WorldWideScience

Sample records for provincial medical history

  1. Assessing accuracy of an electronic provincial medication repository

    Directory of Open Access Journals (Sweden)

    Price Morgan

    2012-05-01

    Full Text Available Abstract Background Jurisdictional drug information systems are being implemented in many regions around the world. British Columbia, Canada has had a provincial medication dispensing record, PharmaNet, system since 1995. Little is known about how accurately PharmaNet reflects actual medication usage. Methods This prospective, multi-centre study compared pharmacist collected Best Possible Medication Histories (BPMH to PharmaNet profiles to assess accuracy of the PharmaNet profiles for patients receiving a BPMH as part of clinical care. A review panel examined the anonymized BPMHs and discrepancies to estimate clinical significance of discrepancies. Results 16% of medication profiles were accurate, with 48% of the discrepant profiles considered potentially clinically significant by the clinical review panel. Cardiac medications tended to be more accurate (e.g. ramipril was accurate >90% of the time, while insulin, warfarin, salbutamol and pain relief medications were often inaccurate (80–85% of the time. 1215 sequential BPMHs were collected and reviewed for this study. Conclusions The PharmaNet medication repository has a low accuracy and should be used in conjunction with other sources for medication histories for clinical or research purposes. This finding is consistent with other, smaller medication repository accuracy studies in other jurisdictions. Our study highlights specific medications that tend to be lower in accuracy.

  2. Usability inspection to improve an electronic provincial medication repository.

    Science.gov (United States)

    Kitson, Nicole A; Price, Morgan; Bowen, Michael; Lau, Francis

    2013-01-01

    Medication errors are a significant source of actual and potential harm for patients. Community medication records have the potential to reduce medication errors, but they can also introduce unintended consequences when there is low fit to task (low cognitive fit). PharmaNet is a provincially managed electronic repository that contains the records for community-based pharmacy-dispensed medications in British Columbia. This research explores the usability of PharmaNet, as a representative community-based medication repository. We completed usability inspections of PharmaNet through vendor applications. Vendor participants were asked to complete activity-driven scenarios, which highlighted aspects of medication management workflow. Screen recording was later reviewed. Heuristics were applied to explore usability issues and improvement opportunities. Usability inspection was conducted with four PharmaNet applications. Ninety-six usability issues were identified; half of these had potential implications for patient safety. These were primarily related to login and logout procedures; display of patient name; display of medications; update and display of alert information; and the changing or discontinuation of medications. PharmaNet was designed primarily to support medication dispensing and billing activities by community pharmacies, but is also used to support care providers with monitoring and prescribing activities. As such, some of the features do not have a strong fit for other clinical activities. To improve fit, we recommend: having a Current Medications List and Displaying Medication Utilization Charts.

  3. Can National History Be De-Provincialized? U.S. History Textbook Controversies in the 1940s and 1990s

    Directory of Open Access Journals (Sweden)

    Thomas Bender

    2015-03-01

    Full Text Available Thomas Bender’s 2009 essay “Can National History Be De-Provincialized? U.S. History Textbook Controversies in the 1940s and 1990s,” originally published in Contexts: The Journal of Educational Media, Memory, and Society, asks the important question of how a nation-specific curriculum in history—that is, how “American” history itself—can be taught with the least influence of political factions and the least interference of commercial factors, in light of the fact that both elements, the political and the commercial, have played a role in the construction of the US history textbook. Bender’s essay demonstrates the complexity of the problem as multiple stakeholders seek to control, limit, or promote particular elements of the narratives of US history. Professional historians, Bender argues, like history itself, have “no responsibility to supply comfort”—that is, no role in promoting nationalism or American exceptionalism—yet he also warns that, due to changes in the textbook industry, they also may have little role in determining what is finally published. Bender’s essay, which specifically discusses the impact of political conditions—World War II, for example—on the daily practice of teaching and writing about history, serves as an insightful reminder of the complexity and vulnerability of a nation’s memory.

  4. [Descriptive Study of the Activities Performed By the Provincial Medical Deontology Commissions].

    Science.gov (United States)

    García-Guerrero, Julio; Tarazona López, Ernesto; Martínez Calduch, Blanca; Vera-Remartínez, Enrique Jesús; Jiménez de Aldasoro, María Antonia; Boix Rajadell, Vicente; Ventura López, Mario

    2016-01-01

    to describe the expedient's features those settle the medical ethics commissions of the provincial colleges (PMEC). descriptive study, retrospective from the typology of the received claims to the PMEC between 01-06-2013 and 31-05-2014. The colleges were selected by simple stratified random sample. Variables related with the origin of the claim, chapter of the Medical Ethics Code affected, resolution timescales, judgement and others; were gathered. Descriptive analysis of the variables, expressing with medians the quantitative variables and their corresponding interquartile ranges; and with absolute and relative frequencies the qualitative ones. A bivariate analysis, through Kruskal-Wallis and Chi-square tests. 10 provincial colleges participated (47.652 members, 20.2% from the Spanish total) that communicated 120 claims. Overall impact: 2.5 claims %0 members/year. The denouncers are mainly patients (80%). The family medicine is the most affected specialty (19.2% of the claims), the quality of the medical attention the most affected chapter of the CD (60% of the claims). The global resolution timescale was 115.5 days (55-187). The PMEC judged ethical failure in 17 cases (14.2), 10 of them within the private sector. 8 (6.7%) were pending on the date 01-03-2015. 8 cases (6.7%) ended in disciplinary file by the management board, one in verbal amonestation and one was pendent of resolution. the incidence of the medical ethics claims is low, as well as the proportion of disciplinary files. Too many discrepancies exist between the judgements of the PMEC and the college's management boards.

  5. Twelve tips for teaching in a provincially distributed medical education program.

    Science.gov (United States)

    Wong, Roger Y; Chen, Luke; Dhadwal, Gurbir; Fok, Mark C; Harder, Ken; Huynh, Hanh; Lunge, Ryan; Mackenzie, Mark; Mckinney, James; Ovalle, William; Rauniyar, Pooja; Tse, Luke; Villanyi, Diane

    2012-01-01

    As distributed undergraduate and postgraduate medical education becomes more common, the challenges with the teaching and learning process also increase. To collaboratively engage front line teachers in improving teaching in a distributed medical program. We recently conducted a contest on teaching tips in a provincially distributed medical education program and received entries from faculty and resident teachers. Tips that are helpful for teaching around clinical cases at distributed teaching sites include: ask "what if" questions to maximize clinical teaching opportunities, try the 5-min short snapper, multitask to allow direct observation, create dedicated time for feedback, there are really no stupid questions, and work with heterogeneous group of learners. Tips that are helpful for multi-site classroom teaching include: promote teacher-learner connectivity, optimize the long distance working relationship, use the reality television show model to maximize retention and captivate learners, include less teaching content if possible, tell learners what you are teaching and make it relevant and turn on the technology tap to fill the knowledge gap. Overall, the above-mentioned tips offered by front line teachers can be helpful in distributed medical education.

  6. Medical science and the Cruelty to Animals Act 1876: A re-examination of anti-vivisectionism in provincial Britain.

    Science.gov (United States)

    Finn, Michael A; Stark, James F

    2015-02-01

    The Cruelty to Animals Act 1876 was an important but ambiguous piece of legislation. For researchers it stymied British science, yet ensured that vivisection could continue under certain restrictions. For anti-vivisection protestors it was positive proof of the influence of their campaigns, yet overly deferent to Britain's scientific elite. In previous accounts of the Act and the rise of anti-vivisectionism, scientific medicine central to these debates has been treated as monolithic rather than a heterogeneous mix of approaches; and this has gone hand-in-hand with the marginalizing of provincial practices, as scholarship has focused largely on the 'Golden Triangle' of London, Oxford and Cambridge. We look instead at provincial research: brain studies from Wakefield and anthrax investigations in Bradford. The former case elucidates a key role for specific medical science in informing the anti-vivisection movement, whilst the latter demonstrates how the Act affected the particular practices of provincial medical scientists. It will be seen, therefore, how provincial medical practices were both influential upon, and profoundly affected by, the growth of anti-vivisectionism and the passing of the Act. This paper emphasises how regional and varied medico-scientific practices were central to the story of the creation and impact of the Cruelty to Animals Act. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. History of medical radionuclide production.

    Science.gov (United States)

    Ice, R D

    1995-11-01

    Radionuclide production for medical use originally was incidental to isotope discoveries by physicists and chemists. Once the available radionuclides were identified they were evaluated for potential medical use. Hevesy first used 32P in 1935 to study phosphorous metabolism in rats. Since that time, the development of cyclotrons, linear accelerators, and nuclear reactors have produced hundreds of radionuclides for potential medical use. The history of medical radionuclide production represents an evolutionary, interdisciplinary development of applied nuclear technology. Today the technology is represented by a mature industry and provides medical benefits to millions of patients annually.

  8. Medizinhistorische Literatur [Medical history literature

    Directory of Open Access Journals (Sweden)

    Bauer, Bruno

    2012-09-01

    Full Text Available [english] The focus of the current issue 1-2/2012 of GMS Medizin – Bibliothek – Information is on medical history literature. In six articles special collections and recent projects of medical history libraries in Berlin, Hamburg, Heidelberg, Leipzig, Vienna and Zurich are presented. The authors in this issue are Melanie Scholz & Vera Seehausen (From Augusta to Klingsor, from Luise to Benjamin – past, present and future of the library of the Institute of the History of Medicine in Berlin, Alexandra Veith (Library of the Institute for History of Medicine and Ethics of Medicine, Heidelberg, Melanie Kintzel, Meike Knittel & Tanja Krutky (Historic collections of the Medical Library of the University of the University Medical Center Hamburg-Eppendorf and their deacidification, Dagmar Geithner (Library of the Karl Sudhoff Institute for the History of Medicine and Science, Leipzig – a Historical Review, Harald Albrecht, Bruno Bauer & Walter Mentzel (The Josephinian Library and the medical-historic stock of the University Library of the Medical University of Vienna and Monika Huber & Ursula Reis (Library of the Institute and Museum of the History of Medicine Zurich.[german] Schwerpunktthema der aktuellen Ausgabe 1-2/2012von GMS Medizin – Bibliothek – Information ist medizinhistorische Literatur. In sechs Beiträgen werden Bestände und aktuelle Projekte medizinhistorischer Bibliotheken in Berlin, Hamburg, Heidelberg, Leipzig, Wien und Zürich vorgestellt. Verfasst wurden die Beiträge der Schwerpunktausgabe von Melanie Scholz & Vera Seehausen (Von August zu Klingsor, von Luise zu Benjamin – Vergangenheit, Gegenwart und Zukunft der Bibliothek des Instituts für Geschichte der Medizin in Berlin, Melanie Kintzel, Meike Knittel & Tanja Krutky (Medizinhistorische Buchbestände am Universitätsklinikum Hamburg-Eppendorf und ihre Entsäuerung, Ara Veith (Bibliothek des Instituts für Geschichte und Ethik der Medizin in Heidelberg, Dagmar Geithner

  9. Genetic counseling for schizophrenia: a review of referrals to a provincial medical genetics program from 1968–2007

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    Hunter, MJ; Hippman, Catriona; Honer, William G; Austin, Jehannine C.

    2014-01-01

    Purpose Recent studies have shown that individuals with schizophrenia and their family members are interested in genetic counseling, but few have received this service. We conducted an exploratory, retrospective study to describe (a) the population of individuals who were referred to the provincial program for genetic counseling for a primary indication of schizophrenia, and (b) trends in number of referrals between 1968 and 2007. Methods Referrals for a primary indication of schizophrenia were identified through the provincial program database. Charts were reviewed and the following information was recorded: discipline of referring physician, demographics, psychiatric diagnosis, referred individual’s and partner’s (if applicable) family history, and any current pregnancy history. Data were characterized using descriptive statistics. Results Between 1968 and 2007, 288 referrals were made for a primary indication of schizophrenia. Most referrals were made: (a) for individuals who had a first-degree family member with schizophrenia, rather than for affected individuals, (b) for preconception counseling, and (c) by family physicians (69%), with only 2% by psychiatrists. Conclusions In British Columbia, individuals affected with schizophrenia and their family members are rarely referred for psychiatric genetic counseling. There is a need to identify barriers to psychiatric genetic counseling and develop strategies to improve access. PMID:20034078

  10. 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.

  11. 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.

  12. An Analysison Provincial Medical Science Basic Research Competitiveness Based on the National Natural Science Foundation of China

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    Xing Xia

    2017-06-01

    Full Text Available [Purpose/significance] The National Natural Science Foundation of China (NSFC is one of the most important channels to support basic research in China. Competition for funding by the NSFC has been a very important indicator to measure the basic research level of various province and scientific research institutions. [Method/process] By combing and analyzing the status quo of NSFC in medical science, it is helpful to narrow the provincial gap and improve the basic research of medical science in China. Based on the project information of NSFC and previous scholars’ research, the paper update the index of basic research competitiveness, and analyzes project number and project funding of medical science during 2006-2016. At the same time, the competitiveness of medical science basic research and its changing trend in 31 provinces of China are analyzed. [Result/conclusion] The result shows that, in recent years, China’s basic scientific research has greatly improved, but there is a large gap between the provinces.

  13. 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 ...

  14. Equity and efficiency of medical service systems at the provincial level of China's mainland: a comparative study from 2009 to 2014.

    Science.gov (United States)

    Ding, Jingmei; Hu, Xuejun; Zhang, Xianzhi; Shang, Lei; Yu, Min; Chen, Huoliang

    2018-02-05

    The astonishing economic achievements of China in the past few decades have remarkably increased not only the quantity and quality of medical services but also the inequalities in health resources allocation across regions and inefficiency of the medical service delivery. A descriptive analysis was used to compare the inequities in inputs and outputs of the provincial medical service systems, a non-radial super-efficiency data envelopment analysis model was then used to estimate the efficiency, and a regression analysis of the panel data was used to explore the determinants. The inputs and outputs of most provincial medical service systems increased gradually from 2009 to 2014. Overall, the eastern region allocated more human and capital resources than the other two regions, and produced more than 50% of the total outpatient and emergency room visits, whereas the western region produced more inpatient services (about 30% of the total volume of inpatient services) according to the distribution of the population. The average efficiency scores of the provincial medical systems in China's mainland were 0.895, 0.927, 0.929, 0.963, 0.977 and 0.968 from 2009 to 2014, with a slight average improvement of 1.60%. The efficiency score of each provincial medical service system varied greatly from one another: Tibet (1.475 ± 0.057) performed extremely well, whereas several others including Heilongjiang (0.579 ± 0.001) performed poorly. Furthermore, the proportion of high-class medical facilities was negatively associated with efficiency, whereas the proportion of the vulnerable population, the per capita Gross Domestic Product, the proportion of the illiterate population and the improvement of primary health care had positive effects on efficiency. Inequity in health resources allocation and service provision existed across the regions, but not all the gaps have begun to narrow since 2009. The difference of efficiency was great among provincial medical service systems

  15. Bi-Provincial Upgrader

    International Nuclear Information System (INIS)

    1997-01-01

    Husky Oil's Bi-Provincial Upgrader is located in the rural municipality of Wilton, east of Lloydminster, Saskatchewan. It is jointly owned by Husky Oil and the Saskatchewan government. The upgrader is designed to produce 7.300 m 3 /cd of synthetic crude from 8.440 m 3 /cd of diluted Lloyd blend and distillates from the existing Lloydminster refinery. The designed coke and sulphur production is 415 t/day and 240 t/day respectively. Chronology of the Bi-Provincial Upgrader project was presented, along with details of the heavy oil feedstock properties for Cold Lake, Lloydminster and Lloyd Blend. Upgrader production history since start-up, synthetic crude oil customers, and the evolution of prices for Edmonton light vs. Husky LLB at Hardisty were also reviewed. 3 tabs., 9 figs

  16. 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.

  17. 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 & ...

  18. Experience with a pharmacy technician medication history program.

    Science.gov (United States)

    Cooper, Julie B; Lilliston, Michelle; Brooks, DeAnne; Swords, Bruce

    2014-09-15

    The implementation and outcomes of a pharmacy technician medication history program are described. An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  19. Pharmacy collected medication histories in an observation unit

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    Gabrielle L Procopio

    2015-08-01

    Full Text Available Background: Clear processes to facilitate medication reconciliation in a hospital setting are still undefined. The observation unit allows for a high patient turnover rate, where obtaining accurate medication histories is critical. Objectives: The objective of this study was to assess the ability of pharmacists and student pharmacists to identify discrepancies in medication histories obtained at triage in observation patients. Methods: Pharmacists and student pharmacists obtained a medication history for each patient placed in observation status. Patients were excluded if they were unable to provide a medication history and family, caregiver, or community pharmacy was also unable to provide the history. A comparison was made between triage and pharmacy collected medication histories to identify discrepancies. Results: A total of 501 medications histories were collected, accounting for 3213 medication records. There were 1176 (37% matched medication records and 1467 discrepancies identified, including 808 (55% omissions, 296 (20.2% wrong frequency, 278 (19% wrong dose, 51 (3.5% discontinued, and 34 (2.3% wrong medication. There was an average of 2.9 discrepancies per patient profile. In all, 76 (15% of the profiles were matched. The median time to obtain a medication history was 4 min (range: 1–48 min. Conclusion: Pharmacy collected medication histories in an observation unit identify discrepancies that can be reconciled by the interdisciplinary team.

  20. The Provincialism problem

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    Terry Smith

    2011-06-01

    Full Text Available The system through which art is created, exhibited, collected, interpreted, and, in some special cases, enters the history of art is not a 'natural' order built around the development of Art as such. It is profoundly shaped by an inequitable distribution of reputation-conferring power that is centered on the New York artworld. While artists, critics, curators and others living elsewhere are subject to the provincialising effects of distance from the centre, those working at the centre are also provincials in that they are subject to an internal hierarchy that confers star status on just a few artists at a time. The article explores the patterns of artmaking at peripheries through the example of Australian art, and at the centre through its institutionalized acceptance of 'accelerated avant-gardism'. Can the provincialist bind be broken? Only through exceptional acts of critical reflexivity on the part of artists, critics and curators. This must occur at all points in this iniquitous, self-perpetuating system––something that, at the moment, does not seem likely.

  1. 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…

  2. Prescription data improve the medication history in primary care

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  3. 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...

  4. USE OF ELECTRONIC CASE HISTORIES IN OPERATION OF MEDICAL UNITS

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    I. B. Boltenkova

    2016-01-01

    Full Text Available Introduction of electronic case histories to medical units including TB units is one of the factors allowing enhancing quality of medical care provision. Use of the electronic case histories provides conditions for information transparency improvement in a medical unit: financial, statistic and medico-technological. Information contained in the electronic case history is important and required both for internal and external use. Use of electronic case histories contributes to reduction of labor costs of workers in medical units, provides fast access of medical personnel to information, formalizes data, provides preservation, invariance and reliability of the information entered into electronic case history during the whole period of storage, regulates the access rights and confidentiality, personifies data and allows unifying health data of all Russian population into one pool.

  5. 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.

  6. 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...

  7. 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.

  8. Provincial hydro expansions

    Energy Technology Data Exchange (ETDEWEB)

    Froschauer, K J

    1993-01-01

    A study of the development of five provincial hydroelectric utilities in Canada indicates that power companies and the state invited manufacturers to use hydroelectricity and natural resources in order to diversify provincial economies. These hydro expansions also show that utilities and government designed hydro projects to serve continental requirements; serving both objectives became problematic. It is argued that when the Canadian state and firms such as utilities use hydro expansions to serve both continentalism and industrialization, then at best they foster dependent industrialization and staple processing. At worst, they overbuild the infrastructure to generate provincial surplus energy for continental, rather than national, integration. Hydro developments became subject to state intervention in Canada mainly through the failures of private utilities to provide power for the less-lucrative industrial markets within provincial subregions. Although the state and utilities invited foreign firms to manufacture hydro equipment within the provinces and others to use electricity to diversify production beyond resource processing, such a diversification did not occur. Since 1962, ca 80% of industrial energy was used to semi-process wood-derived products, chemicals, and metals. The idea for a national power network became undermined by interprovincial political-economic factors and since 1963, the federal national/continential power policy prevailed. 187 refs., 6 figs., 52 tabs.

  9. 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.

  10. [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.

  11. 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…

  12. Brief histories of medical physics in Asia-Oceania.

    Science.gov (United States)

    Round, W H; Jafari, S; Kron, T; Azhari, H A; Chhom, S; Hu, Y; Mauldon, G F; Cheung, K Y; Kuppusamy, T; Pawiro, S A; Lubis, L E; Soejoko, D S; Haryanto, F; Endo, M; Han, Y; Suh, T S; Ng, K H; Luvsan-Ish, A; Maung, S O; Chaurasia, P P; Jafri, S M A; Farrukh, S; Peralta, A; Toh, H J; Sarasanandarajah, S; Shiau, A C; Krisanachinda, A; Suriyapee, S; Vinijsorn, S; Nguyen, T C

    2015-09-01

    The history of medical physics in Asia-Oceania goes back to the late nineteenth century when X-ray imaging was introduced, although medical physicists were not appointed until much later. Medical physics developed very quickly in some countries, but in others the socio-economic situation as such prevented it being established for many years. In others, the political situation and war has impeded its development. In many countries their medical physics history has not been well recorded and there is a danger that it will be lost to future generations. In this paper, brief histories of the development of medical physics in most countries in Asia-Oceania are presented by a large number of authors to serve as a record. The histories are necessarily brief; otherwise the paper would quickly turn into a book of hundreds of pages. The emphasis in each history as recorded here varies as the focus and culture of the countries as well as the length of their histories varies considerably.

  13. 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.

  14. [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.

  15. Adolescents' knowledge of medical terminology and family health history.

    Science.gov (United States)

    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.

  16. 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

  17. 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...

  18. 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.

  19. 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.

  20. Physician recruitment in Ontario Provincial Psychiatric Hospitals.

    Science.gov (United States)

    Draper, R; Galbraith, D; Frost, B

    1989-11-01

    Recruitment of Physicians/Psychiatrists to staff the Ontario Provincial Psychiatric Hospitals remains an ongoing problem despite the introduction of measures such as University Affiliation and Incentive Grants. Historically there has been heavy reliance upon Foreign Medical Graduates (GOFM's) who have been denied the possibility of professional mobility and advancement because of restrictive licences. Recent changes in regulations have severely restricted the recruitment of GOFM's. During 1987, details of all physicians employed in the provincial hospitals during the preceeding five years were entered into a computerized data base. This paper presents some initial analyses which indicate that Canadian graduates have provided low levels of service, especially outside major urban centres, quite insufficient to replace the GOFM's. These findings raise urgent social and professional concerns.

  1. 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)

  2. Provincial geology and the Industrial Revolution.

    Science.gov (United States)

    Veneer, Leucha

    2006-06-01

    In the early nineteenth century, geology was a new but rapidly growing science, in the provinces and among the gentlemen scientists of London, Oxford and Cambridge. Industry, particularly mining, often motivated local practical geologists, and the construction of canals and railways exposed the strata for all to see. The most notable of the early practical men of geology was the mineral surveyor William Smith; his geological map of England and Wales, published in 1815, was the first of its kind. He was not alone. The contributions of professional men, and the provincial societies with which they were connected, are sometimes underestimated in the history of geology.

  3. 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".

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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)

  9. 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.

  10. 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

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

    Science.gov (United States)

    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.

  12. 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.

  13. 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

  14. 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.

  15. [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.

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

    Directory of Open Access Journals (Sweden)

    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

  17. 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...

  18. 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.

  19. 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.

  20. 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

  1. 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)

  2. 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.

  3. 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…

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

    Science.gov (United States)

    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.

  5. 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

  6. 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.

  7. 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.

  8. 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 ...

  9. [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.

  10. [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

  11. 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

  12. 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.

  13. [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.

  14. 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

  15. 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...

  16. 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 ...

  17. 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.

  18. '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'.

  19. 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.

  20. Wandering spleen: a medical enigma, its natural history and rationalization.

    Science.gov (United States)

    Magowska, Anita

    2013-03-01

    Wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region because of the laxity of the peritoneal attachments. Many patients with wandering spleen are asymptomatic, hence the condition can be discovered only by abdominal examination or at a hospital emergency department if a patient is admitted to hospital because of severe abdominal pain, vomiting or obstipation. This article aims to provide a historical overview of wandering spleen diagnostics and surgical treatment supplemented with an analyses of articles on wandering spleen included in the PubMed database. One of the first clinical descriptions of a wandering spleen was written by Józef Dietl in 1854. The next years of vital importance are 1877 when A. Martin conducted the first splenectomy and in 1895 when Ludwik Rydygier carried out the first splenopexy to immobilize a wandering spleen. Since that time various techniques of splenectomy and splenopexy have been developed. Introducing medical technologies was a watershed in the development and treatment of wandering spleen, which is confirmed by the PubMed database. Despite the increased number of publications medical literature shows that a wandering spleen still remains a misdiagnosed condition, especially among children.

  1. [History of Medical Mycology in the former German Democratic Republic].

    Science.gov (United States)

    Seebacher, C; Blaschke-Hellmessen, Renate; Kielstein, P

    2002-01-01

    After the Second World War the development of medical mycology in Germany had taken a very different course in the east and west parts depending on the political division. In this respect our contribution deals with the situation in the former German Democratic Republic. Efficient mycological centres were founded step by step almost in all medical universities on the basis of the mycological laboratories in dermatological hospitals competent for diagnostic work, but also for teaching and scientific research. In this context biologists were the main stay of mycology, they finally were integrated to the same degree in the universities like physicians. The effectiveness of the Gesellschaft für Medizinische Mykologie der DDR (GMM), its board of directors and its working groups as well as the topics of human and animal mycology during this period are described. Especially the merger of the GMM with the Deutschsprachige Mykologische Gesellschaft after the reunification of Germany without problems and the kind co-operation of Prof. Dr. Johannes Müller during this procedure are emphasized.

  2. 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...

  3. [The red face: art, history and medical representations].

    Science.gov (United States)

    Cribier, B

    2011-09-01

    For millennia, a red face has been a handicap in social relations, mainly because of the associated bias against alcoholics. The color red is also the color of emotion, betrayal of the person who blushes. Since the color red is one of the main characteristics of rosacea, it contributes to the bad reputation this disorder has, which is therefore the subject of a pressing therapeutic demand, principally in women. Nineteenth-century French novelists such as Balzac and later Proust, admirably described blotchy, red, or sanguine faces, which always announced a difficult, violent temperament, or was simply the mark of the laboring class. The color red remains ambivalent today, on the one hand denoting blood and life and on the other suffering, shame, and death. The history of dermatology shows that the semiology of rosacea was very well described in the earliest reports, notably those written in the Middle Ages. The term "acne rosacea" appeared in Bateman's writings, who made it a clinical form of acne. This confusion lasted throughout the nineteenth century. It was not until Hebra in Austria and Darier in France that the differential diagnosis was clearly made between acne and rosacea. A "couperosis" previously referred to the entire range of the disease, particularly the papules and pustules, and it was not until the twentieth century that the current meaning of rosacea progressively gained ground: this term today designates facial telangiectasia, whether or not it is associated with a characteristic redness. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  4. [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.

  5. The red face: art, history and medical representations.

    Science.gov (United States)

    Cribier, B

    2011-11-01

    For millennia, a red face has been a handicap in social relations, mainly because of the associated bias against alcoholics. The color red is also the color of emotion, betrayal of the person who blushes. Since the color red is one of the main characteristics of rosacea, it contributes to the bad reputation this disorder has, which is therefore the subject of a pressing therapeutic demand, principally in women. Nineteenth-century French novelists such as Balzac and later Proust, admirably described blotchy, red, or sanguine faces, which always announced a difficult, violent temperament, or was simply the mark of the laboring class. The color red remains ambivalent today, on the one hand denoting blood and life and on the other suffering, shame, and death. The history of dermatology shows that the semiology of rosacea was very well described in the earliest reports, notably those written in the Middle Ages. The term "acne rosacea" appeared in Bateman's writings, who made it a clinical form of acne. This confusion lasted throughout the nineteenth century. It was not until Hebra in Austria and Darier in France that the differential diagnosis was clearly made between acne and rosacea. A "couperosis" previously referred to the entire range of the disease, particularly the papules and pustules, and it was not until the twentieth century that the current meaning of rosacea progressively gained ground: this term today designates facial telangiectasia, whether or not it is associated with a characteristic redness. Rosacea is a conspicuous disease, since the lesions involve the central portion of the face.Among the many manifestations of rosacea, redness is the most characteristic [1]. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

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

    Science.gov (United States)

    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.

  7. 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.

  8. Case studies in cholera: lessons in medical history and science.

    Science.gov (United States)

    Kavic, S. M.; Frehm, E. J.; Segal, A. S.

    1999-01-01

    Cholera, a prototypical secretory diarrheal disease, is an ancient scourge that has both wrought great suffering and taught many valuable lessons, from basic sanitation to molecular signal transduction. Victims experience the voluminous loss of bicarbonate-rich isotonic saline at a rate that may lead to hypovolemic shock, metabolic acidosis, and death within afew hours. Intravenous solution therapy as we know it was first developed in an attempt to provide life-saving volume replacement for cholera patients. Breakthroughs in epithelial membrane transport physiology, such as the discovery of sugar and salt cotransport, have paved the way for oral replacement therapy in areas of the world where intravenous replacement is not readily available. In addition, the discovery of the cholera toxin has yielded vital information about toxigenic infectious diseases, providing a framework in which to study fundamental elements of intracellular signal transduction pathways, such as G-proteins. Cholera may even shed light on the evolution and pathophysiology of cystic fibrosis, the most commonly inherited disease among Caucasians. The goal of this paper is to review, using case studies, some of the lessons learned from cholera throughout the ages, acknowledging those pioneers whose seminal work led to our understanding of many basic concepts in medical epidemiology, microbiology, physiology, and therapeutics. PMID:11138935

  9. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2016-01-01

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

  12. 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

    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

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. [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.

  18. 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.

  19. 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

  20. 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…

  1. 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

  2. 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...

  3. [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.

  4. 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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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

  8. 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.

  9. 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.

  10. 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/

  11. Provincial corruption and local development bank performance

    Directory of Open Access Journals (Sweden)

    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.

  12. 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…

  13. [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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. 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.

  18. [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.

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

    Science.gov (United States)

    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.

  20. 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.

  1. 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...

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

    Science.gov (United States)

    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.

  3. 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.

  4. 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.

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

    Science.gov (United States)

    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

  6. 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.…

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

    Science.gov (United States)

    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.

  8. 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.

  9. 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

  10. 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

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

  15. 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.

  16. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  19. [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.

  20. 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.

  1. 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

  2. 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.

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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 ...

  6. 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.

  7. 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.

  8. 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.

  9. [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.

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. 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

  16. 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.

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

    Science.gov (United States)

    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.

  18. [2000 year history of tonsillectomy. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt].

    Science.gov (United States)

    Feldmann, H

    1997-12-01

    The etymology of the anatomical terms and their use in history are elucidated: "Tonsil" (from Latin tonsa = the oar) in use since Celsus (about 40 AD). The Greek terms of that time, "antiádes", "paristhmia", were not adopted in later medical terminology. "Amygdala" (Greek/Latin = the almond) was introduced by Vesalius in 1543. Vesalius was also the first to depict the tonsils in a specimen of the whole human body; Duverney (1761) gives the first exact depiction of the pharyngeal region. Special anatomical and histological studies of the tonsils were carried out in the 19 century. Cornelius Celsus in Rome (about 40 AD) described the blunt removal of the tonsils by use of the finger. This method was favoured anew by numerous laryngologists at the beginning of the 20th century when it had been realised that a gentle enucleation of the entire tonsil including its capsule was advisable against cutting off a slice, but before long this procedure was discarded again for hygienic reasons. Precursors of special instruments for tonsillectomy were instruments designed for shortening the uvula: uvulotomy. Paré (1564) and Scultetus (1655) devised instruments that permitted placing a thread shaped like a snare around the uvula and cutting it off by strangulation. Hildanus (1646), Scultetus (1655) and Heister (1763) presented an instrument of the guillotine-type for uvulotomy. This instrument was modified by P. S. Physick (USA 1828) and used for tonsillotomy. It became the prototype for a number of similar instruments which were to follow: W. M. F. Fahnestock (USA 1832). M. Mackenzie (London 1880), G. Sluder (USA 1911). Besides these guillotines snares were also perfected and used for tonsillotomy, e.g. by W. Brünings (1908). The concentration on tonsillotomy aimed at performing the operation as quickly as possible, especially in children, as it was not yet possible to sustain general anaesthesia for a longer period of time while doing surgery in the pharynx. The operation of

  19. 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.

  20. 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.

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

    Science.gov (United States)

    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…

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. Programa provincial de lectura del Chubut

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. 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 ...

  12. 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.

  13. 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

  14. 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.

  15. The Structure and Presentation of Provincial Budgets

    Directory of Open Access Journals (Sweden)

    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

  16. 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…

  17. 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...

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

    Science.gov (United States)

    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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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....

  2. 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.

  3. 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.

  4. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Disparity and convergence: Chinese provincial government health expenditures.

    Science.gov (United States)

    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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 78 FR 17917 - Medical Waivers for Merchant Mariner Credential Applicants With a History of Seizure Disorders

    Science.gov (United States)

    2013-03-25

    ... be considered for a waiver. (1) Mariners with a history of epilepsy or seizure disorder may be... Waivers for Merchant Mariner Credential Applicants With a History of Seizure Disorders AGENCY: Coast Guard... of seizure disorders. Coast Guard regulations provide that convulsive disorders (also known as...

  12. 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...

  13. 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.

  14. 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.

  15. 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.

  16. History of the medical licensing examination (uieop in Korea’s Goryeo Dynasty (918-1392

    Directory of Open Access Journals (Sweden)

    Kyung-Lock Lee

    2015-05-01

    Full Text Available This article aims to describe the training and medical licensing system (uieop for becoming a physician officer (uigwan during Korea’s Goryeo Dynasty (918-1392. In the Goryeo Dynasty, although no license was necessary to provide medical services to the common people, there was a licensing examination to become a physician officer. No other national licensing system for healthcare professionals existed in Korea at that time. The medical licensing examination was administered beginning in 958. Physician officers who passed the medical licensing examination worked in two main healthcare institutions: the Government Hospital (Taeuigam and Pharmacy for the King (Sangyakguk. The promotion and expansion of medical education differed depending on the historical period. Until the reign of King Munjong (1046-1083, medical education as a path to licensure was encouraged in order to increase the number of physician officers qualifying for licensure by examination; thus, the number of applicants sitting for the examination increased. However, in the late Goryeo Dynasty, after the officer class of the local authorities (hyangri showed a tendency to monopolize the examination, the Goryeo government limited the examination applications by this group. The medical licensing examination was divided into two parts: medicine and ‘feeling the pulse and acupuncture’ (jugeumeop. The Goryeo Dynasty followed the Chinese Dang Dynasty’s medical system while also taking a strong interest in the Chinese Song Dynasty’s ideas about medicine.

  17. [History of diaphanoscopy. Pictures from the history of otorhinolaryngology, illustrated by instruments from the collection of the Ingolstadt German Medical History Museum].

    Science.gov (United States)

    Feldmann, H

    1998-05-01

    introduced this technique prior to Voltolini. Voltolini had died in 1889 and could not comment on this. A careful study of the original publications, however, shows that Cozzolino had only inspected the nasal cavity with retronasal illumination, but had not demonstrated the maxillary sinus by transillumination. The diaphanoscopy of the paranal sinuses was very soon elaborated to perfection: Vohse in 1890 applied it to the frontal sinuses, Gerber in 1900 invented a double diaphanoscope for examining both frontal sinuses simultaneously. Although the shortcomings of diaphanoscopy soon became apparent, the method was widely used for about half a century, but in the end could not compete with modern techniques of radiography and ultrasound. The history is related in detail and illustrated with numerous figures.

  18. 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.

  19. "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.

  20. [From otoscope to ophthalmoscope and back. The interwoven history of their invention and introduction into medical practice. Pictures from the history of otorhinolaryngology, illustrated by instruments from the collection of the Ingolstadt German Medical History Museum].

    Science.gov (United States)

    Feldmann, H

    1995-11-01

    Friedrich Hofmann, medical officer in Burgsteinfurt, Westphalia, Germany, in 1841 described a concave mirror with a central aperture in it as the ideal instrument that allowed reflecting and focussing light into the external auditory canal and simultaneously inspecting the tympanic membrane without obstructing either the light or the view. He recommended his device also for the inspection of other concealed regions of the body. His invention was referred to by Martell Frank in his textbook of otology in 1845, but otherwise attracted no attention. Hermann Helmholtz, physiologist in Königsberg, East Prussia, devised his ophthalmoscope in 1850-51 in order to study the phenomenon of glowing eyes. With this instrument he was the first to see the retina of a living human. As means of illumination he used small panes of glass similar to cover-glasses which were introduced into the common visual axis of the observer and the subject at such an angle that light from a lamp was reflected into the subject's eye while the observer inspected the subject's retina through the glass and an appropriate lens. He recommended this type of illumination also for otoscopy. His invention was at once acclaimed throughout the world and opened completely new opportunities in ophthalmology. The slanting panes of glass, however, were not the ideal solution for illumination. It was only one year later that Ruete in Göttingen replaced them with a concave mirror with a central aperture, and there is every indication that Frank's report on Hofmann's mirror had suggested this technique to him. During the following two years quite a number of other modifications of the ophthalmoscope were constructed, all of them using the concave mirror with a central aperture, which soon became synonymous with the ophthalmoscope as such. Von Tröltsch, otologist and ophthalmologist in Würzburg, presented a concave mirror with a central aperture for otoscopy in Paris in 1855-56. His instrument was obviously

  1. 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.

  2. History of neurosciences at the School of Medical Sciences, Universiti Sains Malaysia.

    Science.gov (United States)

    Idris, Badrisyah; Sayuti, Sani; Abdullah, Jafri Malin

    2007-02-01

    Universiti Sains Malaysia is the only institution in Malaysia which incorporates all fields of the neurosciences under one roof. The integration of basic and clinical neurosciences has made it possible for this institution to become an excellent academic and research centre. This article describes the history, academic contributions and scientific progress of neurosciences at Universiti Sains Malaysia.

  3. Veterinary Homeopathy: The Implications of Its History for Unorthodox Veterinary Concepts and Veterinary Medical Education.

    Science.gov (United States)

    Coulter, Dwight B.

    1979-01-01

    The history of veterinary homeopathy, its future and implications are discussed. The need for investigation into the validity of both allopathic and homeopathic claims is stressed and it is suggested that maintenance of quality is the key factor in any approach. (BH)

  4. 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

  5. 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.

  6. 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.

  7. 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)

  8. JPRS Report, China, Selected Provincial Reports.

    Science.gov (United States)

    1991-07-26

    sports. In 1990, the region’s athletes broke a lion yuan, a rise of 5.09 percent over 1989. A total of world record in women’s snatch weightlifting ...insurance. In 1990, Asian record in women’s clean-and-jerk weightlifting , insurance companies provided 49 different kinds of and broke a national...continue to insurance. In addition, we should try to reform the improve the ways and means for managing plans, medical insurance and workers’ injury

  9. 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

  10. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    Directory of Open Access Journals (Sweden)

    Turovskaya N.G.,

    2015-10-01

    Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history

  11. 50th Anniversary International Medical Informatics Association (IMIA) History Working Group and Its Projects.

    Science.gov (United States)

    Kulikowski, Casimir A; Mihalas, George; Greenes, Robert; Yacubsohn, Valerio; Park, Hyeoun-Ae

    2017-01-01

    The IMIA History Working Group has as its first goal the editing of a volume of contributions from pioneers and leaders in the field of biomedical and health informatics (BMHI) to commemorate the 50th anniversary of IMIA's predecessor IFIP-TC4. This paper describes how the IMIA History WG evolved from an earlier Taskforce, and has focused on producing the edited book of original contributions. We describe its proposed outline of objectives for the personal stories, and national and regional society narratives, together with some comments on the evolution of Medinfo meeting contributions over the years, to provide a reference source for the early motivations of the scientific, clinical, educational, and professional changes that have influenced the historical course of our field.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. [Maimonides, a physician in the 12 century. Contribution to the history of medical ethics and deontology].

    Science.gov (United States)

    Pavlović, B

    2000-01-01

    Maimonides, Moses ben Maimon (1135-1204), Jewish physician, philosopher and scholar was the first after Hippocrates to write a text of a "prayer" he spoke out at the beginning of his medical profession, e. i. when he took oath. The text of "Maimonides's prayer" is today obligatory in some schools of medicine in the United States of America.

  14. Daniel Alcides Carrion (1857-1885) and a history of medical martyrdom.

    Science.gov (United States)

    Chatterjee, Pranab; Chandra, Shivika; Biswas, Tamoghna

    2015-11-01

    Daniel Carrion, a sixth-year medical student, died while investigating the effects of self-inoculation of the causative organism of Oroya Fever and Bartonellosis and thereby contributed to understanding of the disease before the organisms had been identified. © The Author(s) 2014.

  15. 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 ...

  16. 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 ...

  17. 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 ...

  18. 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.

  19. History and Outcomes of 50 Years of Physician-Scientist Training in Medical Scientist Training Programs.

    Science.gov (United States)

    Harding, Clifford V; Akabas, Myles H; Andersen, Olaf S

    2017-10-01

    Physician-scientists are needed to continue the great pace of recent biomedical research and translate scientific findings to clinical applications. MD-PhD programs represent one approach to train physician-scientists. MD-PhD training started in the 1950s and expanded greatly with the Medical Scientist Training Program (MSTP), launched in 1964 by the National Institute of General Medical Sciences (NIGMS) at the National Institutes of Health. MD-PhD training has been influenced by substantial changes in medical education, science, and clinical fields since its inception. In 2014, NIGMS held a 50th Anniversary MSTP Symposium highlighting the program and assessing its outcomes. In 2016, there were over 90 active MD-PhD programs in the United States, of which 45 were MSTP supported, with a total of 988 trainee slots. Over 10,000 students have received MSTP support since 1964. The authors present data for the demographic characteristics and outcomes for 9,683 MSTP trainees from 1975-2014. The integration of MD and PhD training has allowed trainees to develop a rigorous foundation in research in concert with clinical training. MSTP graduates have had relative success in obtaining research grants and have become prominent leaders in many biomedical research fields. Many challenges remain, however, including the need to maintain rigorous scientific components in evolving medical curricula, to enhance research-oriented residency and fellowship opportunities in a widening scope of fields targeted by MSTP graduates, to achieve greater racial diversity and gender balance in the physician-scientist workforce, and to sustain subsequent research activities of physician-scientists.

  20. Rembrandt’s Jewish Physician—Dr Ephraim Bueno (1599–1665: A Brief Medical History

    Directory of Open Access Journals (Sweden)

    George M. Weisz

    2013-04-01

    Full Text Available Medicine in the Middle Ages was, and ever since remained, one of the main preoccupations of the professionally restricted Jews. One of the medical dynasties on the Iberian Peninsula was the Bueno (Bonus family. Following the expulsion of the Jews from Spain and their spread in Europe, these Iberian physicians became successful everywhere—just as the Buenos were in the Netherlands.

  1. From Roentgen to magnetic resonance imaging: the history of medical imaging.

    Science.gov (United States)

    Scatliff, James H; Morris, Peter J

    2014-01-01

    Medical imaging has advanced in remarkable ways since the discovery of x-rays 120 years ago. Today's radiologists can image the human body in intricate detail using computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, and various other modalities. Such technology allows for improved screening, diagnosis, and monitoring of disease, but it also comes with risks. Many imaging modalities expose patients to ionizing radiation, which potentially increases their risk of developing cancer in the future, and imaging may also be associated with possible allergic reactions or risks related to the use of intravenous contrast agents. In addition, the financial costs of imaging are taxing our health care system, and incidental findings can trigger anxiety and further testing. This issue of the NCMJ addresses the pros and cons of medical imaging and discusses in detail the following uses of medical imaging: screening for breast cancer with mammography, screening for osteoporosis and monitoring of bone mineral density with dual-energy x-ray absorptiometry, screening for congenital hip dysplasia in infants with ultrasound, and evaluation of various heart conditions with cardiac imaging. Together, these articles show the challenges that must be met as we seek to harness the power of today's imaging technologies, as well as the potential benefits that can be achieved when these hurdles are overcome.

  2. Anti-tuberculosis medication-induced oculogyric crisis and the importance of proper history taking

    Directory of Open Access Journals (Sweden)

    Wong LH

    2017-10-01

    Full Text Available Lin Ho Wong,1 Endean Tan2 1University College Cork, Cork, Ireland; 2Tan Tock Seng Hospital, Singapore Abstract: Oculogyric crisis (OGC, frequently caused by medications such as antiemetics, antidepressants, and anti-epileptics, is an acute dystonic reaction of the ocular muscles. It consists of wide-staring gaze (lasting variably from seconds to minutes, seizures, and a widely-opened mouth. To date, there have been no reports of anti-tuberculosis medications such as rifampicin, isoniazid, pyrazinamide or ethambutol inducing OGC. It is of utmost importance to recognize this adverse reaction, which could be incorrectly diagnosed as an anaphylactic-like reaction. In this paper, we highlight a case of a 66-year-old Indian man who presented with OGC induced by anti-tuberculosis medications which was initially suspected to be an anaphylactic reaction and was subsequently halted with the administration of diphenhydramine. Keywords: oculogyric crisis, tuberculosis, rifampicin, isoniazid, ethambutol, adverse drug reaction 

  3. History of the medical uses of radiation regulatory and voluntary standards of protection

    International Nuclear Information System (INIS)

    Brodsky, A.; Kathren, R.L.; Willis, Ch.A.

    1996-01-01

    The main focus of this paper is on the historical development of safety in the use of radiation or radioactive materials in medicine. However, to provide better understanding and perspective on this history, it must be interwoven with major events and advancements in the development and use of radiation, particularly in the field of medicine. Since this history, as well as that of major events that stimulated the development of radiation protection standard, is extensive, only a very brief overview can be given here. Thus, a sufficient list of references is also provided to allow further examination of detailed historical documentation, and to provide an easier entry into further research. Also, some identification of individuals who have made important contributions to the development of standards, but who are not widely identified in either the relevant standards or the historical literature, is included. This will aid the serious historian in examining files of organizations to uncover facts or nationals that could better explain historical events or developments. (author), 233 Refs., 1 Tabs

  4. 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.

  5. 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.

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

    Science.gov (United States)

    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.

  7. [Accuracy in the medication history and reconciliation errors in the emergency department].

    Science.gov (United States)

    de Andrés-Lázaro, Ana M; Sevilla-Sánchez, Daniel; Ortega-Romero, M del Mar; Codina-Jané, Carles; Calderón-Hernanz, Beatriz; Sánchez-Sánchez, Miquel

    2015-10-05

    To assess the accuracy of pharmaceutical anamnesis obtained at the Emergency Department (ED) of a tertiary referral hospital and to determine the prevalence of medication reconciliation errors (RE). This was a single-center, prospective, interventional study. The home medication list obtained by a pharmacist was compared with the one recorded by a doctor to identify inaccuracies. Subsequently, the home medication list was compared with the active prescription at the ED. All unexplained discrepancies were checked with the doctor in charge to evaluate if a RE has occurred. An univariate analysis was performed to identify factors associated with RE. The pharmacist identified a higher number of drugs than doctors (6.89 versus 5.70; P<0.05). Only 39% of the drugs obtained by doctors were properly written down in the patient's record. The main cause of discrepancy was omission of information regarding the name of the drug (39%) or its dosage (33%). One hundred and fifty-seven RE were identified and they affected 85 patients (43%), mainly related to information omission (62%). Age and polymedication were identified as main risk factors of RE. The presence of a caregiver or relative in the ED was judged to be a protective factor. No relationship was found between inaccuracies in the registries and RE. The process of obtaining a proper pharmaceutical anamnesis still needs improvement. The pharmacist may play a role in the process of obtaining a good quality anamnesis and increase patient safety by detecting RE. Better information systems are needed to avoid this type of incidents. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  8. John Foster Dulles, his medical history and its impact on Cold War politics.

    Science.gov (United States)

    Pappas, Theodore N; Willett, Christopher G

    2018-01-01

    John Foster Dulles was the United States Secretary of State during the administration of President Dwight D Eisenhower. At the height of the Cold War, Dulles was Eisenhower's emissary, traveling over 450,000 international miles, leading United States foreign policy. In November of 1956, during an international crisis involving the Suez Canal, Dulles became ill and underwent an operation for a perforated colon cancer. During much of his impactful term as Secretary of State, Dulles was being treated for this cancer that ultimately resulted in his death in May of 1959. This paper highlights the medical care of John Foster Dulles and the global events during his illness.

  9. 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

  10. Remarkable Works and Cases in the History of Medical Mycology in Japan.

    Science.gov (United States)

    Nishimoto, Katsutaro

    2017-01-01

    Several pathogenic fungi and cases related to Japanese medical mycologists were reviewed. Trichosporon inkin (as Sarcinomyces inkin) was reported as a pathogen of scrotal lesion by Oho in 1921, and Trichosporon asahii was isolated from generalized keratotic lesions in 1922 by Akagi in Japan. They were once included in Trichophyton beigelii, but then based on revision using DNA molecular technology, were returned to their original names.Microsporum ferrugineum was reported by Ota as a causative dermatophyte of tinea capitis in Japan and surrounding areas. It was once classified under the genus Trichophyton, but after the discovery of characteristic rough-walled macroconidia belonging to genus Microsporum, the fungus was again assigned to the original name.

  11. [A history of Korean medical association's emblem: the caduceus of Asklepios and Hermes].

    Science.gov (United States)

    Shin, Young-Jeon

    2007-06-01

    An emblem represents the identity of an organization. Through the emblem of an organization, they differentiate the members from others and reinforce the membership, homogeneity, and pride. It is also a tool that an organization officially publicizes its mission and values. The symbol designed by Cho, Byungduk was announced as the first emblem of Korean Medical Association (KMA) on October 31st 1947. His design work has the caduceus with the Taeguk sign on the top, the symbol of Korea, and the Red Cross in the background including the name, 'KMA'. Since then, the emblem was revised three times: in 1964, 1973, and 1995. The current symbol is based on the design of the first one. Although Asklepian, the single serpent-entwined staff of Asklepios, is the one known as the symbol of medicine, this emblem takes the caduceus of Hermes who is the patron god of merchants, thieves, and travelers. The mistake comes from the unawareness of the distinction between the caduceus of Asklepios and Hermes. Moreover, it proves that U. S. Army Medical Corps (USAMC) heavily influenced the reconstruction of Korean health care system including KMA. The USAMC has used the symbol of caduceus since 1902. In 1947, the year that the first emblem of KMA was established, Southern part of Korea was governed by the United States Military Government (USMG, 1945-1948). The current emblem of KMA brings up a question whether we should continue to use the symbol that was taken from USMAC in the historical period of USMG governance. Celebrating 100th anniversary year of KMA, KMA needs to re-evaluate the appropriateness of the KMA symbol.

  12. [Who decides what data should be recorded in the medical history in relation to the biological origin?

    Science.gov (United States)

    Gallego Riestra, Sergio; Riaño Galán, Isolina

    2018-02-01

    There is an increasing request by patients or their representatives not to have some data registered in their clinical history or if such data exists to be deleted. Without doubt, this is so because such clinical data is accessed by various professionals who in most cases are not directly involved in caring for such patients. On the other hand, such data is copied and iteratively and unnecessary reproduced in various discharge reports and others forms. The problem arises when such controversial data refer to particularly sensitive clinical aspects such as assisted reproduction techniques, which invades personal and family privacy. Therefore, the question is who determines what data should be recorded in the medical records and according to what criteria should be taken that decision? Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. [History of training and certification programs of medical specialists in Peru].

    Science.gov (United States)

    Burstein Alva, Zuño

    2014-01-01

    In this paper, historical reference is made about legal provisions for recognition of the training and certification of medical specialists in Peru through university programs provided since 1928 and culminating in 1973 with the legal authorization by the relevant state authority to implement the Second Specialization Program in Human Medicine and to grant the Certification of Specialist in the Name of the Nation upon completion of a university residency program and specialized training by the “regular modality”, and the recognition by the university with the “non-regular modality”. In Peru it has been established to the present that the Professional Certifications of Specialists in Human Medicine “in the Name of the Nation”, both in “regular modality” as well as in “non-regular modality”, can only be granted by public or private universities authorized for this mission and, besides, no other public or private institution can claim this role that corresponds exclusively for the Peruvian University.

  14. 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

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

    Science.gov (United States)

    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.

  16. Factors Influencing Suicidal Tendencies of Patients with Diagnosis of Attempted Suicide in Medical History and Potential Prevention of Relapse Prevention.

    Science.gov (United States)

    Kotrbová, Kvetoslava; Dóci, Ivan; Hamplová, Lidmila; Dvořák, Vít; Selingerová, Šárka; Růžičková, Veronika; Chmelařová, Šárka

    2017-12-01

    The authors researched the incidence of suicidal thoughts and related factors in 123 patients of the psychiatric ward of the Hospital of České Budějovice with diagnosed attempted suicide in their medical history for the period from January 2013 – June 2015. The research was carried out in two stages. At the beginning of the hospitalization, quantitative data collection was implemented using a semi-structured questionnaire, followed by qualitative research conducted with semi-structured phone conversation, based on previous patient's written consent. The research data were statistically processed to obtain information about the character of relations among individual characteristics. To quantify them, the Bayesian Network (BN) was constructed, and to identify relations among individual characteristics, the Hill-Climbing algorithm was used. Before deriving the network, variables were discretized. The network parameters were set based on a data matrix using the maximal plausibility method. The results of analysed set show that the probability of suicidal thoughts is high, achieving a value of 0.750 (0.781 for women and 0.724 for men). If the patient visits a contact centre for drug-addicted persons, the probability of suicidal thoughts decreases to 0.683. If the patient visits a psychotherapist, the values of 0.736 are achieved. If a daily care centre is visited, the estimated risk rises to 0.832 and the probability of the patient repetitively attempting suicide is 0.606. If the interviewed person regularly consumes alcohol, the probable relapse amounts to 0.616. But if the person consumes alcohol from time to time, the probability rises to 0.701. In case of abstinence, the probable relapse decreases to 0.565. The incidence of suicidal thoughts in observed patients was high, and the amount of risk was influenced by gender, by visiting follow-up care facilities, psychotherapy, and particularly by the frequency of alcohol consumption. Intermittent alcohol

  17. 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

  18. History and Guideline of Emergency Medicine Residency Discipline in Shahid Beheshti University of Medical Sciences, Iran; Review of 2014

    Directory of Open Access Journals (Sweden)

    Majid Shojaee

    2014-09-01

    directly declared to him. Lastly, in ministry time of Dr. Farhadi in 2001 this major was initiated for the first time in Iran University of Medical Sciences. The present report was addressed to the education guideline of emergency medicine at Shahid Beheshti University of Medical Sciences besides evaluating the formation history of emergency medicine discipline in Iran. 

  19. 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

  20. Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data

    Directory of Open Access Journals (Sweden)

    Yeon-Yong Kim

    2017-09-01

    Full Text Available Objectives The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Methods Data from self-reported questionnaires that assessed an individual’s history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Results Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Conclusions Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

  1. Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data.

    Science.gov (United States)

    Kim, Yeon-Yong; Park, Jong Heon; Kang, Hee-Jin; Lee, Eun Joo; Ha, Seongjun; Shin, Soon-Ae

    2017-09-01

    The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

  2. 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.

  3. 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.

  4. Natural histroy of trisomy 18 and trisomy 13: I. Growth, physical assessment, medical histories, survival, and recurrence risk

    Energy Technology Data Exchange (ETDEWEB)

    Baty, B.J.; Blackburn, B.L.; Carey, J.C. [Univ. of Utah School of Medicine, Salt Lake City, UT (United States)

    1994-01-15

    The natural history of trisomy 18 and trisomy 13 was investigated using data derived from parent questionnaires and medical records from 98 families with an index case of trisomy 18 and 32 families with an index case of trisomy 13. Data are presented on pregnancy, delivery, survival, medical complications, immunizations, growth, cause of death, cytogenetics, and recurrence risk. Half of the trisomy 18 babies were delivered by C-section. Fetal distress was a factor in half, and the only reason in a third of C-section deliveries. One minute Apgar scores were significantly lower in C-section and breech deliveries. There were more small-for-gestational-age babies than in the general population, but most of the low-birth-weight newborns were small for gestational age, unlike the general population. Survival in this group of children was better than in other studies due to ascertainment bias. There were more girls than boys at all ages for both conditions, and the sex ratio decreased with time. Growth curves for length, weight, head circumference, and weight vs height are provided. Long-term survival did not appear to be due to mosaicism. There were no adverse reactions attributable to immunizations. At age 1 year there was an average of approximately 2 operations per living child. The authors report the second case of successful major cardiac surgery in a trisomy 18 child. Almost 70% of deaths were attributed to cardiopulmonary arrest. The sibling recurrence risk for trisomy 18 or trisomy 13 was 0.55%. 86 refs., 5 figs., 5 tabs.

  5. 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

  6. 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

  7. 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 ...

  8. 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

  9. 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.

  10. 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.

  11. A Declining Region: Provincial Renaissance Revisited (Case of Volgograd Region

    Directory of Open Access Journals (Sweden)

    Drozdova Yuliya

    2014-12-01

    exceeds incoming migrants. Young people under 35 showed the highest rate of willingness to leave the region – 57.6 % of respondents, which arouses concern about the region’s future as this cohort capable of developing the region is the target of all plans about boosting the regional image, and these people are not going to cast in their lot with the Volgograd region. For the moment, we can point out that the region shows poor attractiveness for the main target groups in the region, which encumbers the formation of the region’s image and regional identity, indicates negative tendencies and implies great effort on the part of management entities if they want to change the situation in the Volgograd region. Our study revealed the main trends in building a positive image of the region and changing the local context; these are traditional (centre of war and history memorials – 38 % of respondents, industrial – 46.0 % of respondents, tourism – 26.8 % of respondents, and innovative (centre for training and education – 35.5 %, centre for culture – 37.9 % of respondents. The regional image and local context do not change spontaneously; they are rather a product of conscious, well-regulated conceptualization, a product of artificially organized public reflection and projection. According to the surveyed people residing in the region, the region’s development and change in local context can be helped along by such factors as “active cooperation of the authorities and business – 49.3 % of respondents; “honesty among regional and municipal officials – 38.6 % of respondents; “safety of business operations” – 34.3 % of respondents; “presence of a regional strategy that meets the region’s needs” – 33.9 % of respondents; “social and tax benefits” – 33.0 % of respondents; “the people should be informed about the project of regional development and take part in them” – 26.8 % of respondents. Revealing the factors that determine the local

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

    Science.gov (United States)

    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

  13. Factors affecting frequency of communication about family health history with family members and doctors in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Goodman, Melody; Pandya, Chintan; Garg, Priyanka; Stafford, Jewel; Lachance, Christina

    2012-08-01

    Family history contributes to risk for many common chronic diseases. Little research has investigated patient factors affecting communication of this information. 1061 adult community health center patients were surveyed. We examined factors related to frequency of discussions about family health history (FHH) with family members and doctors. Patients who talked frequently with family members about FHH were more likely to report a family history of cancer (p =.012) and heart disease (p history of heart disease (p = .011), meet physical activity recommendations (p = .022), seek health information frequently in newspapers (p history of some diseases, those not meeting physical activity recommendations, and those who do not frequently seek health information may not have ongoing FHH discussions. Interventions are needed to encourage providers to update patients' family histories systematically and assist patients in initiating FHH conversations in order to use this information for disease prevention and control. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. [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

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

    Directory of Open Access Journals (Sweden)

    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

  1. The medical Doppler in hand surgery: its scientific basis, applications, and the history of its namesake, Christian Johann Doppler.

    Science.gov (United States)

    Ghori, Ahmer K; Chung, Kevin C

    2007-12-01

    The word Doppler is used synonymously in hand surgery for evaluating patency of vascular structures; however, the science and history behind the Doppler effect are not as well-known. We will present the theories behind the Doppler effect and the history of the person who made this discovery.

  2. 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…

  3. 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)

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

    Directory of Open Access Journals (Sweden)

    Paula Dhiman

    Full Text Available The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD. However the quality of family health information in primary care records is unclear.To assess the availability and quality of family history of CHD documented in electronic primary care records.Cross-sectional study.537 UK family practices contributing to The Health Improvement Network database.Data were obtained from patients aged 20 years or more, registered with their current practice between 1(st January 1998 and 31(st December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively.In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR:1.23 (1.21 to 1.25, however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88. Of the 140,058 patients with a positive family history recorded (9% of total cohort, age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration.Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.

  9. Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

    Science.gov (United States)

    Dhiman, Paula; Kai, Joe; Horsfall, Laura; Walters, Kate; Qureshi, Nadeem

    2014-01-01

    The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD). However the quality of family health information in primary care records is unclear. To assess the availability and quality of family history of CHD documented in electronic primary care records. Cross-sectional study. 537 UK family practices contributing to The Health Improvement Network database. Data were obtained from patients aged 20 years or more, registered with their current practice between 1(st) January 1998 and 31(st) December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively. In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR:1.23 (1.21 to 1.25)), however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88)). Of the 140,058 patients with a positive family history recorded (9% of total cohort), age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration. Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.

  10. 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.

  11. A 40-Year History of End-of-Life Offerings in US Medical Schools: 1975-2015.

    Science.gov (United States)

    Dickinson, George E

    2017-07-01

    The purpose of this longitudinal study of US medical schools over a 40-year period was to ascertain their offerings on end-of-life (EOL) issues. At 5-year intervals, beginning in 1975, US medical schools were surveyed via a questionnaire to determine their EOL offerings. Data were reported with frequency distributions. The Institute of Medicine has encouraged more emphasis on EOL issues over the past 2 decades. Findings revealed that undergraduate medical students in the United States are now exposed to death and dying, palliative care, and geriatric medicine. The inclusion of EOL topics has definitely expanded over the 40-year period as findings reveal that US undergraduate medical students are currently exposed in over 90% of programs to death and dying, palliative care, and geriatric medicine, with the emphasis on these topics varying with the medical programs. Such inclusion should produce future favorable outcomes for undergraduate medical students, patients, and their families.

  12. [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.

  13. [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.

  14. Patients Who Attend the Emergency Department Following Medication Overdose: Self-Reported Mental Health History and Intended Outcomes of Overdose

    Science.gov (United States)

    Buykx, Penny; Ritter, Alison; Loxley, Wendy; Dietze, Paul

    2012-01-01

    Medication overdose is a common method of non-fatal self-harm. Previous studies have established which mental health disorders are commonly associated with the behaviour (affective, substance use, anxiety and personality disorders) and which medications are most frequently implicated (benzodiazepines, antidepressants, antipsychotics and non-opioid…

  15. An anthropological approach to teach and evaluate cultural competence in medical students - the application of mini-ethnography in medical history taking.

    Science.gov (United States)

    Hsieh, Jyh-Gang; Hsu, Mutsu; Wang, Ying-Wei

    2016-01-01

    Purpose To use mini-ethnographies narrating patient illness to improve the cultural competence of the medical students. Methods Between September 2013 and June 2015, all sixth-year medical students doing their internship at a medical center in eastern Taiwan were trained to write mini-ethnographies for one of the patients in their care. The mini-ethnographies were analyzed by authors with focus on the various aspects of cultural sensitivity and a holistic care approach. Results Ninety-one students handed in mini-ethnographies, of whom 56 were male (61.5%) and 35 were female (38.5%). From the mini-ethnographies, three core aspects were derived: 1) the explanatory models and perceptions of illness, 2) culture and health care, and 3) society, resources, and health care. Based on the qualities of each aspect, nine secondary nodes were classified: expectations and attitude about illness/treatment, perceptions about their own prognosis in particular, knowledge and feelings regarding illness, cause of illness, choice of treatment method (including traditional medical treatments), prejudice and discrimination, influences of traditional culture and language, social support and resources, and inequality in health care. Conclusions Mini-ethnography is an effective teaching method that can help students to develop cultural competence. It also serves as an effective instrument to assess the cultural competence of medical students.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Human rights from the Nuremberg Doctors Trial to the Geneva Declaration. Persons and institutions in medical ethics and history.

    Science.gov (United States)

    Frewer, Andreas

    2010-08-01

    The "Universal Declaration of Human Rights" and the "Geneva Declaration" by the World Medical Association, both in 1948, were preceded by the foundation of the United Nations in New York (1945), the World Medical Association in London (1946) and the World Health Organization in Geneva (1948). After the end of World War II the community of nations strove to achieve and sustain their primary goals of peace and security, as well as their basic premise, namely the health of human beings. All these associations were well aware of the crimes by medicine, in particular by the accused Nazi physicians at the Nuremberg Doctors Trial (1946/47, sentence: August 1947). During the first conference of the World Medical Association (September 1947) issues of medical ethics played a major role: and a new document was drafted concerning the values of the medical profession. After the catastrophe of the War and the criminal activities of scientists, the late 1940s saw increased scrutiny paid to fundamental questions of human rights and medical ethics, which are still highly relevant for today's medicine and morality. The article focuses on the development of medical ethics and human rights reflected in the statement of important persons, codes and institutions in the field.

  18. 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.

  19. 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.

  20. 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.

  1. Medical genetic issues in clinical of pediatric neurology practice:a history of pediatrics in Peking University First Hospital.

    Science.gov (United States)

    Wu, Xi-ru

    2006-02-18

    The Department of Pediatrics of Peking University First Hospital has a long term of outstanding history. It was established about 60 years ago. After the division of pediatric neurology (DPN) had been established in 1960s, it had been assigned to cover genetic disorders. During the recent 20 years, efforts have been put on three aspects: (1) Pediatric neurology clinical service and education; (2) research studies of childhood epilepsies and pediatric neurogenetic disorders; and (3) development of a strong DPN team to establish a comprehensive pediatric neurological program. In this paper, we reviewed the history of the pediatric neurology division in our department, our clinical and research work and achievements for neurogenetic diseases.

  2. Disability assessment interview : the role of detailed information on functioning in addition to medical history-taking

    NARCIS (Netherlands)

    Spanjer, J.; Krol, B.; Popping, R.; Groothoff, J.W.; Brouwer, Sandra

    Objective: To investigate whether the provision of detailed information on participation and activity limitations, compared with medical information alone, influences the assessment of work limitations by physicians. Methods: Three groups each of 9 insurance physicians used written interview reports

  3. 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. PMID:28584871

  4. "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.

  5. 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.

  6. [For a history of medical teaching in the 'Marche". Libraries and universities: Lancisi and the University Library of Urbino].

    Science.gov (United States)

    Fortuna, Stefania; Moranti, Maria; Patti, Maria

    2004-01-01

    During the Modern Age, in the Marche, in the Pontifical State, it was possible to study medicine and to obtain a degree in medicine in Macerata, Fermo, Urbino, Camerino and Fano. In these cities, from the end of the XVII century to the beginning of the XIX century, public libraries were founded also to support academic teaching. Private collections of medical books, generally formed in Rome, arrived in the Marche to increase the newborn public libraries. In 1720 Pope Clemens XI founded a public library in the monastery of Saint Francis in Urbino. In this library the medical books were bequeathed by the famous Roman physician Giovanni Maria Lancisi. The present article provides the first results of a research, which aims at identifying Lancisi's medical books.

  7. An Evaluation of Provincial Infectious Disease Surveillance Reports in Ontario.

    Science.gov (United States)

    Chan, Ellen; Barnes, Morgan E; Sharif, Omar

    Public Health Ontario (PHO) publishes various infectious disease surveillance reports, but none have yet been formally evaluated. PHO evaluated its monthly and annual infectious disease surveillance reports to assess public health stakeholders' current perception of the products and to develop recommendations for improving future products. An evaluation consisting of an online survey and a review of public Web sites of other jurisdictions with similar annual reports. For the online survey, stakeholder organizations targeted were the 36 local public health units and the Health health ministry in Ontario, Canada. Survey participants included epidemiologists, managers, directors, and other public health practitioners from participating organizations. Online survey respondents' awareness and access to the reports, their rated usefulness of reports and subsections, and suggestions for improving usefulness; timeliness of select annual reports from other jurisdictions based on the period from data described to report publication. Among 57 survey respondents, between 74% and 97% rated each report as useful; the most common use was for situational awareness. Respondents ranked timeliness as the most important attribute of surveillance reports, followed by data completeness. Among 6 annual reports reviewed, the median time to publication was 11.5 months compared with 23.2 months for PHO. Recommendations based on this evaluation have already been applied to the monthly report (eg, focusing on the most useful sections) and have become key considerations when developing future annual reports and other surveillance reporting tools (eg, need to provide more timely reports). Other public health organizations may also use this evaluation to inform aspects of their surveillance report development and evaluation. The evaluation results have provided PHO with direction on how to improve its provincial infectious disease surveillance reporting moving forward, and formed a basis for

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

    Science.gov (United States)

    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.

  9. 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...

  10. 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...

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 隋前正史医事伦理探骊%Discussion on Medical Ethics Based on the History before the Sui Dynasty

    Institute of Scientific and Technical Information of China (English)

    赵仁龙; 任杰

    2015-01-01

    征引隋前正史中医学史料,从高层之医学人文关怀、医学教育及医学传播三个伦理方面进行论述,认为:医与政有着天然紧密相连的渊源关系,医政充分体现了政府有无政治作为和是否实施人文关怀;汉魏南北朝时期太学、地方官学、私学都很活跃,在医学教育方面,也有深刻的进步理念;中医药作为加强民族间交流和融合的友好使者,对当今的中国优秀传统文化对外传播有着重要的引领意义。%Based on the TCM historical information before the history of Sui Dynasty, from the top of the medi-cal humanistic care, medical education and medical communication, the essay discusses three ethical, think: the medical is closely combined with politics have a natural origin, medical administration embodies the government whether any politics as and humanistic care;Jun business, local authority, private and southern and northern dy-nasties period is active, in terms of medical education, also has a profound progress idea; Chinese medicine as strengthen communication and integration between national goodwill ambassador, in today′s Chinese excellent tradi-tional culture of foreign communication has important guide meaning.

  16. 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.

  17. History and perspectives of medical research at the Albert Schweitzer Hospital in Lambaréné, Gabon

    NARCIS (Netherlands)

    Ramharter, Michael; Adegnika, Ayola A.; Agnandji, Selidji T.; Matsiegui, Pierre Blaise; Grobusch, Martin P.; Winkler, Stefan; Graninger, Wolfgang; Krishna, Sanjeev; Yazdanbakhsh, Maria; Mordmüller, Benjamin; Lell, Bertrand; Missinou, Michel A.; Mavoungou, Elie; Issifou, Saadou; Kremsner, Peter G.

    2007-01-01

    In 1913 Albert Schweitzer founded one of the first modern hospitals in Africa dedicated to the health of the local population. The Albert Schweitzer Hospital is located in Lambaréné, a small town in Gabon. In 1981 a research department--the Medical Research Unit--was established with the aim to

  18. Anniversary Paper: History and status of CAD and quantitative image analysis: The role of Medical Physics and AAPM

    International Nuclear Information System (INIS)

    Giger, Maryellen L.; Chan, Heang-Ping; Boone, John

    2008-01-01

    The roles of physicists in medical imaging have expanded over the years, from the study of imaging systems (sources and detectors) and dose to the assessment of image quality and perception, the development of image processing techniques, and the development of image analysis methods to assist in detection and diagnosis. The latter is a natural extension of medical physicists' goals in developing imaging techniques to help physicians acquire diagnostic information and improve clinical decisions. Studies indicate that radiologists do not detect all abnormalities on images that are visible on retrospective review, and they do not always correctly characterize abnormalities that are found. Since the 1950s, the potential use of computers had been considered for analysis of radiographic abnormalities. In the mid-1980s, however, medical physicists and radiologists began major research efforts for computer-aided detection or computer-aided diagnosis (CAD), that is, using the computer output as an aid to radiologists--as opposed to a completely automatic computer interpretation--focusing initially on methods for the detection of lesions on chest radiographs and mammograms. Since then, extensive investigations of computerized image analysis for detection or diagnosis of abnormalities in a variety of 2D and 3D medical images have been conducted. The growth of CAD over the past 20 years has been tremendous--from the early days of time-consuming film digitization and CPU-intensive computations on a limited number of cases to its current status in which developed CAD approaches are evaluated rigorously on large clinically relevant databases. CAD research by medical physicists includes many aspects--collecting relevant normal and pathological cases; developing computer algorithms appropriate for the medical interpretation task including those for segmentation, feature extraction, and classifier design; developing methodology for assessing CAD performance; validating the

  19. 12-Step participation reduces medical use costs among adolescents with a history of alcohol and other drug treatment.

    Science.gov (United States)

    Mundt, Marlon P; Parthasarathy, Sujaya; Chi, Felicia W; Sterling, Stacy; Campbell, Cynthia I

    2012-11-01

    Adolescents who attend 12-step groups following alcohol and other drug (AOD) treatment are more likely to remain abstinent and to avoid relapse post-treatment. We examined whether 12-step attendance is also associated with a corresponding reduction in health care use and costs. We used difference-in-difference analysis to compare changes in seven-year follow-up health care use and costs by changes in 12-step participation. Four Kaiser Permanente Northern California AOD treatment programs enrolled 403 adolescents, 13-18-years old, into a longitudinal cohort study upon AOD treatment entry. Participants self-reported 12-step meeting attendance at six-month, one-year, three-year, and five-year follow-up. Outcomes included counts of hospital inpatient days, emergency room (ER) visits, primary care visits, psychiatric visits, AOD treatment costs and total medical care costs. Each additional 12-step meeting attended was associated with an incremental medical cost reduction of 4.7% during seven-year follow-up. The medical cost offset was largely due to reductions in hospital inpatient days, psychiatric visits, and AOD treatment costs. We estimate total medical use cost savings at $145 per year (in 2010 U.S. dollars) per additional 12-step meeting attended. The findings suggest that 12-step participation conveys medical cost offsets for youth who undergo AOD treatment. Reduced costs may be related to improved AOD outcomes due to 12-step participation, improved general health due to changes in social network following 12-step participation, or better compliance to both AOD treatment and 12-step meetings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. The South East Asian Federation of Organizations for Medical Physics (SEAFOMP): Its history and role in the ASEAN countries.

    Science.gov (United States)

    Ng, Kh; Wong, Jhd

    2008-04-01

    Informal discussion started in 1996 and the South East Asian Federation of Organizations for Medical Physics (SEAFOMP) was officially accepted as a regional chapter of the IOMP at the Chicago World Congress in 2000 with five member countries, namely Indonesia, Malaysia, Philippines, Singapore and Thailand. Professor Kwan-Hoong Ng served as the founding president until 2006. Brunei (2002) and Vietnam (2005) joined subsequently. We are very grateful to the founding members of SEAFOMP: Anchali Krisanachinda, Kwan-Hoong Ng, Agnette Peralta, Ratana Pirabul, Djarwani S Soejoko and Toh-Jui Wong.The objectives of SEAFOMP are to promote (i) co-operation and communication between medical physics organizations in the region; (ii) medical physics and related activities in the region; (iii) the advancement in status and standard of practice of the medical physics profession; (iv) to organize and/or sponsor international and regional conferences, meetings or courses; (v) to collaborate or affiliate with other scientific organizations.SEAFOMP has been organizing a series of congresses to promote scientific exchange and mutual support. The South East Asian Congress of Medical Physics (SEACOMP) series was held respectively in Kuala Lumpur (2001), Bangkok (2003), Kuala Lumpur (2004) and Jakarta (2006). The respective congress themes indicated the emphasis and status of development. The number of participants (countries in parentheses) was encouraging: 110 (17), 150 (16), 220 (23) and 126 (7).In honour of the late Professor John Cameron, an eponymous lecture was established. The inaugural John Cameron Lecture was delivered by Professor Willi Kalender in 2004. His lecture was titled "Recent Developments in Volume CT Scanning".

  1. [Business, politics, science, and visa versa: an institutional history of Brazilian medical journalism between 1827 and 1843].

    Science.gov (United States)

    Ferreira, Luiz Otávio

    2004-01-01

    This analysis of Brazil's first medical newspapers - Propagador das Ciências Médicas (1827-28); Semanário de Saúde Pública (1831-33); Diário de Saúde (1835-36); Revista Médica Fluminense (1835-41); Revista Médica Brasileira (1841-43) - shows how Rio de Janeiro's socio-cultural context made it possible for this type of publication to emerge within the city's dynamic, troubled environment of the 1820s and 30s. I argue that the distinguishing feature of Brazil's early medical journalism was a symbiosis between business (local publishing houses' commercial interests), politics (struggles for political hegemony during the consolidation of the Imperial State), and science (the movement to institutionalize medicine and affirm it as a science).

  2. A clinical procedures curriculum for undergraduate medical students: the eight-year history of a third-year immersive experience

    Directory of Open Access Journals (Sweden)

    Laura Thompson

    2016-05-01

    Full Text Available Background: Procedural skills training is a critical component of medical education, but is often lacking in standard clinical curricula. We describe a unique immersive procedural skills curriculum for medical students, designed and taught primarily by emergency medicine faculty at The Ohio State University College of Medicine. Objectives: The primary educational objective of this program was to formally introduce medical students to clinical procedures thought to be important for success in residency. The immersion strategy (teaching numerous procedures over a 7-day period was intended to complement the student's education on third-year core clinical clerkships. Program design: The course introduced 27 skills over 7 days. Teaching and learning methods included lecture, prereading, videos, task trainers, peer teaching, and procedures practice on cadavers. In year 4 of the program, a peer-team teaching model was adopted. We analyzed program evaluation data over time. Impact: Students valued the selection of procedures covered by the course and felt that it helped prepare them for residency (97%. The highest rated activities were the cadaver lab and the advanced cardiac life support (97 and 93% positive endorsement, respectively. Lectures were less well received (73% positive endorsement, but improved over time. The transition to peer-team teaching resulted in improved student ratings of course activities (p<0.001. Conclusion: A dedicated procedural skills curriculum successfully supplemented the training medical students received in the clinical setting. Students appreciated hands-on activities and practice. The peer-teaching model improved course evaluations by students, which implies that this was an effective teaching method for adult learners. This course was recently expanded and restructured to place the learning closer to the clinical settings in which skills are applied.

  3. Relationship of ABO and Rh blood groups with history of gastritis in the undergraduate medical and dental students: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nilu Manandhar

    2017-12-01

    Full Text Available Background & Objectives: The various ABO and Rh blood groups with different distribution frequencies in the general population have been found to be associated with different diseases, most notably gastritis. Many studies have claimed Rh groups to be indifferent to such association. Nonetheless, ABO group is found to linked with chronic gastritis. The aim of this study was to estimate the frequencies of ABO and Rh blood groups and the gastritis amongst the first and second year undergraduate medical and dental students; and to study their relationships. Materials & Methods: In a descriptive, cross-sectional study, 247 study participants were enrolled. After procuring clearance from the institutional review committee and the informed and written consent from the study participants, data collection was done on the variables, year of study (first or second year, gender, blood groups (ABO and Rh and history of gastritis (present or absent.Results: Blood group O was the commonest (n=99; 40.1% followed by group B (n=77; 31.2%. Similarly, 239 (96.8% participants were Rh-positive as compared to 8 (3.2% Rh-negative. Interestingly, 46 (18.6% of the participants reported positive history of gastritis. Participants with blood group O had the greatest odds (OR=1.64 of having history of gastritis compared with those with other blood groups combined. Distribution of study participants based on gender and history of gastritis in either systems of blood grouping shoed no significant difference in their proportions (p>0.05. Conclusion: In light of the above findings, further longitudinal studies can be designed to better asses the relationship.

  4. 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.

  5. Fish consumption and its motives in households with versus without self-reported medical history of CVD

    DEFF Research Database (Denmark)

    Pieniak, Zuzanna; Verbeke, Wim; Perez-Cueto, Federico

    2008-01-01

    subjective and objective knowledge related to nutrition issues about fish. In the other countries, objective knowledge about fish was on a low level, similar for CVD+ as for CVD- subjects, despite a higher claimed use of medical information sources about fish among CVD+ subjects. Conclusions - Although...... consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing chronic diseases, but also to the broader public. European consumers are convinced that eating fish is healthy, but particular emphasis should be made...

  6. Combining history of medicine and library instruction: an innovative approach to teaching database searching to medical students.

    Science.gov (United States)

    Timm, Donna F; Jones, Dee; Woodson, Deidra; Cyrus, John W

    2012-01-01

    Library faculty members at the Health Sciences Library at the LSU Health Shreveport campus offer a database searching class for third-year medical students during their surgery rotation. For a number of years, students completed "ten-minute clinical challenges," but the instructors decided to replace the clinical challenges with innovative exercises using The Edwin Smith Surgical Papyrus to emphasize concepts learned. The Surgical Papyrus is an online resource that is part of the National Library of Medicine's "Turning the Pages" digital initiative. In addition, vintage surgical instruments and historic books are displayed in the classroom to enhance the learning experience.

  7. Symptom Characteristics and Medical History of an Online Sample of Women Who Experience Symptoms of Persistent Genital Arousal.

    Science.gov (United States)

    Jackowich, Robyn; Pink, Leah; Gordon, Allan; Poirier, Évéline; Pukall, Caroline F

    2018-02-17

    Persistent genital arousal disorder (PGAD; Leiblum & Nathan, 2001 ) is characterized by distressing symptoms suggestive of genital arousal in the absence of subjective feelings of arousal. Although awareness of PGAD is growing, there continues to be a lack of systematic research on it. This study characterized an online sample of women with symptoms of persistent genital arousal (PGA) in terms of their symptom characteristics, medical comorbidities, symptom triggers, management strategies, and predictors of distress. Women reported diverse PGA symptoms, with almost half reporting painful symptoms, and most reported very high distress and negative emotions. Further research and awareness of PGA are needed to provide effective care for this population.

  8. 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.

  9. Autoimmune progesterone dermatitis: Case report with history of urticaria, petechiae and palpable pinpoint purpura triggered by medical abortion.

    Science.gov (United States)

    Mbonile, Lumuli

    2016-03-17

    Autoimmune progesterone dermatitis (APD) is a rare autoimmune response to raised endogenous progesterone levels that occur during the luteal phase of the menstrual cycle. Cutaneous, mucosal lesions and other systemic manifestations develop cyclically during the luteal phase of the menstrual cycle when progesterone levels are elevated. APD symptoms usually start 3 - 10 days before menstruation and resolve 1 - 2 days after menstruation ceases. A 30-year-old woman presented with urticaria, petechiae and palpable pinpoint purpura lesions of the legs, forearms, neck and buttocks 1 week prior to her menses starting and 2 months after a medical abortion. She was diagnosed with allergic contact dermatitis and topical steroids were prescribed. Her skin conditions did not improve and were associated with her menstrual cycle. We performed an intradermal test using progesterone, which was positive. She was treated with oral contraceptive pills and the symptoms were resolved. This is a typical case of APD triggered by increased sensitivity to endogenous progesterone induced a few months after medical abortion.

  10. Socio-demography and medical history as predictors of health-related quality of life of breast cancer survivors.

    Science.gov (United States)

    Ramadas, Amutha; Qureshi, Ahmad Munir; Dominic, Nisha Angela; Botross, Nevein Philip; Riad, Amgad; Thirunavuk Arasoo, Valliammai Jayanthi; Elangovan, Soman

    2015-01-01

    Even after completion of conventional treatment, breast cancer survivors continue to exhibit a variety of psychological and physical symptoms, affecting their quality of life. The study aimed to investigate the relationship between socio-demography, medical characteristics and health-related quality of life (HR-QOL) of a sample of breast cancer survivors in Malaysia. This pilot cross-sectional survey was conducted among breast cancer survivors (n=40) who were members of Breast Cancer Support Group Centre Johor Bahru. A validated self-administered questionnaire was used to identify the relationships between socio-demography, medical characteristics and HR-QOL of the participants. Living with family and completion of treatment were significant predictive factors of self-rated QOL, while living with family and ever giving birth significantly predicted satisfaction with health and physical health. Psychological health had moderate correlations with number of children and early cancer stage. Survivors' higher personal income (>MYR4,500) was the only significant predictor of social relationship, while age, income more than MYR4,500 and giving birth significantly predicted environment domain score. The findings suggested the survivors coped better in all four HR-QOL domains if they were married, lived with family, had children and were employed.

  11. History and perspectives of medical research at the Albert Schweitzer Hospital in Lambaréné, Gabon.

    Science.gov (United States)

    Ramharter, Michael; Adegnika, Ayola A; Agnandji, Selidji T; Matsiegui, Pierre Blaise; Grobusch, Martin P; Winkler, Stefan; Graninger, Wolfgang; Krishna, Sanjeev; Yazdanbakhsh, Maria; Mordmüller, Benjamin; Lell, Bertrand; Missinou, Michel A; Mavoungou, Elie; Issifou, Saadou; Kremsner, Peter G

    2007-01-01

    In 1913 Albert Schweitzer founded one of the first modern hospitals in Africa dedicated to the health of the local population. The Albert Schweitzer Hospital is located in Lambaréné, a small town in Gabon. In 1981 a research department--the Medical Research Unit--was established with the aim to perform research in the field of infectious diseases ( www.lambarene.org ). The main focus lies on clinical research on malaria and other parasitic diseases. Studies on the molecular biology and immunology of parasitic diseases are fostered since the inauguration of a novel building dedicated for basic science. A training program in clinical research in tropical diseases for African scientists has been set up recently.

  12. What's the Original Concept of Meridian and Acupuncture Point in Oriental Medicine? - A Perspective of Medical History

    Directory of Open Access Journals (Sweden)

    YIN Chang- Shik

    2005-12-01

    Full Text Available Meridian and acupuncture point(MAP is a core theory of acupuncture and essential building blocks of oriental medicine. There still continue theoretic or experimental arguments and controversies on the origination or original concept of MAP, without any definite approval or disapproval of a hypothesis. The theory of MAP is an historic product and has never been outside of historic influences. This study discusses the original concept of meridian and acupuncture point theory and its historical evolution, based on the review of classic literatures on meridian including the mawangdui medical texts of Han dynasty. The concept of MAP served as a empirical reference system in clinical settings irrespective of the anatomical entity of MAP.

  13. The return of the Pholela experiment: medical history and primary health care in post-Apartheid South Africa.

    Science.gov (United States)

    Phillips, Howard

    2014-10-01

    I examine why South Africa's pioneering Pholela model of primary health care, dating from the 1940s, held such appeal for the country's new policymakers after 1994, and why those policymakers have failed to make it the basis of an effective public health care system since then. In the 1940s, the innovative Pholela experiment had served as such a model, to be replicated gradually throughout the country until a new health care system in its image was finally in place. However, this vision was dashed by the hostility of the mainstream medical profession and, after 1948, even more so by the new apartheid government, causing the idea to wither and become no more than a vanishing memory. In the 1990s, the model resurfaced as part of the country's transition to democracy, eliciting great enthusiasm among a new generation of health policymakers. I conclude by looking at the fate to date of this second coming of the Pholela experiment.

  14. Rotation therapy for maniacs, melancholics and idiots: theory, practice and perception in European medical and literary case histories.

    Science.gov (United States)

    Dickson, Sheila

    2018-03-01

    This article examines the development and use of rotation therapy in the emerging field of psychiatry at the beginning of the 19th century, and the cross-fertilization between British, Irish, German, French and other European proponents of 'Cox's Swing'. Its short-lived popularity is linked to prevalent Enlightenment thought, to the development of an industrial and technological society, to the modern medical theories of irritability, and to the new practice of 'moral management' of the mentally ill. Case studies documenting the use of the Swing are considered from these perspectives, and are compared with contemporary public reactions in the form of publications in newspapers and of a literary text by German Romantic author Ludwig Achim von Arnim.

  15. [The history of the Science of Stress: From Hans Selye to the discovery of anti-inflammatory medication].

    Science.gov (United States)

    Lupien, Sonia

    2015-01-01

    To make an important scientific discovery that will make history takes a lot of determination, creativity, perseverance and luck! The story behind the discovery of stress and its biological basis is a fascinating one that places Dr. Hans Selye in the forefront. Dr. Selye was a great scientist that taught at the Université de Montréal from 1945 to his death in 1982. Dr. Selye was curious and hard working. He was determined to understand how various disorders can lead to similar physical manifestations, and this interest led him to discover the role of the adrenal glands involved in the stress response and to better understand the effects of glucocorticoids on the body. Today, the science of stress is based on the foundations established by Dr. Selye. In celebration of the 50th anniversary of the Département de psychiatrie de l'Université de Montréal, and the special issue of the Revue Santé Mentale au Québec, this historical review summarizes the discoveries of this great scientist who worked in Quebec.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. [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].

    Science.gov (United States)

    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.

  18. Perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on multiple antihypertensive medications

    Directory of Open Access Journals (Sweden)

    Deb Sanjay Nag

    2017-03-01

    Full Text Available We report a case of perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on regular therapy with atenolol, losartan, prazosin and nicardipine. Severe anaphylactic shock was only transiently responsive to 10 mL of (1:10,000 epinephrine and needed norepinephrine and dopamine infusion. Supportive therapy with vasopressors and inotropes along with mechanical ventilation for the next 24 hours resulted in complete recovery. She was successfully operated upon 2 weeks later with the same anesthetic drugs but intravenous ciprofloxacin as the alternative antibiotic for perioperative prophylaxis. Resumo: Relatamos um caso de choque anafilático refratário no período perianestésico com cefuroxima em paciente com história de alergia à penicilina em terapia regular com atenolol, losartan, prazosina e nicardipine. O choque anafilático grave foi apenas transitoriamente responsivo a 10 mL de epinefrina (1:10000 e precisou de infusão de norepinefrina e dopamina. A terapia de apoio com vasopressores e inotrópicos, juntamente com ventilação mecânica por 24 horas resultaram em recuperação completa. A paciente foi operada com sucesso duas semanas mais tarde, com os mesmos agentes anestésicos, mas com ciprofloxacina intravenosa como antibiótico alternativo para a profilaxia perioperatória. Keywords: Anaphylaxis, Perianesthetic, Cefuroxime, Palavras-chave: Anafilaxia, Perianestésico, Cefuroxima

  19. Hydronephrosis in Infants and Children: Natural History and Risk Factors for Persistence in Children Followed by a Medical Service

    Directory of Open Access Journals (Sweden)

    Kristy Van Dervoort

    2009-01-01

    Full Text Available Background Infants with neonatal hydronephrosis and a normal voiding cystourethrogram (VCUG are presumed to have ureteropelvic junction obstruction (UPJO. There is little current information about the natural history of children with hydronephrosis or clinical factors that predict resolution of the radiological abnormality. Objective To determine the time course until spontaneous resolution of neonatal hydronephrosis and define risk factors for persistence of the abnormality. Methods This retrospective single center review examined infants and children <5 years of age with hydronephrosis who were followed for at least 12 months. Results 136 children were identified (96 male:40 female. The mean age at diagnosis of hydronephrosis was 3.3 ± 9.7 months and 76% of the patients were diagnosed at birth. The hydronephrosis was unilateral in 98 (72% of cases, and hydronephrosis was at least moderate in severity in 22% of affected kidneys. At last follow-up at 30 ± 10 months, the abnormality had resolved in 77 out of 115 (67% available patients, 30 (26% had been referred to urology, and 12 (10% had persistent hydronephrosis. Severity of hydronephrosis was the only clinical feature that predicted persistence of the abnormality (P < 0.001. There was an association between detection at birth and lack of resolution of hydronephrosis. Conclusions Children with hydronephrosis and presumed UPJO and normal kidney parenchyma can be followed for at least 2 years to allow for spontaneous resolution before referral to urology. Serial sonography can be performed at 6 month intervals in uncomplicated cases. More severe hydronephrosis and presence of the lesion at birth may predict infants and children requiring closer observation and referral for possible surgical correction of the hydronephrosis.

  20. [Knowledge of the "Gräfenberg zone" and female ejaculation in ancient Indian sexual science. A medical history contribution].

    Science.gov (United States)

    Syed, R

    1999-01-01

    Ancient Indian texts in sexology (kamaśastra) from the 11th century onwards prove that their authors knew about the area later termed the "Gräfenberg zone" in Europe, as well as about the female ejaculation connected with the stimulation of this area. The Gräfenberg zone is a sexually arousable zone in the front part of the vagina, stimulation of which can lead to the discharge of liquid from the urethra, a phenomenon which is described as female ejaculation. The german gynaecologist Ernst Gräfenberg, who worked in America, described this zone, situated beneath the clitoris, for the first time (at least in this century) in Western medicine in an article published in 1950. (There are, however, evidences, that the 17th-century anatomist Regnier de Graaf had knowledge about the mentioned erogenous zone as well as female ejaculation.) Since the 1980s the so-called Gräfenberg zone, popularly termed "G-spot", and female ejaculation have been controversially discussed medically as well as in popular science, first in the United States, then in Europe; both phenomena have meanwhile been accepted as facts in medical manuals and reference books (e.g. the "Pschyrembel"). Whereas the oldest and most well-known sexological-erotological work of Ancient India, the Kamasutra, dating probably from the third century A.D., apparently did not know the Gräfenberg zone and female ejaculation, texts such as the Pañcasayaka (11th century), Jayamangala (Yaśodhara's commentary on the Kamasutra from the 13th century), the Ratirahasya (13th century), as well as the late kamaśastra-works Smaradipika and Anangaranga (16th century?) demonstrably describe both, the Gräfenberg zone and female ejaculation, in great detail. The female ejaculation is described already in the 7th century in a non-kamaśastra-text, in a work of the poet Amaru called the Amaruśataka.

  1. Fibromyalgia and Obesity: The Association Between Body Mass Index and Disability, Depression, History of Abuse, Medications, and Comorbidities.

    Science.gov (United States)

    Gota, Carmen E; Kaouk, Sahar; Wilke, William S

    2015-09-01

    The aim of this study was to determine the frequency of increasing body mass index (BMI) in fibromyalgia (FM) and to understand the impact of increasing BMI on FM. Patients with FM were divided into 3 BMI classifications: normal weight, overweight, and obese. We then sought relationships of increasing BMI to core process FM variables and symptoms and disability, as well as medical comorbidities and demographic, socioeconomic, psychiatric, and treatment data. Of 224 patients, 0.4% were underweight; 25.9%, normal weight; 29.9%, overweight; 43.8%, obese. We found no differences within groups with regard to age, gender, demographics, FM symptoms, FM impact questionnaire scores, and meeting the American College of Rheumatology 1990 criteria and FM survey criteria. Patients with FM who are obese, compared with normal-weight patients, have higher depression scores measured by Patient Health Questionnaire 9 (13.2 [6.6] vs 10.5 [6], P = 0.03), report increased disability by Health Assessment Questionnaire Disability Index scores (1.3 [0.6] vs 0.9 [0.6], P BMI with the Health Assessment Questionnaire Disability Index (not FM impact questionnaire) and depression. We confirm that the prevalence of overweight and obesity is high in FM and believe that physicians treating FM should be aware of our bivariate linear correlations and discuss weight loss with their FM patients. Even if increasing BMI is not intrinsic to FM, it contributes to poor mood and functional outcome and should be a treatment goal.

  2. [On the history of the German Democratic Republic Journal Psychiatry, Neurology and Medical Psychology (1949-1990)].

    Science.gov (United States)

    Teitge, M; Kumbier, E

    2015-05-01

    Scientific journals were established in the Soviet occupied zone following WWII in order to distinguish themselves from the other occupying powers. Starting in 1949 a journal with the title "Psychiatry, Neurology and Medical Psychology" was founded as no publishing house existed in the field of psychiatry and neurology and it became necessary to establish a new journal that was competitive. The journal was primarily distributed in the German Democratic Republic (GDR) until 1990 but the interest internationally was very limited. State affairs had a great influence from the very beginning so that the political involvement was reflected in the selection of staff, such as the publishers and the head of the editorial department and by the close interconnection between the Society for Psychiatry and Neurology of the GDR and the editorship of the journal. The publishers who were primarily responsible and the authors were at the interface of politics and science. Nevertheless, in an international comparison many parallels can be found in the orientation with respect to the content.

  3. 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

  4. 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.

  5. Risk of pancreatic cancer associated with family history of cancer and other medical conditions by accounting for smoking among relatives.

    Science.gov (United States)

    Molina-Montes, E; Gomez-Rubio, P; Márquez, M; Rava, M; Löhr, M; Michalski, C W; Molero, X; Farré, A; Perea, J; Greenhalf, W; Ilzarbe, L; O'Rorke, M; Tardón, A; Gress, T; Barberà, V M; Crnogorac-Jurcevic, T; Domínguez-Muñoz, E; Muñoz-Bellvís, L; Balsells, J; Costello, E; Huang, J; Iglesias, M; Kleeff, J; Kong, Bo; Mora, J; Murray, L; O'Driscoll, D; Poves, I; Scarpa, A; Ye, W; Hidalgo, M; Sharp, L; Carrato, A; Real, F X; Malats, N

    2018-04-01

    Family history (FH) of pancreatic cancer (PC) has been associated with an increased risk of PC, but little is known regarding the role of inherited/environmental factors or that of FH of other comorbidities in PC risk. We aimed to address these issues using multiple methodological approaches. Case-control study including 1431 PC cases and 1090 controls and a reconstructed-cohort study (N = 16 747) made up of their first-degree relatives (FDR). Logistic regression was used to evaluate PC risk associated with FH of cancer, diabetes, allergies, asthma, cystic fibrosis and chronic pancreatitis by relative type and number of affected relatives, by smoking status and other potential effect modifiers, and by tumour stage and location. Familial aggregation of cancer was assessed within the cohort using Cox proportional hazard regression. FH of PC was associated with an increased PC risk [odds ratio (OR) = 2.68; 95% confidence interval (CI): 2.27-4.06] when compared with cancer-free FH, the risk being greater when ≥ 2 FDRs suffered PC (OR = 3.88; 95% CI: 2.96-9.73) and among current smokers (OR = 3.16; 95% CI: 2.56-5.78, interaction FHPC*smoking P-value = 0.04). PC cumulative risk by age 75 was 2.2% among FDRs of cases and 0.7% in those of controls [hazard ratio (HR) = 2.42; 95% CI: 2.16-2.71]. PC risk was significantly associated with FH of cancer (OR = 1.30; 95% CI: 1.13-1.54) and diabetes (OR = 1.24; 95% CI: 1.01-1.52), but not with FH of other diseases. The concordant findings using both approaches strengthen the notion that FH of cancer, PC or diabetes confers a higher PC risk. Smoking notably increases PC risk associated with FH of PC. Further evaluation of these associations should be undertaken to guide PC prevention strategies.

  6. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Fish consumption and its motives in households with versus without self-reported medical history of CVD: A consumer survey from five European countries

    Directory of Open Access Journals (Sweden)

    Brunsø Karen

    2008-09-01

    Full Text Available Abstract Background The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+ or without (CVD- medical history of cardiovascular disease, using data obtained in five European countries. Methods A cross-sectional consumer survey was carried out in November-December 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4,786 respondents, aged 18–84 and who were responsible for food purchasing and cooking in the household. Results Individuals from households in the CVD+ group consumed fish more frequently in Belgium and in Denmark as compared to those in the CVD- group. The consumption of fatty fish, which is the main sources of omega-3 PUFA associated with prevention of cardiovascular diseases, was on the same level for the two CVD groups in the majority of the countries, except in Belgium where CVD+ subjects reported to eat fatty fish significantly more frequently than CVD- subjects. All respondents perceived fish as a very healthy and nutritious food product. Only Danish consumers reported a higher subjective and objective knowledge related to nutrition issues about fish. In the other countries, objective knowledge about fish was on a low level, similar for CVD+ as for CVD- subjects, despite a higher claimed use of medical information sources about fish among CVD+ subjects. Conclusion Although a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits – rather than a medical history of CVD – account for large differences between the countries, particularly in fatty fish consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing chronic

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  12. Performance and Symptom Validity Testing as a Function of Medical Board Evaluation in U.S. Military Service Members with a History of Mild Traumatic Brain Injury.

    Science.gov (United States)

    Armistead-Jehle, Patrick; Cole, Wesley R; Stegman, Robert L

    2018-02-01

    The study was designed to replicate and extend pervious findings demonstrating the high rates of invalid neuropsychological testing in military service members (SMs) with a history of mild traumatic brain injury (mTBI) assessed in the context of a medical evaluation board (MEB). Two hundred thirty-one active duty SMs (61 of which were undergoing an MEB) underwent neuropsychological assessment. Performance validity (Word Memory Test) and symptom validity (MMPI-2-RF) test data were compared across those evaluated within disability (MEB) and clinical contexts. As with previous studies, there were significantly more individuals in an MEB context that failed performance (MEB = 57%, non-MEB = 31%) and symptom validity testing (MEB = 57%, non-MEB = 22%) and performance validity testing had a notable affect on cognitive test scores. Performance and symptom validity test failure rates did not vary as a function of the reason for disability evaluation when divided into behavioral versus physical health conditions. These data are consistent with past studies, and extends those studies by including symptom validity testing and investigating the effect of reason for MEB. This and previous studies demonstrate that more than 50% of SMs seen in the context of an MEB will fail performance validity tests and over-report on symptom validity measures. These results emphasize the importance of using both performance and symptom validity testing when evaluating SMs with a history of mTBI, especially if they are being seen for disability evaluations, in order to ensure the accuracy of cognitive and psychological test data. Published by Oxford University Press 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

  15. 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.

  16. 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...

  17. 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

  18. 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...

  19. 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.

  20. 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.

  1. 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…

  2. 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. 

  3. 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

  4. 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

  5. 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...

  6. 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 ...

  7. A current landscape of provincial perinatal data collection in Canada.

    Science.gov (United States)

    Massey, Kiran A; Magee, Laura A; Dale, Sheryll; Claydon, Jennifer; Morris, Tara J; von Dadelszen, Peter; Liston, Robert M; Ansermino, J Mark

    2009-03-01

    The Canadian Perinatal Network (CPN) was launched in 2005 as a national perinatal database project designed to identify best practices in maternity care. The inaugural project of CPN is focused on interventions that optimize maternal and perinatal outcomes in women with threatened preterm birth at 22+0 to 28+6 weeks' gestation. To examine existing data collection by perinatal health programs (PHPs) to inform decisions about shared data collection and CPN database construction. We reviewed the database manuals and websites of all Canadian PHPs and compiled a list of data fields and their definitions. We compared these fields and definitions with those of CPN and the Canadian Minimal Dataset, proposed as a common dataset by the Canadian Perinatal Programs Coalition of Canadian PHPs. PHPs collect information on 2/3 of deliveries in Canada. PHPs consistently collect information on maternal demographics (including both maternal and neonatal personal identifiers), past obstetrical history, maternal lifestyle, aspects of labour and delivery, and basic neonatal outcomes. However, most PHPs collect insufficient data to enable identification of obstetric (and neonatal) practices associated with improved maternal and perinatal outcomes. In addition, there is between-PHP variability in defining many data fields. Construction of a separate CPN database was needed although harmonization of data field definitions with those of the proposed Canadian Minimal Dataset was done to plan for future shared data collection. This convergence should be the goal of researchers and clinicians alike as we construct a common language for electronic health records.

  8. Provincial practice: adopting the new reference levels for Radon

    International Nuclear Information System (INIS)

    Kennedy, Christine; Johnson, Darryl

    2008-01-01

    Full text: In June 2007 new reference levels for radon gas were announced from Health Canada. These new levels brought new attention to the issue of radon gas exposure in the Province of Newfoundland and Labrador. Research in radon gas exposure has a long history in the fluorspar mines of the Burin Peninsula, indeed, occupational data from the 1950 's and 60 's had been included in Darby et al. large scale occupational meta analyses. Radon was also implicated in a royal commission of occupational mining hazards in Newfoundland in 1968. Although, the occupational exposures of miners have been well documented, very little is known about population exposures in indoor spaces. Geological maps are currently being composed for national areas, but data for this province is not yet published. Information about mining tailings used in construction materials or as fill is very poor (unlike the data known for uranium mining tailings in Ontario and Manitoba). The challenges of estimating radon exposures for the province are myriad and these are explored here in this narrative study of how new information has to be generated, and then incorporated into new environmental public health policies for a population. The process by which new scientific information informs public health policy is described in this study of radon in Newfoundland and Labrador. Anticipated regulations for new buildings are discussed. (author)

  9. Nontuberculous Mycobacteria Infections at a Provincial Reference Hospital, Cambodia.

    Science.gov (United States)

    Bonnet, Maryline; San, Kim Chamroeun; Pho, Yati; Sok, Chandara; Dousset, Jean-Philippe; Brant, William; Hurtado, Northan; Eam, Khun Kim; Ardizzoni, Elisa; Heng, Seiha; Godreuil, Sylvain; Yew, Wing-Wai; Hewison, Cathy

    2017-07-01

    Prevalence of nontuberculous mycobacteria (NTM) disease is poorly documented in countries with high prevalence of tuberculosis (TB). We describe prevalence, risk factors, and TB program implications for NTM isolates and disease in Cambodia. A prospective cohort of 1,183 patients with presumptive TB underwent epidemiologic, clinical, radiologic, and microbiologic evaluation, including >12-months of follow-up for patients with NTM isolates. Prevalence of NTM isolates was 10.8% and of disease was 0.9%; 217 (18.3%) patients had TB. Of 197 smear-positive patients, 171 (86.8%) had TB confirmed (167 by culture and 4 by Xpert MTB/RIF assay only) and 11 (5.6%) had NTM isolates. HIV infection and past TB were independently associated with having NTM isolates. Improved detection of NTM isolates in Cambodia might require more systematic use of mycobacterial culture and the use of Xpert MTB/RIF to confirm smear-positive TB cases, especially in patients with HIV infection or a history of TB.

  10. 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

  11. Increased deep sleep in a medication-free, detoxified female offender with schizophrenia, alcoholism and a history of attempted homicide: Case report

    Directory of Open Access Journals (Sweden)

    Sailas Eila

    2004-10-01

    Full Text Available Abstract Background Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Both schizophrenia and alcoholism are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep, the physiologically significant, refreshing part of the sleep. Antisocial behaviour with severe aggression, on the contrary, has been reported to associate with increased deep sleep reflecting either specific brain pathology or a delay in the normal development of sleep patterns. The authors are not aware of previous sleep studies in patients with both schizophrenia and antisocial personality disorder. Case presentation The aim of the present case-study was to characterize the sleep architecture of a violent, medication-free and detoxified female offender with schizophrenia, alcoholism and features of antisocial personality disorder using polysomnography. The controls consisted of three healthy, age-matched women with no history of physical violence. The offender's sleep architecture was otherwise very typical for patients with schizophrenia and/or alcoholism, but an extremely high amount of deep sleep was observed in her sleep recording. Conclusions The finding strengthens the view that severe aggression is related to an abnormal sleep pattern with increased deep sleep. The authors were able to observe this phenomenon in an antisocially behaving, violent female offender with schizophrenia and alcohol dependence, the latter disorders previously reported to be associated with low levels of slow wave sleep. New studies are, however, needed to confirm and explain this preliminary finding.

  12. [Summary of Guangdong provincial seminar on avian influenza and influenza].

    Science.gov (United States)

    Yu, Shou-yi; Chen, Qing; Hu, Gui-fang

    2005-12-01

    On 8th November 2005, an academic seminar on avian influenza and influenza in Guangdong Province was held by Guangdong Society of Tropical Medicine and the Epidemiology Committee of the Guangdong Preventive Medicine Society in Southern Medical University, addressing the current problems in epidemics of avian influenza. The specialists attending the conference arrived at the common consideration that at present, the avian influenza virus H5N1 has not the capacity to trigger an pandemic in human population, but scattered cases had been reported to increase the suspicions of H5N1 virus transmission between humans. Due attention should be paid to the tendency of expansion of the host range and epidemic area, and the possibility of disastrous influenza pandemic among human populations persists, for which rational consideration is called for, and the role of specialists should be fully recognized who are endeavoring to examine the possible scale of influenza occurrence and devise strategy to deal with the epidemic in Guangdong province according to the practical situation in China. Increased funds and investment in scientific research on avian influenza is urged for influenza prediction and surveillance, rapid and early diagnostic assays, understanding of virus variation, mechanism of H5N1 virus adaptation to human hosts, effective medicines and vaccines for prevention and therapy of avian influenza. Laboratory bio-safety control should be enforced to prevent infections originated from laboratories. The specialists appeal that the media report the news objectively and issue the public warnings against avian influenza after consulting specialists, so as to avoid unnecessary social panic.

  13. Quality of Best Possible Medication History upon Admission to Hospital: Comparison of Nurses and Pharmacy Students and Consideration of National Quality Indicators.

    Science.gov (United States)

    Sproul, Ashley; Goodine, Carole; Moore, David; McLeod, Amy; Gordon, Jacqueline; Digby, Jennifer; Stoica, George

    2018-01-01

    Medication reconciliation at transitions of care increases patient safety. Collection of an accurate best possible medication history (BPMH) on admission is a key step. National quality indicators are used as surrogate markers for BPMH quality, but no literature on their accuracy exists. Obtaining a high-quality BPMH is often labour- and resource-intensive. Pharmacy students are now being assigned to obtain BPMHs, as a cost-effective means to increase BPMH completion, despite limited information to support the quality of BPMHs obtained by students relative to other health care professionals. To determine whether the national quality indicator of using more than one source to complete a BPMH is a true marker of quality and to assess whether BPMHs obtained by pharmacy students were of quality equal to those obtained by nurses. This prospective trial compared BPMHs for the same group of patients collected by nurses and by trained pharmacy students in the emergency departments of 2 sites within a large health network over a 2-month period (July and August 2016). Discrepancies between the 2 versions were identified by a pharmacist, who determined which party (nurse, pharmacy student, or both) had made an error. A panel of experts reviewed the errors and ranked their severity. BPMHs were prepared for a total of 40 patients. Those prepared by nurses were more likely to contain an error than those prepared by pharmacy students (171 versus 43 errors, p = 0.006). There was a nonsignificant trend toward less severe errors in BPMHs completed by pharmacy students. There was no significant difference in the mean number of errors in relation to the specified quality indicator (mean of 2.7 errors for BPMHs prepared from 1 source versus 4.8 errors for BPMHs prepared from ≥ 2 sources, p = 0.08). The surrogate marker (number of BPMH sources) may not reflect BPMH quality. However, it appears that BPMHs prepared by pharmacy students had fewer errors and were of similar quality (in

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. [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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  19. 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,...

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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.

  2. Foreign University Involvement in Sustainable New Town Planning in Provincial China

    Directory of Open Access Journals (Sweden)

    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

  3. 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.

  4. 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...

  5. 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...

  6. 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.

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

    Science.gov (United States)

    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.

  8. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. 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.

  12. 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.

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

    Science.gov (United States)

    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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. 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.

  18. NEGOTIATING STRUCTURAL VULNERABILITY FOLLOWING REGULATORY CHANGES TO A PROVINCIAL METHADONE PROGRAM IN VANCOUVER, CANADA: A QUALITATIVE STUDY

    Science.gov (United States)

    McNeil, Ryan; Kerr, Thomas; Anderson, Solanna; Maher, Lisa; Keewatin, Chereece; Milloy, MJ; Wood, Evan; Small, Will

    2015-01-01

    While regulatory frameworks governing methadone maintenance therapy (MMT) require highly regimented treatment programs that shape treatment outcomes, little research has examined the effects of regulatory changes to these programs on those receiving treatment, and located their experiences within the wider context of socialstructural inequities. In British Columbia (BC), Canada, provincial regulations governing MMT have recently been modified, including: replacing the existing methadone formulation with Methadose® (pre-mixed and 10 times more concentrated); prohibiting pharmacy delivery of methadone; and, prohibiting pharmacies incentives for methadone dispensation. We undertook this study to examine the impacts of these changes on a structurally vulnerable population enrolled in MMT in Vancouver, BC. Qualitative interviews were conducted with 34 people enrolled in MMT and recruited from two ongoing observational prospective cohort studies comprised of drug-using individuals in the six-month period in 2014 following these regulatory changes. Interview transcripts were analyzed thematically, and by drawing on the concept of ‘structural vulnerability’. Findings underscore how these regulatory changes disrupted treatment engagement, producing considerable health and social harms. The introduction of Methadose® precipitated increased withdrawal symptoms. The discontinuation of pharmacy delivery services led to interruptions in MMT and codispensed HIV medications due to constraints stemming from their structural vulnerability (e.g., poverty, homelessness). Meanwhile, the loss of pharmacy incentives limited access to material supports utilized by participants to overcome barriers to MMT, while diminishing their capacity to assert some degree of agency in negotiating dispensation arrangements with pharmacies. Collectively, these changes functioned to compromise MMT engagement and increased structural vulnerability to harm, including re-initiation of injection drug

  19. 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.

  20. 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.

  1. 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.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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)

  7. 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

  8. 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.

  9. 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.

  10. The influence of family history of cancer, irradiation and anticancer medication (mitomycin C), on the occurrence of multiple primary neoplasms with breast cancer

    International Nuclear Information System (INIS)

    Yoshimoto, Masataka; Kasumi, Fujio; Fukami, Atsuo; Nishi, Mitsumasa; Kajitani, Tamaki; Sakamoto, Goi

    1985-01-01

    The influence of family history of cancer, radiation therapy and anticancer drug therapy (mitomycin C) on the occurrence of multiple primary neoplasms, following treatment of a first primary cancer of the breast, was analyzed by the person-year method in 1,359 patients, in Japan. During 14,371.8 person-years of observation, 111 multiple primary neoplasms including bilateral breast cancers were found in 109 patients. The incidence rate of multiple primary neoplasms were 0.00772 per person-year. The incidence in patients with a family history of cancer was 1.29 times greater than that in patients without such a family history, and the incidence in patients with a family history of breast cancer was about three times greater than that in those without it (p < 0.01). Radiation therapy raised the occurrence of subsequent primary neoplasms 1.28-fold (or 1.62 fold after 5 years), and mitomycin C (a total dose of 0.8 mg/kg) therapy caused no increase in the occurrence of subsequent primary cancers, after an observation of 10 years or so. (author)

  11. 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

  12. Bohmian histories and decoherent histories

    International Nuclear Information System (INIS)

    Hartle, James B.

    2004-01-01

    The predictions of the Bohmian and the decoherent (or consistent) histories formulations of the quantum mechanics of a closed system are compared for histories--sequences of alternatives at a series of times. For certain kinds of histories, Bohmian mechanics and decoherent histories may both be formulated in the same mathematical framework within which they can be compared. In that framework, Bohmian mechanics and decoherent histories represent a given history by different operators. Their predictions for the probabilities of histories of a closed system therefore generally differ. However, in an idealized model of measurement, the predictions of Bohmian mechanics and decoherent histories coincide for the probabilities of records of measurement outcomes. The formulations are thus difficult to distinguish experimentally. They may differ in their accounts of the past history of the Universe in quantum cosmology

  13. 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)

  14. [Twenty-year History and Future Challenges in Transparency Enhancement of Review Process for Approval: Focus on Public Release of Review Reports regarding New Drugs and Medical Devices].

    Science.gov (United States)

    Morimoto, Kazushige; Kawasaki, Satoko; Yoshida, Yasunori

    2015-01-01

    For 20 years, the Ministry of Health, Labour and Welfare (MHLW, formerly Ministry of Health and Welfare (MHW)) has been trying to increase transparency of the review process for approving reports in order to promote the rational use of newly approved drugs and medical devices. The first Summary Basis of Approval (SBA) was published by MHW in 1994. In 1999, evaluation reports were prepared by MHW and the Pharmaceuticals and Medical Devices Evaluation Center to make them available to the public. In 2005, a notice from the Chief Executive of the Pharmaceuticals and Medical Devices Agency (PMDA) made procedures for public release of information on reviewing applications for new drugs. In 2006, 90 review reports of newly approved drugs and eight medical devices were revealed on PMDA websites. The dissemination of information by the United States Food and Drug Administration (FDA) and that of the European Medicines Agency (EMA) were studied and compared with that of the MHLW and PMDA. While common technical documents (CTD) for new drugs and summary technical documents (STED) for new medical devices have been released by PMDA, such documents are not released by the FDA and EMA. The European Public Assessment Report (EAPR) summary for the public is an interesting questionnaire approach that uses the "What," "How" and "Why" format. Finally, future proposals for the next decade are also outlined.

  15. History Matters

    Institute of Scientific and Technical Information of China (English)

    2017-01-01

    In 2002, she began working as alecturer at Minzu University of China.Now, she teaches English, historicalliterature, ancient Chinese history,historical theory and method, ancientsocial history of China, ancient palacepolitical history of China and the historyof the Sui and Tang dynasties and thePeriod of Five Dynasties.

  16. History of medical micology in Colombia, 1930-1970 = Historia de la micología médica en Colombia, 1930-1970

    Directory of Open Access Journals (Sweden)

    Galvis Pérez, Yeisson

    2013-04-01

    Full Text Available The overall objective of this research was to understand the events that made possible the creation, diffusion and appropriation of medical mycology in Colombia between 1930 and 1970. It was based on the review of scientific journals and theses in different libraries, archives and documentation centers in Medellin and Bogota. The report includes the different problems faced by physicians and laboratory personnel concerning the classification of fungi, the relationship between dermatology and mycology, the development of the study of systemic mycoses and the role played by some persons in the institutionalization of medical mycology.

  17. Histories electromagnetism

    International Nuclear Information System (INIS)

    Burch, Aidan

    2004-01-01

    Working within the HPO (History Projection Operator) Consistent Histories formalism, we follow the work of Savvidou on (scalar) field theory [J. Math. Phys. 43, 3053 (2002)] and that of Savvidou and Anastopoulos on (first-class) constrained systems [Class. Quantum Gravt. 17, 2463 (2000)] to write a histories theory (both classical and quantum) of Electromagnetism. We focus particularly on the foliation-dependence of the histories phase space/Hilbert space and the action thereon of the two Poincare groups that arise in histories field theory. We quantize in the spirit of the Dirac scheme for constrained systems

  18. 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.

  19. A History of Medicine and the Establishment of Medical Institutions in Middlesex County, New Jersey that Transformed Doctor and Patient Relationships during the Early Twentieth Century

    Science.gov (United States)

    Whitfield-Spinner, Linda

    2011-01-01

    The early twentieth century was a period of tremendous advancements in medicine and technology and as a result experienced a revolutionary change in the delivery of healthcare in America. Modern medicine which encompassed specialized knowledge, technical procedures, and rules of behavior, changed the way medical care was provided in the United…

  20. How stressful is doctor-patient communication? Physiological and psychological stress of medical students in simulated history taking and bad-news consultations

    NARCIS (Netherlands)

    Hulsman, Robert L.; Pranger, Susan; Koot, Stephanie; Fabriek, Marcel; Karemaker, John M.; Smets, Ellen M. A.

    2010-01-01

    Introduction: Medical communication can be a stressful experience for both doctors and patients. In particular, inexperienced doctors facing the demanding task of a bad news consultation may experience high levels of distress. The aim of this exploratory study is to test students' differential

  1. The Role of Traumatic Event History in Non-Medical Use of Prescription Drugs among a Nationally Representative Sample of US Adolescents

    Science.gov (United States)

    McCauley, Jenna L.; Danielson, Carla Kmett; Amstadter, Ananda B.; Ruggiero, Kenneth J.; Resnick, Heidi S.; Hanson, Rochelle F.; Smith, Daniel W.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2010-01-01

    Background: Building on previous research with adolescents that examined demographic variables and other forms of substance abuse in relation to non-medical use of prescription drugs (NMUPD), the current study examined potentially traumatic events, depression, posttraumatic stress disorder (PTSD), other substance use, and delinquent behavior as…

  2. Decision of National and Provincial Highway Asphalt Pavement Structure Based on Value Engineering

    Directory of Open Access Journals (Sweden)

    Yingwei Ren

    2014-01-01

    Full Text Available It is important that decision of asphalt pavement structure requires overall considerations of the performance and financial investment. To have asphalt pavement structure fulfilling good reliability, the asphalt pavement structure decision was researched based on value engineering theory. According to the national and provincial highway investigation data in Shandong Province during the last decade, the asphalt pavement performance attenuation rules of traffic levels and asphalt layer thicknesses were developed, and then the road performance evaluation method was presented. In addition, the initial investments, the costs of road maintenance, and middle-scale repair in a period were analyzed. For the light traffic and medium traffic example, using the value engineering method, the pavement performance and costs of which thickness varies from 6 cm to 10 cm were calculated and compared. It was concluded that value engineering was an effective method in deciding the asphalt pavement structure.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Sharing the Burden? Assessing the Lithuanian Decision to Establish a Provincial Reconstruction Team in Afghanistan

    Directory of Open Access Journals (Sweden)

    Maskaliūnaitė Asta

    2014-12-01

    Full Text Available The paper assesses theories explaining the states’ burden-sharing decisions in an alliance and uses them to evaluate the Lithuanian decision to establish a Provincial Reconstruction Team (PRT in Afghanistan. In the literature, several influences on such decision-making are identified. These fall into two broad categories of systemic and domestic factors. From the former, threat perception, alliance dependence, systemic pressures of alliance politics are analysed; and from the latter three clusters of aspects such as: state autonomy, elite consensus, space of manoeuver of the executive; bureaucratic politics and organizational interests, and third, some additional elements of strategic culture/state identity. While most factors have some explanatory value, the analysis invites the conclusion that in case of the decision to lead a PRT, the two most important elements were alliance dependence from the first cluster and strategic culture and bureaucratic politics from the second.

  5. 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.

  6. State and use of monitoring and evaluation systems in national and provincial departments

    Directory of Open Access Journals (Sweden)

    Futhi Umlaw

    2015-09-01

    Full Text Available Since 2009, South Africa has seen a major shift in emphasis concerning monitoring and evaluation (M&E systems. This shift was partially stimulated by the South African government being faced with a number of pressures, key amongst which were persistent poverty and inequality and widespread service delivery protests. These pressures resulted ina greater willingness by government to address the poor quality of public services, and other governance problems that needed a greater focus on M&E to address these challenges. This led to the establishment of the Department of Performance Monitoring and Evaluation (DPME in early 2010. A comprehensive survey on the state and use of M&E systems in national and provincial government was conducted by the DPME as an attempt to understand the M&E landscape since 1994. The results were used to make informed policy and programme decisions. This paper outlines the findings of the survey.

  7. [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.

  8. 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.

  9. Recurrent themes in the history of the home use of electrical stimulation: Transcranial direct current stimulation (tDCS) and the medical battery (1870-1920).

    Science.gov (United States)

    Wexler, Anna

    In recent years, neuroscientists and ethicists have warned of the dangers of the unsupervised home use of transcranial direct current stimulation (tDCS), in which individuals stimulate their own brains with low levels of electricity for self-improvement purposes. Although the home use of tDCS is often referred to as a novel phenomenon, in reality the late nineteenth and early twentieth century saw a proliferation of electrical stimulation devices for home use. In particular, the use of an object known as the medical battery bears a number of striking similarities to the modern-day use of tDCS. This article reviews a number of features thought to be unique to the present day home use of brain stimulation, with a particular focus on analogies between tDCS and the medical battery. Archival research was conducted at the Bakken Museum and at the American Medical Association's Historical Health Fraud Archives. Many of the features characterizing the contemporary home use tDCS-a do-it-yourself (DIY) movement, anti-medical establishment themes, conflicts between lay and professional usage-are a repetition of themes that occurred a century ago with regard to the medical battery. A number of features, however, seem to be unique to the present, such as the dominant discourse about risk and safety, the division between cranial and non-cranial stimulation, and utilization for cognitive enhancement purposes. Viewed in the long durée, the contemporary use of electrical stimulation at home is not a novel phenomenon, but rather the latest wave in a series of ongoing attempts by lay individuals to utilize electricity for therapeutic purposes. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Provincial Health Accounts in Kerman, Iran: An Evidence of a “Mixed” Healthcare Financing System

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Mehrolhassani

    2014-02-01

    Full Text Available Background Provincial Health Accounts (PHA as a subset of National Health Accounts (NHA present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC. This study aimed to examine Health Accounts in Kerman Province. Methods The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General’s office. In order to classify the data, the International Classification for Health Accounts (ICHA method was used, in which data set was adjusted for the province. Results During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41 was related to private household funds, of which the Out-of-Pocket (OOP payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs (65.19% was related to curative services. Conclusion The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By performing the Family Physician Program (FPP and emphasizing Social Determinant of Health (SDH approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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…

  16. 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.

  17. 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.

  18. 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…

  19. 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…

  20. 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

  1. 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

  2. History of medical micology in Colombia, 1930-1970 = Historia de la micología médica en Colombia, 1930-1970

    OpenAIRE

    Galvis Pérez, Yeisson; Cano Restrepo, Luz Elena; Vásquez Valencia, María Fernanda

    2013-01-01

    The overall objective of this research was to understand the events that made possible the creation, diffusion and appropriation of medical mycology in Colombia between 1930 and 1970. It was based on the review of scientific journals and theses in different libraries, archives and documentation centers in Medellin and Bogota. The report includes the different problems faced by physicians and laboratory personnel concerning the classification of fungi, the relationship between dermatology and ...

  3. The Accreditation Council for Graduate Medical Education resident duty hour new standards: history, changes, and impact on staffing of intensive care units.

    Science.gov (United States)

    Pastores, Stephen M; O'Connor, Michael F; Kleinpell, Ruth M; Napolitano, Lena; Ward, Nicholas; Bailey, Heatherlee; Mollenkopf, Fred P; Coopersmith, Craig M

    2011-11-01

    The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine convened a task force to develop a white paper on the impact of changes in resident duty hours on the critical care workforce and staffing of intensive care units. A multidisciplinary group of professionals with expertise in critical care education and clinical practice. Relevant medical literature was accessed through a systematic MEDLINE search and by requesting references from all task force members. Material published by the Accreditation Council for Graduate Medical Education and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force corresponded by electronic mail and held several conference calls to finalize this report. The new rules mandate that all first-year residents work no more than 16 hrs continuously, preserving the 80-hr limit on the resident workweek and 10-hr period between duty periods. More senior trainees may work a maximum of 24 hrs continuously, with an additional 4 hrs permitted for handoffs. Strategic napping is strongly suggested for trainees working longer shifts. Compliance with the new Accreditation Council for Graduate Medical Education duty-hour standards will compel workflow restructuring in intensive care units, which depend on residents to provide a substantial portion of care. Potential solutions include expanded utilization of nurse practitioners and physician assistants, telemedicine, offering critical care training positions to emergency medicine residents, and partnerships with hospitalists. Additional research will be necessary to evaluate the impact of the new standards on patient safety, continuity of care, resident learning, and staffing in the intensive care unit.

  4. Entangled histories

    International Nuclear Information System (INIS)

    Cotler, Jordan; Wilczek, Frank

    2016-01-01

    We introduce quantum history states and their mathematical framework, thereby reinterpreting and extending the consistent histories approach to quantum theory. Through thought experiments, we demonstrate that our formalism allows us to analyze a quantum version of history in which we reconstruct the past by observations. In particular, we can pass from measurements to inferences about ‘what happened’ in a way that is sensible and free of paradox. Our framework allows for a richer understanding of the temporal structure of quantum theory, and we construct history states that embody peculiar, non-classical correlations in time. (paper)

  5. Path tortuosity in everyday movements of elderly persons increases fall prediction beyond knowledge of fall history, medication use, and standardized gait and balance assessments.

    Science.gov (United States)

    Kearns, William D; Fozard, James L; Becker, Marion; Jasiewicz, Jan M; Craighead, Jeffrey D; Holtsclaw, Lori; Dion, Charles

    2012-09-01

    We hypothesized that variability in voluntary movement paths of assisted living facility (ALF) residents would be greater in the week preceding a fall compared with residents who did not fall. Prospective, observational study using telesurveillance technology. Two ALFs. The sample consisted of 69 older ALF residents (53 female) aged 76.9 (SD ± 11.9 years). Daytime movement in ALF common use areas was automatically tracked using a commercially available ultra-wideband radio real-time location sensor network with a spatial resolution of approximately 20 cm. Movement path variability (tortuosity) was gauged using fractal dimension (fractal D). A logistic regression was performed predicting movement related falls from fractal D, presence of a fall in the prior year, psychoactive medication use, and movement path length. Fallers and non-fallers were also compared on activities of daily living requiring supervision or assistance, performance on standardized static and dynamic balance, and stride velocity assessments gathered at the start of a 1-year fall observation period. Fall risk due to cognitive deficit was assessed by the Mini Mental Status Examination (MMSE), and by clinical dementia diagnoses from participant's activities of daily living health record. Logistic regression analysis revealed odds of falling increased 2.548 (P = .021) for every 0.1 increase in fractal D, and having a fall in the prior year increased odds of falling by 7.36 (P = .006). There was a trend for longer movement paths to reduce the odds of falling (OR .976 P = .08) but it was not significant. Number of psychoactive medications did not contribute significantly to fall prediction in the model. Fallers had more variable stride-to-stride velocities and required more activities of daily living assistance. High fractal D levels can be detected using commercially available telesurveillance technologies and offers a new tool for health services administrators seeking to reduce falls at their

  6. Intellectual History

    DEFF Research Database (Denmark)

    In the 5 Questions book series, this volume presents a range of leading scholars in Intellectual History and the History of Ideas through their answers to a brief questionnaire. Respondents include Michael Friedman, Jacques le Goff, Hans Ulrich Gumbrecht, Jonathan Israel, Phiip Pettit, John Pocock...

  7. [Mental health problems among female staff in a provincial maternal and child health hospital: an investigation of 647 individuals].

    Science.gov (United States)

    He, W J; Xia, J H; Lv, X; Li, L M

    2018-02-20

    Objective: To investigate the current status of depression and anxiety among female staff in a maternal and child health hospital, and to provide a basis for developing related prevention and intervention measures and promoting the mental health of female staff. Methods: The female staff from a provincial maternal and child health hospital completed a psycho-health questionnaire survey on Internet from June to October, 2016. The questionnaires used in the survey consisted of Patient Health Questionnaire (PHQ-9) , Generalized Anxiety Disorder Scale (GAD-7) , and Symptom Checklist-90 (SCL-90) . The distribution features of mental health problems such as depression and anxiety were analyzed according to the results: of the questionnaire survey. Results Of all female staff surveyed, 42.04% showed depression symptoms, 28.90% showed anxiety symptoms, and 26.12% showed comorbid symptoms of depression and anxiety. Moderate or severe depression (anxiety) was mainly distributed among the female staff with comorbid symptoms (90.63% and 97.01%, respectively) . There were significant differences in the distribution of moderate or severe anxiety symptoms between the medical staff and nursing staff (χ(2)= 5.81, P =0.05) and between those with intermediate and junior professional titles (χ(2)=7.99, P =0.018) . As for SCL-90 results, the total score, total average score, and scores on factors of somatization, compulsion, interpersonal sensitivity, depression, and anxiety in the female staff with comorbid symptoms, moderate or severe depression, and moderate or severe anxiety were significantly higher than the national norm ( P staff with comorbid symptoms than in the female staff with a single symptom and asymptomatic female staff (both P staff in the maternal and child health hospital, mainly characterized by comorbid symptoms of moderate or severe depression and anxiety. Comorbidity is accompanied by mental health problems such as interpersonal sensitivity, obsessive compulsion

  8. THE TEACHING-LEARNING PROCESS OF THE CUBAN HISTORY IN THE MEDICAL SCIENCES CARREERS / LA ENSEÑANZA-APRENDIZAJE DE LA HISTORIA DE CUBA EN LAS CIENCIAS MÉDICAS

    Directory of Open Access Journals (Sweden)

    Francisco Felino Riverón Morales

    2012-10-01

    Full Text Available En el artículo se realiza un análisis de la evolución que ha The article makes an analysis of the evolution experienced by the various interpretations which can be steeped in history teaching. Stands as the subject History of Cuba is an array of historical science teaching and highlights the role of science content which include the development of knowledge, skills, habits and values in the teaching-learning process. Underlying the formative importance of the discipline of History of Cuba to the Cuban school, from the role the teacher in this process. Is particularized for Medical Sciences to assess the inclusion of the History of Cuba in the teaching-learning process in medical science responds to the need to contribute to the formation of a historical culture in the industry professionals as part of the humanistic education should possess.ResumenEn el artículo se realiza un análisis de la evolución que ha experimentado las diversas interpretaciones por cuales puede ser sumida la enseñanza de la historia. Se sostiene como la asignatura Historia de Cuba es un arreglo didáctico de la ciencia histórica y se destaca el papel del contenido de la ciencia en el que se incluyen el desarrollo de los conocimientos, habilidades, hábitos y valores en el proceso de enseñanza-aprendizaje. Se fundamenta la importancia formativa de la disciplina la Historia de Cuba para la escuela cubana, a partir del rol que tiene el profesor en este proceso. Se particulariza para las ciencias médicas al valorar como la inclusión de la Historia de Cuba dentro del proceso de enseñanza-aprendizaje en las ciencias médicas responde a la necesidad de contribuir a la formación de una cultura histórica en los profesionales de este sector como parte de la formación humanística que deben poseer.

  9. [Once upon a time there was a medical faculty--a brief history of the Medical Faculty of the Erzsébet University in Pressburg (1914-1919)].

    Science.gov (United States)

    Kiss, László

    2010-01-01

    Despite the fact that the idea of expanding the medical faculties of Budapest and Kolozsvár was formed in the 1870s, it only came true in the 1910s. The XXXVI. Law of 1912 ensured establishing new faculties in Pozsony and Debrecen. The medical faculty of Erzsébet University in Pozsony opened in 1914. The first three professors, i.e. Lajos Bakay, Ferenc Herzog and Dezső Velits, who formerly worked as head physicians for the State Hospital in Pozsony and the Institute for Midwives, were appointed then. The appointment of further professors and launching the 3rd, 4th and 5th forms were delayed by the outbreak of the war until 1918. After the collapse of the Austro-Hungarian Monarchy the newly formed Czechoslovakia dissolved the Hungarian university in 1919. The clinics and institutes of the medical faculty were passed to Czechoslovak ownership, the Hungarian lecturers were dismissed. It is worth mentioning though that Albert Szent-Györgyi and Carl Ferdinand Cori (both Nobel Prize winners) started their scientific career in Pozsony.

  10. 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

  11. 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.

  12. Evaluating human papillomavirus vaccination programs in Canada: should provincial healthcare pay for voluntary adult vaccination?

    Directory of Open Access Journals (Sweden)

    Smith? Robert J

    2008-04-01

    Full Text Available Abstract Background Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged 9–13. While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated. Adult women who are eligible for the vaccine may still receive it, but at a cost of approximately CAN$400. Given the high efficacy and immunogenicity of the vaccine, the possibility of eradicating targeted types of the virus may be feasible, assuming the vaccination programs are undertaken strategically. Methods We develop a mathematical model to describe the epidemiology of vaccination against human papillomavirus, accounting for a widespread childhood vaccination program that may be supplemented by voluntary adult vaccination. A stability analysis is performed to determine the stability of the disease-free equilibrium. The critical vaccine efficacy and immunogenicity thresholds are derived, and the minimum level of adult vaccination required for eradication of targeted types is determined. Results We demonstrate that eradication of targeted types is indeed feasible, although the burden of coverage for a childhood-only vaccination program may be high. However, if a small, but non-negligible, proportion of eligible adults can be vaccinated, then the possibility of eradication of targeted types becomes much more favourable. We provide a threshold for eradication in general communities and illustrate the results with numerical simulations. We also investigate the effects of suboptimal efficacy and immunogenicity and show that there is a critical efficacy below which eradication of targeted types is not possible. If eradication is possible, then there is a critical immunogenicity such that even 100% childhood vaccination will not eradicate the targeted types of the virus and must be supplemented with voluntary adult vaccination. However, the level of adult

  13. To Discern the Medical Thoughts of Heo Joon, the Best Physician in Korean History - An Analysis of Disease Experiences and Treatment Cases in the -

    Directory of Open Access Journals (Sweden)

    재근 오

    2015-12-01

    Full Text Available Heo Joon is one of the best-known physicians of the Chosun Dynasty, the last imperial dynasty (1392~1910 of Korea. He had served King Seonjo during his practice, and has produced many publications on medicine. Then, how did he actually treat the patients? So far, other than the case when he treated Gwanghaegun’s smallpox, it is not clearly known how and when he attended and treated the ill. In his most famous book, the Treasured Mirror of Eastern Medicine (TMEM, he details the physiopathological mechanisms, diagnoses, treatments or prescriptions, and treatment cases, however, it is not clear if they’re from his own clinical experiences. Nevertheless, based on the written method, the original information is reconstituted according to its respective editors of the TMEM, a particular case being included may be considered as an agreement and acceptance of an actual treatment executed. This research analyzes what type of medicinal theory that the main writer Heo Joon employed in his real treatments, as well as how he diagnosed and treated diseases. After analyzing the complete series of the TMEM, we found a total of 301 clinical cases. Here, one may wonder, why does the Section of Inner and External Bodily Elements, that deal with diseases and the structure of the body, have far outnumber cases than the Section of Miscellaneous Disorders? Why does the TMEM introduce the various types of disease experiences and treatment cases, medical cases, simple treatments, nurturing life, materia medica, and also include supernatural phenomena? Why does the TMEM include the experiences and cases from the book published in the Song (宋, Jin (金, Yuan (元 dynasty of China, moreover in the Ming (明 Dynasty of its time. These questions can be answered to the extent that Heo Joon and the others who participated in completing the book sought to justify the new clinical medicine practices, and because it had to be acceptable to the Confucius beliefs which

  14. Changing Smoking Behavior of Staff at Dr. Zainoel Abidin Provincial General Hospital, Banda Aceh

    Directory of Open Access Journals (Sweden)

    Said Usman

    2014-01-01

    Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.

  15. An impact assessment of sustainable technologies for the Chinese urban residential sector at provincial level

    Science.gov (United States)

    Xing, Rui; Hanaoka, Tatsuya; Kanamori, Yuko; Dai, Hancheng; Masui, Toshihiko

    2015-06-01

    Recently, energy use in the urban residential sector of China has drastically increased due to higher incomes and urbanization. The fossil fuels dominant energy supply has since worsened the air quality, especially in urban areas. In this study we estimate the future energy service demands in Chinese urban residential areas, and then use an AIM/Enduse model to evaluate the emission reduction potential of CO2, SO2, NOx and PM. Considering the climate diversity and its impact on household energy service demands, our analysis is down-scaled to the provincial-level. The results show that in most of the regions, penetration of efficient technologies will bring CO2 emission reductions of over 20% compared to the baseline by the year 2030. Deployment of energy efficient technologies also co-benefits GHG emission reduction. However, efficient technology selection appears to differ across provinces due to climatic variation and economic disparity. For instance, geothermal heating technology is effective for the cold Northern areas while biomass technology contributes to emission reduction the most in the warm Southern areas.

  16. El Beato del archivo histórico provincial de Zamora

    Directory of Open Access Journals (Sweden)

    Suárez González, Ana

    2003-12-01

    Full Text Available Fragments 276 and 277 of the Archivo Histórico Provincial de Zamora provide evidence of a heretofore unknown codex of the Commentary on the Apocalypse by Beatus of Liébana. Written in visigothic script, the Beatus manuscript to which they pertain can be dated to the first half of the tenth century. This study provides an analysis —external and internal— of both fragments, along with an edition of the text, comparing them with the surviving visigothic examples in order to situate the manuscript within the stemma of known Beatus manuscripts.

    Los fragmentos 276 y 277 del A.H.P. de Zamora son los testigos de un nuevo códice del Comentario al Apocalipsis atribuido a Beato de Liébana. El Beato al que pertenecen, en escritura visigótica, puede datarse en la primera mitad del siglo X. El presente trabajo recoge el análisis externo e interno de ambas piezas y la edición de su texto, cotejado con el de los restantes ejemplares visigóticos, para situar el volumen al que remiten en el stemma de los beatos conocidos hasta la fecha.

  17. Spatiotemporal Characteristics, Determinants and Scenario Analysis of CO2 Emissions in China Using Provincial Panel Data.

    Science.gov (United States)

    Wang, Shaojian; Fang, Chuanglin; Li, Guangdong

    2015-01-01

    This paper empirically investigated the spatiotemporal variations, influencing factors and future emission trends of China's CO2 emissions based on a provincial panel data set. A series of panel econometric models were used taking the period 1995-2011 into consideration. The results indicated that CO2 emissions in China increased over time, and were characterized by noticeable regional discrepancies; in addition, CO2 emissions also exhibited properties of spatial dependence and convergence. Factors such as population scale, economic level and urbanization level exerted a positive influence on CO2 emissions. Conversely, energy intensity was identified as having a negative influence on CO2 emissions. In addition, the significance of the relationship between CO2 emissions and the four variables varied across the provinces based on their scale of economic development. Scenario simulations further showed that the scenario of middle economic growth, middle population increase, low urbanization growth, and high technology improvement (here referred to as Scenario BTU), constitutes the best development model for China to realize the future sustainable development. Based on these empirical findings, we also provide a number of policy recommendations with respect to the future mitigation of CO2 emissions.

  18. In itinere strategic environmental assessment of an integrated provincial waste system.

    Science.gov (United States)

    Federico, Giovanna; Rizzo, Gianfranco; Traverso, Marzia

    2009-06-01

    In the paper, the practical problem of analysing in an integrated way the performance of provincial waste systems is approached, in the framework of the Strategic Environmental Assessment (SEA). In particular, the in itinere phase of SEA is analysed herein. After separating out a proper group of ambits, to which the waste system is supposed to determine relevant impacts, pertinent sets of single indicators are proposed. Through the adoption of such indicators the time trend of the system is investigated, and the suitability of each indicator is critically revised. The structure of the evaluation scheme, which is essentially based on the use of ambit issues and analytical indicators, calls for the application of the method of the Dashboard of Sustainability for the integrated evaluation of the whole system. The suitability of this method is shown through the paper, together with the possibility of a comparative analysis of different scenarios of interventions. Of course, the reliability of the proposed method strongly relies on the availability of a detailed set of territorial data. The method appears to represent a useful tool for public administration in the process of optimizing the policy actions aimed at minimizing the increasing problem represented by waste production in urban areas.

  19. Displacement efficiency of alternative energy and trans-provincial imported electricity in China.

    Science.gov (United States)

    Hu, Yuanan; Cheng, Hefa

    2017-02-17

    China has invested heavily on alternative energy, but the effectiveness of such energy sources at substituting the dominant coal-fired generation remains unknown. Here we analyse the displacement of fossil-fuel-generated electricity by alternative energy, primarily hydropower, and by trans-provincial imported electricity in China between 1995 and 2014 using two-way fixed-effects panel regression models. Nationwide, each unit of alternative energy displaces nearly one-quarter of a unit of fossil-fuel-generated electricity, while each unit of imported electricity (regardless of the generation source) displaces ∼0.3 unit of fossil-fuel electricity generated locally. Results from the six regional grids indicate that significant displacement of fossil-fuel-generated electricity occurs once the share of alternative energy in the electricity supply mix exceeds ∼10%, which is accompanied by 10-50% rebound in the consumption of fossil-fuel-generated electricity. These findings indicate the need for a policy that integrates carbon taxation, alternative energy and energy efficiency to facilitate China's transition towards a low-carbon economy.

  20. Lessons from an evaluation of a provincial-level smoking control policy in Shanghai, China.

    Science.gov (United States)

    Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J; Wong, Frank Y; Berg, Carla J

    2013-01-01

    The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Six months after implementation, 82% of the participants agreed that "legislation is enforced most of the time". The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future.

  1. Provincial human development index, a guide for efficiency level analysis: the case of iran.

    Science.gov (United States)

    Sabermahani, Asma; Barouni, Mohsen; Seyedin, Hesam; Aryankhesal, Aidin

    2013-01-01

    Human Development Index (HDI) is a composite indicator that can show the impact of economic strategies on human life standards. The index is calculated by three main factors of income, education and health. This research studies the status of HDI across the Iranian provinces, its changes over time and the efficiency of provinces in using resources. The data for 2001 and 2009 was obtained from the Iranian Center of Statistics. Data envelopment analysis technique was used to analyze the data. To calculate the efficiency, Banker, Charnes and Cooper's model was used. The national mean for the HDI in 2001 was 0.717 while it grew to 0.747 in 2009. Except for one province, all others had an improved human development index. Low ranked provinces such as Sistan & Baluchistan and Kurdistan stayed at the bottom in 2009 as well. Some provinces such as Bushehr with developing oil industries, or those purposively benefited from national oil income showed good growth. In some provinces, such as Hormozgan, out-migration of manpower to its neighboring province, Bushehr, was associated with decrease of the provincial income level. The number of efficient provinces increased from 5 to 13 in 2009. Iran falls among countries with high human development index based on the 2009 data. However, the distribution of HDI status across provinces was highly varied and the difference between high- and low-developed provinces increased in 2009. The government needs to revise policies concerning distribution of resources among the provinces.

  2. 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

  3. Government auditing and corruption control: Evidence from China’s provincial panel data

    Directory of Open Access Journals (Sweden)

    Jin Liu

    2012-06-01

    Full Text Available Since its foundation, China’s government auditing system has played a very important role in maintaining financial and economic order and improving government accountability and transparency. Though a great deal of research has discussed the role of government auditing in discovering and deterring corruption, there is little empirical evidence on whether government auditing actually helps to reduce corruption. Using China’s provincial panel data from 1999 to 2008, this paper empirically examines the role of government auditing in China’s corruption control initiatives. Our findings indicate that the number of irregularities detected in government auditing is positively related to the corruption level in that province, which means the more severe the corruption is in a province, the more irregularities in government accounts are found by local audit institutions. Also, post-audit rectification effort is negatively related to the corruption level in that province, indicating that greater rectification effort is associated with less corruption. This paper provides empirical evidence on how government auditing can contribute to curbing corruption, which is also helpful for understanding the role of China’s local audit institutions in government governance and can enrich the literature on both government auditing and corruption control.

  4. 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.

  5. [Provincial public center for crisis intervention and psycho-social rehabilitation. A path towards communitary suicidology].

    Science.gov (United States)

    Martínez, Carlos

    2014-01-01

    This work on the systematic comprehensive approach towards the Prevention and Postvencion of Suicide started to develop back in mid 2011 in Río Gallegos, capital of Santa Cruz Province. The first step on this development was a Pilot Plan for the Training of Professionals and also field intervention. The Center for Crisis Intervention and Psycho-social Rehabilitation was founded eight months later. The case-client in crisis plus family group- undergoes quantitative and qualitative evaluation by means of a triage system, all of which allows starting intensive face-to-face and also phone follow up according to the Crisis Intervention Model. Such intervention is developed by means of the participation in the "Grupo Sostén", the Adolescents Group if the client fits into that age, and also family relationship interviews as well as Multi-family meetings open to the Community. There is also a Community Team in the Center which performs collective assessment in schools, in conjunction with the "Equidad en Redes" Educational Specialty Team, belonging to the Provincial Education Council. The approach takes place on the field, and works as a screening step for the early detection of risk. Such risk is dealt with by means of short term intervention group programs involving the whole of the educational community. When facing situations of committed suicide there are interventions in communities to the interior of the province, fundamentally through the Hospital Team which works as the cluster convener for the social intersectoral frame-work.

  6. Displacement efficiency of alternative energy and trans-provincial imported electricity in China

    Science.gov (United States)

    Hu, Yuanan; Cheng, Hefa

    2017-02-01

    China has invested heavily on alternative energy, but the effectiveness of such energy sources at substituting the dominant coal-fired generation remains unknown. Here we analyse the displacement of fossil-fuel-generated electricity by alternative energy, primarily hydropower, and by trans-provincial imported electricity in China between 1995 and 2014 using two-way fixed-effects panel regression models. Nationwide, each unit of alternative energy displaces nearly one-quarter of a unit of fossil-fuel-generated electricity, while each unit of imported electricity (regardless of the generation source) displaces ~0.3 unit of fossil-fuel electricity generated locally. Results from the six regional grids indicate that significant displacement of fossil-fuel-generated electricity occurs once the share of alternative energy in the electricity supply mix exceeds ~10%, which is accompanied by 10-50% rebound in the consumption of fossil-fuel-generated electricity. These findings indicate the need for a policy that integrates carbon taxation, alternative energy and energy efficiency to facilitate China's transition towards a low-carbon economy.

  7. An Assessment of Epidemiology Capacity in a One Health Team at the Provincial Level in Thailand

    Directory of Open Access Journals (Sweden)

    Soawapak Hinjoy

    2016-10-01

    Full Text Available A multi-sectoral core epidemiology capacity assessment was conducted in provinces that implemented One Health services in order to assess the efficacy of a One Health approach in Thailand. In order to conduct the assessment, four provinces were randomly selected as a study group from a total of 19 Thai provinces that are currently using a One Health approach. As a control group, four additional provinces that never implemented a One Health approach were also sampled. The provincial officers were interviewed on the epidemiologic capacity of their respective provinces. The average score of epidemiologic capacity in the provinces implementing the One Health approach was 66.45%, while the provinces that did not implement this approach earned a score of 54.61%. The epidemiologic capacity of surveillance systems in provinces that utilized the One Health approach earned higher scores in comparison to provinces that did not implement the approach (75.00% vs. 53.13%, p-value 0.13. Although none of the capacity evaluations showed significant differences between the two groups, we found evidence that provinces implementing the One Health approach gained higher scores in both surveillance and outbreak investigation capacities. This may be explained by more efficient capacity when using a One Health approach, specifically in preventing, protecting, and responding to threats in local communities.

  8. Comunicaciones romanas del ámbito provincial de Toledo en las antiguas fuentes itinerarias

    Directory of Open Access Journals (Sweden)

    Gregorio Carrasco Serrano

    1995-01-01

    Full Text Available Sin duda alguna uno de ios elementos más destacables en el fenómeno de la romanización, viene a estar representado por las vías de comunicación de ahí la cada vez mayor importancia y relieve que los estudios al respecto han llegado a adquirir últimamente. En la actualidad la investigación sobre vías de comunicación romanas, presenta una complejidad derivada de la conjunción de trabajos de tipo arqueológico, histórico-geográfico y filológico que necesariamente requieren. Partiendo de este hecho, nuestro propósito en el presente estudio ha consistido básicamente en analizar aquellas vías y sus respectivas mansiones del área territorial correspondiente al ámbito provincial de Toledo, constatadas en las fuentes antiguas itinerarias, punto de partida obligado en toda investigación sobre viaria romana, dejando aparte por tanto, aquellos trazados no citados en dichas fuentes.

  9. Role of the provincial government of Saskatchewan in encouraging growth in the oil and gas sector

    International Nuclear Information System (INIS)

    Lautermilch, E.

    1997-01-01

    The year 1996 was one of the most successful years for the oil and gas industry in Saskatchewan. In the view of the author this may be said to be due, at least in part, to the provincial government's efforts to establish and implement policies that stimulate economic activity. Government regulation is essential to ensure safe and sensible development, a level playing field for all participants, and to ensure that residents of the province receive a fair share of the benefits of resource development. Some of the positive government actions taken in 1996 include: revisions to the royalty rate structure, simplification of the natural gas administration system, a program to encourage exploration in less-explored areas, re-balancing electrical rates, and a review of all regulations with the goal of streamlining or eliminating them. New technologies such as horizontal drilling were also encouraged. Issues presently before the government include postage stamp tolls, global warming, greenhouse gas emissions and environmental concerns from farmers. On the whole, the oil and gas industry received high marks for taking a responsible approach to self-regulation, but continued public support will depend on how well the industry addresses environmental concerns and demonstrates the benefits of oil and development to the people

  10. Impact of provincial characteristics on the number of traffic accident victims on interurban roads in Spain.

    Science.gov (United States)

    Sánchez González, María Pilar; Escribano Sotos, Francisco; Tejada Ponce, Ángel

    2018-02-21

    This study has two aims. The first is to determine how various factors impact on the number of fatalities, serious injuries and slight injuries adjusted for the level of traffic on interurban roads in Spain. The second is to establish the number of victims per million vehicle-kilometres (veh-km) travelled on interurban roads in each province resulting from the effect of its specific characteristics. To this end, we developed six fixed effect panel data models with panel corrected standard errors for the 1999-2015 period. Our results show that while the proportion of high capacity roads, the unemployment rate and the motorization rate contribute to a reduction in the number of fatalities, serious injuries and slight injuries adjusted for level of traffic, the penalty-points licence system is effective in reducing the number of fatalities and serious injuries but not the number of slight injuries. Furthermore, the specific conditions in Ávila, Toledo, Madrid, Santa Cruz de Tenerife, Las Palmas de Gran Canaria, the Balearic Islands, Lleida and all the provinces on the Mediterranean coast cause a higher number of victims per million veh-km travelled than in the remaining provinces. Thus, greater public investment and more socially responsible behaviour are essential tools for reducing the number of traffic accident victims on Spanish interurban roads. Moreover, the provincial institutions emerge as key agents in improving road safety, due to their greater knowledge of the specific conditions and factors affecting each province. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. [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

  12. 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 ...

  13. Family History

    Science.gov (United States)

    Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, ... as heart disease, stroke, and cancer. Having a family member with a disease raises your risk, but ...

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. [The connective tissues, from the origin of the concept to its "Maturation" to extracellular matrix. Application to ocular tissues. Contribution to the history of medical sciences].

    Science.gov (United States)

    Labat-Robert, J; Robert, L; Pouliquen, Y

    2011-06-01

    The "Tissue" concept emerged apparently in the medical literature at about the French revolution, during the second half of the 18(th) century. It was found in the texts written by the physicians of Béarn and Montpellier, the Bordeu-s and also by the famous physician, Felix Vicq d'Azyr, the last attending physician of the queen Marie-Antoinette, "Bordeu et al. (1775) et Pouliquen (2009)". It was elaborated into a coherent doctrine somewhat later by Xavier Bichat, considered as the founder of modern pathological anatomy, Bichat. With the advent of histochemistry, from the beginning of the 20(th) century, several of the principal macromolecular components of connective tissues, collagens, elastin, "acid mucopolysaccharides" (later glycosaminoglycans and proteoglycans) and finally structural glycoproteins were characterized. These constituents of connective tissues were then designated as components of the extracellular matrix (ECM), closely associated to the cellular components of these tissues by adhesive (structural) glycoproteins as fibronectin, several others and cell receptors, "recognising" ECM-components as integrins, the elastin-receptor and others. This molecular arrangement fastens cells to the ECM-components they synthesize and mediates the exchange of informations between the cells to the ECM (inside-out) and also from the ECM-components to the cells (outside-in). This macromolecular arrangement is specific for each tissue as a result of the differentiation of their cellular components. It is also the basis and condition of the fulfillment of the specific functions of differentiated tissues. This is a short description of the passage of the "tissue" concept from its vague origin towards its precise identification at the cellular and molecular level up to the recognition of its functional importance and its establishment as an autonomous science. This can be considered as a new example of the importance of metaphors for the progress of science, Keller

  20. 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

  1. 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....

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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...

  4. 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

  5. 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

    Directory of Open Access Journals (Sweden)

    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

  6. 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

  7. 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 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.

  8. 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.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Planning for Economic Growth with Reduced CO2 Emissions in Provincial China: The Case of Jiangxi

    Directory of Open Access Journals (Sweden)

    Yu-Lin Tsou

    Full Text Available ABSTRACT: Since the Industrial Revolution, the concentration of greenhouse gases (GHG, primarily carbon dioxide (CO2, has put increasing pressure on the atmosphere's ability to absorb them. China is the fastest growing major economy in the world, and is following a process of rapid industrialization. This process, however, contributes dramatically to global warming through major CO2 emissions. The widespread provision of electricity through coal-fired power plants is just one contributor, but industrial structures, transportation systems, and the construction of large superblock residential towers also play major roles. The large cities and industrialized provinces of China emit the most CO2, a fact that requires serious attention. However, stemming this trend elsewhere in China would provide a greater opportunity for success in reducing overall CO2 emissions in the country. Consequently, the question this paper addresses is what policies can be adopted to reduce CO2 emissions in provinces in China where development is still in its early stages, while maintaining economic growth. Jiangxi is a province that has historically been a major agricultural area. In recent years, however, because of the economic development policies of the Chinese central government, the province's rich mineral deposits, favorable location, and convenient transportation system are attracting more investments and projects for development (Statistical Bureau of Jiangxi, 2010. Jiangxi, then, provides an excellent case study because the province, although developing quickly, might still produce less CO2 if proper growth policies and actions are implemented. According to the results of this research, CO2 emissions would indeed decline in Jiangxi if the province would adopt new technology for electricity generation and increase the GDP role of the service sector. KEYWORDS: Provincial Chinese development, economic growth and global warming, CO2 emissions in China, Chinese

  12. Provincial Poverty Dynamics in Lao PDR: A Case Study of Savannakhet

    Directory of Open Access Journals (Sweden)

    Edo Andriesse

    2012-01-01

    Full Text Available Although the average poverty level in Lao PDR has declined substantially since the beginning of economic reforms in 1986, sub-national dynamics give rise to a discussion of the trends and issues that determine and sustain provincial poverty and the variegated processes of rural transition. It appears that migration to core areas does not always generate better living standards, as migration to Vientiane Capital and Vientiane Province also results in a relocation of poverty from peripheral to core areas. This article sheds light on these problems and discusses the implications for the spatial dimensions of poverty in core provinces located on emerging Greater Mekong Subregion corridors and peripheral provinces. A case study of Savannakhet, located along the East West Economic Corridor, shows how rural households cope with the pressures arising from increasing market forces and regionalization. Based on in-depth fieldwork in the village of Ban Gnang Pho Sy, the results indicate that a shift occurred among the rural poor, in which their livelihoods changed from being based purely on subsistence agriculture to being focused increasingly upon pluriactive (commercial farming, livelihood diversification and labour migration to Thailand. Provinces located along emerging corridors experience a complex mosaic of impacts of integration due to fragmented ethnic-linguistic geographies and the varying relevance of pull versus push factors: imports versus exports, inward versus outward investments, and in- versus out-migration. In sum, rather than the neoliberal promise of a flatter socioeconomic landscape, the human geography of the Greater Mekong Subregion remains rough, due to politicization of foreign direct investments, complex land dealings and landlessness, migration patterns and rising inequality.

  13. Lessons from an evaluation of a provincial-level smoking control policy in Shanghai, China.

    Directory of Open Access Journals (Sweden)

    Xiang Li

    Full Text Available BACKGROUND: The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. OBJECTIVE: To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS, respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls. METHODS: A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. RESULTS: Six months after implementation, 82% of the participants agreed that "legislation is enforced most of the time". The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%, with less compliance in hotels and shopping malls (about 70%. Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10% and high in hotels and shopping malls (40% and above. The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes among employees decreased from 83% to 67%. CONCLUSIONS: Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future.

  14. Lessons from an Evaluation of a Provincial-Level Smoking Control Policy in Shanghai, China

    Science.gov (United States)

    Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J.; Wong, Frank Y.; Berg, Carla J.

    2013-01-01

    Background The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. Objective To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). Methods A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Results Six months after implementation, 82% of the participants agreed that “legislation is enforced most of the time”. The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Conclusions Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future. PMID:24058544

  15. A quantile regression analysis of China's provincial CO_2 emissions: Where does the difference lie?

    International Nuclear Information System (INIS)

    Xu, Bin; Lin, Boqiang

    2016-01-01

    China is already the largest carbon dioxide emitter in the world. This paper adopts provincial panel data from 1990 to 2014 and employs quantile regression model to investigate the influencing factors of China's CO_2 emissions. The results show that economic growth plays a dominant role in the growth of CO_2 emissions due to massive fixed–asset investment and export trade. The influences of energy intensity on the lower 10th and upper 90th quantile provinces are stronger than those in the 25th–50th quantile provinces because of big differences in R&D expenditure and human resources distribution. The impact of urbanization increases continuously from the lower 10th quantile provinces to the 10th–25th, 25th–50th, 50th–75th, 75th–90th and upper 90th quantile provinces, owing to the differences in R&D personnel, real estate development and motor–vehicle ownership. The effect of industrialization on the upper 90th quantile provinces is greater than those on other quantile provinces on account of the differences in the industrial scale and the development of the building industry. Thus, the heterogeneity effects of influencing factors on different quantile provinces should be taken into consideration when discussing the mitigation of CO_2 emissions in China. - Highlights: • The driving forces of China's CO_2 emissions are investigated. • Economic growth plays a dominant role in the growth of CO_2 emissions. • The impact of urbanization increases from the lower 10th quantiles to the upper 90th quantiles.

  16. Effect of a provincial system of stroke care delivery on stroke care and outcomes

    Science.gov (United States)

    Kapral, Moira K.; Fang, Jiming; Silver, Frank L.; Hall, Ruth; Stamplecoski, Melissa; O’Callaghan, Christina; Tu, Jack V.

    2013-01-01

    Background: Systems of stroke care delivery have been promoted as a means of improving the quality of stroke care, but little is known about their effectiveness. We assessed the effect of the Ontario Stroke System, a province-wide strategy of regionalized stroke care delivery, on stroke care and outcomes in Ontario, Canada. Methods: We used population-based provincial administrative databases to identify all emergency department visits and hospital admissions for acute stroke and transient ischemic attack from Jan. 1, 2001, to Dec. 31, 2010. Using piecewise regression analyses, we assessed the effect of the full implementation of the Ontario Stroke System in 2005 on the proportion of patients who received care at stroke centres, and on rates of discharge to long-term care facilities and 30-day mortality after stroke. Results: We included 243 287 visits by patients with acute stroke or transient ischemic attack. The full implementation of the Ontario Stroke System in 2005 was associated with an increase in rates of care at stroke centres (before implementation: 40.0%; after implementation: 46.5%), decreased rates of discharge to long-term care facilities (before implementation: 16.9%; after implementation: 14.8%) and decreased 30-day mortality for hemorrhagic (before implementation: 38.3%; after implementation: 34.4%) and ischemic stroke (before implementation: 16.3%; after implementation: 15.7%). The system’s implementation was also associated with marked increases in the proportion of patients who received neuroimaging, thrombolytic therapy, care in a stroke unit and antithrombotic therapy. Interpretation: The implementation of an organized system of stroke care delivery was associated with improved processes of care and outcomes after stroke. PMID:23713072

  17. Theropod Fauna from Southern Australia Indicates High Polar Diversity and Climate-Driven Dinosaur Provinciality

    Science.gov (United States)

    Benson, Roger B. J.; Rich, Thomas H.; Vickers-Rich, Patricia; Hall, Mike

    2012-01-01

    hallmark ‘Gondwanan’ fauna of South America and Africa may therefore reflect climate-driven provinciality, not vicariant evolution driven by continental fragmentation. However, vicariance may still be detected at lower phylogenetic levels. PMID:22615916

  18. 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...

  19. 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

  20. Environmental history

    DEFF Research Database (Denmark)

    Pawson, Eric; Christensen, Andreas Aagaard

    2017-01-01

    Environmental history is an interdisciplinary pursuit that has developed as a form of conscience to counter an increasingly powerful, forward-looking liberal theory of the environment. It deals with the relations between environmental ideas and materialities, from the work of the geographers George...... risks”. These are exposed by environmental history’s focus on long-run analysis and its narrative form that identifies the stories that we tell ourselves about nature. How a better understanding of past environmental transformations helps to analyse society and agency, and what this can mean...... for solutions and policies, is the agenda for an engaged environmental history from now on....

  1. Ildens historier

    DEFF Research Database (Denmark)

    Lassen, Henrik Roesgaard

    have been written by Andersen. In several chapters the curiously forgotten history of fire-lighting technology is outlined, and it is demonstrated that "Tællelyset" is written by a person with a modern perspective on how to light a candle - among other things. The central argument in the book springs...... from a point-by-point tracing of 'the origins and history' of Hans Christian Andersen's famous fairy tales. Where did the come from? How did they become the iconic texts that we know today? On this background it becomes quite clear that "Tællelyset" is a modern pastiche and not a genuine Hans Christian...

  2. Business History

    DEFF Research Database (Denmark)

    Hansen, Per H.

    2012-01-01

    This article argues that a cultural and narrative perspective can enrich the business history field, encourage new and different questions and answers, and provide new ways of thinking about methods and empirical material. It discusses what culture is and how it relates to narratives. Taking...

  3. LCA History

    DEFF Research Database (Denmark)

    Bjørn, Anders; Owsianiak, Mikołaj; Molin, Christine

    2018-01-01

    The idea of LCA was conceived in the 1960s when environmental degradation and in particular the limited access to resources started becoming a concern. This chapter gives a brief summary of the history of LCA since then with a focus on the fields of methodological development, application...

  4. Rewriting History.

    Science.gov (United States)

    Ramirez, Catherine Clark

    1994-01-01

    Suggests that the telling of vivid stories can help engage elementary students' emotions and increase the chances of fostering an interest in Texas history. Suggests that incorporating elements of the process approach to writing can merge with social studies objectives in creating a curriculum for wisdom. (RS)

  5. 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

  6. [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.

  7. Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history.

    Science.gov (United States)

    Poon, Liona C; Wright, David; Rolnik, Daniel L; Syngelaki, Argyro; Delgado, Juan Luis; Tsokaki, Theodora; Leipold, Gergo; Akolekar, Ranjit; Shearing, Siobhan; De Stefani, Luciana; Jani, Jacques C; Plasencia, Walter; Evangelinakis, Nikolaos; Gonzalez-Vanegas, Otilia; Persico, Nicola; Nicolaides, Kypros H

    2017-11-01

    The Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention trial demonstrated that in women who were at high risk for preterm preeclampsia with delivery at aspirin administration from 11 to 14 until 36 weeks' gestation was associated with a significant reduction in the incidence of preterm preeclampsia (odds ratio 0.38; 95% confidence interval, 0.20 to 0.74; P=0.004). We sought to examine whether there are differences in the effect of aspirin on the incidence of preterm preeclampsia in the Aspirin for Evidence-Based Preeclampsia Prevention trial in subgroups defined according to maternal characteristics and medical and obstetrical history. This was a secondary analysis of data from the Aspirin for Evidence-Based Preeclampsia Prevention trial. Subgroup analysis was performed to assess evidence of differences in the effect of aspirin on incidence of preterm preeclampsia in subgroups defined by maternal age (aspirin effect in subgroups defined according to maternal characteristics and obstetrical history. In participants with chronic hypertension preterm preeclampsia occurred in 10.2% (5/49) in the aspirin group and 8.2% (5/61) in the placebo group (adjusted odds ratio, 1.29; 95% confidence interval, 0.33-5.12). The respective values in those without chronic hypertension were 1.1% (8/749) in the aspirin group and 3.9% (30/761) in the placebo group (adjusted odds ratio, 0.27; 95% confidence interval, 0.12-0.60). In all participants with adherence of ≥90% the adjusted odds ratio in the aspirin group was 0.24 (95% confidence interval, 0.09-0.65); in the subgroup with chronic hypertension it was 2.06 (95% confidence interval, 0.40-10.71); and in those without chronic hypertension it was 0.05 (95% confidence interval, 0.01-0.41). For the complete data set the test of interaction was not significant at the 5% level (P = .055), but in those with adherence ≥90%, after adjustment for multiple comparisons

  8. Successful Teaching of Radiobiology Students in the Medical Management of Acute Radiation Effects From Real Case Histories Using Clinical Signs and Symptoms and Taking Advantage of Recently Developed Software Tools.

    Science.gov (United States)

    Majewski, Matthäus; Combs, Stephanie E; Trott, Klaus-Rüdiger; Abend, Michael; Port, Matthias

    2018-07-01

    In 2015, the Bundeswehr Institute of Radiobiology organized a North Atlantic Treaty Organization exercise to examine the significance of clinical signs and symptoms for the prediction of late-occurring acute radiation syndrome. Cases were generated using either the Medical Treatment Protocols for Radiation Accident Victims (METREPOL, n = 167) system or using real-case descriptions extracted from a database system for evaluation and archiving of radiation accidents based on case histories (SEARCH, n = 24). The cases ranged from unexposed [response category 0 (RC 0, n = 89)] to mild (RC 1, n = 45), moderate (RC 2, n = 19), severe (RC 3, n = 20), and lethal (RC 4, n = 18) acute radiation syndrome. During the previous exercise, expert teams successfully predicted hematological acute radiation syndrome severity, determined whether hospitalization was required, and gave treatment recommendations, taking advantage of different software tools developed by the North Atlantic Treaty Organization teams. The authors provided the same data set to radiobiology students who were introduced to the medical management of acute effects after radiation exposure and the software tools during a class lasting 15 h. Corresponding to the previous results, difficulties in the discrimination between RC 0/RC 1 and RC 3/RC 4, as well as a systematic underestimation of RC 1 and RC 2, were observed. Nevertheless, after merging reported response categories into clinically relevant groups (RC 0-1, RC 2-3, and RC 3-4), it was found that the majority of cases (95.2% ± 2.2 standard deviations) were correctly identified and that 94.7% (±2.6 standard deviations) developing acute radiation syndrome and z96.4% (±1.6 standard deviations) requiring hospitalization were identified correctly. Two out of three student teams also provided a dose estimate. These results are comparable to the best-performing team of the 2015 North Atlantic Treaty Organization exercise (response category: 92.5%; acute

  9. Business History as Cultural History

    DEFF Research Database (Denmark)

    Lunde Jørgensen, Ida

    The paper engages with the larger question of how cultural heritage becomes taken for granted and offers a complimentary view to the anthropological ʻCopenhagen School’ of business history, one that draws attention to the way corporate wealth directly and indirectly influences the culture available...

  10. Pursuing air pollutant co-benefits of CO2 mitigation in China: A provincial leveled analysis

    International Nuclear Information System (INIS)

    Dong, Huijuan; Dai, Hancheng; Dong, Liang; Fujita, Tsuyoshi; Geng, Yong; Klimont, Zbigniew; Inoue, Tsuyoshi; Bunya, Shintaro; Fujii, Minoru; Masui, Toshihiko

    2015-01-01

    Highlights: • China’s future CO 2 reduction and its co-benefits on air pollutants were projected. • GAINS-China and AIM/CGE models were combined for emission and cost estimation. • High GDP regions tended to have higher emission, reduction potential and co-benefit. • Coal ratio and coal quality were also key factors to affect reduction and co-benefit. • Mitigation investment to less developed western regions was more effective. - Abstract: With fast economic development, industrialization and urbanization, China faces increasing pressures on carbon emission reduction, and especially on air pollutants (SO 2 , NOx, PM) reduction, particularly the notorious haze issue caused by air pollution in recent years. Pursuing co-benefits is an effective approach to simultaneously respond to both carbon and air pollutant problems. In this paper, the AIM/CGE (Asia–Pacific Integrated Assessment Model/Computational General Equilibrium) model and GAINS (Greenhouse Gas and Air Pollution Interactions and Synergies)-China model are combined together to project future CO 2 and air pollutants emissions in China, as well as reduction costs and co-benefit effects. Considering implementation of carbon mitigation policy and air pollutant mitigation technologies, four scenarios (S1, S2, S3 and S4) are analyzed. Results indicate that by implementing both carbon and air pollutant mitigation (S4), CO 2 emission per GDP can be reduced by 41% by 2020, compared with the 2005 level, and SO 2 , NOx and PM2.5 emissions would change by a factor 0.8, 1.26 and 1.0 of the 2005 level, respectively in 2030. The real co-benefits of emission reductions (S2 minus S4) for SO 2 , NOx and PM2.5 are 2.4 Mt, 2.1 Mt and 0.3 Mt in 2020, and the corresponding cost reduction co-benefits are 4, 0.11, and 0.8 billion €, respectively. Provincial disparity analysis reveals that regions with higher co-benefits are those with higher GDP such as Guangdong, Shandong and Jiangsu, energy production bases such as

  11. Radomir Konstantinović and “Provincial Philosophy”: Binaries as Borders

    Directory of Open Access Journals (Sweden)

    John Kayl Cox

    2017-11-01

    Full Text Available Radomir Konstantinović and Provincial Philosophy: Binaries as Borders This essay is a partial reconsideration of the complex and often-cited work Filozofije palanke (1969 by the Serbian novelist and essayist Radomir Konstantinović. The fiery condemnations of Serbia’s stalled social and intellectual development and its accompanying predilection for barbaric violence are fiercely debated to this day, nearly six years after the death of the author and approaching fifty years since the book’s first publication. One way that Konstantinovic builds his argument is by establishing borders between Serbia, or other societies, and Europe or modernity; three main types of these borders can be expressed as binaries centered on values, time, and geography. The “spirit” or mindset of the palanka, or small Serbian town, can perhaps be rehabilited by converting it into a historically contingent philosophy, which comes to term with the forces of time, evolution, and agency.   Radomir Konstantinović i filozofia prowincjalna. Przeciwstawności jako granice Esej jest cząstkowym spojrzeniem na złożoną i często cytowaną pracę Filozofije palanke (1969 napisaną przez serbskiego powieściopisarza i eseistę Radomira Konstantinovicia. Ostra krytyka opóźnionego rozwoju społecznego i intelektualnego Serbii oraz towarzyszącego mu upodobania do barbarzyńskiej przemocy także dziś – prawie sześć lat po śmierci autora, i prawie pięćdziesiąt lat od pierwszego wydania książki, stanowią temat dyskusji. Jednym ze sposobów, w jaki Konstantinović buduje swoją argumentację, jest ustanowienie granicy między Serbią a innymi społeczeństwami, czy Europą i nowoczesnością. Trzy główne typy tych granic można wyrazić jako przeciwstawności skoncentrowane na wartościach, czasie i geografii. „Duch” lub sposób myślenia palanki, czyli serbskiego pipidówka, może zostać zrehabilitowany poprzez przekształcenie go w historycznie

  12. River history.

    Science.gov (United States)

    Vita-Finzi, Claudio

    2012-05-13

    During the last half century, advances in geomorphology-abetted by conceptual and technical developments in geophysics, geochemistry, remote sensing, geodesy, computing and ecology-have enhanced the potential value of fluvial history for reconstructing erosional and depositional sequences on the Earth and on Mars and for evaluating climatic and tectonic changes, the impact of fluvial processes on human settlement and health, and the problems faced in managing unstable fluvial systems. This journal is © 2012 The Royal Society

  13. Environmental History

    OpenAIRE

    Kearns, Gerard

    2004-01-01

    There was a time when almost all Western geography could be termed environmental history. In the late nineteenth century, physical geographers explained landscapes by describing how they had evolved. Likewise, human geographers saw society as shaped by the directing hands of the environment. By the 1960s this had very much changed. Process studies shortened the temporal framework in geographical explanation and cut the cord between nature and society. Now, physical and human...

  14. Themes in the history of medical professionalism.

    Science.gov (United States)

    Stevens, Rosemary A

    2002-11-01

    Professionalism in medicine is an ambiguous term. Discussions are hampered by understandings of the past that are counterproductive to today s debates. Three decades of criticism of physicians as self-interested and arrogant, and of professional organizations as unfairly monopolistic have shaken the confidence of professional leaders and their constituents in their ability to act as a positive social force, and left the concept of professional autonomy without a useful meaning. Inherited assumptions about conflict between the profession, government and the market have encouraged organizational policies to fight familiar enemies for short-term gains, rather than reinvent professionalism as a social force or seek new strategic alliances. This article stresses the importance of distancing the present from the past in re-inventing professionalism for the future, and lists eight fundamental goals.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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

  17. 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

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    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

  18. Wie wichtig ist der Unterricht in Medizinethik und Medizingeschichte im Medizinstudium? Eine empirische Studie zu den Einschätzungen Studierender [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

    2012-02-01

    Full Text Available [english] 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 5 semester of the Bochum Model curriculum (GTE teaching from the first semester onwards or followed the traditional curriculum (GTE teaching in the 5/6 semester, questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1 and 5 (model curriculum or 6 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 1 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

  19. 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.

  20. 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