained in Okinawa Prefecture to practice medicine. As a result, the program has enhanced the physician workforce for the islands of Okinawa and neighbor archipelagos of Miyako and Yaeyama Islands.
Morris, Jonathan M; Totterdell, James; Bin, Yu Sun; Ford, Jane B; Roberts, Christine L
As age is not modifiable, pregnancy risk information based on age alone is unhelpful for older women. To determine severe morbidity/mortality rates for women aged ≥35 years according to maternal profile based on parity, pre-existing medical conditions and prior pregnancy complications, and to assess the independent contribution of age. Population-based record-linkage study using NSW hospitalisation and birth records 2006-2012. Maternal and perinatal mortality/morbidity were assessed for non-anomalous singleton births to women aged ≥35 years. For 117 357 pregnancies among 99 375 women aged ≥35 years, the median age at delivery was 37 years (range 35-56 years), including: 35 652 (30.4%) multiparae without pre-existing medical or obstetric complications, 33,058 (28.2%) nulliparae without pre-existing medical conditions and 30 325 (25.8%) multiparae with prior pregnancy complications. Maternal and perinatal mortality/morbidity varied by maternal profile with ranges of 0.9-3.5% and 2.4-11.9%, respectively. For nulliparae, each five-year increase in age did not contribute significantly to maternal risk after controlling for medical conditions (adjustedodds ratio 1.08, 95% CI 0.93-1.25), but did confer perinatal risk (1.14; 1.05-1.25). For multiparae, each five-year increase in age beyond 35 years was independently associated with adverse maternal (1.23; 1.09-1.39) and perinatal outcomes (1.23; 1.09-1.39). For women aged ≥35 years, presence of medical conditions conferred a greater risk for morbidity/mortality than age itself. For multiparous women, the effects of medical and obstetric history were additive. The contribution of maternal age to adverse outcomes in pregnancies without significant medical and obstetric history is modest. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Bolnga, John W; Morris, Marilyn; Totona, Catherine; Laman, Moses
Maternal near-miss indices are World Health Organisation (WHO) recognised indicators that may improve our understanding of factors associated with maternal morbidity and mortality. In Papua New Guinea (PNG) where maternal mortality is among the highest in the world, only one study has documented near-miss indices in a tertiary-level hospital, but none from provincial hospitals where the majority of under-privileged women access healthcare services. To determine the near-miss ratio, maternal mortality index (MMI), and associated maternal indices for Modilon Hospital in Madang Province of PNG. All women attending Modilon Hospital who met the WHO maternal near-miss definition and/or a WHO-modified (PNG-specific) near-miss definition, were prospectively enrolled. There were 6019 live births during the audit period; 163 women presented with life-threatening conditions (153 near-misses and 10 maternal deaths). The maternal near-miss ratio was 25.4/1000 live births and the maternal mortality ratio (MMR) was 166/100 000 live births, with a maternal death to near-miss ratio of 1:15.3. The severe maternal outcome ratio was 27.1/1000 live births and the total mortality index was 6.8%. Higher proportions of near-miss women were aged ≥30 years, nulliparous, illiterate, from rural communities, lacked formal employment, referred from peripheral health facilities, unbooked, had history of still births and were anaemic. Sociodemographic factors such as women's rights, education level and status in society, in addition to appropriate health reforms with greater financial and political support are urgently needed to ensure underprivileged women in rural PNG have access to family planning, supervised deliveries and skilled emergency obstetric care. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Chen, Xiude; Qin, Quande; Wei, Y.-M.
Improving energy productivity is one of the most cost-effective ways to achieve a sustainable development target. The existing literature has shown some factors that have driven the improvement in China’s energy productivity. However, these studies do little to tackle the role of Chinese local officials. Political promotions can be seen as the most important career incentive for Chinese local officials. Hence, we intend to study whether energy productivity affects Chinese local officials’ promotions in this paper. The data of position changes for the 31 provincial governors during 1978‐2012 are utilized. We adopted probit models to empirically examine the correlation between provincial governors’ political promotions and energy productivity. The empirical results demonstrate that (1) energy productivity has a significantly positive impact on provincial governors’ political promotions in China, meaning that the provincial governors have the momentum to improve energy productivity; and (2) the effect of energy productivity on provincial governors’ political promotions has evolved, dynamically changing along with the transformation of the economic growth mode and the adjustment of the local officials’ promotion mechanism. The results are helpful in understanding the drivers of the improvement in China’s energy productivity and provide insightful implications for conducting energy policy in China. - Highlights: •The data of position changes for China’s provincial governors during 1978–2012 are utilized. •Energy productivity has a positive impact on provincial governors’ promotion in China. •Political incentive is an important driver of the improvement in China’s energy productivity. •The correlation between energy productivity and local officials’ promotions was evolved.
M. Cristina Rodríguez-Díez
methods have been proposed: virtual patients, high fidelity devices and standard patients. We propose the use of 5th-6th year Medical School students acting as patients when teaching history taking to their 1st year colleagues. Subjects and methods. A total of 207 students from 1st year Medical School underwent training in history taking at the Simulation Center, with senior students acting as actors. The quality of the written medical records was evaluated by two medical doctors. The satisfaction of all students involved in the course was evaluated through an anonymous voluntary questionnaire. Results. The average score of the written medical histories was 8.2/10, more than satisfactory for our goals. Students' satisfaction rate was high. Mean score on questions inquiring the usefulness of patient simulation in learning how to perform a clinical history was 9/10 and 9.2/10 for first and fifth-sixth year students respectively. Questions on improvement of communication skills scored 8.6/10 and 8.6/10 respectively. The fruitfulness of training with simulated patients before practicing with real patients was 9.3/10 and 9.3/10 respectively. Finally, the assessment of the whole course with simulated patients was of 9.3/10. Conclusion. Learning history taking in first year Medical School with simulated patients acted by senior students was beneficial and user-friendly for both students and actors. An early contact with the clinical practice through simulated patients could improve performance and safety.
Giger, Maryellen L.; Chan, Heang-Ping; Boone, John
The roles of physicists in medical imaging have expanded over the years, from the study of imaging systems (sources and detectors) and dose to the assessment of image quality and perception, the development of image processing techniques, and the development of image analysis methods to assist in detection and diagnosis. The latter is a natural extension of medical physicists' goals in developing imaging techniques to help physicians acquire diagnostic information and improve clinical decisions. Studies indicate that radiologists do not detect all abnormalities on images that are visible on retrospective review, and they do not always correctly characterize abnormalities that are found. Since the 1950s, the potential use of computers had been considered for analysis of radiographic abnormalities. In the mid-1980s, however, medical physicists and radiologists began major research efforts for computer-aided detection or computer-aided diagnosis (CAD), that is, using the computer output as an aid to radiologists--as opposed to a completely automatic computer interpretation--focusing initially on methods for the detection of lesions on chest radiographs and mammograms. Since then, extensive investigations of computerized image analysis for detection or diagnosis of abnormalities in a variety of 2D and 3D medical images have been conducted. The growth of CAD over the past 20 years has been tremendous--from the early days of time-consuming film digitization and CPU-intensive computations on a limited number of cases to its current status in which developed CAD approaches are evaluated rigorously on large clinically relevant databases. CAD research by medical physicists includes many aspects--collecting relevant normal and pathological cases; developing computer algorithms appropriate for the medical interpretation task including those for segmentation, feature extraction, and classifier design; developing methodology for assessing CAD performance; validating the
Pham, Anh Van; Le, Dzung Trung; Nguyen, Son Lan Hung; Ziegler, Thomas
Abstract We report six new records of skinks from northwestern Vietnam: Eutropis macularius, Scincella devorator, S. monticola, S. ochracea, Sphenomorphus cryptotis and S. indicus. Our new findings increase the species number of skinks (Scincidae) to nine in Dien Bien Province and to 14 in Son La Province. We also provide additional natural history data of aforementioned species. PMID:25698899
Ng, Kh; Wong, Jhd
Informal discussion started in 1996 and the South East Asian Federation of Organizations for Medical Physics (SEAFOMP) was officially accepted as a regional chapter of the IOMP at the Chicago World Congress in 2000 with five member countries, namely Indonesia, Malaysia, Philippines, Singapore and Thailand. Professor Kwan-Hoong Ng served as the founding president until 2006. Brunei (2002) and Vietnam (2005) joined subsequently. We are very grateful to the founding members of SEAFOMP: Anchali Krisanachinda, Kwan-Hoong Ng, Agnette Peralta, Ratana Pirabul, Djarwani S Soejoko and Toh-Jui Wong.The objectives of SEAFOMP are to promote (i) co-operation and communication between medical physics organizations in the region; (ii) medical physics and related activities in the region; (iii) the advancement in status and standard of practice of the medical physics profession; (iv) to organize and/or sponsor international and regional conferences, meetings or courses; (v) to collaborate or affiliate with other scientific organizations.SEAFOMP has been organizing a series of congresses to promote scientific exchange and mutual support. The South East Asian Congress of Medical Physics (SEACOMP) series was held respectively in Kuala Lumpur (2001), Bangkok (2003), Kuala Lumpur (2004) and Jakarta (2006). The respective congress themes indicated the emphasis and status of development. The number of participants (countries in parentheses) was encouraging: 110 (17), 150 (16), 220 (23) and 126 (7).In honour of the late Professor John Cameron, an eponymous lecture was established. The inaugural John Cameron Lecture was delivered by Professor Willi Kalender in 2004. His lecture was titled "Recent Developments in Volume CT Scanning".
Ng, KH; Wong, JHD
Informal discussion started in 1996 and the South East Asian Federation of Organizations for Medical Physics (SEAFOMP) was officially accepted as a regional chapter of the IOMP at the Chicago World Congress in 2000 with five member countries, namely Indonesia, Malaysia, Philippines, Singapore and Thailand. Professor Kwan-Hoong Ng served as the founding president until 2006. Brunei (2002) and Vietnam (2005) joined subsequently. We are very grateful to the founding members of SEAFOMP: Anchali Krisanachinda, Kwan-Hoong Ng, Agnette Peralta, Ratana Pirabul, Djarwani S Soejoko and Toh-Jui Wong. The objectives of SEAFOMP are to promote (i) co-operation and communication between medical physics organizations in the region; (ii) medical physics and related activities in the region; (iii) the advancement in status and standard of practice of the medical physics profession; (iv) to organize and/or sponsor international and regional conferences, meetings or courses; (v) to collaborate or affiliate with other scientific organizations. SEAFOMP has been organizing a series of congresses to promote scientific exchange and mutual support. The South East Asian Congress of Medical Physics (SEACOMP) series was held respectively in Kuala Lumpur (2001), Bangkok (2003), Kuala Lumpur (2004) and Jakarta (2006). The respective congress themes indicated the emphasis and status of development. The number of participants (countries in parentheses) was encouraging: 110 (17), 150 (16), 220 (23) and 126 (7). In honour of the late Professor John Cameron, an eponymous lecture was established. The inaugural John Cameron Lecture was delivered by Professor Willi Kalender in 2004. His lecture was titled “Recent Developments in Volume CT Scanning”. PMID:21614324
Abdulghani, Hamza Mohammad; Haque, Shafiul; Irshad, Mohammad; Al-Zahrani, Noor; Al-Bedaie, Eman; Al-Fahad, Latifah; Al-Eid, Manar; Al-Mohaimeed, Abdulrahman
This study explores the experiences of Saudi undergraduate medical students about intimate-area examination (IAE) and sexual history taking (SHT) skills and assesses the barriers and their impacts on students' learning. This survey-based study was performed at 2 Saudi university medical colleges and revealed that most of the students never performed IAE, that is, female breast, male genital, female genital, female pelvic, male rectal, and female rectal. We found that 42.3% students had never taken any sexual history during their course. Both, male and female students reported barriers of patient refusal, mismatched sex, cultural background, ethical factors, lack of supervision, lack of training, and lack of skills. Among the currently used pedagogical techniques, majority of the students were satisfied with real patient-based learning, followed by video and manikin-based learning. The study indicates that Saudi students do not have sufficient experience of IAE and SHT because of above-mentioned barriers along with religious issues. This study suggests that teachers provide positive support to students and that they develop novel, competent teaching-and-learning techniques to meet the skills training of students without compromising on religious, sociocultural, and ethical values of the kingdom.
De Korvin, G; Delarque, A
The European Community is based on a series of treaties and legal decisions, which result from preliminary documents prepared long before by different organizations and lobbies. The European union of medical specialists (Union européenne des médecins specialists [UEMS]) came into being in order to address the questions raised by European directives (e.g., free circulation of people and services, reciprocal recognition of diplomas, medical training, quality improvements). The specialty sections of the UEMS contribute actively to this work. The physical and rehabilitation medicine (PRM) section is composed of three committees: the PRM board is devoted to initial and continuing education and has published a harmonized teaching programme and organized a certification procedure, which can be considered as a European seal of quality; the Clinical Affairs Committee is concerned with the quality of PRM care, and it has set up a European accreditation system for PRM programs of care, which will help to describe PRM clinical activity more concretely; and the Professional Practice Committee works on the fields of competence in our specialty. This third committee has already published a White Book, and further documents are being prepared, based on both the International classification of functioning, disability and health (ICF) and reference texts developed by the French Federation of PRM.
Full Text Available The aim of this paper is twofold: firstly to examine how the concepts of accounting andaccountability are understood by indigenous Fijians; and secondly to examine the role ofaccounting in the accountability of provincial councils.Provincial councils are part of the Fijian Administration, which runs alongside the centralgovernment but applies only to indigenous Fijians. The Fijian Administration was introducedby the British colonial administration in the late 1800s as a mechanism for controllingindigenous Fijians. It has undergone several reviews resulting from criticisms that it has failedto fulfill the aspirations of indigenous Fijians.There is evidence of implied and actual accountability by indigenous Fijians in Namosi. Thisis supported by monitoring mechanisms established by provincial offices. On the other hand,neither the Fijian Affairs Board nor the Namosi Provincial Council appears to take seriousresponsibility for accounting to indigenous Fijians in the province. Sadly, there is littleevidence to demonstrate an explicit accountability to indigenous Fijians. Significant scopeexists for improving the standard of accounting and accountability by provincial councils.This study contributes to understanding the role of accounting among indigenous peoples, inthe context of inherited colonial structures. It also represents accounting research conductedby indigenous academics, primarily in the Fijian language. This enables an examination ofhow language frames understanding of accounting concepts.
Fazeli Farsani, Soulmaz; Souverein, Patrick C.; van der Vorst, Marja M. J.; Mantel-Teeuwisse, Aukje K.; Knibbe, Catherijne A. J.; de Boer, Anthonius
Background There is a highly variable asymptomatic period of beta cell destruction prior to the clinical presentation of type1 diabetes. It is not well known what triggers type 1 diabetes to become a clinically overt disease. This explorative study aimed to identify the association between disease history/medication use and the clinical manifestation of type 1 diabetes. Methodology/Principal Findings An explorative case control study was conducted in the Dutch PHARMO Record Linkage System. Cases (n = 1,107) were younger than 25 years and had at least 2 insulin prescriptions between 1999 and 2009. For each case, up to 4 controls (without any prescription for the glucose lowering medications (n = 4,424)) were matched by age and sex. Conditional logistic regression analysis was used to evaluate the association between disease history/medication use in the year prior to the diagnosis of type1 diabetes and clinical manifestation of this disease. Type1 diabetes was significantly associated with a history of mental disorder (odds ratio (OR) 8.0, 95% confidence interval (CI) 1.5–43.7), anemia (OR 5.1, 95% CI 1.1–22.9), and disease of digestive system (OR 2.6, 95% CI 1.2–5.5). The following drug exposures were significantly associated with the clinical manifestation of type 1 diabetes: “systemic hormonal preparations” (OR 1.7, 95% CI 1.1–2.6), medications for “blood and blood forming organs” (OR 1.6, 95% CI 1.1–2.6), “alimentary tract and metabolism” (OR 1.3, 95% CI 1.1–1.6), and “anti-infectives for systemic use” (OR 1.2, 95% CI 1.01–1.4). Conclusions Our explorative study demonstrated that in the year prior to the presentation of type1 diabetes in children and young adults, hospitalization for a diverse group of diseases and drug exposures were significantly more prevalent compared with age- and sex-matched diabetes-free controls. PMID:24498320
Soulmaz Fazeli Farsani
Full Text Available BACKGROUND: There is a highly variable asymptomatic period of beta cell destruction prior to the clinical presentation of type1 diabetes. It is not well known what triggers type 1 diabetes to become a clinically overt disease. This explorative study aimed to identify the association between disease history/medication use and the clinical manifestation of type 1 diabetes. METHODOLOGY/PRINCIPAL FINDINGS: An explorative case control study was conducted in the Dutch PHARMO Record Linkage System. Cases (n = 1,107 were younger than 25 years and had at least 2 insulin prescriptions between 1999 and 2009. For each case, up to 4 controls (without any prescription for the glucose lowering medications (n = 4,424 were matched by age and sex. Conditional logistic regression analysis was used to evaluate the association between disease history/medication use in the year prior to the diagnosis of type 1 diabetes and clinical manifestation of this disease. Type1 diabetes was significantly associated with a history of mental disorder (odds ratio (OR 8.0, 95% confidence interval (CI 1.5-43.7, anemia (OR 5.1, 95% CI 1.1-22.9, and disease of digestive system (OR 2.6, 95% CI 1.2-5.5. The following drug exposures were significantly associated with the clinical manifestation of type 1 diabetes: "systemic hormonal preparations" (OR 1.7, 95% CI 1.1-2.6, medications for "blood and blood forming organs" (OR 1.6, 95% CI 1.1-2.6, "alimentary tract and metabolism" (OR 1.3, 95% CI 1.1-1.6, and "anti-infectives for systemic use" (OR 1.2, 95% CI 1.01-1.4. CONCLUSIONS: Our explorative study demonstrated that in the year prior to the presentation of type 1 diabetes in children and young adults, hospitalization for a diverse group of diseases and drug exposures were significantly more prevalent compared with age- and sex-matched diabetes-free controls.
Jeanette M. Sebaeng
Full Text Available Background: Sexual assault poses a serious health problem to both the survivor and the health system. Experiencing sexual assault requires women to seek medical and psychological assistance as part of their journey towards recovery. This study examined the experiences of women who received post-sexual assault services from a specialised care centre within a provincial hospital.Methods: A qualitative, exploratory and contextual design was used to explore and describe experiences of women. Data were obtained through individual in-depth interviews from a total of 18 women aged between 18 and 55 years. Interviews were supplemented by the researcher’s field notes and audiotape recordings.Results: Findings yielded two main themes: Women expressed their lived experiences of sexual assault characterised by different forms of trauma. The second theme was an expression of a need for safety and support.Conclusion: Women who experience sexual assault are left with devastating effects such as physical and psychological harm and social victimisation. There is also a need for safety and support towards the recovery of these women. This study recommends that professional practitioners involved in the management of sexual assault be sensitised regarding the ordeal experienced by women and stop perceiving survivors as crime scene ‘clients’ from whom only medico-legal evidence has to be collected. Professional practitioners and family members must be supportive, non-judgemental and considerate of the dignity of survivors. The establishment of sexual assault response teams (SART is also recommended. There should also be inter-professional education for better coordination of services rendered to sexually assaulted women.
Lata, Stanisław; Janiszewski, Jacek
The thesis presents a short history and organization of an acute poisoning centre in the1995 functioning within the internal diseases department in a multi-profile provincial hospital. The data show the number of patients treated beetween 1995-2009 an the types of toxic substances that caused poisoning. The conclusions presented refer to the role of the centre to help people suffering from acute poisoning within the city of Tarnow.
Full Text Available Background: Procedural skills training is a critical component of medical education, but is often lacking in standard clinical curricula. We describe a unique immersive procedural skills curriculum for medical students, designed and taught primarily by emergency medicine faculty at The Ohio State University College of Medicine. Objectives: The primary educational objective of this program was to formally introduce medical students to clinical procedures thought to be important for success in residency. The immersion strategy (teaching numerous procedures over a 7-day period was intended to complement the student's education on third-year core clinical clerkships. Program design: The course introduced 27 skills over 7 days. Teaching and learning methods included lecture, prereading, videos, task trainers, peer teaching, and procedures practice on cadavers. In year 4 of the program, a peer-team teaching model was adopted. We analyzed program evaluation data over time. Impact: Students valued the selection of procedures covered by the course and felt that it helped prepare them for residency (97%. The highest rated activities were the cadaver lab and the advanced cardiac life support (97 and 93% positive endorsement, respectively. Lectures were less well received (73% positive endorsement, but improved over time. The transition to peer-team teaching resulted in improved student ratings of course activities (p<0.001. Conclusion: A dedicated procedural skills curriculum successfully supplemented the training medical students received in the clinical setting. Students appreciated hands-on activities and practice. The peer-teaching model improved course evaluations by students, which implies that this was an effective teaching method for adult learners. This course was recently expanded and restructured to place the learning closer to the clinical settings in which skills are applied.
Custers, Eugène J F M; Cate, Olle Ten
In this article, the authors present a historic overview of the development of medical education in the United States and Europe (in particular the Netherlands), as it relates to the issues of time (duration of the course) and proficiency (performance requirements and examinations). This overview is necessarily limited and based largely on post hoc interpretation, as historic data on time frames are not well documented and the issue of competence has only recently been addressed.During times when there were few, if any, formal regulations, physicians were primarily "learned gentlemen" in command of few effective practical skills, and the duration of education and the competencies acquired by the end of a course simply did not appear to be issues of any interest to universities or state authorities. Though uniform criteria gradually developed for undergraduate medical education, postgraduate specialty training remained, before accreditation organizations set regulations, at the discretion of individual institutions and medical societies. This resulted in large variability in training time and acquired competencies between residency programs, which were often judged on the basis of opaque or questionable criteria. Considering the high costs of health care today and the increasing demand for patient safety and educational efficiency, continuing historic models of nonstandardized practices will no longer be feasible. Efforts to constrain, restructure, and individualize training time and licensing tracks to optimize training for safe care, both in the United States and Europe, are needed.
Full Text Available Background & Objectives: The various ABO and Rh blood groups with different distribution frequencies in the general population have been found to be associated with different diseases, most notably gastritis. Many studies have claimed Rh groups to be indifferent to such association. Nonetheless, ABO group is found to linked with chronic gastritis. The aim of this study was to estimate the frequencies of ABO and Rh blood groups and the gastritis amongst the first and second year undergraduate medical and dental students; and to study their relationships. Materials & Methods: In a descriptive, cross-sectional study, 247 study participants were enrolled. After procuring clearance from the institutional review committee and the informed and written consent from the study participants, data collection was done on the variables, year of study (first or second year, gender, blood groups (ABO and Rh and history of gastritis (present or absent.Results: Blood group O was the commonest (n=99; 40.1% followed by group B (n=77; 31.2%. Similarly, 239 (96.8% participants were Rh-positive as compared to 8 (3.2% Rh-negative. Interestingly, 46 (18.6% of the participants reported positive history of gastritis. Participants with blood group O had the greatest odds (OR=1.64 of having history of gastritis compared with those with other blood groups combined. Distribution of study participants based on gender and history of gastritis in either systems of blood grouping shoed no significant difference in their proportions (p>0.05. Conclusion: In light of the above findings, further longitudinal studies can be designed to better asses the relationship.
Liu, Lige; Brown, Melissa J.; Feldman, Marcus W.
Since the 1990s, inter-provincial female migration for marriage has become important in central and eastern rural China. Using survey data from X County in rural Anhui Province, we explore the arrangement of inter-provincial marriages, as well as the characteristics of husbands and wives, marital satisfaction, and marital stability for these marriages. We find that inter-provincial marriage is an important option for local men to respond to the marriage squeeze and the increasing expense of marriage. It helps to relieve the shortage of marriageable women in the local marriage market. Because this kind of marriage is based on economic exchange, but not affection, it is often subject to a higher risk of marriage instability, and can lead to such illegal behaviors as marriage fraud and mercenary marriage. PMID:26594102
Gota, Carmen E; Kaouk, Sahar; Wilke, William S
The aim of this study was to determine the frequency of increasing body mass index (BMI) in fibromyalgia (FM) and to understand the impact of increasing BMI on FM. Patients with FM were divided into 3 BMI classifications: normal weight, overweight, and obese. We then sought relationships of increasing BMI to core process FM variables and symptoms and disability, as well as medical comorbidities and demographic, socioeconomic, psychiatric, and treatment data. Of 224 patients, 0.4% were underweight; 25.9%, normal weight; 29.9%, overweight; 43.8%, obese. We found no differences within groups with regard to age, gender, demographics, FM symptoms, FM impact questionnaire scores, and meeting the American College of Rheumatology 1990 criteria and FM survey criteria. Patients with FM who are obese, compared with normal-weight patients, have higher depression scores measured by Patient Health Questionnaire 9 (13.2 [6.6] vs 10.5 , P = 0.03), report increased disability by Health Assessment Questionnaire Disability Index scores (1.3 [0.6] vs 0.9 [0.6], P disabled, report more medical comorbidities, exercise less, have a higher incidence of abuse, report increased depressive symptoms, and take more medications for FM. Bivariate analysis showed association of increasing BMI with the Health Assessment Questionnaire Disability Index (not FM impact questionnaire) and depression. We confirm that the prevalence of overweight and obesity is high in FM and believe that physicians treating FM should be aware of our bivariate linear correlations and discuss weight loss with their FM patients. Even if increasing BMI is not intrinsic to FM, it contributes to poor mood and functional outcome and should be a treatment goal.
Ramadas, Amutha; Qureshi, Ahmad Munir; Dominic, Nisha Angela; Botross, Nevein Philip; Riad, Amgad; Thirunavuk Arasoo, Valliammai Jayanthi; Elangovan, Soman
Even after completion of conventional treatment, breast cancer survivors continue to exhibit a variety of psychological and physical symptoms, affecting their quality of life. The study aimed to investigate the relationship between socio-demography, medical characteristics and health-related quality of life (HR-QOL) of a sample of breast cancer survivors in Malaysia. This pilot cross-sectional survey was conducted among breast cancer survivors (n=40) who were members of Breast Cancer Support Group Centre Johor Bahru. A validated self-administered questionnaire was used to identify the relationships between socio-demography, medical characteristics and HR-QOL of the participants. Living with family and completion of treatment were significant predictive factors of self-rated QOL, while living with family and ever giving birth significantly predicted satisfaction with health and physical health. Psychological health had moderate correlations with number of children and early cancer stage. Survivors' higher personal income (>MYR4,500) was the only significant predictor of social relationship, while age, income more than MYR4,500 and giving birth significantly predicted environment domain score. The findings suggested the survivors coped better in all four HR-QOL domains if they were married, lived with family, had children and were employed.
Autoimmune progesterone dermatitis (APD) is a rare autoimmune response to raised endogenous progesterone levels that occur during the luteal phase of the menstrual cycle. Cutaneous, mucosal lesions and other systemic manifestations develop cyclically during the luteal phase of the menstrual cycle when progesterone levels are elevated. APD symptoms usually start 3 - 10 days before menstruation and resolve 1 - 2 days after menstruation ceases. A 30-year-old woman presented with urticaria, petechiae and palpable pinpoint purpura lesions of the legs, forearms, neck and buttocks 1 week prior to her menses starting and 2 months after a medical abortion. She was diagnosed with allergic contact dermatitis and topical steroids were prescribed. Her skin conditions did not improve and were associated with her menstrual cycle. We performed an intradermal test using progesterone, which was positive. She was treated with oral contraceptive pills and the symptoms were resolved. This is a typical case of APD triggered by increased sensitivity to endogenous progesterone induced a few months after medical abortion.
Wright, D; Silva, M; Papadopoulos, S; Wright, A; Nicolaides, K H
To define the contribution of maternal variables which influence the measured level of maternal serum pregnancy-associated plasma protein-A (PAPP-A) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum PAPP-A was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of PAPP-A were determined from a linear mixed-effects multiple regression. Serum PAPP-A was measured in 94,966 cases in the first trimester, 7785 in the second trimester and 8286 in the third trimester. Significant independent contributions to serum PAPP-A were provided by gestational age, maternal weight, height, racial origin, cigarette smoking, diabetes mellitus, method of conception, previous pregnancy with or without pre-eclampsia (PE) and birth-weight Z-score of the neonate in the previous pregnancy. The effects of some variables were similar and those for others differed in the three different trimesters. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum PAPP-A and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed PE and in those without this pregnancy complication. A model was fitted to express the measured serum PAPP-A across the three trimesters of pregnancy as MoMs, after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Full Text Available Starting from the Great War, fracture of historic course, watershed of contemporary culture and beginning point in the process of shifting the center of the world, the article reflects on currency of Indian Subaltern Studies. In particular, in the cultural debate on postcoloniality, it focuses on the contribution of Dipesh Chakrabarty in proving that the pattern of a euro-centric and patriarchal universal History, originated in Europe with the primacy of its modernity, must necessarily give space to the subaltern voices emerging from the suburbs of the globe (Provincializing Europe, by an adequate methodology that recoveries them in terms of historical and cultural reconstruction. Then it emerges the work of feminist scholar Gayatri Chakravorty Spivak on the gender subalternity, neglected issue in the official Indian historiography. Spivak locates in literature useful source through which to make the history more closely at what happened, notwithstanding the possibility that subalterns have had to express themselves, and she also shows, in the Indian postcolonial context, that different forms of minority, from ethnicity to caste, embodied in the condition of the female gender, intertwine in the figure of the woman, subaltern subject par excellence. This is the case of the tribal women of Bengal, to which, however, the Indian writer Mahasweta Devi can give a significant voice.
YIN Chang- Shik
Full Text Available Meridian and acupuncture point(MAP is a core theory of acupuncture and essential building blocks of oriental medicine. There still continue theoretic or experimental arguments and controversies on the origination or original concept of MAP, without any definite approval or disapproval of a hypothesis. The theory of MAP is an historic product and has never been outside of historic influences. This study discusses the original concept of meridian and acupuncture point theory and its historical evolution, based on the review of classic literatures on meridian including the mawangdui medical texts of Han dynasty. The concept of MAP served as a empirical reference system in clinical settings irrespective of the anatomical entity of MAP.
I examine why South Africa's pioneering Pholela model of primary health care, dating from the 1940s, held such appeal for the country's new policymakers after 1994, and why those policymakers have failed to make it the basis of an effective public health care system since then. In the 1940s, the innovative Pholela experiment had served as such a model, to be replicated gradually throughout the country until a new health care system in its image was finally in place. However, this vision was dashed by the hostility of the mainstream medical profession and, after 1948, even more so by the new apartheid government, causing the idea to wither and become no more than a vanishing memory. In the 1990s, the model resurfaced as part of the country's transition to democracy, eliciting great enthusiasm among a new generation of health policymakers. I conclude by looking at the fate to date of this second coming of the Pholela experiment.
This article examines the development and use of rotation therapy in the emerging field of psychiatry at the beginning of the 19th century, and the cross-fertilization between British, Irish, German, French and other European proponents of 'Cox's Swing'. Its short-lived popularity is linked to prevalent Enlightenment thought, to the development of an industrial and technological society, to the modern medical theories of irritability, and to the new practice of 'moral management' of the mentally ill. Case studies documenting the use of the Swing are considered from these perspectives, and are compared with contemporary public reactions in the form of publications in newspapers and of a literary text by German Romantic author Ludwig Achim von Arnim.
To make an important scientific discovery that will make history takes a lot of determination, creativity, perseverance and luck! The story behind the discovery of stress and its biological basis is a fascinating one that places Dr. Hans Selye in the forefront. Dr. Selye was a great scientist that taught at the Université de Montréal from 1945 to his death in 1982. Dr. Selye was curious and hard working. He was determined to understand how various disorders can lead to similar physical manifestations, and this interest led him to discover the role of the adrenal glands involved in the stress response and to better understand the effects of glucocorticoids on the body. Today, the science of stress is based on the foundations established by Dr. Selye. In celebration of the 50th anniversary of the Département de psychiatrie de l'Université de Montréal, and the special issue of the Revue Santé Mentale au Québec, this historical review summarizes the discoveries of this great scientist who worked in Quebec.
Hellfritzsch, Maja; Thomsen, Reimar Wernich; Baggesen, Lisbeth Munksgård
-of-charge influenza vaccination to the elderly. Methods We conducted a cross-sectional study among Danes aged 65–79 years participating in a survey. We compared elderly persons with and without a recent (within six months) influenza vaccination in terms of (i) lifestyle and socioeconomic characteristics obtained from......Background Observational studies on effectiveness of influenza vaccination in the elderly are thought to be biased by healthier lifestyles and higher socioeconomic status among vaccinated vs. unvaccinated persons. We examined this hypothesis in a uniform tax-supported health care system with free...... the survey and (ii) health factors including medical history provided by Danish registries. We compared the prevalence of study variables among vaccinated and unvaccinated persons using age- and sex-adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs). Results Among the 4237 elderly persons...
Hulsman, Robert L; Pranger, Susan; Koot, Stephanie; Fabriek, Marcel; Karemaker, John M; Smets, Ellen M A
Medical communication can be a stressful experience for both doctors and patients. In particular, inexperienced doctors facing the demanding task of a bad news consultation may experience high levels of distress. The aim of this exploratory study is to test students' differential cardiovascular reactivity to history taking and bad news consultations with a simulated patient, and to test the relation between the students' self-reported stressfulness of the consultation and their cardiovascular response. Fourth and fifth year medical students (n=20) conducted a history taking (HT) and a bad news (BN) consultation in a randomized order with a standardized patient. Heart rate (HR), mean arterial pressure (MAP), cardiac output (CO) and systemic vascular resistance (SVR) were assessed by way of the Finapres-technique in four conditions: rest, reading aloud, and during both consultations. Self-reported stress was assessed before and after each interview using the State and Trait Anxiety Inventory (STAI), and a visual analogue scale (VAS). Both HT and BN provoked more cardiovascular stress than reading. Bad-news provoked the highest HR and CO responses compared to all other conditions, and had a greater impact when it was the student's first consultation. The STAI and VAS data showed some correlations with the cardiovascular stress measures and a comparable but less significant pattern in stress response. The effect of order of the HT and BN consultations on the students' stress levels suggests an additional impact of novelty and habituation. Unfamiliarity with the patient may enhance the stressfulness of the task of breaking bad news. 2010 Elsevier B.V. All rights reserved.
Kristy Van Dervoort
Full Text Available Background Infants with neonatal hydronephrosis and a normal voiding cystourethrogram (VCUG are presumed to have ureteropelvic junction obstruction (UPJO. There is little current information about the natural history of children with hydronephrosis or clinical factors that predict resolution of the radiological abnormality. Objective To determine the time course until spontaneous resolution of neonatal hydronephrosis and define risk factors for persistence of the abnormality. Methods This retrospective single center review examined infants and children <5 years of age with hydronephrosis who were followed for at least 12 months. Results 136 children were identified (96 male:40 female. The mean age at diagnosis of hydronephrosis was 3.3 ± 9.7 months and 76% of the patients were diagnosed at birth. The hydronephrosis was unilateral in 98 (72% of cases, and hydronephrosis was at least moderate in severity in 22% of affected kidneys. At last follow-up at 30 ± 10 months, the abnormality had resolved in 77 out of 115 (67% available patients, 30 (26% had been referred to urology, and 12 (10% had persistent hydronephrosis. Severity of hydronephrosis was the only clinical feature that predicted persistence of the abnormality (P < 0.001. There was an association between detection at birth and lack of resolution of hydronephrosis. Conclusions Children with hydronephrosis and presumed UPJO and normal kidney parenchyma can be followed for at least 2 years to allow for spontaneous resolution before referral to urology. Serial sonography can be performed at 6 month intervals in uncomplicated cases. More severe hydronephrosis and presence of the lesion at birth may predict infants and children requiring closer observation and referral for possible surgical correction of the hydronephrosis.
Full Text Available During the last decade in Argentina, the growth of open pit mining has faced strong social resistance and provincial laws prohibiting such activity. This work aims to analyse the ways in which the different subnational political regimes and economic systems impact upon the possibility of incidence of social resistance on provincial mining legislation, looking at the cases of Cordoba and Catamarca.
[History of the tuning fork. I: Invention of the tuning fork, its course in music and natural sciences. Pictures from the history of otorhinolaryngology, presented by instruments from the collection of the Ingolstadt German Medical History Museum].
used sets of electromagnetically powered tuning forks for his famous experiments on the sensations of tone. Until the invention of the electronic valve, tuning forks remained indispensible instruments for producing defined sinusoidal vibrations. The history of this development is presented in detail. The diagnostic use of the tuning fork in otology will be described in a separate article.
Full Text Available Abstract Background Although factors associated with the utilisation of bone density measurement (BDM and osteoporosis treatment have been regularly assessed in the US and Canada, they have not been effectively analysed in European countries. This study assessed factors associated with the utilisation of BDM and osteoporosis medication (OM in Switzerland. Methods The Swiss Health Survey 2007 data included self-reported information on BDM and OM for women aged 40 years and older who were living in private households. Multivariable logistic regression analysis was used to identify sociodemographic, socioeconomic, healthcare-related and osteoporosis risk factors associated with BDM and OM utilisation. Results The lifetime prevalence of BDM was 25.6% (95% CI: 24.3-26.9% for women aged 40 years and older. BDM utilisation was associated with most sociodemographic factors, all the socioeconomic and healthcare-related factors, and with major osteoporosis risk factors analysed. The prevalence of current OM was 7.8% (95% CI: 7.0-8.6% and it was associated with some sociodemographic and most healthcare-related factors but only with one socioeconomic factor. Conclusions In Swiss women, ever having had a BDM and current OM were low and utilisation disparities exist according to sociodemographic, socioeconomic and healthcare-related factors. This might foster further health inequalities. The reasons for these findings should be addressed in further studies of the elderly women, including those living in institutions.
Teitge, M; Kumbier, E
Scientific journals were established in the Soviet occupied zone following WWII in order to distinguish themselves from the other occupying powers. Starting in 1949 a journal with the title "Psychiatry, Neurology and Medical Psychology" was founded as no publishing house existed in the field of psychiatry and neurology and it became necessary to establish a new journal that was competitive. The journal was primarily distributed in the German Democratic Republic (GDR) until 1990 but the interest internationally was very limited. State affairs had a great influence from the very beginning so that the political involvement was reflected in the selection of staff, such as the publishers and the head of the editorial department and by the close interconnection between the Society for Psychiatry and Neurology of the GDR and the editorship of the journal. The publishers who were primarily responsible and the authors were at the interface of politics and science. Nevertheless, in an international comparison many parallels can be found in the orientation with respect to the content.
Campos López, María Teresa
Full Text Available From the necessity for restoration and the need to present a conservation proposal for one of the most symbolic buildings in Jaén, Andalucía, a discovery was made of what are, according to researchers, the last remains of the «ancient Arab palaces». Through a combined study of wall stratigraphy, archaeological intervention and the study of documentary sources, it has been possible to prove the historical sequence of the building which is the central office of the Provincial History Archive, located in one of the most historically relevant areas of the city. The building has been occupied since Roman times, later housing the Almohade Muslim dynasty, a royal palace, a convent, a university, a stronghold of resistance during the War of Independence, a men’s hospice and presently the History Archive. This is one example of how buildings stay alive in urban areas, adapting and transforming, and of the reading of these sequences and the mark that this constant state of development leaves on the facings, in the cellars.A partir de la necesidad de restaurar y presentar una propuesta de conservación para uno de los inmuebles más emblemáticos de la capital jiennense, se descubre lo que, a juicio de los investigadores, son los últimos restos de los «antiguos palacios árabes», y a través de un estudio combinado de estratigrafía muraria, intervención arqueológica y el estudio de las fuentes documentales, se ha podido constatar la secuencia histórica del edificio que es sede del Archivo Histórico Provincial, localizado en una de las zonas de más relevancia histórica de la ciudad. La ocupación documentada abarca desde niveles romanos, almohades, siendo más tarde palacio real, convento, universidad, plaza fuerte de la resistencia en la Guerra de la Independencia, hospicio de hombres y, finalmente, Archivo Histórico. Es un ejemplo de cómo los edificios se mantienen vivos dentro de la trama urbana, adaptándose, transformándose y de la
Full Text Available The paper traces the history of the Capuchin monastery libraries of Genoa, since the 1535 to the present day. The main sources used are the Capuchin Constitutions, the documents kept at the Provincial Archives and the library catalogs of the cloisters (including the Bibliotheca Scriptorum Minorum Ordinis S. Francisci Capuccinorum p. Dionisio from Genoa and, finally, was some piece of news by private libraries. The story of the thirty-four cloister libraries is linked with the Provincial Library, which is representative of the Capuchin Province of Genoa and an important center for the conservation of all monastic book collections.
Costescu, Dustin; Guilbert, Edith; Bernardin, Jeanne; Black, Amanda; Dunn, Sheila; Fitzsimmons, Brian; Norman, Wendy V; Pymar, Helen; Soon, Judith; Trouton, Konia; Wagner, Marie-Soleil; Wiebe, Ellen; Gold, Karen; Murray, Marie-Ève; Winikoff, Beverly; Reeves, Matthew
This guideline reviews the evidence relating to the provision of first-trimester medical induced abortion, including patient eligibility, counselling, and consent; evidence-based regimens; and special considerations for clinicians providing medical abortion care. Gynaecologists, family physicians, registered nurses, midwives, residents, and other healthcare providers who currently or intend to provide pregnancy options counselling, medical abortion care, or family planning services. Women with an unintended first trimester pregnancy. Published literature was retrieved through searches of PubMed, MEDLINE, and Cochrane Library between July 2015 and November 2015 using appropriately controlled vocabulary (MeSH search terms: Induced Abortion, Medical Abortion, Mifepristone, Misoprostol, Methotrexate). Results were restricted to systematic reviews, randomized controlled trials, clinical trials, and observational studies published from June 1986 to November 2015 in English. Additionally, existing guidelines from other countries were consulted for review. A grey literature search was not required. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force for Preventive Medicine rating scale (Table 1). Medical abortion is safe and effective. Complications from medical abortion are rare. Access and costs will be dependent on provincial and territorial funding for combination mifepristone/misoprostol and provider availability. Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
Linden, van der J.; Poelmans, W.
Since 1987 the distribution of many plant species in the central and eastern parts of the province Noord-Brabant has been mapped for country use planning by the Provincial Authorities. Distribution maps (with a 5 x 5 km² grid) of the Potamogeton (broad-leaved pondweed) species, which are important
After the fall of Soeharto in 1998, and an increased connection to the global world, politics at the local level in Indonesia have changed significantly. This has contributed to a change in how business is conducted in provincial towns. This thesis explores the changing relationship between the
Bukin, V. P.
A survey conducted in two provincial areas of Russia provides the basis for an examination of the relation between the self-identification and the social status affiliation of young people. Self-assessments serve as the basis for a model of the social structure and a typology of the younger generation in these regions, in accordance with their…
José Luis Merlo Fuertes
Full Text Available This article will analyze the urban plans of those municipalities in the Province of Valencia that embraced the technical assistance given by the Provincial Council for the planning composition, at the time of Luis Albert Ballesteros, the provincial council architect. Those first urban plans of the Provincial Council make up a homogeneous set of documents since they respond to a unique style of urban planning that varies as much as the original core of the population does. The common element is the ground plan centrality that would be highlighted by an area or a protected green zone that will somehow link to the urban proposals connected to the city-garden model by Howard. Commencement of which began at a time characterized mainly by the co-existence of a great diversity of laws and percepts, making it so that the meaning of the term urban planning could be applied in a variety of ways. The urban plans of the Provincial Council represent the latest inheritance of the extension models and interior remodeling. In the transition to the Land Planning Act (Ley de Suelo of 1956, these plans have the interest in being, in addition to the last examples of the so-called urbanism in the municipal tradition, one of the ancestors of the current master plans of urban development (plan general de ordenación urbana.
The aim of the study was to identify the most preferred post-match recovery methods utilized by U19 and U21 provincial rugby union players (n=97; Mean age: ± 20.2 years) in Gauteng Province of South Africa. Questionnaire-based data were collected from a purposive sample size of 97 rugby players. The findings ...
Alejandra Carrasco Ulloa
Esta ciudad, se constituye como un enclave urbano de gran importancia por ser centro del carácter provincial de un vasto sector costero de asentamientos mapuches, etnia que hoy intenta incorporarse con fuerza al desarrollo integrado regional, conservando sus costumbres, tradiciones y valores.
Vanderloo, Leigh M; Tucker, Patricia; Ismail, Ali; van Zandvroort, Melissa M
Preschoolers spend a substantial portion of their day in childcare; therefore, these centers are an ideal venue to encourage healthy active behaviors. It is important that provinces'/territories' childcare legislation encourage physical activity (PA) opportunities. The purpose of this study was to review Canadian provincial/territorial childcare legislation regarding PA participation. Specifically, this review sought to 1) appraise each provincial/territorial childcare regulation for PA requirements, 2) compare such regulations with the NASPE PA guidelines, and 3) appraise these regulations regarding PA infrastructure. A review of all provincial/territorial childcare legislation was performed. Each document was reviewed separately by 2 researchers, and the PA regulations were coded and summarized. The specific provincial/territorial PA requirements (eg, type/frequency of activity) were compared with the NASPE guidelines. PA legislation for Canadian childcare facilities varies greatly. Eight of the thirteen provinces/territories provide PA recommendations; however, none provided specific time requirements for daily PA. All provinces/territories did require access to an outdoor play space. All Canadian provinces/territories lack specific PA guidelines for childcare facilities. The development, implementation, and enforcement of national PA legislation for childcare facilities may aid in tackling the childhood obesity epidemic and assist childcare staff in supporting and encouraging PA participation.
Tetanus is still a public health problem in developing countries including the Democratic Republic of Congo. The objective of this study was to determine the prognosis of patients with tetanus admitted in the Intensive Care Unit (ICU) of Provincial Hospital Jason Sendwe,Lubumbashi, DR Congo. This is a descriptive study ...
M. Grandia Mantas
De Provincial Reconstruction Teams (PRT’s) zijn voor de NAVO het belangrijkste middel geweest om haar gebiedsuitbreiding naar geheel Afghanistan te realiseren. Daarnaast zijn PRT’S populair bij de media omdat ze veel met de lokale bevolking werken en projecten opzetten. De PRT’s zijn er in
Fertel, Camille; Bahn, Olivier; Vaillancourt, Kathleen; Waaub, Jean-Philippe
This paper presents an analysis of Canadian energy and climate policies in terms of the coherence between federal and provincial/territorial strategies. After briefly describing the institutional, energy, and climate contexts, we perform a SWOT analysis on the themes of energy security, energy efficiency, and technology and innovation. Within this analytical framework, we discuss the coherence of federal and provincial policies and of energy and climate policies. Our analysis shows that there is a lack of consistency in the Canadian energy and climate strategies beyond the application of market principles. Furthermore, in certain sectors, the Canadian approach amounts to an amalgam of decisions made at a provincial level without cooperation with other provinces or with the federal government. One way to improve policy coherence would be to increase the cooperation between the different jurisdictions by using a combination of policy tools and by relying on existing intergovernmental agencies. - Highlights: • We perform a SWOT analysis of the Canadian energy and climate policies. • We analyse policy coherence between federal and provincial/territorial strategies. • We show that a lack of coordination leads to a weak coherence among policies. • The absence of cooperation results in additional costs for Canada
to be aware oftheir incidence and nature. S Air Med J 1993; 83: 339-342. TIe popularity and success that cricket, especially limited-overs cricket at provincial level, has enjoyed over the past decade has placed greater demands on cricketers as a result of the increase in the number of matches played. The increased physical.
Molina-Montes, E; Gomez-Rubio, P; Márquez, M; Rava, M; Löhr, M; Michalski, C W; Molero, X; Farré, A; Perea, J; Greenhalf, W; Ilzarbe, L; O'Rorke, M; Tardón, A; Gress, T; Barberà, V M; Crnogorac-Jurcevic, T; Domínguez-Muñoz, E; Muñoz-Bellvís, L; Balsells, J; Costello, E; Huang, J; Iglesias, M; Kleeff, J; Kong, Bo; Mora, J; Murray, L; O'Driscoll, D; Poves, I; Scarpa, A; Ye, W; Hidalgo, M; Sharp, L; Carrato, A; Real, F X; Malats, N
Family history (FH) of pancreatic cancer (PC) has been associated with an increased risk of PC, but little is known regarding the role of inherited/environmental factors or that of FH of other comorbidities in PC risk. We aimed to address these issues using multiple methodological approaches. Case-control study including 1431 PC cases and 1090 controls and a reconstructed-cohort study (N = 16 747) made up of their first-degree relatives (FDR). Logistic regression was used to evaluate PC risk associated with FH of cancer, diabetes, allergies, asthma, cystic fibrosis and chronic pancreatitis by relative type and number of affected relatives, by smoking status and other potential effect modifiers, and by tumour stage and location. Familial aggregation of cancer was assessed within the cohort using Cox proportional hazard regression. FH of PC was associated with an increased PC risk [odds ratio (OR) = 2.68; 95% confidence interval (CI): 2.27-4.06] when compared with cancer-free FH, the risk being greater when ≥ 2 FDRs suffered PC (OR = 3.88; 95% CI: 2.96-9.73) and among current smokers (OR = 3.16; 95% CI: 2.56-5.78, interaction FHPC*smoking P-value = 0.04). PC cumulative risk by age 75 was 2.2% among FDRs of cases and 0.7% in those of controls [hazard ratio (HR) = 2.42; 95% CI: 2.16-2.71]. PC risk was significantly associated with FH of cancer (OR = 1.30; 95% CI: 1.13-1.54) and diabetes (OR = 1.24; 95% CI: 1.01-1.52), but not with FH of other diseases. The concordant findings using both approaches strengthen the notion that FH of cancer, PC or diabetes confers a higher PC risk. Smoking notably increases PC risk associated with FH of PC. Further evaluation of these associations should be undertaken to guide PC prevention strategies. © The Author(s) 2018; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association
Full Text Available Masanobu Okayama,1,2 Taro Takeshima,2 Masanori Harada,3 Ryusuke Ae,4 Eiji Kajii2 1Division of Community Medicine and Medical Education, Kobe University Graduate School of Medicine, Kobe, Hyogo, 2Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, 3Department of Support of Rural Medicine, Yamaguchi Grand Medical Center, Hofu, Yamaguchi, 4Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan Objective: Disclosing genetic testing results may contribute to the prevention and management of many common diseases. However, whether the presence of a disease influences these effects is unclear. This study aimed to clarify the difference in the effects of disclosing genetic testing results of the risk for developing salt-sensitive hypertension on the behavioral modifications with respect to salt intake in hypertensive and nonhypertensive patients.Methods: A cross-sectional study using a self-administered questionnaire was conducted for outpatients aged >20 years (N=2,237 at six primary care clinics and hospitals in Japan. The main factors assessed were medical histories of hypertension, salt preferences, reduced salt intakes, and behavior modifications for reducing salt intake. Behavioral modifications of participants were assessed using their behavior stages before and after disclosure of the hypothetical genetic testing results. Results: Of the 2,237 participants, 1,644 (73.5% responded to the survey. Of these respondents, 558 (33.9% patients were hypertensive and 1,086 (66.1% were nonhypertensive. After being notified of the result “If with genetic risk”, the nonhypertensive participants were more likely to make positive behavioral modifications compared to the hypertensive patients among all participants and in those aged <65 years (adjusted relative ratio [ad-RR], 1.76; 95% confidence interval, 1.12−2.76 and ad-RR, 1
Full Text Available Abstract Background The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+ or without (CVD- medical history of cardiovascular disease, using data obtained in five European countries. Methods A cross-sectional consumer survey was carried out in November-December 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4,786 respondents, aged 18–84 and who were responsible for food purchasing and cooking in the household. Results Individuals from households in the CVD+ group consumed fish more frequently in Belgium and in Denmark as compared to those in the CVD- group. The consumption of fatty fish, which is the main sources of omega-3 PUFA associated with prevention of cardiovascular diseases, was on the same level for the two CVD groups in the majority of the countries, except in Belgium where CVD+ subjects reported to eat fatty fish significantly more frequently than CVD- subjects. All respondents perceived fish as a very healthy and nutritious food product. Only Danish consumers reported a higher subjective and objective knowledge related to nutrition issues about fish. In the other countries, objective knowledge about fish was on a low level, similar for CVD+ as for CVD- subjects, despite a higher claimed use of medical information sources about fish among CVD+ subjects. Conclusion Although a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits – rather than a medical history of CVD – account for large differences between the countries, particularly in fatty fish consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing chronic
Bonnet, Maryline; San, Kim Chamroeun; Pho, Yati; Sok, Chandara; Dousset, Jean-Philippe; Brant, William; Hurtado, Northan; Eam, Khun Kim; Ardizzoni, Elisa; Heng, Seiha; Godreuil, Sylvain; Yew, Wing-Wai; Hewison, Cathy
Prevalence of nontuberculous mycobacteria (NTM) disease is poorly documented in countries with high prevalence of tuberculosis (TB). We describe prevalence, risk factors, and TB program implications for NTM isolates and disease in Cambodia. A prospective cohort of 1,183 patients with presumptive TB underwent epidemiologic, clinical, radiologic, and microbiologic evaluation, including >12-months of follow-up for patients with NTM isolates. Prevalence of NTM isolates was 10.8% and of disease was 0.9%; 217 (18.3%) patients had TB. Of 197 smear-positive patients, 171 (86.8%) had TB confirmed (167 by culture and 4 by Xpert MTB/RIF assay only) and 11 (5.6%) had NTM isolates. HIV infection and past TB were independently associated with having NTM isolates. Improved detection of NTM isolates in Cambodia might require more systematic use of mycobacterial culture and the use of Xpert MTB/RIF to confirm smear-positive TB cases, especially in patients with HIV infection or a history of TB.
Kennedy, Christine; Johnson, Darryl
Full text: In June 2007 new reference levels for radon gas were announced from Health Canada. These new levels brought new attention to the issue of radon gas exposure in the Province of Newfoundland and Labrador. Research in radon gas exposure has a long history in the fluorspar mines of the Burin Peninsula, indeed, occupational data from the 1950 's and 60 's had been included in Darby et al. large scale occupational meta analyses. Radon was also implicated in a royal commission of occupational mining hazards in Newfoundland in 1968. Although, the occupational exposures of miners have been well documented, very little is known about population exposures in indoor spaces. Geological maps are currently being composed for national areas, but data for this province is not yet published. Information about mining tailings used in construction materials or as fill is very poor (unlike the data known for uranium mining tailings in Ontario and Manitoba). The challenges of estimating radon exposures for the province are myriad and these are explored here in this narrative study of how new information has to be generated, and then incorporated into new environmental public health policies for a population. The process by which new scientific information informs public health policy is described in this study of radon in Newfoundland and Labrador. Anticipated regulations for new buildings are discussed. (author)
Inserting adults with psychic problems into families has recently been practiced in various European countries and also in Italy, where some mental health departments support such families. Beyond the well known story of Gheel, the etero and omofamily care of psychiatric patients has a forgotten history. On the basis of unexplored and exceptionally rich sources from the archives of the asylums in Florence, as well as of the Province di Florence, which funded assistance to the mentally ill--this research focuses on the subsidized "domestic custody" of hundreds of psychiatric patients, who had already been institutionalized. Beginning in 1866, outboarding was supported by the provincial administration in Florence with the collaboration of the asylum medical direction. In the late 19th C. and in the early 20th C. prestigious psychiatrists sought alternatives to the institutionalisation. These alternatives involved varied participants in a community (the patients and their families, the administrators and the medical specialists, the neighborhood and the police). The families played a special role that historians of the psychiatry exclusively dedicated to the insane asylums have not really seen. The role of the families in the interaction with the psychiatric staff is not, even on a historiographical level, simply an additional and marginal chapter of the practices and of the culture of the mental health. These archival evidence contradicts some common places on the past of the Italian psychiatry before 1978, and provokes new reflections of possible relevance to the present.
Ballarin, V L; Isoardi, R A
The paper discusses the major Argentineans contributors, medical physicists and scientists, in medical imaging and the development of medical imaging in Argentina. The following are presented: history of medical imaging in Argentina: the pioneers; medical imaging and medical revolution; nuclear medicine imaging; ultrasound imaging; and mathematics, physics, and electronics in medical image research: a multidisciplinary endeavor.
... you collect information about your relatives, respect their right to confidentiality. You might want to consult family documents, such as existing family trees, baby books, old letters, obituaries or records from places of ...
Armistead-Jehle, Patrick; Cole, Wesley R; Stegman, Robert L
The study was designed to replicate and extend pervious findings demonstrating the high rates of invalid neuropsychological testing in military service members (SMs) with a history of mild traumatic brain injury (mTBI) assessed in the context of a medical evaluation board (MEB). Two hundred thirty-one active duty SMs (61 of which were undergoing an MEB) underwent neuropsychological assessment. Performance validity (Word Memory Test) and symptom validity (MMPI-2-RF) test data were compared across those evaluated within disability (MEB) and clinical contexts. As with previous studies, there were significantly more individuals in an MEB context that failed performance (MEB = 57%, non-MEB = 31%) and symptom validity testing (MEB = 57%, non-MEB = 22%) and performance validity testing had a notable affect on cognitive test scores. Performance and symptom validity test failure rates did not vary as a function of the reason for disability evaluation when divided into behavioral versus physical health conditions. These data are consistent with past studies, and extends those studies by including symptom validity testing and investigating the effect of reason for MEB. This and previous studies demonstrate that more than 50% of SMs seen in the context of an MEB will fail performance validity tests and over-report on symptom validity measures. These results emphasize the importance of using both performance and symptom validity testing when evaluating SMs with a history of mTBI, especially if they are being seen for disability evaluations, in order to ensure the accuracy of cognitive and psychological test data. Published by Oxford University Press 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Vinogradov, Andrei; Petriashin, Stanislav
This article explores interactions between the chemical industry, the environment, and Russian provincial society in the late nineteenth and early twentieth centuries, using the example of the Kokshan chemical works, in the Elabuga District, Viatka Province, Russian Empire (today Mendeleevsk District, Republic of Tatarstan, Russian Federation). The plant's location facilitated its rapid development due to a number of factors, including a cheap labour force, the availability of raw materials, and the absence of local competition. However, the factory's development came in conjunction with the deterioration of the environment and subsequent health problems for employees and the surrounding population. Conflicts connected with the Kokshan works illustrate differences between this case and similar examples in Russia and Europe. In Viatka Province, the local community remained mostly silent regarding these issues, and made no demands for improving sanitary control and working conditions or reducing pollution; rather, it was distant activists who personally suffered no harm who intervened in the interest of social justice. The history of the company reflects the contrast between the transfer of European technological innovations to Russia and laborious efforts to increase national wealth on the one hand, and the exploitation of the environment and endangerment of workers' health on the other.
Full Text Available Beginning in 1909, mainland Chinese governments routinely held elections, and lawmakers devoted considerable resources to writing and revising election laws. The earliest elections, held under the late Qing and the early Republic, utilized laws based on restricted electorates and indirect voting. By contrast, election laws designed during the provincial autonomy movement of the 1920s and the post-1927 Nationalist government featured direct voting in elections with (near-universal adult suffrage. Each of these two systems of electoral law incorporated different elements of foreign electoral practice with concerns and ideas that arose from the experiences and ideals of late imperial Chinese political thought. The transition between these two systems highlights the surprising influence of the short-lived provincial autonomy movement on the legal structures of the centralized one-party states that followed.
Ye, Z.; Xiang, H.
The paper discusses the basic principles and the problem solutions during the design and implementation of the mobile GIS system, and base on the research result, we developed the General Provincial Situation Visualization System Based on iOS of Shandong Province. The system is developed in the Objective-C programming language, and use the ArcGIS Runtime SDK for IOS as the development tool to call the "World-map Shandong" services to implement the development of the General Provincial Situation Visualization System Based on iOS devices. The system is currently available for download in the Appstore and is chosen as the typical application case of ESRI China ArcGIS API for iOS.
Joaquín Martínez Pino
Full Text Available Recoge este artículo la labor desarrollada por la Comisión Provincial de Monumentos de Murcia desde su creación en 1844 hasta su reorganización en 1865. Procura este estudio también plasmar las actividades llevadas a cabo por la Comisión Científico Artística de Murcia, como organismo precedente de las Comisiones de Monumentos.This article puts forward the work developed by the Provincial Commission on Monuments of Murcia (Spain since it was created in 1844 until its reorganization in 1865. This research also tries to capture the activities carried out by the Scientific Artistic Commission of Murcia (Spain, as the predecessor of the Commission on Monuments.
Hu, Song Bo; Wang, Fang; Yu, Chuan Hua
To assess the data quality and estimate the provincial infant mortality rate (1q0) from China's sixth census. A log-quadratic model is applied to under-fifteen data. We analyze and compare the average relative errors (AREs) for 1q0 between the estimated and reported values using the leave-one-out cross-validation method. For the sixth census, the AREs are more than 100% for almost all provinces. The estimated average 1q0 level for 31 provinces is 12.3‰ for males and 10.7‰ for females. The data for the provincial 1q0 from China's sixth census have a serious data quality problem. The actual levels of 1q0 for each province are significantly higher than the reported values. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.
Nephrology is a relatively new discipline that emerged at a time when the writing of the history of medicine was changing drastically. While the merits of medical history were valued since antiquity, it was only in the 18th century that the actual historiography of medicine began. It was nurtured, matured and appreciated enough that by the late 19th and early 20th centuries, medical history was incorporated into the medical curriculum and presented at national meetings. Unfortunately, the merits of medical history and its inclusion in medical education have come under increasing scrutiny over the past few decades. Ironically, the erosion began at about the same time that scholarly work on the history of medicine was flourishing whilst that of scientific discovery and innovation in medicine was accelerating. The demands of rigorous research into the history of medicine gradually led to the emergence of medical history as an independent discipline within academic departments of history. Simultaneously, the exponential growth of new information generated by medical research led to an overflow of medical knowledge in which the inclusion of medical history was contested and dismissed. That is just about the time that nephrology emerged in the 1960s. Whereas initially the quest for origins led renal journals to publish historical articles, the more recent quest to increase impact factors has led to the exclusion of historical articles from consideration for publication. This manuscript examines the reasons that brought about the separation of nephrology from its history and proposes potential solutions to their rapprochement.
Full Text Available Abstract Background Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Both schizophrenia and alcoholism are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep, the physiologically significant, refreshing part of the sleep. Antisocial behaviour with severe aggression, on the contrary, has been reported to associate with increased deep sleep reflecting either specific brain pathology or a delay in the normal development of sleep patterns. The authors are not aware of previous sleep studies in patients with both schizophrenia and antisocial personality disorder. Case presentation The aim of the present case-study was to characterize the sleep architecture of a violent, medication-free and detoxified female offender with schizophrenia, alcoholism and features of antisocial personality disorder using polysomnography. The controls consisted of three healthy, age-matched women with no history of physical violence. The offender's sleep architecture was otherwise very typical for patients with schizophrenia and/or alcoholism, but an extremely high amount of deep sleep was observed in her sleep recording. Conclusions The finding strengthens the view that severe aggression is related to an abnormal sleep pattern with increased deep sleep. The authors were able to observe this phenomenon in an antisocially behaving, violent female offender with schizophrenia and alcohol dependence, the latter disorders previously reported to be associated with low levels of slow wave sleep. New studies are, however, needed to confirm and explain this preliminary finding.
Nielsen, Thomas Alexander Sick
This paper presents the results from a detailed study of the land use ? transport connection, with special emphasis on the location of residences, in the context of a larger Danish provincial city (the city of Aalborg with approx. 120.000 inhabitants, situated in North Jutland). The study...... was carried out as a part of the authors PhD-work and as part of the research programme: Transportation and urban structure at Aalborg University....
Sobari, Nasuha Ali; Hariyanti, Puji
The tourism sector indeed is a resourceful sector to be developed into one source of local regional revenue. Therefore, the development of tourism becomes the objective of the Government of Indonesia at this time. This research aims to explain the integrated marketing communication strategy undertaken by the Provincial Tourism Office of Banten in promoting Banten tourism. Qualitative research utilizes the primary data obtained through interviews. The outcomes of this research indicate that in...
Smith? Robert J; Llamazares Marco
Abstract Background Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged 9–13. While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated. Adult women who are eligible for the vaccine may still receive it, but at a cost of approximately CAN$400. Given the high efficacy and immunogenicity of the vaccine, the possibility of eradicating targeted t...
Haryono P. Kamase
Full Text Available This study examines a reporting system change of a provincial government in Indonesia. The study also draws attention to the institutional capacity of the provincial administration andimplementation problems it encountered in adopting an accrual accounting system. Following the work of Lapsley and Pallot (2000, this study uses economic and institutional perspectives in conceptualising how an accounting change has been undertaken. The study shows that from an economic based perspective, the adoption of the new reporting system was stimulated by the wish to improve government organisations’ performance in the country. It is also found that the change of the reporting system was not accompanied by the separation of the roles of elected local officials (i.e. the governor and local parliamentary members as politicians and decision-makers in the allocation of funding and budget formulation in theprovincial government. This situation undermines the instrumental roles of accounting for decision making. Moreover, drawing upon institutional theory, the adoption of the new reporting system at provincial level in the country is indicated by the presence of coercive pressure as local administrations in Indonesia are required to comply with rules imposed by the central government. However, based on the experience of a provincial government in implementing the new accounting system, the policy to adopt the new accounting regime fails to recognise a low level of institutional capacity of local administrations. As a consequence, the institutionalisation of the new accounting system has yet to bring intended outcomes. Inthis vein, the role of accounting as a political tool for controlling people overshadows its roles for efficiency and performance improvement. As the study demonstrates the use of mixedmethodological perspectives (i.e. economic and institutional theories is useful to fully capture and understand the dynamic process of accounting change in a
Liu, Jin; Lin, Bin
Since its foundation, China’s government auditing system has played a very important role in maintaining financial and economic order and improving government accountability and transparency. Though a great deal of research has discussed the role of government auditing in discovering and deterring corruption, there is little empirical evidence on whether government auditing actually helps to reduce corruption. Using China’s provincial panel data from 1999 to 2008, this paper empirically exami...
Full Text Available The relationship between urbanization, economic growth, and water use change is one of the key issues for China’s sustainable development, as rapid urbanization and continuous economic growth are accompanied by a steady water stress. Thus, we applied a cointegration test and a VECM (vector error correction model Granger causality test to investigate the causal relationship between the urbanization level, the economic development level, and the total water use in China and its 31 provincial administrative regions during 1997–2013. Results show that the three indicators have a long-run equilibrium relationship in most provincial administrative regions in China. However, the short-run effects and Granger causal relationship are insignificant for China and most provincial administrative regions. Therefore, that an idea such as urbanization as the engine or major driving force of economic growth, and that China’s urbanization and economic growth will bring a water crisis and will be strongly constrained by water resources, might be properly weakened. Targeted and relatively separate policies should be emphasized more for the coordinated development of China’s urbanization, economy, and water resources.
Hu, Yu; Chen, Yaping
Vaccination coverage in Zhejiang province, east China, is evaluated through repeated coverage surveys. The Zhejiang provincial immunization information system (ZJIIS) was established in 2004 with links to all immunization clinics. ZJIIS has become an alternative to quickly assess the vaccination coverage. To assess the current completeness and accuracy on the vaccination coverage derived from ZJIIS, we compared the estimates from ZJIIS with the estimates from the most recent provincial coverage survey in 2014, which combined interview data with verified data from ZJIIS. Of the enrolled 2772 children in the 2014 provincial survey, the proportions of children with vaccination cards and registered in ZJIIS were 94.0% and 87.4%, respectively. Coverage estimates from ZJIIS were systematically higher than the corresponding estimates obtained through the survey, with a mean difference of 4.5%. Of the vaccination doses registered in ZJIIS, 16.7% differed from the date recorded in the corresponding vaccination cards. Under-registration in ZJIIS significantly influenced the coverage estimates derived from ZJIIS. Therefore, periodic coverage surveys currently provide more complete and reliable results than the estimates based on ZJIIS alone. However, further improvement of completeness and accuracy of ZJIIS will likely allow more reliable and timely estimates in future.
David. J. Edelman
Full Text Available ABSTRACT: Recent concern with sustainable urban development has focused on the widespread development of new towns and the expansion of cities throughout China. In recent decades, an increasing number of planning and design professionals in the United States and Europe have undertaken consulting work in China. This study examines the first instance of a Chinese city funding an American academic planning unit to create a conceptual plan for a new town. The School of Planning from the University of Cincinnati was commissioned to prepare the conceptual plan for the Anyang Eastern New Town. Prior to the drafting of the plan, faculty and students visited the site on a reconnaissance and data gathering mission, undertook research and studio work, organized presentations, and navigated the labyrinthine bureaucracy at the local, provincial, and national levels. These experiences differ considerably from those encountered in places such as Shanghai and the southern coastal plain region. This article identifies a number of issues that play a key role in the success of projects involving American or European Universities in conjunction with the Chinese government, particularly provincial authorities. This paper provides a valuable reference for any organization involved in such undertakings. KEYWORDS: Chinese urban planning, sustainable urban design, provincial planning
Lapping, Karin; Frongillo, Edward A; Nguyen, Phuong H; Coates, Jennifer; Webb, Patrick; Menon, Purnima
Translating national policies and guidelines into effective action at the subnational level (e.g., province or region) is a prerequisite for ensuring an impact on nutrition. In several countries, including Vietnam, the focus of this paper, this process is affected by the quality of the decentralized process of planning and action. This study examined how provincial planning processes for nutrition occurred in Vietnam during 2009 and 2010. Key goals were to understand variability in processes across provinces, identify factors that influenced the process, and assess the usefulness of the process for individuals involved in planning and action. A qualitative case-study methodology was used. Data were drawn from interviews with 51 government officials in eight provinces. The study found little variability in the planning process among these eight provinces, probably due to a planning process that was predominantly a fiscal exercise within the confines of a largely centralized structure. Respondents were almost unanimous about the main barriers: a top-down approach to planning, limited human capacity for effective planning at subnational levels, and difficulty in integrating actions from multiple sectors. Provincial-level actors were deeply dissatisfied with the nature of their role in the process. Despite the rhetoric to the contrary, too much power is probably still retained at the central level. A strategic multiyear approach is needed to strengthen the provincial planning process and address many of the key barriers identified in this study.
Nordengen, Paul A
Full Text Available This paper describes the development and implementation of a bridge management system for the Provincial Government Western Cape (PGWC). During the first phase of the project, the inventory and inspection modules were customised to meet the needs...
Limpopo provincial departments like all other South African government departments are required to report on performance against predetermined objectives in terms of Section 40 of the Public Finance Management Act 1 of 1999, read in conjunction with Section 5.1.1 of the Treasury Regulations. The purpose of this article is to report on a study that was undertaken to establish the challenges faced by the Limpopo provincial departments in reporting on performance against predetermined objectives...
Rodés, J; Trilla, A; Asenjo, M A; Grau, J
The development of an evaluation protocol for assessing the scientific contribution and the impact on medical care of the sabbatical leaves granted in a large Spanish teaching hospital. The sabbatical leaves for all faculty staff of the Hospital Clínic i Provincial of Barcelona (HCPB) were analyzed since 1980 trough 1991. The scientific production analysis was done according to the impact factor (IF) score of the Science Citation Index. Descriptive statistical techniques as well as parametric and non-parametric tests were used for comparisons. A total of 52 sabbatical leaves was analyzed of all 60 leaves granted (87%). Mean duration of the leave was 7.94 +/- 3.86 months. The scientific production includes 89 original articles published in peer-reviewed medical journals, with a total score of 300.82 IF points (mean score: 5.78 +/- 7.12 IF points by leave). There were significant differences in the mean duration, number of papers published and IF points score by sabbatical leave between the Medicine, Surgery and Other Departments. In 16 cases (31%) there was a professional promotion following the sabbatical leave and in 20 cases (39%) an academic promotion. In 27 cases (60%) there was no promotion after the leave. Most of the faculty staff physicians (96%) are still employed in the same institution, and believe that the sabbatical leave has significantly contributed to their promotion (67%). A high percentage (94%) has also been able to develop afterwards the methods and techniques learned during the sabbatical leave. The experience of the Hospital Clinic of Barcelona in granting sabbatical leaves has been highly positive. The scientific performance of the individuals on leave is high. Our institution has been able to add and develop most of the techniques and methods learned overseas. The future of the sabbatical leaves in other Spanish Universities and Hospitals should be regarded as a high priority target. The performance of these leaves is supported by its
Early modern natural history: Contributions from the Americas and India. Rajesh Kochhar. Perspectives Volume 37 Issue ... Keywords. India; medical botany; natural history; scientific botany; the Americas. Author Affiliations. Rajesh Kochhar1. Indian Institute of Science Education and Research, Mohali 140 306 Punjab, India ...
Full Text Available City green economy plays an important role in the development of low-carbon economy and the achievement of sustainable development of economy, society and ecological environment. From the perspective of economy, society, environment and resources, the evaluation of the green economy in urban areas tends to offer us a new insight into the green economy of cities. This paper is about the creation of a novel urban green economy evaluation model and its application. First of all, we established a city green economy evaluation index system based on R cluster analysis and coefficient of variation. Secondly, based on the nonlinear weighted utilizing entropy weight method, a city green economy evaluation model is established based on inferior constraints. Thirdly, by comparing the differences between evaluation rankings under inferior constraints and non-inferior constraints, the advantageous factors and the disadvantageous ones in urban green economy development are obtained. The proposed model has been verified with the data on 15 sub-provincial cities in China. Empirical analysis results show that: (1 The proposed approach can accurately find out the advantageous and disadvantageous factors for each sub-provincial city; (2 In the evaluation of green economy development, the order of importance of the three criterion layers is X1 Economy development > X2 Social livelihood of the people > X3 Resources and environment; (3 Local governments should implement differential, reasonable policies in order to improve their green economy development. Moreover, our research is not only significant for developing green economy in China’s sub-provincial cities, but also serves as a reference for the development of green economy in other cities in the world.
Wu, Jie; Zhu, Qingyuan; Liang, Liang
Highlights: • DEA is used to evaluate the energy and environmental efficiency of 30 provincial industrial sector in China. • A new DEA-based model is proposed to allocate the CO 2 emissions and energy intensity reduction targets. • The context-dependent DEA is used to characterize the production plans. - Abstract: High energy consumption by the industry of developing countries has led to the problems of increasing emission of greenhouse gases (GHG) (primarily CO 2 ) and worsening energy shortages. To address these problems, many mitigation measures have been utilized. One major measure is to mandate fixed reductions of GHG emission and energy consumption. Therefore, it is important for each developing country to disaggregate their national reduction targets into targets for various geographical parts of the country. In this paper, we propose a DEA-based approach to allocate China’s national CO 2 emissions and energy intensity reduction targets over Chinese provincial industrial sectors. We firstly evaluate the energy and environmental efficiency of Chinese industry considering energy consumption and GHG emissions. Then, considering the necessity of mitigating GHG emission and energy consumption, we develop a context-dependent DEA technique which can better characterize the changeable production with reductions of CO 2 emission and energy intensity, to help allocate the national reduction targets over provincial industrial sectors. Our empirical study of 30 Chinese regions for the period 2005–2010 shows that the industry of China had poor energy and environmental efficiency. Considering three major geographical areas, eastern China’s industrial sector had the highest efficiency scores while in this aspect central and western China were similar to each other at a lower level. Our study shows that the most effective allocation of the national reduction target requires most of the 30 regional industrial to reduce CO 2 emission and energy intensity, while a
Yang, Guangfei; Li, Wenli; Wang, Jianliang; Zhang, Dongqing
China has become the largest energy consumer worldwide, and it is important to study the energy intensity to realize the sustainable development goal of China. This paper focuses on investigating the influential factors of China's energy intensity using provincial-level panel data from 1985 to 2012. More specifically, we try to identify which factor is relatively more important to pay attention to. A novel approach based on evolutionary computation is proposed to intelligently mine the intrinsic relations between observed phenomena and to let the important factors automatically emerge from the discovered nonlinear models. However, due to China's vast territory and significant heterogeneities, this approach may fail to examine some detailed or hidden information when analyzing the country as a whole. Instead, we concentrate on the provincial level because the provinces play vital roles in reducing energy intensity in China. From our analytical results, the main findings are as follows: (1) the Total Population is the most important influential factor across China's provinces, while the Energy Price Index has the least impact; and (2) the provinces could be naturally classified into four categories based on the primary factors emerged from data, and such classification could reveal more about the true underlying features of each area. - Highlights: • Identify the important factors of China's energy intensity by symbolic regression. • Analyze China's energy intensity using provincial-level panel data from 1985 to 2012. • Intelligently investigate nonlinear models and the emergence of important factors. • The Total Population is discovered to be the most important influential factor. • Provinces are naturally classified into four categories by the influential factors.
Rydlewska-Liszkowska, I; Jugo, B
The financing of occupational health services (OHS) at the provincial level is an important issue in view of the transformation process going on not only in OHS but also in the overall health care system in Poland. New principles of financing must be now based on the cost and effects analyses. Thus, the question arises on how to provide financial means adequate to needs of health care institutions resulting from their tasks and responsibilities. The gaps existing in the information system have encouraged us to examine the situation in regard to the structure of financing and internal allocation of financial means. The objectives were formulated as follows: to characterise the sources of financial means received by provincial OHS centres; to analyse the structure of financial means derived from various sources, taking into account forms of financial administration, using the data provided by selected centres; to define the relation between the financial means being at the disposal of OHS centres and the scope of their activities; The information on the financing system was collected using a questionnaire mailed to directors of selected OHS centres. The information collected proved to be a valuable source of knowledge on the above mentioned issues as well as on how far the new system of financing associated with a new form of financial administration--an independent public health institution--has already been implemented. The studies indicated that at the present stage of the OHS system transformation it is very difficult to formulate conclusions on the financing administration in provincial OHS centres.
Zhang, Chao; Zhong, Lijin; Liang, Sai; Sanders, Kelly T.; Wang, Jiao; Xu, Ming
Highlights: • Virtual water in inter-provincial electricity transmission in China is calculated. • A Water Stress Index is used to reflect relative scarcity of water consumption. • West Inner Mongolia is the largest exporter of scarce water. • Hebei, Beijing and Shandong are the three largest receivers of scarce water. - Abstract: Intra-national electricity transmission drives virtual water transfer from electricity production regions to electricity consumption regions. In China, the water-intensive thermoelectric power industry is expanding quickly in many water-scarce energy production hubs in northern and northwestern provinces. This study constructed a node-flow model of inter-provincial electricity transmission to investigate the virtual water and scarcity-adjusted virtual water (or virtual scarce water) embodied in the electricity transmission network. It is revealed that total inter-provincial virtual water transfer embodied in electricity transmission was 623 million m 3 in 2011, equivalent to 12.7% of the national total thermoelectric water consumption. The top three largest single virtual water flows are West Inner Mongolia-to-Beijing (44 million m 3 ), East Inner Mongolia-to-Liaoning (39 million m 3 ), and Guizhou-to-Guangdong (37 million m 3 ). If the actual volumes of consumptive water use are translated into scarcity-adjusted water consumption based on Water Stress Index, West Inner Mongolia (81 million m 3 ), Shanxi (63 million m 3 ) and Ningxia (30 million m 3 ) become the top three exporters of virtual scarce water. Many ongoing long-distance electricity transmission projects in China will enlarge the scale of scarce water outflows from northwestern regions and potentially increase their water stress.
J. C Edmondson
Full Text Available SUMMARY: This paper suggests some general approaches and raises some problems in studying the impact of Rome on the rural landscape in Lusitania. It concentrates on three crucial ways in which the landscape was transformed under Roman rule: (a changes in the pattern of rural settlement; (b changes in the nature of land use and agrarian exploitation; and (c changes in the ways in which the inhabitants of Lusitania perceived and thought about their world. It argues that a synthesis is needed of archaeological evidence from across the province, so that the impact of Rome on rural settlemet patterns may be compared in differing environmental regions. Further intensive field survey should also help to resolve some current problems in reconstructing the pattern of Iron Age and Roman rural settlement. Increased collection and analysis of pollen samples, carbonised wood, seeds, agricultural implements and animal bones is needed to assess more precisely the extent to which the Romans caused major changes in the nature of land use and agrarian exploitation. When accounting for change, it is essential to consider a wide variety of factors and to remember that rural change continued to occur throughout the Roman period. Finally, it was in forcing the inhabitants of Lusitania to perceive their world in radically new ways that the Romans made a lasting impact on the provincial landscape. First, the Romans created broad ethnic identities for their opponents, ignoring the complex, highly fragmented ethnic and regional geography of the area. Then by dividing the region into clearly defined civitates, they forced the inhabitants of Lusitania to envisage the landscape in a very different manner than before. Finally, a series of rituals emphasising Roman power (the census, the holding of judicial assizes, and the activities of the provincial council regularly reinforced these radically new mental maps of the new Roman provincial landscape.
Guo Ju’e; Zhang Zengkai; Meng Lei
Trades create a mechanism of embodied CO 2 emissions transfer among regions, causing distortion on the total emissions. As the world’s second largest economy, China has a large scale of trade, which results in the serious problem of embodied CO 2 emissions transfer. This paper analyzes the characteristics of China’s CO 2 emissions embodied in international and interprovincial trade from the provincial perspective. The multi-regional Input–Output Model is used to clarify provincial CO 2 emissions from geographical and sectoral dimensions, including 30 provinces and 28 sectors. Two calculating principles (production accounting principle and consumption accounting principle, ) are applied. The results show that for international trade, the eastern area accounts for a large proportion in China’s embodied CO 2 emissions. The sectors as net exporters and importers of embodied CO 2 emissions belong to labor-intensive and energy-intensive industries, respectively. For interprovincial trade, the net transfer of embodied CO 2 emissions is from the eastern area to the central area, and energy-intensive industries are the main contributors. With the largest amount of direct CO 2 emissions, the eastern area plays an important role in CO 2 emissions reduction. The central and western areas need supportive policies to avoid the transfer of industries with high emissions. - Highlights: ► China’s embodied CO 2 emissions are analyzed from the provincial perspective. ► Eastern provinces have larger CO 2 emissions embodied in international trade. ► Embodied CO 2 emissions are mainly transferred from eastern area to central area. ► Coastal provinces play important roles in CO 2 emissions reduction. ► Inland provinces need supportive policies on emissions reduction.
Demers, Virginie; Melo, Magda; Jackevicius, Cynthia; Cox, Jafna; Kalavrouziotis, Dimitri; Rinfret, Stéphane; Humphries, Karin H; Johansen, Helen; Tu, Jack V; Pilote, Louise
Reimbursement for outpatient prescription drugs is not mandated by the Canada Health Act or any other federal legislation. Provincial governments independently establish reimbursement plans. We sought to describe variations in publicly funded provincial drug plans across Canada and to examine the impact of this variation on patients' annual expenditures. We collected information, accurate to December 2006, about publicly funded prescription drug plans from all 10 Canadian provinces. Using clinical scenarios, we calculated the impact of provincial cost-sharing strategies on individual annual drug expenditures for 3 categories of patients with different levels of income and 2 levels of annual prescription burden ($260 and $1000). We found that eligibility criteria and cost-sharing details of the publicly funded prescription drug plans differed markedly across Canada, as did the personal financial burden due to prescription drug costs. Seniors pay 35% or less of their prescription costs in 2 provinces, but elsewhere they may pay as much as 100%. With few exceptions, nonseniors pay more than 35% of their prescription costs in every province. Most social assistance recipients pay 35% or less of their prescription costs in 5 provinces and pay no costs in the other 5. In an example of a patient with congestive heart failure, his out-of-pocket costs for a prescription burden of $1283 varied between $74 and $1332 across the provinces. Considerable interprovincial variation in publicly funded prescription drug plans results in substantial variation in annual expenditures by Canadians with identical prescription burdens. A revised pharmaceutical strategy might reduce these major inequities.
David F. Mitchell
Full Text Available This article introduces a new provincial-level dataset on non-governmental organizations (NGOs in Afghanistan. The data—which are freely available for download—provide information on the locations and sectors of activity of 891 international and local (Afghan NGOs that operated in the country between 2000 and 2014. A summary and visualization of the data is presented in the article following a brief historical overview of NGOs in Afghanistan. Links to download the full dataset are provided in the conclusion.
Angelow, R.V.; Bazinet, N.
The purpose of this document is to develop an interim provincial water quality objective for aniline for the protection of aquatic life in Ontario. It reviews the sources of aniline in the environment, its environmental fate and properties, acute and chronic toxicity as determined from results reported in the literature on toxicity tests using vertebrates and invertebrates, the bioaccumulation of aniline in the environment, mutagenic effects, and threshold aniline concentrations affecting fish odour and taste. The document then explains the derivation of the interim water quality objective. Water quality criteria for aniline developed in other jurisdictions are noted.
Leehan, Joaquín Azpiroz; Cañas, Silvia Vides; Licona, Fabiola Martínez; Méndez, Miguel Cadena; Lerallut, Jean-François
This paper describes the design and implantation issues for a Picture Archiving and Communications System (PACS) in a 60-bed provincial hospital. Considerations such as the state of the imaging equipment, preventive maintenance, use and misuse of the equipment and the difficulties regarding migration to an all-digital imaging unit are discussed, as well as the criteria for the selection of the imaging modalities. Finally a design is proposed with four imaging modalities that use open-source database and display workstations. The system is currently under evaluation for possible reproduction in as many as 60 small clinics and hospitals throughout the country.
Serrano Morales, Riansares
En este artículo se analiza el papel que representan las Asociaciones culturales en la difusión de las actividades de los archivos. A través de una experiencia concreta, la Asociación de Amigos del Archivo Histórico Provincial de Guadalajara (España), se muestra la colaboración de la sociedad civil en la gestión cultural. This article describes the role played by cultural associations in order to disseminate the activities of the archives. Through a concrete experience as the Association ...
Huntsman, Eric D.
Describes the "Ara Pacis Augustae" that is a monumental altar commemorating the emperor Augustus' safe return in 13 B.C. from his provincial tour of Spain and Gaul. Explains how students in a Roman history class can learn about the culture during the age of emperor Augustus by studying the altar. (CMK)
Ömer Faruk YAZICI
Full Text Available Aim: The aim of this study was to investigate the social appearance anxiety of staff in Youth Services and Sport Provincial Directorate. Material and Methods: Totally 300 staff who were working in Youth Services and Sport Provincial Directorates of Malatya, Trabzon and Istanbul had participated to the study. As data collection tools; “Social Appearance Anxiety Scale” which developed by Hart et al. (2008 and modified to Turkish with reliability and validity study by Doğan (2010 and “Personal Data Form” created by the researchers were used. In analyzing the data; descriptive analysis, t-test and one way Anova were used. Results: Social anxiety concerns of personnel has been found to be the low level. After the analysis it was determined that there was a significant difference in age, income, doing sports and city that working according to the staff’s social appearance anxiety. Conclusion: In this context, the studies should be included in studying of staff in other cities.
Full Text Available Aim: The purpose of this study was investigate to level of subjective happiness levels of staff who works in provincial organization of General Directorate of Sport. Material and Methods: The study group of the research consisted of 400 staff (164 female, 236 male who works in General Directorate of Sport’s İstanbul, Trabzon, Malatya and Tokat Youth Services and Sport provincial directorates. In the study as data collection tool; Subjective Happiness Scale (SHS which developed by Lyubomirsky & Lepper (1999 and adapted to Turkish by Akın and Satıcı (2011 was used. And also “personal data form” which created by the researchers was used. The data analyzed by descriptive statistics, T-test and Anova test. Also, Scheffe test was used to find out the significant differences of groups. Results: In accordance with t-test results obtained from the present study, there are significant differences with respect to variables such as marital status, income state and sport participation (p<0.05. Conclusion: As a result, it was determined that married staff is happier than single staff. Also, the staff who determined themselves in moderate income level is happier than the staff who determined themselves in lower income level.
Dong, Huijuan; Geng, Yong; Fujita, Tsuyoshi; Fujii, Minoru; Hao, Dong; Yu, Xiaoman
With rapid economic development in China, water crisis is becoming serious and may impede future sustainable development. The uneven distribution of water resources further aggravates such a problem. Under such a circumstance, the concepts of water footprint and virtual water have been proposed in order to respond water scarcity problems. This paper focuses on studying provincial disparity of China's water footprints and inter-provincial virtual water trade flows by adopting inter-regional input-output (IRIO) method. The results show that fast developing areas with larger economic scales such as Guangdong, Jiangsu, Shandong, Zhejiang, Shanghai and Xinjiang had the largest water footprints. The most developed and water scarce areas such as Shanghai, Beijing, Tianjin and Shandong intended to import virtual water, a rational choice for mitigating their water crisis. Xinjiang, Jiangsu, Heilongjiang, Inner Mongolia, Guangxi and Hunan, had the largest per GDP water intensities and were the main water import regions. Another key finding is that agriculture water footprint was the main part in water footprint composition and water export trade. On the basis of these findings, policy implications on agriculture geographical dispersion, consumption behavior changes, trade structure adjustment and water use efficiency improvement are further discussed. Copyright © 2014 Elsevier B.V. All rights reserved.
Tahir, S.N.A.; Alaamer, A.S.
In order to assess the degree of radon awareness in the general public in the provincial capital Lahore of Punjab province of Pakistan, a survey was conducted in all nine municipal towns of Lahore city. In this regard, volunteers from three Universities and six Colleges were deputed to collect data from hospitals, educational institutes, business points, markets, residential areas, public offices and private sector organisations. About 400 un-educated and educated persons of various educational background from each municipal town participated in this survey and their responses were recorded on the questionnaire prepared for this purpose. In this way, a total of 3600 persons participated in this survey. Results of this survey imply that on average, only 30.9% participants were scientifically aware of radon. These results suggest that a nationwide mass media campaign may be launched by the Federal Ministry of Environment, Provincial Environment Protection Agency and Community Development Dept. to educate the general public in this respect at the union council level about hazards of radon to avoid its harmful effects. (authors)
Peter J Ross
Full Text Available This paper examines the liberal grounded provincial societies of Argentina from 1890 to 1940. A close examination of provincial government expenditures reveals that these states spent most of their revenues on law and order and education with little being directed to social welfare and to health. This form of government was extremely limited, therefore, in providing for the welfare of most of its citizens, and left many of them excluded from full participation in the political, economic and social life of the nation. The type of liberalism espoused by the Argentine elites effectively undermined the very project of state building that they espoused and resulted in the Peronist revolution of the 1940s when the state, under the slogan of social justice, became much more interventionist in the areas of welfare, health and housing, and much more inclusionist with regard to the Argentine people as a whole. The liberal state, and this includes the provinces, became a victim of its own chosen limitations.
Chen, Nengcheng; Xu, Lei
Air pollution in China has become increasingly severe with rapid economic growth in recent years. We analyzed the relationship between the gross regional product (GRP) per capita and the Integrated Air Pollution Index (IAPI) in all the provincial capital cities in China from 2003 to 2014 and clustered them into six urban development patterns. These patterns are as follows: inverse U-shaped, N-1-shaped, N-2-shaped, U-shaped, linear decline, and stable. The majority of the provincial capitals are N-1, N-2, and U types, suggesting that the air quality is deteriorating currently or will deteriorate in the future. Meteorological conditions and industrial structure are taken into consideration when testing the environmental Kuznets curve (EKC) hypothesis between the economy and air pollutant concentration. Results show that there exists no direct relationship between three main pollutants and GRP per capita, while an inverse U-shaped relationship with the secondary industry and a U-shaped relationship with the tertiary industry. These results will be a meaningful reference for policy makers to develop policies that coordinate the environmental protection and economic development.
Xu, W.; Kruminaite, M.; Onrust, B.; Liu, H.; Xiong, Q.; Zlatanova, S.
3D models are more powerful than 2D maps for indoor navigation in a complicate space like Hubei Provincial Museum because they can provide accurate descriptions of locations of indoor objects (e.g., doors, windows, tables) and context information of these objects. In addition, the 3D model is the preferred navigation environment by the user according to the survey. Therefore a 3D model based indoor navigation system is developed for Hubei Provincial Museum to guide the visitors of museum. The system consists of three layers: application, web service and navigation, which is built to support localization, navigation and visualization functions of the system. There are three main strengths of this system: it stores all data needed in one database and processes most calculations on the webserver which make the mobile client very lightweight, the network used for navigation is extracted semi-automatically and renewable, the graphic user interface (GUI), which is based on a game engine, has high performance of visualizing 3D model on a mobile display.
Harris, Jody; Nguyen, Phuong H; To, Quyen; Frongillo, Edward A; Menon, Purnima
Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
Sim, S Meaghan; Kirk, Sara F L
Healthy Eating Nova Scotia represents the first provincial comprehensive healthy eating strategy in Canada and a strategy that is framed within a population-health model. Five years after strategy launch, our objective was to evaluate Healthy Eating Nova Scotia to determine perceptions of strategy implementation and strategy outputs. The focus of the current paper is on the findings of this evaluation. We conducted an evaluation of the strategy through three activities that included a document review, survey of key stakeholders and in-depth interviews with key strategy informants. The findings from each of the activities were integrated to determine what has worked well with strategy implementation, what could be improved and what outputs have resulted. The evaluation was conducted in the Canadian province of Nova Scotia. Participants for this evaluation included survey respondents (n 120) and key informants (n 16). A total of 156 documents were also reviewed. Significant investments have been made towards inter-sectoral partnerships and resourcing that has provided the necessary leadership and momentum for the strategy. Policy development has been leveraged through the strategy primarily in the health and education sectors and is perceived as a visible success. Clarity of human resource roles and funding within the context of a provincial strategy may be beneficial for continued strategy implementation, as is expansion of policy development. Known to be the first evaluation of its kind, these findings and related considerations will be of interest to policy makers developing and implementing similar strategies in their own jurisdictions.
Jacques, David A.; Guan, Dabo; Geng, Yong; Xue, Bing; Wang, Xiaoguang
With ever growing urgency, climate change mitigation is fast becoming a priority for China. A successful policy of implementing and expanding sustainable development and the use of renewable energy is therefore vital. As well as long-term and near-term targets for installed capacity of renewable energy, in its 12th five-year plan, China has created strict and ambitious carbon intensity targets for each province. This study proposes an inter-provincial clean development mechanism to assist in meeting these targets. This mechanism will create potential co-benefits of assisting in sustainable development in lesser developed provinces, increasing local air quality and supporting the growth of China's renewable energy sector. This paper also highlights the potential that this inter-provincial clean development mechanism has in accelerating the growth of the domestic solar photovoltaics (PV) sector, for which the market in China is still in its infancy. - Highlights: ► We recognise the necessity for each province in China to reduce its GHG emissions. ► We assess the potential of a national scale a CDM style mechanism for China. ► We consider the effect that the national CDM could have on solar PV in China
Alton, Gillian D; Pearl, David L; Bateman, Ken G; McNab, W Bruce; Berke, Olaf
Sentinel surveillance has previously been used to monitor and identify disease outbreaks in both human and animal contexts. Three approaches for the selection of sentinel sites are proposed and evaluated regarding their ability to capture overall respiratory disease trends using provincial abattoir condemnation data from all abattoirs open throughout the study for use in a sentinel syndromic surveillance system. All three sentinel selection criteria approaches resulted in the identification of sentinel abattoirs that captured overall temporal trends in condemnation rates similar to those reported by the full set of abattoirs. However, all selection approaches tended to overestimate the condemnation rates of the full dataset by 1.4 to as high as 3.8 times for cows, heifers and steers. Given the results, the selection approach using abattoirs open all weeks had the closest approximation of temporal trends when compared to the full set of abattoirs. Sentinel abattoirs show promise for integration into a food animal syndromic surveillance system using Ontario provincial abattoir condemnation data. While all selection approaches tended to overestimate the condemnation rates of the full dataset to some degree, the abattoirs open all weeks selection approach appeared to best capture the overall seasonal and temporal trends of the full dataset and would be the most suitable approach for sentinel abattoir selection.
Evans, Amanda; Duncan, Bruce; McHugh, Patrick; Shaw, John; Wilson, Craig
To assess the use and attitudes towards traditional, complementary and alternative medicine and therapies (TCAM) by inpatients of a provincial hospital. Ninety-two Gisborne Hospital inpatients were interviewed face-to-face over a 4-week period using a standardised questionnaire. Of the 92 people interviewed, 84 patients (91%) had used an average of 6.4 TCAM modalities. Most common therapies used were massage (n=62), vitamins (n=5), chiropractor (n=45), and herbal therapies (n=41). Of the 84 people who have used TCAM, 79 (94%) used more than one therapy. Nineteen patients (23%) used 10 or more different therapies. Maori and Non-Maori respondents used the majority of TCAM modalities equally apart from a few notable exceptions. Only 10 (11%) of the 92 patients in this study recalled having been asked by a doctor if they were using TCAM. Fifty-five (65%) of those who use TCAM believed that it is safe. This study of in-patients interviewed at Gisborne Hospital had the highest rate of TCAM use published to date. Most of these patients intend to continue using TCAM (86%), seek pluralistic care for their maladies and select from a broad array of modalities rooted in the community. Patients are not telling their doctors about this use, not because patients fear disapproval, but they are simply not being asked. Patients do not volunteer this information because they believe that TCAM use is safe and are unaware of its potential risks. There are ethnic trends in the selection of TCAM modalities and potential exists to reach some hard to reach populations through integrated care. The high prevalence of TCAM use in an in-patient population and patients' naivety regarding risks and interactions underscores the need for greater cooperation between orthodox and complementary practitioners, effective regulation with emphasis given to public safety, the need for new funding for TCAM research, increased undergraduate and postgraduate medical TCAM education, and better information
McNeil, Ryan; Kerr, Thomas; Anderson, Solanna; Maher, Lisa; Keewatin, Chereece; Milloy, MJ; Wood, Evan; Small, Will
While regulatory frameworks governing methadone maintenance therapy (MMT) require highly regimented treatment programs that shape treatment outcomes, little research has examined the effects of regulatory changes to these programs on those receiving treatment, and located their experiences within the wider context of socialstructural inequities. In British Columbia (BC), Canada, provincial regulations governing MMT have recently been modified, including: replacing the existing methadone formulation with Methadose® (pre-mixed and 10 times more concentrated); prohibiting pharmacy delivery of methadone; and, prohibiting pharmacies incentives for methadone dispensation. We undertook this study to examine the impacts of these changes on a structurally vulnerable population enrolled in MMT in Vancouver, BC. Qualitative interviews were conducted with 34 people enrolled in MMT and recruited from two ongoing observational prospective cohort studies comprised of drug-using individuals in the six-month period in 2014 following these regulatory changes. Interview transcripts were analyzed thematically, and by drawing on the concept of ‘structural vulnerability’. Findings underscore how these regulatory changes disrupted treatment engagement, producing considerable health and social harms. The introduction of Methadose® precipitated increased withdrawal symptoms. The discontinuation of pharmacy delivery services led to interruptions in MMT and codispensed HIV medications due to constraints stemming from their structural vulnerability (e.g., poverty, homelessness). Meanwhile, the loss of pharmacy incentives limited access to material supports utilized by participants to overcome barriers to MMT, while diminishing their capacity to assert some degree of agency in negotiating dispensation arrangements with pharmacies. Collectively, these changes functioned to compromise MMT engagement and increased structural vulnerability to harm, including re-initiation of injection drug
This book presents a collection of more than 300 cartoons which were published in 'Oilweek Magazine' between February 1973 and 1983. For the oil industry, this decade represented a time of increased provincial royalties and rising federal taxation. The cartoons depict the ongoing federal-provincial conflict over oil industry revenue sharing. The implication of the title is that while federal and provincial governments each determined the oil industry to be their own golden goose, the goose concluded that future demands for golden eggs would be painful to satisfy. At the time, the cartoons were submitted anonymously, but were well received by 'Oilweek' readers. In 1986, Amoco Regional Petroleum Engineering Supervisor Don Smith, revealed that he was the anonymous artist
Helena Gozalbes García
Full Text Available This paper aims to present three new unpublished copies of possible variants of provincial coinage of Hispania deposited in the Museum of Cuenca. The careful observation of these pieces has revealed the presence of particular aspects of its iconography, until now undocumented in the catalogs of consultation. Thus, with the news in monetary specimens that we present we intend to expand the large and extensive information available about the provincial coinage of Hispania, indicating, in some cases, very specific data relating to the iconographic trends related to these productions.
Zhao, Z P; Wang, L M; Li, Y C; Jiang, Y; Zhang, M; Huang, Z J; Zhang, X; Li, C; Zhou, M G
Objective: To evaluate the provincial representativeness of China Non-communicable and Chronic Disease Risk Factor Surveillance System, 2013. Methods: The Sixth National Population Census data which was collected by National Bureau of Statistics of People's Republic of China was used to calculate proportion of population who aged 65 and above, mortality rate, the proportion of non-agriculture population, the illiteracy rate and urbanization rate in order to evaluate the surveillance system in each province. The Mann-Whitney U test was used to determine the statistically differences between the surveillance system and corresponding general population. Results: Among the 298 disease surveillance points (DSPs) in China Non-communicable and Chronic Disease Risk Factor Surveillance System, there were 111, 85, and 102 DSPs located in the east, middle, and west area of China, which covering 13.90%, 11.48%, and 12.28% of the total population, respectively. The surveillance system covered 169 million of the population of China, accounting for 12.70% of Chinese population. The number of DSPs by provinces ranges from 6 (Hainan, Qinghai, and Ningxia) to 14 (Shandong, Guangdong and Henan). It indicated that mortality rate (DSP: 0.238%; Province: 0.482%) and the illiteracy rate (DSP: 15.54%; Province: 26.22%) among DSPs in Tibet were significantly lower than the provincial level, on the other hand, the proportion of non-agriculture population among DSPs (40.6%) was significantly higher than the provincial level (18.8%). The urbanization rate among Jiangxi DSPs (43.4%) was significantly lower than the provincial level (59.9%). The proportion of non-agriculture population among Shandong DSPs (32.8%) was significantly higher than the provincial level (24.2%), however, the illiteracy rate among Shandong DSPs (3.86%) was significantly lower than the provincial level (5.25%). Other than the provinces mentioned above, there was no statistical differences ( P> 0.05) among proportions of
Roč. 8, č. 66 (2017), s. 64-67 ISSN 1804-2260 Institutional support: RVO:67985963 Keywords : Travellers * Czech Jesuits * Philipines Subject RIV: AB - History OBOR OECD: History (history of science and technology to be 6.3, history of specific sciences to be under the respective headings)
Blangiardi, F; Ferrera, G; Cilia, S; Aprile, E
Cancer screening is a secondary prevention program that permits early diagnosis of neoplasias and precancerous lesions are in order to diminish mortality and morbidity for certain types of tumors (breast, colon-rectal, and cervical). In 2010, the Ragusa Provincial Health Agency began screening for colon-rectal cancer in an experimental phase that initially involved only the municipality of Ragusa but that was then extended to other municipalities of the province. Although the organizing model suffered from many managerial problems including lack of human resources and tools, there was good collaboration and involvement of the public health/hygiene offices and the general practitioners and volunteer associations. This type of networking was useful in that adhesion to screening was well above that expected. Another winning aspect of the project resulted in clear and pertinent communication to the population.
Full Text Available A spatial autocorrelation analysis method is adopted to process the spatial dynamic change of industrial Chemical Oxygen Demand (COD discharge in China over the past 15 years. Studies show that amount and intensity of industrial COD discharges are on a decrease, and the tendency is more remarkable for discharge intensity. There are large differences between inter-provincial discharge amount and intensity, and with different spatial differentiation features. Global spatial autocorrelation analysis reveals that Global Moran’s I of discharge amount and intensity is on the decrease. In space, there is an evolution from an agglomeration pattern to a discretization pattern. Local spatial autocorrelation analysis shows that the agglomeration area of industrial COD discharge amount and intensity varies greatly in space with time. Stringent environmental regulations and increased funding for environmental protections are the crucial factors to cut down industrial COD discharge amount and intensity.
Zhao, Xiaofeng; Huang, Xianjin; Liu, Yibo
A spatial autocorrelation analysis method is adopted to process the spatial dynamic change of industrial Chemical Oxygen Demand (COD) discharge in China over the past 15 years. Studies show that amount and intensity of industrial COD discharges are on a decrease, and the tendency is more remarkable for discharge intensity. There are large differences between inter-provincial discharge amount and intensity, and with different spatial differentiation features. Global spatial autocorrelation analysis reveals that Global Moran's I of discharge amount and intensity is on the decrease. In space, there is an evolution from an agglomeration pattern to a discretization pattern. Local spatial autocorrelation analysis shows that the agglomeration area of industrial COD discharge amount and intensity varies greatly in space with time. Stringent environmental regulations and increased funding for environmental protections are the crucial factors to cut down industrial COD discharge amount and intensity.
Full Text Available Since 2009, South Africa has seen a major shift in emphasis concerning monitoring and evaluation (M&E systems. This shift was partially stimulated by the South African government being faced with a number of pressures, key amongst which were persistent poverty and inequality and widespread service delivery protests. These pressures resulted ina greater willingness by government to address the poor quality of public services, and other governance problems that needed a greater focus on M&E to address these challenges. This led to the establishment of the Department of Performance Monitoring and Evaluation (DPME in early 2010. A comprehensive survey on the state and use of M&E systems in national and provincial government was conducted by the DPME as an attempt to understand the M&E landscape since 1994. The results were used to make informed policy and programme decisions. This paper outlines the findings of the survey.
Full Text Available The paper assesses theories explaining the states’ burden-sharing decisions in an alliance and uses them to evaluate the Lithuanian decision to establish a Provincial Reconstruction Team (PRT in Afghanistan. In the literature, several influences on such decision-making are identified. These fall into two broad categories of systemic and domestic factors. From the former, threat perception, alliance dependence, systemic pressures of alliance politics are analysed; and from the latter three clusters of aspects such as: state autonomy, elite consensus, space of manoeuver of the executive; bureaucratic politics and organizational interests, and third, some additional elements of strategic culture/state identity. While most factors have some explanatory value, the analysis invites the conclusion that in case of the decision to lead a PRT, the two most important elements were alliance dependence from the first cluster and strategic culture and bureaucratic politics from the second.
Full Text Available The development of subnational credit-rating methodologies affords benefits for subnationals, the sovereign and its citizens. Trusted credit ratings facilitate access to financial markets and above-average ratings allow for the negotiation of better collateral and guarantee agreements, as well as for funding of, for example, infrastructure projects at superior (lower interest rates. This paper develops the quantitative section of a credit-rating methodology for South African subnationals. The unique characteristics of South African data, their assembly, and the selection of dependent and independent variables for the linear-regression model chosen, are discussed. The methodology is then applied to the provincial Department of Health using linear regression modelling.
Full Text Available It is important that decision of asphalt pavement structure requires overall considerations of the performance and financial investment. To have asphalt pavement structure fulfilling good reliability, the asphalt pavement structure decision was researched based on value engineering theory. According to the national and provincial highway investigation data in Shandong Province during the last decade, the asphalt pavement performance attenuation rules of traffic levels and asphalt layer thicknesses were developed, and then the road performance evaluation method was presented. In addition, the initial investments, the costs of road maintenance, and middle-scale repair in a period were analyzed. For the light traffic and medium traffic example, using the value engineering method, the pavement performance and costs of which thickness varies from 6 cm to 10 cm were calculated and compared. It was concluded that value engineering was an effective method in deciding the asphalt pavement structure.
Full Text Available This paper analyzes the differences in the amount and the structure of residential energy consumption at the provincial level in China and identifies the hidden factors behind such differences. The econometrical analysis reveals that population, economic development level, energy resource endowment and climatic conditions are the main factors driving residential energy consumption; while the regional differences in energy consumption per capita and the consumption structure can be mainly illustrated by various economic development levels, energy resource endowments and climatic conditions. Economic development level has a significant positive impact on the proportion of gasoline consumption, whereas its impact on the proportion of electricity consumption is not notable; energy resource endowment and climatic condition indirectly affect both the proportion of electricity consumption and that of gasoline consumption, primarily through their impacts on the proportions of coal consumption and heat consumption.
Mbeva, Jean Bosco Kahindo; Schirvel, Carole; Godelet, Eliane; Wodon, Alain; Porignon, Denis; Bonami, Michel
In the framework of implementation of health system reform in the Democratic Republic of the Congo (DRC), and in a context of decentralization dictated by the National Constitution, this study presents the process and results obtained in terms of the provincial level of health care organization in DRC. A two-year multidisciplinary interventional research protocol was elaborated with two phases and 9 steps including organizational analysis, team building, and organizational learning. It resulted in transformational actions and improved knowledge, allowing the development of an innovative organizational model of the intermediate level of the health care system in the Democratic Republic of the Congo. This interventional research gave rise to function plans set up by the provincial health division (PHD) in order to develop a more participative management and to compensate for the weaknesses of the current structural organization. Experts provided support to PHD for implementation of a new structure in order to institutionalize this new participative management. The new organizational structure of the PHD is based on 4 professions: i) health district support; ii) control and inspection; iii) information, communication and research and iv) resources management. PHD and experts defined these professions and described the required skills. RESULTS were integrated into the new national health plan. Apart from the concrete results obtained, two major challenges need to be addressed: i) support the transformation of PHD from the current situation to the new model and ii) extend this new model to the other provinces, according to the same participative approach, a necessary condition to adjust the organization flow-chart to the context.
Irina N. Litvinova
Full Text Available On the basis of for the first time the massif of new archival material introduced into scientific circulation in article the problem of consolidation of society of the Lower Volga province in the years of great tests of World War I is analyzed. Particular attention is paid to the practices used by local charitable committees and non-governmental organizations created in that period in Tsaritsyn. In particular, it analyzes the activities of local branches of the committees of the Grand Duchess Elizabeth, to assist the families of soldiers and Grand Duchess Tatiana – to support refugee families. The article was first introduced into scientific circulation new archival sources on the issue of the functioning of national non-governmental organizations based in the city of Lithuanian, Latvian, Polish and Jewish refugees who were engaged in assisting their fellow countrymen, to move from front-line areas in the new place of residence, in Tsaritsyn. The questions of organizational character connected with difficulties of official registration of the public unions by the provincial authorities are specified; severity of rules of the Ministry of Internal Affairs, when carrying out public monetary collecting by societies from the population. On the basis of concrete historical material, revealed new tricks and techniques used by charitable institutions for admission donations from citizens, as well as forms of voluntary activity themselves representatives of provincial society, to assist the families of the soldiers called to the front, wounded, children, refugees. The microanalysis of some unique historical sources which are of interest both for researchers of the region, and for experts of the "culture of the back" direction of times of World War I is carried out.
Zhang, Long; Yu, Jing; Sovacool, Benjamin K.; Ren, Jingzheng
China has been the world's largest energy consumer and producer for many years, yet while myriad studies have investigated Chinese performance on energy metrics compared to other countries, few to none have looked internally at Chinese provinces. This paper firstly develops a five-dimensional evaluation system centered on the energy security dimensions of availability and diversity, affordability and equality, technology and efficiency, environmental sustainability, and governance and innovation. It then correlates these dimensions to 20 distinct energy security metrics that are used to assess the energy security performance of 30 Chinese provinces, divided into eight regions. Our results reveal both trends in energy policy and practice as well as provincial status of comparative energy security for the year 2013. We find, for instance, that there is no province which performs well in all five of the energy security dimensions, and that all provinces confronted threats related to energy availability and diversity. We also demonstrate that in comparative terms, the Middle Reaches of Yellow River and the Northwest were the most energy-secure, while the Middle Reaches of Yangtze River and the Northeast were least energy-secure. - Highlights: • We assessed energy security for 30 Chinese provinces across five dimensions. • Fuzzy AHP, PROMETHEE and Sensitivity Analysis are used to investigate. • Western provinces perform better performance than eastern provinces in 2013. • Energy availability and diversity is the most severe threat facing China's energy security. • Developing renewable energy will help improve China's Provincial energy security significantly.
Gonzalo Zambrano, Ruben Dario; Fundora Madruga, Guillermo; Rodriguez Jimenez, Pablo
We carried out a descriptive study of prevalence or cross sectional study to assess predictive and prognostic factors of the breast cancer from recidivism in 406 women treated at the Matanzas Provincial Oncology Unit, and remitted from provincial and territorial hospitals, since January 2004 to December 2008. Data were collected from clinical records and biopsy informs, processed with the Epi Info System, Version 6.04. There was a higher incidence of the breast cancer in post-menopausal women and a higher aggressiveness in pre-menopausal women. Almost half of the patients were diagnosed in the precocious stage and there was a high index of recidivism, mainly in advanced stages. The invasive lobular carcinoma presented more recidivists, while the tubular one had a better prognosis; the ductal carcinoma in situ and the lobular carcinoma in situ had more recurrences than they were expected. The conservative surgery showed a higher number of recidivists in distance than the modified radical mastectomy, while the last one showed local recidivism (2,1 %) and the first, no one; the conservative one was related with a high percent of disease persistence, in which the compromised section edges. The ganglion status, tumour size and histological level were pointed out as the main anatomic-pathological prognosis facts, but not the hormonal receptors. There it was a good answer to tamoxifen and to CMF (cyclophosphamide, metothrexate and 5 flouracil) cycles. In conclusion, we demonstrated the influence of the modifiable and non-modifiable prognostic and predictive facts on the high index of recidivism and recommend taking measures to improve those indicators
Mohammad Hossein Mehrolhassani
Full Text Available Background Provincial Health Accounts (PHA as a subset of National Health Accounts (NHA present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC. This study aimed to examine Health Accounts in Kerman Province. Methods The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General’s office. In order to classify the data, the International Classification for Health Accounts (ICHA method was used, in which data set was adjusted for the province. Results During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41 was related to private household funds, of which the Out-of-Pocket (OOP payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs (65.19% was related to curative services. Conclusion The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By performing the Family Physician Program (FPP and emphasizing Social Determinant of Health (SDH approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor
Goksel, Ali Gurel; Caz, Cagdas; Yazici, Omer Faruk; Ikizler, Huseyin Can
The purpose of this research is to study the relation between the level of organizational stress at the staff of the Youth Services and Sports Provincial Directorate and their performance. The study group of research, Istanbul province in the Uskudar district officials operating in the Youth Services and Sports Provincial Directorate constitute a…
Veldhuis, A.J.; Reinders, Angelina H.M.E.
In this study we estimate the potential of off-grid PV systems in Indonesia at a provincial level as a follow-up of a study on the potential of grid-connected PV systems in Indonesia which we executed in 2012 . For this study we use an adapted methodology leading to cumulative numbers for the
Bax, C. A. Eenink, R.G. Commandeur, J.J.F. & Loenis, B.J.C.
A light variant of ProMeV applied in twelve provinces : a risk based approach to road infrastructure. ProMeV Light quickly and proactively gives an overview of the biggest safety bottlenecks on road sections in the provincial road network. This way it offers a useful alternative to a policy on the
Full Text Available classification of the Gauteng provincial road network using the South African Road Classification and Access Management Manual (TRH26) as a guideline. In combination with high resolution up-to-date satellite reference imagery, dwelling and building inventories...
Yang, Yang; Hu, Jun; Lv, Yingchun; Zhang, Mu
As the tourism industry has gradually become the strategic mainstay industry of the national economy, the scope of the tourism discipline has developed rigorously. This paper makes a predictive study on the development of the scope of Guangdong provincial tourism discipline based on the artificial neural network BP model in order to find out how…
Full Text Available This paper analyzes the notion of provincial identity in the Pampean Association of Writers of Santa Rosa, province of La Pampa. Although the group was shaped around literature, discourses and actions overflow this purpose and present a particular ideological stance regarding Pampean identity. Analysis focuses on interviews to members and documents produced both by local writers and the Association.
How should we assess the historical development of health care? Many historians are deeply reluctant to endorse ideas involving progress in human affairs, including the evolution of modern medicine. We tend to think either that our present situation is little better than in the past, or that most kinds of value judgments about history are subjective and inappropriate. A laudatory approach to medical history commonly adopted by "amateur" medical historians in the tradition of Sir William Osler has often been eschewed by "professionals" as faulty, feel-good history. But Osler was right in his belief that, on balance, the progress of medicine has been spectacular, that modern health care offers one of the finest examples of the possibility of "man's redemption of man." Written objectively, medical history is about progress and achievement, and can properly seen as inspiring. If we mordantly or relativistically dismiss the unprecedentedly high quality of modern health care, we lose the ability to understand why citizens value it so highly, and this distorts our understanding of current issues. We also lose our sense of the wonders of human and medical achievement.
Galvis Pérez, Yeisson
Full Text Available The overall objective of this research was to understand the events that made possible the creation, diffusion and appropriation of medical mycology in Colombia between 1930 and 1970. It was based on the review of scientific journals and theses in different libraries, archives and documentation centers in Medellin and Bogota. The report includes the different problems faced by physicians and laboratory personnel concerning the classification of fungi, the relationship between dermatology and mycology, the development of the study of systemic mycoses and the role played by some persons in the institutionalization of medical mycology.
Beaulieu, Pierre; Boulanger, Aline; Desroches, Julie; Clark, Alexander J
New regulations are in place at the federal and provincial levels in Canada regarding the way medical cannabis is to be controlled. We present them together with guidance for the safe use of medical cannabis and recent clinical trials on cannabis and pain. The new Canadian regulations on the use of medical cannabis, the provincial regulations, and the various cannabis products available from the Canadian Licensed Producers were reviewed from Health Canada, provincial licensing authorities, and the licensed producers website, respectively. Recent clinical trials on cannabis and pain were reviewed from the existing literature. Health Canada has approved a new regulation on medical marijuana/cannabis, the Marihuana for Medical Purposes Regulations: The production of medical cannabis by individuals is illegal. Health Canada, however, has licensed authorized producers across the country, limiting the production to specific licenses of certain cannabis products. There are currently 26 authorized licensed producers from seven Canadian provinces offering more than 200 strains of marijuana. We provide guidance for the safe use of medical cannabis. The recent literature indicates that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain. The science of medical cannabis and the need for education of healthcare professionals and patients require continued effort. Although cannabinoids work to decrease pain, there is still a need to confirm these beneficial effects clinically and to exploit them with acceptable benefit-to-risk ratios.
Working within the HPO (History Projection Operator) Consistent Histories formalism, we follow the work of Savvidou on (scalar) field theory [J. Math. Phys. 43, 3053 (2002)] and that of Savvidou and Anastopoulos on (first-class) constrained systems [Class. Quantum Gravt. 17, 2463 (2000)] to write a histories theory (both classical and quantum) of Electromagnetism. We focus particularly on the foliation-dependence of the histories phase space/Hilbert space and the action thereon of the two Poincare groups that arise in histories field theory. We quantize in the spirit of the Dirac scheme for constrained systems
The early twentieth century was a period of tremendous advancements in medicine and technology and as a result experienced a revolutionary change in the delivery of healthcare in America. Modern medicine which encompassed specialized knowledge, technical procedures, and rules of behavior, changed the way medical care was provided in the United…
Hulsman, Robert L.; Pranger, Susan; Koot, Stephanie; Fabriek, Marcel; Karemaker, John M.; Smets, Ellen M. A.
Introduction: Medical communication can be a stressful experience for both doctors and patients. In particular, inexperienced doctors facing the demanding task of a bad news consultation may experience high levels of distress. The aim of this exploratory study is to test students' differential
He, W J; Xia, J H; Lv, X; Li, L M
Objective: To investigate the current status of depression and anxiety among female staff in a maternal and child health hospital, and to provide a basis for developing related prevention and intervention measures and promoting the mental health of female staff. Methods: The female staff from a provincial maternal and child health hospital completed a psycho-health questionnaire survey on Internet from June to October, 2016. The questionnaires used in the survey consisted of Patient Health Questionnaire (PHQ-9) , Generalized Anxiety Disorder Scale (GAD-7) , and Symptom Checklist-90 (SCL-90) . The distribution features of mental health problems such as depression and anxiety were analyzed according to the results: of the questionnaire survey. Results Of all female staff surveyed, 42.04% showed depression symptoms, 28.90% showed anxiety symptoms, and 26.12% showed comorbid symptoms of depression and anxiety. Moderate or severe depression (anxiety) was mainly distributed among the female staff with comorbid symptoms (90.63% and 97.01%, respectively) . There were significant differences in the distribution of moderate or severe anxiety symptoms between the medical staff and nursing staff (χ(2)= 5.81, P =0.05) and between those with intermediate and junior professional titles (χ(2)=7.99, P =0.018) . As for SCL-90 results, the total score, total average score, and scores on factors of somatization, compulsion, interpersonal sensitivity, depression, and anxiety in the female staff with comorbid symptoms, moderate or severe depression, and moderate or severe anxiety were significantly higher than the national norm ( P staff with comorbid symptoms than in the female staff with a single symptom and asymptomatic female staff (both P staff in the maternal and child health hospital, mainly characterized by comorbid symptoms of moderate or severe depression and anxiety. Comorbidity is accompanied by mental health problems such as interpersonal sensitivity, obsessive compulsion
In recent years, neuroscientists and ethicists have warned of the dangers of the unsupervised home use of transcranial direct current stimulation (tDCS), in which individuals stimulate their own brains with low levels of electricity for self-improvement purposes. Although the home use of tDCS is often referred to as a novel phenomenon, in reality the late nineteenth and early twentieth century saw a proliferation of electrical stimulation devices for home use. In particular, the use of an object known as the medical battery bears a number of striking similarities to the modern-day use of tDCS. This article reviews a number of features thought to be unique to the present day home use of brain stimulation, with a particular focus on analogies between tDCS and the medical battery. Archival research was conducted at the Bakken Museum and at the American Medical Association's Historical Health Fraud Archives. Many of the features characterizing the contemporary home use tDCS-a do-it-yourself (DIY) movement, anti-medical establishment themes, conflicts between lay and professional usage-are a repetition of themes that occurred a century ago with regard to the medical battery. A number of features, however, seem to be unique to the present, such as the dominant discourse about risk and safety, the division between cranial and non-cranial stimulation, and utilization for cognitive enhancement purposes. Viewed in the long durée, the contemporary use of electrical stimulation at home is not a novel phenomenon, but rather the latest wave in a series of ongoing attempts by lay individuals to utilize electricity for therapeutic purposes. Copyright Â© 2016 Elsevier Inc. All rights reserved.
Phillips, Christina Ann
This thesis focuses on explorations of science, technology, society and the environment (i.e., STS[E]) outcomes/expectations in tenth-grade level science curricula across three Canadian provinces (i.e., Alberta, Manitoba & Ontario) with distinctive provincial political environments at the time of curriculum construction and/or implementation. Document analysis, discourse analysis and a range of theoretical frameworks (i.e., Levinson, 2010; Pedretti & Nazir, 2011 & Krathwohl, 2002) were used to aid in explorations of STS[E] curriculum segments and discourses in each provincial region. More detailed analysis and thematic exploration is presented for each unit associated with climate change as some interesting patterns emerged following initial analysis. My findings are presented as three comparative case studies and represent a small and original contribution to the large body of scholarly research devoted to studies of STS[E] education, where each province represents a unique case that has been explored regarding some aspects the STS[E] curriculum outcomes/expectations and general political culture as well as some other theoretical factors. Findings from this study indicate that Alberta's STS[E] outcomes may be related to Levinson's (2010) 'deliberative' citizenship focus. The following currents from Pedretti and Nazir (2011) appear to be emphasized: logical reasoning, historical, application & design and socio-cultural aligned outcomes when STS[E] is considered as an entity separate from the Alberta curriculum combination of STS and Knowledge. Ontario's STS[E] expectations may align with Levinson's (2010) 'deliberative' or in some select cases a 'deliberative'/'praxis' framework category with some emphasis related to logical reasoning and socio-cultural awareness (Pedretti & Nazir, 2011) in their STS[E] curriculum. The Manitoba STS[E] outcomes may be aligned with a more 'deliberative' approach with some associations that could intersect with the framework
Smith? Robert J
Full Text Available Abstract Background Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged 9–13. While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated. Adult women who are eligible for the vaccine may still receive it, but at a cost of approximately CAN$400. Given the high efficacy and immunogenicity of the vaccine, the possibility of eradicating targeted types of the virus may be feasible, assuming the vaccination programs are undertaken strategically. Methods We develop a mathematical model to describe the epidemiology of vaccination against human papillomavirus, accounting for a widespread childhood vaccination program that may be supplemented by voluntary adult vaccination. A stability analysis is performed to determine the stability of the disease-free equilibrium. The critical vaccine efficacy and immunogenicity thresholds are derived, and the minimum level of adult vaccination required for eradication of targeted types is determined. Results We demonstrate that eradication of targeted types is indeed feasible, although the burden of coverage for a childhood-only vaccination program may be high. However, if a small, but non-negligible, proportion of eligible adults can be vaccinated, then the possibility of eradication of targeted types becomes much more favourable. We provide a threshold for eradication in general communities and illustrate the results with numerical simulations. We also investigate the effects of suboptimal efficacy and immunogenicity and show that there is a critical efficacy below which eradication of targeted types is not possible. If eradication is possible, then there is a critical immunogenicity such that even 100% childhood vaccination will not eradicate the targeted types of the virus and must be supplemented with voluntary adult vaccination. However, the level of adult
Pastores, Stephen M; O'Connor, Michael F; Kleinpell, Ruth M; Napolitano, Lena; Ward, Nicholas; Bailey, Heatherlee; Mollenkopf, Fred P; Coopersmith, Craig M
The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine convened a task force to develop a white paper on the impact of changes in resident duty hours on the critical care workforce and staffing of intensive care units. A multidisciplinary group of professionals with expertise in critical care education and clinical practice. Relevant medical literature was accessed through a systematic MEDLINE search and by requesting references from all task force members. Material published by the Accreditation Council for Graduate Medical Education and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force corresponded by electronic mail and held several conference calls to finalize this report. The new rules mandate that all first-year residents work no more than 16 hrs continuously, preserving the 80-hr limit on the resident workweek and 10-hr period between duty periods. More senior trainees may work a maximum of 24 hrs continuously, with an additional 4 hrs permitted for handoffs. Strategic napping is strongly suggested for trainees working longer shifts. Compliance with the new Accreditation Council for Graduate Medical Education duty-hour standards will compel workflow restructuring in intensive care units, which depend on residents to provide a substantial portion of care. Potential solutions include expanded utilization of nurse practitioners and physician assistants, telemedicine, offering critical care training positions to emergency medicine residents, and partnerships with hospitalists. Additional research will be necessary to evaluate the impact of the new standards on patient safety, continuity of care, resident learning, and staffing in the intensive care unit.
When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists.
Cotler, Jordan; Wilczek, Frank
We introduce quantum history states and their mathematical framework, thereby reinterpreting and extending the consistent histories approach to quantum theory. Through thought experiments, we demonstrate that our formalism allows us to analyze a quantum version of history in which we reconstruct the past by observations. In particular, we can pass from measurements to inferences about ‘what happened’ in a way that is sensible and free of paradox. Our framework allows for a richer understanding of the temporal structure of quantum theory, and we construct history states that embody peculiar, non-classical correlations in time. (paper)
Sabermahani, Asma; Barouni, Mohsen; Seyedin, Hesam; Aryankhesal, Aidin
Human Development Index (HDI) is a composite indicator that can show the impact of economic strategies on human life standards. The index is calculated by three main factors of income, education and health. This research studies the status of HDI across the Iranian provinces, its changes over time and the efficiency of provinces in using resources. The data for 2001 and 2009 was obtained from the Iranian Center of Statistics. Data envelopment analysis technique was used to analyze the data. To calculate the efficiency, Banker, Charnes and Cooper's model was used. The national mean for the HDI in 2001 was 0.717 while it grew to 0.747 in 2009. Except for one province, all others had an improved human development index. Low ranked provinces such as Sistan & Baluchistan and Kurdistan stayed at the bottom in 2009 as well. Some provinces such as Bushehr with developing oil industries, or those purposively benefited from national oil income showed good growth. In some provinces, such as Hormozgan, out-migration of manpower to its neighboring province, Bushehr, was associated with decrease of the provincial income level. The number of efficient provinces increased from 5 to 13 in 2009. Iran falls among countries with high human development index based on the 2009 data. However, the distribution of HDI status across provinces was highly varied and the difference between high- and low-developed provinces increased in 2009. The government needs to revise policies concerning distribution of resources among the provinces.
David F Mitchell
Full Text Available Members of nongovernmental organizations (NGOs have been critical of the Provincial Reconstruction Team (PRT initiative in Afghanistan since its inception, claiming that the mixture of military and humanitarian operations has resulted in ‘blurred lines’ that inhibit insurgents from identifying who is and is not a combatant. Certain organizations have hypothesized that aid workers are more likely to come under attack as a result of this mixture. Although this claim has surfaced in multiple outlets over the years, there was a lack of empirical evidence to support it. This study tests this hypothesis using a panel-corrected standard error regression model of all 34 Afghan provinces in 2010 and 2011. Preliminary results show that NGOs were likely to encounter a greater number of security incidents in provinces with PRTs; however, further analysis reveals this was only the case in provinces with teams not led by the US. This calls into question the validity of a general ‘blurred lines’ explanation for decreased aid worker security.
This paper empirically investigated the spatiotemporal variations, influencing factors and future emission trends of China’s CO2 emissions based on a provincial panel data set. A series of panel econometric models were used taking the period 1995–2011 into consideration. The results indicated that CO2 emissions in China increased over time, and were characterized by noticeable regional discrepancies; in addition, CO2 emissions also exhibited properties of spatial dependence and convergence. Factors such as population scale, economic level and urbanization level exerted a positive influence on CO2 emissions. Conversely, energy intensity was identified as having a negative influence on CO2 emissions. In addition, the significance of the relationship between CO2 emissions and the four variables varied across the provinces based on their scale of economic development. Scenario simulations further showed that the scenario of middle economic growth, middle population increase, low urbanization growth, and high technology improvement (here referred to as Scenario BTU), constitutes the best development model for China to realize the future sustainable development. Based on these empirical findings, we also provide a number of policy recommendations with respect to the future mitigation of CO2 emissions. PMID:26397373
Full Text Available Team Leaders were a crucial element of Iraq Provincial Reconstruction Teams (PRTs, and they dramatically impacted the performance of a team, both positively and negatively. This review examines PRT members’ perspectives of Team Leaders (TLs and the roles leaders played in PRT successes, as well as the particular challenges that leaders faced. This review is based primarily upon interviews of PRT members ending their tours. Beginning in the latter half of 2009, the Center for Army Lessons Learned (CALL and the Center for Complex Operations (CCO conducted lessons learned interviews with departing Iraq PRT members. Over 100 interviews from this process were examined for this review (initially completed in October of 2010. Though derived from feedback on Iraqi operations, the examples and insights found here should also be applicable to other or future reconstruction and stabilization operations. It is likely that similar leadership challenges or roles will be required in similar circumstances, when operating in hostile conditions, and with teams composed of members with a number of different organizational perspectives and goals.
Dube, Anik; Harris, Greg; Gahagan, Jacqueline; Doucet, Shelley
The Our Youth Our Response (OYOR) study explored the scope and accessibility of existing youth-oriented human immunodeficiency virus (HIV) and Hepatitis C (HCV) prevention in Atlantic Canada. A cross-provincial, qualitative population health and gender-based analytic approach was used in this study. Four hundred and twenty-five documents were part of the initial scoping review, while 47 in-depth interviews across youth-relevant sectors were undertaken to explore the perceptions related to current approaches to youth-oriented HIV/HCV prevention policies and programs. The study also conducted focus group discussions with 21 key informants aimed at identifying strategies to address the challenges identified from the interview data. Five overarching themes emerged from our triangulated data in relation to the present state of youth-related HIV/HCV prevention. These included: inter-organizational and intersectoral collaboration; youth engagement; access to testing; harm reduction; and education. Our findings will assist in informing the next generation for HIV/HCV prevention aimed at youth. Specifically, the results indicate that future prevention initiatives should support the use of intersectoral collaboration, gender-based approaches, and HIV/HCV testing innovation to help de-stigmatize prevention efforts.
This work on the systematic comprehensive approach towards the Prevention and Postvencion of Suicide started to develop back in mid 2011 in Río Gallegos, capital of Santa Cruz Province. The first step on this development was a Pilot Plan for the Training of Professionals and also field intervention. The Center for Crisis Intervention and Psycho-social Rehabilitation was founded eight months later. The case-client in crisis plus family group- undergoes quantitative and qualitative evaluation by means of a triage system, all of which allows starting intensive face-to-face and also phone follow up according to the Crisis Intervention Model. Such intervention is developed by means of the participation in the "Grupo Sostén", the Adolescents Group if the client fits into that age, and also family relationship interviews as well as Multi-family meetings open to the Community. There is also a Community Team in the Center which performs collective assessment in schools, in conjunction with the "Equidad en Redes" Educational Specialty Team, belonging to the Provincial Education Council. The approach takes place on the field, and works as a screening step for the early detection of risk. Such risk is dealt with by means of short term intervention group programs involving the whole of the educational community. When facing situations of committed suicide there are interventions in communities to the interior of the province, fundamentally through the Hospital Team which works as the cluster convener for the social intersectoral frame-work.
Currie, Shawn R; Hodgins, David C; Wang, JianLi; el-Guebaly, Nady; Wynne, Harold; Miller, Natalie V
A set of low-risk gambling limits were recently produced using Canadian epidemiological data on the intensity of gambling behavior and related consequences (Currie et al. Addiction 101:570-580, 2006). The empirically derived limits (gambling no more than two to three times per month, spending no more than $501-$100o CAN per year or no more than 1% of gross income spent on gambling) accurately predicted risk of gambling-related harm after controlling for other risk factors. The present study sought to replicate these limits on data collected in three independently conducted Canadian provincial gambling surveys. Dose-response curves and logistic regression analyses were applied to gambling prevalence data collected in surveys conducted in 2001-2002 within the provinces of Alberta, British Columbia, and Ontario (combined sample N = 7,675). A comparable dose-response relationship between gambling intensity and risk of harm was found in each province. The optimal thresholds for defining an upper limit of low-risk gambling were similar across the three provinces despite variations in the availability and organization of legalized gambling opportunities within each region. These results provide additional evidence supporting the validity of the low-risk gambling limits. Quantitative limits could be used to augment existing responsible gambling guidelines.
Full Text Available Since its foundation, China’s government auditing system has played a very important role in maintaining financial and economic order and improving government accountability and transparency. Though a great deal of research has discussed the role of government auditing in discovering and deterring corruption, there is little empirical evidence on whether government auditing actually helps to reduce corruption. Using China’s provincial panel data from 1999 to 2008, this paper empirically examines the role of government auditing in China’s corruption control initiatives. Our findings indicate that the number of irregularities detected in government auditing is positively related to the corruption level in that province, which means the more severe the corruption is in a province, the more irregularities in government accounts are found by local audit institutions. Also, post-audit rectification effort is negatively related to the corruption level in that province, indicating that greater rectification effort is associated with less corruption. This paper provides empirical evidence on how government auditing can contribute to curbing corruption, which is also helpful for understanding the role of China’s local audit institutions in government governance and can enrich the literature on both government auditing and corruption control.
Full Text Available A multi-sectoral core epidemiology capacity assessment was conducted in provinces that implemented One Health services in order to assess the efficacy of a One Health approach in Thailand. In order to conduct the assessment, four provinces were randomly selected as a study group from a total of 19 Thai provinces that are currently using a One Health approach. As a control group, four additional provinces that never implemented a One Health approach were also sampled. The provincial officers were interviewed on the epidemiologic capacity of their respective provinces. The average score of epidemiologic capacity in the provinces implementing the One Health approach was 66.45%, while the provinces that did not implement this approach earned a score of 54.61%. The epidemiologic capacity of surveillance systems in provinces that utilized the One Health approach earned higher scores in comparison to provinces that did not implement the approach (75.00% vs. 53.13%, p-value 0.13. Although none of the capacity evaluations showed significant differences between the two groups, we found evidence that provinces implementing the One Health approach gained higher scores in both surveillance and outbreak investigation capacities. This may be explained by more efficient capacity when using a One Health approach, specifically in preventing, protecting, and responding to threats in local communities.
Gregorio Carrasco Serrano
Full Text Available Sin duda alguna uno de ios elementos más destacables en el fenómeno de la romanización, viene a estar representado por las vías de comunicación de ahí la cada vez mayor importancia y relieve que los estudios al respecto han llegado a adquirir últimamente. En la actualidad la investigación sobre vías de comunicación romanas, presenta una complejidad derivada de la conjunción de trabajos de tipo arqueológico, histórico-geográfico y filológico que necesariamente requieren. Partiendo de este hecho, nuestro propósito en el presente estudio ha consistido básicamente en analizar aquellas vías y sus respectivas mansiones del área territorial correspondiente al ámbito provincial de Toledo, constatadas en las fuentes antiguas itinerarias, punto de partida obligado en toda investigación sobre viaria romana, dejando aparte por tanto, aquellos trazados no citados en dichas fuentes.
Hu, Yuanan; Cheng, Hefa
China has invested heavily on alternative energy, but the effectiveness of such energy sources at substituting the dominant coal-fired generation remains unknown. Here we analyse the displacement of fossil-fuel-generated electricity by alternative energy, primarily hydropower, and by trans-provincial imported electricity in China between 1995 and 2014 using two-way fixed-effects panel regression models. Nationwide, each unit of alternative energy displaces nearly one-quarter of a unit of fossil-fuel-generated electricity, while each unit of imported electricity (regardless of the generation source) displaces ∼0.3 unit of fossil-fuel electricity generated locally. Results from the six regional grids indicate that significant displacement of fossil-fuel-generated electricity occurs once the share of alternative energy in the electricity supply mix exceeds ∼10%, which is accompanied by 10-50% rebound in the consumption of fossil-fuel-generated electricity. These findings indicate the need for a policy that integrates carbon taxation, alternative energy and energy efficiency to facilitate China's transition towards a low-carbon economy.
Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.
Sánchez González, María Pilar; Escribano Sotos, Francisco; Tejada Ponce, Ángel
This study has two aims. The first is to determine how various factors impact on the number of fatalities, serious injuries and slight injuries adjusted for the level of traffic on interurban roads in Spain. The second is to establish the number of victims per million vehicle-kilometres (veh-km) travelled on interurban roads in each province resulting from the effect of its specific characteristics. To this end, we developed six fixed effect panel data models with panel corrected standard errors for the 1999-2015 period. Our results show that while the proportion of high capacity roads, the unemployment rate and the motorization rate contribute to a reduction in the number of fatalities, serious injuries and slight injuries adjusted for level of traffic, the penalty-points licence system is effective in reducing the number of fatalities and serious injuries but not the number of slight injuries. Furthermore, the specific conditions in Ávila, Toledo, Madrid, Santa Cruz de Tenerife, Las Palmas de Gran Canaria, the Balearic Islands, Lleida and all the provinces on the Mediterranean coast cause a higher number of victims per million veh-km travelled than in the remaining provinces. Thus, greater public investment and more socially responsible behaviour are essential tools for reducing the number of traffic accident victims on Spanish interurban roads. Moreover, the provincial institutions emerge as key agents in improving road safety, due to their greater knowledge of the specific conditions and factors affecting each province. Copyright © 2018 Elsevier Ltd. All rights reserved.
Full Text Available BACKGROUND: We examine the environmental, climatic and geographical controls on tropical ostracod distribution in the marine Ordovician of North America. METHODOLOGY/PRINCIPAL FINDINGS: Analysis of the inter-regional distribution patterns of Ordovician Laurentian ostracods, focussing particularly on the diverse Late Ordovician Sandbian (ca 461 to 456 Ma faunas, demonstrates strong endemicity at the species-level. Local endemism is very pronounced, ranging from 25% (e.g. Foxe basin to 75% (e.g. Michigan basin in each basin, a pattern that is also reflected in other benthic faunas such as brachiopods. Multivariate (ordination analyses of the ostracod faunas allow demarcation of a Midcontinent Province and a southern Marginal Province in Laurentia. While these are most clearly differentiated at the stratigraphical level of the bicornis graptolite biozone, analyses of the entire dataset suggest that these provinces remain distinct throughout the Sandbian interval. Differences in species composition between the provinces appear to have been controlled by changes in physical parameters (e.g. temperature and salinity related to water depth and latitude and a possible regional geographic barrier, and these differences persist into the Katian and possibly the Hirnantian. Local environmental parameters, perhaps operating at the microhabitat scale, may have been significant in driving local speciation events from ancestor species in each region. CONCLUSIONS/SIGNIFICANCE: Our work establishes a refined methodology for assessing marine benthic arthropod micro-benthos provinciality for the Early Palaeozoic.
Rodriguez Gonzalez, Jose Antonio; Martinez Sanchez, Yariana; Estorino Escaig, Nereida; Vidal Jimenez, Eligio
We developed a retrospective, interventionist, transversal study, with the objective of identifying the most frequently diagnosed Mamma Cancers in the Provincial Consultation of Mamma Cancer at the Hospital 'Jose Ramon Lopez Tabranes' of Matanzas, during 2009. The universe was 305 women assisting the consultation with possible mammary pathologies. Data were collected from the records of the Statistic Department of the hospital. They were grouped by age. The ultrasound diagnosis was compared with the mammographic and histological ones. Our sample were 114 women with nodules suspected of mamma cancer diagnosed using the before mentioned studies. We decided surgical treatment in patients with positive cytologies and metastasis found in CT. The highest percent of studied patients were in the age group from 31 to 49 years old. There was a predominance of hypoechoic nodules in ultrasound studies, and spiculated nodules with axillary adenopathies in mammographic studies. The most frequent diagnosis of mammographic studies was duct infiltrating carcinomas. The highest percent was subject for mastectomy. Axillary ganglion and bone metastasis were observed more frequently in CT made in operated patients
Federico, Giovanna; Rizzo, Gianfranco; Traverso, Marzia
In the paper, the practical problem of analysing in an integrated way the performance of provincial waste systems is approached, in the framework of the Strategic Environmental Assessment (SEA). In particular, the in itinere phase of SEA is analysed herein. After separating out a proper group of ambits, to which the waste system is supposed to determine relevant impacts, pertinent sets of single indicators are proposed. Through the adoption of such indicators the time trend of the system is investigated, and the suitability of each indicator is critically revised. The structure of the evaluation scheme, which is essentially based on the use of ambit issues and analytical indicators, calls for the application of the method of the Dashboard of Sustainability for the integrated evaluation of the whole system. The suitability of this method is shown through the paper, together with the possibility of a comparative analysis of different scenarios of interventions. Of course, the reliability of the proposed method strongly relies on the availability of a detailed set of territorial data. The method appears to represent a useful tool for public administration in the process of optimizing the policy actions aimed at minimizing the increasing problem represented by waste production in urban areas.
Full Text Available Background: Fertility in the current situation is the most important determinant of a country's population increase rate. Iran's fertility rate has declined since the mid 1981’s, and has reached a relative stability below the replacement level in recent years. However, the fertility levels are different among provinces in the country. Methods: The present study investigated the reproductive behavior of women at both individual and provincial levels, so the two-level model was used. Data were adapted from the census in 2011 and Demographic and Health Surveys in 2010. The statistical population of the study was the 15-49 year-old married women in Iran and the study sample included 299,539 woman of the statistical population. Results: The results showed significant differences among the provinces in terms of the variance of the number of children born alive. Residence, employment status and educational status had significant effects on the number of children born. Moreover, the two-level variables (The mean age of women in the first marriage, contraception prevalence and development level by province had a significant effect on the slope of education and employment status. Conclusion: A convergence of fertility behavior has been initiated in the Iranian women, and the difference between some provinces is influenced by the development level of the given provinces. Other variables (such as education and employment status that affect women’s reproductive behavior are influenced by the development level of the province.
Suárez González, Ana
Full Text Available Fragments 276 and 277 of the Archivo Histórico Provincial de Zamora provide evidence of a heretofore unknown codex of the Commentary on the Apocalypse by Beatus of Liébana. Written in visigothic script, the Beatus manuscript to which they pertain can be dated to the first half of the tenth century. This study provides an analysis —external and internal— of both fragments, along with an edition of the text, comparing them with the surviving visigothic examples in order to situate the manuscript within the stemma of known Beatus manuscripts.
Los fragmentos 276 y 277 del A.H.P. de Zamora son los testigos de un nuevo códice del Comentario al Apocalipsis atribuido a Beato de Liébana. El Beato al que pertenecen, en escritura visigótica, puede datarse en la primera mitad del siglo X. El presente trabajo recoge el análisis externo e interno de ambas piezas y la edición de su texto, cotejado con el de los restantes ejemplares visigóticos, para situar el volumen al que remiten en el stemma de los beatos conocidos hasta la fecha.
Viktor Zhivov (†
Full Text Available V. M. Zhivov’s introduction to Studies in Historical Semantics of the Russian Language in the Early Modern Period (2009, translated here for the first time, offers a critical survey of the historiography on Begriffsgeschichte, the German school of conceptual history associated with the work of Reinhart Koselleck, as well as of its application to the study of Russian culture. By situating Begriffsgeschichte in the context of late-nineteenth and early twentieth-century European philosophy, particularly hermeneutics and phenomenology, the author points out the important, and as yet unacknowledged, role that Russian linguists have played in the development of a native school of conceptual history. In the process of outlining this alternative history of the discipline, Zhivov provides some specific examples of the way in which the study of “historical semantics” can be used to analyze the development of Russian modernity.
Mostofi, Keyvan; Khouzani, Reza Karimi
The incidence of cervical disc herniation is estimated about 5.5/100,000, and they lead to surgical intervention in 26 %. Cervical disc herniation causes radiculopathy, which defines by radicular pain and sensory deficit and maybe weakness following the path of the affected nerves. Classically, cervical radiculopathy is expected to follow its specific dermatome-C4, C5, C6, C7 and C8. We investigate patients who present with discrepancy between classical radiculopathy and imaging findings in the daily practice of our profession. We reviewed the medical records of 102 patients with cervical radiculopathy, caused by cervical disc herniation. All patients had surgery. We found an apparent discrepancy between clinical and radiological findings, patients complained of radiculopathy on one side, and magnetic resonance imaging (MRI) scan or CT scan finding on the other side in ten patients (10.2 %). We did not found any other abnormalities in preoperative and post-operative period. All patients underwent cervical diskectomy via anterior approach. Six weeks after surgery eight patients (80 %) recovered completely, and 3 months after all ten patients (100 %) had been relieved totally. The aim of this paper is review of this medical concept and management of radiculopathy in patients with this discrepancy. As far as we know, the subject has not yet been touched in this light in medical literature. The discrepancy between clinical radiculopathy and disc herniation level on MRI or on CT scan is not rare. Management of this discrepancy requires further investigation to avoid missing diagnosis and treatment failure.
Kearns, William D; Fozard, James L; Becker, Marion; Jasiewicz, Jan M; Craighead, Jeffrey D; Holtsclaw, Lori; Dion, Charles
We hypothesized that variability in voluntary movement paths of assisted living facility (ALF) residents would be greater in the week preceding a fall compared with residents who did not fall. Prospective, observational study using telesurveillance technology. Two ALFs. The sample consisted of 69 older ALF residents (53 female) aged 76.9 (SD ± 11.9 years). Daytime movement in ALF common use areas was automatically tracked using a commercially available ultra-wideband radio real-time location sensor network with a spatial resolution of approximately 20 cm. Movement path variability (tortuosity) was gauged using fractal dimension (fractal D). A logistic regression was performed predicting movement related falls from fractal D, presence of a fall in the prior year, psychoactive medication use, and movement path length. Fallers and non-fallers were also compared on activities of daily living requiring supervision or assistance, performance on standardized static and dynamic balance, and stride velocity assessments gathered at the start of a 1-year fall observation period. Fall risk due to cognitive deficit was assessed by the Mini Mental Status Examination (MMSE), and by clinical dementia diagnoses from participant's activities of daily living health record. Logistic regression analysis revealed odds of falling increased 2.548 (P = .021) for every 0.1 increase in fractal D, and having a fall in the prior year increased odds of falling by 7.36 (P = .006). There was a trend for longer movement paths to reduce the odds of falling (OR .976 P = .08) but it was not significant. Number of psychoactive medications did not contribute significantly to fall prediction in the model. Fallers had more variable stride-to-stride velocities and required more activities of daily living assistance. High fractal D levels can be detected using commercially available telesurveillance technologies and offers a new tool for health services administrators seeking to reduce falls at their
Sjoraida, D. F.; Asmawi, A.; Anwar, R. K.
This article analyses the implementation of Law Number 14/2008 on Public Information Disclosure on the Provincial Government of West Java. This descriptive-qualitative study presents a discussion of the spirit of democracy in the implementation of the abovem-entioned policy in West Java Province. With the theory of policy implementation and democratization, data obtains that the element of democratic spirit in the implementation of public information policy in the government of West Java is quite thick. Therefore, there must be a massification of the implementation of the law in West Java, especially its socialization to districts/cities and society in general. It was found that the democratization of the West Java Provincial Government in implementing the Act has been well received in the community. However, the lack of publicity about this Law can reduce the strength of moral messages that exist in the law to the public.
Hurlbut, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Zhou, Ella [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Wang, Qin [National Renewable Energy Lab. (NREL), Golden, CO (United States)
A strategically planned transmission network is an important source of flexibility for the integration of large-scale renewable energy (RE). Such a network can offer access to a broad geographic diversity of resources, which can reduce flexibility needs and facilitate sharing between neighboring balancing areas. This report builds on two previous NREL technical reports - Advancing System Flexibility for High Penetration Renewable Integration (Milligan et al. 2015) and 'Renewables-Friendly' Grid Development Strategies (Hurlbut et al. 2015) - which discuss various flexibility options and provide an overview of U.S. market models and grid planning. This report focuses on addressing issues with cross-regional/provincial transmission in China with the aim of integrating renewable resources that are concentrated in remote areas and require inter-regional/provincial power exchange.
Zhou, Shengru [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hurlbut, David J. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Bird, Lori A. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Wang, Qin [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
A strategically planned transmission network is an important source of flexibility for the integration of large-scale renewable energy (RE). Such a network can offer access to a broad geographic diversity of resources, which can reduce flexibility needs and facilitate sharing between neighboring balancing areas. This report builds on two previous NREL technical reports - Advancing System Flexibility for High Penetration Renewable Integration (Milligan et al. 2015) and 'Renewables-Friendly' Grid Development Strategies (Hurlbut et al. 2015) - which discuss various flexibility options and provide an overview of U.S. market models and grid planning. This report focuses on addressing issues with cross-regional/provincial transmission in China with the aim of integrating renewable resources that are concentrated in remote areas and require inter-regional/provincial power exchange.
Yuan, Changwei; Wu, Dayong; Liu, Hongchao
The transportation sector is a complex system. Collecting transportation activity and the associated emissions data is extremely expensive and time-consuming. Grey Relational Analysis provides a viable alternative to overcome data insufficiency and gives insights for decision makers into such a complex system. In this paper, we achieved three major goals: (i) we explored the inter-relationships among transportation development, energy consumption and CO₂ emissions for 30 provincial units in China; (ii) we identified the transportation development mode for each individual province; and (iii) we revealed policy implications regarding the sustainable transportation development at the provincial level. We can classify the 30 provinces into eight development modes according to the calculated Grey Relational Grades. Results also indicated that energy consumption has the largest influence on CO₂ emission changes. Lastly, sustainable transportation policies were discussed at the province level according to the level of economy, urbanization and transportation energy structure.
In the 5 Questions book series, this volume presents a range of leading scholars in Intellectual History and the History of Ideas through their answers to a brief questionnaire. Respondents include Michael Friedman, Jacques le Goff, Hans Ulrich Gumbrecht, Jonathan Israel, Phiip Pettit, John Pocock...
Francisco Felino Riverón Morales
Full Text Available En el artículo se realiza un análisis de la evolución que ha The article makes an analysis of the evolution experienced by the various interpretations which can be steeped in history teaching. Stands as the subject History of Cuba is an array of historical science teaching and highlights the role of science content which include the development of knowledge, skills, habits and values in the teaching-learning process. Underlying the formative importance of the discipline of History of Cuba to the Cuban school, from the role the teacher in this process. Is particularized for Medical Sciences to assess the inclusion of the History of Cuba in the teaching-learning process in medical science responds to the need to contribute to the formation of a historical culture in the industry professionals as part of the humanistic education should possess.ResumenEn el artículo se realiza un análisis de la evolución que ha experimentado las diversas interpretaciones por cuales puede ser sumida la enseñanza de la historia. Se sostiene como la asignatura Historia de Cuba es un arreglo didáctico de la ciencia histórica y se destaca el papel del contenido de la ciencia en el que se incluyen el desarrollo de los conocimientos, habilidades, hábitos y valores en el proceso de enseñanza-aprendizaje. Se fundamenta la importancia formativa de la disciplina la Historia de Cuba para la escuela cubana, a partir del rol que tiene el profesor en este proceso. Se particulariza para las ciencias médicas al valorar como la inclusión de la Historia de Cuba dentro del proceso de enseñanza-aprendizaje en las ciencias médicas responde a la necesidad de contribuir a la formación de una cultura histórica en los profesionales de este sector como parte de la formación humanística que deben poseer.
Despite the fact that the idea of expanding the medical faculties of Budapest and Kolozsvár was formed in the 1870s, it only came true in the 1910s. The XXXVI. Law of 1912 ensured establishing new faculties in Pozsony and Debrecen. The medical faculty of Erzsébet University in Pozsony opened in 1914. The first three professors, i.e. Lajos Bakay, Ferenc Herzog and Dezső Velits, who formerly worked as head physicians for the State Hospital in Pozsony and the Institute for Midwives, were appointed then. The appointment of further professors and launching the 3rd, 4th and 5th forms were delayed by the outbreak of the war until 1918. After the collapse of the Austro-Hungarian Monarchy the newly formed Czechoslovakia dissolved the Hungarian university in 1919. The clinics and institutes of the medical faculty were passed to Czechoslovak ownership, the Hungarian lecturers were dismissed. It is worth mentioning though that Albert Szent-Györgyi and Carl Ferdinand Cori (both Nobel Prize winners) started their scientific career in Pozsony.
He, G; Kammen, DM
© 2015 Elsevier Ltd. Integrating variable energy resources, notably solar and wind, requires better understanding of where, when and how much of variable resources are available. China's ambitious solar energy development goal will be greatly facilitated by the resources assessment at higher spatial and temporal resolution. We utilized 10-year hourly solar irradiation data from 2001 to 2010 from 200 representative locations to develop provincial solar availability profiles. We found that Chin...
The recent rapid socio-economic development in Saudi Arabia has significantly affected the administrative systems at local, regional and national levels. The administrative system in Saudi Arabia went through several stages starting with the administrative system before the unification of the Kingdom, Omara system, Regional system and the new Provincial System. The issue of decentralisation and its role in enhancing developmental efforts through the processes of delegated...
Tonkopi, E [Dalhousie University (Canada); Queen Elizabeth II Health Sciences Ctr (Canada); O’Brien, K [Dalhousie University (Canada); IWK Health Centre, Halifax, NS (Canada)
Purpose: To establish provincial diagnostic reference levels (DRLs) in pediatric general radiography and computed tomography (CT) as a tool for the optimization of exposure parameters. Methods: Patient dose survey was conducted in the only pediatric hospital in the province of Nova Scotia. The DRLs were established as the 75th percentile of patient dose distributions in different age groups. For routine radiography projections the DRLs were determined in terms of entrance surface dose (ESD) calculated from the radiation output measurements and the tube current-exposure time product (mAs) recorded for each examination. Patient thickness was measured by the technologist during the examination. The CR and DR systems, employing respectively a fixed technique and phototiming, were evaluated separately; a two-tailed Student’s t-test was used to determine the significance of differences between the means of dose distributions. The CT studies included routine head, chest, abdomen/pelvis, and chest/abdomen/pelvis. The volume CT dose index (CTDIvol) and dose-length product (DLP) values were extracted retrospectively from PACS. The correction factors based on the effective diameter of the patient were applied to the CT dosimetry metrics based on the standard phantoms. Results: The provincial DRLs were established in the following age groups: newborn, 1, 5, 10, and 15 year olds. In general radiography the DR systems demonstrated slightly lower dose than the CR for all views, however the differences were not statistically significant (p > 0.05) for all examinations. In CT the provincial DRLs were lower than the published data, except for head DLPs in all age categories. This might be due to the small patient sample size in the survey. Future work will include additional CT data collection over an extended period of time. Conclusion: Provincial DRLs were established in the dedicated children’s hospital to provide guidance for the other facilities in examinations of pediatric
Darren P Smith; Louise Holt
This paper focuses on processes of studentification, and explores the link between higher education students and contemporary provincial gentrification. The paper provides two main, inter-connected, contributions to advance debates on gentrification. First, the discussion appeals for wider temporal analyses of the lifecourses of gentrifiers to trace the formation and reconfiguration of the cultural and residential predilections of gentrifiers across time and space. With this in mind, it is ar...
Full Text Available Limpopo provincial departments like all other South African government departments are required to report on performance against predetermined objectives in terms of Section 40 of the Public Finance Management Act 1 of 1999, read in conjunction with Section 5.1.1 of the Treasury Regulations. The purpose of this article is to report on a study that was undertaken to establish the challenges faced by the Limpopo provincial departments in reporting on performance against predetermined objectives to the Auditor-General (AG. Reporting on predetermined objectives has been a challenge over the past financial years and this is evident in the AG’s reports, in which Limpopo provincial departments continued to receive qualified audit reports. The literature review carried out for purposes of this study revealed that performance management is fundamental to enhancing organisational performance. A qualitative research design was used to collect and analyse data. Key findings of the study included that management should prioritise strategic planning, performance reporting, monitoring and evaluation to enable it to be in a position to make a determination as to whether what was planned by the department was actually realised. It is also of paramount importance that performance reporting is highly prioritised at strategic, tactical and operational management meetings to ensure more effective and efficient organisational performance.
Wang, Wen; Cheng, Hui; Zhang, Li
All countries around the world and many international bodies, including the United Nations Development Program (UNDP), United Nations Food and Agricultural Organization (FAO), the International Fund for Agricultural Development (IFAD) and the International Labor Organization (ILO), have to eliminate rural poverty. Estimation of regional poverty level is a key issue for making strategies to eradicate poverty. Most of previous studies on regional poverty evaluations are based on statistics collected typically in administrative units. This paper has discussed the deficiencies of traditional studies, and attempted to research regional poverty evaluation issues using 3-year DMSP/OLS night-time light satellite imagery. In this study, we adopted 17 socio-economic indexes to establish an integrated poverty index (IPI) using principal component analysis (PCA), which was proven to provide a good descriptor of poverty levels in 31 regions at a provincial scale in China. We also explored the relationship between DMSP/OLS night-time average light index and the poverty index using regression analysis in SPSS and a good positive linear correlation was modelled, with R2 equal to 0.854. We then looked at provincial poverty problems in China based on this correlation. The research results indicated that the DMSP/OLS night-time light data can assist analysing provincial poverty evaluation issues.
Luo, Yunpeng; Chen, Huai; Zhu, Qiu'an; Peng, Changhui; Yang, Gang; Yang, Yanzheng; Zhang, Yao
With the economic development of China, air pollutants are also growing rapidly in recent decades, especially in big cities of the country. To understand the relationship between economic condition and air pollutants in big cities, we analysed the socioeconomic indictors such as Gross Regional Product per capita (GRP per capita), the concentration of air pollutants (PM10, SO2, NO2) and the air pollution index (API) from 2003 to 2012 in 31 provincial capitals of mainland China. The three main industries had a quadratic correlation with NO2, but a negative relationship with PM10 and SO2. The concentration of air pollutants per ten thousand yuan decreased with the multiplying of GRP in the provincial cities. The concentration of air pollutants and API in the provincial capital cities showed a declining trend or inverted-U trend with the rise of GRP per capita, which provided a strong evidence for the Environmental Kuznets Curve (EKC), that the environmental quality first declines, then improves, with the income growth. The results of this research improved our understanding of the alteration of atmospheric quality with the increase of social economy and demonstrated the feasibility of sustainable development for China.
Schmidt, S; Bounnack, S; Hoehn, T
Aim of this study was to analyze neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program to examine a possible impact on neonatal outcomes. This study is a retrospective data analysis of all neonatal patients treated in five provincial hospitals in Laos after implementation of a neonatal teaching program. A simulation-based teaching program aims to have positive impact on the theoretical and practical skill of hospital staff in the field of newborn care. A comparison between pre-implementation and post-implementation data of newborns admitted to provincial hospitals in Laos was used to quantify the effect of repetitive teaching on neonatal outcomes. Neonatal mortality and morbidity as well as case fatality rates of infections and asphyxia decreased in the post-implementation period. In contrast, neonatal mortality rate as well as case fatality rate of prematurity increased. The total neonatal mortality rate increased in the post-implementation period. The pre-implementation and post-implementation data enable longitudinal comparisons between hospitals and highlight the differences between hospitals concerning neonatal mortality and morbidity in provincial hospitals in Laos. These data can serve as a basis for an individual adaption of the teaching program to the unique requirements of each single hospital. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Dutton, Daniel J; Forest, Pierre-Gerlier; Kneebone, Ronald D; Zwicker, Jennifer D
Escalating health care spending is a concern in Western countries, given the lack of evidence of a direct connection between spending and improvements in health. We aimed to determine the association between spending on health care and social programs and health outcomes in Canada. We used retrospective data from Canadian provincial expenditure reports, for the period 1981 to 2011, to model the effects of social and health spending (as a ratio, social/health) on potentially avoidable mortality, infant mortality and life expectancy. We used linear regressions, accounting for provincial fixed effects and time, and controlling for confounding variables at the provincial level. A 1-cent increase in social spending per dollar spent on health was associated with a 0.1% (95% confidence interval [CI] 0.04% to 0.16%) decrease in potentially avoidable mortality and a 0.01% (95% CI 0.01% to 0.02%) increase in life expectancy. The ratio had a statistically nonsignificant relationship with infant mortality ( p = 0.2). Population-level health outcomes could benefit from a reallocation of government dollars from health to social spending, even if total government spending were left unchanged. This result is consistent with other findings from Canada and the United States. © 2018 Joule Inc. or its licensors.
Full Text Available With the economic development of China, air pollutants are also growing rapidly in recent decades, especially in big cities of the country. To understand the relationship between economic condition and air pollutants in big cities, we analysed the socioeconomic indictors such as Gross Regional Product per capita (GRP per capita, the concentration of air pollutants (PM10, SO2, NO2 and the air pollution index (API from 2003 to 2012 in 31 provincial capitals of mainland China. The three main industries had a quadratic correlation with NO2, but a negative relationship with PM10 and SO2. The concentration of air pollutants per ten thousand yuan decreased with the multiplying of GRP in the provincial cities. The concentration of air pollutants and API in the provincial capital cities showed a declining trend or inverted-U trend with the rise of GRP per capita, which provided a strong evidence for the Environmental Kuznets Curve (EKC, that the environmental quality first declines, then improves, with the income growth. The results of this research improved our understanding of the alteration of atmospheric quality with the increase of social economy and demonstrated the feasibility of sustainable development for China.
In economic terms, hydro-electricity is considered as a quasi-staple, as it prone to the classic staples problem of excess capacity. However, neither water nor hydroelectricity in Canada is produced primarily for export markets. Hydroelectric systems are often thought of as politicized monopolies. This paper discussed changes that have occurred in hydroelectric organizations over time, as they have been governed by a formative mixed regime; postwar provincial hydro systems; a megaprojects regime; and an emerging sustainability regionalization regime. The origins of electricity generation and transmission in Canada were discussed, as well as the ecological footprint of large mega-projects on rivers. The development of provincial hydro monopolies during the mid- to late- twentieth century was also outlined, as well as the sustainability and regionalization regime that developed after 1990. During the mature staples period of the mid-century, rents in hydro-electric organizations were distributed through cheap rates to subsidize and facilitate the development of mass production and mass consumption. However, post-staples consumption has now replaced mass consumption, and demand side management is replacing earlier cheap power policies. Nonetheless, the lack of systematic integration of networks has led to inefficiencies. Provincial grids are now being integrated into interconnected North American regional networks regulated by the United States. It was concluded that the Canadian electricity regime is increasingly influenced by the the supranational role that the United States is playing in structuring markets. 83 refs
A history of psychiatry cannot step back from the question of psychiatric diseases, but the field has in general viewed psychiatric entities as manifestations of the human state rather than medical diseases. There is little acknowledgement that a true disease is likely to rise and fall in incidence. In outlining the North Wales History of Mental Illness project, this paper seeks to provide some evidence that psychiatric diseases do rise and fall in incidence, along with evidence as to how such ideas are received by other historians of psychiatry and by biological psychiatrists. © The Author(s) 2014.
Cardile, Anthony P; Littell, Christopher T; Backlund, Michael G; Heipertz, Richard A; Brammer, Jerod A; Palmer, Sean M; Vento, Todd J; Ortiz, Felix A; Rosa, William R; Major, Michael J; Garman, Patrick M
The U.S. Army 1 st Area Medical Laboratory (1 st AML) is currently the only deployable medical CBRNE (Chemical, Biological, Radiological, Nuclear, and Explosives) laboratory in the Army's Forces Command. In support of the United States Agency for International Development Ebola response, the U.S. military initiated Operation United Assistance (OUA), and deployed approximately 2,500 service members to support the Government of Liberia's Ebola control efforts. Due to its unique molecular diagnostic and expeditionary capabilities, the 1 st AML was ordered to deploy in October of 2014 in support of OUA via establishment of Ebola testing laboratories. To meet the unique mission requirements of OUA, the unit was re-organized to operate in a split-based configuration and sustain four separate Ebola testing laboratories. This article is a review of the 1 st AML's OUA participation in a split-based configuration. Topics highlighted include pre-deployment planning/training, operational/logistical considerations in fielding/withdrawing laboratories, laboratory testing results, disease and non-battle injuries, and lessons learned. Fielding the 1 st AML in a split-based configuration required careful pre-deployment planning, additional training, optimal use of personnel, and the acquisition of additional laboratory equipment. Challenges in establishing and sustaining remote laboratories in Liberia included: difficulties in transportation of equipment due to poor road infrastructure, heavy equipment unloading, and equipment damage during transit. Between November 26, 2014 and February 18, 2015 the four 1 st AML labs successfully tested blood samples from patients and oral swabs collected by burial teams in rural Liberia. The most significant equipment malfunction during laboratory operations was generators powering the labs, with the same problem impacting headquarters. Generator failures delayed laboratory operations/result reporting, and put temperature sensitive reagents at
National Aeronautics and Space Administration — China County-Level Data on Provincial Economic Yearbooks, Keyed To 1:1M GIS Map consists of socioeconomic and boundary data for the administrative regions of China...
Provincial States of North Holland wants to consider the options to stimulate proctices for better welfare among farm animals. This report describes these options for the major farm animal species in North Holland: sheep, dairy cattle, farmed fish and horses
Full Text Available BACKGROUND: The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. OBJECTIVE: To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS, respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls. METHODS: A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. RESULTS: Six months after implementation, 82% of the participants agreed that "legislation is enforced most of the time". The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%, with less compliance in hotels and shopping malls (about 70%. Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10% and high in hotels and shopping malls (40% and above. The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes among employees decreased from 83% to 67%. CONCLUSIONS: Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future.
Full Text Available Although the average poverty level in Lao PDR has declined substantially since the beginning of economic reforms in 1986, sub-national dynamics give rise to a discussion of the trends and issues that determine and sustain provincial poverty and the variegated processes of rural transition. It appears that migration to core areas does not always generate better living standards, as migration to Vientiane Capital and Vientiane Province also results in a relocation of poverty from peripheral to core areas. This article sheds light on these problems and discusses the implications for the spatial dimensions of poverty in core provinces located on emerging Greater Mekong Subregion corridors and peripheral provinces. A case study of Savannakhet, located along the East West Economic Corridor, shows how rural households cope with the pressures arising from increasing market forces and regionalization. Based on in-depth fieldwork in the village of Ban Gnang Pho Sy, the results indicate that a shift occurred among the rural poor, in which their livelihoods changed from being based purely on subsistence agriculture to being focused increasingly upon pluriactive (commercial farming, livelihood diversification and labour migration to Thailand. Provinces located along emerging corridors experience a complex mosaic of impacts of integration due to fragmented ethnic-linguistic geographies and the varying relevance of pull versus push factors: imports versus exports, inward versus outward investments, and in- versus out-migration. In sum, rather than the neoliberal promise of a flatter socioeconomic landscape, the human geography of the Greater Mekong Subregion remains rough, due to politicization of foreign direct investments, complex land dealings and landlessness, migration patterns and rising inequality.
Full Text Available ABSTRACT: Since the Industrial Revolution, the concentration of greenhouse gases (GHG, primarily carbon dioxide (CO2, has put increasing pressure on the atmosphere's ability to absorb them. China is the fastest growing major economy in the world, and is following a process of rapid industrialization. This process, however, contributes dramatically to global warming through major CO2 emissions. The widespread provision of electricity through coal-fired power plants is just one contributor, but industrial structures, transportation systems, and the construction of large superblock residential towers also play major roles. The large cities and industrialized provinces of China emit the most CO2, a fact that requires serious attention. However, stemming this trend elsewhere in China would provide a greater opportunity for success in reducing overall CO2 emissions in the country. Consequently, the question this paper addresses is what policies can be adopted to reduce CO2 emissions in provinces in China where development is still in its early stages, while maintaining economic growth. Jiangxi is a province that has historically been a major agricultural area. In recent years, however, because of the economic development policies of the Chinese central government, the province's rich mineral deposits, favorable location, and convenient transportation system are attracting more investments and projects for development (Statistical Bureau of Jiangxi, 2010. Jiangxi, then, provides an excellent case study because the province, although developing quickly, might still produce less CO2 if proper growth policies and actions are implemented. According to the results of this research, CO2 emissions would indeed decline in Jiangxi if the province would adopt new technology for electricity generation and increase the GDP role of the service sector. KEYWORDS: Provincial Chinese development, economic growth and global warming, CO2 emissions in China, Chinese
Benson, Roger B J; Rich, Thomas H; Vickers-Rich, Patricia; Hall, Mike
'Gondwanan' fauna of South America and Africa may therefore reflect climate-driven provinciality, not vicariant evolution driven by continental fragmentation. However, vicariance may still be detected at lower phylogenetic levels.
Benson, Roger B. J.; Rich, Thomas H.; Vickers-Rich, Patricia; Hall, Mike
hallmark ‘Gondwanan’ fauna of South America and Africa may therefore reflect climate-driven provinciality, not vicariant evolution driven by continental fragmentation. However, vicariance may still be detected at lower phylogenetic levels. PMID:22615916
Full Text Available Kaori Kurata,1 Eitarou Taniai,2 Kanae Nishimura,3 Kenji Fujita,3 Akira Dobashi1 1Education and Research Institute of Information Science, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan; 2Informational Headquarters, Yakuju Corporation, Minato-ku, Tokyo, Japan; 3General Incorporated Foundation Social University, Minato-ku, Tokyo, Japan Purpose: We investigated prescriptions regarding the combined use of donepezil hydrochloride (DPZ and anticholinergics for elderly outpatients in Japan to determine the impact that combination therapy has on decreasing their cognitive functions. Methods: Using electronic medication records from 142 community pharmacies, outpatients older than 40 years of age taking DPZ, with or without other prescription medicines, were assessed over 6 years, beginning in 2007. We estimated the number of medicines administered along with DPZ, the number of anticholinergics administered along with DPZ, and the medicines' anticholinergic cognitive burden (ACB scale cumulative score based on data from the top four pharmacies that filled the highest number of prescriptions for DPZ for outpatients with dementia in 2010. Data were gathered from records of 431 patients; only three patients were younger than 60 years. Results: There was a 1.94-fold increase in the number of prescriptions including DPZ over 6 years. The proportion of patients to whom other medicines were administered along with DPZ was 65.6% (n=283 and the proportion of those taking at least one anticholinergic agent was 24.1% (n=104. The mean number of medicines among subjects taking at least one anticholinergic was 5.7, and the mean cumulative ACB score for anticholinergics contained in these medicines was 2.6. Among 104 patients to whom the anticholinergics were administered along with DPZ, two outpatients taking urologic medicines such as oxybutynin hydrochloride or tolterodine tartrate were found. Conclusion: Our findings suggest that it is
Tu, Karen; Mitiku, Tezeta F; Ivers, Noah M; Guo, Helen; Lu, Hong; Jaakkimainen, Liisa; Kavanagh, Doug G; Lee, Douglas S; Tu, Jack V
Primary care electronic medical records (EMRs) represent a potentially rich source of information for research and evaluation. To assess the completeness of primary care EMR data compared with administrative data. Retrospective comparison of provincial health-related administrative databases and patient records for more than 50,000 patients of 54 physicians in 15 geographically distinct clinics in Ontario, Canada, contained in the Electronic Medical Record Administrative data Linked Database (EMRALD). Physician billings, laboratory tests, medications, specialist consultation letters, and hospital discharges captured in EMRALD were compared with health-related administrative data in a universal access healthcare system. The mean (standard deviation [SD]) percentage of clinic primary care outpatient visits captured in EMRALD compared with administrative data was 94.4% (4.88%). Consultation letters from specialists for first consultations and for hospital discharges were captured at a mean (SD) rate of 72.7% (7.98%) and 58.5% (15.24%), respectively, within 30 days of the occurrence. The mean (SD) capture within EMRALD of the most common laboratory tests billed and the most common drugs dispensed was 67.3% (21.46%) and 68.2% (8.32%), respectively, for all clinics. We found reasonable capture of information within the EMR compared with administrative data, with the advantage in the EMR of having actual laboratory results, prescriptions for patients of all ages, and detailed clinical information. However, the combination of complete EMR records and administrative data is needed to provide a full comprehensive picture of patient health histories and processes, and outcomes of care.
Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, ... as heart disease, stroke, and cancer. Having a family member with a disease raises your risk, but ...
Purpose of review The present review examines recent contributions to the evolving field of historical writing in psychiatry. Recent findings Interest in the history of psychiatry continues to grow, with an increasing emphasis on topics of current interest such as the history of psychopharmacology, electroconvulsive therapy, and the interplay between psychiatry and society. The scope of historical writing in psychiatry as of 2007 is as broad and varied as the discipline itself. Summary More than in other medical specialties such as cardiology or nephrology, treatment and diagnosis in psychiatry are affected by trends in the surrounding culture and society. Studying the history of the discipline provides insights into possible alternatives to the current crop of patent-protected remedies and trend-driven diagnoses. PMID:18852567
Labat-Robert, J; Robert, L; Pouliquen, Y
The "Tissue" concept emerged apparently in the medical literature at about the French revolution, during the second half of the 18(th) century. It was found in the texts written by the physicians of Béarn and Montpellier, the Bordeu-s and also by the famous physician, Felix Vicq d'Azyr, the last attending physician of the queen Marie-Antoinette, "Bordeu et al. (1775) et Pouliquen (2009)". It was elaborated into a coherent doctrine somewhat later by Xavier Bichat, considered as the founder of modern pathological anatomy, Bichat. With the advent of histochemistry, from the beginning of the 20(th) century, several of the principal macromolecular components of connective tissues, collagens, elastin, "acid mucopolysaccharides" (later glycosaminoglycans and proteoglycans) and finally structural glycoproteins were characterized. These constituents of connective tissues were then designated as components of the extracellular matrix (ECM), closely associated to the cellular components of these tissues by adhesive (structural) glycoproteins as fibronectin, several others and cell receptors, "recognising" ECM-components as integrins, the elastin-receptor and others. This molecular arrangement fastens cells to the ECM-components they synthesize and mediates the exchange of informations between the cells to the ECM (inside-out) and also from the ECM-components to the cells (outside-in). This macromolecular arrangement is specific for each tissue as a result of the differentiation of their cellular components. It is also the basis and condition of the fulfillment of the specific functions of differentiated tissues. This is a short description of the passage of the "tissue" concept from its vague origin towards its precise identification at the cellular and molecular level up to the recognition of its functional importance and its establishment as an autonomous science. This can be considered as a new example of the importance of metaphors for the progress of science, Keller
When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists. PMID:23634159
Annandale, Elrista; Nealer, Eric J
It is by now common knowledge that South Africa is a water scarce country and that the correct public management of its potable water sources such as the transportation of it as well as the purification of the used water is of utmost importance. In the history of South Africa, the supply of potable water and basic sanitation services to all the inhabitants has never been higher on the national, provincial and especially the local government sphere agendas than since the end ...
Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz; Hassounah, Sondus
To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programmes in Pakistan. 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB strategy over others due to external influences and 3. Limitations in the overall
Dong, Huijuan; Dai, Hancheng; Dong, Liang; Fujita, Tsuyoshi; Geng, Yong; Klimont, Zbigniew; Inoue, Tsuyoshi; Bunya, Shintaro; Fujii, Minoru; Masui, Toshihiko
Highlights: • China’s future CO 2 reduction and its co-benefits on air pollutants were projected. • GAINS-China and AIM/CGE models were combined for emission and cost estimation. • High GDP regions tended to have higher emission, reduction potential and co-benefit. • Coal ratio and coal quality were also key factors to affect reduction and co-benefit. • Mitigation investment to less developed western regions was more effective. - Abstract: With fast economic development, industrialization and urbanization, China faces increasing pressures on carbon emission reduction, and especially on air pollutants (SO 2 , NOx, PM) reduction, particularly the notorious haze issue caused by air pollution in recent years. Pursuing co-benefits is an effective approach to simultaneously respond to both carbon and air pollutant problems. In this paper, the AIM/CGE (Asia–Pacific Integrated Assessment Model/Computational General Equilibrium) model and GAINS (Greenhouse Gas and Air Pollution Interactions and Synergies)-China model are combined together to project future CO 2 and air pollutants emissions in China, as well as reduction costs and co-benefit effects. Considering implementation of carbon mitigation policy and air pollutant mitigation technologies, four scenarios (S1, S2, S3 and S4) are analyzed. Results indicate that by implementing both carbon and air pollutant mitigation (S4), CO 2 emission per GDP can be reduced by 41% by 2020, compared with the 2005 level, and SO 2 , NOx and PM2.5 emissions would change by a factor 0.8, 1.26 and 1.0 of the 2005 level, respectively in 2030. The real co-benefits of emission reductions (S2 minus S4) for SO 2 , NOx and PM2.5 are 2.4 Mt, 2.1 Mt and 0.3 Mt in 2020, and the corresponding cost reduction co-benefits are 4, 0.11, and 0.8 billion €, respectively. Provincial disparity analysis reveals that regions with higher co-benefits are those with higher GDP such as Guangdong, Shandong and Jiangsu, energy production bases such as
It has become acceptable among historians of medicine to profess a predilection for the historiography of medical ideas. But it is justified all the same to ask whether the logical connection really caused the origin, the change, or the disappearance of the medical objects. The interaction of ideas and medical objects assure as much objectivity as possible. In consequence, the contents of the museums, medical objects, is an aspect rather that a branch of the history of medicine.
Pawson, Eric; Christensen, Andreas Aagaard
Environmental history is an interdisciplinary pursuit that has developed as a form of conscience to counter an increasingly powerful, forward-looking liberal theory of the environment. It deals with the relations between environmental ideas and materialities, from the work of the geographers Geor...... for solutions and policies, is the agenda for an engaged environmental history from now on.......Environmental history is an interdisciplinary pursuit that has developed as a form of conscience to counter an increasingly powerful, forward-looking liberal theory of the environment. It deals with the relations between environmental ideas and materialities, from the work of the geographers George...... risks”. These are exposed by environmental history’s focus on long-run analysis and its narrative form that identifies the stories that we tell ourselves about nature. How a better understanding of past environmental transformations helps to analyse society and agency, and what this can mean...
Whitmer, John Dale
Provides a brief overview for including labor history in the social studies curriculum. Notes the broad range of subjects (geography, history, economics, music, and art) and approaches (women's history, social history, oral history) that encompass labor history. (MJP)
Hansen, Vagn Lundsgaard
Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede.......Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede....
Neither so Recent nor so Dispensable: The 1812 Constitution, the Provincial Governments and the (ReBirth of the Provinces | Ni tan recientes ni tan prescindibles: la Constitución de 1812, las diputaciones y el (renacimiento de las provincias
Francisco Carantoña Álvarez
Full Text Available 2013 celebrated the bicentennial of the constitution of the first provincial governments in Spain. Conversely, constitutional reform issues, including an increasing state federalization, and economic crisis put to question the very existence of the provinces themselves. It may be convenient to revise the emergence of those provincial governments as political and administrative bodies. The term ‘province’ has been used since medieval times to refer both to the old kingdoms, or large territorial units belonging to the Crown, and to territorial subdivisions on the latter. The Cadiz Cortes undertook the task of making territorial divisions more uniform and rational, which brought about the creation of elective government bodies at both the municipal and the provincial level, although strongly dependent on the central administration. It was a centralised system which nonetheless envisaged, for the first time in the history of Spain, local and provincial representative bodies all over the country and, paradoxically, it involved a decentralisation of the State. In 1822 the constitutional mandate was completed with provincial divisions which maintained the old kingdoms’ boundaries and which would be almost fully maintained in 1833 by Javier de Burgos. With those provincial governments the provinces became distinctive political entities. | En 2013 se conmemoró el segundo centenario de la constitución de las primeras diputaciones provinciales, paralelamente, los debates sobre la reforma constitucional y la mayor federalización del Estado y la crisis económica han puesto en cuestión la existencia de las provincias. Una revisión de su nacimiento como entidades político-administrativas quizá resulte conveniente. El término “provincia” se utilizaba desde la época medieval tanto para denominar a los viejos reinos o grandes unidades territoriales que integraban la monarquía como a las circunscripciones en que algunas de estas se divid