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.

LENUS (Irish Health Repository)

Carey, Barbara

2011-04-01

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.

Prescription data improve the medication history in primary care

DEFF Research Database (Denmark)

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

2010-01-01

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

The Political Economy of Provincial TV Stations in China

OpenAIRE

Yang, Shuo

2012-01-01

My master thesis aims to examine how a Chinese political economy context has shaped the media landscape in China, especially in the domain of provincial television. The key issues are: 1) what the role of private profit accumulation is for provincial TV stations in China; 2) Whom the ownership of provincial TV stations in China belongs to; 3) how global capitalism influence provincial TV stations today; 4) how government regulation influence provincial TV stations today. Theoretically, we fol...

Learning medical history in Oslo: training for medical practice.

Science.gov (United States)

Larsen, O

1999-03-01

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.

Network analysis of Chinese provincial economies

Science.gov (United States)

Sun, Xiaoqi; An, Haizhong; Liu, Xiaojia

2018-02-01

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.

Ionizing radiation protection regulation in Canada: the role of the Federal Provincial Territorial Radiation Protection Committee

International Nuclear Information System (INIS)

Clement, Christopher H.

2008-01-01

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

Why Is It Important to Know My Family Medical History?

Science.gov (United States)

... know my family medical history? Why is it important to know my family medical history? A family ... for Links Data Files & API Site Map Subscribe Customer Support USA.gov Copyright Privacy Accessibility FOIA Viewers & ...

An educational tool for teaching medication history taking to pharmacy students.

Science.gov (United States)

Sando, Karen R; Elliott, Jennifer; Stanton, Melonie L; Doty, Randell

2013-06-12

To implement and evaluate the use of a situated-learning experience to prepare second-year pharmacy students to conduct medication history interviews in preparation for introductory pharmacy practice experiences (IPPE) at ambulatory clinic sites. Second-year doctor of pharmacy (PharmD) students (n=200) used the Medication Mysteries Infinite Case Tool, a game-like educational tool in which groups of 3 students assumed the roles of pharmacist, patient, and observer and rolled a die and drew cards to determine the drugs, patient personality, medication problems, and other variables that guided a medication history taking session. After the laboratory session, faculty members assessed students' medication history-taking skills. One hundred sixteen (58%) and 78 (39%) of 200 students achieved excellence or competence, respectively, on the final assessment. Two weeks after the assessment, 53 of 200 (26.5%) students completed a survey instrument. The respondents indicated that their self-confidence in conducting medical history taking significantly improved following completion of the learning experience. Using the Medication Mysteries Infinite Case Tool increased students' confidence and skills in conducting medication history taking prior to their clinical IPPE experience.

Mapping "region" in Canadian medical history: the case of British Columbia.

Science.gov (United States)

Davies, M J

2000-11-01

The notion of "region" can be a valuable analytical tool in the writing of Canadian medical history. This article explores themes in the history of British Columbia that link medicine and regional development. Employing a historiographical sweep from the colonial period to the 1970s, the author considers doctors and imperialism, medical practice and the economy, and the relationship between metropolis and periphery in shaping medical institutions and medical culture in the western province. The intent of the piece is to stimulate thought about the potential of introducing the sense of place into regional medical history in Canada.

Is Ontario Moving to Provincial Negotiation of Teaching Contracts?

Science.gov (United States)

Jefferson, Anne L.

2008-01-01

In Canada, the statutes governing public school teachers' collective bargaining are a combination of the provincial Labour Relations Act or Code and the respective provincial Education/School/Public Schools Act. As education is within the provincial, not federal, domain of legal responsibility, the specifics of each act or code can vary.…

Provincial government performance on climate change: 2000

International Nuclear Information System (INIS)

Hornung, R.

2000-01-01

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

[Medical history as an academic subject at the Bamberg University].

Science.gov (United States)

Locher, W

2000-01-01

A full program of medicine was taught at the Catholic University of Bamberg (founded 1648 as the Academia Ottonia) from 1773 through 1803. Within this period of time, the History of Medicine was taught from 1790 through 1795 by Johann Baptist Dominicus Fin(c)k. This paper elucidates how in this instance protestant universities served as models for catholic universities. Interestingly, it was not the medical faculty itself which developed an interest in teaching medical history. Rather, it was Adalbert Friedrich Marcus (1753-1816), physician-in-waiting of the Prince-Bishop Franz Ludwig von Erthal and medical officer in the principality of Bamberg since June 22, 1790, who was charged by the Prince-Bishop with developing guidelines for medical education. The start of the History of Medicine lectures brought with it a heated dispute about an appropriate textbook. The discussion is evidence of a transition from historiography understood as an account of learned doctors of the past to a study of history in a modern sense.

Categorizing Two Taiwanese Major Political Parties From Their Faces: The Influence of Provincial Appearance

Directory of Open Access Journals (Sweden)

Chien-Kai Chang

2018-03-01

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.

[The function of philosophy of science in the teaching of medical history].

Science.gov (United States)

Li, Yaming

2014-05-01

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.

History of Medicine in US Medical School Curricula.

Science.gov (United States)

Caramiciu, Justin; Arcella, David; Desai, Manisha S

2015-10-01

To determine the extent to which the history of medicine (HOM) and its related topics are included within the curriculum of accredited medical schools in the United States. Survey instrument. US allopathic medical schools. An online survey was sent to officials from every medical school in the US. Respondents were asked to provide institutional identifiers, the presence of an HOM elective offered to medical students, the years during which the elective is offered, the existence of an HOM department, and the contact information for that particular department. Nonresponders were contacted by phone to elicit the same information. History of medicine electives included didactic sessions and seminars with varying degrees of credit offered in different years of medical school. Based on responses from 119 of 121 contacted medical schools (98%), 45 (37%) included formal lectures or weekly seminars in the medical school curriculum. Five (11%) curricula had or have required HOM, whereas 89% offered elective HOM instruction. Course duration and credit awarded varied. Eighteen (15%) medical schools included departments dedicated to HOM. Providing education in HOM was limited by faculty interest, clinical training hours, and low interest. Data collected by our study suggest that substantial barriers exist within the academic medical community towards a wider acceptance of the importance of HOM. Causes for such lack of interest include absence of questions on written or oral tests related to HOM, difficulty in publishing articles related to HOM in peer reviewed journals, near absence of research grants in HOM, difficulty in getting academic promotions or recognition for activities related to HOM, and a lack of support from academic chairpersons for activities related to HOM. Copyright © 2015 Anesthesia History Association. Published by Elsevier Inc. All rights reserved.

Eliciting comprehensive medication histories in the emergency department: the role of the pharmacist.

Directory of Open Access Journals (Sweden)

Crook M

2007-06-01

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.

On the history of New York Medical College.

Science.gov (United States)

Greenberg, S J

1986-01-01

The history of New York Medical College reflects three distinct trends in the development of medical education: the rise and fall of homeopathy, the input of civic leaders (in this case, William Cullen Bryant) and the uneasy relationship between medical schools and hospitals caused by the dramatic increase in the complexity and cost of hospital care.

Using medical history embedded in biometrics medical card for user identity authentication: data representation by AVT hierarchical data tree.

Science.gov (United States)

Fong, Simon; Zhuang, Yan

2012-01-01

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.

Using Medical History Embedded in Biometrics Medical Card for User Identity Authentication: Data Representation by AVT Hierarchical Data Tree

Directory of Open Access Journals (Sweden)

Simon Fong

2012-01-01

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.

Provincial resource development research policy

Energy Technology Data Exchange (ETDEWEB)

Flock, D L

1976-01-01

In Alberta, there is an abundance of oil, natural gas, and coal. But only a small portion of the Alberta oil sands and coal resources are commercially accessible to surface-mining techniques. It is quite apparent that some in-situ technological breakthrough will be required, which will mean a concerted research effort at the provincial level. It is the purpose of this paper to present certain concepts and recommendations for a coordinated provincial resource development research policy for the Province of Alberta. Research as discussed in this paper covers basic and applied research and development. (MCW)

Hypertension in Asymptomatic, Young Medical Students with Parental History of Hypertension

Directory of Open Access Journals (Sweden)

Simran Sidhu

2017-11-01

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.

Medical Genetics at McGill: The History of a Pioneering Research Group.

Science.gov (United States)

Canning, Christopher; Weisz, George; Tone, Andrea; Cambrosio, Alberto

2013-01-01

The McGill Group in Medical Genetics was formed in 1972, supported by the Medical Research Council and successor Canadian Institutes for Health Research until September 2009, making it the longest active biomedical research group in the history of Canada. We document the history of the McGill Group and situate its research within a broader history of medical genetics. Drawing on original oral histories with the Group's members, surviving documents, and archival materials, we explore how the Group's development was structured around epistemological trends in medical genetics, policy choices made by research agencies, and the development of genetics at McGill University and its hospitals.

Forging Provincial Reconstruction Teams

National Research Council Canada - National Science Library

Honore, Russel L; Boslego, David V

2007-01-01

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...

Technology transfer from havana hospitals to primary care: yamila de armas, MD. Deputy director, provincial health department, havana city province.

Science.gov (United States)

Giraldo, Gloria

2009-01-01

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.

Prescription data improve the medication history in primary care

DEFF Research Database (Denmark)

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

2010-01-01

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

Teaching history taking to medical students: a systematic review.

Science.gov (United States)

Keifenheim, Katharina E; Teufel, Martin; Ip, Julianne; Speiser, Natalie; Leehr, Elisabeth J; Zipfel, Stephan; Herrmann-Werner, Anne

2015-09-28

This paper is an up-to-date systematic review on educational interventions addressing history taking. The authors noted that despite the plethora of specialized training programs designed to enhance students' interviewing skills there had not been a review of the literature to assess the quality of each published method of teaching history taking in undergraduate medical education based on the evidence of the program's efficacy. The databases PubMed, PsycINFO, Google Scholar, opengrey, opendoar and SSRN were searched using key words related to medical education and history taking. Articles that described an educational intervention to improve medical students' history-taking skills were selected and reviewed. Included studies had to evaluate learning progress. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Seventy-eight full-text articles were identified and reviewed; of these, 23 studies met the final inclusion criteria. Three studies applied an instructional approach using scripts, lectures, demonstrations and an online course. Seventeen studies applied a more experiential approach by implementing small group workshops including role-play, interviews with patients and feedback. Three studies applied a creative approach. Two of these studies made use of improvisational theatre and one introduced a simulation using Lego® building blocks. Twenty-two studies reported an improvement in students' history taking skills. Mean MERSQI score was 10.4 (range 6.5 to 14; SD = 2.65). These findings suggest that several different educational interventions are effective in teaching history taking skills to medical students. Small group workshops including role-play and interviews with real patients, followed by feedback and discussion, are widespread and best investigated. Feedback using videotape review was also reported as particularly instructive. Students in the early preclinical state might profit from approaches helping

The food industry and provincial economies.

Science.gov (United States)

Walsh, Greg; Li, Duo

2004-01-01

This paper discusses the significance of the food industry for the Zhejiang provincial economy and for provincial economies generally. It is suggested that the strong ties between the food industry and provincial economies in China means that the food industry can be a key influence in the economic development of regional China. Moreover, the geographically diffuse nature of the food industry in China gives the industry a strategic significance in countering regional inequality within and between provinces, a by-product of China's rapid growth over the past 25 years. For these reasons, change in the food industry, whether it has its origins in the introduction of western fast foods, or in environmental, technological or economic trends, not only assumes significance for the health of the Chinese people (as other papers presented to the International Cuisine and Health Workshop at Hangzhou have pointed out), but also for the wealth of the nation and the way that wealth is distributed.

Patterns of wolf pack movements prior to kills as read from tracks in Algonquin Provincial Park, Ont., Canada

NARCIS (Netherlands)

Frijlink, Jan Hilco

1977-01-01

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

The History, Biology and Medical Aspects of Leprosy.

Science.gov (United States)

Eichman, Phillip

1999-01-01

Presents information about the history, biology, and medical aspects of leprosy, including its description in historical documents, its cause and effects, statistics on its prevalence, and various attempts at treatment. Notes that leprosy is one of the few infectious diseases that, although treatable with medication, remains incurable. Contains 30…

Dispatch from the non-HITECH-incented Health IT world: electronic medication history adoption and utilization.

Science.gov (United States)

Gabriel, Meghan Hufstader; Smith, Jaime Y; Sow, Max; Charles, Dustin; Joseph, Seth; Wilkins, Tricia Lee

2016-05-01

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: journals.permissions@oup.com.

Provincial logistics capability and economic development in South Africa

CSIR Research Space (South Africa)

Mashoko, L

2013-07-01

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...

[The life of medical historian Miki Sakae, and the "history of Korean medicine and of diseases in Korea"].

Science.gov (United States)

Kim, Ho

2005-12-01

Miki Sakae was a Medical historian, who is well known for his studies of Korean medicine. He authored the renowned trilogy which dealt with subjects of Korean medicine and diseases, namely the "History of Korean Medicine and of Diseases in Korea", "Bibliography of Korean Medical Books", and "The Chronological Table of Medical Events in Korea"), during the Japanese Occupation period. He was born in 1903 in Osaka, Japan, and graduated from the Kyushu College of Medicine. In 1928 he was assigned to the Gyeongseong Imperial University's College of Medicine as a professor, and also served as Chief of the Suweon Provincial Hospital while he was staying in Korea. During the 18-year period of his stay, he widely collected medical books of Korea and also thoroughly studied them. He returned to Japan in 1944 due to the illness of his father, but continued his studies of Korean medicine, and in 1955 published the "History of Korean Medicine and of Diseases in Korea" for the first time. Following such accomplishment, "Bibliography of Korean Medical Books" was published in 1956, the next year, and finally "The Chronological Table of Medical Events in Korea" was published a few decades later, in 1985. Since the 1950s, aside of continuing to study and author the history of Korean medicine, he had also engaged himself in a joint effort associated with the members of the Medical History Association of Japan (which also included the alumni of the Kyushu College of Medicine) in a group study of Huseya Soteki, the first Japanese Experimental Physiologist. He also attempted at establishing an academic branch which could be referred to as Experimental Historical Studies of Medicine, by recreating the experiments of Huseya Soteki with his own son. Later he also expanded his interest and studies to the medical history of the world and also the area of Medical Ethics. But his ultimate interest and passion were always targeted at the Medicine of Korea, and the one consistent position he

Geographic Medical History: Advances in Geospatial Technology Present New Potentials in Medical Practice

Science.gov (United States)

Faruque, F. S.; Finley, R. W.

2016-06-01

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

Utilisation of Antenatal Services at the Provincial Hospital, Mongomo ...

African Journals Online (AJOL)

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 ...

South African Medical Journal

African Journals Online (AJOL)

The South African Medical Journal is published by the South African Medical Association, which represents ... G Watermeyer, S Thomson, 399-402 ... Assessing the value of Western Cape Provincial Government health administrative data and ...

History and development of medical physics and medical physicist in Japan

International Nuclear Information System (INIS)

Toyofuku, F.

2014-01-01

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)

Provincial nuclear regulatory authority?: The case of the province of Cordoba

International Nuclear Information System (INIS)

Martin, Hugo; Ocana, F.; Scoles, R.

1999-01-01

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

Adolescents' knowledge of medical terminology and family health history.

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Hastrup, J L; Phillips, S M; Vullo, K; Kang, G; Slomka, L

1992-01-01

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.

The Establishment and operation of Longjing Medical College - The History of Longjing Medical College as Frontier History: Focusing on its ‘Disconnection’ and ‘Continuity’ -

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Mira MOON

2017-08-01

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

Disparity and convergence: Chinese provincial government health expenditures.

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Pan, Jay; Wang, Peng; Qin, Xuezheng; Zhang, Shufang

2013-01-01

The huge regional disparity in government health expenditures (GHE) is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.

Disparity and convergence: Chinese provincial government health expenditures.

Directory of Open Access Journals (Sweden)

Jay Pan

Full Text Available The huge regional disparity in government health expenditures (GHE is a major policy concern in China. This paper addresses whether provincial GHE converges in China from 1997 to 2009 using the economic convergence framework based on neoclassical economic growth theory. Our empirical investigation provides compelling evidence of long-term convergence in provincial GHE within China, but not in short-term. Policy implications of these empirical results are discussed.

Investor sentiment and stock returns: Evidence from provincial TV audience rating in China

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Zhang, Yongjie; Zhang, Yuzhao; Shen, Dehua; Zhang, Wei

2017-01-01

In this paper, we advocate the provincial TV audience rating as the novel proxy for the provincial investor sentiment (PIS) and investigate its relation with stock returns. The empirical results firstly show that the PIS is positively related to stock returns. Secondly, we provide direct evidence on the existence of home bias in China by observing that the provincial correlation coefficient is significantly larger than the cross-provincial correlation coefficient. Finally, the PIS can explain a large proportion of provincial comovement. To sum up, all these findings support the role of the non-traditional information sources in understanding the ;anomalies; in stock market.

Energy productivity and Chinese local officials’ promotions: Evidence from provincial governors

International Nuclear Information System (INIS)

Chen, Xiude; Qin, Quande; Wei, Y.-M.

2016-01-01

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.

Secrets and Lies: Sex Education and Gendered Memories of Childhood's End in an Australian Provincial City, 1930s-1950s

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May, Josephine

2006-01-01

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…

An analysis of the performance of Black African junior provincial ...

African Journals Online (AJOL)

been investigated. 1. It was found that these processes were effective in increasing participation of senior black provincial players between. 1996 and 2008. There were ... players were performing at junior provincial level but have not been afforded the ..... batsmen have performed consistently well between 2004 and 2010.

A system dynamics model of coordinated development of central and provincial economy and oil enterprises

International Nuclear Information System (INIS)

Ge, Feng-Long; Fan, Ying

2013-01-01

Based on the characteristics of oil exploration and development and the inherent rule of a coordinated development of central and provincial economy and oil enterprises in oil producing provinces, this paper addresses the principal questions that determine the coordinated development of the central economy, provincial economy and oil enterprises, and establishes a dynamic model for the above three variables. The research takes Shaanxi Province as an example and makes analogue simulation of the situations from 2006 to 2020. The results indicate that China's provincial governments need to share more tax income, reform some taxes on oil enterprises, and China's oil industry needs to be open to both provincial state-owned enterprise and private enterprise. Meanwhile, this research also provides policy proposals for the coordinated development of central and provincial economy and oil enterprises regarding taxation and sustainable development in China's market-oriented economy. - Highlights: • Chinese provincial government should share more oil enterprises' income tax. • Diversifying sources of investment is able to boost provincial economic development. • Compensation for environment relieves provincial governments' financial pressure. • People's welfare hinges on oil enterprises, provincial governments and tax reform

Provincial corruption and local development bank performance

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Murharsito Murharsito

2017-03-01

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.

On the borderland of medical and disability history: a survey of the fields.

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Linker, Beth

2013-01-01

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.

A brief history of medical education in Sub-Saharan Africa.

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Monekosso, G L

2014-08-01

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.

Research on carbon emission driving factors of China’s provincial construction industry

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Shang, Mei; Dong, Rui; Fu, Yujie; Hao, Wentao

2018-03-01

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.

Nature Conservation Division, Transvaal Provincial Administration.

African Journals Online (AJOL)

Nature Conservation Division, Transvaal Provincial Administration. ... The surrogate mothers consisted of a wooden box base covered with 12 gauge iron mesh. This .... Data available for F at the age of five months are included in this table for.

Provincial responsibility for carbon emissions in China under different principles

International Nuclear Information System (INIS)

Zhang, Youguo

2015-01-01

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.

Medical History of Elderly Patients in the Emergency Setting: Not an Easy Point-of-Care Diagnostic Marker

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Tobias Lindner

2015-01-01

Full Text Available Background. Medical histories are a crucially important diagnostic tool. Elderly patients represent a large and increasing group of emergency patients. Due to cognitive deficits, taking a reliable medical history in this patient group can be difficult. We sought to evaluate the medical history-taking in emergency patients above 75 years of age with respect to duration and completeness. Methods. Anonymous data of consecutive patients were recorded. Times for the defined basic medical history-taking were documented, as were the availability of other sources and times to assess these. Results. Data of 104 patients were included in the analysis. In a quarter of patients (25%, n=26 no complete basic medical history could be obtained. In the group of patients where complete data could be gathered, only 16 patients were able to provide all necessary information on their own. Including other sources like relatives or GPs prolonged the time until complete medical history from 7.3 minutes (patient only to 26.4 (+relatives and 56.3 (+GP minutes. Conclusions. Medical histories are important diagnostic tools in the emergency setting and are prolonged in the elderly, especially if additional documentation and third parties need to be involved. New technologies like emergency medical cards might help to improve the availability of important patient data but implementation of these technologies is costly and faces data protection issues.

77 FR 45717 - Proposed Information Collection (Former Prisoner of War Medical History); Comment Request

Science.gov (United States)

2012-08-01

... use of other forms of information technology. Title: Former Prisoner of War (FPOW) Medical History, VA... Prisoner of War veteran. VA will use the data collected as a guide and reference for treatment planning for... Prisoner of War Medical History); Comment Request AGENCY: Veterans Health Administration, Department of...

The Spatio-Temporal Characteristics and Modeling Research of Inter-Provincial Migration in China

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Xiaomei Fan

2018-02-01

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.

Energy conservation in China: Key provincial sectors at two-digit level

International Nuclear Information System (INIS)

Liao, Hua; Du, Jian; Wei, Yi-Ming

2013-01-01

Highlights: ► We identify the keys for energy conversation across China’s 31 provinces × 65 sectors. ► The results are visualized in map and matrix tables, and easy for use. ► 39 Industrial sectors by province are classified into three categories for conservation. ► There is large energy wasting in the public management sector. ► There are both urban–rural gap and provincial inequality on electricity consumption. - Abstract: In March 2011, China’s central government set a new challenging target of reducing its energy intensity by 16% during 2011–2015, after it had achieved a reduction of 19.1% during 2006–2010. And this new target was assigned to provincial authorities in August 2011. However, China’s provincial energy-economic developments are unbalanced and different provinces have different key sectors for energy conservation. Most previous studies focused on provincial energy efficiency at the aggregate level, or the three-industry level (or one-digit level). However, whether for policy decision or academic research, it is necessary to further subdivide the sectors. In this paper, we use three indicators (Gini Coefficient, energy consumption share and energy intensity) to compare provincial energy conservation potentials at the two-digit sector level. To our knowledge, this paper is the first one to identify the keys for energy conversation across the 31 provinces × 65 sectors. And the results are shown in visualized maps and matrix tables to help identify the key province × sectors for energy conservation easier. This also helps the central and provincial governments to distinguish key sectors when they monitor the energy conservation progress

Medical history for the masses: how American comic books celebrated heroes of medicine in the 1940s.

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Hansen, Bert

2004-01-01

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.

The Oral History Program: II. Personal views of health sciences librarianship and the Medical Library Association.

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McKenzie, D; Pifalo, V

1998-07-01

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.

Medical education in a foreign language and history-taking in the native language in Lebanon – a nationwide survey

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Vanda Abi Raad

2016-11-01

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.

Accounting and Accountability by Provincial Councils in Fiji: the Case of Namosi

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Nacanieli Rika

2008-03-01

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.

The humanising power of medical history: responses to biomedicine in the 20th century United States.

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Warner, John Harley

2011-12-01

Most American historians of medicine today would be very hesitant about any claim that medical history humanises doctors, medical students or the larger health care enterprise. Yet, the idea that history can and ought to serve modern medicine as a humanising force has been a persistent refrain in American medicine. This essay explores the emergence of this idea from the end of the 19th century, precisely the moment when modern biomedicine became ascendant. At the same institutions where the new version of scientific medicine was most energetically embraced, some professional leaders warned that the allegiance to science driving the profession's technical and cultural success was endangering humanistic values fundamental to professionalism and the art of medicine. They saw in history a means for rehumanising modern medicine and countering the risk of cultural crisis. While some iteration of this vision of history was remarkably durable, the meanings attached to 'humanism' were both multiple and changing, and the role envisioned for history in a humanistic intervention was transformed. Starting in the 1960s as part of a larger cultural critique of the putative 'dehumanisation' of the medical establishment, some advocates promoted medical history as a tool to help fashion a new kind of humanist physician and to confront social inequities in the health care system. What has persisted across time is the way that the idea of history as a humanising force has almost always functioned as a discourse of deficiency-a response to perceived shortcomings of biomedicine, medical institutions and medical professionalism.

Medical cannabis: considerations for the anesthesiologist and pain physician.

Science.gov (United States)

Beaulieu, Pierre; Boulanger, Aline; Desroches, Julie; Clark, Alexander J

2016-05-01

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.

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

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

2016-01-01

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

[The role of chronic gastritis in past medical history with NSAID administration in patients with osteoarthrosis].

Science.gov (United States)

Zak, M Iu

2014-11-01

122 patients with osteoarthrosis, who have in the past medical history verified chronic gastritis (50 males and 72 females) at the age from 42 to 64 have been examined. Control group was comprised of 40 patients with osteoarthrosis without gastroduodenal zone pathology in the past medical history. For arthralgia relief patients were prescribed meloxicam (average dose--12.5 - 1.39 mg daily) or nimesulide (average dose--150 ± 14.91 mg daily). As a result of this research it was determined that administration of selective NSAID (meloxicam and nimesulide) in patients with chronic gastritis in the past medical history raised the risk of NSAID gastropathy/dyspepsia 2.9 times (P 0.05) of erosive gastropathy. Patients with chronic gastritis in the past medical history when taking NSAID with the purpose of gastropathy prevention are recommended to undergo gastroprotective therapy.

Medical history and the onset of complex regional pain syndrome (CRPS).

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de Mos, M; Huygen, F J P M; Dieleman, J P; Koopman, J S H A; Stricker, B H Ch; Sturkenboom, M C J M

2008-10-15

Knowledge concerning the medical history prior to the onset of complex regional pain syndrome (CRPS) might provide insight into its risk factors and potential underlying disease mechanisms. To evaluate prior to CRPS medical conditions, a case-control study was conducted in the Integrated Primary Care Information (IPCI) project, a general practice (GP) database in the Netherlands. CRPS patients were identified from the records and validated through examination by the investigator (IASP criteria) or through specialist confirmation. Cases were matched to controls on age, gender and injury type. All diagnoses prior to the index date were assessed by manual review of the medical records. Some pre-specified medical conditions were studied for their association with CRPS, whereas all other diagnoses, grouped by pathogenesis, were tested in a hypothesis-generating approach. Of the identified 259 CRPS patients, 186 cases (697 controls) were included, based on validation by the investigator during a visit (102 of 134 visited patients) or on specialist confirmation (84 of 125 unvisited patients). A medical history of migraine (OR: 2.43, 95% CI: 1.18-5.02) and osteoporosis (OR: 2.44, 95% CI: 1.17-5.14) was associated with CRPS. In a recent history (1-year before CRPS), cases had more menstrual cycle-related problems (OR: 2.60, 95% CI: 1.16-5.83) and neuropathies (OR: 5.7; 95% CI: 1.8-18.7). In a sensitivity analysis, including only visited cases, asthma (OR: 3.0; 95% CI: 1.3-6.9) and CRPS were related. Psychological factors were not associated with CRPS onset. Because of the hypothesis-generating character of this study, the findings should be confirmed by other studies.

How important is medical ethics and history of medicine teaching in the medical curriculum? An empirical approach towards students' views.

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Schulz, Stefan; Woestmann, Barbara; Huenges, Bert; Schweikardt, Christoph; Schäfer, Thorsten

2012-01-01

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. 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)). 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. 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 impact. Therefore the teaching of GTE

How Important is Medical Ethics and History of Medicine Teaching in the Medical Curriculum? An Empirical Approach towards Students' Views

Science.gov (United States)

Schulz, Stefan; Woestmann, Barbara; Huenges, Bert; Schweikardt, Christoph; Schäfer, Thorsten

2012-01-01

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

Linkage of the Canadian Study of Health and Aging to provincial administrative health care databases in Nova Scotia.

Science.gov (United States)

Yip, A M; Kephart, G; Rockwood, K

2001-01-01

The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health

An Effective Teaching Method to Enhance History-Taking Skills for Chinese Medical Students

Science.gov (United States)

Huang, Simin; Xu, Peng; Feng, Lie; Lu, Chunting; Yang, Jing

2018-01-01

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…

Radiation oncology and medical physicists quality assurance in British Columbia Cancer Agency Provincial Prostate Brachytherapy Program.

Science.gov (United States)

Keyes, Mira; Morris, William James; Spadinger, Ingrid; Araujo, Cynthia; Cheung, Arthur; Chng, Nick; Crook, Juanita; Halperin, Ross; Lapointe, Vince; Miller, Stacy; Pai, Howard; Pickles, Tom

2013-01-01

To describe in detail British Columbia (BC) Cancer Agency (BCCA) Provincial Prostate Brachytherapy (PB) Quality Assurance (QA) Program. The BCCA PB Program was established in 1997. It operates as one system, unified and supported by electronic and information systems, making it a single PB treatment provider for province of BC and Yukon. To date, >4000 patients have received PB (450 implants in 2011), making it the largest program in Canada. The Program maintains a large provincial prospective electronic database with records on all patients, including disease characteristics, risk stratification, pathology, preplan and postimplant dosimetric data, follow-up of prostate-specific antigen, and toxicity outcomes. QA was an integral part of the program since its inception. A formal QA Program was established in 2002, with key components that include: unified eligibility criteria and planning system, comprehensive database, physics and oncologist training and mentorship programs, peer review process, individual performance outcomes and feedback process, structured continuing education and routine assessment of the program's dosimetry, toxicity and prostate-specific antigen outcomes, administration and program leadership that promotes a strong culture of patient safety. The emphasis on creating a robust, broad-based network of skilled providers has been achieved by the program's requirements for training, education, and the QA process. The formal QA process is considered a key factor for the success of cancer control outcomes achieved at BCCA. Although this QA model may not be wholly transferable to all PB programs, some of its key components may be applicable to other programs to ensure quality in PB and patient safety. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

The library of the Royal Society of Physicians in Budapest becomes today's Semmelweis Medical History Library.

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Kaproncszay, Katalin; Magyar, László András; Putnam, Constance E

2011-01-01

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. 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. 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. 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.

Giuseppe and Aloysius Frari's works on rabies and history of Frari medical family of Sibenik, Dalmatia.

Science.gov (United States)

Krnić, Anton

2007-06-01

This article is an attempt to reconstruct the family history of the Fraris, the famous Sibenik medical family. Three generations of physicians from the Frari family played an important role not only at medical and social scene of Sibenik in the 18th and 19th century, but also in Croatian and Italian medical history. I will try to provide important details on the lives, medical and social work, and publications of 5 members of the family, Giuseppe (Josip), Angelo Antonio (Andeo Antun), Sebastiano (Sebastijan), Michele Carlo (Mihovil), and Aloysius (Luigi) Frari. I would also like to pay a special attention to the works on rabies, written by Giuseppe and Luigi Frari, which are among the earliest and most accurate Croatian works on the subject. To reconstruct the history of the family, I studied the relevant editions about the medical and social history of Sibenik, Dalmatia, Venice, and Croatia, together with the Fraris' publications and reflections. This was the first time Italian and Latin language works by Giuseppe and Luigi Frari on rabies were analyzed. The story on Fraris also documents that medical publishing was a common practice in Dalmatia in the 18th and the 19th century.

Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study.

LENUS (Irish Health Repository)

Macfarlane, T V

2012-04-01

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.

GEOGRAPHIC MEDICAL HISTORY: ADVANCES IN GEOSPATIAL TECHNOLOGY PRESENT NEW POTENTIALS IN MEDICAL PRACTICE

Directory of Open Access Journals (Sweden)

F. S. Faruque

2016-06-01

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

Evaluation of computer-based medical histories taken by patients at home.

Science.gov (United States)

Slack, Warner V; Kowaloff, Hollis B; Davis, Roger B; Delbanco, Tom; Locke, Steven E; Safran, Charles; Bleich, Howard L

2012-01-01

The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the history and post-history assessment questionnaire and were for the most part positive in their assessment; and 23 continued on to complete their post-visit assessment questionnaire and were for the most part positive about the helpfulness of the history and its summary at the time of their visit with the doctor. The doctors in turn strongly favored the immediate, routine use of two modules of the history--the family and social histories--for all their new patients. The doctors suggested further that the summaries of the other modules of the history be revised and shortened to make it easier for them to focus on clinical issues in the order of their preference.

How is Funding Medical Research Better for Patients?

Directory of Open Access Journals (Sweden)

Jennifer D. Zwicker

2015-08-01

Full Text Available With rising health care costs, often health research is viewed as a major cost driver, calling to question the role and value of provincial funding of health research. Most agree that the quality of healthcare provided is directly linked to our ability to conduct quality research; however currently there is little empirical evidence supporting the link between engagement in health research and healthcare performance. In Canada this has resulted in funding for health research that varies over time and between provinces. While medical knowledge is a public good, we hypothesize there are local benefits from health research, such as the attraction of a specialized human capital workforce, which fosters a culture of innovation in clinical practice. To address this question, we look at whether health outcomes are impacted by changes in provincial research funding in Alberta compared to other provinces. Provincial funding for medical research, which varies greatly over time and among provinces, is used as a proxy for medical treatment inputs. Trend rates of reduction in mortality from potentially avoidable causes (MPAC (comprised of mortality from preventable causes (MPC and mortality from treatable causes (MTC, are used as a proxy health outcome measure sensitive to the contributions of technological progress in medical treatment. Our analysis suggests that investment in health research has payback in health outcomes, with greater improvements in the province where the research occurs. The trend declines seen in age standardized MPAC rates in different Canadian provinces may be impacted by shifts in provincial research funding investment, suggesting that knowledge is not transferred without cost between provinces. Up until the mid-1980s, Alberta had the most rapid rate of decline in MPAC compared to the other provinces. This is striking given the large and unique investment in medical research funding in Alberta in the early 1980s through AHFMR, the

History of TB in the Sudan | Zaki | Sudan Journal of Medical Sciences

African Journals Online (AJOL)

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 ...

Evaluation of medical record quality and communication skills among pediatric interns after standardized parent training history-taking in China.

Science.gov (United States)

Yu, Mu Xue; Jiang, Xiao Yun; Li, Yi Juan; Shen, Zhen Yu; Zhuang, Si Qi; Gu, Yu Fen

2018-02-01

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.

[The origin, diffusion and development of healing doctrines in medical history--exemplified by homeopathy].

Science.gov (United States)

Schmidt, Josef M

2007-01-01

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.

Survey of the sevoflurane sedation status in one provincial dental clinic center for the disabled

Science.gov (United States)

Park, Chang-hyun

2016-01-01

Background Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. Methods We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016. Results We analyzed 387 cases (215 male patients, 172 female patients). Male patients aged 20 year or older accounted for 39.0% of all patients, marking the highest proportion. Patient's lack of cooperation was the most common reason for performing dental sedation. Prosthetic treatment was the most frequently practiced, accounting for 174 treatment cases. The mean lengths of the entire treatment and of the dental procedure were 55.2 min and 39.8 min, respectively. Conclusions Sevoflurane sedation has the advantage of fast anesthesia induction and recovery compared to general anesthesia; therefore, it can be used efficiently to induce anesthesia in pediatric and disabled patients during short dental procedures, enabling stable treatment of these patients. PMID:28879316

A Preoperative Medical History and Physical Should Not Be a Requirement for All Cataract Patients.

Science.gov (United States)

Schein, Oliver D; Pronovost, Peter J

2017-07-01

Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery. We propose that the minority of patients who might benefit from a preoperative medical history and physical can be identified prospectively. Regulatory agencies should not constrain medical practice in a way that adds enormous cost and patient burden in the absence of value.

Evaluation of forensic medical history taking from the child in cases of child physical and sexual abuse and neglect.

Science.gov (United States)

Drummond, Rachel; Gall, John A M

2017-02-01

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.

Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

Directory of Open Access Journals (Sweden)

Simon Munyua

2015-08-01

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

The Investigation of the Patent Resources of Main Provincial Academies of Sciences and Its Management

OpenAIRE

Zeng Jing

2017-01-01

[Purpose/significance] The provincial academy of sciences is an important part of national-wide scientific academies and regional innovation system. Promoting the transformation of the intellectual property is an important work for provincial academy of sciences. Nobody has ever revealed the status of the intellectual property resources and its management strategy of the provincial academy of sciences. [Method/process] With the methods of bibliometrics and investigations, this paper revealed ...

Analyzing the present Yunnan provincial condition and countermeasure of radioactive environmental management

International Nuclear Information System (INIS)

Zhang Jianping; Sun Ye; Zhou Liqiang

2005-01-01

Being aware of the present Yunnan provincial realities of the nuclear technology application, the present supervision conditions on nuclear safety and radioactive environment are analysed. Some suggestions, such as constituting Yunnan supervision structure of radioactive environment, demonstrating radiation supervisions in critical regions, and speeding up the system development of Yunnan provincial supervision on radiation environment, are brought out to the details. (authors)

[Medication reconciliation: an innovative experience in an internal medicine unit to decrease errors due to inacurrate medication histories].

Science.gov (United States)

Pérennes, Maud; Carde, Axel; Nicolas, Xavier; Dolz, Manuel; Bihannic, René; Grimont, Pauline; Chapot, Thierry; Granier, Hervé

2012-03-01

An inaccurate medication history may prevent the discovery of a pre-admission iatrogenic event or lead to interrupted drug therapy during hospitalization. Medication reconciliation is a process that ensures the transfer of medication information at admission to the hospital. The aims of this prospective study were to evaluate the interest in clinical practice of this concept and the resources needed for its implementation. We chose to include patients aged 65 years or over admitted in the internal medicine unit between June and October 2010. We obtained an accurate list of each patient's home medications. This list was then compared with medication orders. All medication variances were classified as intended or unintended. An internist and a pharmacist classified the clinical importance of each unintended variance. Sixty-one patients (mean age: 78 ± 7.4 years) were included in our study. We identified 38 unintended discrepancies. The average number of unintended discrepancies was 0.62 per patient. Twenty-five patients (41%) had one or more unintended discrepancies at admission. The contact with the community pharmacist permitted us to identify 21 (55%) unintended discrepancies. The most common errors were the omission of a regularly used medication (76%) and an incorrect dosage (16%). Our intervention resulted in order changes by the physician for 30 (79%) unintended discrepancies. Fifty percent of the unintended variances were judged by the internist and 76% by the pharmacist to be clinically significant. The admission to the hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Empirical Study of China’s Provincial Carbon Responsibility Sharing: Provincial Value Chain Perspective

Directory of Open Access Journals (Sweden)

Rui Xie

2017-04-01

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.

Writing women into medical history in the 1930s: Kate Campbell Hurd-Mead and "medical women" of the past and present.

Science.gov (United States)

Appel, Toby A

2014-01-01

Kate Campbell Hurd-Mead (1867–1941), a leader among second-generation women physicians in America, became a pioneer historian of women in medicine in the 1930s. The coalescence of events in her personal life, the declining status of women in medicine, and the growing significance of the new and relatively open field of history of medicine all contributed to this transformation in her career. While she endeavored to become part of the community of male physicians who wrote medical history, her primary identity remained that of a “medical woman.” For Hurd-Mead, the history of women in the past not only filled a vital gap in scholarship but served practical ends that she had earlier pursued by other means—those of inspiring and advancing the careers of women physicians of the present day, promoting organizations of women physicians, and advocating for equality of opportunity in the medical profession.

Implementation of an IT-guided checklist to improve the quality of medication history records at hospital admission.

Science.gov (United States)

Huber, Tanja; Brinkmann, Franziska; Lim, Silke; Schröder, Christoph; Stekhoven, Daniel Johannes; Marti, Walter Richard; Egger, Richard Robert

2017-12-01

Background Medication discrepancies often occur at transition of care such as hospital admission and discharge. Obtaining a complete and accurate medication history on admission is essential as further treatment is based on it. Objective The goal of this study was to reduce the proportion of patients with at least one medication discrepancy in the medication history at admission by implementing an IT-guided checklist. Setting Surgery ward focused on vascular and visceral surgery at a Swiss Cantonal Hospital. Method The study was divided into two phases, before and after implementation of an IT-guided checklist. For both phases a pharmacist collected and compared the medication history (defined as gold standard) with that of the admitting physician. Medication discrepancies were subdivided in omissions and commissions, incorrect medications or dose changes, and incorrect dosage forms or strength. Main outcome measure The proportion of patients with at least one medication discrepancy in the medication history before and after intervention was assessed. Results Out of 415 admissions, 228 patients that met the inclusion criteria were enrolled in the study, 113 before and 115 patients after intervention. After intervention, medication discrepancies declined from 69.9 to 29.6% (p < 0.0001) of patients, the mean medication discrepancy per patient was reduced from 2.3 to 0.6 (p < 0.0001), and the most common error, omission of a regularly used medication, was reduced from 76.4 to 44.1% (p < 0.001). Conclusion The implementation of the IT-guided checklist is associated with a significant reduction of medication discrepancies at admission and potentially improves the medication safety for the patient.

Making Canada a destination for medical tourists: why Canadian provinces should not try to become "Mayo Clinics of the North".

Science.gov (United States)

Turner, Leigh

2012-05-01

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.

Cardiac arrest while exercising on mountains in national or provincial parks: A national observational study from 2012 to 2015.

Science.gov (United States)

Jung, Eujene; Park, Jeong Ho; Kong, So Yeon; Hong, Ki Jeong; Ro, Young Sun; Song, Kyoung Jun; Ryu, Hyun Ho; Shin, Sang Do

2017-12-20

Previous studies on cardiac arrest in mountainous areas were focused on environmental features such as altitude and temperature. However, those are limited to factors affecting the prognosis of patients after cardiac arrest. We analyzed the cardiac arrests in national or provincial parks located in the mountains and determined the factors affecting the prognosis of patients after cardiac arrest. This study included all emergency medical service (EMS) treated patients over the age of 40 experiencing out-of-hospital cardiac arrests (OHCAs) of presumed cardiac etiology during exercise, between January 2012 and December 2015. The main focus of interest was the location of cardiac arrest occurrence (national mountain parks and provincial parks vs. other sites). The main outcome was survival to discharge and multivariable logistic regression was performed to adjust for possible confounding effects. A total 1835 patients who suffered a cardiac arrest while exercising were included. From these, 68 patients experienced cardiac arrest in national or provincial parks, and 1767 occurred in other locations. The unadjusted and adjusted ORs (95% CI) for a good cerebral performance scale (CPC) were 0.09 (0.01-0.63) and 0.08(0.01-0.56), survival discharges were 0.13(0.03-0.53) and 0.11 (0.03-0.48). Cardiac arrests occurring while exercising in the mountainous areas have worse prognosis compared to alternative locations. Copyright © 2017. Published by Elsevier Inc.

[Thoughts and methods of study on acupuncture medical history: an example of Mr. MA Ji-Xing].

Science.gov (United States)

Yang, Feng; Zhu, Ling

2014-03-01

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.

Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students.

Science.gov (United States)

Allami, Abbas; Mohammadi, Navid; Najar, Azade

2014-04-01

We conducted this study to assess the seroprevalence of Varicella zoster virus (VZV) antibodies in a group of Iranian medical sciences students that were at risk of Varicella and the value of self-reported history as a predictor of immunity. 255 medical, nursing and obstetrics students who had not entered as a student or worked in a hospital from 3 different schools were enrolled in the study in 2012 (Qazvin province, Iran). Demographics and other information as well as the history of Varicella were obtained through a self-administered questionnaire. Blood samples were collected to determine the Varicella IgG levels via an enzyme-linked immunosorbent assay. A statistical analysis was performed by calculating prevalences and their 95% confidence intervals. Sensitivity, specificity, positive and negative predictive values, Cohen's kappa and positive and negative likelihood ratios of recalled history were determined. p history with immunity against the virus were statistically significant. The overall rate of reported history was 57%. The positive and negative predictive values of self-reported history of Varicella were 91% and 47.3%, respectively. Immunization of students of Iranian medical sciences seems logical in the near future. Also, they should be tested for Varicella immunity regardless of the history of previous infection.

A hybrid method for provincial scale energy-related carbon emission allocation in China.

Science.gov (United States)

Bai, Hongtao; Zhang, Yingxuan; Wang, Huizhi; Huang, Yanying; Xu, He

2014-01-01

Achievement of carbon emission reduction targets proposed by national governments relies on provincial/state allocations. In this study, a hybrid method for provincial energy-related carbon emissions allocation in China was developed to provide a good balance between production- and consumption-based approaches. In this method, provincial energy-related carbon emissions are decomposed into direct emissions of local activities other than thermal power generation and indirect emissions as a result of electricity consumption. Based on the carbon reduction efficiency principle, the responsibility for embodied emissions of provincial product transactions is assigned entirely to the production area. The responsibility for carbon generation during the production of thermal power is borne by the electricity consumption area, which ensures that different regions with resource endowments have rational development space. Empirical studies were conducted to examine the hybrid method and three indices, per capita GDP, resource endowment index and the proportion of energy-intensive industries, were screened to preliminarily interpret the differences among China's regional carbon emissions. Uncertainty analysis and a discussion of this method are also provided herein.

Effect of teaching and checklist implementation on accuracy of medication history recording at hospital admission.

Science.gov (United States)

Lea, Marianne; Barstad, Ingeborg; Mathiesen, Liv; Mowe, Morten; Molden, Espen

2016-02-01

Medication discrepancies at hospital admission is an extensive problem and knowledge is limited regarding improvement strategies. To investigate the effect of teaching and checklist implementation on accuracy of medication history recording during hospitalization. Patients admitted to an internal medicine ward were prospectively included in two consecutive periods. Between the periods, non-mandatory teaching lessons were provided and a checklist assisting medication history recording implemented. Discrepancies between the recorded medications at admission and the patient's actual drug use, as revealed by pharmacist-conducted medication reconciliation, were compared between the periods. The primary endpoint was difference between the periods in proportion of patients with minimum one discrepancy. Difference in median number of discrepancies was included as a secondary endpoint. 56 and 119 patients were included in period 1 (P1) and period 2 (P2), respectively. There was no significant difference in proportion of patients with minimum one discrepancy in P2 (68.9 %) versus P1 (76.8 %, p = 0.36), but a tendency of lower median number of discrepancies was observed in P2 than P1, i.e. 1 and 2, respectively (p = 0.087). More powerful strategies than non-mandatory teaching activities and checklist implementation are required to achieve sufficient improvements in medication history recording during hospitalization.

Making Canada a Destination for Medical Tourists: Why Canadian Provinces Should Not Try to Become “Mayo Clinics of the North”

Science.gov (United States)

Turner, Leigh

2012-01-01

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

The Search for Stability: Provincial Reconstruction Teams in Afghanistan

National Research Council Canada - National Science Library

Wardle, Russel

2004-01-01

... 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...

Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills

Directory of Open Access Journals (Sweden)

Keifenheim, Katharina Eva

2017-08-01

Full Text Available 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 not written does not exist': the importance of proper documentation of medication use history.

Science.gov (United States)

Silvestre, Carina Carvalho; Santos, Lincoln Marques Cavalcante; de Oliveira-Filho, Alfredo Dias; de Lyra, Divaldo Pereira

2017-10-01

Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44.8%). Similarly, in the medical charts of 52 (53.6%) paediatric patients, there was no record of parents and/or relatives interviews about prior use of medications. One hundred thirty-seven medical charts of adult patients (52.4%) and seventy-two medical charts of paediatric patients (74.2%) had no record about medication allergies and intolerances. In other words, there was a lack of basic documentation regarding the patient's medication use history. As patients move between settings in care, there is insufficient tracking of verbal and written information related to medication changes, which results in a progressive and cumulative loss of information, as evidenced by problems associated with clinical transfers and medication orders. Proper documentation of medication information during transfer is a key step in the procedure; hence, it should be rightly performed. It remains unclear whether interviews, and other investigations about medication use history have been performed but have not been recorded as health-care data. Therefore, it is crucial to the improvement of medication use safety that documentation of all drug-related information-even if not directly related to the actual event-become routine practice in health-care organizations, since 'what is not written does not exist'.

The end of medical confidentiality? Patients, physicians and the state in history.

Science.gov (United States)

Rieder, Philip; Louis-Courvoisier, Micheline; Huber, Philippe

2016-09-01

Medical confidentiality has come under attack in the public sphere. In recent disasters both journalists and politicians have questioned medical confidentiality and claimed that in specific contexts physicians should be compelled to communicate data on their patients' health. The murders of innocent individuals by a suicidal pilot and a Swiss convicted criminal have generated polemical debates on the topic. In this article, historical data on medical confidentiality is used to show that medical practices of secrecy were regularly attacked in the past, and that the nature of medical confidentiality evolved through time depending on physicians' values and judgements. Our demonstration is based on three moments in history. First, at the end of the 16th century, lay authorities put pressure on physicians to disclose the names of patients suffering from syphilis. Second, in the 18th century, physicians faced constant demands for information about patients' health from relatives and friends. Third, employers and insurance companies in the 20th century requested medical data on sick employees. In these three different situations, history reveals that the concept of medical confidentiality was plastic, modelled in the first instance to defend well-to-do patients, in the second instance it was adapted to accommodate the physician's social role and, finally, to defend universal values and public health. Medical secrecy was, and is today, a medical and societal norm that is shaped collectively. Any change in its definition and enforcement was and should be the result of negotiations with all social actors concerned. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Assessment of Medical Student and Resident/Fellow Knowledge, Comfort, and Training With Sexual History Taking in LGBTQ Patients.

Science.gov (United States)

Hayes, Victoria; Blondeau, Whitney; Bing-You, Robert G

2015-05-01

Sexual health is an important aspect of overall health. Barriers to taking an adequate patient sexual history exist. Few studies have explored medical learners' comfort, knowledge, and training surrounding taking sexual histories with lesbian, gay, bisexual, transgender, questioning/queer (LGBTQ) patients specifically. A 10-question survey was offered to medical students and resident/fellows at one US institution. Survey questions reflected participants' knowledge, comfort, and training related to sexual history taking with attention to LGBTQ care. A total of 159 surveys were returned (rate of 42%). A significantly lower level of comfort existed with taking sexual histories and managing sexual health issues in the LGBTQ segment of the patient population versus all patients, especially in the advanced training group. Participants recognized the importance of understanding their patients' overall sexual health, though medical students rated this as more important than the resident/fellow group did. A correlation existed between both comfort with taking sexual histories and discussing safe sexual practices and management of sexual issues, suggesting that further training would be helpful in this area. Twenty percent of the respondents reported receiving no training at all in eliciting sexual histories in LGBTQ patients. The most preferred format in this study for future training was interviewing standardized patients. Medical students and resident/fellows reported a significantly lower level of comfort with sexual history-taking and management of sexual issues in the LGBTQ population. A comprehensive training format that not only views sexual health as an integral part of overall patient health, but also integrates LGBTQ care, is needed in medical education.

Parochialism or self-consciousness? Internationality in medical history journals 1997-2006.

Science.gov (United States)

Steinke, Hubert; Lang, Yves

2011-10-01

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.

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

Science.gov (United States)

Echenberg, Donald

2007-11-28

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

Male marriage squeeze and inter-provincial marriage in central China: evidence from Anhui

Science.gov (United States)

Liu, Lige; Brown, Melissa J.; Feldman, Marcus W.

2015-01-01

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

Male marriage squeeze and inter-provincial marriage in central China: evidence from Anhui.

Science.gov (United States)

Liu, Lige; Jin, Xiaoyi; 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.

The many and conflicting histories of medical education in Canada and the USA: an introduction to the paradigm wars.

Science.gov (United States)

Hodges, Brian

2005-06-01

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.

Motorcycle Accident injuries seen at Kakamega Provincial Hospital ...

African Journals Online (AJOL)

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 ...

Functional classification of the Gauteng provincial road network ...

African Journals Online (AJOL)

The built environment consists of various land uses and activities connected by a road network. The efficiency and effectiveness of the road network directly impacts economic growth and societal movement. This study involved the functional classification of the Gauteng provincial road network using the South African Road ...

Toxic substances: Federal-provincial control. Revised edition. Current issue review No. 88-11E

Energy Technology Data Exchange (ETDEWEB)

Douglas, K; Johansen, D

1993-01-01

There is widespread public concern about the effect of toxic substances on human health and the environment. This document looks at the federal-provincial control on toxic substances. It specifically examines the control of toxic substances under the Canadian constitution; the political arena; the federal- provincial co-operation; the Green Plan; and the 1991 Auditor General's Report.

Provincialism within limits?

DEFF Research Database (Denmark)

Hesselager, Jens

2015-01-01

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...... 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...

Giuseppe and Aloysius Frari’s Works on Rabies and History of Frari Medical Family of Šibenik, Dalmatia

Science.gov (United States)

Krnić, Anton

2007-01-01

This article is an attempt to reconstruct the family history of the Fraris, the famous Šibenik medical family. Three generations of physicians from the Frari family played an important role not only at medical and social scene of Šibenik in the 18th and 19th century, but also in Croatian and Italian medical history. I will try to provide important details on the lives, medical and social work, and publications of 5 members of the family, Giuseppe (Josip), Angelo Antonio (Anđeo Antun), Sebastiano (Sebastijan), Michele Carlo (Mihovil), and Aloysius (Luigi) Frari. I would also like to pay a special attention to the works on rabies, written by Giuseppe and Luigi Frari, which are among the earliest and most accurate Croatian works on the subject. To reconstruct the history of the family, I studied the relevant editions about the medical and social history of Šibenik, Dalmatia, Venice, and Croatia, together with the Fraris’ publications and reflections. This was the first time Italian and Latin language works by Giuseppe and Luigi Frari on rabies were analyzed. The story on Fraris also documents that medical publishing was a common practice in Dalmatia in the 18th and the 19th century. PMID:17589982

A short history of medical informatics in bosnia and herzegovina.

Science.gov (United States)

Masic, Izet

2014-02-01

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.

Physical activity opportunities in Canadian childcare facilities: a provincial/territorial review of legislation.

Science.gov (United States)

Vanderloo, Leigh M; Tucker, Patricia; Ismail, Ali; van Zandvroort, Melissa M

2012-05-01

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.

Previous medical history of diseases in children with attention deficit hyperactivity disorder and their parents

Directory of Open Access Journals (Sweden)

Ayyoub Malek

2014-02-01

Full Text Available Introduction: The etiology of Attention deficit hyperactivity disorder (ADHD is complex and most likely includes genetic and environmental factors. This study was conducted to evaluatethe role of previous medical history of diseases in ADHD children and their parents during theearlier years of the ADHD children's lives. Methods: In this case-control study, 164 ADHD children attending to Child and AdolescentPsychiatric Clinics of Tabriz University of Medical Sciences, Iran, compared with 166 normal children selected in a random-cluster method from primary and guidance schools. ADHDrating scale (Parents version and clinical interview based on schedule for Schedule forAffective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version(K-SADS were used to diagnose ADHD cases and to select the control group. Two groupswere compared for the existence of previous medical history of diseases in children andparents. Fisher's exact test and logistic regression model were used for data analysis. Results: The frequency of maternal history of medical disorders (28.7% vs. 12.0%; P = 0.001was significantly higher in children with ADHD compared with the control group. The frequency of jaundice, dysentery, epilepsy, asthma, allergy, and head trauma in the medicalhistory of children were not significantly differed between the two groups. Conclusion: According to this preliminary study, it may be concluded that the maternal historyof medical disorders is one of contributing risk factors for ADHD.

Sex in the Curriculum: The Effect of a Multi-Modal Sexual History-Taking Module on Medical Student Skills

Science.gov (United States)

Lindau, Stacy Tessler; Goodrich, Katie G.; Leitsch, Sara A.; Cook, Sandy

2008-01-01

Purpose: The objective of this study was to determine the effect of a multi-modal curricular intervention designed to teach sexual history-taking skills to medical students. The Association of Professors of Gynecology and Obstetrics, the National Board of Medical Examiners, and others, have identified sexual history-taking as a learning objective…

On history of medical radiology in Ukraine: main directions of scientific development (1920-1941)

International Nuclear Information System (INIS)

Pilipenko, M.Yi.; Artamonova, N.O.; Busigyina, N.O.

1994-01-01

The work is devoted to the history of medical radiology in Ukraine. It deals with principal problems of scientific research development during 1920-1941. The authors describe both known and little known facts of the history of foundation and development of the first Ukrainian radiological, roentgenological and oncological institutes. Main achievements in radiology development i.e. foundation of large specialized research centres in Kharkov, kiev, Odessa, independent departments of roentgenology both at the majority of medical institutes and three advanced training institutes for doctors, organization of ALL-Union and Republican Congresses and Conferences of Radiologists, publication of a special journal > (Problems of Oncology) are described

Towards Cyber City: DKI Jakarta and Surabaya Provincial Government Digital Public Services

Directory of Open Access Journals (Sweden)

Mia Angeline

2016-10-01

Full Text Available The goal of this research was to do a comparative study on the use of information technology in DKI Jakarta Provincial Government through Jakarta.go.id website and Surabaya City Local Government through Surabaya.go.id website. This research focused on public services and interactive use of communication media. Research method used was descriptive qualitative. Data were collected through a depth interview with Jakarta.go.id and Surabaya.go.id website administrators, observation of digital data, literature review, and through secondary data. Data analysis was done through a constant comparative technique. The results indicates that diffusion innovation theory is used by provincial government to give digital public services. It means that the government is seeking people to adopt the use of information technology in the interaction with the government. Local and Provincial Government provides a media center for public services, which the public can access information and provide input to the government. Some of the challenges show that society is not fully ready to change from conventional public services to digital public services received from the government. There is a massive need to educate society while also providing free mobile internet services. Other than that, there is also a gap in internal governmental human resources skill and competences. As a solution to some of these problems, both DKI Jakarta and Surabaya Provincial Government need to apply information technology to achieve e-government and cyber city. 

Attitudes of Employees of Provincial Directorates of National Education and School Administrators towards Strategic Planning

Science.gov (United States)

Altinkurt, Yahya

2010-01-01

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…

Canadian energy and climate policies: A SWOT analysis in search of federal/provincial coherence

International Nuclear Information System (INIS)

Fertel, Camille; Bahn, Olivier; Vaillancourt, Kathleen; Waaub, Jean-Philippe

2013-01-01

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

Family history and medical examination of occupationally exposed employees against ionizing radiation

International Nuclear Information System (INIS)

Heinemann, G.

2000-01-01

Searching for individual radiosensitivity could improve the quality of the medical examination of occupationally exposed employees and thus provide real protection of the individual against ionizing radiation. For this purpose genetic family history should be recorded by a skilled interviewer. (orig.) [de

Toxic substances: Federal-provincial control -- rev. revised edition. Current issue review No. 88-11E

Energy Technology Data Exchange (ETDEWEB)

Douglas, K

1994-12-31

This document provides a background and analysis on federal-provincial control of toxic substances, including their control under the Canadian Constitution, legislation passed by both levels of government, political aspects, federal-provincial cooperation, the Green Plan, and the Auditor General`s report. Parliamentary action taken and a chronology of events are also included.

LBA-ECO LC-01 National, Provincial, and Park Boundaries, Ecuador

Data.gov (United States)

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...

LBA-ECO LC-01 National, Provincial, and Park Boundaries, Ecuador

Data.gov (United States)

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...

78 FR 50136 - Notice of Information Collection Under Emergency Review: Medical History and Examination for...

Science.gov (United States)

2013-08-16

...: Medical History and Examination for Foreign Service DS-1843 and DS-1622 ACTION: Notice of request for... methods: Web: Persons with access to the Internet may use the Federal Docket Management System (FDMS) to... History and Examination for Foreign Service. OMB Control Number: 1405-0068. Type of Request: Emergency...

The prevalence of burnout and depression in medical doctors ...

African Journals Online (AJOL)

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.

A tale of Congress, continuing medical education, and the history of medicine.

Science.gov (United States)

Partin, Clyde; Kushner, Howard I; Horton, Mary E Kollmer

2014-04-01

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.

THE SOCIOLOGICAL PORTRAIT OF PROVINCIAL UNIVERSITY ENTRANTS ON THE EXAMPLE OF UST-ILIMSK CITY

Directory of Open Access Journals (Sweden)

Filipp Rozanov

2012-01-01

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.

Parochialism or Self-Consciousness? Internationality in Medical History Journals 1997–2006

Science.gov (United States)

Steinke, Hubert; Lang, Yves

2011-01-01

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

A history and overview of the certification exam for medical dosimetrists

International Nuclear Information System (INIS)

Pusey, Damien; Smith, Lisette; Zeman, Elaine M.; Adams, Robert

2005-01-01

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

Teaching history of medicine in the perspective of "medical humanities".

Science.gov (United States)

von Engelhardt, D

1999-03-01

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".

A study on the optimization of referring method about medical images using MIH (Medical Image History)

International Nuclear Information System (INIS)

Kim, Sun Chil; Kim, Jung Min

2002-01-01

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

From papyrus to the electronic tablet: a brief history of the clinical medical record with lessons for the digital age.

Science.gov (United States)

Gillum, Richard F

2013-10-01

A major transition is underway in documentation of patient-related data in clinical settings with rapidly accelerating adoption of the electronic health record and electronic medical record. This article examines the history of the development of medical records in the West in order to suggest lessons applicable to the current transition. The first documented major transition in the evolution of the clinical medical record occurred in antiquity, with the development of written case history reports for didactic purposes. Benefiting from Classical and Hellenistic models earlier than physicians in the West, medieval Islamic physicians continued the development of case histories for didactic use. A forerunner of modern medical records first appeared in Paris and Berlin by the early 19th century. Development of the clinical record in America was pioneered in the 19th century in major teaching hospitals. However, a clinical medical record useful for direct patient care in hospital and ambulatory settings was not developed until the 20th century. Several lessons are drawn from the 4000-year history of the medical record that may help physicians improve patient care in the digital age. Copyright © 2013 Elsevier Inc. All rights reserved.

Foreign University Involvement in Sustainable New Town Planning in Provincial China

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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

Chemistry 300. Administration Manual for Supervising Teachers, Provincial Examination, Answer Key--Multiple-Choice and Written-Answer Questions, and Provincial Summary Report = Chimie 300. Guide d'administration a l'intention des surveillants d'examen, Examen provincial, Cle de correction--Questions choix multiple et Questions responses ouvertes, et Rapport sommaire provincial.

Science.gov (United States)

Manitoba Dept. of Education and Training, Winnipeg.

This collection of manuals contains the Manitoba Provincial Chemistry Examination for students seeking credit in Senior 4 Chemistry (Chemistry 300) and instructions for its use and grading. The examination is based on the Core Topics of the Senior 4 Chemistry course and accounts for 30% of the student's final grade in the course. The examination…

Provincial prenatal record revision: a multiple case study of evidence-based decision-making at the population-policy level

Directory of Open Access Journals (Sweden)

Olson Joanne

2008-12-01

Full Text Available Abstract Background There is a significant gap in the knowledge translation literature related to how research evidence actually contributes to health care decision-making. Decisions around what care to provide at the population (rather than individual level are particularly complex, involving considerations such as feasibility, cost, and population needs in addition to scientific evidence. One example of decision-making at this "population-policy" level involves what screening questions and intervention guides to include on standardized provincial prenatal records. As mandatory medical reporting forms, prenatal records are potentially powerful vehicles for promoting population-wide evidence-based care. However, the extent to which Canadian prenatal records reflect best-practice recommendations for the assessment of well-known risk factors such as maternal smoking and alcohol consumption varies markedly across Canadian provinces and territories. The goal of this study is to better understand the interaction of contextual factors and research evidence on decision-making at the population-policy level, by examining the processes by which provincial prenatal records are reviewed and revised. Methods Guided by Dobrow et al.'s (2004 conceptual model for context-based evidence-based decision-making, this study will use a multiple case study design with embedded units of analysis to examine contextual factors influencing the prenatal record revision process in different Canadian provinces and territories. Data will be collected using multiple methods to construct detailed case descriptions for each province/territory. Using qualitative data analysis techniques, decision-making processes involving prenatal record content specifically related to maternal smoking and alcohol use will be compared both within and across each case, to identify key contextual factors influencing the uptake and application of research evidence by prenatal record review

Details acquired from medical history and patients’ experience of empathy – two sides of the same coin

Science.gov (United States)

2013-01-01

Background History taking and empathetic communication are two important aspects in successful physician-patient interaction. Gathering important information from the patient’s medical history is needed for effective clinical decision making while empathy is relevant for patient satisfaction. We wanted to investigate whether medical students near graduation are able to combine both skills as required in daily medical practice. Methods Thirty near graduates from Hamburg Medical School participated in an assessment for clinical competences including a consultation hour with five standardized patients. Each patient interview was videotaped and standardized patients rated participants with the CARE questionnaire for consultation and relational empathy. All videotaped interviews were rated with a checklist based on the number of important medical aspects for each case. Data were analysed with the linear mixed model to correct for random effects. Regression analysis was performed to look for correlations between the number of questions asked by a participant and their respective empathy rating. Results Of the 123 aspects that could have been gathered in total, students only requested 56.4% (95% CI 53.5-59.3). While no difference between male and female participants was found, a significant difference (p sides of the coin of history taking. While both skills have to be acquired during medical school training with particular focus on their respective learning objectives, medical students need to be provided with additional learning and feedback opportunities where they can be observed exercising both skills combined as required in physicians’ daily practice. PMID:23659369

Are medical students confident in taking a sexual history? An assessment on attitude and skills from an upper middle income country.

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Ariffin, Farnaza; Chin, Ken Lee; Ng, ChirkJenn; Miskan, Maizatullifah; Lee, Verna KarMun; Isa, Mohammad Rodi

2015-06-17

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.

Enhancing Student Empathetic Engagement, History-Taking, and Communication Skills During Electronic Medical Record Use in Patient Care.

Science.gov (United States)

LoSasso, Alisa Alfonsi; Lamberton, Courtney E; Sammon, Mary; Berg, Katherine T; Caruso, John W; Cass, Jonathan; Hojat, Mohammadreza

2017-07-01

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.

A study on the optimization of referring method about medical images using MIH (Medical Image History)

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Chil; Kim, Jung Min [College of Health Sciences, Korea University, Seoul (Korea, Republic of)

2002-09-15

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.

Are medical students confident in taking a sexual history? An assessment on attitude and skills from an upper middle income country

OpenAIRE

Ariffin, Farnaza; Chin, Ken Lee; Ng, ChirkJenn; Miskan, Maizatullifah; Lee, Verna KarMun; Isa, Mohammad Rodi

2015-01-01

Background 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. Methods The study used a cross-sectional survey of 379 final-year medical students from three medical schools in Malaysia. Students were asked to...

Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities.

Science.gov (United States)

Giesbrecht, Norman; Wettlaufer, Ashley; Thomas, Gerald; Stockwell, Tim; Thompson, Kara; April, Nicole; Asbridge, Mark; Cukier, Samantha; Mann, Robert; McAllister, Janet; Murie, Andrew; Pauley, Chris; Plamondon, Laurie; Vallance, Kate

2016-05-01

Alcohol pricing is an effective prevention policy. This paper compares the 10 Canadian provinces on three research-based alcohol pricing policies-minimum pricing, pricing by alcohol content and maintaining prices relative to inflation. The selection of these three policies was based on systematic reviews and seminal research papers. Provincial data for 2012 were obtained from Statistics Canada and relevant provincial ministries, subsequently sent to provincial authorities for verification, and then scored by team members. All provinces, except for Alberta, have minimum prices for at least one beverage type sold in off-premise outlets. All provinces, except for British Columbia and Quebec, have separate (and higher) minimum pricing for on-premise establishments. Regarding pricing on alcohol content, western and central provinces typically scored higher than provinces in Eastern Canada. Generally, minimum prices were lower than the recommended $1.50 per standard drink for off-premise outlets and $3.00 per standard drink in on-premise venues. Seven of 10 provinces scored 60% or higher compared to the ideal on indexing prices to inflation. Prices for a representative basket of alcohol products in Ontario and Quebec have lagged significantly behind inflation since 2006. While examples of evidence-based alcohol pricing policies can be found in every jurisdiction in Canada, significant inter-provincial variation leaves substantial unrealised potential for further reducing alcohol-related harm and costs. This comparative assessment of alcohol price policies provides clear indications of how individual provinces could adjust their pricing policies and practices to improve public health and safety. [Giesbrecht N, Wettlaufer A, Thomas G, Stockwell T, Thompson K, April N, Asbridge M, Cukier S, Mann R, McAllister J, Murie A, Pauley C, Plamondon L, Vallance K. Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities. Drug Alcohol Rev

L'etat, C'est Moi: Why provincial Intra-governmental disputes in ...

African Journals Online (AJOL)

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.

A Comprehensive Assessment and Spatial Analysis of Vulnerability of China’s Provincial Economies

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Chongqiang Ren

2018-04-01

Full Text Available Vulnerability theory is a fundamental scientific knowledge system in sustainable development, and vulnerability assessment is important in vulnerability studies. Economic vulnerability affects economic growth sustainability. Comprehensive assessment of economic vulnerability in the process of economic growth under the theoretical framework of vulnerability will provide a new perspective for vulnerability studies. Based on a vulnerability scoping diagram assessment model, this study selected 22 economic sensitivity indexes and 25 economic adaptability indexes from the economic, social, and nature–resource–environmental subsystems to comprehensively assess and spatially analyse the vulnerability of China’s provincial economies since the year 2000, while applying the entropy method, multilevel extension assessment, spatial measurement method, and geographic information system technology. The results showed the following: (1 There are great differences in the vulnerability of China’s provincial economies. Western China’s vulnerability is higher and the fluctuation range of economic vulnerability is larger. The vulnerability increased significantly based on spatial differential features; (2 Regional differences in economic vulnerability, mainly caused by differences within a region, increased gradually. Eastern and Western China showed the spatial pattern characteristics of prominent and reinforcing regional imbalance, while Central and Northeast China showed declining regional imbalance. The spatial structure evolution of economic vulnerability is characterized by a volatility curve, and regional separation and divergence are strengthened; (3 Growth of China’s provincial economies and economic vulnerability are related negatively. In Eastern, Central, and Northeast China, vulnerability of the provincial economies has a negative spillover effect on neighbouring provinces’ economic growth, while in Western China it has a slight positive

Health aspects of Arctic exploration – Alaska's medical history based on the research files of Dr. Robert Fortuine

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Kathleen Murray

2013-08-01

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

The Structure and Presentation of Provincial Budgets

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Bev Dahlby

2015-05-01

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

The Medical Association and the Full-Timers

African Journals Online (AJOL)

1974-06-15

Jun 15, 1974 ... be extended to all full-time medical practitioners em- ployed by the Provincial Administrations. No to Part-time Practice. At this same meeting of the Executive Committee the question of part-time practice within the precincts of a closed hospital was again fully discussed, and a resolution was passed.

Details acquired from medical history and patients' experience of empathy--two sides of the same coin.

Science.gov (United States)

Ohm, Friedemann; Vogel, Daniela; Sehner, Susanne; Wijnen-Meijer, Marjo; Harendza, Sigrid

2013-05-09

History taking and empathetic communication are two important aspects in successful physician-patient interaction. Gathering important information from the patient's medical history is needed for effective clinical decision making while empathy is relevant for patient satisfaction. We wanted to investigate whether medical students near graduation are able to combine both skills as required in daily medical practice. Thirty near graduates from Hamburg Medical School participated in an assessment for clinical competences including a consultation hour with five standardized patients. Each patient interview was videotaped and standardized patients rated participants with the CARE questionnaire for consultation and relational empathy. All videotaped interviews were rated with a checklist based on the number of important medical aspects for each case. Data were analysed with the linear mixed model to correct for random effects. Regression analysis was performed to look for correlations between the number of questions asked by a participant and their respective empathy rating. Of the 123 aspects that could have been gathered in total, students only requested 56.4% (95% CI 53.5-59.3). While no difference between male and female participants was found, a significant difference (pexercising both skills combined as required in physicians' daily practice.

The Roman-Irish Bath: Medical/health history as therapeutic assemblage.

Science.gov (United States)

Foley, Ronan

2014-04-01

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.

Structured communicative skills training for medical interns improves history taking skills on sensitive issues: An interventional study

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Anupama Sukhlecha

2016-01-01

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.

A combination of process of care and clinical target among type 2 diabetes mellitus patients in general medical clinics and specialist diabetes clinics at hospital levels.

Science.gov (United States)

Sieng, Sokha; Hurst, Cameron

2017-08-07

This study compares a combination of processes of care and clinical targets among patients with type 2 diabetes mellitus (T2DM) between specialist diabetes clinics (SDCs) and general medical clinics (GMCs), and how differences between these two types of clinics differ with hospital type (community, provincial and regional). Type 2 diabetes mellitus patient medical records were collected from 595 hospitals (499 community, 70 provincial, 26 regional) in Thailand between April 1 to June 30, 2012 resulting in a cross-sectional sample of 26,860 patients. Generalized linear mixed modeling was conducted to examine associations between clinic type and quality of care. The outcome variables of interest were split into clinical targets and process of care. A subsequent subgroup analysis was conducted to examine if the nature of clinical target and process of care differences between GMCs and SDCs varied with hospital type (regional, provincial, community). Regardless of the types of hospitals (regional, provincial, or community) patients attending SDCs were considerably more likely to have eye and foot exam. In terms of larger hospitals (regional and provincial) patients attending SDCs were more likely to achieve HbA1c exam, All FACE exam, BP target, and the Num7Q. Interestingly, SDCs performed better than GMCs at only provincial hospitals for LDL-C target and the All7Q. Finally, patients with T2DM who attended community hospital-GMCs had a better chance of achieving the blood pressure target than patients who attended community hospital-SDCs. Specialized diabetes clinics outperform general medical clinics for both regional and provincial hospitals for all quality of care indicators and the number of quality of care indicators achieved was never lower. However, this better performance of SDC was not observed in community hospital. Indeed, GMCs outperformed SDCs for some quality of care indicators in the community level setting.

It only hurts when you produce : ten years of federal/provincial conflict over oil industry revenue sharing

International Nuclear Information System (INIS)

Smith, D.C.

1998-01-01

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

Hernia Surgery in Nyeri Provincial General Hospital, Kenya: Our 6 ...

African Journals Online (AJOL)

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 ...

[About Itching and scabies. Pruritus in medical history--from ancient world to the French revolution].

Science.gov (United States)

Weisshaar, E; König, A; Diepgen, T L; Eckart, W U

2008-12-01

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.

The history of parkinsonism: descriptions in ancient Indian medical literature.

Science.gov (United States)

Ovallath, Sujith; Deepa, P

2013-05-01

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.

The Myth of the Citizen Soldier: Rhode Island Provincial Soldiers in the French and Indian War

Science.gov (United States)

2016-06-10

14 Revolution, is an excellent account of social, economic, and political factors in colonial America that influenced the concept of the citizen ...THE MYTH OF THE CITIZEN -SOLDIER: RHODE ISLAND PROVINCIAL SOLDIERS IN THE FRENCH AND INDIAN WAR A thesis presented to the...From - To) AUG 2015 – JUN 2016 4. TITLE AND SUBTITLE The Myth of the Citizen Soldier: Rhode Island Provincial Soldiers in the French and Indian War

[Study on medical records of acupuncture-moxibustion in The Twenty-four Histories].

Science.gov (United States)

Huang, Kai-Wen

2012-03-01

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.

Medical History: Compiling Your Medical Family Tree

Science.gov (United States)

... are missing. If you're adopted, ask your adoptive parents if they received any medical information about your biological parents at the time of your adoption. Adoption agencies also might have family medical information on file. If you were adopted ...

Impact of a Student Pharmacist Driven Medication Reconciliation and Antidepressant Treatment History Project at a Depression Clinic: A Pilot Study

Science.gov (United States)

Tang, Stella S.; Jaward, Leanna; Ward, Kristen; Parikh, Sagar V.; Bostwick, Jolene R.

2017-01-01

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

Significance of experts' overall ratings for medical student competence in relation to history-taking

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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.

Programa provincial de lectura del Chubut

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Natalia Alejandra Alaniz

2014-10-01

Full Text Available En el marco del proyecto “Dispositivos pedagógicos en las dinámicas de lavida escolar en contexto de pobreza urbana” lo que se propuso investigar es la forma de implementación del Programa de Lectura de la provincia de Chubut. El mismo fue creado por Resolución Ministerial N° 1044/ 08, a partir de diversos trabajos que comenzaron en el año 2003 a través de la Ley de Educación 26. 026, y que posteriormente se incorporaron a nivel provincial mediante la Resolución N ° 174/12 para revalorizar las trayectorias escolares de cada niño/a. El programa consiste en poner el énfasis en el vínculo pedagógico mediante la adecuación de los espacios curriculares, de tal modo que se pueda lograr una articulación entre los diferentes niveles educativos, desde el nivel inicial al secundario. Articulando para ello recursos materiales y humanos que posibiliten el acompañamiento del proceso de enseñanza y aprendizaje de lectura.A partir de esto, el objetivo de este trabajo fue indagar cómo perciben los docentes de una escuela pública la implementación del Programa Provincial de Lectura, lo que implico utilizar metodologías y técnicas de investigación apropiadas para obtener las experiencias actuales en el territorio y en la cotidianidad de los propios actores escolares. Teniendo en consideración que el dispositivo pedagógico es una construcción histórica, que produce subjetividades, y por consiguiente formas de ver y entender el mundo.

[Poison cases and types of poisons based on data obtained of patients hospitalized from 1995-2009 with acute poisoning in the second internal ward in a multi-profile provincial hospital in Tarnow].

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Lata, Stanisław; Janiszewski, Jacek

2010-01-01

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.

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

LENUS (Irish Health Repository)

Grimes, T

2013-01-27

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

Accounting Change and Institutional Capacity: The Case of a Provincial Government in Indonesia

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Haryono P. Kamase

2012-06-01

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

[Sources of finance for provincial occupational health services. Theory and practice].

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Rydlewska-Liszkowska, I; Jugo, B

1999-01-01

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.

Virtual scarce water embodied in inter-provincial electricity transmission in China

International Nuclear Information System (INIS)

Zhang, Chao; Zhong, Lijin; Liang, Sai; Sanders, Kelly T.; Wang, Jiao; Xu, Ming

2017-01-01

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.

Incidence of social resistance in provincial mining legislation. The cases of Córdoba and Catamarca (2003-2008

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Lucas Christel

2013-11-01

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.

Challenges in reporting on predetermined objectives to the Auditor-General: The case of Limpopo provincial departments

OpenAIRE

Melvin Diedericks

2017-01-01

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...

The effective and preventive factors of taking patients\\' history from the viewpoint of the students of Birjand Medical School in 2010-2011

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Z. Khazaee

2013-06-01

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.

A successful Charter challenge to medicare? Policy options for Canadian provincial governments.

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Flood, Colleen M; Thomas, Bryan

2018-03-26

In September 2016, a case went to trial in British Columbia that seeks to test the constitutionality of provincial laws that (1) ban private health insurance for medically necessary hospital and physician services; (2) ban extra-billing (physicians cannot charge patients more than the public tariff); and (3) require physicians to work solely for the public system or 'opt-out' and practice privately. All provinces have similar laws that have been passed to meet the requirements of federal legislation, the Canada Health Act (and thus qualify for federal funds). Consequently, a finding of unconstitutionality of one or more of these laws could have a very significant impact on the future of Canada's single-payer system ('medicare'). However, should the court find that a particular law is not in compliance with the Canadian Charter of Rights and Freedoms, the baton is then passed back to the government which may respond with other laws or policies that they believe to be constitutionally compliant. The ultimate impact of any successful Charter challenge to laws protecting medicare from privatization will thus significantly depend on how Canadian governments respond. Provincial governments could allow privatization to undercut equity and access, or they could respond creatively with new legal and policy solutions to both improve equity and access and tackle some of the problems that have long bedeviled Canadian medicare. This paper provides an understanding - grounded in comparative health systems evidence - of law and policy options available to Canadian lawmakers for limiting two-tier care in the wake of any successful challenge to existing laws. The paper presents the results of a large inter-disciplinary, comparative study, started in 2015, that systematically reviewed the legal and broader regulatory schemes used to regulate the public/private divide in 15 Organization for Economic Co-Operation and Development countries with a particular eye to what the effect of

Competing risks model in screening for preeclampsia by maternal characteristics and medical history.

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Wright, David; Syngelaki, Argyro; Akolekar, Ranjit; Poon, Leona C; Nicolaides, Kypros H

2015-07-01

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

Rhazes, a genius physician in diagnosis and treatment of kidney calculi in medical history.

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Changizi Ashtiyani, Saeed; Cyrus, Ali

2010-04-01

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.

Iraq Provincial Reconstruction Team Handbook: Observations, Insights, and Lessons

Science.gov (United States)

2010-11-01

with Inma have included joint efforts in training, farmer association strengthening, and increased productivity involving two large fish farms, 10...beef and lamb feedlots, five forage sites, two packing sheds, six feed mills, an olive factory, 10 strawberry farms, 20 farmer associations, over 500...vegetables, and fodder. There are also a large number of orchards , and the province has 2.5 million palm 69 IRAQ PROVINCIAL RECONSTRUCTION TEAM trees

[The life of Dr. RO Kishun, a reflection of modern Korean medical history of the borders].

Science.gov (United States)

Shin, Young-Jeon; Park, Se-Hong

2009-06-01

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.

Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

Science.gov (United States)

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes

A case of basilar artery aneurysm rupture from 1836: lessons in clinical observation and the natural history of the disease.

Science.gov (United States)

Demetriades, Andreas K; Horiguchi, Takashi; Goodrich, James T; Kawase, Takeshi

2014-11-01

Although credit is given to Sir William Gull for highlighting the clinical picture of subarachnoid hemorrhage in 1859, we discuss a case presented by Mr. Egerton A. Jennings, Fellow of the Linnaean Society, published 23 years earlier in the 1836 edition of the Transactions of the Provincial Medical and Surgical Association. This case, probably the first reported in the English language of a basilar aneurysm rupture, is of medico-historical interest. Jennings provided a remarkably accurate and detailed description of the patient, who experienced coma as a result of the severity of subarachnoid hemorrhage. The detailed clinical observations on initial assessment and the description of the patient's deterioration to the time of death are a succinct representation of the natural history of this disease. The author's discussion provides evidence of a philosophy committed to medical education and progress at the time based on principles of rational observation, meticulous clinical acumen, insight into experimental physiology, and the awareness of ethical boundaries. In provincial 1836 England, similar to most of Europe, cerebral localization was elementary. Nonetheless, this case report highlights the attempt at linking structure to function by means of observation on the effects of lesioning. It provides evidence of an established thought process already in progress in England in the 19th century. It is characteristic that this thought process came from a surgical practitioner. The cultivation of practical observation in British surgical culture would allow the late 19th century surgeon scientists to match the contributions of British neurologists with landmark steps in the development and establishment of neurosurgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Workplace-based assessment for vocational registration of international medical graduates.

Science.gov (United States)

Lillis, Steven; Van Dyk, Valencia

2014-01-01

Medical regulatory authorities need efficient and effective methods of ensuring the competence of immigrating international medical graduates (IMGs). Not all IMGs who apply for specialist vocational registration will have directly comparable qualifications to those usually accepted. As general licensure examinations are inappropriate for these doctors, workplace-based assessment (WBA) techniques would appear to provide a solution. However, there is little published data on such outcomes. All cases of WBA (n = 81) used for vocational registration of IMGs in New Zealand between 2008 and 2013 were collated and analyzed. The successful completion rate of IMGs through the pathway was 87%. The majority (64%) undertook the year of supervised practice and the final assessment in a provincial center. For those unsuccessful in the pathway, inadequate clinical knowledge was the most common deficit found, followed by poor clinical reasoning. A WBA approach for assessing readiness of IMGs for vocational registration is feasible. The constructivist theoretical perspective of WBA has particular advantages in assessing the standard of practice for experienced practitioners working in narrow scopes than traditional methods of assessment. The majority of IMGs undertook both the clinical year and the assessment in provincial hospitals, thus providing a workforce for underserved areas. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Arqueología, Arquitectura e Historia en el Archivo Histórico Provincial de Jaén

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Campos López, María Teresa

2003-12-01

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

An Unbiased View of the History of Polish Medical Physics by a Senior Polish Medical Physicist

International Nuclear Information System (INIS)

Chomicki, O. A.

2008-01-01

Here is a story told by Maria Sklodowska-Curie at the meeting of the International Committee of Intellectual Cooperation in 1921: 'In a free literary competition on the role and importance of elephants the Englishman's story was 'My adventures while shooting elephants in South Africa', the Frenchman was more concerned with 'The sexual and erotic life of elephants', while the Polish approach was invariably 'The elephant versus Poland's national independence', which seemed quite understandable in the light of over 120 years when Poland was partitioned and lost its independence. Since then this saying has become proverbial and came to express the unmistakably Polish tendency to see everything in terms of Polish interests. In my remarks and reminiscences on the history of the Polish Society of Medical Physics you will quickly recognize the same tendency. First, I will, among other things, try to open some old cupboards to 'produce good [things] from the store of good' (Matthew 12:35), especially concerning the first few years of the activity in medical physics in Poland, and second, I will draw some conclusions and/or offer suggestions based on what a senior medical physicist has seen for more than 50 years of his activity in this field. (author)

Medication refusal in children with oppositional defiant disorder or conduct disorder and comorbid attention-deficit/hyperactivity disorder: medication history and clinical correlates.

Science.gov (United States)

Demidovich, Mark; Kolko, David J; Bukstein, Oscar G; Hart, Jonathan

2011-02-01

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.

History of Medical Specialty Interest Assessment

Science.gov (United States)

Burns, Stephanie T.

2016-01-01

Medical specialties require decidedly different abilities, skills, and talents; which results in divergent experiences, lifestyles, skill sets, and income levels. To help medical students select their preferred medical specialty and alleviate shortages in medical specialty staffing, US medical schools and associations invest time and money in…

Revisiting the history of immigration and colonization in provincial Paraná

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Joseli Maria Nunes Mendonça

2016-01-01

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.

Creating a provincial landscape: roman imperialism and rural change in Lusitania

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J. C Edmondson

2010-02-01

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.

Stakeholders' analysis of the medical tourism industry: development strategies in Isfahan.

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Jabbari, Alireza; Ferdosi, Masoud; Keyvanara, Mahmoud; Agharahimi, Zahra

2013-01-01

Policy makers and decision makers must identify the stakeholders in medical tourism, who will be affected by and/or affect this industry, and determine their status for partnership. The aim of this study was to identify the main stakeholders in Isfahan's medical tourism, analyze them, and provide strategies for developing this industry. A qualitative study was conducted in 2011. At first, the key stakeholders in medical tourism were identified in accordance with the experts' idea and literature review. Then we interviewed the key stakeholders. Data analysis was conducted using the stakeholders' analyses, which helped in developing strategies. The result showed that the key stakeholders were made up of nine groups. They included the provincial governance of Isfahan, the Cultural Heritage and Tourism Organization of Isfahan, the Chamber of Commerce, the Medical Council, the Isfahan University of Medical Sciences, health service providers, tourism services providers, investors, and the Tosea Saderat Bank. The rate of knowledge of the Cultural Heritage and Tourism Organization of Isfahan, clinic and international relationship of Isfahan University of Medical Sciences from government policy about medical tourism were very much. Private Hospitals, the Medical Council, investors, and the University of Medical Sciences had great power. Private hospitals, clinics, the Cultural Heritage and Tourism Organization of Isfahan, and the University of Medical Sciences were in the supporter position. The effected strategies were the included strategies, focused on increasing power; increasing support, and on maintaining the position. There are different stakeholders in the medical tourism industry. Thus, policy makers can plan, make a policy and decision, and use effective strategies to develop medical tourism by designing a medical tourism stakeholders' network, a medical tourism provincial council, and clarify the roles and responsibilities of stakeholders.

Stakeholders’ analysis of the medical tourism industry: development strategies in Isfahan

Science.gov (United States)

Jabbari, Alireza; Ferdosi, Masoud; Keyvanara, Mahmoud; Agharahimi, Zahra

2013-01-01

Introduction: Policy makers and decision makers must identify the stakeholders in medical tourism, who will be affected by and/or affect this industry, and determine their status for partnership. The aim of this study was to identify the main stakeholders in Isfahan's medical tourism, analyze them, and provide strategies for developing this industry. Materials and Methods: A qualitative study was conducted in 2011. At first, the key stakeholders in medical tourism were identified in accordance with the experts’ idea and literature review. Then we interviewed the key stakeholders. Data analysis was conducted using the stakeholders’ analyses, which helped in developing strategies. Results: The result showed that the key stakeholders were made up of nine groups. They included the provincial governance of Isfahan, the Cultural Heritage and Tourism Organization of Isfahan, the Chamber of Commerce, the Medical Council, the Isfahan University of Medical Sciences, health service providers, tourism services providers, investors, and the Tosea Saderat Bank. The rate of knowledge of the Cultural Heritage and Tourism Organization of Isfahan, clinic and international relationship of Isfahan University of Medical Sciences from government policy about medical tourism were very much. Private Hospitals, the Medical Council, investors, and the University of Medical Sciences had great power. Private hospitals, clinics, the Cultural Heritage and Tourism Organization of Isfahan, and the University of Medical Sciences were in the supporter position. The effected strategies were the included strategies, focused on increasing power; increasing support, and on maintaining the position. Conclusion: There are different stakeholders in the medical tourism industry. Thus, policy makers can plan, make a policy and decision, and use effective strategies to develop medical tourism by designing a medical tourism stakeholders’ network, a medical tourism provincial council, and clarify the

El Organismo Provincial para el Desarrollo Sostenible (OPDS y los municipios en el marco de la ley de radicación industrial: delegación y descentralización en la regionalización provincial

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Federico Del Giorgio Solfa

2013-01-01

Full Text Available El horizonte en la temática ambiental es la producción limpia, estrategia preventiva de la contaminación e instrumento clave de la política ambiental. La tendencia es generar un desarrollo productivo sustentable, incorporando la dimensión ambiental. Entre las normativas, la Ley N° 11723 “Ley de Medio Ambiente”, tiene por objeto la protección, conservación, mejoramiento y restauración de los recursos naturales y del ambiente, en la Provincia de Buenos Aires. La misma, obliga a que el Poder Ejecutivo Provincial y los Municipios, garanticen los derechos ambientales y los principios de política ambiental; al mismo tiempo que cada emprendimiento industrial cuente con una evaluación de impacto ambiental. En este contexto, el presente trabajo da cuenta de la relación existente entre el Organismo Provincial para el Desarrollo Sostenible (OPDS -como Autoridad de Aplicación de la Ley- y los Municipios bonaerenses. Se clasificó a los Municipios, tomando en cuenta sus características productivas y recursos territoriales. Se diagnosticó el perfil industrial de cada municipio y se determinaron las necesidades de controles más directos y exhaustivos, para el fortalecimiento de la protección medioambiental. También se analizaron ventajas y obstáculos –operativos, legales y económicos- desde las perspectivas municipal y provincial, para la delegación de facultades del OPDS a los Municipios, en la expedición de Certificados Ambientales y las fiscalizaciones de los establecimientos industriales (Art. 2°, Ley N° 11459. Una vez realizado el diagnóstico y el análisis respectivo, concluimos con algunas propuestas tendientes a alinear está temática con los principales ejes del gobierno provincial y de esta manera, fortalecer la gestión medioambiental. Se desarrollan dos líneas: 1. Fortalecimiento de la delegación de facultades del OPDS a los Municipios; y, 2. Descentralización del OPDS en el marco del Programa de Regionalizaci

Importance of philosophy of science to the history of medical thinking.

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Zalewski, Z

1999-03-01

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.

[[History of Community Health in Africa. The Swiss Medical Missionaries' Endeavour in South Africa].

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Mabika, Hines

2015-01-01

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.

Social appearance anxiety of staff in youth services and sport provincial directorate

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Ömer Faruk YAZICI

2016-06-01

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.

Downsizing of a provincial department of health--causes and implications for fiscal policy.

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Blecher, Mark

2002-06-01

To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Western Cape (WC) Department of Health (DOH). Downsizing involving 9,282 health workers (27.9%) and closure of 3,601 hospital beds (24.4%) over 5 years. Total aggregate provincial transfers (all provinces) remained fairly constant in real terms. The WC's share decreased from 11.8% in 1996/97 to 9.8% in 2002/03. This was offset by the DOH's share of the WC budget increasing from 25.6% to 29.6%, mainly because of an increase in national health conditional grants. The net effect of financing changes was that the DOH's allocation in real terms was similar in 2002/03 and 1995/96, which suggests that financing changes are not the major cause of downsizing. Expenditure analysis revealed a 39.7% real rise in the average cost of health personnel. Substantial interprovincial inequities remain. The major cause of downsizing was wage growth, particularly following the 1996 wage agreement. Disjointed fiscal and wage policy has affected health services. Simultaneous application of policies of fiscal constraint, redistribution and substantial real wage growth has resulted in substantial downsizing with limited inroads into inequities. Inequities will continue to call for further redistribution, reduction in conditional grants and downsizing, much of which could have been avoided if fiscal and wage policy choices had been optimal.

La Comisión Provincial de Monumentos de Murcia : precedentes y actuaciones (1835-1865

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Joaquín Martínez Pino

2006-01-01

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.

[Teaching courses on aspects of medical history taking and communication skills in Germany: a survey among students of 12 medical faculties].

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Schildmann, Jan; Kampmann, Margareta; Schwantes, Ulrich

2004-06-01

Good communication between patients and doctors has positive effects on health and the patients' quality of life. Communication skills can be trained. In many countries communication skills training is an important part of medical education and continuing medical education. In this study German medical students were questioned about current communication training. Questionnaires were sent to 28 Medical Schools in Germany and distributed in General Practice courses. Using Likert scales students were asked to rate both existing teaching courses on communication skills and their ability to communicate. 377 students of 12 Medical Schools participated in this study. Two Medical Schools offer teaching courses on communication skills as part of their regular curriculum. On a scale ranging from 1 (no such courses available) to 7 (courses fully available) students assessed the practical teaching of communication skills to be 3 (median). In addition, on a scale ranging from 1 to 7 students rated their general communication skills as 3 (median) and their ability of taking a sexual history and breaking bad news as 4 (median). Although these results are not representative, they give a general idea of communication skills teaching in Germany. During their clinical education students should be especially trained for difficult situations in the patient-doctor encounter. The international experience of other Medical Schools should be taken into account when implementing communication skills training as part of medical education.

The Life of Medical Historian(醫史學者 Miki Sakae, and the

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KIM Ho

2005-12-01

Full Text Available Miki Sakae was a Medical historian, who is well known for his studies of Korean medicine. He authored the renowned trilogy which dealt with subjects of Korean medicine and diseases, namely the , , and , during the Japanese Occupation period. He was born in 1903 in Osaka, Japan, and graduated from the Kyushu(九州 College of Medicine. In 1928 he was assigned to the Gyeongseong Imperial University's College of Medicine as a professor, and also served as Chief of the Suweon Provincial Hospital while he was staying in Korea. During the 18-year period of his stay, he widely collected medical books of Korea and also thoroughly studied them. He returned to Japan in 1944 due to the illness of his father, but continued his studies of Korean medicine, and in 1955 published the for the first time. Following such accomplishment, was published in 1956, the next year, and finally was published a few decades later, in 1985. Since the 1950s, aside of continuing to study and author the history of Korean medicine, he had also engaged himself in a joint effort associated with the members of the Medical History Association of Japan in a group study of Huseya Soteki 伏屋素狄 the first Japanese Experimental Physiologist. He also attempted at establishing an academic branch which could be referred to as Experimental Historical Studies of Medicine, by recreating the experiments of Huseya Sotek 伏屋素狄 with his own son 三木謙. Later he also expanded his interest and studies to the medical history of the world and also the area of Medical Ethics. But his ultimate interest and passion were always targeted at the Medicine of Korea, and the one consistent position he maintained during his entire life regarding the Korean medicine, was that 'One can only talk about the medicine of China and Japan when he or she is well versed in the medicine of Korea'. And his lifetime achievement, was authored upon the basis established by such conviction and philosophy. First

Clinical guidelines and the fate of medical autonomy in Ontario.

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Rappolt, S G

1997-04-01

Conceptually, clinical guidelines and professional autonomy have a paradoxical relationship. Despite being the quintessence of medical knowledge at the corporate level, guidelines diminish the clinical autonomy of individual practitioners, and therefore threaten medicine's justification for its autonomy. Theorists have argued that professional autonomy will be retained through elite dominance of practitioners, while comparative research suggests that economic autonomy can be traded off to retain clinical autonomy. Under government pressure to regulate the growth of Ontario physicians' fee-for-service public expenditure, the profession's representative organization, the Ontario Medical Association (OMA), promoted voluntary clinical guidelines, hoping to both constrain costs and preserve professional control over the content of medical care. The OMA collaborated with the Ministry of Health in developing guidelines and establishing a provincial centre for health service research. Ontario's practitioners disregarded the OMA's exhortations to implement clinical guidelines, suggesting that in the absence of external constraints, practitioners can subvert elite dominance. However, practitioners' unchecked clinical and economic autonomy, combined with evidence of wide provincial variations in medical care, served to legitimize the government's increasingly unilateral control over the schedule of insured medical services, and, in 1993, their imposition of a global cap on physicians' fee-for-service income pool. When analysed in the context of ongoing Ministry-OMA relations, the failure of the OMA's guidelines strategy to constrain medical service costs has expedited an overall decline in medical autonomy in Ontario. The emergence and course of Ontario's clinical guidelines movement is consistent with the view that medical autonomy is contingent upon broad class forces, and the conceptualization of professional organizations as instruments for mediated occupational control.

Introducing medical genetics services in Ethiopia using the MiGene Family History App.

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Quinonez, Shane C; Yeshidinber, Abate; Lourie, Michael A; Bekele, Delayehu; Mekonnen, Yemisrach; Nigatu, Balkachew; Metaferia, Gesit; Jebessa, Solomie

2018-06-11

Almost all low-income countries and many middle-income countries lack the capacity to deliver medical genetics services. We developed the MiGene Family History App (MFHA), which assists doctors with family history collection and population-level epidemiologic analysis. The MFHA was studied at St. Paul's Hospital in Addis Ababa, Ethiopia. A needs assessment was used to assess Ethiopian physicians' experience with genetics services. The MFHA then collected patient data over a 6-month period. The majority of doctors provide genetics services, with only 16% reporting their genetics knowledge is sufficient. A total of 1699 patients from the pediatric ward (n = 367), neonatal intensive care unit (NICU) (n = 477), and antenatal clinic (n = 855) were collected using the MFHA with a 4% incidence of a MFHA-screened condition present. The incidence was 11.7% in the pediatric ward, 3% in the NICU, and 0.5% in the antenatal clinic. Heart malformations (5.5% of patients) and trisomy 21 (4.4% of patients) were the most common conditions in the pediatric ward. Medical genetics services are needed in Ethiopia. As other countries increase their genetics capacity, the MFHA can provide fundamental genetics services and collect necessary epidemiologic data.

China’s provincial CO2 emissions embodied in international and interprovincial trade

International Nuclear Information System (INIS)

Guo Ju’e; Zhang Zengkai; Meng Lei

2012-01-01

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.

A comparative study on the influential factors of China's provincial energy intensity

International Nuclear Information System (INIS)

Yang, Guangfei; Li, Wenli; Wang, Jianliang; Zhang, Dongqing

2016-01-01

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.

A comparison of catastrophic injury incidence rates by Provincial Rugby Union in South Africa.

Science.gov (United States)

Badenhorst, Marelise; Verhagen, Evert A L M; van Mechelen, Willem; Lambert, Michael I; Viljoen, Wayne; Readhead, Clint; Baerecke, Gail; Brown, James C

2017-07-01

To compare catastrophic injury rates between the 14 South African Provincial Rugby Unions. A prospective, population-based study conducted among all South African Unions between 2008-2014. Player numbers in each Union were obtained from South African Rugby's 2013 Census. Catastrophic injuries were analysed from BokSmart's serious injury database. Incidence rates with 95% Confidence Intervals were calculated. Catastrophic injuries (Acute Spinal Cord Injuries and catastrophic Traumatic Brain Injuries) within Unions were compared statistically, using a Poisson regression with Incidence Rate Ratios (IRR) and a 95% confidence level (pUnion ranged from 1.8 per 100000 players (95% CI: 0.0-6.5) to 7.9 (95% CI: 0.0-28.5) per 100000 players per year. The highest incidence rate of permanent outcome Acute Spinal Cord Injuries was reported at 7.1 per 100000 players (95% CI: 0.0-17.6). Compared to this Union, five (n=5/14, 36%) of the Unions had significantly lower incidence rates of Acute Spinal Cord Injuries. Proportionately, three Unions had more Acute Spinal Cord Injuries and three other Unions had more catastrophic Traumatic Brain Injuries. There were significant differences in the catastrophic injury incidence rates amongst the Provincial Unions in South Africa. Future studies should investigate the underlying reasons contributing to these provincial differences. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Pitfalls in training simulated patients to respond appropriately to questions from medical students in family history-taking activities: the current situation surrounding the training of simulated patients for learning activities at Nippon Medical School.

Science.gov (United States)

Aso, Ryoko; Inoue, Chikako; Yoshimura, Akinobu; Shimura, Toshiro

2013-01-01

Our goal was to train simulated patients (SPs) to respond appropriately to questions about family history from medical students in simulated medical interviews. To this end, we carried out a survey of 91 SPs and 76 4th-year medical students to investigate their notions of what constitutes a family. All of the SPs and students surveyed deemed parents and children living together to be members of a family. In a situation where one spouse's parents live together with the basic family unit, 93% of the SPs considered them to be members of the family, whereas only 79% of the students did. Married children living apart from their parents were considered members of the family by 18% of the SPs and 39% of the students. These results indicate clear differences between the SPs and students in their notions of the family. To verify the level of understanding of the definitions of family and blood relatives in particular scenarios used in simulated medical interviews, we administered a written test to 14 SPs who were training to assist in the nationwide common achievement test in medicine, the Objective Structured Clinical Examination (OSCE). The overall score of the SPs was 93.5%; the incorrect answers were "a sibling is not a blood relative" and "a spouse is a blood relative." We analyzed the performance of these 14 SPs in medical interviews carried out after training for the OSCE, in which they were asked questions that required them to reveal their understanding of blood relatives, cohabiting relatives, and the family. All of the SPs responded appropriately to the students' questions about family history. After the OSCE, we asked the SPs to assess themselves on how well they had given their family histories and to evaluate the usefulness of the SP training they had received. Their mean self-assessment score on providing a family history was 3.6 (scale: 1-4); on the usefulness of training, it was 3.4 (scale: 1-4). In conclusion, training SPs to respond appropriately to

A General Provincial Situation Visualization System Based on iPhone Operating System of Shandong Province

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Ye, Z.; Xiang, H.

2014-04-01

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.

Medical illness, medication use and suicide in seniors: a population-based case-control study.

Science.gov (United States)

Voaklander, D C; Rowe, B H; Dryden, D M; Pahal, J; Saar, P; Kelly, K D

2008-02-01

Suicide among seniors is a significant health problem in north America, particularly for men in whom the rates rise steadily after 50 years of age. The goal of this study was to examine elder suicides identified from a large population-based database using case-control methods to determine disease and medication factors related to suicide. A population-based 1 : 5 case-control study was conducted comparing seniors aged 66 years and older who had died by suicide with age and sex-matched controls. Case data were obtained through British Columbia (BC) Vital Statistics, whereas controls were randomly selected from the BC Health Insurance Registry. Cases and controls were linked to the provincial PharmaCare database to determine medication use and the provincial Physician Claims and Inpatient Hospitalization databases to determine co-morbidity. Between 1993 and 2002 a total of 602 seniors died by suicide in BC giving an annual rate of 13.2 per 100,000. Firearms were the most common mechanism (28%), followed by hanging/suffocation (25%), self-poisoning (21%), and jumping from height (7%). In the adjusted logistic model, variables related to suicide included: lower socioeconomic status, depression/psychosis, neurosis, stroke, cancer, liver disease, parasuicide, benzodiazepine use, narcotic pain killer use and diuretic use. There was an elevated risk for those prescribed inappropriate benzodiazepines and for those using strong narcotic pain killers. This study is consistent with previous studies that have identified a relationship between medical or psychiatric co-morbidity and suicide in seniors. In addition, new and potentially useful information confirms that certain types and dosages of benzodiazepines are harmful to seniors and their use should be avoided.

Achieving focused infrastructure investment in South Africa: Technical advances in provincial spatial planning

CSIR Research Space (South Africa)

Meiklejohn, C

2008-11-01

Full Text Available for The Presidency, and in making a contribution towards addressing some of the weaknesses of provincial-level spatial planning identified in this assessment. The specific focus is on specialist services (spatial analysis and policy advice) undertaken by CSIR Built...

Using medical history embedded in biometrics medical card for user identity authentication: privacy preserving authentication model by features matching.

Science.gov (United States)

Fong, Simon; Zhuang, Yan

2012-01-01

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.

Using Medical History Embedded in Biometrics Medical Card for User Identity Authentication: Privacy Preserving Authentication Model by Features Matching

Directory of Open Access Journals (Sweden)

Simon Fong

2012-01-01

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.

Quantifying the uncertainties of China's emission inventory for industrial sources: From national to provincial and city scales

Science.gov (United States)

Zhao, Yu; Zhou, Yaduan; Qiu, Liping; Zhang, Jie

2017-09-01

A comprehensive uncertainty analysis was conducted on emission inventories for industrial sources at national (China), provincial (Jiangsu), and city (Nanjing) scales for 2012. Based on various methods and data sources, Monte-Carlo simulation was applied at sector level for national inventory, and at plant level (whenever possible) for provincial and city inventories. The uncertainties of national inventory were estimated at -17-37% (expressed as 95% confidence intervals, CIs), -21-35%, -19-34%, -29-40%, -22-47%, -21-54%, -33-84%, and -32-92% for SO2, NOX, CO, TSP (total suspended particles), PM10, PM2.5, black carbon (BC), and organic carbon (OC) emissions respectively for the whole country. At provincial and city levels, the uncertainties of corresponding pollutant emissions were estimated at -15-18%, -18-33%, -16-37%, -20-30%, -23-45%, -26-50%, -33-79%, and -33-71% for Jiangsu, and -17-22%, -10-33%, -23-75%, -19-36%, -23-41%, -28-48%, -45-82%, and -34-96% for Nanjing, respectively. Emission factors (or associated parameters) were identified as the biggest contributors to the uncertainties of emissions for most source categories except iron & steel production in the national inventory. Compared to national one, uncertainties of total emissions in the provincial and city-scale inventories were not significantly reduced for most species with an exception of SO2. For power and other industrial boilers, the uncertainties were reduced, and the plant-specific parameters played more important roles to the uncertainties. Much larger PM10 and PM2.5 emissions for Jiangsu were estimated in this provincial inventory than other studies, implying the big discrepancies on data sources of emission factors and activity data between local and national inventories. Although the uncertainty analysis of bottom-up emission inventories at national and local scales partly supported the ;top-down; estimates using observation and/or chemistry transport models, detailed investigations and

[Purveyors of technology: provincial engineers and the construction of road infrastructure in Minas Gerais].

Science.gov (United States)

Barbosa, Lidiany Silva

2011-01-01

The article analyzes the role played by engineers in the construction of road infrastructure in Minas Gerais between the 1840s and 1880s. Building and providing regular maintenance for roads and bridges was a task carried out by the Minas Gerais provincial government, which since the 1830s had a specific agency assigned to designing, building, and maintaining public communication routes. Engineers were part of the agency from its inception, playing a significant role in designing projects and in the actual execution of certain works. The current study is grounded in administrative documentation in which the details of work progress are reported to the provincial government. The gathered records provide technical, administrative, and financial information, along with data on labor power and the agents engaged in construction works.

Family history, not lack of medication use, is associated with the development of postpartum depression in a high-risk sample.

Science.gov (United States)

Kimmel, Mary; Hess, Edward; Roy, Patricia S; Palmer, Jennifer Teitelbaum; Meltzer-Brody, Samantha; Meuchel, Jennifer M; Bost-Baxter, Emily; Payne, Jennifer L

2015-02-01

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.

Radon awareness in the provincial capital Lahore of Punjab province of Pakistan

International Nuclear Information System (INIS)

Tahir, S.N.A.; Alaamer, A.S.

2008-01-01

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)

A 3D Model Based Imdoor Navigation System for Hubei Provincial Museum

Science.gov (United States)

Xu, W.; Kruminaite, M.; Onrust, B.; Liu, H.; Xiong, Q.; Zlatanova, S.

2013-11-01

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.

Medical History in the Hellenic Journal of Nuclear Medicine.

Science.gov (United States)

Otte, Andreas

2017-01-01

The Hellenic Journal of Nuclear Medicine is about to celebrate its 20th anniversary end of 2017. On board of the editorial team since 2003, this journal has influenced me like a good friend over the many past years. From time to time, the journal has published interesting and valuable historical notes. They show that nuclear medicine has a history and that medicine is its basis. They also teach us today, and some of the ancient perspectives and approaches are still valid. The reader of HJNM may be interested in these historical contributions, as they are timeless. Therefore, it was our idea to summarize these in the following pages. Where there is a link to the free article, this is noted. Upon opening all articles, you will find out that these are a book or so of its own. In thanks to the editor-in-chief of the Journal for his continuing support on the historical section. Below we refer to the historical papers of the Journal: History of Nuclear Medicine. Nuclear Medicine and History of Science and Philosophy: Atomic Theory of the Matter. G.N. Sfakianakis, 2001; 4(3); 155-60. Editorial. Pioneers of nuclear medicine, Madame Curie. P.C. Grammaticos. 2004; 7(1); 29-30. http://nuclmed.web.auth.gr/ magazine/eng/jan04/editorial.htm Editor's note. Hippocrates' Oath. The editor. 2004; 7(1); 31. Editorial. Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus. P. Grammaticos, A. Diamantis. 2008; 11(1): 2-4. http://nuclmed.web.auth.gr/magazine/eng/jan08/2.pdf Special Article. The contribution of Maria Sklodowska-Curie and Pierre Curie to Nuclear and Medical Physics. A hundred and ten years after the discovery of radium. A. Diamantis, E. Magiorkinis, 2008; 11(1): 33-8. http://nuclmed.web.auth.gr/magazine/ eng/jan08/33.pdf Brief Historical Review. Lymphatic system and lymphoscintigraphy. P. Valsamaki. 2009; 12(1): 87-89. http://nuclmed.web. auth.gr/magazine/eng/jan09/89.pdf (In Greek) Historical Review. The philosophic and

Post-match recovery methods used by U19 and U21 provincial ...

African Journals Online (AJOL)

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 ...

Whither radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Ross, W M

1987-03-01

The 1986 Glyn Evans Memorial Lecture, given at the Joint Provincial Meeting of the Royal College of Radiologists, Sheffield, September 1986, sketches an outline of the history of radiotherapy and discusses the future development of the art. Topics included are siting of centres, training needs, the relationship of radiotherapy to other medical specialities, and the advantages and disadvantages of radiotherapy practitioners forming a separate medical College. (U.K.)

Examination of the Relationship between Organizational Stress and Employee Performance: A Research on Staff Working on Provincial Directorate of Youth and Sports

Science.gov (United States)

Goksel, Ali Gurel; Caz, Cagdas; Yazici, Omer Faruk; Ikizler, Huseyin Can

2017-01-01

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…

MO-FG-CAMPUS-IeP1-03: Establishment of Provincial Diagnostic Reference Levels in Pediatric Imaging

International Nuclear Information System (INIS)

Tonkopi, E; O’Brien, K

2016-01-01

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

MO-FG-CAMPUS-IeP1-03: Establishment of Provincial Diagnostic Reference Levels in Pediatric Imaging

Energy Technology Data Exchange (ETDEWEB)

Tonkopi, E [Dalhousie University (Canada); Queen Elizabeth II Health Sciences Ctr (Canada); O’Brien, K [Dalhousie University (Canada); IWK Health Centre, Halifax, NS (Canada)

2016-06-15

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

Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study.

Science.gov (United States)

Haring, Catharina M; Cools, Bernadette M; van Gurp, Petra J M; van der Meer, Jos W M; Postma, Cornelis T

2017-08-29

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. A grounded theory approach was used to analyze what expert physicians apply as indicators in their assessment of medical students' diagnostic reasoning abilities during history taking. Twelve randomly selected clinical encounter recordings of students at the end of the internal medicine clerkships were observed by six expert assessors, who were prompted to formulate their assessment criteria in a think-aloud procedure. These formulations were then analyzed to identify the common denominators and leading principles. The main indicators of clinical reasoning ability were abstracted from students' observable acts during history taking in the encounter. These were: taking control, recognizing and responding to relevant information, specifying symptoms, asking specific questions that point to pathophysiological thinking, placing questions in a logical order, checking agreement with patients, summarizing and body language. In addition, patients' acts and the course, result and efficiency of the conversation were identified as indicators of clinical reasoning, whereas context, using self as a reference, and emotion/feelings were identified by the clinicians as variables in their assessment of clinical reasoning. In observing and assessing clinical reasoning during history taking by medical students, general and specific phenomena to be used as indicators for this process could be identified. These phenomena can be traced back to theories on the development and the process of clinical reasoning.

The timing of drug funding announcements relative to elections: a case study involving dementia medications.

Directory of Open Access Journals (Sweden)

Sudeep S Gill

Full Text Available Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions.Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections.Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032; funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements.Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.

The timing of drug funding announcements relative to elections: a case study involving dementia medications.

Science.gov (United States)

Gill, Sudeep S; Gupta, Neeraj; Bell, Chaim M; Rochon, Paula A; Austin, Peter C; Laupacis, Andreas

2013-01-01

Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions. Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections. Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032); funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements. Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.

Bridge management system for the Western Cape provincial government, South Africa: implementation and utilization

CSIR Research Space (South Africa)

Nell, AJ

2008-10-01

Full Text Available This paper describes the implementation and utilization of the bridge management system (BMS) of the Department of Transport and Public Works of the Western Cape Provincial Government. The implementation of the BMS as well as the visual assessment...

No More Provincialism: Art and Text

Directory of Open Access Journals (Sweden)

Heather Barker

2010-11-01

Full Text Available This essay discusses the writing and personalities surrounding the 1981 establishment of the Australian art magazine, Art & Text, and traces its progression under Paul Taylor’s editorship up to his relocation to New York. During this period, Art & Text published Taylor’s own essays and, more importantly, those of other writers and artists — Meaghan Morris, Paul Foss, Philip Brophy, Imants Tillers, Rex Butler, Edward Colless — all articulating a consistent and complex postmodern position. The magazine’s founder and editor, Paul Taylor, personified the shattering impact of postmodernism upon the Australian art world as well as postmodernism’s limitations. Taylor facilitated a new theoretical framework for the discussion of Australian art, one that continues to dominate the internationalist aspirations of Australian art writers. He produced temporarily convincing solutions to problems that earlier critics had wrestled with unsuccessfully, in particular the twin problems of provincialism, and the relationship of Australian to international art.

Poverty assessment using DMSP/OLS night-time light satellite imagery at a provincial scale in China

Science.gov (United States)

Wang, Wen; Cheng, Hui; Zhang, Li

2012-04-01

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.

Medical conditions, family history of cancer, and the risk of biliary tract cancers.

Science.gov (United States)

Rosato, Valentina; Bosetti, Cristina; Dal Maso, Luigino; Montella, Maurizio; Serraino, Diego; Negri, Eva; La Vecchia, Carlo

2016-06-02

Scanty data exist on the role of personal medical conditions, except for gallstones, and family history of cancer on the risk of biliary tract cancers (BTC). We analyzed this issue using data from two Italian case-control studies, including 159 cases of BTC and 795 matched hospital controls. Odds ratios (ORs) of BTC and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression models. Gallstones were associated with a 2-fold excess risk of BTC (95% CI 1.24-3.45). No significant associations were observed with other conditions investigated, including diabetes (OR 1.15, 95% CI 0.63-2.11), hypertension (OR 0.65, 95% CI 0.39-1.11), hyperlipidemia (OR 0.61, 95% CI 0.31-1.21), allergy (OR 0.64, 95% CI 0.29-1.40), gastroduodenal ulcer (OR 0.52, 95% CI 0.24-1.12), hepatitis (OR 2.02, 95% CI 0.35-11.67), benign thyroid diseases (OR 1.16, 95% CI 0.56-2.40), hysterectomy (OR 1.19, 95% CI 0.53-2.68), unilateral oophorectomy (OR 1.75, 95% CI 0.44-6.93), and bilateral oophorectomy (OR 2.48, 95% CI 0.79-7.82). We found an excess risk of BTC in relation to family history of any cancer (OR 1.52, 95% CI 1.03-2.24) and family history of gallbladder cancer (OR 3.83, 95% CI 0.59-24.75). The present study confirms a strong association between BTC and history of gallstones, and provides further evidence of a positive association with family history of cancer.

Job insecurity and the use of antidepressant medication among Danish employees with and without a history of prolonged unemployment: a 3.5-year follow-up study

DEFF Research Database (Denmark)

Rugulies, R; Thielen, K; Nygaard, E

2010-01-01

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....

A history of the INTERNIST-1 and Quick Medical Reference (QMR) computer-assisted diagnosis projects, with lessons learned.

Science.gov (United States)

Miller, R A

2010-01-01

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.

Serum alpha-fetoprotein in the three trimesters of pregnancy: effects of maternal characteristics and medical history.

Science.gov (United States)

Bredaki, F E; Sciorio, C; Wright, A; Wright, D; Nicolaides, K H

2015-07-01

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.

The choice of surgical specialization by medical students and their syncopal history.

Science.gov (United States)

Rudnicki, Jerzy; Zyśko, Dorota; Kozłowski, Dariusz; Kuliczkowski, Wiktor; Koźluk, Edward; Lelonek, Małgorzata; Piątkowska, Agnieszka; Gajek, Jacek; Negrusz-Kawecka, Marta; Agrawal, Anil Kumar

2013-01-01

The aim of the study was to assess whether medical students' fainting outside the university or while witnessing surgical procedures and/or autopsies influenced their choice of a specialization. The study group consisted of 605 medical students (from fourth to sixth year of study) from five medical universities in Poland (325 women, 212 men and 8 responders of an unspecified gender). The median age of subjects studied was 23 years, and the interquartile range was 23-24 years. The students at each university were chosen randomly by the author who worked there and had contact with them. An anonymous questionnaire was developed to gather information regarding demographics, the specialization which each student wanted to choose, the syncope occurrence in the medical history, the syncope and presyncope occurrence during surgery and autopsy as well as the syncopal events' characteristics. The group of 15% of women and 30% of men declared to have pursued the surgical specialization (P<0.001), 29% of women and 56% of men declared the intention to pursue an invasive specialization (P<0.001). As many as 36.0% of women studied and 13.1% of men studied reported syncopal spells outside university (P<0.001). Only 41 students (6.8%) reported that syncope or presyncope in any studied circumstances had an impact on their specialization choice. The multivariate analysis showed that the choice of surgical specialization is related to the male gender and the absence of syncopal spells outside the university. Syncopal and presyncopal spells may affect the professional choices of the medical students. The male gender and a lack of syncope occurrence outside operating room are related to the choice of surgical specialization.

An Alternative Periodization of Romanian History. A Research Agenda

Directory of Open Access Journals (Sweden)

Poenaru Florin

2016-06-01

Full Text Available In this paper, I suggest an alternative form of periodization of Romanian history. My aim is not to move around historical posts; rather I propose a different way of understanding Romanian history as such. This is the research agenda. I seek to write a world history from the perspective of a peripheral place like Romania has been. Therefore, this is not simply an attempt to insert a local, neglected, silenced or distorted history into a wider, European, global story (that is, to discover the history of “people without history”, just as it is not another attempt to “provincialize Europe” in favour of a view from its repressed margins. Instead, following Coronil (2004, I believe it is indispensable to globalize the periphery, to understand its worldwide formation. My investigation draws upon the conceptual toolkit of world-system theory and its underlining philosophy of history (Wallerstein, 2011. In the same vein, the guiding principles of my periodization elaborate on Andre Gunder Frank’s insight that the exchange (or rather direct transfer of surplus between societies is what links regions and societies as whole (Frank, 1978. The focus then shifts from a given society/state and its internal relations to the wider world-system, or world-economy, in which it is embedded. The unit of analysis is not a geographical location, but relations and networks and their historical development.

Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

Science.gov (United States)

Sanders, Vicki L; Flanagan, Jennifer

2015-01-01

The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

Comparison of provincial prescription drug plans and the impact on patients' annual drug expenditures.

Science.gov (United States)

Demers, Virginie; Melo, Magda; Jackevicius, Cynthia; Cox, Jafna; Kalavrouziotis, Dimitri; Rinfret, Stéphane; Humphries, Karin H; Johansen, Helen; Tu, Jack V; Pilote, Louise

2008-02-12

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.

Challenges in reporting on pre-determined objectives to the Auditor-General : the case of Limpopo Provincial Departments / Hilgard Maputle Mawela

OpenAIRE

Mawela, Hilgard Maputle

2015-01-01

All provincial departments are required to report on pre-determined objectives in terms of Section 40 of the Public Finance Management Act, read in conjunction with Section 5.1.1. of the Treasury Regulations. The purpose of this study was to establish the challenges faced by the Limpopo provincial departments in reporting pre-determined objectives to the Auditor-General. Reporting pre-determined objectives has been a challenge over the past financial years and this is evident in the Audito...

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

Directory of Open Access Journals (Sweden)

Francisco Carantoña Álvarez

2016-12-01

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

ISLAM IN PROVINCIAL INDONESIA: Middle Class, Lifestyle, and Democracy

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Noorhaidi Hasan

2011-02-01

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

The provincial administration of the Ottoman Empire in the XVI century on the ground of the kanunname

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M. V. Kovalchuk

2016-11-01

Full Text Available The title of the article is ‘The provincial administration of the Ottoman empire in the XVI century on the ground of the kanunname’. The purpose of the article is to characterize the structure of the provincial administration of the Ottoman Empire in the XVI century on the ground of the sultans’ kanunname. The administrative divisions of the Ottoman Empire has been studied in the article: the largest ottoman provinces - eyalets were divided into two types: timarli, in which the system of sanjaks, ottoman law, timar system were established; and salyaneli, where timar system was absent, all taxes were gathered and distributed to local needs; the second administrative-military territorial units were sanjaks, the subdivisions of sanjak were kazas and kadiluks, then – nahiyes. Moreover, outside this system there were various types of vassal and tributary states. The governance of such large territory, control over the execution of orders, establishment of relations between different groups of multi-ethnic population of the empire, which lived mostly not in the metropolitan area, but in the provinces, needed the constant functioning of local authorities. The main task of the provincial administration was to organize and to strengthen the communications between the province and the center. Special attention has been given to the description of the place and role, rights and duties of beylerbey, sanjakbey, qadi (judge, defterdar and other local managers at the system of the Ottoman provincial administration. In conclusion it is necessary to point out that the system of local authorities was formed by representatives of the military-administrative (sipahi-timarli, sanjakbey, beylerbey, the Grand Vizier, judicial (qadis (judges, kazaskers, sheikh-ul-Islam and financial (defterdars branches of the Ottoman government. Legal prohibitions and mutual cooperation supported sustainable balance between these executive power branches.

Best possible medication history for hemodialysis patients obtained by a pharmacy technician.

Science.gov (United States)

Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

2009-09-01

Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician's BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems.

The choice of surgical specialization by medical students and their syncopal history.

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Jerzy Rudnicki

Full Text Available BACKGROUND: The aim of the study was to assess whether medical students' fainting outside the university or while witnessing surgical procedures and/or autopsies influenced their choice of a specialization. MATERIALS AND METHODS: The study group consisted of 605 medical students (from fourth to sixth year of study from five medical universities in Poland (325 women, 212 men and 8 responders of an unspecified gender. The median age of subjects studied was 23 years, and the interquartile range was 23-24 years. The students at each university were chosen randomly by the author who worked there and had contact with them. An anonymous questionnaire was developed to gather information regarding demographics, the specialization which each student wanted to choose, the syncope occurrence in the medical history, the syncope and presyncope occurrence during surgery and autopsy as well as the syncopal events' characteristics. RESULTS: The group of 15% of women and 30% of men declared to have pursued the surgical specialization (P<0.001, 29% of women and 56% of men declared the intention to pursue an invasive specialization (P<0.001. As many as 36.0% of women studied and 13.1% of men studied reported syncopal spells outside university (P<0.001. Only 41 students (6.8% reported that syncope or presyncope in any studied circumstances had an impact on their specialization choice. The multivariate analysis showed that the choice of surgical specialization is related to the male gender and the absence of syncopal spells outside the university. CONCLUSIONS: Syncopal and presyncopal spells may affect the professional choices of the medical students. The male gender and a lack of syncope occurrence outside operating room are related to the choice of surgical specialization.

Challenges in reporting on predetermined objectives to the Auditor-General: The case of Limpopo provincial departments

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Melvin Diedericks

2017-04-01

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.

Rethinking the social history in the era of biolegitimacy: global health and medical education in the care of Palestinian and Syrian refugees in Beirut, Lebanon.

Science.gov (United States)

Premkumar, Ashish; Raad, Kareem; Haidar, Mona H

2016-01-01

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.

From the Great War to the Indian Subaltern Studies: provincializing Europe among possible worlds, minor stories, and gender subalternity

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Eugenio Zito

2016-03-01

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.

STD Training in Canadian Medical Schools

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Jo-Anne A Doherty

1992-01-01

of teaching was considered ‘excellent’ in three schools, ‘good’ in nine, and ‘poorly co-ordinated’ in one. CONCLUSIONS: There is no simple solution to ensure that every physician in Canada receives sufficient clinical training in STDs. Collaborative and cooperative efforts by federal, provincial and local governments, professional societies, licensing bodies, medical schools, residency programs, STD clinical directors and provincial and territorial directors of STD control, should be encouraged.

Relationship between air pollutants and economic development of the provincial capital cities in China during the past decade.

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Luo, Yunpeng; Chen, Huai; Zhu, Qiu'an; Peng, Changhui; Yang, Gang; Yang, Yanzheng; Zhang, Yao

2014-01-01

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.

Protection status against hepatitis B infection assessed fromanti-HBs level, history of vaccination andhistory of infection based on anti-HBc in medical students

Science.gov (United States)

Annisa; Zain, LH; Loesnihari, R.

2018-03-01

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.

Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study

NARCIS (Netherlands)

Haring, C.M.; Cools, B.M.; Gurp, P.J.M. van; Meer, J.W.M. van der; Postma, C.T.

2017-01-01

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

Provincial land use planning in British Columbia

International Nuclear Information System (INIS)

Mitchell, W.

1998-01-01

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

Transmission Challenges and Best Practices for Cost-Effective Renewable Energy Delivery across State and Provincial Boundaries

Energy Technology Data Exchange (ETDEWEB)

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)

2017-08-22

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.

Transmission Challenges and Best Practices for Cost-Effective Renewable Energy Delivery across State and Provincial Boundaries

Energy Technology Data Exchange (ETDEWEB)

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)

2017-03-21

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.

"Modern medical science and the divine providence of god": rethinking the place of religion in postwar U.S. medical history.

Science.gov (United States)

Golden, Janet; Abel, Emily K

2014-10-01

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: journals.permissions@oup.com.

Urban Boundary Extraction and Urban Sprawl Measurement Using High-Resolution Remote Sensing Images: a Case Study of China's Provincial

Science.gov (United States)

Wang, H.; Ning, X.; Zhang, H.; Liu, Y.; Yu, F.

2018-04-01

Urban boundary is an important indicator for urban sprawl analysis. However, methods of urban boundary extraction were inconsistent, and construction land or urban impervious surfaces was usually used to represent urban areas with coarse-resolution images, resulting in lower precision and incomparable urban boundary products. To solve above problems, a semi-automatic method of urban boundary extraction was proposed by using high-resolution image and geographic information data. Urban landscape and form characteristics, geographical knowledge were combined to generate a series of standardized rules for urban boundary extraction. Urban boundaries of China's 31 provincial capitals in year 2000, 2005, 2010 and 2015 were extracted with above-mentioned method. Compared with other two open urban boundary products, accuracy of urban boundary in this study was the highest. Urban boundary, together with other thematic data, were integrated to measure and analyse urban sprawl. Results showed that China's provincial capitals had undergone a rapid urbanization from year 2000 to 2015, with the area change from 6520 square kilometres to 12398 square kilometres. Urban area of provincial capital had a remarkable region difference and a high degree of concentration. Urban land became more intensive in general. Urban sprawl rate showed inharmonious with population growth rate. About sixty percent of the new urban areas came from cultivated land. The paper provided a consistent method of urban boundary extraction and urban sprawl measurement using high-resolution remote sensing images. The result of urban sprawl of China's provincial capital provided valuable urbanization information for government and public.

Recente vondsten van breedbladige fonteinkruiden (Groenlandia en Potamogeton spec.) in de provincie Noord-Brabant

NARCIS (Netherlands)

Linden, van der J.; Poelmans, W.

1993-01-01

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

Medical history, lifestyle, family history, and occupational risk factors for adult acute lymphocytic leukemia: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.

Science.gov (United States)

Skibola, Christine F; Slager, Susan L; Berndt, Sonja I; Lightfoot, Tracy; Sampson, Joshua N; Morton, Lindsay M; Weisenburger, Dennis D

2014-08-01

Acute lymphoblastic leukemia/lymphoma (ALL) in adults is a rare malignancy with a poor clinical outcome, and few reported etiologic risk factors. We performed an exploratory pooled study of 152 ALL cases and 23096 controls from 16 case-control studies to investigate the role of medical history, lifestyle, family history, and occupational risk factors and risk of ALL. Age- race/ethnicity-, sex-, and study-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. An increased risk of ALL was found in those with a family history of a hematological malignancy (OR = 2.6, 95% CI = 1.22 to 5.54) and in leather (OR = 3.91, 95% CI = 1.35 to 11.35) and sewing/embroidery workers (OR = 2.92, 95% CI = 1.00 to 8.49). Consumers of alcohol had an increased risk of B-cell ALL (OR = 2.87, 95% CI = 1.18 to 6.95). The small number of statistically significant risk factors identified out of the 112 variables examined could be chance findings and will require further replication to assess their role in the etiology of adult ALL. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Provincial Carbon Emissions Reduction Allocation Plan in China Based on Consumption Perspective

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Xuecheng Wang

2018-04-01

Full Text Available China is a country with substantial differences in economic development, energy consumption mix, resources, and technologies, as well as the development path at the provincial level. Therefore, China’s provinces have different potential and degrees of difficulty to carry out carbon emission reduction (CER requirements. In addition, interprovincial trade, with a large amount of embodied carbon emissions, has become the fastest growing driver of China’s total carbon emissions. A reasonable CER allocation plan is, therefore, crucial for realizing the commitment that China announced in the Paris Agreement. How to determine a fair way to allocate provincial CER duties has become a significant challenge for both policy-makers and researchers. In this paper, ecological network analysis (ENA, combined with a multi-regional input-output model (MRIO, is adopted to build an ecological network of embodied emissions across 30 provinces. Then, by using flow analysis and utility analysis based on the ENA model, the specific relationships among different provinces were determined, and the amount of responsibility that a certain province should take quantified, with respect to the embodied carbon emission (ECE flows from interprovincial trade. As a result, we suggest a new CER allocation plan, based on the detailed data of interprovincial relationships and ECE flows.

Los orígenes del Instituto provincial de higiene de las Canarias orientales y la sanidad municipal (1926-1927: cambios estructurales y asistenciales

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Martín del Castillo, Juan Francisco

2005-12-01

Full Text Available The «Instituto Provincial de Higiene de las Canarias Orientales» is an example of Estatuto Provincial of José Calvo Sotelo (1925. Involved in administrative affaires and economical distributions between the Townhall of Las Palmas de Gran Canaria and Insular Council, its beginning is labour of Doctor Antonio Ortiz de Landázuri, in that moment Health Inspector. In this paper, be described the structure and functions of Hygiene Institute, so the change of technical members of laboratories and stations of previous town health services.

El Instituto Provincial de Higiene de las Canarias Orientales es un ejemplo de la puesta en marcha del Estatuto Provincial de José Calvo Sotelo (1925. Envuelto en medidas administrativas y repartos financieros entre el Ayuntamiento de Las Palmas de Gran Canaria y el Cabildo Insular, su inicio es obra directa del doctor Antonio Ortiz de Landázuri, en aquellos momentos al cargo de la Inspección de Sanidad. En el presente, quedan descritos la estructura y funciones del Instituto de Higiene, además del pase de los miembros facultativos de los laboratorios y estaciones de anteriores servicios municipales del ramo.

Command and Control Analysis of the South West Provincial Regional Emergency Operations Centre during Vancouver 2010

Science.gov (United States)

2011-06-01

Venue Site WACC - Whistler Area Command Centre OTHER GPPAG - Government Partners Public Affairs Group 18 ANNEX B. Interview questions...Vancouver Vancouver Richmond WACC Decision Authority Link Information Sharing Link DOC’s 2010 Provincial Games Secretariat GPPAG CCG

Urban-Rural and Provincial Disparities in Child Malnutrition in China.

Science.gov (United States)

Wu, Yichao; Qi, Di

2016-10-01

This article investigates how the nutritional deprivation and inequality among children in China by provinces and urban/rural areas has changed over time from 1991 to 2009 using the China Health and Nutrition Survey data. The children who were undernourished in stunting and underweight have declined over years, but provincial disparities were significant and urban children performed better than the rural peers. The nutritional deprivation of children has been alleviated in China over time, but more efforts should be made by the government to improve the nutritional condition in less developed provinces and for those children who are severely undernourished.

The political economy of Canadian hydro-electricity : between old provincial hydros and neoliberal regional energy regimes

International Nuclear Information System (INIS)

Netherton, A.

2007-01-01

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

Organizational factors, planning capacity, and integration challenges constrain provincial planning processes for nutrition in decentralizing Vietnam.

Science.gov (United States)

Lapping, Karin; Frongillo, Edward A; Nguyen, Phuong H; Coates, Jennifer; Webb, Patrick; Menon, Purnima

2014-09-01

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.

Doctrinal Debates in the Fourth Mexican Provincial Council (1771

Directory of Open Access Journals (Sweden)

Elisa Luque Alcaide

2005-07-01

Full Text Available Based on  the  most  important sources  of The  Fourth Mexican Provincial  Council  (1771 —specifically its decrees, dairies and catechism for the use of priests— the author reviews the main topics debated along the sessions. The article stresses the discussion over  the  main currents  of theological  and political  thought by “modern” ecclesiastics  who  favoured catholic  Enlightenment, and  those  favourable  to  “traditional” perspectives.  This  paper deals with  regalism,  conciliarist  v.s. episcopalist  views, certain traces of the auxiliis controversy as well as antijesuit policies.

Forecasting residential electricity demand in provincial China.

Science.gov (United States)

Liao, Hua; Liu, Yanan; Gao, Yixuan; Hao, Yu; Ma, Xiao-Wei; Wang, Kan

2017-03-01

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.

CO_2 emissions and energy intensity reduction allocation over provincial industrial sectors in China

International Nuclear Information System (INIS)

Wu, Jie; Zhu, Qingyuan; Liang, Liang

2016-01-01

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

Business and politics in provincial Indonesia: The batik and construction sector in Pekalongan, Central Java

NARCIS (Netherlands)

Savirani, A.

2015-01-01

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

Relationship between air quality and economic development in the provincial capital cities of China.

Science.gov (United States)

Chen, Nengcheng; Xu, Lei

2017-01-01

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.

Parish school inspection as a means of implementation of the policy on Paraná’s provincial education (1853-1889

Directory of Open Access Journals (Sweden)

Maria Elisabeth Blanck Miguel

2015-07-01

Full Text Available This paper addresses the primary public inspection, particularly that exercised by parish inspectors, considered as one of the forms of manifestation of the policy on education. A research about reports and official letters concerning the primary public education in Paraná in the provincial period (1853-1889 shows ordinary school issues and, especially, the relationship between teachers and the authorities responsible for the administration and control of the work in schools. This paper aims to deep the knowledge on parish inspection and literary council, as components of the inspection that used to be present in the relations between teachers and inspectors. The methodology includes documental research, analysis of sources and crossing of information from reports and official letters with the provincial legislation of Paraná. We can conclude that, in spite of a relative legal organization when it comes to the distribution of administrative functions and control over public instruction, the latter remained quite precarious at the end of the provincial period, since only with the advance of social relations of production of material life the school would become necessary.

The accuracy of self-reported medical history: a preliminary analysis of the promise of internet-based research in Inflammatory Bowel Diseases.

Science.gov (United States)

Kelstrup, Anne Mette; Juillerat, Pascal; Korzenik, Joshua

2014-05-01

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

Relationship between air pollutants and economic development of the provincial capital cities in China during the past decade.

Directory of Open Access Journals (Sweden)

Yunpeng Luo

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.

Measuring energy security performance within China: Toward an inter-provincial prospective

International Nuclear Information System (INIS)

Zhang, Long; Yu, Jing; Sovacool, Benjamin K.; Ren, Jingzheng

2017-01-01

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.

Analysis of differences in exercise recognition by constraints on physical activity of hospitalized cancer patients based on their medical history.

Science.gov (United States)

Choi, Mi-Ri; Jeon, Sang-Wan; Yi, Eun-Surk

2018-04-01

The purpose of this study is to analyze the differences among the hospitalized cancer patients on their perception of exercise and physical activity constraints based on their medical history. The study used questionnaire survey as measurement tool for 194 cancer patients (male or female, aged 20 or older) living in Seoul metropolitan area (Seoul, Gyeonggi, Incheon). The collected data were analyzed using frequency analysis, exploratory factor analysis, reliability analysis t -test, and one-way distribution using statistical program SPSS 18.0. The following results were obtained. First, there was no statistically significant difference between cancer stage and exercise recognition/physical activity constraint. Second, there was a significant difference between cancer stage and sociocultural constraint/facility constraint/program constraint. Third, there was a significant difference between cancer operation history and physical/socio-cultural/facility/program constraint. Fourth, there was a significant difference between cancer operation history and negative perception/facility/program constraint. Fifth, there was a significant difference between ancillary cancer treatment method and negative perception/facility/program constraint. Sixth, there was a significant difference between hospitalization period and positive perception/negative perception/physical constraint/cognitive constraint. In conclusion, this study will provide information necessary to create patient-centered healthcare service system by analyzing exercise recognition of hospitalized cancer patients based on their medical history and to investigate the constraint factors that prevents patients from actually making efforts to exercise.

Carbon inequality at the sub-national scale: A case study of provincial-level inequality in CO2 emissions in China 1997-2007

International Nuclear Information System (INIS)

Clarke-Sather, Afton; Qu Jiansheng; Wang Qin; Zeng Jingjing; Li Yan

2011-01-01

This study asks whether sub-national inequalities in carbon dioxide (CO 2 ) emissions mirror international patterns in carbon inequality using the case study of China. Several studies have examined global-level carbon inequality; however, such approaches have not been used on a sub-national scale. This study examines inter-provincial inequality in CO 2 emissions within China using common measures of inequality (coefficient of variation, Gini Index, Theil Index) to analyze provincial-level data derived from the IPCC reference approach for the years 1997-2007. It decomposes CO 2 emissions inequality into its inter-regional and intra-regional components. Patterns of per capita CO 2 emissions inequality in China appear superficially similar to, though slightly lower than, per capita income inequality. However, decomposing these inequalities reveals different patterns. While inter-provincial income inequality is highly regional in character, inter-provincial CO 2 emissions inequality is primarily intra-regional. While apparently similar, global patterns in CO 2 emissions are not mirrored at the sub-national scale. - Highlights: → Carbon inequality is different in character within China than at global scale. → Interprovincial CO 2 emissions inequality in China is slightly lower than income inequality. → Interprovincial GDP inequality in China is regional in character. → Interprovincial CO 2 emissions inequality in China is not regional in character.

Comparison of Pilot Medical History and Medications Found In Postmortem Specimens

National Research Council Canada - National Science Library

Canfield, Dennis V; Salazar, Guillermo J; Lewis, Russell J; Whinnery, James E

2006-01-01

Pilots are required by FAA regulations to report all medications and medical conditions to the FAA Office of Aerospace Medicine for review as to the overall suitability of the pilot for flight activities...

Progress and turning points in legal development of native forests protection at the argentine provincial and uruguayan jurisdictions

Directory of Open Access Journals (Sweden)

Clara María Minaverry

2017-04-01

Full Text Available The general purpose of this paper is to investigate native forests protection regulatory development level, in a selection of argentine provinces in possession of valuable ecosystem forest´s resources, such as the Andean-Patagonian ones. The especial objectives are: To state if provincial regulations have complied with national native forests environmental protection law 26.331 (and if it regulates water resources, and to make a comparative analysis with Uruguay. This is an exploratory research, where analytical comparative method and legal hermeneutics were applied to this study. We could conclude that law 26.331 exceeded some of the selected argentine provincial regulations outlines, and that Uruguay does not have enough regulatory development in order to make an overall comparative analysis.

Accuracy of family history of cancer : clinical genetic implications

NARCIS (Netherlands)

Sijmons, RH; Boonstra, AE; Reefhuis, J; Hordijk-Hos, JM; de Walle, HEK; Oosterwijk, JC; Cornel, MC

Family medical history is the cornerstone of clinical genetic diagnosis and management in cases of familial cancer. The soundness of medical decisions can be compromised if reports by the family on affected relatives are inaccurate. Although very time consuming, family medical histories are

Medical ethics in an era of bioethics: resetting the medical profession's compass.

Science.gov (United States)

Pellegrino, Edmund D

2012-02-01

What it means to be a medical professional has been defined by medical ethicists throughout history and remains a contemporary concern addressed by this paper. A medical professional is generally considered to be one who makes a public promise to fulfill the ethical obligations expressed in the Hippocratic Code. This presentation summarizes the history of medical professionalism and refocuses attention on the interpersonal relationship of doctor and patient. This keynote address was delivered at the Founders of Bioethics International Congress (June, 2010).

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

Science.gov (United States)

Arda, B

1998-01-01

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

Uncovering regional disparity of China's water footprint and inter-provincial virtual water flows.

Science.gov (United States)

Dong, Huijuan; Geng, Yong; Fujita, Tsuyoshi; Fujii, Minoru; Hao, Dong; Yu, Xiaoman

2014-12-01

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.

Mapping and modeling multiple benefits of energy efficiency and emission mitigation in China’s cement industry at the provincial level

International Nuclear Information System (INIS)

Zhang, Shaohui; Worrell, Ernst; Crijns-Graus, Wina

2015-01-01

Highlights: • Provincial disparities in energy use and emissions are quantified for China’s cement industry. • We describe emission mitigation impacts on EEMs with integrated assessment model. • We quantify the multiple benefits potential in China’s cement industry on provincial level. • Energy efficiency would lead to huge reductions in air pollution in all provinces. • We discuss uncertainty in relation to distribution of energy saving and emission reduction. - Abstract: China’s cement industry is the second largest energy consumer and key emitter of CO 2 and air pollutants. It accounts for 7% of total energy consumption in China and 15% of CO 2 , 21% of PM, 4% SO 2 and 10% of NOx of total emissions, respectively. Provincial disparities in energy consumption and emissions of CO 2 and air pollutants in China’s cement industry are rarely quantified. In this study, an integrated assessment model including provincial energy conservation supply curves (ECSC) (which can shows the cost-effective and technical energy saving potential per province), the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model (which can be used to calculate air pollutant emissions), and ArcGIS (a geographical information system (GIS) with elaborated spatial functions) is developed and used to assess the potential of energy savings in terms of emission mitigation of CO 2 and air pollutants and multiple benefits of energy efficiency measures at the provincial level during the period 2011–2030. The results show significant heterogeneity across provinces in terms of potential of energy saving as well as emission mitigation of CO 2 and air pollutants (i.e. PM, SO 2 , and NOx) in the next two decades. Seven provinces (i.e. Shandong, Sichuan, Jiangsu, Guangdong, Zhejiang, Henan, Hebei), six of which are located in the central- and east-China, account for 47% of the total energy saving potential, equivalent to 26% of baseline energy use in 2030. The energy

No Time for Nostalgia!: Asylum-Making, Medicalized Colonialism in British Columbia (1859-97) and Artistic Praxis for Social Transformation

Science.gov (United States)

Roman, Leslie G.; Brown, Sheena; Noble, Steven; Wainer, Rafael; Young, Alannah Earl

2009-01-01

This article asks: How have disability, indigenous arts and cultural praxis transformed and challenged the historical sociological archival research into relationships among asylum-making, medicalized colonialism and eugenics in the Woodlands School, formerly the Victoria Lunatic Asylum, the Provincial Asylum for the Insane in Victoria, BC 1859-72…

Visual Means of Communication in a Contemporary Provincial Town (on the Example of Kurgan Graffiti

Directory of Open Access Journals (Sweden)

E V Maiseeva

2011-12-01

Full Text Available This article considers graffiti as a means of communication in the contemporary urban environment of a provincial town. The author provides several basic approaches to the definition of graffiti and gives some key classifications of graffiti that are used as a basis for analyzing and ranking the empirical data of the research.

Sexual History-Taking: Using Educational Interventions to Overcome Barriers to Learning

Science.gov (United States)

Jayasuriya, Ashini N.; Dennick, Reg

2011-01-01

Sexual history-taking is a basic medical skill that is traditionally taught poorly in medical school. Practising medical professionals have frequently reported feeling inadequately trained at taking these histories or discussing sexual risk. In order to promote and enhance the learning of this basic skill, those who teach sexual history-taking…

Medical History's Moment in Art Photography (1920 to 1950): How Lejaren à Hiller and Valentino Sarra Created a Fashion for Scenes of Early Surgery.

Science.gov (United States)

Hansen, Bert

2017-10-01

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: journals.permissions@oup.com.

Pilot Trial of an Electronic Family Medical History in US Faith-Based Communities.

Science.gov (United States)

Newcomb, Patricia; Canclini, Sharon; Cauble, Denise; Raudonis, Barbara; Golden, Paulette

2014-07-01

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.

Carbon inequality at the sub-national scale: A case study of provincial-level inequality in CO{sub 2} emissions in China 1997-2007

Energy Technology Data Exchange (ETDEWEB)

Clarke-Sather, Afton, E-mail: Afton.Clarke-Sather@colorado.edu [Scientific Information Center for Resources and Environment, Lanzhou Branch of the National Science Library, Chinese Academy of Sciences, 8 Middle Tianshui Road, Lanzhou 730000 (China); Department of Geography, University of Colorado, Boulder, 260 UCB, Boulder, CO 80309 (United States); Qu Jiansheng [Scientific Information Center for Resources and Environment, Lanzhou Branch of the National Science Library, Chinese Academy of Sciences, 8 Middle Tianshui Road, Lanzhou 730000 (China); MOE Key Laboratory of Western China' s Environmental Systems, Research School of Arid Environment and Climate Change, Lanzhou University, Lanzhou (China); Wang Qin [MOE Key Laboratory of Western China' s Environmental Systems, Research School of Arid Environment and Climate Change, Lanzhou University, Lanzhou (China); Zeng Jingjing [Scientific Information Center for Resources and Environment, Lanzhou Branch of the National Science Library, Chinese Academy of Sciences, 8 Middle Tianshui Road, Lanzhou 730000 (China); Li Yan [MOE Key Laboratory of Western China' s Environmental Systems, Research School of Arid Environment and Climate Change, Lanzhou University, Lanzhou (China)

2011-09-15

This study asks whether sub-national inequalities in carbon dioxide (CO{sub 2}) emissions mirror international patterns in carbon inequality using the case study of China. Several studies have examined global-level carbon inequality; however, such approaches have not been used on a sub-national scale. This study examines inter-provincial inequality in CO{sub 2} emissions within China using common measures of inequality (coefficient of variation, Gini Index, Theil Index) to analyze provincial-level data derived from the IPCC reference approach for the years 1997-2007. It decomposes CO{sub 2} emissions inequality into its inter-regional and intra-regional components. Patterns of per capita CO{sub 2} emissions inequality in China appear superficially similar to, though slightly lower than, per capita income inequality. However, decomposing these inequalities reveals different patterns. While inter-provincial income inequality is highly regional in character, inter-provincial CO{sub 2} emissions inequality is primarily intra-regional. While apparently similar, global patterns in CO{sub 2} emissions are not mirrored at the sub-national scale. - Highlights: > Carbon inequality is different in character within China than at global scale. > Interprovincial CO{sub 2} emissions inequality in China is slightly lower than income inequality. > Interprovincial GDP inequality in China is regional in character. > Interprovincial CO{sub 2} emissions inequality in China is not regional in character.

Aprendizaje de la historia clínica con pacientes simulados en el grado de Medicina Learning to take medical histories through patients simulation in undergraduate Medical School students

Directory of Open Access Journals (Sweden)

M. Cristina Rodríguez-Díez

2012-03-01

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.

[Operation directions by comparing financial ratio of 22 provincial hospitals].

Science.gov (United States)

Wang, J Y; Ko, Y C; Wang, J W; Jan, L C; Chang, F M; Lin, K C

1996-12-01

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

Sexual orientation and medical history among Iranian people with Complete Androgen Insensitivity Syndrome and Congenital Adrenal Hyperplasia.

Science.gov (United States)

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

2017-01-01

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.

Hannah's Feeding Journey: A Multidisciplinary Treatment Approach to Establishing Oral Acceptance for a Toddler with a Complex Medical History

Science.gov (United States)

Dunn, Dena M.; Galbally, Sandra Lynn; Markowitz, Goldie; Pucci, Kristy N.; Brochi, Ligia; Cohen, Sherri Shubin

2017-01-01

This article presents the importance of multidisciplinary, family-centered care, and a developmental bio-psycho-social approach to treating feeding difficulties in a child with a complex medical history. Hannah spent the first 9 months of her life in the hospital and was discharged dependent on nasogastric tube feeding. Her journey to recovery…

Education at the Dittrick Museum of Medical History, Case Western Reserve University, Cleveland, Ohio, USA.

Science.gov (United States)

Edmonson, James M

2009-01-01

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.

CHRONICLES OF MEDICAL HISTORY IN AFRICA Medical Icon and ...

African Journals Online (AJOL)

Joly was the Foundation Dean of the Faculty of Medicine, University. College, Ibadan (1948 ... when female education was considered unimportant. Beatrice made up ... best prizes. She went on to pursue a successful postgraduate medical.

Impact of urban structure on personal transportation in the context of a large Danish provincial city

DEFF Research Database (Denmark)

Nielsen, Thomas Alexander Sick

2004-01-01

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 car...

Flora of vascular plants in the Chilgapsan Provincial Park, Korea

Directory of Open Access Journals (Sweden)

Ro-Young Lee

2014-09-01

Full Text Available The flora of Chilgapsan Provincial Park in Cheongyang-gun (Chungcheongnam-do, Korea was surveyed from 2000 to 2014. In 19 field surveys, vascular plants were revealed 490 taxa belonging to 97 families, 309 genera, 433 species, four subspecies, 48 varieties, and five forms. Plants of various categories were discovered in this study. For the Korean endemic plants 15 taxa were recorded, and 11 taxa designated by the Korean Forest Service as rare plants were investigated in this region. The plants above the third degree among the floristic regional indicator plants designated by the Korean Ministry of Environment were 10 taxa. In addition, 33 taxa of naturalized and 73 taxa of cultivated plants were recorded.

Where, when and how much wind is available? A provincial-scale wind resource assessment for China

International Nuclear Information System (INIS)

He, Gang; Kammen, Daniel M.

2014-01-01

China's wind installed capacity has grown at a remarkable rate, over 80% annually average growth since 2005, reaching 91.5 GW of capacity by end of 2013, accounting for over 27% of global capacity. This rapid growth has been the result of a domestic manufacturing base and favorable national policies. Further evolution will be greatly aided with a detailed wind resource assessment that incorporates spatial and temporal variability across China. We utilized 200 representative locations for which 10 years of hourly wind speed data exist to develop provincial capacity factors from 2001 to 2010, and to build analytic wind speed profiles. From these data and analysis we find that China's annual wind generation could reach 2000 TWh to 3500 TWh. Nationally this would correspond to an average capacity factor of 0.18. The diurnal and seasonal variation shows spring and winter has better wind resources than in the summer and fall. A highly interconnected and coordinated power system is needed to effectively exploit this large but variable resource. A full economic assessment of exploitable wind resources demands a larger, systems-level analysis of China's energy options, for which this work is a core requirement. - Highlights: • We assessed China's wind resources by utilizing 10 years of hourly wind speed data of 200 sites. • We built provincial scale wind speed profiles and develop provincial capacity factors for China. • We found that China's wind generation could reach 2000 TWh to 3500 TWh annually. • We observed similar temporal variation pattern of wind availability across China

A history of shaker nurse-herbalists, health reform, and the american botanical medical movement (1830-1860).

Science.gov (United States)

Libster, Martha M

2009-12-01

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.

State of Digital Education Options in the areas of Medical Terminology and the History, Theory and Ethics of Medicine.

Science.gov (United States)

Schochow, Maximilian; Steger, Florian

2015-01-01

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.

State of Digital Education Options in the areas of Medical Terminology and the History, Theory and Ethics of Medicine

Science.gov (United States)

Schochow, Maximilian; Steger, Florian

2015-01-01

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. PMID:26038682

Unesco – to preserve Slovenian medical history

Directory of Open Access Journals (Sweden)

Darinka Soban

2006-03-01

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.

History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population.

Science.gov (United States)

Rocca, Walter A; Yawn, Barbara P; St Sauver, Jennifer L; Grossardt, Brandon R; Melton, L Joseph

2012-12-01

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. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Provincial Coordination and Inter-Institutional Collaboration in British Columbia's College, University College and Institute System. Monograph Series.

Science.gov (United States)

Gaber, Devron

This document addresses a study that aimed to better understand the historical development of British Columbia community college, university college, and institute system with special attention given to recent changes in inter-institutional collaboration in relation to provincial coordination. The study also addresses centralization and…

On history of medical radiology development in Ukraine: war period and after war reconstruction (1941-1947)

International Nuclear Information System (INIS)

Pilipenko, M.Yi.; Artamonova, N.O.; Busigyina, N.O.; Kononenko, O.K.

1994-01-01

The paper is devoted to history of Ukrainian medical radiology development, namely main problems of its scientific and practical aspects of development during 1941-1947. The authors describe the work of Ukrainian roentgenologists and radiologists during the war and after war restoration of radiological service. Contribution of Ukrainian scientists to practical and theoretical achievements of military roentgenology is shown. Operative mobilization of all the forces for restoration of destroyed during the war years roentgenological service allowed to start scientific research within a short term (already in 1945)

China Dimensions Data Collection: China County-Level Data from Provincial Economic Yearbooks, Keyed to 1:1M GIS Map

Data.gov (United States)

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...

Selection and construction of nuclear and radiation emergency medical center in a region

International Nuclear Information System (INIS)

Wang Guojun; He Xu; Liao Li; Gao Dong

2014-01-01

Three level of first-class comprehensive hospital is an important force of nuclear and radiation accident rescue, has a very rich experience in response to nuclear and radiation accidents and deal with large quantities of the sick and wounded. With the foundation and the ability of the construction and operation of medical emergency rescue center. This paper according to the median model location theory of emergency center, combined with the specific situation of the nuclear and radiation accident in Hunan Province, reference location, rescue experience, emergency allocation of resources, teaching and research capacity, establish regional medical emergency center of nuclear and radiation accidents based on three level of first-class comprehensive hospital, break the traditional concept that the center must be provincial capital,form a multi-level, three-dimensional, network of emergency hospital rescue system. The main duties of the center are accident emergency response, on-site treatment and technical guidance of accident, psychological grooming. The author propose building measures according to the duties of the center: increase national and provincial financial investment, carry out training, drills and first aid knowledge missionaries regularly, innovative materials management, speed up the construction of information platform, establish and improve the hospital rescue system, improve organization institution and system of plans, reengineering rescue process. (authors)

Social, psychological and psychosomatic disorders in the people with combat stress in their medical histories

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L. V. Gracheva

2013-01-01

Full Text Available The authors examined three groups of patients – military men (40 men in each group with combat stress of different intensity in their medical histories (two main groups and a  control group – without combat stress. The results showed that the military men with a high level combat stress in the past (more than 5 years ago more frequently demonstrated socialmental disadaptation against the background of subclinical chronic posttraumatic stress disorder (PTSD. The conclusion is that this group of people requires dynamic followup and adequate medicopsychological aid.

A proposed quantitative credit-rating methodology for South African provincial departments

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Erika Fourie

2016-05-01

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.

Electricity exports: Discussion of provincial economic benefits and costs

International Nuclear Information System (INIS)

1993-01-01

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

NGO Presence and Activity in Afghanistan, 2000–2014: A Provincial-Level Dataset

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David F. Mitchell

2017-06-01

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.

Manual de reclutamiento selección, contratación e inducción de personal por competencias para el Gobierno Provincial del Azuay

OpenAIRE

Siavichay Martínez, Welington Bolívar

2013-01-01

La institución en estudio el Gobierno Provincial del Azuay, es una organización de servicios públicos y atención a la colectividad azuaya. En este mundo globalizado la competitividad y la eficiencia, son elementos de supervivencia y definen el futuro de las instituciones, la utilización efectiva de políticas de reclutamiento selección, contratación e inducción de personal por competencias para el Gobierno Provincial del Azuay constituye un elemento clave, ya que de este proceso dependerá en g...

Subjective happiness levels of staff working in provincial organization of general directorate of sport

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Ömer YAZICI

2016-03-01

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.

Family history record and hereditary cancer risk perception according to National Cancer Institute criteria in a Spanish medical oncology service: a retrospective study.

Science.gov (United States)

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

2012-01-01

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.

Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism.

Science.gov (United States)

Doukas, David J; McCullough, Laurence B; Wear, Stephen

2012-03-01

Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.

Development and implementation of a Bridge Management System for the Provincial Government of the Western Cape, South Africa

CSIR Research Space (South Africa)

Nordengen, Paul A

2005-04-01

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...

[Medical theories and urban management: Fortaleza's 1877-79 drought].

Science.gov (United States)

Costa, Maria Clélia Lustosa

2004-01-01

Down through the nineteenth century, new medical theories on the origin of disease influenced the norms and regulations that controlled the population's behavior and the urban space. The present study discusses the ideas, medical practices , and administrative initiatives adopted during the 1877-79 drought in Fortaleza, capital of Ceará province. The drought was accompanied by a smallpox epidemic, along with the increased migration of sertão dwellers to the capitol. The city lacked a public service network capable of meeting the needs of this new population, which took up lodgings on the city and periphery. The municipal administration endeavored to implement the recommendations of physicians based on modern principles of hygienization. Through an analysis of reports by the provincial presidents and by public health inspectors, the study intends to show how these medical theories influenced the practices of urban reorganization at a moment of public emergency.

Oral health Status, Medical History, Xerostomia dan Quality of Life of elderly In Luwu Timur, Sulawesi Selatan

OpenAIRE

Samad, Rasmidar

2013-01-01

Xerostomia is a common condition in elderly people which may result in permanent impairtment that would be one risk factor for decreased quality of life Objective the aim of this study is to determine the relathionship of sociodemographic status, medical history, xerostomia, tooth loss and caries status with quality of life of elderly in luwu timur Xerostomia is a common condition in elderly people which may result in permanent impairtment that would be one risk factor for decreased qua...

Inter-provincial clean development mechanism in China: A case study of the solar PV sector

International Nuclear Information System (INIS)

Jacques, David A.; Guan, Dabo; Geng, Yong; Xue, Bing; Wang, Xiaoguang

2013-01-01

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

Beyond "medical tourism": Canadian companies marketing medical travel.

Science.gov (United States)

Turner, Leigh

2012-06-15

Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, "Liberation therapy" for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other businesses market regional, cross

The spirit of democracy in the implementation of public information policy at the provincial government of West Java

Science.gov (United States)

Sjoraida, D. F.; Asmawi, A.; Anwar, R. K.

2018-03-01

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.

Medical revolution in Argentina.

Science.gov (United States)

Ballarin, V L; Isoardi, R A

2010-01-01

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.

The current situation and development of medical device testing institutes in China.

Science.gov (United States)

Yang, Xiaofang; Mu, Ruihong; Fan, Yubo; Wang, Chunren; Li, Deyu

2017-04-01

This article analyses the current situation and development of Chinese medical device testing institutes from the perspectives of the two most important functions - testing functions and medical device standardization functions. Areas Covered: The objective of the Chinese government regulations for medical device industry is to ensure the safety and effectiveness of medical devices for Chinese patients. To support the regulation system, the Chinese government has established medical device testing institutes at different levels for example, the national, provincial, and municipal levels. These testing institutes also play an important role in technical support during medical device premarket registration and post market surveillance, they are also the vital practitioners of Chinese medical device standardization. Expert Commentary: Chinese medical device testing institutes are technical departments established by government, and serve the regulatory functions of government agency. In recent years, with the rapid development of medical device industry as well as constantly increasing international and domestic medical device market, the importance of medical device testing institute is more prominent, However, there are still some problems unsolved, such as their overall capacity remains to be improved, construction of standardization is to be strengthened, etc.

Texas Medication Algorithm Project, phase 3 (TMAP-3): clinical results for patients with a history of mania.

Science.gov (United States)

Suppes, Trisha; Rush, A John; Dennehy, Ellen B; Crismon, M Lynn; Kashner, T Michael; Toprac, Marcia G; Carmody, Thomas J; Brown, E Sherwood; Biggs, Melanie M; Shores-Wilson, Kathy; Witte, Bradley P; Trivedi, Madhukar H; Miller, Alexander L; Altshuler, Kenneth Z; Shon, Steven P

2003-04-01

The Texas Medication Algorithm Project (TMAP) assessed the clinical and economic impact of algorithm-driven treatment (ALGO) as compared with treatment-as-usual (TAU) in patients served in public mental health centers. This report presents clinical outcomes in patients with a history of mania (BD), including bipolar I and schizoaffective disorder, bipolar type, during 12 months of treatment beginning March 1998 and ending with the final active patient visit in April 2000. Patients were diagnosed with bipolar I disorder or schizoaffective disorder, bipolar type, according to DSM-IV criteria. ALGO was comprised of a medication algorithm and manual to guide treatment decisions. Physicians and clinical coordinators received training and expert consultation throughout the project. ALGO also provided a disorder-specific patient and family education package. TAU clinics had no exposure to the medication algorithms. Quarterly outcome evaluations were obtained by independent raters. Hierarchical linear modeling, based on a declining effects model, was used to assess clinical outcome of ALGO versus TAU. ALGO and TAU patients showed significant initial decreases in symptoms (p =.03 and p <.001, respectively) measured by the 24-item Brief Psychiatric Rating Scale (BPRS-24) at the 3-month assessment interval, with significantly greater effects for the ALGO group. Limited catch-up by TAU was observed over the remaining 3 quarters. Differences were also observed in measures of mania and psychosis but not in depression, side-effect burden, or functioning. For patients with a history of mania, relative to TAU, the ALGO intervention package was associated with greater initial and sustained improvement on the primary clinical outcome measure, the BPRS-24, and the secondary outcome measure, the Clinician-Administered Rating Scale for Mania (CARS-M). Further research is planned to clarify which elements of the ALGO package contributed to this between-group difference.

Aniversario XXX de la creación del Centro Provincial de Información de Las Tunas

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Edenny Reina Castillo Montes de Oca

2014-08-01

Full Text Available El 4 de enero de 1984 se inauguró el Centro Provincial de Información de Ciencias Médicas de Las Tunas, lo que permitió organizar la Red Provincial de Bibliotecas Médicas y con ello crear nuevos escenarios para desarrollar la actividad científico - informativa en el territorio; con la apertura de una biblioteca en cada unidad de salud. El Centro inicialmente estuvo ubicado en un pequeño local cercano a la biblioteca del Hospital “Dr. Ernesto Guevara de la Serna”. En el año 1988; con la misión, la visión y los objetivos de trabajo de su objeto social bien definidos, fue trasladado para la Facultad de Ciencias Médicas “Dr. Zoilo Marinello Vidaurreta”, de la provincia de Las Tunas y al crearse la Universidad de Ciencias Médicas en esta provincia, el Centro Provincial de Información pasa a ser una dependencia directa de la misma. En la primera década se sentaron las bases de lo que es hoy el Sistema Provincial de Información de Ciencias de la Salud, constituido por 25 bibliotecas médicas distribuidas en toda la geografía tunera, con la misión de: “garantizar la prestación de servicios de información científico tecnológica a la comunidad de profesionales que conforman el sector de la salud en la provincia, con el fin de elevar la calidad de la asistencia, la investigación, la docencia, la dirección y la cultura médica nueva y propiciar el hallazgo de soluciones que posibiliten enfrentar los problemas de salud”. Durante estos 30 años, los trabajadores de la información en el territorio han laborado con verdadera dedicación para cumplir cada tarea encomendada, asumir los retos del desarrollo continuo de la ciencia, asimilar las nuevas tecnologías y brindar a nuestros usuarios servicios y productos de alto valor informacional. La movilización de recursos lograda a través de los proyectos de la Red Nacional de Salud INFOMED, entre los cuales figuran: Proyecto SIDA, Proyecto para la Promoción de Publicaciones

PLAN DE MANEJO ECOTURÍSTICO: ESTUDIO DE CASO ÁREA PROTEGIDA PROVINCIAL CAMARONES, CANTÓN JAMA, MANABÍ

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Neme Yamil Doumet Chilán

2015-10-01

Full Text Available Esta investigación tuvo como objetivo elaborar un plan de manejo ecoturístico en el área protegida provincial Camarones del cantón Jama. Este estudio forma parte de la estructura de un plan de manejo ejecutado por el Gobierno Provincial de Manabí para la creación de esta área protegida. Fue necesario desarrollar los siguientes estudios y procesos metodológicos: diagnóstico turístico situacional, zonificación, senderización, e implementación de facilidades y señalética turística. Se utilizó manuales de la UICN y Sistema de Áreas de Conservación Provincial (SACP, además programas de georeferenciación y equipos de GPS. Con esto se busca el uso sustentable y la gestión ecoturística de los recursos existentes. Se observa que en los estudios de diagnóstico y zonificación se determina que el área posee una infinidad de recursos naturales y altos indicadores de biodiversidad, se trata de un ecosistema que está en peligro de desaparecer. Es importante la aplicación de un plan de manejo que sirva como línea base para la gestión de los recursos naturales y culturales. La investigación sirvió como fundamento para el análisis, gestión y ejecución de proyectos ecoturísticos que permitirán el desarrollo de actividades vinculadas al turismo y a la sustentabilidad. Los documentos que se generaron estarán a disposición y vinculados a los Ministerios de Ambiente y Turismo.

Predictions on the Development Dimensions of Provincial Tourism Discipline Based on the Artificial Neural Network BP Model

Science.gov (United States)

Yang, Yang; Hu, Jun; Lv, Yingchun; Zhang, Mu

2013-01-01

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…

Potential and cost-effectiveness of off-grid PV systems in Indonesia - An evaluation on a provincial level

NARCIS (Netherlands)

Veldhuis, A.J.; Reinders, Angelina H.M.E.

2014-01-01

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 [1]. For this study we use an adapted methodology leading to cumulative numbers for the

Medical profession and nuclear war: a social history

International Nuclear Information System (INIS)

Day, B.; Waitzkin, H.

1985-01-01

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

[Remarks to the quality of historical contributions in recent medical journals. Critical comments on the example of the history of traumatology].

Science.gov (United States)

WeiBer, Christoph

2004-01-01

Review articles on the history of medical topics in recent medical (non-historical) journals are often of a much worse quality than observational and experimental articles. The criteria of quality of a historical review article, elaborated on the example of the contribution. "300 years of intramedullary fixation - from Aztec practice to standard treatment modality" by U. Knothe, M. L. Knothe Tate, and S. M. Perren, are: clear definition of the theme treated, extensive heuristic investigations, exact study of source material and original publications, critical sifting of secondary literature, naming of the first names and biographical data of historical persons, account of the historical background, use of historical evidences, and reviewing by a medical historian. By taking notice of these items historical misjudgements can be avoided.

Perspective: Teaching and mentoring the history of medicine: an Oslerian perspective.

Science.gov (United States)

Bryan, Charles S; Longo, Lawrence D

2013-01-01

Many predict a takeover (seen by some as hostile, and by others as inadvertent) of professional virtues and values by government and capitalism. One source of professional virtues and values consists of lessons from the history of medicine as taught and mentored by Sir William Osler. Some medical schools have required courses in medical history, but proposing a new requirement would probably be a tough sell to most curriculum committees. Osler himself argued against compulsory courses in medical history. The authors propose that exposing medical students to the history of medicine promotes at least two of the seven types of professionalism identified by Hafferty and Castellani. Exposure to the evolution of medical science and to exemplary physicians of bygone eras promotes nostalgic professionalism, which, although in some ways suspect and naïve, fosters a sense of belonging and solidarity as members of a profession, not a trade, whereas exposure to the evolution of medicine as a public service, to the sad history of health care disparities, and to patients' perspectives promotes activist professionalism, fostering a sense of civic responsibility and opposition to excessive commercialism.Steps to promote such exposure include (1) identifying faculty, community physicians, and others interested in the history of medicine, (2) including the history of medicine in faculty development programs, (3) considering a segment in the history of medicine during the introduction to each major course, (4) sponsoring history clubs, and (5) promoting environments favorable for mentor-protégé relationships for faculty and students with further interest.

El sistema de control interno y su incidencia en las unidades de logística y control patrimonial de la municipalidad provincial de talara - 2014

OpenAIRE

Alfaro Alfaro, Gustavo Otilano

2016-01-01

La investigación titulada, “El Sistema de Control Interno y su incidencia en las Unidades de Logística y Control Patrimonial de la Municipalidad Provincial de Talara”, tiene como propósito, proponer la implementación de una eficiente Estructura de Control Interno, mediante la aplicación del Informe COSO I, enfoque moderno sobre Control Interno, en las Unidades de Logística y Control Patrimonial de la Municipalidad provincial de Talara, para el mejoramiento de su gestión y el logro de sus obje...

Medical tourism’s impact for health systems: A study from three Asian countries

Directory of Open Access Journals (Sweden)

Ala`a Nimer AbuKhalifeh

2015-12-01

Full Text Available Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism’s growth for health systems, illustration on the cases of Thailand, Singapore and Malaysia, three provincial centres for medical tourism, via an extensive review of academic and grey literature. Variables for further analysis of the potential impact of medical tourism on health systems are also identified. The framework can provide a basis for empirical, in country studies weighing the benefits and disadvantages of medical tourism for health systems. The policy implications described are of particular relevance for policymakers and industry practitioners in other Southeast Asian countries with similar health systems where governments have expressed interest in facilitating the growing of the medical tourist industry.

Beyond "medical tourism": Canadian companies marketing medical travel

Science.gov (United States)

2012-01-01

Background Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, “Liberation therapy” for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Methods Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Results Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other

38 CFR 4.41 - History of injury.

Science.gov (United States)

2010-07-01

... DISABILITIES Disability Ratings The Musculoskeletal System § 4.41 History of injury. In considering the residuals of injury, it is essential to trace the medical-industrial history of the disabled person from the... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false History of injury. 4.41...

Development of a Computerized Medical History Profile for Children in Out-of-Home Placement Using Medicaid Data

Science.gov (United States)

Chisolm, Deena J.; Scribano, Philip V.; Purnell, Tanjala S.; Kelleher, Kelly J.

2010-01-01

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

MEDICAL TOURISM : Demand for Cuban Medical Tourism by Russian Consumers

OpenAIRE

Ulanova, Anastasia

2015-01-01

Medical tourism, often addressed as health tourism, is a new concept in terms of tourism industry in general, and it is also one of the rapidly developing and growing ones. This thesis gives information on the medical tourism in general and its history. It also revises the development stages of the medical tourism in the world. Cuban medical tourism is analyzed on its own, as well as Russian medical tourism and the demand for it. Medical tourism is rather popular among Russians due to various...

Ethanol research with representatives of provincial/territorial governments and ethanol retailers : final report

Energy Technology Data Exchange (ETDEWEB)

NONE

2007-03-15

This paper provided the results of a survey conducted to obtain feedback from retailers and provincial and territorial governments concerning the promotion of ethanol use. A key objective of the research was to determine whether local and provincial governments and retailers are interested in cooperating with the federal government in promoting ethanol use. Thirteen government representatives were interviewed as well as 11 retailers. Results of the study suggested that approaches to collaboration with the diverse stakeholders involved in the promotion of ethanol will require a tailored approach. The needs and interests of jurisdictions and provinces varied widely. Outlets selling ethanol-blended gasoline were concentrated in Ontario, Quebec, and Saskatchewan. Retailers who embraced the alternative fuel tended to be well-established in the ethanol market, and did not require assistance from the Government of Canada. Retailers who were reluctant to embrace ethanol stated that they were only likely to enter the market when required to do so by law. Many stakeholders felt that consumers entertained common misperceptions concerning ethanol, and that consumers were unsure of the effect of ethanol on their vehicles. Many retailers had taken steps to communicate with consumers about the relative benefits of ethanol-blended gasoline. Results indicated that the federal government can assist provinces and retailers by providing promotional tools such as flyers, pamphlets and brochures. Interest among retailers in collaborating with the government was only moderate. It was recommended that retailers be provided with accurate information on ethanol. It was concluded that strategies should be developed by the federal government to increase public awareness of ethanol use.

Explorations of Tenth-Grade STS[E] Curricula across Three Provincial Political Landscapes

Science.gov (United States)

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

History of the term prostate.

Science.gov (United States)

Josef Marx, Franz; Karenberg, Axel

2009-02-01

We comprehensively review the history of the word "prostate" and related terms from 600 BC to the present. Both medical and non-medical ancient texts were searched to clarify the term's etymology and use. Anatomy textbooks of the 16th through the 18th century were analyzed to identify descriptions, illustrations and various expressions used by contemporary authors to designate the prostate. In ancient Greek the masculine term "prostatēs" meant "president" and was exclusively used in a non-medical sense. It was not until the Renaissance that anatomists discovered the organ naming it "glandulous body." In 1600 the French physician du Laurens introduced the metaphoric denomination "prostatae." However he and his contemporaries misinterpreted the history of the organ and the term, choose the wrong gender when translating it into Latin, and believed that it designated a double organ. Only in the 1800s was this anatomical error corrected while the grammatical one lived on. The history of the term "prostate" is a prime example of the difficulties with which the development of a precise urologic terminology had to struggle. At the same time this retrospective view provides a stimulus to avoid linguistic ambiguity in the future.

Factors associated with whole carcass condemnation rates in provincially-inspected abattoirs in Ontario 2001-2007: implications for food animal syndromic surveillance

Directory of Open Access Journals (Sweden)

Alton Gillian D

2010-08-01

Full Text Available Abstract Background Ontario provincial abattoirs have the potential to be important sources of syndromic surveillance data for emerging diseases of concern to animal health, public health and food safety. The objectives of this study were to: (1 describe provincially inspected abattoirs processing cattle in Ontario in terms of the number of abattoirs, the number of weeks abattoirs process cattle, geographical distribution, types of whole carcass condemnations reported, and the distance animals are shipped for slaughter; and (2 identify various seasonal, secular, disease and non-disease factors that might bias the results of quantitative methods, such as cluster detection methods, used for food animal syndromic surveillance. Results Data were collected from the Ontario Ministry of Agriculture, Food and Rural Affairs and the Ontario Cattlemen's Association regarding whole carcass condemnation rates for cattle animal classes, abattoir compliance ratings, and the monthly sales-yard price for various cattle classes from 2001-2007. To analyze the association between condemnation rates and potential explanatory variables including abattoir characteristics, season, year and commodity price, as well as animal class, negative binomial regression models were fit using generalized estimating equations (GEE to account for autocorrelation among observations from the same abattoir. Results of the fitted model found animal class, year, season, price, and audit rating are associated with condemnation rates in Ontario abattoirs. In addition, a subset of data was used to estimate the average distance cattle are shipped to Ontario provincial abattoirs. The median distance from the farm to the abattoir was approximately 82 km, and 75% of cattle were shipped less than 100 km. Conclusions The results suggest that secular and seasonal trends, as well as some non-disease factors will need to be corrected for when applying quantitative methods for syndromic surveillance

Business and politics in provincial Indonesia: The batik and construction sector in Pekalongan, Central Java

OpenAIRE

Savirani, A.

2015-01-01

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 state and business after decentralization policy in 2001 followed by various technocratic approach in public sector. The study focuses on two business sectors: the batik and construction in Pekalongan,...

Predicting Risk of Suicide Attempt Using History of Physical Illnesses From Electronic Medical Records

Science.gov (United States)

Luo, Wei; Tran, Truyen; Berk, Michael; Venkatesh, Svetha

2016-01-01

Background Although physical illnesses, routinely documented in electronic medical records (EMR), have been found to be a contributing factor to suicides, no automated systems use this information to predict suicide risk. Objective The aim of this study is to quantify the impact of physical illnesses on suicide risk, and develop a predictive model that captures this relationship using EMR data. Methods We used history of physical illnesses (except chapter V: Mental and behavioral disorders) from EMR data over different time-periods to build a lookup table that contains the probability of suicide risk for each chapter of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes. The lookup table was then used to predict the probability of suicide risk for any new assessment. Based on the different lengths of history of physical illnesses, we developed six different models to predict suicide risk. We tested the performance of developed models to predict 90-day risk using historical data over differing time-periods ranging from 3 to 48 months. A total of 16,858 assessments from 7399 mental health patients with at least one risk assessment was used for the validation of the developed model. The performance was measured using area under the receiver operating characteristic curve (AUC). Results The best predictive results were derived (AUC=0.71) using combined data across all time-periods, which significantly outperformed the clinical baseline derived from routine risk assessment (AUC=0.56). The proposed approach thus shows potential to be incorporated in the broader risk assessment processes used by clinicians. Conclusions This study provides a novel approach to exploit the history of physical illnesses extracted from EMR (ICD-10 codes without chapter V-mental and behavioral disorders) to predict suicide risk, and this model outperforms existing clinical assessments of suicide risk. PMID:27400764

Women in medicine and dermatology: history and advances.

Science.gov (United States)

França, Katlein; Ledon, Jennifer; Savas, Jessica; Nouri, Keyvan

2014-01-01

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology.

Women in medicine and dermatology: history and advances*

Science.gov (United States)

França, Katlein; Ledon, Jennifer; Savas, Jessica; Nouri, Keyvan

2014-01-01

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology. PMID:24626675

Literature, history and the humanization of bioethics.

Science.gov (United States)

Emmerich, Nathan

2011-02-01

This paper considers the disciplines of literature and history and the contributions each makes to the discourse of bioethics. In each case I note the pedagogic ends that can be enacted though the appropriate use of the each of these disciplines in the sphere of medical education, particularly in the medical ethics classroom.(1) I then explore the contribution that both these disciplines and their respective methodologies can and do bring to the academic field of bioethics. I conclude with a brief consideration of the relations between literature and history with particular attention to the possibilities for a future bioethics informed by history and literature after the empirical turn. © 2010 Blackwell Publishing Ltd.

A history of medical student debt: observations and implications for the future of medical education.

Science.gov (United States)

Greysen, S Ryan; Chen, Candice; Mullan, Fitzhugh

2011-07-01

Over the last 50 years, medical student debt has become a problem of national importance, and obtaining medical education in the United States has become a loan-dependent, individual investment. Although this phenomenon must be understood in the general context of U.S. higher education as well as economic and social trends in late-20th-century America, the historical problem of medical student debt requires specific attention for several reasons. First, current mechanisms for students' educational financing may not withstand debt levels above a certain ceiling which is rapidly approaching. Second, there are no standards for costs of medical school attendance, and these can vary dramatically between different schools even within a single city. Third, there is no consensus on the true cost of educating a medical student, which limits accountability to students and society for these costs. Fourth, policy efforts to improve physician workforce diversity and mitigate shortages in the primary care workforce are inhibited by rising levels of medical student indebtedness. Fortunately, the current effort to expand the U.S. physician workforce presents a unique opportunity to confront the unsustainable growth of medical student debt and explore new approaches to the financing of medical students' education.

Working conditions that contribute to absenteeism among nurses in a provincial hospital in the Limpopo Province.

Science.gov (United States)

Nyathi, M; Jooste, K

2008-03-01

Absenteeism results in an increased workload for nurses who stand in for colleagues and can lead to situations in which a lack of motivation among nurses and a lowering of the quality of patient care may occur. The researcher observed that certain conditions, such as inflexible working schedules, were given as reasons for the absenteeism in units in a provincial hospital. A non-experimental, descriptive, quantitative study was undertaken. The purpose of the article was to describe the working conditions that contribute to absenteeism among the professional and sub-professional nurses at a provincial hospital in the Limpopo province of South Africa. The sample included 107 professional nurses and 163 sub-professional nurses who voluntarily agreed to participate in the study. A questionnaire was used to collect data, which was analysed by using descriptive and inferential statistics. The findings of this study indicated that personal and managerial characteristics, and organisational and working conditions may lead to absenteeism in the workplace. This article focuses on the working conditions that are constraints, namely inadequate group cohesion, inadequate delegation of autonomy, role ambiguity, ineffective routinisation and the effect of the workload in the workplace. Recommendations are made for improving working conditions to combat absenteeism among nurses. The limitations of this study are highlighted.

Administrative health data in Canada: lessons from history.

Science.gov (United States)

Lucyk, Kelsey; Lu, Mingshan; Sajobi, Tolulope; Quan, Hude

2015-08-19

Health decision-making requires evidence from high-quality data. As one example, the Discharge Abstract Database (DAD) compiles data from the majority of Canadian hospitals to form one of the most comprehensive and highly regarded administrative health databases available for health research, internationally. However, despite the success of this and other administrative health data resources, little is known about their history or the factors that have led to their success. The purpose of this paper is to provide an historical overview of Canadian administrative health data for health research to contribute to the institutional memory of this field. We conducted a qualitative content analysis of approximately 20 key sources to construct an historical narrative of administrative health data in Canada. Specifically, we searched for content related to key events, individuals, challenges, and successes in this field over time. In Canada, administrative health data for health research has developed in tangent with provincial research centres. Interestingly, the lessons learned from this history align with the original recommendations of the 1964 Royal Commission on Health Services: (1) standardization, and (2) centralization of data resources, that is (3) facilitated through governmental financial support. The overview history provided here illustrates the need for longstanding partnerships between government and academia, for classification, terminology and standardization are time-consuming and ever-evolving processes. This paper will be of interest to those who work with administrative health data, and also for countries that are looking to build or improve upon their use of administrative health data for decision-making.

Forms of Consolidation of Provincial Society in the Conditions of World War I

Directory of Open Access Journals (Sweden)

Irina N. Litvinova

2015-12-01

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.

History of psychiatry

Science.gov (United States)

Shorter, Edward

2013-01-01

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

A Methodology to Institutionalise User Experience in Provincial Government

Directory of Open Access Journals (Sweden)

Marco Cobus Pretorius

2014-12-01

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.

El nacimiento de la hacienda provincial alavesa (1463-1537

Directory of Open Access Journals (Sweden)

José Ramón DÍAZ DE DURANA

2009-12-01

Full Text Available En una época de afirmación de la autonomía local y provincial como la que vivimos, resulta paradójico constatar cómo el origen y primeros pasos de algunas instituciones locales o provinciales es todavía un tema mal conocido. Un buen ejemplo es el de las instituciones forales alavesas, aunque no sean escasos, sin embargo, los trabajos de carácter general donde se aborda el problema. Estudios que, desde luego, describen con perfección, más o menos milimétrica, el funcionamiento puntual de aquéllas en etapas históricas y especialmente en el momento en que fueron escritos. Pero esos trabajos, amén de haber contribuido a alimentar más de un tópico y alguna que otra interesada interpretación, pecan por defecto en una cuestión de gran interés para entender por qué los acontecimientos se desarrollaron como lo hicieron, al mostrarnos una imagen demasiado estática de esas instituciones.

Development of Colonial Medical and Health Services in Ibadan ...

African Journals Online (AJOL)

Journal of History and Diplomatic Studies ... There is no doubt that medicine is important in the history of any society. ... This limitation of colonial medical intervention coupled with age old medical ideas in Ibadan consequently occasioned the continuity of indigenous medical culture and adaptation of Western medicine in ...

“Glorioso templo de sabedoria”: o Lyceu Provincial e a Instrução Secundária na Parahyba do Norte

Directory of Open Access Journals (Sweden)

Nayana Rodrigues Cordeiro Mariano

2017-12-01

Full Text Available FERRONATO, Cristiano de Jesus. (2014. Das Aulas Avulsas ao Lyceu Provincial: As primeiras configurações da instrução secundária na província da Parahyba do Norte (1836-1884. Aracaju: EDISE/Edunit.

Value of pharmacist medication interviews on optimizing the electronic medication reconciliation process.

Science.gov (United States)

Lee, Audrey; Varma, Arjun; Boro, Maureen; Korman, Nancy

2014-06-01

Few studies have explored the impact of using different methods for obtaining accurate medication histories on medication safety. This study was conducted to compare the accuracy and clinical impact of pharmacist medication histories obtained by electronic medical record review (EMRR) alone with those obtained by direct interviews combined with EMRR. This 18-week prospective study included patients who were admitted to the Inpatient Medicine Service at the study institution and who had a pharmacist-conducted medication reconciliation EMRR within 48 hours of hospital admission. A chart review was performed to collect data to determine whether differences existed in the number of discrepancies, recommendations, and medication errors between the EMRR alone group compared to the EMRR combined with the patient interview group. Five hundred thirteen discrepancies were identified with the EMRR group compared to 986 from the combined EMRR and patient interview group (P < .001). Significantly more recommendations were made in the combination interview group compared to the EMRR alone group (260 vs 97; P < .001). Fewer medication errors were identified for the EMRR alone group compared to the combination interview group (55 vs 134; P < .001). The most common errors were omitted medications followed by extra dose/failure to discontinue therapy and wrong dose/frequency errors. Pharmacist-conducted admission medication interviews combined with EMRR can potentially identify harmful medication discrepancies and prevent medication errors.

Een lichte variant van ProMeV toegepast in twaalf provincies : een invulling van een risicogestuurde aanpak van weginfrastructuur.

NARCIS (Netherlands)

Bax, C. A. Eenink, R.G. Commandeur, J.J.F. & Loenis, B.J.C.

2017-01-01

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

The impact of socially-accountable, community-engaged medical education on graduates in the Central Philippines: Implications for the global rural medical workforce.

Science.gov (United States)

Siega-Sur, J L; Woolley, T; Ross, S J; Reeve, C; Neusy, A-J

2017-10-01

Developing and retaining a high quality medical workforce, especially within low-resource countries has been a world-wide challenge exacerbated by a lack of medical schools, the maldistribution of doctors towards urban practice, health system inequities, and training doctors in tertiary centers rather than in rural communities. To describe the impact of socially-accountable health professional education on graduates; specifically: their motivation towards community-based service, preparation for addressing local priority health issues, career choices, and practice location. Cross-sectional survey of graduates from two medical schools in the Philippines: the University of Manila-School of Health Sciences (SHS-Palo) and a medical school with a more conventional curriculum. SHS-Palo graduates had significantly (p < 0.05) more positive attitudes to community service. SHS-Palo graduates were also more likely to work in rural and remote areas (p < 0.001) either at district or provincial hospitals (p = 0.032) or in rural government health services (p < 0.001) as Municipal or Public Health Officers (p < 0.001). Graduates also stayed longer in both their first medical position (p = 0.028) and their current position (p < 0.001). SHS-Palo medical graduates fulfilled a key aim of their socially-accountable institution to develop a health professional workforce willing and able, and have a commitment to work in underserved rural communties.

Using Grey Relational Analysis to Evaluate Energy Consumption, CO2 Emissions and Growth Patterns in China’s Provincial Transportation Sectors

Science.gov (United States)

Yuan, Changwei; Liu, Hongchao

2017-01-01

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. PMID:29292779

Medication Review and Transitions of Care: A Case Report of a Decade-Old Medication Error.

Science.gov (United States)

Comer, Rachel; Lizer, Mitsi

2017-10-01

A 69-year-old Caucasian male with a 25-year history of paranoid schizophrenia was brought to the emergency department because of violence toward the staff in his nursing facility. He was diagnosed with a urinary tract infection and was admitted to the behavioral health unit for medication stabilization. History included a five-year state psychiatric hospital admission and nursing facility placement. Because of poor cognitive function, the patient was unable to corroborate medication history, so the pharmacy student on rotation performed an in-depth chart review. The review revealed a transcription error in 2003 deleting amantadine 100 mg twice daily and adding amiodarone 100 mg twice daily. Subsequent hospitalization resulted in another transcription error increasing the amiodarone to 200 mg twice daily. All electrocardiograms conducted were negative for atrial fibrillation. Once detected, the consulted cardiologist discontinued the amiodarone, and the primary care provider was notified via letter and discharge papers. An admission four months later revealed that the nursing facility restarted the amiodarone. Amiodarone was discontinued and the facility was again notified. This case reviews how a 10-year-old medication error went undetected in the electronic medical records through numerous medication reconciliations, but was uncovered when a single comprehensive medication review was conducted.

Physician input and licensing of at-risk drivers: a review of all-inclusive medical evaluation forms in the US and Canada.

Science.gov (United States)

Meuser, Thomas M; Berg-Weger, Marla; Niewoehner, Patricia M; Harmon, Annie C; Kuenzie, Jill C; Carr, David B; Barco, Peggy P

2012-05-01

This article details a systematic review of medical evaluation forms in support of licensing decisions for medically at-risk drivers. Comparisons were made between all-inclusive forms utilized by 52 State and Provincial Departments of Motor Vehicles (DMVs) in the US and Canada. Comparisons focused on length, format, content, instructional quality, medical coverage, ease of use, and other qualitative characteristics. Median page length was 2 (range 1-10), and mean word count was 1083 (494-3884). Common response options included open-ended (98%), forced choice (87%), and check box (81%). While the majority of forms (77%) required driver consent, only 24% requested information from the driver. Less than half (46%) included text on confidentiality protection. While all forms requested general medical information, just over half included specific sections for vision (54%) and cognitive/neurological conditions (56%). Most forms (81%) required that a judgment be made concerning driver safety, and half prompted for possible license restrictions. Criterion-based quality ratings were assigned on a five-point Likert scale by group consensus. One third of forms were rated as marginal or poor in comprehensiveness and utility, and just two garnered an excellent overall rating. Findings are discussed relative to current research on driver fitness and elements of a proposed model form. Best practice recommendations include a page length limitation, emphasis on in-person evaluation (i.e., as opposed to a records-only review), prompts to collect crash and other driving history information, clear instructions and stepwise format, content prompts across relevant medical categories, documentation of functional status and impairment levels, options for driving with restrictions in lieu of de-licensing, and emphasis on relative (vs. absolute) clinical judgments of overall driver safety. Copyright © 2011 Elsevier Ltd. All rights reserved.

The use of virtual patients to teach medical students history taking and communication skills.

Science.gov (United States)

Stevens, Amy; Hernandez, Jonathan; Johnsen, Kyle; Dickerson, Robert; Raij, Andrew; Harrison, Cyrus; DiPietro, Meredith; Allen, Bryan; Ferdig, Richard; Foti, Sebastian; Jackson, Jonathan; Shin, Min; Cendan, Juan; Watson, Robert; Duerson, Margaret; Lok, Benjamin; Cohen, Marc; Wagner, Peggy; Lind, D Scott

2006-06-01

At most institutions, medical students learn communication skills through the use of standardized patients (SPs), but SPs are time and resource expensive. Virtual patients (VPs) may offer several advantages over SPs, but little data exist regarding the use of VPs in teaching communication skills. Therefore, we report our initial efforts to create an interactive virtual clinical scenario of a patient with acute abdominal pain to teach medical students history-taking and communication skills. In the virtual scenario, a life-sized VP is projected on the wall of an examination room. Before the virtual encounter, the student reviews patient information on a handheld tablet personal computer, and they are directed to take a history and develop a differential diagnosis. The virtual system includes 2 networked personal computers (PCs), 1 data projector, 2 USB2 Web cameras to track the user's head and hand movement, a tablet PC, and a microphone. The VP is programmed with specific answers and gestures in response to questions asked by students. The VP responses to student questions were developed by reviewing videotapes of students' performances with real SPs. After obtaining informed consent, 20 students underwent voice recognition training followed by a videotaped VP encounter. Immediately after the virtual scenario, students completed a technology and SP questionnaire (Maastricht Simulated Patient Assessment). All participants had prior experience with real SPs. Initially, the VP correctly recognized approximately 60% of the student's questions, and improving the script depth and variability of the VP responses enhanced most incorrect voice recognition. Student comments were favorable particularly related to feedback provided by the virtual instructor. The overall student rating of the virtual experience was 6.47 +/- 1.63 (1 = lowest, 10 = highest) for version 1.0 and 7.22 +/- 1.76 for version 2.0 (4 months later) reflecting enhanced voice recognition and other

Studentification and ‘apprentice’ gentrifiers within Britain’s provincial towns and cities: extending the meaning of gentrification

OpenAIRE

Darren P Smith; Louise Holt

2007-01-01

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...

Federal, provincial and territorial public health response plan for biological events.

Science.gov (United States)

McNeill, R; Topping, J

2018-01-04

The Federal/Provincial/Territorial (FPT) Public Health Response Plan for Biological Events was developed for the Public Health Network Council (PHNC). This plan outlines how the national response to public health events caused by biological agents will be conducted and coordinated, with a focus on implementation of responses led by senior-level FPT public health decision-makers. The plan was developed by an expert task group and was approved by PHNC in October, 2017. The plan describes roles, responsibilities and authorities of FPT governments for public health and emergency management, a concept of operations outlining four scalable response levels and a governance structure that aims to facilitate an efficient, timely, evidence-informed and consistent approach across jurisdictions. Improving effective engagement amongst public health, health care delivery and health emergency management authorities is a key objective of the plan.

Z české provincie až do Pacifiku

Czech Academy of Sciences Publication Activity Database

Martínek, Jiří

2017-01-01

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)

Comparisons between written and computerised patient histories

NARCIS (Netherlands)

Quaak, Martien; Westerman, R. Frans; van Bemmel, Jan H.

1987-01-01

Patient histories were obtained from 99 patients in three different ways: by a computerised patient interview (patient record), by the usual written interview (medical record), and by the transcribed record, which was a computerised version of the medical record. Patient complaints, diagnostic

A history of the American College of Medical Quality.

Science.gov (United States)

Fetterolf, Donald; Brodie, Bridget

2011-01-01

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.

Library Collaboration with Medical Humanities in an American Medical College in Qatar

Directory of Open Access Journals (Sweden)

Sally Birch

2013-11-01

Full Text Available The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of ‘doctors’ stories’ related to the practice of medicine (including medically-oriented movies and TV programs, and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a ‘best practices’ approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.

Library collaboration with medical humanities in an american medical college in qatar.

Science.gov (United States)

Birch, Sally; Magid, Amani; Weber, Alan

2013-11-01

The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of 'doctors' stories' related to the practice of medicine (including medically-oriented movies and TV programs), and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a 'best practices' approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.

Impulsive aggression, delay discounting, and adolescent suicide attempts: effects of current psychotropic medication use and family history of suicidal behavior.

Science.gov (United States)

Bridge, Jeffrey A; Reynolds, Brady; McBee-Strayer, Sandra M; Sheftall, Arielle H; Ackerman, John; Stevens, Jack; Mendoza, Kristen; Campo, John V; Brent, David A

2015-03-01

Impulsive-aggressive behaviors have been consistently implicated in the phenomenology, neurobiology, and familial aggregation of suicidal behavior. The purpose of this study was to extend previous work by examining laboratory behavioral measures of delayed reward impulsivity and impulsive aggression in adolescent suicide attempters and never-suicidal comparison subjects. Using the Point Subtraction Aggression Paradigm (PSAP) and the Delay Discounting Task (DDQ), the authors examined delay discounting and impulsive aggression in 40 adolescent suicide attempters, ages 13-18, and 40 never-suicidal, demographically matched psychiatric comparison subjects. Overall, suicide attempters and comparison subjects performed similarly on the PSAP and DDQ. There was a significant group by current psychotropic medication use interaction (p=0.013) for mean aggressive responses on the PSAP. Group comparisons revealed that attempters emitted more aggressive responses per provocation than comparison subjects, only in those not on psychotropic medication (p=0.049), whereas for those currently treated with psychotropic medication, there were no group differences (p>0.05). This interaction effect was specific to current antidepressant use. Among all subjects, family history of suicidal behavior (suicide or suicide attempt) in first degree relatives was significantly correlated with both delay discounting (r=-0.22, p=0.049), and aggressive responding (r=0.27, p=0.015). Family history of suicidal behavior was associated with delay discounting, but not with aggressive responding on the PSAP, after controlling for relevant covariates. In this study, impulsive-aggressive responding was associated with suicide attempt only in those not being treated with antidepressants. Future work to replicate and extend these findings could have important therapeutic implications for the treatment of depressed suicide attempters, many of whom are affected by impulsive aggression.

The Hidden History of a Famous Drug : Tracing the Medical and Public Acculturation of Peruvian Bark in Early Modern Western Europe (c. 1650-1720)

NARCIS (Netherlands)

Klein, Wouter; Pieters, Toine

2016-01-01

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

[The attempts at drug therapy of cancer by Anton Störck (1731-1803). History of experimental pharmacology in the old Vienna Medical School].

Science.gov (United States)

Schweppe, K W; Probst, C

1982-03-15

The essay deals with the development of medical research in Vienna - especially the development of therapeutic drugs. This progress is related to the philosophical, historical, and political background of the enlightened absolutism and the reformatory efforts of van Swieten during the regency of Maria Theresia in Austria. Anton Störck's research on hemlock (Conium maculatum) is used as an example. The method of Störck's research-work is described. Furthermore it is demonstrated to what extent Störck's data, deduced from empirical examinations, are integrated in the official medical system, i.e. Boerhaave's iatromechanic system. Finally the attempt is made to correlate these processes of medical history with the scientific-historical model of Thomas Kuhn.

Relationship between Air Pollutants and Economic Development of the Provincial Capital Cities in China during the Past Decade

Science.gov (United States)

Luo, Yunpeng; Chen, Huai; Zhu, Qiu'an; Peng, Changhui; Yang, Gang; Yang, Yanzheng; Zhang, Yao

2014-01-01

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 indictorssuch 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 provinical 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. PMID:25083711

Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam.

Science.gov (United States)

Harris, Jody; Nguyen, Phuong H; To, Quyen; Frongillo, Edward A; Menon, Purnima

2016-12-01

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.

21 CFR 820.184 - Device history record.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Device history record. 820.184 Section 820.184 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES QUALITY SYSTEM REGULATION Records § 820.184 Device history record. Each manufacturer shall...

eLearning in Higher Education Makes Its Debut in Cambodia: Implications of the Provincial Business Education Project

Directory of Open Access Journals (Sweden)

Buenafe R. Abdon

2007-03-01

Full Text Available Developing countries face a number of challenges in their efforts to compete successfully in the new global economy. Perhaps the most critical resource needed to achieve these goals is trained human capital. While many developing countries are trying to address this need through traditional means, this may not be the most effective or efficient response. e-Learning has been suggested as an alternative approach that can overcome many of the challenges involved in reaching underserved students. But most educational institutions in developing countries are unfamiliar with e-Learning, have low levels of computer availability, access, familiarity and Internet penetration which leads to skepticism about the feasibility of this approach. In an effort to assess the potential of e-Learning in meeting the needs for developing human capital in Cambodia, this paper reports on the experience and achievements of the Provincial Business Education through the Community Information Centers (CICs project. Key findings are that e-Learning was able to successfully deliver tertiary educational opportunities to underserved provincial students, Cambodian students were able to overcome serious challenges and that female Cambodian students demonstrated superior performance in online classes. These results suggest that e-Learning is an effective alternative for delivering tertiary education in Cambodia.

[The First World War and medical school of Petrograd].

Science.gov (United States)

Rostovtsev, E A; Sidorchuk, I V

2014-09-01

The article is devoted to the history of higher medical education of the Petrograd just before and during the First World War. The topical issue is the lack of information concerning this period of the history of Russian medicine and medical education, and the history of development of domestic medicine during the First World War, the centenary of which is celebrated this year. On the basis of a wide range of published and archival sources the authors show the basic vectors of development of medical education and exploring the role of St. Petersburg as one of the leading academic medical centres in the country.

Medical tourism and bariatric surgery: who pays?

Science.gov (United States)

Sheppard, Caroline E; Lester, Erica L W; Chuck, Anderson W; Kim, David H; Karmali, Shahzeer; de Gara, Christopher J; Birch, Daniel W

2014-12-01

The objective of this study was to determine the short-term cost impact that medical tourism for bariatric surgery has on a public healthcare system. Due to long wait times for bariatric surgery services, Canadians are venturing to private clinics in other provinces/countries. Postoperative care in this population not only burdens the provincial health system with intervention costs required for complicated patients, but may also impact resources allotted to patients in the public clinic. A chart review was performed from January 2009 to June 2013, which identified 62 medical tourists requiring costly interventions related to bariatric surgery. Secondarily, a survey was conducted to estimate the frequency of bariatric medical tourists presenting to general surgeons in Alberta, necessary interventions, and associated costs. A threshold analysis was used to compare costs of medical tourism to those from our institution. A conservative cost estimate of $1.8 million CAD was calculated for all interventions in 62 medical tourists. The survey established that 25 Albertan general surgeons consulted 59 medical tourists per year: a cost of approximately $1 million CAD. Medical tourism was calculated to require a complication rate ≤ 28% (average intervention cost of $37,000 per patient) to equate the cost of locally conducted surgery: a rate less than the current supported evidence. Conducting 250 primary bariatric surgeries in Alberta is approximately $1.9 million less than the modeled cost of treating 250 medical tourists returning to Alberta. Medical tourism has a substantial impact on healthcare costs in Alberta. When compared to bariatric medical tourists, the complication rate for locally conducted surgery is less, and the cost of managing the complications is also much less. Therefore, we conclude that it is a better use of resources to conduct bariatric surgery for Albertan residents in Alberta than to fund patients to seek surgery out of province/country.

American College of Medical Toxicology

Science.gov (United States)

... Publications Journal of Medical Toxicology About ACMT About Us History of ACMT ACMT Fact Sheet Strategic Plan ACMT ... Policies IJMT JMT Editorial Board About ACMT About Us History of ACMT ACMT Fact Sheet Strategic Plan ACMT ...

[History in the public communication of specialist scientific societies: history marketing].

Science.gov (United States)

Moll, F H; Halling, T; Rathert, P; Fangerau, H

2014-10-01

History is nowadays used as an economic factor. The past is therefore specifically targeted and cultivated, which for specialist scientific associations and societies often fullfils totally different functions in comparison to the open market, although the techniques and requirements are similar. Within medical specialties these facts are often still unknown. Museums and archives as well as the historians and curators working in them are very familiar with the special cultures of communication within these scientific communities and they play a major role in the establishment and development of history as a modern part of public relations and public identity.

Represión en Sevilla: el tribunal de responsabilidades políticas. Fondo del Archivo Histórico Provincial de Sevilla (Repression in Seville: the court of political responsibilities. Fund of the Historical Provincial Archive of Seville

Directory of Open Access Journals (Sweden)

Antonio Rosa Félix

2013-12-01

Full Text Available Resumen: El Archivo Histórico Provincial de Sevilla guarda un fondo de expedientes de Responsabilidades Políticas, procedentes del Juzgado de Primera Instancia e Instrucción de Sanlúcar la Mayor. La Ley de Responsabilidades Políticas de 1939 aglutina la normativa que los generales golpistas aplicaron desde el verano de 1936. Había que arruinar al vencido y para ello se creó esta jurisdicción especial, una inversión en la represión para crear y mantener un régimen lleno de adeptos. En el mundo rural se quería recuperar la hegemonía de la oligarquía agraria y mantener la situación anterior a la reforma agraria.Abstract: The Historical Provincial Archive of Seville keeps a collection of files record of Political Responsibilities, proceeding from the Court of The First Instance and Sanlúcar's Instruction. The Law of Political Responsibilities of 1939 agglutinates the regulation that the general rebels applied from the summer of 1936. It was necessary to ruin the defeated one and for it this special jurisdiction, an investment was created in the repression to create and to support a regime full followers'. In the rural world one wanted to recover the hegemony of the agrarian oligarchy and to support the situation previous to the agrarian reform.

Archives of Medical Education; 1876 - 1971.

Science.gov (United States)

Association of American Medical Colleges, Washington, DC.

This bibliography of the archives of the Association of Medical Colleges includes: general history entries (1876-1971); AMA history publications (1904-1970); other history publications (1934-1962); biomedical research policy publications (1955-1971); reports of conferences, seminars, institutes, workshops, and special studies (1910-1971); Council…

Morbilidad geriátrica en el Hospital Provincial Clinicoquirúrgico Docente "Saturnino Lora" de Santiago de Cuba Geriatric morbidity in "Saturnino Lora" Provincial Clinical Surgical Teaching Hospital of Santiago de Cuba

Directory of Open Access Journals (Sweden)

Graciela Trinidad Tejera Ibarra

2012-12-01

Full Text Available Se realizó un estudio retrospectivo, descriptivo y transversal de 130 pacientes mayores de 65 años, seleccionados a través del método aleatorio simple durante su ingreso en la Sala de Geriatría del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, de junio a diciembre del 2011, con vistas a identificar las principales causas de morbilidad en estos ancianos. En la serie la mayoría de los integrantes correspondieron al sexo masculino, con predominio del grupo etario de 65-69 años, y se destacaron las enfermedades respiratorias como originarias de morbilidad, fundamentalmente la bronconeumonía, seguidas en menor frecuencia de las afecciones cardiovasculares y las neoplásicas, de las cuales sobresalieron, con un número superior de afectados, la hipertensión arterial y el cáncer de pulmón, respectivamente. Se calculó la tasa de prevalencia para expresar la morbilidad y como unidad de resumen estadístico se empleó el porcentaje.A retrospective, descriptive and cross-sectional study was conducted in 130 patients older than 65 years, selected through simple random method during their admission to the Geriatrics Department of "Saturnino Lora" Provincial Clinical Surgical Teaching Hospital of Santiago de Cuba, from June to December 2011, in order to identify the main causes of morbidity in these elderly. In the series most of the patients were male with prevalence of the age group of 65-69 years, and respiratory diseases as cause of morbidity, mainly bronchopneumonia, followed by a lesser frequency of cardiovascular and neoplastic diseases predominated, of them hypertension and lung cancer prevailed with a higher number of patients, respectively. Rate of prevalence was estimated to express the morbidity and as statistical summary unit, percentage was used.

A brief history of plastic surgery in Iran.

Science.gov (United States)

Kalantar-Hormozi, Abdoljalil

2013-03-01

 Although the exact time of performing plastic surgery is not addressed in the medical and historical literature, it can be supposed that these surgical procedures have a long and fascinating history.  Recent excavations provided many documents regarding the application of medical instruments, surgical and even reconstructive procedures during the pre-historic and ancient periods. Actually, there is no historical definite time-zone separating general and cosmetic operations in the pre-modern time; however, historically there have been many surgeons who tried to perform reconstructive procedures during their usual medical practice. This article presents a brief look at the history of plastic surgery form the ancient to the contemporary era, with a special focus on Iran.

[Field investigation of occupational disease diagnosis in Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014: an analysis of 136 cases].

Science.gov (United States)

Fan, C Y; Li, X D; Wen, W; Wang, Y Y; Zhang, Y; Lang, L

2016-04-20

To investigate the characteristics of 136 patients with occupational diseases, to summarize key techniques used in field investigation, and to provide a scientific basis for the development of standard operating procedures for field investigation of occupational disease diagnosis. Field investigation and routine data analysis were performed to analyze the cases diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from January 2009 to December 2014. A total of 136 cases of occupational diseases were diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014, and there were 66 cases of leukemia, 18 cases of suspected occupational benzene poisoning, 12 cases of suspected occupational handarm vibration disease, and 11 cases of suspected pneumoconiosis. Of all these patients, 41.91% were engaged in at least three types of work, 70.59% were exposed to at least three types of chemicals, 25.74% experienced changes in technical processes and chemicals, and 47.06% had disputes on the chemicals they were exposed to during verification by both parties. Occupational hazard factors were detected. Most samples (358)were used to measure benzene concentration in workplace air, among which 11.7% had a benzene concentration of >6.00 mg/m(3)(exceeding standard), 13.41% had a benzene concentration of 3.26~6.00 mg/m(3), 75.42% had a benzene concentration ofoccupational hand-arm vibration disease, suspected pneumoconiosis, and suspected occupational noiseinduced hearing loss had high overstandard rates (100%, 93.8%, and 83.3%, respectively). Field investigation of occupational disease diagnosis reveals large numbers of cases of leukemia, suspected occupational benzene poisoning, suspected occupational hand-arm vibration disease, and suspected pneumoconiosis. The key aspects of field investigation include confirmation of the history of occupational exposure, identification of occupational hazard

Argentina enacts first law on medical use of the cannabis plant. History and perspectives

Directory of Open Access Journals (Sweden)

Eduardo L De Vito

2017-10-01

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.

An Exercise in Paleobiogeographic Provinciality.

Science.gov (United States)

Rowland, Stephen M.

1984-01-01

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…

Early modern natural history: Contributions from the Americas

Indian Academy of Sciences (India)

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 ...

The Hidden History of a Famous Drug: Tracing the Medical and Public Acculturation of Peruvian Bark in Early Modern Western Europe (c. 1650-1720).

Science.gov (United States)

Klein, Wouter; Pieters, Toine

2016-10-01

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: journals.permissions@oup.com.

Prognostic and predictive factors of the breast cancer impact at the Matanzas Provincial Oncology Unit

International Nuclear Information System (INIS)

Gonzalo Zambrano, Ruben Dario; Fundora Madruga, Guillermo; Rodriguez Jimenez, Pablo

2010-01-01

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

Weaving together peer assessment, audios and medical vignettes in teaching medical terms

Science.gov (United States)

Khan, Lateef M.

2015-01-01

Objectives The current study aims at exploring the possibility of aligning peer assessment, audiovisuals, and medical case-report extracts (vignettes) in medical terminology teaching. In addition, the study wishes to highlight the effectiveness of audio materials and medical history vignettes in preventing medical students' comprehension, listening, writing, and pronunciation errors. The study also aims at reflecting the medical students' attitudes towards the teaching and learning process. Methods The study involved 161 medical students who received an intensive medical terminology course through audio and medical history extracts. Peer assessment and formative assessment platforms were applied through fake quizzes in a pre- and post-test manner. An 18-item survey was distributed amongst students to investigate their attitudes and feedback towards the teaching and learning process. Quantitative and qualitative data were analysed using the SPSS software. Results The students did better in the posttests than on the pretests for both the quizzes of audios and medical vignettes showing a t-test of -12.09 and -13.60 respectively. Moreover, out of the 133 students, 120 students (90.22%) responded to the survey questions. The students gave positive attitudes towards the application of audios and vignettes in the teaching and learning of medical terminology and towards the learning process. Conclusions The current study revealed that the teaching and learning of medical terminology have more room for the application of advanced technologies, effective assessment platforms, and active learning strategies in higher education. It also highlights that students are capable of carrying more responsibilities of assessment, feedback, and e-learning. PMID:26637986

Trauma history is associated with prior suicide attempt history in hospitalized patients with major depressive disorder.

Science.gov (United States)

Brown, Lily A; Armey, Michael A; Sejourne, Corinne; Miller, Ivan W; Weinstock, Lauren M

2016-09-30

Although the relationships between PTSD, abuse history, and suicidal behaviors are well-established in military and outpatient samples, little data is available on this relationship in inpatient samples. This study examines the relationships between these variables and related demographic and clinical correlates in a sample of psychiatric inpatients with a diagnosis of major depressive disorder using electronic medical record (EMR) data. Controlling for relevant demographic and clinical variables, PTSD diagnosis and history of abuse were both significantly associated with history of suicide attempt, but in a combined model, only history of abuse remained as a significant predictor. Whereas history of abuse was associated with a history multiple suicide attempts, PTSD diagnosis was not. Both insurance status and gender acted as significant moderators of the relationship between history of abuse and history of suicide attempt, with males and those with public/no insurance having greater associations with history of suicide attempts when an abuse history was present. These data indicate the importance of documentation of PTSD, abuse history, and history of suicide attempts. The results also suggest that in the presence of an abuse history or PTSD diagnosis, additional time spent on safety and aftercare planning following hospital discharge may be indicated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Constructing Indicators for Measuring Provincial Sustainable Development Index in Vietnam

Science.gov (United States)

Truong, Van Canh; Lisowski, Andrzej

2018-03-01

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.

Scientific criteria document for the development of an interim provincial water quality objective for aniline

Energy Technology Data Exchange (ETDEWEB)

Angelow, R.V.; Bazinet, N.

1996-11-01

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.

The effects of energy policy of the Dutch province Overijssel; De effecten van het energiebeleid van de Provincie Overijssel

Energy Technology Data Exchange (ETDEWEB)

Wetzels, W.; Van Hout, M.; Jablonska, B.; Koutstaal, P.R.; Kroon, P.; Lako, P.; Plomp, A.J.; Volkers, C.H. [ECN Beleidsstudies, Petten (Netherlands)

2013-06-15

The Dutch Province of Overijssel has the ambition to reach a 20% share of renewable energy in 2020. The province is using a range of policy instruments to improve the investment climate for renewable energy and energy savings. Overijssel has asked ECN to investigate which effects can be expected in the period 2007-2020. The policies have significant positive effects on renewable energy, energy efficiency and employment, but are not sufficient for the province to reach the target of 20% renewable energy in 2020 [Dutch] De Provincie Overijssel heeft de ambitie om in 2020 een aandeel van 20% hernieuwbare energie te bereiken. Overijssel richt zich op het creëren van een goed investeringsklimaat voor hernieuwbare energie en energiebesparing. Het is de bedoeling dat het provinciale energiebeleid bijdraagt aan lastenverlichting, energiezekerheid, werkgelegenheid en innovatie. De Provincie Overijssel heeft ECN gevraagd onderzoek te doen naar de effecten van het Overijsselse energiebeleid. De twee onderzoeksvragen zijn: (1) Wat zijn de beleidseffecten van het Energiepact en het programma Nieuwe Energie; en (2) Wat is de verwachting met betrekking tot het halen van de doelen tot en met 2020.

On climate adaptability of nine species of Adiantum ornamental ferns in 34 provincial capital cities,China

Directory of Open Access Journals (Sweden)

CHEN Yunhui

2015-10-01

Full Text Available Adiantum malesianum,A. myriosorum,A. capillus-junonis,A. capillus-veneris,A. caudatum,A. davadii,A. deentulum,A. edgeworthii and A. erythrochlamys are nine ornamental ferns of the family Adinataceae,with potential application prospect in the aspect of urban landscape and greening construction.To understand their climatic adaptation characteristics in 34 provincial capital cities in China,so as to provide the guidance for their cultivation.Based on 11 current biological climate data in RCP45CO2 emissions scenario,and 694 occurrence records in China,records,MaxEnt model and Arc Gis9.3 software were applied to quantitatively predict the potential distribution ranges of these nine fern species in China.The results show a quietly differences among the nine fern species in their climatic adaptation in 34 provincial capital cities.A. malesianum,A. myriosorum,A. capillus-junonis,A. capillus-veneris,A. deentulum and A. edgeworthii are more suitable grow in southwest China including Southeastern Sichuan,Chongqing,Yunnan,Guizhou,with wider potential distribution ranges;A. malesianum,A. capillus-junonis,A. capillus-veneris and A. caudatum have higher climatic adaptability in Southern China;Adiantum myriosorum,A. capillus-junonis,A. capillus-veneris,A. davadii and A. edgeworthii have higher climate adaptability in Central China;The potential distribution ranges of A. capillus-junonis and A. edgeworthii cover the north area of Beijing,Tianjin and Shijiazhuang,with their combined climate suitability index reaching as high as 0.60.

Economic Impacts from PM2.5 Pollution-Related Health Effects in China: A Provincial-Level Analysis.

Science.gov (United States)

Xie, Yang; Dai, Hancheng; Dong, Huijuan; Hanaoka, Tatsuya; Masui, Toshihiko

2016-05-03

This study evaluates the PM2.5 pollution-related health impacts on the national and provincial economy of China using a computable general equilibrium (CGE) model and the latest nonlinear exposure-response functions. Results show that the health and economic impacts may be substantial in provinces with a high PM2.5 concentration. In the WoPol scenario without PM2.5 pollution control policy, we estimate that China experiences a 2.00% GDP loss and 25.2 billion USD in health expenditure from PM2.5 pollution in 2030. In contrast, with control policy in the WPol scenario, a control investment of 101.8 billion USD (0.79% of GDP) and a gain of 1.17% of China's GDP from improving PM2.5 pollution are projected. At the provincial level, GDP loss in 2030 in the WoPol scenario is high in Tianjin (3.08%), Shanghai (2.98%), Henan (2.32%), Beijing (2.75%), and Hebei (2.60%) and the top five provinces with the highest additional health expenditure are Henan, Sichuan, Shandong, Hebei, and Jiangsu. Controlling PM2.5 pollution could bring positive benefits in two-thirds of provinces. Tianjin, Shanghai, Beijing, Henan, Jiangsu, and Hebei experience most benefits from PM2.5 pollution control as a result of a higher PM2.5 pollution and dense population distribution. Conversely, the control investment is higher than GDP gain in some underdeveloped provinces, such as Ningxia, Guizhou, Shanxi, Gansu, and Yunnan.

[The history of the institutionalization of medical psychology in Austria].

Science.gov (United States)

Hirnsperger, Hans; Mundschütz, Reinhard; Sonneck, Gernot

2011-01-01

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.

Maternal near-misses at a provincial hospital in Papua New Guinea: A prospective observational study.

Science.gov (United States)

Bolnga, John W; Morris, Marilyn; Totona, Catherine; Laman, Moses

2017-12-01

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.

Design Issues and Information Contents of the Provincial Government Websites of Indonesia: A Content Analysis on Visual Messages

Directory of Open Access Journals (Sweden)

Achmad Syarief

2009-07-01

Full Text Available A website is not just merely act as an object of displaying information, but it also represents a contextual medium of communication through visuals and contents. The interplay of website design elements builds up meanings that affect users beyond what previous communication practices have uncovered. Previous research acknowledges that visuals and contents have significant effects in attracting users’ attention and trust. Thus, the ability of a website to provide credible information through visuals and contents to target users is therefore plays great importance in the success of a website. However, although a considerable number of researches on website design have been performed, study in understanding the characteristics of site’s visual appearances and information contents for the purpose of promoting local investment in Indonesia has been very limited. This paper addresses visual design issues and information contents of eighteen provincial government websites of Indonesia. Through content analysis, the paper comparatively examines visual appearances, information contents, and functions of each website, in order to determine visual characteristics and contents that suit the purpose of promoting local potencies. The paper focuses on commonality, discrepancy, and pattern of contents, provide suggestions to improve the use of provincial government website design of Indonesia.

Does rural generalist focused medical school and family medicine training make a difference? Memorial University of Newfoundland outcomes.

Science.gov (United States)

Rourke, James; Asghari, Shabnam; Hurley, Oliver; Ravalia, Mohamed; Jong, Michael; Graham, Wendy; Parsons, Wanda; Duggan, Norah; O'Keefe, Danielle; Moffatt, Scott; Stringer, Katherine; Sturge Sparkes, Carolyn; Hippe, Janelle; Harris Walsh, Kristin; McKay, Donald; Samarasena, Asoka

2018-03-01

Rural recruitment and retention of physicians is a global issue. The Faculty of Medicine at Memorial University of Newfoundland, Canada, was established as a rural-focused medical school with a social accountability mandate that aimed to meet the healthcare needs of a sparse population distributed over a large landmass as well as the needs of other rural and remote areas of Canada. This study aimed to assess whether Memorial medical degree (MD) and postgraduate (PG) programs were effective at producing physicians for their province and rural physicians for Canada compared with other Canadian medical schools. This retrospective cohort study included medical school graduates who completed their PG training between 2004 and 2013 in Canada. Practice locations of study subjects were georeferenced and assigned to three geographic classes: Large Urban; Small City/Town; and Rural. Analyses were performed at two levels. (1) Provincial level analysis compared Memorial PG graduates practicing where they received their MD and/or PG training with other medical schools who are the only medical school in their province (n=4). (2) National-level analysis compared Memorial PG graduates practicing in rural Canada with all other Canadian medical schools (n=16). Descriptive and bivariate analyses were performed. Overall, 18 766 physicians practicing in Canada completed Canadian PG training (2004-2013), and of those, 8091 (43%) completed Family Medicine (FM) training. Of all physicians completing Canadian PG training, 1254 (7%) physicians were practicing rurally and of those, 1076 were family physicians. There were 379 Memorial PG graduates and of those, 208 (55%) completed FM training and 72 (19%) were practicing rurally, and of those practicing rurally, 56 were family physicians. At the national level, the percentage of all Memorial PG graduates (19.0%) and FM PG graduates (26.9%) practicing rurally was significantly better than the national average for PG (6.4%, p<0.000) and FM (12

[Medical history impressions of Karl Marx 1983].

Science.gov (United States)

Kaiser, W

1983-12-15

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.

Evaluation of Randomly Selected Completed Medical Records Sheets in Teaching Hospitals of Jahrom University of Medical Sciences, 2009

Directory of Open Access Journals (Sweden)

Mohammad Parsa Mahjob

2011-06-01

Full Text Available Background and objective: Medical record documentation, often use to protect the patients legal rights, also providing information for medical researchers, general studies, education of health care staff and qualitative surveys is used. There is a need to control the amount of data entered in the medical record sheets of patients, considering the completion of these sheets is often carried out after completion of service delivery to the patients. Therefore, in this study the prevalence of completeness of medical history, operation reports, and physician order sheets by different documentaries in Jahrom teaching hospitals during year 2009 was analyzed. Methods and Materials: In this descriptive / retrospective study, the 400 medical record sheets of the patients from two teaching hospitals affiliated to Jahrom medical university was randomly selected. The tool of data collection was a checklist based on the content of medical history sheet, operation report and physician order sheets. The data were analyzed by SPSS (Version10 software and Microsoft Office Excel 2003. Results: Average of personal (Demography data entered in medical history, physician order and operation report sheets which is done by department's secretaries were 32.9, 35.8 and 40.18 percent. Average of clinical data entered by physician in medical history sheet is 38 percent. Surgical data entered by the surgeon in operation report sheet was 94.77 percent. Average of data entered by operation room's nurse in operation report sheet was 36.78 percent; Average of physician order data in physician order sheet entered by physician was 99.3 percent. Conclusion: According to this study, the rate of completed record papers reviewed by documentary in Jahrom teaching hospitals were not desirable and in some cases were very weak and incomplete. This deficiency was due to different reason such as medical record documentaries negligence, lack of adequate education for documentaries, High work

Electronic medical history designed by a multidisciplinary unit mastology; Historia clinica electronica disenada por una unidad de mastologia multidisciplinaria

Energy Technology Data Exchange (ETDEWEB)

Camejo, N.; Castillo, C.; Vaca, N.; Camargo, B.; Artagaveytia, N.; Acuna, S.; Milans, S.; Lavina, G.; Carzoglio, J.; Jacobo, O.; Pressa, C.; Delgado, L. [Servicio de Oncologia, Hospital de Clinicas, Montevideo (Uruguay)

2012-11-15

Full text: Objective: To facilitate the collection, organization and analysis of data from patients Unit assisted in Mastology by producing an electronic health record. Materials and Methods: We evaluated forms provided by medical oncologists, radio therapists, radiologists, pathologists, and plastic surgeons mastologists collect data interrogation, physical examination, complementary examinations, diagnoses, anatomy pathological evolution and treatment instituted and generating the system was computerized {sup U}nit Mastology - Electronic Health Record ( UMAHCE){sup .} Results: The story was designed in modules that collect data on instances arising diagnostic, treatment and monitoring of patients. Each module is represented by an icon that changes color to enter data, allowing the objectify doctor if they are or not the data for that module. The system can attach images recorded by breast exam photos, photos of study, imaging (mammography, CT, MRI) in the same way that the surgeon to enter the protocol surgical or anatomical pathologist enter a pathological report of a study untimely or after definitive surgery. The system can generate an automatic report of the input data that can be printed and placed in the patient's medical history. It also can generate the e mail alerts doctors on pathological results were entered into regarding the diagnosis or treatment breast cancer (eg, mammography B I-Rads 4 or 5, report positive cytologic puncture malignancy, H R and Her status). Conclusions: We developed an electronic medical record that allows different doctors involved in the management of breast disease can be accessed through the web regardless of where they are ( pathology laboratory, room radiology reports, clinic, operation theater), both for information about a patient to enter data the same in relation to their specialty. Moreover, homogenize manages the type and quality of the data and therefore can improve the care and research activities as well as

Factor Analysis of Residential Energy Consumption at the Provincial Level in China

Directory of Open Access Journals (Sweden)

Weibin Lin

2014-11-01

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.

The history of genetics in Mexico in the light of A Cultural History of Heredity.

Science.gov (United States)

Barahona, Ana

2013-01-01

In this paper I analyze the conditions for scientific research and the social relationships that allowed the establishment of genetics in Mexico, in the laboratory, the clinic and in agronomy. I give three examples to illustrate how the cultural history of heredity has enlightened this work: the introduction and institutionalization of Mendelism in Mexico, the hereditarian ideas of medical doctors in the late nineteenth century, and the introduction of medical genetics in Mexico.

Nota sobre la evolución de la prensa provincial española a mediados del siglo XIX (1850-1860

Directory of Open Access Journals (Sweden)

Antonio ROJAS FRIEND

2010-02-01

Full Text Available RESUMEN: En este artículo se realiza una aproximación cuantitativa a la evolución de los periódicos de provincias entre los años 1850 y 1860, tomando como fuente las informaciones sobre el gasto de correo para el franqueo de periódicos e impresos que publica la "Gaceta de Madrid". A partir de la constatación del peso abrumador de la prensa madrileña en el mercado periodístico nacional y del incremento de la distribución postal de periódicos en este período, las fuentes manejadas permiten avanzar algunas conclusiones provisionales: una relativa pérdida de posiciones en el mercado nacional; su fuerte componente oficialista; una clara tendencia hacia la descentralización; su estructura minifundista, de la que sólo escapa la prensa barcelonesa, sensible como la de Madrid a las leyes del mercado; la abrumadora hegemonía del poder político sobre el económico —y por tanto, de Madrid sobre la periferia— como elemento determinante del desarrollo de la prensa. Finalmente, se establecen algunos cálculos sobre las tiradas totales y por publicación de la prensa en España en este período. Palabras Clave: España Isabelina, Prensa Provincial, Correo, Empresas Periodísticas. ABSTRACT: In this article a quantitative approach is made to the evolution of provincial newspapers between the years 1850 and 1860, taking as a source infor- mation on the postal costs of newspapers and printed matter published by the "Gaceta de Madrid". Based on confirmation of the overwhelming importance of the Madrid press in the national newspaper market and the increase in the postal distribution of newspapers during this period, the sources handled allow some provisional conclusions to be advanced with relation to the provincial press: a relative loss of positions in the national market, its strong officialist component; a clear tendency towards descentralization; its "minifundista" structure, of which only the Barcelona press is free, as, like Madrid, it

Quantitative Analysis of Dynamic Behaviours of Rural Areas at Provincial Level Using Public Data of Gross Domestic Product

DEFF Research Database (Denmark)

Chen, Yi; Zhang, Guangfeng; Li, Yiyang

2013-01-01

A spatial approach that incorporates three economic components and one environmental factor has been developed to evaluate the dynamic behaviours of the rural areas at a provincial level. An artificial fish swarm algorithm with variable population size (AFSAVP) is proposed for the spatial problem......, and the results have shown that the modelling method based on GDP data can assess the spatial dynamic behaviours and can be taken as an operational tool for the policy planners....

[Cracow medical chamber in the special collection of the main medical library].

Science.gov (United States)

Szkudaj, T

2000-01-01

The article on Cracow Medical Chamber in the Special Collection of the Main Medical Library concerns the history of establishing medical chambers and covers the period from 1893 to 1950. It presents in detail the territorial extent of Cracow Medical Chamber, its membership and presidents' functions as well as the composition of its various boards and councils. It also talks about the legal acts regulating the functioning of medical chambers and their sphere of activity. The collection of archived records kept in the Special Collection of Main Medical Library constitutes a small percentage of the preserved records; these being mainly personal files of doctors comprising personal questionnaires, registration cards and photographs.

Provincial health accounts in Kerman, Iran: an evidence of a "mixed" healthcare financing system.

Science.gov (United States)

Mehrolhassani, Mohammad Hossein; Jafari, Mohammad; Zeinali, Javad; Ansari, Mina

2014-02-01

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. 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. 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. 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 emphasizing on 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 initiatives and reforms in healthcare sector.

Medical education: Changes and perspectives

Science.gov (United States)

Zhang, Qin; Lee, Liming; Gruppen, Larry D.; Ba, Denian

2013-01-01

As medical education undergoes significant internationalization, it is important for the medical education community to understand how different countries structure and provide medical education. This article highlights the current landscape of medical education in China, particularly the changes that have taken place in recent years. It also examines policies and offers suggestions about future strategies for medical education in China. Although many of these changes reflect international trends, Chinese medical education has seen unique transformations that reflect its particular culture and history. PMID:23631405

Medical record validation of maternally reported history of preeclampsia

NARCIS (Netherlands)

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)

2010-01-01

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

[The diagnostic value of medical thoracoscopy for unexplained pleural effusion].

Science.gov (United States)

Jiang, Shu-juan; Mu, Xiao-yan; Zhang, Song; Su, Li-li; Ma, Wei-xia

2013-05-01

To explore the endoscopic features of patients with unexplained pleural effusion, and to evaluate the diagnostic value of medical thoracoscopy. A retrospective analysis of 2380 patients with unexplained pleural effusion (1320 males and 1060 females; age 15-94 years) in Shandong Provincial Hospital from 1992 to 2011 were performed .The diagnosis was confirmed by medical thoracoscopy. The endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes. The nodules could be grape-like, cauliflower-like, fused into masses, or diffused small nodules . The appearance of cancerous nodules was more diversified compared to tuberculous nodules. Tuberculous pleurisy was manifested as diffuse pleural congestion and miliary changes, multiple small gray-white nodules, fibrin deposition and adhesion in the pleural cavity, pleural thickening and loculation . The pathological diagnosis was as follows: pleural metastases in 899 (37.8%), primary pleural mesothelioma in 439 (18.4%), tuberculous pleurisy in 514 (21.6%), non-specific inflammation in 226 (9.5%), empyema in 190 (8.0%), hepatic pleural effusion in 36 (1.5%) and pleural effusion of unknown causes in 76 (3.2%) cases. The diagnostic positive rate of medical thoracoscopy was 96.8%. No serious complications were observed. Medical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

"History, Theory and Ethics of Medicine": The Last Ten Years. A Survey of Course Content, Methods and Structural Preconditions at Twenty-nine German Medical Faculties.

Science.gov (United States)

Schildmann, Jan; Bruns, Florian; Hess, Volker; Vollmann, Jochen

2017-01-01

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.

Provincial alcohol index and its relationship to alcohol-related harm in Thailand: implications for subnational alcohol policy development

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Surasak Chaiyasong

2016-07-01

Full Text Available Abstract Background The Provincial Alcohol Index (PAI is one of the efforts to develop a composite measurement to operationalize the situation of alcohol consumption and related risk behaviors. The index offers a means for national and subnational alcohol control committees to address alcohol-related problems in their responsible jurisdiction areas. The objective of this study is to assess the relationship between PAI scores and alcohol-related problems using Thailand as an example. Methods Cross-sectional analyses of PAI scores based on the 2007 National Cigarette Smoking and Alcohol Drinking Behavior Survey (CSAD and the National Statistical Office data were conducted. CSAD data were collected from 168,285 Thai residents aged 15 years and above in 76 provinces of Thailand (population range 180,787 to 5,716,248. The PAI scores were generated using three different methods based on five indicators: 1 prevalence of adult (≥15 years drinkers, 2 prevalence of underage drinkers, 3 proportion of regular drinkers, 4 proportion of binge drinkers and 5 proportion of drink-drivers. Alcohol-related injuries and violent events together with provincial level covariates (age, gender, income and region were assessed. Correlational and linear regression analyses were performed to examine the relationship between PAI scores and alcohol-related problems. Results The PAI scores generated from the three methods were significantly correlated with one another (r > 0.7, p < 0.05 and significantly related to alcohol-related problems after adjusting for the provincial level covariates. Based on the normalized method, PAI scores had a significant and positive relationship with prevalence of alcohol-related injuries (beta = 562 cases per million population, p = 0.027 and violence (beta = 451 events per million population, p = 0.013. PAI scores were highest in the north and lowest in the south of the country. Conclusions The findings of this

Mejoramiento de los procesos administrativos y de servicios en el Honorable Consejo Provincial del Cañar

OpenAIRE

Buestán Toral, José Remigio; Urgilés Pauta, Diego

2006-01-01

Como conclusión el autor manifiesta que el sistema organizacional del H. Consejo Provincial del Cañar, mantiene una estructura vertical, tadicional ya que está en función jerárquica, y no permite alcanzar efectividad y eficiencia en los principales procesos administrativos y operativos, a su vez imposibilita a sus servidores actuar en función del cliente, cumpliendo sus actividades en base a órdenes y prácticas institucionales que han sido repetitivas en cada administración

Governmental oversight of prescribing medications: history of the US Food and Drug Administration and prescriptive authority.

Science.gov (United States)

Plank, Linda S

2011-01-01

The evolution of drug regulation and awarding of prescriptive authority is a complex and sometimes convoluted process that can be confusing for health care providers. A review of the history of how drugs have been manufactured and dispensed helps explain why this process has been so laborious and complicated. Because the federal and state governments have the responsibility for protecting the public, most regulations have been passed with the intentions of ensuring consumer safety. The current system of laws and regulations is the result of many years of using the legal system to correct drug marketing that had adverse health consequences. Government oversight will continue as prescribing medications transitions to an electronic form and as health care professionals in addition to physicians seek to gain prescriptive authority. © 2011 by the American College of Nurse-Midwives.

Introducing medical humanities in the medical curriculum in Saudi Arabia: A pedagogical experiment

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Rabie E Abdel-Halim

2012-01-01

Full Text Available In a marked shift from the modern positivist materialist philosophy that influenced medical education for more than a century, Western medical educators are now beginning to realize the significance of the spiritual element of human nature. Consensus is currently building up in Europe and North America on the need to give more emphasis to the study of humanities disciplines such as history of medicine, ethics, religion, philosophy, medically related poetry, literature, arts and medical sociology in medical colleges with the aim of allowing graduates to reach to the heart of human learning about meaning of life and death and to become kinder, more reflective practitioners. The medicine taught and practiced during the Islamic civilization era was a vivid example of the unity of the two components of medical knowledge: natural sciences and humanities. It was also a brilliant illustration of medical ethics driven by a divine moral code. This historical fact formed the foundation for the three medical humanities courses presented in this article reporting a pedagogical experiment in preparation for starting a humanities program in Alfaisal University Medical College in Riyadh. In a series of lectures alternating with interactive sessions, active learning strategies were employed in teaching a course on history of medicine during the Islamic era and another on Islamic medical ethics. Furthermore, a third course on medically relevant Arabic poetry was designed and prepared in a similar way. The end-of-the-course feedback comments reflected effectiveness of the courses and highlighted the importance of employing student-centered learning techniques in order to motivate medical students to become critical thinkers, problem solvers, life-long learners and self-learners.

chronicles of medical history biomimetics: the early years

African Journals Online (AJOL)

2014-12-22

Dec 22, 2014 ... basic sciences of physics, mathematics and chemistry ... Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of ... approach man's tool for the ultimate conquest of sickness and disease ...

What goes around, comes around: a history of medical tuition*

Science.gov (United States)

Duffin, Jacalyn

2001-01-01

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

What goes around, comes around: a history of medical tuition.

Science.gov (United States)

Duffin, J

2001-01-09

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.

Does a medical history of hypertension influence disclosing genetic testing results of the risk for salt-sensitive hypertension, in primary care?

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Okayama M

2016-07-01

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

The Regulation of Multi-Age Groupings in Canadian Centre-based Child Care Settings: An Analysis of Provincial and Territorial Policies, Legislation and Regulations.

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Bernhard, Judith; Pollard, June; Chud, Gyda; Vukelich, Goranka; Pacini-Ketchabaw, Veronica

2000-01-01

Examined the ways Canadian provincial and territorial policies address the inclusion of infants in multi-age early childhood education settings and the ways practitioners and licensing personnel interpret these policies. Noted policy patterns that affect the inclusion of infants and older children. Derived recommendations for policymakers and…

Does the Central Government’s Environmental Policy Work? Evidence from the Provincial-Level Environment Efficiency in China

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Qiong Xia

2016-12-01

Full Text Available This paper aims at checking the effectiveness of environmental policy pushed by the Central Government at provincial level since China’s entry into the World Trade Organization (WTO. For this purpose, the industrial system of each province is divided into industrial production sub-system and pollution treatment sub-system, and a novel slack-based measure data envelopment analysis (SBM-DEA model with non-cooperative game is proposed to evaluate the environment efficiency of both industrial production sub-system and pollutant treatment sub-system. The results show that the proposed model can describe the environmental efficiency more precisely than the traditional DEA models. During 2003–2012, the efficiencies of industrial production sub-system and pollution treatment sub-system at the provincial level are both relatively low. Specifically, the efficiency of industrial production is not only lower than pollution treatment efficiency, but is falling generally, especially in the Eastern area. However, in the Central and Western area, the efficiency of industrial production remains relatively stable, and pollution treatment efficiency is rising steadily. The technology gap between the Central/Western area and the Eastern area is narrowing, particularly concerning pollution treatment technology. We thus conclude that though the Central Government’s environmental policies fail to solve the inner contradiction between economic and environmental systems, and they indirectly contribute to the expansion of pollutant treatment technology among the Eastern, Central, and Western areas, which is conducive to the coordinated development among different areas.

Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.

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Nghia Ho Dang Trung

Full Text Available Infectious diseases of the central nervous system (CNS remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52% of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24% and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%. Mycobacterium tuberculosis was confirmed in 34/617 (6% adult patients and 11/624 (2% paediatric patients. The acute case fatality rate (CFR during hospital admission was 73/617 (12% in adults and to 42/624 (7% in children.Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

Rhazes, a pioneer in contribution to trials in medical practice.

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Ghaffari, Farzaneh; Naseri, Mohsen; Jafari Hajati, Razieh; Zargaran, Arman

2017-12-01

Medical history explains that Persian physicians used scientific methods based on clinical experiences and observations for treatment from pre-Islamic time (before 637 AD) and centuries later (in the Islamic era). Rhazes was one of the Persian physicians acknowledged as a pharmacist, chemist and prominent scientific writer on various subjects of medicine and philosophy. In this study, we aimed to investigate clinical experiences, as well as the ethical and critical views of Rhazes in medical practice. Rhazes promoted ethics in the medical profession. He expressed critical key points about ancient written texts. He broke ancient physicians' taboos in medical theories and evaluated them based on his own experiences. He designed animal and preclinical evaluations for his theories and also performed the first clinical trials with control groups in the history. His critical views about medical sciences as well as his beliefs in experiments resulted in many medical, chemical and pharmaceutical findings. Therefore, in history, he can be considered as the pioneer in using trials and experiments for approving medical methods.

The history of neuromyelitis optica

Science.gov (United States)

2013-01-01

The discovery of a novel serum autoantibody (termed NMO-IgG or AQP4-Ab) in a subset of patients in 2004 has revived interest in neuromyelitis optica (NMO). While the history of classical multiple sclerosis has been extensively studied, only little is known about the history of NMO. In the present article, we provide a comprehensive review of the early history of this rare but intriguing syndrome. We trace the origins of the concept of NMO in the 19th century medical literature and follow its evolution throughout the 20th and into the 21st century. Finally, we discuss recent proposals to revise the concept of NMO and explain why there is indeed a need for a more systematic and descriptive nomenclature. PMID:23320783

[Angel Pulido Martín (1878-1970). 4th Chief of the Urology Service of the Provincial Hospital of Madrid].

Science.gov (United States)

Sáiz Carrero, Ataúlfo

2003-05-01

To review the biography and scientific contributions of Dr. Angel Pulido Martin, fourth chairman of the Department of Urology at the Hospital Provincial of Madrid, and formerly at the Urology Clinic at the San Juan de Dios Hospital of Madrid. In addition, to show a panoramic view on how doctors who obtained scholarships to study outside Spain were trained in a specialty at the beginning of the 20th century. We reviewed memoirs books from Dr. Pulido Martin ("Medical letters", "Dr. Pulido and his time", and "Memoirs of a doctor"), his Ph.D. thesis and other works. We also reviewed biographic data obtained from his contemporaries in different publications. We report his experiences as a student in the specialities of Urology and Gynecology, since he first thought about taking this last one. Main european urologic and gynecologic centers of that time are represented, as well as some of the main characters in these specialties. We appreciate his great working spirit, which was inculcated into him by his father Dr. Pulido Fernandez, his enterprising desire, and the great professional he was, creating departments of urology which were school and model for many urologists of his time. A sincere clinician, Dr. Pulido Martin liked accuracy and daily self-improvement. He also was exceptional for his kindness treating patients and disciples. His publications on urologic topics were numerous; he also was fluent and entertaining as a non medical writer. He was an outstanding urologist in the early 20th century; he was member of the committee which elaborated the statutes of the Spanish Society of Urology, in which he was President for 11 years. He was also one of the founding members of the International Society of Urology and delegate of its Spanish chapter. He was official lecturer in several meetings, and also member of the Spanish Academy of Medicine and Surgery.

Why Teach Physical Education History?

Science.gov (United States)

Patterson, Jan

2004-01-01

The physical education discipline has had a long development, incorporating concepts learned and appreciated from ancient and modern Olympics, exercise and training, physical activity and sport, and the history of physical education itself. Nevertheless, it continues to evolve as educators improve their instructional methods, medical experts…

Federal-Provincial Business Tax Reforms: A Growth Agenda with Competitive Rates and a Neutral Treatment of Business Activities

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Duanjie Chen

2011-01-01

Full Text Available As the federal and provincial governments look to create jobs and attract business investment, productivity-enhanced business tax structures are in high order. Tax structures that combine internationally competitive tax rates on neutral tax bases foster long-term economic growth and generate sustainable tax revenue. This report examines tax policy in Canada over the past few years, specifically its impact on capital investment, labour and the cost of doing business across provinces and industries. Suggestions for tax reform are provided.

Battling demons with medical authority: werewolves, physicians and rationalization.

Science.gov (United States)

Metzger, Nadine

2013-09-01

Werewolves and physicians experienced their closest contact in the context of early modern witch and werewolf trials. For medical critics of the trials, melancholic diseases served as reference points for medical explanations of both individual cases and werewolf beliefs in general. This paper attempts to construct a conceptual history of werewolf beliefs and their respective medical responses. After differentiating the relevant terms, pre-modern werewolf concepts and medical lycanthropy are introduced. The early modern controversy between medical and demonological explanations forms the main part of this study. The history of werewolves and their medical explanations is then traced through to present times. An important point of discussion is to what extent the physicians' engagements with werewolves can be characterized as rationalization.

Why doctors have difficulty with sex histories.

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Merrill, J M; Laux, L F; Thornby, J I

1990-06-01

Studies have shown that physicians' performance has not been as good as it should be in detecting sexually transmitted diseases (STDs) and in counseling patients about their transmission. The AIDS pandemic has underscored the need to find out why this is true. In our study, we identified the major reasons physicians believe other doctors fail to take adequate sex histories. Scales were then developed to measure the three principal reasons given by these physicians: embarrassment, belief that the sex history is not relevant to the patient's chief complaint, and belief by the physicians that they are not adequately trained. When 350 senior medical students were surveyed, 93% thought that knowledge of a patient's sexual practices is an important part of their patient's medical history, but 50% felt poorly trained to take this history and 25% felt embarrassed to ask the necessary questions. To learn why some students score well on these three dimensions and others do not, a limited number of personal attributes were measured and correlated with the scores on these three measures. Shyness and social anxiety as a personal trait predicted which student was most likely to experience embarrassment in taking a sex history. A nonsympathetic view of patients' psychosocial problems was the variable most closely related to the belief that the sex history was of little importance in understanding a patient's problem. Students who believed this most strongly were the same ones who were most homophobic, authoritarian, and had the greatest fear of AIDS infection. The sense of not feeling adequately trained to take a sex history related most strongly to low self-esteem. How these barriers to STD risk assessment might be overcome is discussed.

14 CFR 67.213 - General medical condition.

Science.gov (United States)

2010-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... unable to perform those duties or exercise those privileges. (c) No medication or other treatment that... relating to the medication or other treatment involved, finds— (1) Makes the person unable to safely...

14 CFR 67.113 - General medical condition.

Science.gov (United States)

2010-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... unable to perform those duties or exercise those privileges. (c) No medication or other treatment that... relating to the medication or other treatment involved, finds— (1) Makes the person unable to safely...

14 CFR 67.313 - General medical condition.

Science.gov (United States)

2010-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... unable to perform those duties or exercise those privileges. (c) No medication or other treatment that... relating to the medication or other treatment involved, finds— (1) Makes the person unable to safely...

Mamma cancer behavior at the Provincial Consultation of Mammary Pathologies. 2009

International Nuclear Information System (INIS)

Rodriguez Gonzalez, Jose Antonio; Martinez Sanchez, Yariana; Estorino Escaig, Nereida; Vidal Jimenez, Eligio

2010-01-01

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

Ideology and wildlands management: The case of Rondeau Provincial Park, Ontario

Science.gov (United States)

Mann, D. L.; Nelson, J. G.

1980-03-01

This is a critical examination of some of the basic concepts that have guided management of parks and related reserves, often termed wildlands. Study is focussed on Rondeau Provincial Park, Ontario, and on concepts such as wilderness, primeval forest, and the Carolinian forest. Deer culling and other management policies and practices have been based upon the idea that the highly valued sassafras, tulip, and other species of the Carolinian forest are decreasing due to browsing. Field mapping and analysis of historic vegetation records indicate that this trend is not in fact occurring. Historic research also reveals difficulties in defining the Carolinian or other perceived types of forest for management purposes. A major reassessment of ideology and management policy and practice seem to be required in Rondeau and other wildlands. Vague or general concepts such as wilderness or preservation should be strongly complemented and supported by more precise statements of objectives, a learning attitude, and experimentation and research. As a result of the technical uncertainties and value judgments frequently involved, management should also be based upon the expressed preferences and continuing involvement of citizens.

Systems of medicine and nationalist discourse in India: towards "new horizons" in medical anthropology and history.

Science.gov (United States)

Khan, Shamshad

2006-06-01

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.

A Clinical Decision Support Engine Based on a National Medication Repository for the Detection of Potential Duplicate Medications: Design and Evaluation.

Science.gov (United States)

Yang, Cheng-Yi; Lo, Yu-Sheng; Chen, Ray-Jade; Liu, Chien-Tsai

2018-01-19

A computerized physician order entry (CPOE) system combined with a clinical decision support system can reduce duplication of medications and thus adverse drug reactions. However, without infrastructure that supports patients' integrated medication history across health care facilities nationwide, duplication of medication can still occur. In Taiwan, the National Health Insurance Administration has implemented a national medication repository and Web-based query system known as the PharmaCloud, which allows physicians to access their patients' medication records prescribed by different health care facilities across Taiwan. This study aimed to develop a scalable, flexible, and thematic design-based clinical decision support (CDS) engine, which integrates a national medication repository to support CPOE systems in the detection of potential duplication of medication across health care facilities, as well as to analyze its impact on clinical encounters. A CDS engine was developed that can download patients' up-to-date medication history from the PharmaCloud and support a CPOE system in the detection of potential duplicate medications. When prescribing a medication order using the CPOE system, a physician receives an alert if there is a potential duplicate medication. To investigate the impact of the CDS engine on clinical encounters in outpatient services, a clinical encounter log was created to collect information about time, prescribed drugs, and physicians' responses to handling the alerts for each encounter. The CDS engine was installed in a teaching affiliate hospital, and the clinical encounter log collected information for 3 months, during which a total of 178,300 prescriptions were prescribed in the outpatient departments. In all, 43,844/178,300 (24.59%) patients signed the PharmaCloud consent form allowing their physicians to access their medication history in the PharmaCloud. The rate of duplicate medication was 5.83% (1843/31,614) of prescriptions. When

[Organization of colon-rectal cancer screening in the Provincial Health Agency of Ragusa].

Science.gov (United States)

Blangiardi, F; Ferrera, G; Cilia, S; Aprile, E

2012-01-01

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.

The legacy of Douglas Guthrie (1885-1975), surgeon and medical historian.

Science.gov (United States)

Macintyre, Iain

2018-01-01

After graduating in medicine Douglas Guthrie embarked on a career as an ENT surgeon. When his Edinburgh hospital appointment ended in 1936 he began to write History of Medicine, which, thanks to a favourable review by George Bernard Shaw, became a worldwide best seller when first published in 1945. This marked the start of Guthrie's second career as a lecturer in history of medicine at the University of Edinburgh where his prime responsibility was delivering systematic lectures on medical history to medical undergraduates. At a time when history of medicine was virtually the exclusive preserve of medical doctors, Guthrie promoted to them the historiography techniques of the academic historian. His vision that social historians should become involved in the field and that history of medicine should be taught in arts and humanities faculties began to be adopted in British universities a decade or so after Guthrie made the recommendation. His legacy includes the Scottish Society of the History of Medicine and the British Society for the History of Medicine, both of which he helped to found. His name is commemorated in various charitable trusts which he established to promote the study of history of medicine.