WorldWideScience

Sample records for significant medical advances

  1. Advances in medical image computing.

    Science.gov (United States)

    Tolxdorff, T; Deserno, T M; Handels, H; Meinzer, H-P

    2009-01-01

    Medical image computing has become a key technology in high-tech applications in medicine and an ubiquitous part of modern imaging systems and the related processes of clinical diagnosis and intervention. Over the past years significant progress has been made in the field, both on methodological and on application level. Despite this progress there are still big challenges to meet in order to establish image processing routinely in health care. In this issue, selected contributions of the German Conference on Medical Image Processing (BVM) are assembled to present latest advances in the field of medical image computing. The winners of scientific awards of the German Conference on Medical Image Processing (BVM) 2008 were invited to submit a manuscript on their latest developments and results for possible publication in Methods of Information in Medicine. Finally, seven excellent papers were selected to describe important aspects of recent advances in the field of medical image processing. The selected papers give an impression of the breadth and heterogeneity of new developments. New methods for improved image segmentation, non-linear image registration and modeling of organs are presented together with applications of image analysis methods in different medical disciplines. Furthermore, state-of-the-art tools and techniques to support the development and evaluation of medical image processing systems in practice are described. The selected articles describe different aspects of the intense development in medical image computing. The image processing methods presented enable new insights into the patient's image data and have the future potential to improve medical diagnostics and patient treatment.

  2. Advanced Accelerators for Medical Applications

    Science.gov (United States)

    Uesaka, Mitsuru; Koyama, Kazuyoshi

    We review advanced accelerators for medical applications with respect to the following key technologies: (i) higher RF electron linear accelerator (hereafter “linac”); (ii) optimization of alignment for the proton linac, cyclotron and synchrotron; (iii) superconducting magnet; (iv) laser technology. Advanced accelerators for medical applications are categorized into two groups. The first group consists of compact medical linacs with high RF, cyclotrons and synchrotrons downsized by optimization of alignment and superconducting magnets. The second group comprises laser-based acceleration systems aimed of medical applications in the future. Laser plasma electron/ion accelerating systems for cancer therapy and laser dielectric accelerating systems for radiation biology are mentioned. Since the second group has important potential for a compact system, the current status of the established energy and intensity and of the required stability are given.

  3. Egyptian Journal of Medical Laboratory Sciences: Advanced Search

    African Journals Online (AJOL)

    Egyptian Journal of Medical Laboratory Sciences: Advanced Search. Journal Home > Egyptian Journal of Medical Laboratory Sciences: Advanced Search. Log in or Register to get access to full text downloads.

  4. Use of medications of questionable benefit in advanced dementia.

    Science.gov (United States)

    Tjia, Jennifer; Briesacher, Becky A; Peterson, Daniel; Liu, Qin; Andrade, Susan E; Mitchell, Susan L

    2014-11-01

    Advanced dementia is characterized by severe cognitive impairment and complete functional dependence. Patients' goals of care should guide the prescribing of medication during such terminal illness. Medications that do not promote the primary goal of care should be minimized. To estimate the prevalence of medications with questionable benefit used by nursing home residents with advanced dementia, identify resident- and facility-level characteristics associated with such use, and estimate associated medication expenditures. Cross-sectional study of medication use by nursing home residents with advanced dementia using a nationwide long-term care pharmacy database linked to the Minimum Data Set (460 facilities) between October 1, 2009, and September 30, 2010. Use of medication deemed of questionable benefit in advanced dementia based on previously published criteria and mean 90-day expenditures attributable to these medications per resident. Generalized estimating equations using the logit link function were used to identify resident- and facility-related factors independently associated with the likelihood of receiving medications of questionable benefit after accounting for clustering within nursing homes. Of 5406 nursing home residents with advanced dementia, 2911 (53.9%) received at least 1 medication with questionable benefit (range, 44.7% in the Mid-Atlantic census region to 65.0% in the West South Central census region). Cholinesterase inhibitors (36.4%), memantine hydrochloride (25.2%), and lipid-lowering agents (22.4%) were the most commonly prescribed. In adjusted analyses, having eating problems (adjusted odds ratio [AOR], 0.68; 95% CI, 0.59-0.78), a feeding tube (AOR, 0.58; 95% CI, 0.48-0.70), or a do-not-resuscitate order (AOR, 0.65; 95% CI, 0.57-0.75), and enrolling in hospice (AOR, 0.69; 95% CI, 0.58-0.82) lowered the likelihood of receiving these medications. High facility-level use of feeding tubes increased the likelihood of receiving these

  5. Medical technology advances from space research

    Science.gov (United States)

    Pool, S. L.

    1972-01-01

    Details of medical research and development programs, particularly an integrated medical laboratory, as derived from space technology are given. The program covers digital biotelemetry systems, automatic visual field mapping equipment, sponge electrode caps for clinical electroencephalograms, and advanced respiratory analysis equipment. The possibility of using the medical laboratory in ground based remote areas and regional health care facilities, as well as long duration space missions is discussed.

  6. A shift from significance test to hypothesis test through power analysis in medical research.

    Science.gov (United States)

    Singh, G

    2006-01-01

    Medical research literature until recently, exhibited substantial dominance of the Fisher's significance test approach of statistical inference concentrating more on probability of type I error over Neyman-Pearson's hypothesis test considering both probability of type I and II error. Fisher's approach dichotomises results into significant or not significant results with a P value. The Neyman-Pearson's approach talks of acceptance or rejection of null hypothesis. Based on the same theory these two approaches deal with same objective and conclude in their own way. The advancement in computing techniques and availability of statistical software have resulted in increasing application of power calculations in medical research and thereby reporting the result of significance tests in the light of power of the test also. Significance test approach, when it incorporates power analysis contains the essence of hypothesis test approach. It may be safely argued that rising application of power analysis in medical research may have initiated a shift from Fisher's significance test to Neyman-Pearson's hypothesis test procedure.

  7. Advanced maternal age: ethical and medical considerations for assisted reproductive technology.

    Science.gov (United States)

    Harrison, Brittany J; Hilton, Tara N; Rivière, Raphaël N; Ferraro, Zachary M; Deonandan, Raywat; Walker, Mark C

    2017-01-01

    This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs) make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved. A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]. Overall, 28 papers encompassing two major themes (ethical and medical) were included in the review. There are significant ethical considerations and medical (maternal and fetal) complications related to pregnancy in peri- and post-menopausal women. When examining the ethical and sociological perspective, the literature portrays an overall positive attitude toward pregnancy in advanced maternal age. With respect to the medical complications, the general consensus in the evaluated studies suggests that there is greater risk of complication for spontaneous pregnancy when the mother is older (eg, >35 years old). This risk can be mitigated by careful medical screening of the mother and the use of ARTs in healthy women. In these instances, a woman of advanced maternal age who is otherwise healthy can carry a pregnancy with a similar risk profile to that of her younger counterparts when using donated oocytes.

  8. A shift from significance test to hypothesis test through power analysis in medical research

    Directory of Open Access Journals (Sweden)

    Singh Girish

    2006-01-01

    Full Text Available Medical research literature until recently, exhibited substantial dominance of the Fisher′s significance test approach of statistical inference concentrating more on probability of type I error over Neyman-Pearson′s hypothesis test considering both probability of type I and II error. Fisher′s approach dichotomises results into significant or not significant results with a P value. The Neyman-Pearson′s approach talks of acceptance or rejection of null hypothesis. Based on the same theory these two approaches deal with same objective and conclude in their own way. The advancement in computing techniques and availability of statistical software have resulted in increasing application of power calculations in medical research and thereby reporting the result of significance tests in the light of power of the test also. Significance test approach, when it incorporates power analysis contains the essence of hypothesis test approach. It may be safely argued that rising application of power analysis in medical research may have initiated a shift from Fisher′s significance test to Neyman-Pearson′s hypothesis test procedure.

  9. Advanced medical interventions in pleural disease

    Directory of Open Access Journals (Sweden)

    Rahul Bhatnagar

    2016-06-01

    Full Text Available The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy. We also aim to inform the reader regarding the latest updates to more established procedures such as chemical pleurodesis, thoracentesis and the management of chest drains, drawing on contemporary data from recent randomised trials. Finally, we shall look to explore the challenges faced by those practicing pleural medicine, especially relating to training, as well as possible future directions for the use and expansion of advanced medical interventions in pleural disease.

  10. [Development of performance evaluation and management system on advanced schistosomiasis medical treatment].

    Science.gov (United States)

    Zhou, Xiao-Rong; Huang, Shui-Sheng; Gong, Xin-Guo; Cen, Li-Ping; Zhang, Cong; Zhu, Hong; Yang, Jun-Jing; Chen, Li

    2012-04-01

    To construct a performance evaluation and management system on advanced schistosomiasis medical treatment, and analyze and evaluate the work of the advanced schistosomiasis medical treatment over the years. By applying the database management technique and C++ programming technique, we inputted the information of the advanced schistosomiasis cases into the system, and comprehensively evaluated the work of the advanced schistosomiasis medical treatment through the cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. We made a set of software formula about cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. This system had many features such as clear building, easy to operate, friendly surface, convenient information input and information search. It could benefit the performance evaluation of the province's advanced schistosomiasis medical treatment work. This system can satisfy the current needs of advanced schistosomiasis medical treatment work and can be easy to be widely used.

  11. Establishing advanced practice for medical imaging in New Zealand

    International Nuclear Information System (INIS)

    Yielder, Jill; Young, Adrienne; Park, Shelley; Coleman, Karen

    2014-01-01

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ

  12. Establishing advanced practice for medical imaging in New Zealand

    Energy Technology Data Exchange (ETDEWEB)

    Yielder, Jill, E-mail: j.yielder@auckland.ac.nz [University of Auckland, Auckland (New Zealand); Young, Adrienne; Park, Shelley; Coleman, Karen [University of Otago, Wellington (New Zealand); University of Auckland, Auckland (New Zealand)

    2014-02-15

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

  13. Java advanced medical image toolkit

    International Nuclear Information System (INIS)

    Saunder, T.H.C.; O'Keefe, G.J.; Scott, A.M.

    2002-01-01

    Full text: The Java Advanced Medical Image Toolkit (jAMIT) has been developed at the Center for PET and Department of Nuclear Medicine in an effort to provide a suite of tools that can be utilised in applications required to perform analysis, processing and visualisation of medical images. jAMIT uses Java Advanced Imaging (JAI) to combine the platform independent nature of Java with the speed benefits associated with native code. The object-orientated nature of Java allows the production of an extensible and robust package which is easily maintained. In addition to jAMIT, a Medical Image VO API called Sushi has been developed to provide access to many commonly used image formats. These include DICOM, Analyze, MINC/NetCDF, Trionix, Beat 6.4, Interfile 3.2/3.3 and Odyssey. This allows jAMIT to access data and study information contained in different medical image formats transparently. Additional formats can be added at any time without any modification to the jAMIT package. Tools available in jAMIT include 2D ROI Analysis, Palette Thresholding, Image Groping, Image Transposition, Scaling, Maximum Intensity Projection, Image Fusion, Image Annotation and Format Conversion. Future tools may include 2D Linear and Non-linear Registration, PET SUV Calculation, 3D Rendering and 3D ROI Analysis. Applications currently using JAMIT include Antibody Dosimetry Analysis, Mean Hemispheric Blood Flow Analysis, QuickViewing of PET Studies for Clinical Training, Pharamcodynamic Modelling based on Planar Imaging, and Medical Image Format Conversion. The use of jAMIT and Sushi for scripting and analysis in Matlab v6.1 and Jython is currently being explored. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  14. 75 FR 52472 - Spectrum Requirements for Advanced Medical Technologies

    Science.gov (United States)

    2010-08-26

    ... medical devices. Under this framework, the rules for MedRadio service incorporates the MICS ``core'' band... Requirements for Advanced Medical Technologies AGENCY: Federal Communications Commission. ACTION: Final rule.... (Medtronic) regarding rules for the Medical Device Radiocommunication (MedRadio) service. The Commission...

  15. [Medical Humanities--the Historical Significance and Mission in Medical Education].

    Science.gov (United States)

    Fujino, Akihiro

    2015-12-01

    In this paper we consider the significance and mission of medical humanities in medical education from the following six viewpoints: (1) misunderstanding of the medical humanities; (2) its historical development; (3) the criteria for the ideal physician; (4) the contents of current Medical Humanities education; (5) the basic philosophy; and (6) its relation to medical professionalism. Medical humanities consists of the three academic components of bioethics, clinical ethics and medical anthropology, and it is a philosophy and an art which penetrate to the fundamental essence of medicine. The purpose of medical humanities is to develop one's own humanity and spirituality through medical practice and contemplation by empathizing with patients' illness narratives through spiritual self-awakening and by understanding the mutual healing powers of human relations by way of the realization of primordial life. The basic philosophy is "the coincidence of contraries". The ultimate mission of medical humanities is to cultivate physicians to educate themselves and have a life-long philosophy of devotion to understanding, through experience, the coincidence of contraries.

  16. Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

    Directory of Open Access Journals (Sweden)

    Scheffer Gert J

    2010-03-01

    Full Text Available Abstract Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS and a Helicopter Emergency Medical Service (HEMS for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

  17. Gender Disparities in Faculty Rank: Factors that Affect Advancement of Women Scientists at Academic Medical Centers

    Directory of Open Access Journals (Sweden)

    Cristina M. López

    2018-04-01

    Full Text Available While a significant portion of women within academic science are employed within medical schools, women faculty in these academic medical centers are disproportionately represented in lower faculty ranks. The medical school setting is a critical case for both understanding and advancing women in basic sciences. This study highlights the findings from focus groups conducted with women faculty across Assistant, Associate, and Full Professor ranks (n = 35 in which they discussed barriers and facilitators for advancement of women basic scientists at an academic medical center. Qualitative analysis demonstrated several emergent themes that affect women’s advancement, including gendered expectation norms (e.g., good citizenship, volunteerism, work-life balance, mentorship/sponsorship, adoption of a team science approach, tenure process milestones, soft money research infrastructure, institution specific policies (or lack thereof, and operating within an MD-biased culture. These findings are compared with the extant literature of women scientists in STEM institutions. Factors that emerged from these focus groups highlight the need for evidence-based interventions in the often overlooked STEM arena of academic medical centers.

  18. Train medical physicist-urgent need for advanced radiotherapy

    International Nuclear Information System (INIS)

    Hareyama, Masato; Teshima, Teruki; Yamamoto, Tokihiro; Haga, Akihiro; Nakagawa, Keiichi; Uesaka, Mitsuru

    2008-01-01

    A Japanese advanced charged particle therapy for cancer that places fewer physical burdens on patients is leading the world and stereotactic radiotherapy and intensity-modulated radiotherapy (IMRT) have been implemented also as a high precision radiotherapy. For the further advancement and dissemination of the therapy, training and qualification of medical physicists has become more needed. Cancer professional train course plan has been performed at many universities in Japan partly to train medical physicists. This special issue consists of seven relevant articles from experts of academia. Medical physicists have been qualified by the Japan Radiological Society, but should have national qualification such as to carry out the R and D of therapy equipment. This has been supported by many academia such as the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) but not by the Japan Association of Radiological Technologists (JART). (T. Tanaka)

  19. Improving advanced cardiovascular life support skills in medical students: simulation-based education approach

    Directory of Open Access Journals (Sweden)

    Hamidreza Reihani

    2015-01-01

    Full Text Available Objective: In this trial, we intend to assess the effect of simulation-based education approach on advanced cardiovascular life support skills among medical students. Methods: Through convenient sampling method, 40 interns of Mashhad University of Medical Sciences in their emergency medicine rotation (from September to December 2012 participated in this study. Advanced Cardiovascular Life Support (ACLS workshops with pretest and post-test exams were performed. Workshops and checklists for pretest and post-test exams were designed according to the latest American Heart Association (AHA guidelines. Results: The total score of the students increased significantly after workshops (24.6 out of 100 to 78.6 out of 100. This demonstrates 53.9% improvement in the skills after the simulation-based education (P< 0.001. Also the mean score of each station had a significant improvement (P< 0.001. Conclusion: Pretests showed that interns had poor performance in practical clinical matters while their scientific knowledge, such as ECG interpretation was acceptable. The overall results of the study highlights that Simulation based-education approach is highly effective in Improving ACLS skills among medical students.

  20. Advanced maternal age: ethical and medical considerations for assisted reproductive technology

    Directory of Open Access Journals (Sweden)

    Harrison BJ

    2017-08-01

    Full Text Available Brittany J Harrison,1 Tara N Hilton,1 Raphaël N Rivière,1 Zachary M Ferraro,1–3 Raywat Deonandan,4 Mark C Walker1–3,51Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 2Division of Maternal-Fetal Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada; 3Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada; 4University of Ottawa Interdisciplinary School of Health Sciences, Ottawa, ON, Canada; 5Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, CanadaObjectives: This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved.Methods: A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]. Overall, 28 papers encompassing two major themes (ethical and medical were included in the review.Conclusion: There are significant ethical considerations and medical (maternal and fetal complications related to pregnancy in peri- and post-menopausal women. When examining the ethical and sociological perspective, the literature portrays an overall positive attitude toward pregnancy in advanced maternal age. With respect to the medical complications, the general consensus in the evaluated studies suggests that there is greater risk of complication for spontaneous pregnancy when the mother is older (eg, >35 years old. This risk can be mitigated by careful medical screening of the mother and the use of ARTs in healthy women. In these instances, a woman of advanced maternal age who is otherwise healthy can carry a

  1. Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service.

    NARCIS (Netherlands)

    Gerritse, B.M.; Schalkwijk, A.; Pelzer, B.J.; Scheffer, G.J.; Draaisma, J.M.T.

    2010-01-01

    BACKGROUND: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures

  2. Teaching advance care planning to medical students with a computer-based decision aid.

    Science.gov (United States)

    Green, Michael J; Levi, Benjamin H

    2011-03-01

    Discussing end-of-life decisions with cancer patients is a crucial skill for physicians. This article reports findings from a pilot study evaluating the effectiveness of a computer-based decision aid for teaching medical students about advance care planning. Second-year medical students at a single medical school were randomized to use a standard advance directive or a computer-based decision aid to help patients with advance care planning. Students' knowledge, skills, and satisfaction were measured by self-report; their performance was rated by patients. 121/133 (91%) of students participated. The Decision-Aid Group (n = 60) outperformed the Standard Group (n = 61) in terms of students' knowledge (p satisfaction with their learning experience (p student performance. Use of a computer-based decision aid may be an effective way to teach medical students how to discuss advance care planning with cancer patients.

  3. Teaching Advanced Leadership Skills in Community Service (ALSCS) to medical students.

    Science.gov (United States)

    Goldstein, Adam O; Calleson, Diane; Bearman, Rachel; Steiner, Beat D; Frasier, Pamela Y; Slatt, Lisa

    2009-06-01

    Inadequate access to health care, lack of health insurance, and significant health disparities reflect crises in health care affecting all of society. Training U.S. physicians to possess not only clinical expertise but also sufficient leadership skills is essential to solve these problems and to effectively improve health care systems. Few models in the undergraduate medical curriculum exist for teaching students how to combine needed leadership competencies with actual service opportunities.The Advanced Leadership Skills in Community Service (ALSCS) selective developed in response to the shortage of leadership models and leadership training for medical students. The ALSCS selective is designed specifically to increase students' leadership skills, with an emphasis on community service. The selective integrates classroom-based learning, hands-on application of learned skills, and service learning. More than 60 medical students have participated in the selective since inception. Short-term outcomes demonstrate an increase in students' self-efficacy around multiple dimensions of leadership skills (e.g., fundraising, networking, motivating others). Students have also successfully completed more than a dozen leadership and community service projects. The selective offers an innovative model of a leadership-skills-based course that can have a positive impact on leadership skill development among medical school students and that can be incorporated into the medical school curriculum.

  4. Attributes of advanced practice registered nurse care coordination for children with medical complexity.

    Science.gov (United States)

    Cady, Rhonda G; Kelly, Anne M; Finkelstein, Stanley M; Looman, Wendy S; Garwick, Ann W

    2014-01-01

    Care coordination is an essential component of the pediatric health care home. This study investigated the attributes of relationship-based advanced practice registered nurse care coordination for children with medical complexity enrolled in a tertiary hospital-based health care home. Retrospective review of 2,628 care coordination episodes conducted by telehealth over a consecutive 3-year time period for 27 children indicated that parents initiated the majority of episodes and the most frequent reason was acute and chronic condition management. During this period, care coordination episodes tripled, with a significant increase (p < .001) between years 1 and 2. The increased episodes could explain previously reported reductions in hospitalizations for this group of children. Descriptive analysis of a program-specific survey showed that parents valued having a single place to call and assistance in managing their child's complex needs. The advanced practice registered nurse care coordination model has potential for changing the health management processes for children with medical complexity. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  5. Endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma: Is it a significant prognostic factor?

    Science.gov (United States)

    Shin, Hae Jin; Moon, Hee Seok; Kang, Sun Hyung; Sung, Jae Kyu; Jeong, Hyun Yong; Kim, Seok Hyun; Lee, Byung Seok; Kim, Ju Seok; Yun, Gee Young

    2017-12-01

    The purpose of this study was to evaluate the prognostic impact of endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma.This retrospective study was based on medical records from a single tertiary medical center. The records of 317 patients with esophageal squamous cell carcinoma treated with surgery or definitive chemoradiotherapy (CRT) between January 2009 and March 2016 were reviewed. Finally, we retrieved the data on 168 consecutive patients. These 168 patients were divided into 2 groups based on their endoscopic traversability findings: Group A (the endoscope traversable group), and Group B (the endoscope non-traversable group). We then retrospectively compared the clinical characteristics of these 2 groups.The endoscope non-traversable group (Group B) revealed an advanced clinical stage, a poor Eastern Cooperative Oncology Group (ECOG) score, a lower serum albumin level, a higher rate of requirement for esophageal stent insertion and definitive CRT as initial treatment than the endoscope traversable group (Group A). Patients with endoscope traversable cancer showed a significantly higher 3-year overall survival and 3-year relapse-free survival than patients who were endoscope non-traversable (53.8% vs 17.3%, P squamous cell carcinoma treated with definitive CRT, the serum albumin level squamous cell carcinoma treated with definitive CRT is a significant prognostic factor. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  6. Japan's advanced medicine.

    Science.gov (United States)

    Sho, Ri; Narimatsu, Hiroto; Murakami, Masayasu

    2013-10-01

    Like health care systems in other developed countries, Japan's health care system faces significant challenges due to aging of the population and economic stagnation. Advanced medicine (Senshin Iryou) is a unique system of medical care in Japan offering highly technology-driven medical care that is not covered by public health insurance. Advanced medicine has recently developed and expanded as part of health care reform. Will it work? To answer this question, we briefly trace the historical development of advanced medicine and describe the characteristics and current state of advanced medical care in Japan. We then offer our opinions on the future of advanced medicine with careful consideration of its pros and cons. We believe that developing advanced medicine is an attempt to bring health care reform in line rather than the goal of health care reform.

  7. Audience responses to television news coverage of medical advances: The mediating role of audience emotions and identification.

    Science.gov (United States)

    Hong, Hyehyun

    2015-08-01

    Exemplifying a real person in news stories has become a popular journalistic technique to describe an event or issue. With the frequent appearance of medical news reports in local television in recent years, this news presentation style is widely believed to help audiences better engage in and understand complex medical information and to influence their perceptions and judgments. In terms of television news coverage of medical advances, this study investigates how audiences respond to embedded human examples (mainly patients who experience benefits from the advances) and to overall news stories, and how such responses are related to their perception of portrayed medical advances. The experimental results indicate that news stories with a human example were more likely to intensify the audience's positive emotions than those without, which in turn influenced favorable perceptions of the described medical advance. In addition, the extent to which the audience identified with a human example (in particular, sympathy) mediated the relationship between the audience's involvement in the news story and its perception of the portrayed medical advance. © The Author(s) 2014.

  8. Law on advance health care directives: a medical perspective.

    Science.gov (United States)

    Di Luca, A; Del Rio, A; Bosco, M; Di Luca, N M

    2018-01-01

    The paper's authors aim to elaborate on law 22 dicembre 2017, n. 219 , designed to regulate informed consent practices and advance health care directives", which has sparked a passionate debate centered on the substantial innovation achieved over the past decades in bio-medical science and at the same time, the noteworthy accomplishments made in enforcing human and personal rights. Within the paper, article three is delved into, which covers the creation of the so-called DAT ("Disposizioni anticipate di trattamento", advance health care directives), by which patients, in light of possible future incapacity to choose, can express their convictions and decisions on how to be treated and their consent or dissent to undergo treatments and procedures, including artificial nutrition and hydration. The authors peruse the new law's provisions through a medical perspective, and observe how they are heavily tilted towards patient choice, thus making doctors little more than mere tools of such decisions.

  9. 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

  10. 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

  11. Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS): prospective cohort study protocol.

    Science.gov (United States)

    Teo, Irene; Singh, Ratna; Malhotra, Chetna; Ozdemir, Semra; Dent, Rebecca A; Kumarakulasinghe, Nesaretnam Barr; Yeo, Wee Lee; Cheung, Yin Bun; Malhotra, Rahul; Kanesvaran, Ravindran; Yee, Alethea Chung Pheng; Chan, Noreen; Wu, Huei Yaw; Chin, Soh Mun; Allyn, Hum Yin Mei; Yang, Grace Meijuan; Neo, Patricia Soek Hui; Nadkarni, Nivedita V; Harding, Richard; Finkelstein, Eric A

    2018-04-23

    Advanced cancer significantly impacts quality of life of patients and families as they cope with symptom burden, treatment decision-making, uncertainty and costs of treatment. In Singapore, information about the experiences of advanced cancer patients and families and the financial cost they incur for end-of-life care is lacking. Understanding of this information is needed to inform practice and policy to ensure continuity and affordability of care at the end of life. The primary objectives of the Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS) cohort study are to describe changes in quality of life and to quantify healthcare utilization and costs of patients with advanced cancer at the end of life. Secondary objectives are to investigate patient and caregiver preferences for diagnostic and prognostic information, preferences for end-of-life care, caregiver burden and perceived quality of care and to explore how these change as illness progresses and finally to measure bereavement adjustment. The purpose of this paper is to present the COMPASS protocol in order to promote scientific transparency. This cohort study recruits advanced cancer patients (n = 600) from outpatient medical oncology clinics at two public tertiary healthcare institutions in Singapore. Patients and their primary informal caregiver are surveyed every 3 months until patients' death; caregivers are followed until 6 months post patient death. Patient medical and billing records are obtained and merged with patient survey data. The treating medical oncologists of participating patients are surveyed to obtain their beliefs regarding care delivery for the patient. The study will allow combination of self-report, medical, and cost data from various sources to present a comprehensive picture of the end-of-life experience of advanced cancer patients in a unique Asian setting. This study is responsive to Singapore's National Strategy for Palliative Care which

  12. Inhaler Reminders Significantly Improve Asthma Patients' Use of Controller Medications

    Science.gov (United States)

    ... controller medications Share | Inhaler reminders significantly improve asthma patients’ use of controller medications Published Online: July 22, ... the burden and risk of asthma, but many patients do not use them regularly. This poor adherence ...

  13. Encountering Challenges with the EU Regulation on Advance Therapy Medical Products.

    Science.gov (United States)

    Mansnérus, Juli

    2015-12-01

    This article aims at analysing how well the Advanced Therapy Medical Product Regulation (EC) No. 1394/2007 (ATMP Regulation) meets the needs of small and medium-sized enterprises (SMES), academia and public tissue establishments developing advanced therapy medical products (ATMPS). Benefits and shortcomings of the ATMP Regulation are identified, and possible amendments are proposed to accelerate the translation of research into advanced therapies and to facilitate the commercialisation of ATMPS whilst ensuring safety. It was set up as a lex specialis to ensure the free movement of ATMPS within the EU in order to facilitate their access to the internal market and to foster the competitiveness of European pharmaceutical companies, while guaranteeing the highest level protection of public health. Since the adoption of the ATMP Regulation in late 2008, only 5 ATMPS have been granted marketing authorisations thus far. Hence, there is a need to analyse whether the ATMP Regulation meets its objectives.

  14. Impact of Integrated Care Model (ICM) on Direct Medical Costs in Management of Advanced Chronic Obstructive Pulmonary Disease (COPD).

    Science.gov (United States)

    Bandurska, Ewa; Damps-Konstańska, Iwona; Popowski, Piotr; Jędrzejczyk, Tadeusz; Janowiak, Piotr; Świętnicka, Katarzyna; Zarzeczna-Baran, Marzena; Jassem, Ewa

    2017-06-12

    BACKGROUND Chronic obstructive pulmonary disease (COPD) is a commonly diagnosed condition in people older than 50 years of age. In advanced stage of this disease, integrated care (IC) is recommended as an optimal approach. IC allows for holistic and patient-focused care carried out at the patient's home. The aim of this study was to analyze the impact of IC on costs of care and on demand for medical services among patients included in IC. MATERIAL AND METHODS The study included 154 patients diagnosed with advanced COPD. Costs of care (general, COPD, and exacerbations-related) were evaluated for 1 year, including 6-months before and after implementing IC. The analysis included assessment of the number of medical procedures of various types before and after entering IC and changes in medical services providers. RESULTS Direct medical costs of standard care in advanced COPD were 886.78 EUR per 6 months. Costs of care of all types decreased after introducing IC. Changes in COPD and exacerbation-related costs were statistically significant (p=0.012492 and p=0.017023, respectively). Patients less frequently used medical services for respiratory system and cardiovascular diseases. Similarly, the number of hospitalizations and visits to emergency medicine departments decreased (by 40.24% and 8.5%, respectively). The number of GP visits increased after introducing IC (by 7.14%). CONCLUSIONS The high costs of care in advanced COPD indicate the need for new forms of effective care. IC caused a decrease in costs and in the number of hospitalization, with a simultaneous increase in the number of GP visits.

  15. The current format and ongoing advances of medical education in the United States.

    Science.gov (United States)

    Gishen, Kriya; Ovadia, Steven; Arzillo, Samantha; Avashia, Yash; Thaller, Seth R

    2014-01-01

    The objective of this study was to examine the current system of medical education along with the advances that are being made to support the demands of a changing health care system. American medical education must reform to anticipate the future needs of a changing health care system. Since the dramatic transformations to medical education that followed the publication of the Flexner report in 1910, medical education in the United States has largely remained unaltered. Today, the education of future physicians is undergoing modifications at all levels: premedical education, medical school, and residency training. Advances are being made with respect to curriculum design and content, standardized testing, and accreditation milestones. Fields such as plastic surgery are taking strides toward improving resident training as the next accreditation system is established. To promote more efficacious medical education, the American Medical Association has provided grants for innovations in education. Likewise, the Accreditation Council for Graduate Medical Education outlined 6 core competencies to standardize the educational goals of residency training. Such efforts are likely to improve the education of future physicians so that they are able to meet the future needs of American health care.

  16. Frontier of Advanced Accelerator Applications and Medical Treatments Using Nuclear Techniques. Abstract

    International Nuclear Information System (INIS)

    2015-01-01

    To address the challenges of research-based practice, developing advanced accelerator applications, and medical treatments using nuclear tecniqoes, researchers from Rajamakala University of Technology Lanna, Office of Atoms for Peace, and Chiang Mai University have joined in hosting this conference. Nuclear medicine, amedical specialty, diagnoses and treats diseases in a safe and painless way. Nuclear techniques can determine medical information that may otherwise be unavailable, require surgery, or necessitate more expensive and invasive diagnostic tests. Advance in nuclear techniques also offer the potential to detect abnormalities at earlier stages, leasding to earlier treatment and a more successful prognosis.

  17. IOMP - Challenges for advancing medical physic globally

    International Nuclear Information System (INIS)

    Nusslin, F.

    2010-01-01

    IOMP stands for International Organization for Medical Physics. The determinants of health care include; science, research, academia, education, technology, engineering, industry, politics, economic, society, ethics, culture and medicine. However, physics and engineering are the driving forces of progress in health care. Medical Physics is a branch of Applied Physics, pursued by medical physicists, which uses physics principles, methods and techniques in practice and research for the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. How can we achieve Health Care improvement through Medical Physics globally? By forming international alliances in the Medical Physics community to develop and implement coherent concepts of • Appropriate University / Hospital Structures • Education & Training and Certification Schemes • Research & Development Platforms • Professional Career Development • International Cooperation within the Science Community IOMP represents ca. 18.000 medical physicists worldwide, it is affiliated to 80 national member organizations, six regional organizations as Members plus Corporate Members. The mission of IOMP is to advance medical physics practice worldwide by disseminating scientific and technical information, fostering the educational and professional development of medical physics and promoting the highest quality medical services for patients. 6 Medical physicists are professionals with education and specialist training in the concepts and techniques of applying physics in medicine. They work in clinical, academic or research institutions. Challenges, Efforts and Achievements of the International Organization for Medical Physics Recognition of the Medical Physics profession by the National Health Authorities. Medical Physicists are essential to ensure adequate and safe use of radiation equipment, Radiation Protection of patients, workers and public in a clinical

  18. Perspectives on the value of advanced medical imaging: a national survey of primary care physicians.

    Science.gov (United States)

    Hughes, Christine M; Kramer, Erich; Colamonico, Jennifer; Duszak, Richard

    2015-05-01

    To understand perceptions of primary care physicians (PCPs) about the value of advanced medical imaging. A national quantitative survey of 500 PCPs was conducted using an online self-administered questionnaire. Questions focused on advanced medical imaging (CT, MRI, and PET) and its perceived impact on the delivery of patient care. Responses were stratified by physician demographics. Large majorities of the PCPs indicated that advanced imaging increases their diagnostic confidence (441; 88%); provides data not otherwise available (451; 90%); permits better clinical decision making (440; 88%); increases confidence in treatment choices (438; 88%), and shortens time to definitive diagnosis (430; 86%]). Most (424; 85%) believe that patient care would be negatively affected without access to advanced imaging. PCPs whose clinical careers predated the proliferation of advanced imaging modalities (>20 years of practice) assigned higher value to advanced imaging on several dimensions compared with younger physicians whose training overlapped widespread technology availability. By a variety of metrics, large majorities of PCPs believe that advanced medical imaging provides considerable value to patient care. Those whose careers predated the widespread availability of advanced imaging tended to associate it with even higher value. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. Dictionary Pruning with Visual Word Significance for Medical Image Retrieval.

    Science.gov (United States)

    Zhang, Fan; Song, Yang; Cai, Weidong; Hauptmann, Alexander G; Liu, Sidong; Pujol, Sonia; Kikinis, Ron; Fulham, Michael J; Feng, David Dagan; Chen, Mei

    2016-02-12

    Content-based medical image retrieval (CBMIR) is an active research area for disease diagnosis and treatment but it can be problematic given the small visual variations between anatomical structures. We propose a retrieval method based on a bag-of-visual-words (BoVW) to identify discriminative characteristics between different medical images with Pruned Dictionary based on Latent Semantic Topic description. We refer to this as the PD-LST retrieval. Our method has two main components. First, we calculate a topic-word significance value for each visual word given a certain latent topic to evaluate how the word is connected to this latent topic. The latent topics are learnt, based on the relationship between the images and words, and are employed to bridge the gap between low-level visual features and high-level semantics. These latent topics describe the images and words semantically and can thus facilitate more meaningful comparisons between the words. Second, we compute an overall-word significance value to evaluate the significance of a visual word within the entire dictionary. We designed an iterative ranking method to measure overall-word significance by considering the relationship between all latent topics and words. The words with higher values are considered meaningful with more significant discriminative power in differentiating medical images. We evaluated our method on two public medical imaging datasets and it showed improved retrieval accuracy and efficiency.

  20. 76 FR 71982 - Advancing Regulatory Science for Highly Multiplexed Microbiology/Medical Countermeasure Devices...

    Science.gov (United States)

    2011-11-21

    ... Multiplexed Microbiology Devices: Their clinical application and public health/clinical needs; inclusion of...] Advancing Regulatory Science for Highly Multiplexed Microbiology/ Medical Countermeasure Devices; Public... Multiplexed Microbiology/ Medical Countermeasure Devices'' that published in the Federal Register of August 8...

  1. Uranium chemistry: significant advances

    International Nuclear Information System (INIS)

    Mazzanti, M.

    2011-01-01

    The author reviews recent progress in uranium chemistry achieved in CEA laboratories. Like its neighbors in the Mendeleev chart uranium undergoes hydrolysis, oxidation and disproportionation reactions which make the chemistry of these species in water highly complex. The study of the chemistry of uranium in an anhydrous medium has led to correlate the structural and electronic differences observed in the interaction of uranium(III) and the lanthanides(III) with nitrogen or sulfur molecules and the effectiveness of these molecules in An(III)/Ln(III) separation via liquid-liquid extraction. Recent work on the redox reactivity of trivalent uranium U(III) in an organic medium with molecules such as water or an azide ion (N 3 - ) in stoichiometric quantities, led to extremely interesting uranium aggregates particular those involved in actinide migration in the environment or in aggregation problems in the fuel processing cycle. Another significant advance was the discovery of a compound containing the uranyl ion with a degree of oxidation (V) UO 2 + , obtained by oxidation of uranium(III). Recently chemists have succeeded in blocking the disproportionation reaction of uranyl(V) and in stabilizing polymetallic complexes of uranyl(V), opening the way to to a systematic study of the reactivity and the electronic and magnetic properties of uranyl(V) compounds. (A.C.)

  2. Image analysis and modeling in medical image computing. Recent developments and advances.

    Science.gov (United States)

    Handels, H; Deserno, T M; Meinzer, H-P; Tolxdorff, T

    2012-01-01

    Medical image computing is of growing importance in medical diagnostics and image-guided therapy. Nowadays, image analysis systems integrating advanced image computing methods are used in practice e.g. to extract quantitative image parameters or to support the surgeon during a navigated intervention. However, the grade of automation, accuracy, reproducibility and robustness of medical image computing methods has to be increased to meet the requirements in clinical routine. In the focus theme, recent developments and advances in the field of modeling and model-based image analysis are described. The introduction of models in the image analysis process enables improvements of image analysis algorithms in terms of automation, accuracy, reproducibility and robustness. Furthermore, model-based image computing techniques open up new perspectives for prediction of organ changes and risk analysis of patients. Selected contributions are assembled to present latest advances in the field. The authors were invited to present their recent work and results based on their outstanding contributions to the Conference on Medical Image Computing BVM 2011 held at the University of Lübeck, Germany. All manuscripts had to pass a comprehensive peer review. Modeling approaches and model-based image analysis methods showing new trends and perspectives in model-based medical image computing are described. Complex models are used in different medical applications and medical images like radiographic images, dual-energy CT images, MR images, diffusion tensor images as well as microscopic images are analyzed. The applications emphasize the high potential and the wide application range of these methods. The use of model-based image analysis methods can improve segmentation quality as well as the accuracy and reproducibility of quantitative image analysis. Furthermore, image-based models enable new insights and can lead to a deeper understanding of complex dynamic mechanisms in the human body

  3. Deep Brain Stimulation Target Selection in an Advanced Parkinson's Disease Patient with Significant Tremor and Comorbid Depression

    Directory of Open Access Journals (Sweden)

    Amar S. Patel

    2017-04-01

    Full Text Available Clinical Vignette: A 67-year-old female with advanced Parkinson's disease (PD, medically refractory tremor, and a history of significant depression presents for evaluation of deep brain stimulation (DBS candidacy.  Clinical Dilemma: Traditionally, stimulation of the subthalamic nucleus (STN has been the preferred target for patients with significant PD tremor. However, STN stimulation is avoided in patients with a significant pre-surgical history of mood disorder.  Clinical Solution: Bilateral DBS of the globus pallidus interna led to significant short term improvement in PD motor symptoms, including significant tremor reduction.  Gap in Knowledge: There is insufficient evidence to support or refute clinicians' traditional preference for STN stimulation in treating refractory PD tremor. Similarly, the available evidence for risk of worsening depression and/or suicidality after STN DBS is mixed. Both questions require further clarification to guide patient and clinician decision-making.

  4. [Organization of anesthesia management and advanced life support at military medical evacuation levels].

    Science.gov (United States)

    Shchegolev, A V; Petrakov, V A; Savchenko, I F

    2014-07-01

    Anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels in armed conflict (local war) is time-consuming and resource-requiring task. One of the mathematical modeling methods was used to evaluate capabilities of anesthesia and intensive care units at tactical level. Obtained result allows us to tell that there is a need to make several system changes of the existing system of anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels. In addition to increasing number of staff of anesthesiology-critical care during the given period of time another solution should be the creation of an early evacuation to a specialized medical care level by special means while conducting intensive monitoring and treatment.

  5. Prognostic significance of obstructive uropathy in advanced prostate cancer.

    Science.gov (United States)

    Oefelein, Michael G

    2004-06-01

    To report the incidence and prognostic implications of obstructive uropathy (OU) in patients with advanced prostate cancer receiving androgen deprivation therapy and to define the impact initial local therapy has on the development of OU in patients with prostate cancer who develop recurrence and begin androgen deprivation therapy. From a population of 260 patients with advanced prostate cancer diagnosed between 1986 and 2003, OU was identified in 51 patients. The OU treatment options included ureteral stent, percutaneous nephrostomy, transurethral resection of the prostate, Foley catheter placement, and urinary diversion. Overall survival and the factors that influenced survival were calculated using standard statistical methods. OU was diagnosed in 15 (16%) of 80 patients who received local therapy with curative intent and in whom local therapy subsequently failed and in 36 (19%) of 180 patients who had never received local therapy (P = 0.7, chi-square test). Of these 51 patients, 39 had bladder neck obstruction and 16 had ureteral obstruction. Overall survival was significantly worse for the men with OU compared with those without OU (41 versus 54 months). OU was associated with tumor stage and androgen-insensitive prostate cancer. OU results in significantly reduced survival in men with prostate cancer. In a select group of patients with prostate cancer with progression after local therapy (primarily radiotherapy), no statistically significant reduction in the development of OU was observed relative to patients matched for stage, grade, and pretreatment prostate-specific antigen level treated with androgen deprivation therapy alone. Aggressive advanced stage and hormone-insensitive disease are variables associated with OU.

  6. Advanced Medication Dispenser

    Directory of Open Access Journals (Sweden)

    A.I. Alexan

    2013-12-01

    Full Text Available Medication dispensing is an important activity that can have major implications if done improperly. Dispensing must be done in the correct time interval, at the correct user, with the correct drug and dose. We propose a smart medication dispenser that can satisfy these needs and provide a mechanism for supervision. In order to ensure that the dispensing process is error free, the concept of a new smart medication container is used. A smart medication container is “smart” as it holds the medication dispensing parameters for the drugs it contains: dispensing time and date and name. Based on this information, the actual dispensing is done.

  7. The consequences of using advanced physical assessment skills in medical and surgical nursing: A hermeneutic pragmatic study.

    Science.gov (United States)

    Zambas, Shelaine I; Smythe, Elizabeth A; Koziol-Mclain, Jane

    2016-01-01

    The aim of this study was to explore the consequences of the nurse's use of advanced assessment skills on medical and surgical wards. Appropriate, accurate, and timely assessment by nurses is the cornerstone of maintaining patient safety in hospitals. The inclusion of "advanced" physical assessment skills such as auscultation, palpation, and percussion is thought to better prepare nurses for complex patient presentations within a wide range of clinical situations. This qualitative study used a hermeneutic pragmatic approach. Unstructured interviews were conducted with five experienced medical and surgical nurses to obtain 13 detailed narratives of assessment practice. Narratives were analyzed using Van Manen's six-step approach to identify the consequences of the nurse's use of advanced assessment skills. The consequences of using advanced assessment skills include looking for more, challenging interpretations, and perseverance. The use of advanced assessment skills directs what the nurse looks for, what she sees, interpretation of the findings, and her response. It is the interpretation of what is seen, heard, or felt within the full context of the patient situation, which is the advanced skill. Advanced assessment skill is the means to an accurate interpretation of the clinical situation and contributes to appropriate diagnosis and medical management in complex patient situations. The nurse's use of advanced assessment skills enables her to contribute to diagnostic reasoning within the acute medical and surgical setting.

  8. Medical image computing for computer-supported diagnostics and therapy. Advances and perspectives.

    Science.gov (United States)

    Handels, H; Ehrhardt, J

    2009-01-01

    Medical image computing has become one of the most challenging fields in medical informatics. In image-based diagnostics of the future software assistance will become more and more important, and image analysis systems integrating advanced image computing methods are needed to extract quantitative image parameters to characterize the state and changes of image structures of interest (e.g. tumors, organs, vessels, bones etc.) in a reproducible and objective way. Furthermore, in the field of software-assisted and navigated surgery medical image computing methods play a key role and have opened up new perspectives for patient treatment. However, further developments are needed to increase the grade of automation, accuracy, reproducibility and robustness. Moreover, the systems developed have to be integrated into the clinical workflow. For the development of advanced image computing systems methods of different scientific fields have to be adapted and used in combination. The principal methodologies in medical image computing are the following: image segmentation, image registration, image analysis for quantification and computer assisted image interpretation, modeling and simulation as well as visualization and virtual reality. Especially, model-based image computing techniques open up new perspectives for prediction of organ changes and risk analysis of patients and will gain importance in diagnostic and therapy of the future. From a methodical point of view the authors identify the following future trends and perspectives in medical image computing: development of optimized application-specific systems and integration into the clinical workflow, enhanced computational models for image analysis and virtual reality training systems, integration of different image computing methods, further integration of multimodal image data and biosignals and advanced methods for 4D medical image computing. The development of image analysis systems for diagnostic support or

  9. Significance of Metabolic Super scan in Patients With Locally Advanced Bladder Cancer

    International Nuclear Information System (INIS)

    Kotb, M.H.; El-Kholy, E.; Omar, W.; El-Refaei, S.; Taher, A.N.; El-Marakby, H.

    2011-01-01

    Non-metastatic metabolic related skeletal changes are predicted in patients with locally advanced bladder cancer. Renal impairment may be a contributing factor in such abnormalities. The aim of this study was to verify the presence of metabolic bone disease in patients with different pathological subgroups of locally advanced bladder cancer and determine its clinical impact, and to correlate these metabolic super scan features with variable laboratory tests of bone bio markers and renal functions. In this study, a total of 350 patients (mean age = 58±8.4 y) with histopathologically proven locally advanced bladder cancer; 238 transitional cell carcinoma (TCC), 100 squamous cell carcinoma (SCC), 7 adenocarcinoma, 2 mucinous adenocarcinoma, 2 undifferentiated carcinoma and 1 leiomyosarcoma. The patients were referred to the Nuclear Medicine Unit, National Cancer Institute, Cairo, Egypt, between July 2006 and December 2009. Whole body bone scan was obtained 3 hours following IV administration of 555-925 MBq Tc-99m MDP. Serum alkaline phosphatase (ALP), calcium and parathormone (PTH) levels were monitored as markers for bone metabolism while serum creatinine was used to monitor kidney function. The exclusion criteria included patients who had liver disease or those taking calcium or vitamin D supplement or any medication that affects bone metabolism. All bone scan results in the study were verified by correlation with other radiological imaging, laboratory data and follow-up for at least 12 months. According to bone scan results, patients were classified into four groups: group A: normal scan (n=223), group B: metabolic super scan features (MSS) (n=70), group C: metastatic bone disease (n=45) and group D: bone scan with indeterminate lesions (n=12). Osteomalacic MSS features were detected in 20 % of the studied patients (locally advanced bladder cancer) compared to 14.5% who had bone metastases. Contrary to metastases which showed high prevalence in TCC (P<0.001), MSS

  10. Prognostic significance of normal-sized ovary in advanced serous epithelial ovarian cancer.

    Science.gov (United States)

    Paik, E Sun; Kim, Ji Hye; Kim, Tae Joong; Lee, Jeong Won; Kim, Byoung Gie; Bae, Duk Soo; Choi, Chel Hun

    2018-01-01

    We compared survival outcomes of advanced serous type epithelial ovarian cancer (EOC) patients with normal-sized ovaries and enlarged-ovarian tumors by propensity score matching analysis. The medical records of EOC patients treated at Samsung Medical Center between 2002 and 2015 were reviewed retrospectively. We investigated EOC patients with high grade serous type histology and International Federation of Gynecology and Obstetrics (FIGO) stage IIIB, IIIC, or IV who underwent primary debulking surgery (PDS) and adjuvant chemotherapy to identify patients with normal-sized ovaries. Propensity score matching was performed to compare patients with normal-sized ovaries to patients with enlarged-ovarian tumors (ratio, 1:3) according to age, FIGO stage, initial cancer antigen (CA)-125 level, and residual disease status after PDS. Of the 419 EOC patients, 48 patients had normal-sized ovary. Patients with enlarged-ovarian tumor were younger (54.0±10.3 vs. 58.4±9.2 years, p=0.005) than those with normal-sized ovary, and there was a statistically significant difference in residual disease status between the 2 groups. In total cohort with a median follow-up period of 43 months (range, 3-164 months), inferior overall survival (OS) was shown in the normal-sized ovary group (median OS, 71.2 vs. 41.4 months; p=0.003). After propensity score matching, the group with normal-sized ovary showed inferior OS compared to the group with enlarged-ovarian tumor (median OS, 72.1 vs. 41.4 months; p=0.031). In multivariate analysis for OS, normal-sized ovary remained a significant factor. Normal-sized ovary was associated with poor OS compared with the common presentation of enlarged ovaries in EOC, independent of CA-125 level or residual disease. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

  11. Recent advances in medical device triage technologies for chemical, biological, radiological, and nuclear events.

    Science.gov (United States)

    Lansdowne, Krystal; Scully, Christopher G; Galeotti, Loriano; Schwartz, Suzanne; Marcozzi, David; Strauss, David G

    2015-06-01

    In 2010, the US Food and Drug Administration (Silver Spring, Maryland USA) created the Medical Countermeasures Initiative with the mission of development and promoting medical countermeasures that would be needed to protect the nation from identified, high-priority chemical, biological, radiological, or nuclear (CBRN) threats and emerging infectious diseases. The aim of this review was to promote regulatory science research of medical devices and to analyze how the devices can be employed in different CBRN scenarios. Triage in CBRN scenarios presents unique challenges for first responders because the effects of CBRN agents and the clinical presentations of casualties at each triage stage can vary. The uniqueness of a CBRN event can render standard patient monitoring medical device and conventional triage algorithms ineffective. Despite the challenges, there have been recent advances in CBRN triage technology that include: novel technologies; mobile medical applications ("medical apps") for CBRN disasters; electronic triage tags, such as eTriage; diagnostic field devices, such as the Joint Biological Agent Identification System; and decision support systems, such as the Chemical Hazards Emergency Medical Management Intelligent Syndromes Tool (CHEMM-IST). Further research and medical device validation can help to advance prehospital triage technology for CBRN events.

  12. Advances in intelligent analysis of medical data and decision support systems

    CERN Document Server

    Iantovics, Barna

    2013-01-01

    This volume is a result of the fruitful and vivid discussions during the MedDecSup'2012 International Workshop bringing together a relevant body of knowledge, and new developments in the increasingly important field of medical informatics. This carefully edited book presents new ideas aimed at the development of intelligent processing of various kinds of medical information and the perfection of the contemporary computer systems for medical decision support. The book presents advances of the medical information systems for intelligent archiving, processing, analysis and search-by-content which will improve the quality of the medical services for every patient and of the global healthcare system. The book combines in a synergistic way theoretical developments with the practicability of the approaches developed and presents the last developments and achievements in  medical informatics to a broad range of readers: engineers, mathematicians, physicians, and PhD students.

  13. [Significance of the doctorate in scientific medical education].

    Science.gov (United States)

    Frosch, Matthias

    2018-02-01

    According to European and German law, the medical education of physicians must take place in a scientific degree program at a university or under the supervision of a university. To keep up the ideal of a scientific degree program, various organizations and associations, such as the German Research Foundation, the German Council of Science and Humanities and the German Medical Faculty Association, see the need for an even stronger anchoring of academic learning content in the course of study. Traditionally, a scientific project, which is carried out during the studies, provides the basis for the Doctor of Medicine (Dr. med.) after graduation, although the research projects as a basis for medical degrees are currently not obligatory parts of the curricula. The number of medical students performing such research projects is significantly decreasing, thus they are missing major skills for working in science. To counteract these developments, faculties of medicine are currently developing model curricula including deepened scientific education. Despite these efforts, the German Association of Faculties of Medicine argues that the performance of research projects leading to the doctoral degree is most suitable for obtaining expertise in scientific work. According to recommendations by the German Council of Science on the requirements for quality assurance of graduation doctoral degree programs have been introduced. This and further measures, like MD/PhD programs or research-based additional study programs serving the scientific qualification of medical students, are the subject of this article.

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

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg, Pharm.D.

    2010-01-01

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

  15. Evaluation of the Effectiveness of an Advance Organizer in a Medical Microbiology Course.

    Science.gov (United States)

    Slock, James A.; And Others

    1980-01-01

    An advance organizer is a set of conceptual statements about the unifying ideas of a topic in terms already familiar to the learner. A study is reported that sought to determine whether two presentations of an advance organizer for a unit on pathogenic bacteria would result in increasing medical students' knowledge and ability to solve problems in…

  16. Holistic integrative medicine: toward a new era of medical advancement.

    Science.gov (United States)

    Fan, Daiming

    2017-03-01

    Medicine has encountered unprecedented problems associated with changes in nature, society, and environment, as well as with new human quests for survival, longevity, and health. In the meantime, the development of medicine is facing challenges that resulted from the over-division and specialization of disciplines and the fragmentation of medical knowledge. To construct a new medical system that is more suitable for human health and disease treatment, holistic integrative medicine (HIM), which regards the human body as a holistic entity, organically integrates the most advanced knowledge and theories in each medical field and the most effective practices in various clinical specialties to revise and adjust on the basis of social, environmental, and psychological conditions. HIM is the inevitable and necessary direction for the future development of medicine. In this article, we illustrated the connotation of HIM, the differences between HIM and other medical conceptions, and the practice of HIM in recent years.

  17. 1st International Conference on Advancements of Medical Electronics

    CERN Document Server

    Bag, Sandip; Ganguly, Karabi; Sarkar, Indranath; Biswas, Papun

    2015-01-01

    The book is a collection of peer-reviewed scientific papers submitted by active researchers in the 1st International Conference on Advancements of Medical Electronics (ICAME2015). The conference is organized jointly by the Department of Biomedical Engineering and Electronics and Communication Engineering, JIS College of Engineering, West Bengal, India. The primary objective of the conference is to strengthen interdisciplinary research and its applications for the welfare of humanity. A galaxy of academicians, professionals, scientists, statesman and researchers from different parts of the country and abroad got together and shared their knowledge. The book presents research articles of medical image processing & analysis, biomedical instrumentation & measurements, DSP & clinical applications, embedded systems & its applications in healthcare. The book can be referred as a tool for further research.

  18. The Medical Academic Advancement Program at the University of Virginia School of Medicine.

    Science.gov (United States)

    Fang, W L; Woode, M K; Carey, R M; Apprey, M; Schuyler, J M; Atkins-Brady, T L

    1999-04-01

    Since 1984 the University of Virginia School of Medicine has conducted the Medical Academic Advancement Program for minority and disadvantaged students interested in careers in medicine. The program is a six-week residential program for approximately 130 undergraduate and post-baccalaureate students per year. It emphasizes academic course work--biology, chemistry, physics, and essay writing--to prepare the participants for the Medical College Admission Test. Non-graded activities, such as a clinical medicine lecture series, clinical experiences, and a special lecture series, and special workshops are also offered. The participants take two simulated MCAT exams. Between 1984 and 1998, 1,497 students have participated in the program, with complete follow-up information available for 690 (46%). Of the 1,487 participants, 80 (5%) have graduated from the University of Virginia School of Medicine and 174 (12%) from other medical schools; 44 (3%) are attending the medical school now, and 237 (16%) are at other medical schools; 44 (3%) have graduated from other health professions schools, and 54 (3%) are attending such schools. The retention rate for participants at the University of Virginia School of Medicine is 91% (that is, all but seven of the 80 who matriculated have been retained past the first year). The Medical Academic Advancement Program has been successful in increasing the number of underrepresented minority students matriculating into and continuing in medical education. Such programs warrant continued support and encouragement.

  19. Advanced robotics for medical rehabilitation current state of the art and recent advances

    CERN Document Server

    Xie, Shane

    2016-01-01

    Focussing on the key technologies in developing robots for a wide range of medical rehabilitation activities – which will include robotics basics, modelling and control, biomechanics modelling, rehabilitation strategies, robot assistance, clinical setup/implementation as well as neural and muscular interfaces for rehabilitation robot control – this book is split into two parts; a review of the current state of the art, and recent advances in robotics for medical rehabilitation. Both parts will include five sections for the five key areas in rehabilitation robotics: (i) the upper limb; (ii) lower limb for gait rehabilitation (iii) hand, finger and wrist; (iv) ankle for strains and sprains; and (v) the use of EEG and EMG to create interfaces between the neurological and muscular functions of the patients and the rehabilitation robots. Each chapter provides a description of the design of the device, the control system used, and the implementation and testing to show how it fulfils the needs of that specific ...

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

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg

    2010-06-01

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

  1. Integrating advanced practice providers into medical critical care teams.

    Science.gov (United States)

    McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

    2013-03-01

    Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings.

  2. Do patients discharged from advanced practice physiotherapy-led clinics re-present to specialist medical services?

    Science.gov (United States)

    Chang, Angela T; Gavaghan, Belinda; O'Leary, Shaun; McBride, Liza-Jane; Raymer, Maree

    2017-05-15

    Objective The aim of the present study was to determine the rates of re-referral to specialist out-patient clinics for patients previously managed and discharged from an advanced practice physiotherapy-led service in three metropolitan hospitals. Methods A retrospective audit was undertaken of 462 patient cases with non-urgent musculoskeletal conditions discharged between 1 April 2014 and 30 March 2015 from three metropolitan hospitals. These patients had been discharged from the physiotherapy-led service without requiring specialist medical review. Rates and patterns of re-referral to specialist orthopaedic, neurosurgical, chronic pain, or rheumatology services within 12 months of discharge were investigated. Results Forty-six of the 462 patients (10.0%) who were managed by the physiotherapy-led service were re-referred to specialist medical orthopaedic, neurosurgical, chronic pain or rheumatology departments within 12 months of discharge. Only 22 of these patients (4.8%) were re-referred for the same condition as managed previously and discharged. Conclusions Ninety-five per cent of patients with non-urgent musculoskeletal conditions managed by an advanced practice physiotherapy-led service at three metropolitan hospitals did not re-present to access public specialist medical services for the same condition within 12 months of discharge. This is the first time that re-presentation rates have been reported for patients managed in advanced practice physiotherapy services and the findings support the effectiveness of these models of care in managing demand for speciality out-patient services. What is known about the topic? Advanced practice physiotherapy-led services have been implemented to address the needs of patients referred with non-urgent musculoskeletal conditions to hospital specialist out-patient services. Although this model is widely used in Australia, there has been very little information about whether patients managed in these services subsequently re

  3. A Review of Significant Advances in Neutron Imaging from Conception to the Present

    Science.gov (United States)

    Brenizer, J. S.

    This review summarizes the history of neutron imaging with a focus on the significant events and technical advancements in neutron imaging methods, from the first radiograph to more recent imaging methods. A timeline is presented to illustrate the key accomplishments that advanced the neutron imaging technique. Only three years after the discovery of the neutron by English physicist James Chadwick in 1932, neutron imaging began with the work of Hartmut Kallmann and Ernst Kuhn in Berlin, Germany, from 1935-1944. Kallmann and Kuhn were awarded a joint US Patent issued in January 1940. Little progress was made until the mid-1950's when Thewlis utilized a neutron beam from the BEPO reactor at Harwell, marking the beginning of the application of neutron imaging to practical applications. As the film method was improved, imaging moved from a qualitative to a quantitative technique, with applications in industry and in nuclear fuels. Standards were developed to aid in the quantification of the neutron images and the facility's capabilities. The introduction of dynamic neutron imaging (initially called real-time neutron radiography and neutron television) in the late 1970's opened the door to new opportunities and new challenges. As the electronic imaging matured, the introduction of the CCD imaging devices and solid-state light intensifiers helped address some of these challenges. Development of improved imaging devices for the medical community has had a major impact on neutron imaging. Additionally, amorphous silicon sensors provided improvements in temporal resolution, while providing a reasonably large imaging area. The development of new neutron imaging sensors and the development of new neutron imaging techniques in the past decade has advanced the technique's ability to provide insight and understanding of problems that other non-destructive techniques could not provide. This rapid increase in capability and application would not have been possible without the

  4. The presence of advanced lesions and associating risk factors for advanced cervical carcinoma in patients with atypical sguamous cells of undetermined significance.

    Science.gov (United States)

    Sun, L L; Chen, W; Fan, Y Y; Wang, M L; Wang, L N

    2015-01-01

    To characterize histopathological status, high-risk human papillomavirus (hr-HPV) infection status, and associated risk factors in patients with atypical squamous cells of undetermined significance (ASCUS). Cervical biopsies obtained from 130 ASCUS patients were subjected to histopathological examination and hr-HPV testing. Associations between advanced lesions and hr-HPV load or age were analyzed, and the confounding factors for high-grade cervical lesions were identified. Cervical biopsies from ASCUS patients had a wide range of pathological states, ranging from normal to invasive cervical carcinoma. High-risk HPV infection was significantly associated with advanced cervical lesions in ASCUS patients; hr-HPV infection and the number of gestations were risk factors for developing advanced cervical disease. A significant portion of ASCUS patients harbor advanced cervical lesions. The number of gestations and hr-HPV infection can increase the risk of developing advanced cervical lesions in ASCUS patients.

  5. The use of advanced medical technologies at home: a systematic review of the literature.

    Science.gov (United States)

    Ten Haken, Ingrid; Ben Allouch, Somaya; van Harten, Wim H

    2018-02-26

    The number of medical technologies used in home settings has increased substantially over the last 10-15 years. In order to manage their use and to guarantee quality and safety, data on usage trends and practical experiences are important. This paper presents a literature review on types, trends and experiences with the use of advanced medical technologies at home. The study focused on advanced medical technologies that are part of the technical nursing process and 'hands on' processes by nurses, excluding information technology such as domotica. The systematic review of literature was performed by searching the databases MEDLINE, Scopus and Cinahl. We included papers from 2000 to 2015 and selected articles containing empirical material. The review identified 87 relevant articles, 62% was published in the period 2011-2015. Of the included studies, 45% considered devices for respiratory support, 39% devices for dialysis and 29% devices for oxygen therapy. Most research has been conducted on the topic 'user experiences' (36%), mainly regarding patients or informal caregivers. Results show that nurses have a key role in supporting patients and family caregivers in the process of homecare with advanced medical technologies and in providing information for, and as a member of multi-disciplinary teams. However, relatively low numbers of articles were found studying nurses perspective. Research on medical technologies used at home has increased considerably until 2015. Much is already known on topics, such as user experiences; safety, risks, incidents and complications; and design and technological development. We also identified a lack of research exploring the views of nurses with regard to medical technologies for homecare, such as user experiences of nurses with different technologies, training, instruction and education of nurses and human factors by nurses in risk management and patient safety.

  6. Health-illness transition among persons using advanced medical technology at home.

    Science.gov (United States)

    Fex, Angelika; Flensner, Gullvi; Ek, Anna-Christina; Söderhamn, Olle

    2011-06-01

    This study aimed to elucidate meanings of health-illness transition experiences among adult persons using advanced medical technology at home. As an increasing number of persons perform self-care while using different sorts of advanced medical technology at home, knowledge about health-illness transition experiences in this situation may be useful to caregivers in supporting these patients. A qualitative design was used. Five women and five men, all of whom performed self-care at home, either using long-term oxygen therapy from a ventilator or oxygen cylinder, or performing peritoneal or haemodialysis, were interviewed. Ethics committee approval was obtained. Informed consent was received from all participants, and ethical issues concerning their rights in research were raised. The interviews were analysed using a phenomenological hermeneutical methodology, including both an inductive and a deductive structural analysis. This method offers possibilities to obtain an increased understanding by uncovering a deeper meaning of lived experiences through interviews transcribed as texts. The health-illness transition for adult persons in this context was found to mean a learning process of accepting, managing, adjusting and improving daily life with technology, facilitated by realizing the gain from technology at home. Further, the meaning of the health-illness transition experience was interpreted as contentment with being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The healthy transition experience was characterized by human growth and becoming. This study elucidates one meaning of health-illness transition experiences in relation to the use of advanced medical technology on a more generic level, independent of the specific type of technology used. A positive attitude towards technology at home facilitates the transition. © 2010 The Authors. Scandinavian Journal of

  7. Effect of ionizing radiation on advanced life support medications

    International Nuclear Information System (INIS)

    Sullivan, D.J.; Hubbard, L.B.; Broadbent, M.V.; Stewart, P.; Jaeger, M.

    1987-01-01

    Advanced life support medications stored in emergency department stretcher areas, diagnostic radiology rooms, and radiotherapy suites are exposed to ionizing radiation. We hypothesized that radiation may decrease the potency and thus the shelf life of medications stored in these areas. Atropine, dopamine, epinephrine, and isoproterenol were exposed to a wide range of ionizing radiation. The potency of the four drugs was unaffected by levels of radiation found in ED stretcher areas and high-volume diagnostic radiograph rooms (eg, chest radiograph, computed tomography, fluoroscopy). The potency of atropine may be reduced by gamma radiation in high-use radiotherapy suites. However, dopamine, epinephrine, and isoproterenol were unaffected by high doses of gamma radiation. Atropine, dopamine, epinephrine, and isoproterenol may be safely kept in ED stretcher areas and diagnostic radiology rooms without loss of potency over the shelf life of the drugs

  8. Early bedside care during preclinical medical education: can technology-enhanced patient simulation advance the Flexnerian ideal?

    Science.gov (United States)

    Gordon, James A; Hayden, Emily M; Ahmed, Rami A; Pawlowski, John B; Khoury, Kimberly N; Oriol, Nancy E

    2010-02-01

    Flexner wanted medical students to study at the patient bedside-a remarkable innovation in his time-so that they could apply science to clinical care under the watchful eye of senior physicians. Ever since his report, medical schools have reserved the latter years of their curricula for such an "advanced" apprenticeship, providing clinical clerkship experiences only after an initial period of instruction in basic medical sciences. Although Flexner codified the segregation of preclinical and clinical instruction, he was committed to ensuring that both domains were integrated into a modern medical education. The aspiration to fully integrate preclinical and clinical instruction continues to drive medical education reform even to this day. In this article, the authors revisit the original justification for sequential preclinical-clinical instruction and argue that modern, technology-enhanced patient simulation platforms are uniquely powerful for fostering simultaneous integration of preclinical-clinical content in a way that Flexner would have applauded. To date, medical educators tend to focus on using technology-enhanced medical simulation in clinical and postgraduate medical education; few have devoted significant attention to using immersive clinical simulation among preclinical students. The authors present an argument for the use of dynamic robot-mannequins in teaching basic medical science, and describe their experience with simulator-based preclinical instruction at Harvard Medical School. They discuss common misconceptions and barriers to the approach, describe their curricular responses to the technique, and articulate a unifying theory of cognitive and emotional learning that broadens the view of what is possible, feasible, and desirable with simulator-based medical education.

  9. [Significance of COI disclosure in medical research in Japan].

    Science.gov (United States)

    Sone, Saburo

    2011-11-01

    In medical research, remarkable increase in collaboration with industry, public organizations such as universities, research institutions, and academic societies makes researchers to be more deeply involved with the activities of commercial entities. Activities of education and research, which are the responsibilities of academic institutions and societies, conflict with the interests of individuals associated with industrial-academic collaboration. Management of such conflict of interest (COI) is of much importance for academic institutions and societies to appropriately promote industrial-academic collaborative activities. Particularly, participation not only by healthy individuals, but also patients, is essential in the medical field as subjects of clinical research. For those involved in medical research, the deeper the level of COI with commercial entities, who are the financial or benefit provider, becomes serious, the more human rights of subjects could be violated, safety of life could be endangered, and research methods, data analysis and interpretation of results could be distorted. It is also possible that research may be unfairly evaluated or not published, even if the results are accurate, sometimes resulting in the ascertained effects of reporting bias included the overestimation of efficacy and the underestimation of safety risks of interventions. According to the COI management guideline of the Japanese Association of Medical Science (JAMS), significance of COI management is discussed.

  10. Medical significance of the essential biological metals

    International Nuclear Information System (INIS)

    Davies, I.J.T.

    1977-01-01

    The medical significance of the essential biological metals such as zinc, copper and molybdenum as well as their nutritional and biochemical importance are reviewed. The following topics are treated: biochemical actions of the essential biological metals; the concept of essentiality; the development of knowledge about the essential biological metals. Data are given on zinc deficiency and hypogonadismi in humans, zinc and acrodermatitis enterophatica, zinc and the skin, zinc in diabetes mellitus, zinc and insulin, zinc and the liver; copper functions, copper deficiency - ''sway back'' in sheep, copper and haemopoiesis, copper and the function of blood vessels; molybdenum and dental caries in humans, oesophageal carcinoma and molybdenum deficiency in humans. (T.G.)

  11. Some advances in medical applications of low energy accelerators

    Science.gov (United States)

    Valković, V.; Moschini, G.

    1991-05-01

    Medical applications of low energy accelerators include: the use of nuclear analytical methods and procedures for laboratory studies and routine measurements; material productions and modifications to meet special requirements; radioisotope productions and their applications in radiopharmaceuticals as well as in positron emission tomography; and radiotherapy with ions, based on improved understanding of the interaction of charged particles with living tissue. Some of the recent advances in these fields are critically summarized. The plan for an improved charged particle facility in a hospital environment dedicated to applications in biology and medicine is presented.

  12. Effect of Advanced Trauma Life Support program on medical interns' performance in simulated trauma patient management.

    Science.gov (United States)

    Ahmadi, Koorosh; Sedaghat, Mohammad; Safdarian, Mahdi; Hashemian, Amir-Masoud; Nezamdoust, Zahra; Vaseie, Mohammad; Rahimi-Movaghar, Vafa

    2013-01-01

    Since appropriate and time-table methods in trauma care have an important impact on patients'outcome, we evaluated the effect of Advanced Trauma Life Support (ATLS) program on medical interns' performance in simulated trauma patient management. A descriptive and analytical study before and after the training was conducted on 24 randomly selected undergraduate medical interns from Imam Reza Hospital in Mashhad, Iran. On the first day, we assessed interns' clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre- and post- ATLS periods, were compared through SPSS version 15.0 software. P values less than 0.05 were considered statistically significant. Our findings showed that interns'ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns' clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P less than 0.001, P equal to 0.016 and P equal to 0.01 respectively). ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.

  13. New players for advanced prostate cancer and the rationalisation of insulin-sensitising medication.

    Science.gov (United States)

    Gunter, Jennifer H; Sarkar, Phoebe L; Lubik, Amy A; Nelson, Colleen C

    2013-01-01

    Obesity and type 2 diabetes are recognised risk factors for the development of some cancers and, increasingly, predict more aggressive disease, treatment failure, and cancer-specific mortality. Many factors may contribute to this clinical observation. Hyperinsulinaemia, dyslipidaemia, hypoxia, ER stress, and inflammation associated with expanded adipose tissue are thought to be among the main culprits driving malignant growth and cancer advancement. This observation has led to the proposal of the potential utility of "old players" for the treatment of type 2 diabetes and metabolic syndrome as new cancer adjuvant therapeutics. Androgen-regulated pathways drive proliferation, differentiation, and survival of benign and malignant prostate tissue. Androgen deprivation therapy (ADT) exploits this dependence to systemically treat advanced prostate cancer resulting in anticancer response and improvement of cancer symptoms. However, the initial therapeutic response from ADT eventually progresses to castrate resistant prostate cancer (CRPC) which is currently incurable. ADT rapidly induces hyperinsulinaemia which is associated with more rapid treatment failure. We discuss current observations of cancer in the context of obesity, diabetes, and insulin-lowering medication. We provide an update on current treatments for advanced prostate cancer and discuss whether metabolic dysfunction, developed during ADT, provides a unique therapeutic window for rapid translation of insulin-sensitising medication as combination therapy with antiandrogen targeting agents for the management of advanced prostate cancer.

  14. Teaching Medical Students About "The Conversation": An Interactive Value-Based Advance Care Planning Session.

    Science.gov (United States)

    Lum, Hillary D; Dukes, Joanna; Church, Skotti; Abbott, Jean; Youngwerth, Jean M

    2018-02-01

    Advance care planning (ACP) promotes care consistent with patient wishes. Medical education should teach how to initiate value-based ACP conversations. To develop and evaluate an ACP educational session to teach medical students a value-based ACP process and to encourage students to take personal ACP action steps. Groups of third-year medical students participated in a 75-minute session using personal reflection and discussion framed by The Conversation Starter Kit. The Conversation Project is a free resource designed to help individuals and families express their wishes for end-of-life care. One hundred twenty-seven US third-year medical students participated in the session. Student evaluations immediately after the session and 1 month later via electronic survey. More than 90% of students positively evaluated the educational value of the session, including rating highly the opportunities to reflect on their own ACP and to use The Conversation Starter Kit. Many students (65%) reported prior ACP conversations. After the session, 73% reported plans to discuss ACP, 91% had thought about preferences for future medical care, and 39% had chosen a medical decision maker. Only a minority had completed an advance directive (14%) or talked with their health-care provider (1%). One month later, there was no evidence that the session increased students' actions regarding these same ACP action steps. A value-based ACP educational session using The Conversation Starter Kit successfully engaged medical students in learning about ACP conversations, both professionally and personally. This session may help students initiate conversations for themselves and their patients.

  15. Improving medical graduates' training in palliative care: advancing education and practice

    Directory of Open Access Journals (Sweden)

    Head BA

    2016-02-01

    Full Text Available Barbara A Head,1 Tara J Schapmire,1 Lori Earnshaw,1 John Chenault,2 Mark Pfeifer,1 Susan Sawning,3 Monica A Shaw,3 1Division of General Internal Medicine, Palliative Care and Medical Education, University of Louisville School of Medicine, 2Kornhouser Health Sciences Library, University of Louisville, 3Undergraduate Medical Education Office, University of Louisville School of Medicine, Louisville, KY, USA Abstract: The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients. Keywords: medical education, palliative care, end-of-life care

  16. Urogenital disease: current medical need and recent advances.

    Science.gov (United States)

    Holoboski, M

    1998-11-01

    The Medicinal Chemistry Division session on Urogenital Disease began with an overview by Dr P-O Andersson (Pharmacia and Upjohn, MI, USA) of current medical need and recent advances in the field. Dr Andersson drew attention to the limited interest that pharmaceutical companies have historically shown in the area of non-malignant diseases of the urogenital tract. Conditions such as bladder overactivity and urinary incontinence, benign prostatic hyperplasia (BPH) and erectile dysfunction have been poorly understood and have been regarded as unavoidable consequences of old age. One factor, which further compounds the problem, is that many people do not seek treatment, a practice which tends to lower the awareness of these conditions.

  17. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Tony [University of Newcastle Department of Rural Health, Taree, New South Wales (Australia); Harris, Jillian [Crown Princess Mary Cancer Centre, Westmead, Sydney, New South Wales (Australia); Woznitza, Nick [Homerton University Hospital and School of Allied Health Professions, Canterbury Christ Church University, Canterbury (Australia); Maresse, Sharon [Department of Imaging and Applied Physics, Curtin University, Perth, Western Australia (Australia); Sale, Charlotte [School of Medical Science, RMIT University, Melbourne, Victoria (Australia); University of Newcastle Department of Rural Health, Taree, New South Wales (Australia)

    2015-09-15

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as ‘a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care’. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to differences in demography, the health system and industrial relations. This article describes a conceptual model of advanced practitioner characteristics in the medical radiation professions, taking into account experiences in other countries and professions. Using the CanMEDS framework, the model includes foundation characteristics of communication, collaboration and professionalism, which are fundamental to advanced clinical practice. Gateway characteristics are: clinical expertise, with high level competency in a particular area of clinical practice; scholarship and teaching, including a masters qualification and knowledge dissemination through educating others; and evidence-based practice, with judgements made on the basis of research findings, including research by the advanced practitioner. The pinnacle of advanced practice is clinical leadership, where the practitioner has a central role in the health care team, with the capacity to influence decision making and advocate for others, including patients. The proposed conceptual model is robust yet adaptable in defining generic characteristics of advanced practitioners, no matter their clinical specialty. The advanced practice roles that evolve to meet future health service demand must focus on the needs of patients, local populations and communities.

  18. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions

    International Nuclear Information System (INIS)

    Smith, Tony; Harris, Jillian; Woznitza, Nick; Maresse, Sharon; Sale, Charlotte

    2015-01-01

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as ‘a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care’. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to differences in demography, the health system and industrial relations. This article describes a conceptual model of advanced practitioner characteristics in the medical radiation professions, taking into account experiences in other countries and professions. Using the CanMEDS framework, the model includes foundation characteristics of communication, collaboration and professionalism, which are fundamental to advanced clinical practice. Gateway characteristics are: clinical expertise, with high level competency in a particular area of clinical practice; scholarship and teaching, including a masters qualification and knowledge dissemination through educating others; and evidence-based practice, with judgements made on the basis of research findings, including research by the advanced practitioner. The pinnacle of advanced practice is clinical leadership, where the practitioner has a central role in the health care team, with the capacity to influence decision making and advocate for others, including patients. The proposed conceptual model is robust yet adaptable in defining generic characteristics of advanced practitioners, no matter their clinical specialty. The advanced practice roles that evolve to meet future health service demand must focus on the needs of patients, local populations and communities

  19. Treatment of Advanced Glaucoma Study: a multicentre randomised controlled trial comparing primary medical treatment with primary trabeculectomy for people with newly diagnosed advanced glaucoma-study protocol.

    Science.gov (United States)

    King, Anthony J; Fernie, Gordon; Azuara-Blanco, Augusto; Burr, Jennifer M; Garway-Heath, Ted; Sparrow, John M; Vale, Luke; Hudson, Jemma; MacLennan, Graeme; McDonald, Alison; Barton, Keith; Norrie, John

    2017-10-26

    Presentation with advanced glaucoma is the major risk factor for lifetime blindness. Effective intervention at diagnosis is expected to minimise risk of further visual loss in this group of patients. To compare clinical and cost-effectiveness of primary medical management compared with primary surgery for people presenting with advanced open-angle glaucoma (OAG). Design : A prospective, pragmatic multicentre randomised controlled trial (RCT). Twenty-seven UK hospital eye services. Four hundred and forty patients presenting with advanced OAG, according to the Hodapp-Parish-Anderson classification of visual field loss. Participants will be randomised to medical treatment or augmented trabeculectomy (1:1 allocation minimised by centre and presence of advanced disease in both eyes). The primary outcome is vision-related quality of life measured by the National Eye Institute-Visual Function Questionnaire-25 at 24 months. Secondary outcomes include generic EQ-5D-5L, Health Utility Index-3 and glaucoma-related health status (Glaucoma Utility Index), patient experience, visual field measured by mean deviation value, logarithm of the mean angle of resolution visual acuity, intraocular pressure, adverse events, standards for driving and eligibility for blind certification. Incremental cost per quality-adjusted life-year (QALY) based on EQ-5D-5L and glaucoma profile instrument will be estimated. The study will report the comparative effectiveness and cost-effectiveness of medical treatment against augmented trabeculectomy in patients presenting with advanced glaucoma in terms of patient-reported health and visual function, clinical outcomes and incremental cost per QALY at 2 years. Treatment of Advanced Glaucoma Study will be the first RCT reporting outcomes from the perspective of those with advanced glaucoma. ISRCTN56878850, Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

  20. Hope or hype: the obsession with medical advances and the high cost of false promises

    National Research Council Canada - National Science Library

    Patrick, Donald L; Deyo, Richard A

    2005-01-01

    .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XV PART I Can There Be Too Much of a Good Uncritically Embracing Medical Advances Thing? The Hazards of 1 What's the Problem? Don't We Need Lifesaving New...

  1. Advancements in Undergraduate Medical Education: Meeting the Challenges of an Evolving World of Education, Healthcare, and Technology.

    Science.gov (United States)

    Shelton, P G; Corral, Irma; Kyle, Brandon

    2017-06-01

    Restructuring of undergraduate medical education (UGME) has occurred from time to time over the past century. Many influences, including the persuasive report of Abraham Flexner in 1910, acted to reorganize medical education in the early twentieth century [1, 2]. In his report, Flexner called on American medical schools to enact higher graduation standards and to stringently adhere to the protocols of mainstream science in their teaching. Prior to this report, UGME had changed little over the previous century but over the last several decades, reform within medical education has become routine. This increasing rate of change has been challenging for those within the realm of undergraduate medical education and can be frustrating to those outside this sphere. Today, the Association of American Medical Colleges (AAMC) and Liaison Committee on Medical Education (LCME) are typically the driving forces behind such changes, along with acceleration of advances in medical care and technology. The number of changes in the last decade is significant and warrants review by those interested or involved in education of medical students. This article aims to provide a summary of recent changes within UGME. Within the article, changes in both the pre-clerkship (1st and 2nd years) and clinical years (3rd and 4th) will be discussed. Finally, this review will attempt to clarify new terminology and concepts such as the recently released Core Entrustable Professional Activities (EPAs). The goal of these UGME changes, as with Flexner's reform, is to ensure future physicians are better prepared for patient care.

  2. Research Strategies for Academic Medical Centers: A Framework for Advancements toward Translational Excellence

    Science.gov (United States)

    Haley, Rand; Champagne, Thomas J., Jr.

    2017-01-01

    This review article presents a simplified framework for thinking about research strategy priorities for academic medical centers (AMCs). The framework can serve as a precursor to future advancements in translational medicine and as a set of planning guideposts toward ultimate translational excellence. While market pressures, reform uncertainties,…

  3. A preliminary investigation of opinions and behaviors regarding advance directives for medical care.

    Science.gov (United States)

    Elpern, E H; Yellen, S B; Burton, L A

    1993-03-01

    Advance directives are a means of promoting patient autonomy in end-of-life decisions but are used infrequently. A recent federal law requires healthcare organizations to provide information to patients about advance directives. This study explored attitudes and behaviors related to the use of advance directives in three areas: familiarity with advance directives, reasons for completing or not completing advance directives and preferences for receiving information about advance directives. A questionnaire was administered by personal interview to a nonrandomized convenience sample of 46 inpatients and 50 outpatients at a large, tertiary care, urban academic medical center in the summer of 1991. Most respondents (77%) had heard of either the living will or durable power of attorney for healthcare, but only 52% correctly understood the purpose of these documents. Twenty-nine percent of the sample had executed an advance directive. Those who had advance directives were older and considered themselves less healthy than did those without advance directives. Unfamiliarity with advance directives and procrastination were cited most often as reasons for not having an advance directive. Most subjects (65%) had spoken with someone, usually a family member or close friend, about preferences for treatment during a critical illness. Although they had rarely discussed advance directives, 83% anticipated that they would be comfortable doing so with a physician or a nurse. Advance directives are used infrequently to document treatment preferences. The success of programs to promote greater use of advance directives depends on a clearer understanding of the factors that influence both decision and action to execute an advance directive. Patients claim to be comfortable in discussing the topic and prefer that such discussions occur in the outpatient setting.

  4. Preparation and Characterization of an Advanced Medical Device for Bone Regeneration

    OpenAIRE

    Dorati, Rossella; Colonna, Claudia; Genta, Ida; Bruni, Giovanna; Visai, Livia; Conti, Bice

    2013-01-01

    Tridimensional scaffolds can promote bone regeneration as a framework supporting the migration of cells from the surrounding tissue into the damaged tissue and as delivery systems for the controlled or prolonged release of cells, genes, and growth factors. The goal of the work was to obtain an advanced medical device for bone regeneration through coating a decellularized and deproteinized bone matrix of bovine origin with a biodegradable, biocompatible polymer, to improve the cell engraftment...

  5. Gastric cancer: a primer on the epidemiology and biology of the disease and an overview of the medical management of advanced disease.

    Science.gov (United States)

    Shah, Manish A; Kelsen, David P

    2010-04-01

    Gastric cancer is a cause of significant morbidity and cancer-related mortality worldwide. Despite recent advances in targeted therapy and understanding of the biology and development of the malignancy, progress in the treatment of gastric cancer has been limited. Most newly diagnosed patients will present with incurable disease, and have a median survival of less than 1 year. Although the disease has widespread ethnic and epidemiologic differences, medical management of gastric cancer does not distinguish among the various disease subtypes. The recent report of the ToGA phase III study has validated Her2 as a molecular target in this disease, supporting the concept that a greater understanding of the biology of gastric cancer subsets may improve treatment selection and overall outcome of individual patients. This article summarizes the epidemiology and ethnic variation of this disease to crystalize subtypes of gastric cancer in the context of current and future medical management of advanced disease.

  6. Advances in medical imaging for the diagnosis and management of common genitourinary cancers.

    Science.gov (United States)

    Bagheri, Mohammad H; Ahlman, Mark A; Lindenberg, Liza; Turkbey, Baris; Lin, Jeffrey; Cahid Civelek, Ali; Malayeri, Ashkan A; Agarwal, Piyush K; Choyke, Peter L; Folio, Les R; Apolo, Andrea B

    2017-07-01

    Medical imaging of the 3 most common genitourinary (GU) cancers-prostate adenocarcinoma, renal cell carcinoma, and urothelial carcinoma of the bladder-has evolved significantly during the last decades. The most commonly used imaging modalities for the diagnosis, staging, and follow-up of GU cancers are computed tomography, magnetic resonance imaging (MRI), and positron emission tomography (PET). Multiplanar multidetector computed tomography and multiparametric MRI with diffusion-weighted imaging are the main imaging modalities for renal cell carcinoma and urothelial carcinoma, and although multiparametric MRI is rapidly becoming the main imaging tool in the evaluation of prostate adenocarcinoma, biopsy is still required for diagnosis. Functional and molecular imaging using 18-fluorodeoxyglucose-PET and sodium fluoride-PET are essential for the diagnosis, and especially follow-up, of metastatic GU tumors. This review provides an overview of the latest advances in the imaging of these 3 major GU cancers. Published by Elsevier Inc.

  7. Perceptions of basic, advanced, and pediatric life support training in a United States medical school.

    Science.gov (United States)

    Pillow, Malford Tyson; Stader, Donald; Nguyen, Matthew; Cao, Dazhe; McArthur, Robert; Hoxhaj, Shkelzen

    2014-05-01

    Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS) are integral parts of emergency resuscitative care. Although this training is usually reserved for residents, introducing the training in the medical student curriculum may enhance acquisition and retention of these skills. We developed a survey to characterize the perceptions and needs of graduating medical students regarding BLS, ACLS, and PALS training. This was a study of graduating 4th-year medical students at a U.S. medical school. The students were surveyed prior to participating in an ACLS course in March of their final year. Of 152 students, 109 (71.7%) completed the survey; 48.6% of students entered medical school without any prior training and 47.7% started clinics without training; 83.4% of students reported witnessing an average of 3.0 in-hospital cardiac arrests during training (range of 0-20). Overall, students rated their preparedness 2.0 (SD 1.0) for adult resuscitations and 1.7 (SD 0.9) for pediatric resuscitations on a 1-5 Likert scale, with 1 being unprepared. A total of 36.8% of students avoided participating in resuscitations due to lack of training; 98.2%, 91.7%, and 64.2% of students believe that BLS, ACLS, and PALS, respectively, should be included in the medical student curriculum. As per previous studies that have examined this topic, students feel unprepared to respond to cardiac arrests and resuscitations. They feel that training is needed in their curriculum and would possibly enhance perceived comfort levels and willingness to participate in resuscitations. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Cardiopulmonary Resuscitation Training for Medical Students in Anesthesiology Rotation in Ardabil Medical University (Iran

    Directory of Open Access Journals (Sweden)

    Kh Isazadehfar

    2009-11-01

    Full Text Available Background and purpose: Cardiopulmonary resuscitation (CPR training for undergraduate medical students has been noted to be poor in the past. Attempts have been made The aim of this study is to determine effect of CPR training in the anesthetic ward to improve knowledge and practice undergraduate medical student of CPR.Methods: A 12 month Educational experimental study with self control was done on all undergraduate medical student (n=30 at the medical university of Ardabil in 2006-2007. During I month of program allthis students have undergone CPR training including basic life support (BLS , advanced cardiac life support (ACLS and practical skills. Data were collected via questionnaire, demographic, pre/post knowledge and practice.Results: After training the acceptable score (good and very good about knowledge of BLS, ACLS and practical skill significantly increased %6.7 to %50 (p=0.0001 , %13.3 to %53.4 (p=0.001 and %3.3 to %100 (p=0.001 respectively. A significant relationship between knowledge of ACLS and practical skills was shown (p=0.005.Conclusion: The CPR training course in anesthetic ward leads to a significant increased in skills and knowledge. Adding this course to undergraduate curriculum of medical students especially in operaticallywards (e.g. Anesthetic ward is essential.Keywords: CARDIOPULMONARY RESUSCITATION; TRAINING; BASIC LIFE SUPPORT; ADVANCED CARDIAC LIFE SUPPORT

  9. The Impact of Advanced Age on Driving Safety in Adults with Medical Conditions.

    Science.gov (United States)

    Moon, Sanghee; Ranchet, Maud; Akinwuntan, Abiodun Emmanuel; Tant, Mark; Carr, David Brian; Raji, Mukaila Ajiboye; Devos, Hannes

    2018-01-01

    Adults aged 85 and older, often referred to as the oldest-old, are the fastest-growing segment of the population. The rapidly increasing number of older adults with chronic and multiple medical conditions poses challenges regarding their driving safety. To investigate the effect of advanced age on driving safety in drivers with medical conditions. We categorized 3,425 drivers with preexisting medical conditions into four age groups: middle-aged (55-64 years, n = 1,386), young-old (65-74 years, n = 1,013), old-old (75-84 years, n = 803), or oldest-old (85 years and older, n = 223). All underwent a formal driving evaluation. The outcome measures included fitness to drive recommendation by the referring physician, comprehensive fitness to drive decision from an official driving evaluation center, history of motor vehicle crashes (MVCs), and history of traffic violations. The oldest-old reported more cardiopulmonary and visual conditions, but less neurological conditions than the old-old. Compared to the middle-aged, the oldest-old were more likely to be considered unfit to drive by the referring physicians (odds ratio [OR] = 4.47, 95% confidence interval [CI] 2.20-9.10) and by the official driving evaluation center (OR = 2.74, 95% CI 1.87-4.03). The oldest-old reported more MVCs (OR = 2.79, 95% CI 1.88-4.12) compared to the middle-aged. Advanced age adversely affected driving safety outcomes. The oldest-old are a unique age group with medical conditions known to interfere with safe driving. Driving safety strategies should particularly target the oldest-old since they are the fastest-growing group and their increased frailty is associated with severe or fatal injuries due to MVCs. © 2018 S. Karger AG, Basel.

  10. Application of a latent variables model for the medical images analysis

    International Nuclear Information System (INIS)

    Campos S, Y.; Ruiz C, S.

    2008-01-01

    In recent years the technological advance has allowed the significant advance in diverse research fields, the medicine has not been exempt of this technology and the use of this technology has allowed a significant advance in the equipment that are used to obtain medical images. The quantity of information that is generated with this equipment has grown in exponential form and it is a difficult task to carry out a quantitative analysis of the data also the manipulation of big quantities of information makes the medical images analysis a complicated task. It is in fact this complexity what motivates this work where one of the main objectives is the analysis of techniques that allow to work with the complexity of the data generated with medical equipment. Likewise, it is wanted to illustrate an application of the peaceful uses of the nuclear energy to treat a medical problem where the diagnostic it depends essentially on the current medical equipment to give an appropriate treatment to the patients. (Author)

  11. Stroke: advances in medical therapy and acute stroke intervention.

    Science.gov (United States)

    Barrett, Kevin M; Lal, Brajesh K; Meschia, James F

    2015-10-01

    Evidence-based therapeutic options for stroke continue to emerge based on results from well-designed clinical studies. Ischemic stroke far exceeds hemorrhagic stroke in terms of prevalence and incidence, both in the USA and worldwide. The public health effect of reducing death and disability related to ischemic stroke justifies the resources that have been invested in identifying safe and effective treatments. The emergence of novel oral anticoagulants for ischemic stroke prevention in atrial fibrillation has introduced complexity to clinical decision making for patients with this common cardiac arrhythmia. Some accepted ischemic stroke preventative strategies, such as carotid revascularization for asymptomatic carotid stenosis, require reassessment, given advances in risk factor management, antithrombotic therapy, and surgical techniques. Intra-arterial therapy, particularly with stent retrievers after intravenous tissue plasminogen activator, has recently been demonstrated to improve functional outcomes and will require investment in system-based care models to ensure that effective treatments are received by patients in a timely fashion. The purpose of this review is to describe recent advances in medical and surgical approaches to ischemic stroke prevention and acute treatment. Results from recently published clinical trials will be highlighted along with ongoing clinical trials addressing key questions in ischemic stroke management and prevention where equipoise remains.

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

    Science.gov (United States)

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

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

  13. Melanoma and medical education: student’s perceptions of skin cancer screening in three medical schools

    Directory of Open Access Journals (Sweden)

    Margaret Finn

    2018-04-01

    Full Text Available Background: This study evaluated how the level of medical education affected confidence of counseling on skin health, performing skin examinations, and the likelihood of using those skills in future screenings. Material and Methods: An online survey was distributed to students at three midwest medical schools that assessed sun protection behaviors, and the student’s perception of education and comfort on the complete skin examination and counseling on skin health. Results: 51.6% (n=243 indicated they were in the last two years of medical school and were considered advanced students, compared to less advanced students in the first two years. Advanced students were significantly more comfortable in performing a complete skin examination and counseling patients on skin health when compared to less advanced students (p < 0.001. However, they were also statistically less likely to indicate they would provide skin screening on future patients when compared to less advanced students (p < 0.001. Only 29.5% (n = 139 and 60.7% (n = 286 of students indicated they had been educated on performing a complete skin examination and counseling on skin health, respectively. Conclusions: Although advanced students were more likely to report education and comfortability in skin cancer screening they were not as likely to indicate they would practice these skills in the future compared to less advanced students. Also, only a small number of students perceived themselves to be educated in these aspects.

  14. Radiation Protection in Medical Physics : Proceedings of the NATO Advanced Study Institute on Radiation Protection in Medical Physics Activities

    CERN Document Server

    Lemoigne, Yves

    2011-01-01

    This book introduces the fundamental aspects of Radiation Protection in Medical Physics and covers three main themes: General Radiation Protection Principles; Radiobiology Principles; Radiation Protection in Hospital Medical Physics. Each of these topics is developed by analysing the underlying physics principles and their implementation, quality and safety aspects, clinical performance and recent advances in the field. Some issues specific to the individual techniques are also treated, e.g. calculation of patient dose as well as that of workers in hospital, optimisation of equipment used, shielding design of radiation facilities, radiation in oncology such as use of brachytherapy in gynecology or interventional procedures. All topics are presented with didactical language and style, making this book an appropriate reference for students and professionals seeking a comprehensive introduction to the field as well as a reliable overview of the most recent developments.

  15. LLNL medical and industrial laser isotope separation: large volume, low cost production through advanced laser technologies

    International Nuclear Information System (INIS)

    Comaskey, B.; Scheibner, K. F.; Shaw, M.; Wilder, J.

    1998-01-01

    The goal of this LDRD project was to demonstrate the technical and economical feasibility of applying laser isotope separation technology to the commercial enrichment (>lkg/y) of stable isotopes. A successful demonstration would well position the laboratory to make a credible case for the creation of an ongoing medical and industrial isotope production and development program at LLNL. Such a program would establish LLNL as a center for advanced medical isotope production, successfully leveraging previous LLNL Research and Development hardware, facilities, and knowledge

  16. Disruptive technology: new medical advances are troublesome for even the most successful health systems and innovator health companies.

    Science.gov (United States)

    Michaelis, Lawrence; Vaul, Joanne; Chumer, Kathleen; Faul, Maureen; Sheehan, Lisa; DeCerce, Jack

    2004-01-01

    An independent expert panel conducted a multi-year research/education/advocacy initiative on the impact of the new drug-eluting stent technology. They conclude that this technology represents a "tipping point" in a series of transformative drugs and medical devices, often used in combination, and recommend that healthcare decision makers develop careful, data-based strategies to avoid the disruptiveness of these medical advances.

  17. A broadband multimedia collaborative system for advanced teleradiology and medical imaging diagnosis.

    Science.gov (United States)

    Gómez, E J; del Pozo, F; Ortiz, E J; Malpica, N; Rahms, H

    1998-09-01

    This paper presents a new telemedicine system currently in routine clinical usage, developed within the European Union (EU) ACTS BONAPARTE project (1). The telemedicine system is developed on an asynchronous transfer mode (ATM) multimedia hardware/software platform comprising the following set of telemedicine services: synchronous cooperative work, high-quality video conference, multimedia mail, medical image digitizing, processing, storing and printing, and local and remote transparent database access. The medical information handled by the platform conforms to the Digital Imaging and Communications in Medicine (DICOM) 3.0 medical imaging standard. The telemedicine system has been installed for clinical routines in three Spanish hospitals since November 1997 and has been used in an average of one/two clinical sessions per week. At each clinical session, a usability and clinical evaluation of the system was carried out. Evaluation is carried out through direct observation of interactions and questionnaire-based subjective data. The usability evaluation methodology and the results of the system usability study are also presented in this article. The experience gained from the design, development, and evaluation of the telemedicine system is providing an indepth knowledge of the benefits and difficulties involved in the installation and clinical usage of this type of high-usability and advanced multimedia telemedicine system in the field of teleradiology and collaborative medical imaging diagnosis.

  18. Adab and its significance for an Islamic medical ethics.

    Science.gov (United States)

    Sartell, Elizabeth; Padela, Aasim I

    2015-09-01

    Discussions of Islamic medical ethics tend to focus on Sharī'ah-based, or obligation-based, ethics. However, limiting Islamic medical ethics discourse to the derivation of religious duties ignores discussions about moulding an inner disposition that inclines towards adherence to the Sharī'ah. In classical Islamic intellectual thought, such writings are the concern of adab literature. In this paper, we call for a renewal of adabi discourse as part of Islamic medical ethics. We argue that adab complements Sharī'ah-based writings to generate a more holistic vision of Islamic medical ethics by supplementing an obligation-based approach with a virtue-based approach. While Sharī'ah-based medical ethics focuses primarily on the moral status of actions, adab literature adds to this genre by addressing the moral formation of the agent. By complementing Sharī'ah-based approaches with adab-focused writings, Islamic medical ethics discourse can describe the relationship between the agent and the action, within a moral universe informed by the Islamic intellectual tradition. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Effect of High-Fidelity Simulation on Medical Students' Knowledge about Advanced Life Support: A Randomized Study.

    Directory of Open Access Journals (Sweden)

    Andrea Cortegiani

    Full Text Available High-fidelity simulation (HFS is a learning method which has proven effective in medical education for technical and non-technical skills. However, its effectiveness for knowledge acquisition is less validated. We performed a randomized study with the primary aim of investigating whether HFS, in association with frontal lessons, would improve knowledge about advanced life support (ALS, in comparison to frontal lessons only among medical students. The secondary aims were to evaluate the effect of HFS on knowledge acquisition of different sections of ALS and personal knowledge perception. Participants answered a pre-test questionnaire consisting of a subjective (evaluating personal perception of knowledge and an objective section (measuring level of knowledge containing 100 questions about algorithms, technical skills, team working/early warning scores/communication strategies according to ALS guidelines. All students participated in 3 frontal lessons before being randomized in group S, undergoing a HFS session, and group C, receiving no further interventions. After 10 days from the end of each intervention, both groups answered a questionnaire (post-test with the same subjective section but a different objective one. The overall number of correct answers of the post-test was significantly higher in group S (mean 74.1, SD 11.2 than in group C (mean 65.5, SD 14.3, p = 0.0017, 95% C.I. 3.34 - 13.9. A significantly higher number of correct answers was reported in group S than in group C for questions investigating knowledge of algorithms (p = 0.0001; 95% C.I 2.22-5.99 and team working/early warning scores/communication strategies (p = 0.0060; 95% C.I 1.13-6.53. Students in group S showed a significantly higher score in the post-test subjective section (p = 0.0074. A lower proportion of students in group S confirmed their perception of knowledge compared to group C (p = 0.0079. HFS showed a beneficial effect on knowledge of ALS among medical students

  20. The impact of medical tourism and the code of medical ethics on advertisement in Nigeria.

    Science.gov (United States)

    Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

    2014-01-01

    Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done.

  1. Advancing medical-surgical nursing practice: improving management of the changing patient condition.

    Science.gov (United States)

    Monroe, Heidi; Plylar, Peggy; Krugman, Mary

    2014-01-01

    Higher patient acuities and more novice nurses on medical-surgical units have Educators focused on achieving positive outcomes with changes in patient condition. An educational program was developed to enhance nurses' knowledge, skill, and confidence in assessing hemodynamics, recognizing early signs of instability, and administering vasoactive medications. The program was successful with significant knowledge improvement as well as an increased use of the Medical Emergency Team while maintaining a low number of code calls.

  2. Clinical Significance of Tumor Marker Detection in Patients 
with Advanced Squamous Cell Carcimoma of the Lung

    Directory of Open Access Journals (Sweden)

    Ping LIANG

    2016-10-01

    Full Text Available Background and objective Due to it's concealment and no obvious symptoms, lung squamous carcimoma often has advanced disease when diagnosed. The aims of this study were to describe the characteristics of the disease, to evaluate the clinical importance of detection of multiple tumor markers in patients with squamous cell carcinoma of the lung. Methods The characteristics of all patients with advanced squamous cell lung cancer treated in Beijing Cancer Hospital of Chinese Academy of Medical Sciences during Jan. 2011 to Dec. 2015 were identified by cases reviewing and data extracting. The characteristics, detection levels and sensitivity of multiple tumor makers among patients were described. Results The 260 patients were treated with mean age of (59.4±9.2 years, 85.8% (n=223 of them were male, 14.2% (n=37 of them were female. 78.1% (n=203 of all were smokers and 3.1% (n=8 of patients had family history of tumor. The positive rate of cytokerantin 19 fragment (CYFRA21-1 was 71.2%, which was the highest among five tumor markers. The five tumor markers median level had no statistical significance between different tumor (T stages and node (N stages (all P>0.05, only the positive rate of SCC had statistical significance between different T stages (P=0.035. The combination measurement of CYFRA21-1+carcinogen-embryonic antigen (CEA, CYFRA21-1+CEA+cancer antigen (CA125, CA125+CYFRA21-1+CEA+neuron specific enolase (NSE, and CA125+CYFRA21-1+NSE+CEA+squamous cell carcinoma antigen (SCC were better and had higher clinical values, the positive rates were 82.7%, 84.6%, 85.0% and 86.2%, respectively. Conclusion The positive rate of CYFRA21-1 was the highest and the sensitivity of single test of five tumor markers was low, the combination of multiple tumor markers increased the sensitivity of diagnosis of SQCLC, the combination of CA125, CYFRA21-1 and CEA was the best choice.

  3. The impact of medical tourism and the code of medical ethics on advertisement in Nigeria

    OpenAIRE

    Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

    2014-01-01

    Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the adve...

  4. Safety significance of ATR [Advanced Test Reactor] passive safety response attributes

    International Nuclear Information System (INIS)

    Atkinson, S.A.

    1989-01-01

    The Advanced Test Reactor (ATR) at the Idaho National Engineering Laboratory was designed with some passive safety response attributes which contribute to the safety posture of the facility. The three passive safety attributes being evaluated in the paper are: (1) In-core and in-vessel natural convection cooling, (2) a passive heat sink capability of the ATR primary coolant system (PCS) for the transfer of decay power from the uninsulated piping to the confinement, and (3) gravity feed of emergency coolant makeup. The safety significance of the ATR passive safety response attributes is that the reactor can passively respond for most transients, given a reactor scram, to provide adequate decay power removal and a significant time for operator action should the normal active heat removal systems and their backup systems both fail. The ATR Interim Level 1 Probabilistic Risk Assessment (PRA) model ands results were used to evaluate the significance to ATR fuel damage frequency (or probability) of the above three passive response attributes. The results of the evaluation indicate that the first attribute is a major safety characteristic of the ATR. The second attribute has a noticeable but only minor safety significance. The third attribute has no significant influence on the ATR Level 1 PRA because of the diversity and redundancy of the ATR firewater injection system (emergency coolant system). 8 refs., 4 figs., 1 tab

  5. Medical devices for the anesthetist: current perspectives

    Directory of Open Access Journals (Sweden)

    Ingrande J

    2014-03-01

    Full Text Available Jerry Ingrande, Hendrikus JM LemmensDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Anesthesiologists are unique among most physicians in that they routinely use technology and medical devices to carry out their daily activities. Recently, there have been significant advances in medical technology. These advances have increased the number and utility of medical devices available to the anesthesiologist. There is little doubt that these new tools have improved the practice of anesthesia. Monitoring has become more comprehensive and less invasive, airway management has become easier, and placement of central venous catheters and regional nerve blockade has become faster and safer. This review focuses on key medical devices such as cardiovascular monitors, airway equipment, neuromonitoring tools, ultrasound, and target controlled drug delivery software and hardware. This review demonstrates how advances in these areas have improved the safety and efficacy of anesthesia and facilitate its administration. When applicable, indications and contraindications to the use of these novel devices will be explored as well as the controversies surrounding their use.Keywords: catheters, echocardiography, ultrasound, fiberoptic bronchoscope, laryngeal mask airway, closed-loop anesthesia

  6. Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies.

    Science.gov (United States)

    Sanghavi, Prachi; Jena, Anupam B; Newhouse, Joseph P; Zaslavsky, Alan M

    2015-11-03

    Most Medicare patients seeking emergency medical transport are treated by ambulance providers trained in advanced life support (ALS). Evidence supporting the superiority of ALS over basic life support (BLS) is limited, but some studies suggest ALS may harm patients. To compare outcomes after ALS and BLS in out-of-hospital medical emergencies. Observational study with adjustment for propensity score weights and instrumental variable analyses based on county-level variations in ALS use. Traditional Medicare. 20% random sample of Medicare beneficiaries from nonrural counties between 2006 and 2011 with major trauma, stroke, acute myocardial infarction (AMI), or respiratory failure. Neurologic functioning and survival to 30 days, 90 days, 1 year, and 2 years. Except in cases of AMI, patients showed superior unadjusted outcomes with BLS despite being older and having more comorbidities. In propensity score analyses, survival to 90 days among patients with trauma, stroke, and respiratory failure was higher with BLS than ALS (6.1 percentage points [95% CI, 5.4 to 6.8 percentage points] for trauma; 7.0 percentage points [CI, 6.2 to 7.7 percentage points] for stroke; and 3.7 percentage points [CI, 2.5 to 4.8 percentage points] for respiratory failure). Patients with AMI did not exhibit differences in survival at 30 days but had better survival at 90 days with ALS (1.0 percentage point [CI, 0.1 to 1.9 percentage points]). Neurologic functioning favored BLS for all diagnoses. Results from instrumental variable analyses were broadly consistent with propensity score analyses for trauma and stroke, showed no survival differences between BLS and ALS for respiratory failure, and showed better survival at all time points with BLS than ALS for patients with AMI. Only Medicare beneficiaries from nonrural counties were studied. Advanced life support is associated with substantially higher mortality for several acute medical emergencies than BLS. National Science Foundation, Agency for

  7. Recent advancements in medical simulation: patient-specific virtual reality simulation.

    Science.gov (United States)

    Willaert, Willem I M; Aggarwal, Rajesh; Van Herzeele, Isabelle; Cheshire, Nicholas J; Vermassen, Frank E

    2012-07-01

    Patient-specific virtual reality simulation (PSVR) is a new technological advancement that allows practice of upcoming real operations and complements the established role of VR simulation as a generic training tool. This review describes current developments in PSVR and draws parallels with other high-stake industries, such as aviation, military, and sports. A review of the literature was performed using PubMed and Internet search engines to retrieve data relevant to PSVR in medicine. All reports pertaining to PSVR were included. Reports on simulators that did not incorporate a haptic interface device were excluded from the review. Fifteen reports described 12 simulators that enabled PSVR. Medical procedures in the field of laparoscopy, vascular surgery, orthopedics, neurosurgery, and plastic surgery were included. In all cases, source data was two-dimensional CT or MRI data. Face validity was most commonly reported. Only one (vascular) simulator had undergone face, content, and construct validity. Of the 12 simulators, 1 is commercialized and 11 are prototypes. Five simulators have been used in conjunction with real patient procedures. PSVR is a promising technological advance within medicine. The majority of simulators are still in the prototype phase. As further developments unfold, the validity of PSVR will have to be examined much like generic VR simulation for training purposes. Nonetheless, similar to the aviation, military, and sport industries, operative performance and patient safety may be enhanced by the application of this novel technology.

  8. Synchrotron radiation applications in medical research

    International Nuclear Information System (INIS)

    Thomlinson, W.

    1995-01-01

    The medical projects employing synchrotron radiation as discussed in this paper are, for the most part, still in their infancies and no one can predict the direction in which they will develop. Both the basic research and applied medical programs are sure to be advanced at the new facilities coming on line, especially the ESRF and Spring- 8. However, success is not guaranteed. There is a lot of competition from advances in conventional imaging with the development of digital angiography, computed tomography, functional magnetic resonance imaging and ultrasound. The synchrotron programs will have to provide significant advantages over these modalities in order to be accepted by the medical profession. Advances in image processing and potentially the development of compact sources will be required in order to move the synchrotron developed imaging technologies into the clinical world. In any event, it can be expected that the images produced by the synchrotron technologies will establish ''gold standards'' to be targeted by conventional modalities. A lot more work needs to be done in order to bring synchrotron radiation therapy and surgery to the level of human studies and, subsequently, to clinical applications

  9. Abdominal macrochaetae of female Hylesia oratex Dyar, 1913 (Insecta: Lepidoptera: Saturniidae: external morphology and medical significance

    Directory of Open Access Journals (Sweden)

    ROSÂNGELA BRITO

    2015-09-01

    Full Text Available The representatives of the genus Hylesia Hübner, [1820] are significant among the medically important Lepidoptera. Adult females use abdominal setae to wrap and protect the eggs that remain for months in nature. These setae, in contact with human skin, may cause allergic reactions including swelling, itching and local erythema, known as lepidopterism. The morphology of the abdominal scales and setae from the female H. oratex Dyar, 1913 is herein described and aspects related to their medical significance are discussed. Portions of each abdominal segment were examined through a scanning electron microscope. Two types of scales without medical importance, and two types of setae with medical importance, classified as "true setae" and "modified setae" were found. The true setae, which are slightly fusiform and have radially arranged lateral projections, are responsible for the allergic reactions caused by skin penetration. The modified setae, which are larger, curved, with the median enlarged and serrated margins, can be responsible for the release of chemical substances. This information provides a better understanding of the structure of the urticating setae, which are responsible for lepidopterism outbreaks in humans, and contributes towards the identification of the moth species involved.

  10. The Advancing a Healthier Wisconsin Endowment: How a Health Care Conversion Foundation Is Transforming a Medical School.

    Science.gov (United States)

    Maurana, Cheryl A; Lucey, Paula A; Ahmed, Syed M; Kerschner, Joseph E; Bolton, G Allen; Raymond, John R

    2016-01-01

    Health care conversion foundations, such as the Advancing a Healthier Wisconsin Endowment (the endowment) at the Medical College of Wisconsin (MCW), result from the conversion of nonprofit health organizations to for-profit corporations. Over the past several decades, nearly 200 of these foundations have been created, and they have had a substantial impact on the field of health philanthropy. The MCW was a recipient of funds resulting from Blue Cross & Blue Shield United of Wisconsin's conversion from a nonprofit to a for-profit status in 1999. Established in 2004, the endowment has invested approximately $185 million in 337 research, education, and public and community health initiatives that benefit Wisconsin residents. However, the transformative potential of the health care conversion foundation has extended well beyond the opportunities provided through the endowment's financial resources. As the endowment celebrates its 10th anniversary, the authors describe the transformative nature of the endowment, as well as significant accomplishments and lessons learned, in the following areas: shared power, community partnerships, translational research, and integration of medicine and public health. It is the authors' hope that these lessons will be valuable to other medical schools and the communities they serve, as they invest in improving the health of their communities, irrespective of the funding source.

  11. Law, autonomy and advance directives.

    Science.gov (United States)

    Willmott, Lindy; White, Ben; Mathews, Ben

    2010-12-01

    The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

  12. [Clinical significance of prognostic nutritional index in patients with advanced gastric cancer].

    Science.gov (United States)

    Song, Shubin; Liu, Honggang; Xue, Yingwei

    2018-02-25

    To investigate the relationship of prognostic nutritional index (PNI) with clinicopathological factors and the clinical significance of PNI in predicting the survival in patients with advanced gastric cancer. Clinicopathological and follow-up data of 1150 patients with advanced gastric cancer who underwent radical gastrectomy from January 2007 to December 2010 at the Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital were analyzed retrospectively. The PNI value was calculated [PNI=absolute value of lymphocyte(10 9 /L)×5 + serum albumin (g/L)] and was grouped according to the mean value of PNI. Relationships of PNI with gender, age, tumor size, depth of invasion, tumor differentiation, tumor stage, tumor location, lymph node metastasis and tumor marker detection level were analyzed. At the same time, for the survival analysis of patients, log-rank method was used for univariate analysis, and Cox method was used for multivariate analysis. Of 1150 cases, 846 were males and 304 were females with an average age of 62 (24 to 88) years. The average maximum diameter of tumor was 5.4(1.0 to 20.0) cm. Tumor of 159 cases located in the gastric fundus, 221 cases in the gastric body, 705 cases in the gastric antrum and 65 cases in the whole stomach. Well differentiated tumors were found in 198 cases and poorly differentiated tumors in 952 cases. As for depth of tumor invasion, 165 cases were T2, 343 cases were T3 and 642 cases were T4. According to TNM stage, 53 cases were stage I(, 397 cases were stage II( and 700 cases were stage III(. The average lymph node metastasis rate was 25.0%, meanwhile lymph node metastasis was N0 in 296 cases, N1 in 246 cases, N2 in 277 cases and N3 in 331 cases. Blood examination showed hemoglobin ≤130 g/L in 544 cases and >130 g/L in 606 cases; carcinoembryonic antigen ≤5 μg/L in 903 cases and >5 μg /L in 247 cases; carbohydrate antigen 19-9 ≤37 kU/L in 927 cases and >37 kU/L in 223 cases. In whole patients

  13. Strategic management of Public Hospitals' medical services.

    Science.gov (United States)

    Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

    2016-01-01

    Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

  14. Safety evaluation in the development of medical devices and combination products

    CERN Document Server

    Gad, Shayne C

    2008-01-01

    Capturing the growth of the global medical device market in recent years, this practical new guide is essential for all who are responsible for ensuring safety in the use and manufacture of medical devices. It has been extensively updated to reflect significant advances, incorporating combination products and helpful case examples of current real-life problems in the field.The Third Edition explores these key current trends:global device marketscontinually advancing technologythe increasing harmonization of device safety regulation worldwideEach aspect of safety evaluation is considered in ter

  15. Hierarchy as a barrier to advancement for women in academic medicine.

    Science.gov (United States)

    Conrad, Peter; Carr, Phyllis; Knight, Sharon; Renfrew, Megan R; Dunn, Mary B; Pololi, Linda

    2010-04-01

    Research on barriers to professional advancement for women in academic medicine has not adequately considered the role of environmental factors and how the structure of organizations affects professional advancement and work experiences. This article examines the impact of the hierarchy, including both the organization's hierarchical structure and professionals' perceptions of this structure, in medical school organization on faculty members' experience and advancement in academic medicine. As part of an inductive qualitative study of faculty in five disparate U.S. medical schools, we interviewed 96 medical faculty at different career stages and in diverse specialties, using in-depth semistructured interviews, about their perceptions about and experiences in academic medicine. Data were coded and analysis was conducted in the grounded theory tradition. Our respondents saw the hierarchy of chairs, based on the indeterminate tenure of department chairs, as a central characteristic of the structure of academic medicine. Many faculty saw this hierarchy as affecting inclusion, reducing transparency in decision making, and impeding advancement. Indeterminate chair terms lessen turnover and may create a bottleneck for advancement. Both men and women faculty perceived this hierarchy, but women saw it as more consequential. The hierarchical structure of academic medicine has a significant impact on faculty work experiences, including advancement, especially for women. We suggest that medical schools consider alternative models of leadership and managerial styles, including fixed terms for chairs with a greater emphasis on inclusion. This is a structural reform that could increase opportunities for advancement especially for women in academic medicine.

  16. Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

    Science.gov (United States)

    Wang, Henry E; Donnelly, John P; Barton, Dustin; Jarvis, Jeffrey L

    2018-05-01

    Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with

  17. 1st European Congress of Medical Physics September 1-4, 2016; Medical Physics innovation and vision within Europe and beyond.

    Science.gov (United States)

    Tsapaki, Virginia; Kagadis, George C; Brambilla, Marco; Ciocca, Mario; Clark, Catharine H; Delis, Harry; Mettivier, Giovanni

    2017-09-01

    Medical Physics is the scientific healthcare profession concerned with the application of the concepts and methods of physics in medicine. The European Federation of Organisations for Medical Physics (EFOMP) acts as the umbrella organization for European Medical Physics societies. Due to the rapid advancements in related scientific fields, medical physicists must have continuous education through workshops, training courses, conferences, and congresses during their professional life. The latest developments related to this increasingly significant medical speciality were presented during the 1st European Congress of Medical Physics 2016, held in Athens, September 1-4, 2016, organized by EFOMP, hosted by the Hellenic Association of Medical Physicists (HAMP), and summarized in the current volume. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. MO-FG-BRC-00: Joint AAPM-ESTRO Symposium: Advances in Experimental Medical Physics

    International Nuclear Information System (INIS)

    2016-01-01

    Experimental research in medical physics has expanded the limits of our knowledge and provided novel imaging and therapy technologies for patients around the world. However, experimental efforts are challenging due to constraints in funding, space, time and other forms of institutional support. In this joint ESTRO-AAPM symposium, four exciting experimental projects from four different countries are highlighted. Each project is focused on a different aspect of radiation therapy. From the USA, we will hear about a new linear accelerator concept for more compact and efficient therapy devices. From Canada, we will learn about novel linear accelerator target design and the implications for imaging and therapy. From France, we will discover a mature translational effort to incorporate theranostic nanoparticles in MR-guided radiation therapy. From Germany, we will find out about a novel in-treatment imaging modality for particle therapy. These examples of high impact, experimental medical physics research are representative of the diversity of such efforts that are on-going around the globe. J. Robar, Research is supported through collaboration with Varian Medical Systems and Brainlab AGD. Westerly, This work is supported by the Department of Radiation Oncology at the University of Colorado School of Medicine. COI: NONEK. Parodi, Part of the presented work is supported by the DFG (German Research Foundation) Cluster of Excellence MAP (Munich-Centre for Advanced Photonics) and has been carried out in collaboration with IBA.

  19. Prognostic significance of symptoms of hospitalised advanced cancer patients

    NARCIS (Netherlands)

    Teunissen, Saskia C.; de Graeff, Alexander; de Haes, Hanneke C.; Voest, Emile E.

    2006-01-01

    To assess the prognostic value of symptoms in hospitalised advanced cancer patients. A prospective analysis was performed of 181 hospitalised patients referred to a Palliative Care Team. Comprehensive symptom questionnaire, functional status, estimated life expectancy and survival were assessed.

  20. Significance of lymphadenectomy with splenectomy in radical surgery for advanced (pT3/pT4) remnant gastric cancer.

    Science.gov (United States)

    Sugita, Hiroki; Oda, Eri; Hirota, Masahiko; Ishikawa, Shinji; Tomiyasu, Shinjiro; Tanaka, Hiroshi; Arita, Tetsumasa; Yagi, Yasushi; Baba, Hideo

    2016-04-01

    To date, the optimal surgical strategy for remnant gastric cancer has not been determined. The purpose of this study was to clarify the significance of lymphadenectomy with splenectomy in remnant gastric cancer surgery. This retrospective cohort study was conducted at the Kumamoto Regional Medical Center. The primary endpoint was overall survival after surgery. We retrospectively analyzed the clinicopathologic features, surgical treatments, and long-term prognosis of remnant gastric cancer patients treated with total gastrectomy. A total of 80 patients with gastric cancer in the remnant stomach after distal gastrectomy and who underwent total gastrectomy were enrolled in the study. Splenectomy was performed in 38 patients. Lymph node metastasis in the splenic hilum was not observed in the patients with pT1/pT2 tumors, whereas nodal metastasis at the splenic hilum was detected in 30.4% of the patients with pT3/pT4 tumors. The survival rate of the patients with pT3/pT4 tumors who underwent splenectomy was significantly higher than that of the patients who did not undergo splenectomy, although there was no difference in the patients with pT1/pT2 tumors. Among the patients classified as R0, the survival rate of the patients with pT3/pT4 tumors who underwent splenectomy was significantly higher than that of the patients who did not undergo splenectomy. Lymphadenectomy with splenectomy in radical surgery is beneficial for patients with advanced (pT3/pT4) remnant gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Advanced data visualization and sensor fusion: Conversion of techniques from medical imaging to Earth science

    Science.gov (United States)

    Savage, Richard C.; Chen, Chin-Tu; Pelizzari, Charles; Ramanathan, Veerabhadran

    1993-01-01

    Hughes Aircraft Company and the University of Chicago propose to transfer existing medical imaging registration algorithms to the area of multi-sensor data fusion. The University of Chicago's algorithms have been successfully demonstrated to provide pixel by pixel comparison capability for medical sensors with different characteristics. The research will attempt to fuse GOES (Geostationary Operational Environmental Satellite), AVHRR (Advanced Very High Resolution Radiometer), and SSM/I (Special Sensor Microwave Imager) sensor data which will benefit a wide range of researchers. The algorithms will utilize data visualization and algorithm development tools created by Hughes in its EOSDIS (Earth Observation SystemData/Information System) prototyping. This will maximize the work on the fusion algorithms since support software (e.g. input/output routines) will already exist. The research will produce a portable software library with documentation for use by other researchers.

  2. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010.

    Science.gov (United States)

    Irby, David M; Cooke, Molly; O'Brien, Bridget C

    2010-02-01

    The Carnegie Foundation for the Advancement of Teaching, which in 1910 helped stimulate the transformation of North American medical education with the publication of the Flexner Report, has a venerated place in the history of American medical education. Within a decade following Flexner's report, a strong scientifically oriented and rigorous form of medical education became well established; its structures and processes have changed relatively little since. However, the forces of change are again challenging medical education, and new calls for reform are emerging. In 2010, the Carnegie Foundation will issue another report, Educating Physicians: A Call for Reform of Medical School and Residency, that calls for (1) standardizing learning outcomes and individualizing the learning process, (2) promoting multiple forms of integration, (3) incorporating habits of inquiry and improvement, and (4) focusing on the progressive formation of the physician's professional identity. The authors, who wrote the 2010 Carnegie report, trace the seeds of these themes in Flexner's work and describe their own conceptions of them, addressing the prior and current challenges to medical education as well as recommendations for achieving excellence. The authors hope that the new report will generate the same excitement about educational innovation and reform of undergraduate and graduate medical education as the Flexner Report did a century ago.

  3. Serum Advanced Oxidation Protein Products in Oral Squamous Cell Carcinoma: Possible Markers of Diagnostic Significance

    Directory of Open Access Journals (Sweden)

    Abhishek Singh Nayyar

    2013-07-01

    Full Text Available Background: The aim of this study was to measure the concentrations (levels ofserum total proteins and advanced oxidation protein products as markers of oxidantmediated protein damage in the sera of patients with oral cancers.Methods: The study consisted of the sera analyses of serum total protein andadvanced oxidation protein products’ levels in 30 age and sex matched controls, 60patients with reported pre-cancerous lesions and/or conditions and 60 patients withhistologically proven oral squamous cell carcinoma. One way analyses of variance wereused to test the difference between groups. To determine which of the two groups’ meanswere significantly different, the post-hoc test of Bonferroni was used. The results wereaveraged as mean ± standard deviation. In the above test, P values less than 0.05 weretaken to be statistically significant. The normality of data was checked before thestatistical analysis was performed.Results: The study revealed statistically significant variations in serum levels ofadvanced oxidation protein products (P<0.001. Serum levels of total protein showedextensive variations; therefore the results were largely inconclusive and statisticallyinsignificant.Conclusion: The results emphasize the need for more studies with larger samplesizes to be conducted before a conclusive role can be determined for sera levels of totalprotein and advanced oxidation protein products as markers both for diagnosticsignificance and the transition from the various oral pre-cancerous lesions and conditionsinto frank oral cancers.

  4. The medical home and integrated behavioral health: advancing the policy agenda.

    Science.gov (United States)

    Ader, Jeremy; Stille, Christopher J; Keller, David; Miller, Benjamin F; Barr, Michael S; Perrin, James M

    2015-05-01

    There has been a considerable expansion of the patient-centered medical home model of primary care delivery, in an effort to reduce health care costs and to improve patient experience and population health. To attain these goals, it is essential to integrate behavioral health services into the patient-centered medical home, because behavioral health problems often first present in the primary care setting, and they significantly affect physical health. At the 2013 Patient-Centered Medical Home Research Conference, an expert workgroup convened to determine policy recommendations to promote the integration of primary care and behavioral health. In this article we present these recommendations: Build demonstration projects to test existing approaches of integration, develop interdisciplinary training programs to support members of the integrated care team, implement population-based strategies to improve behavioral health, eliminate behavioral health carve-outs and test innovative payment models, and develop population-based measures to evaluate integration. Copyright © 2015 by the American Academy of Pediatrics.

  5. Advanced ESPI-based medical instruments for otolaryngology

    Science.gov (United States)

    Castracane, James; Conerty, M.; Cacace, Anthony T.; Gardner, Glendon M.; Miller, Mitchell B.; Parnes, Steven M.

    1993-05-01

    Optical fibers have long been used for visual inspection inside the human body for medical diagnoses and treatment. By making use of sophisticated optical interferometric and ultra- small imaging techniques, combined with automated image processing, it is possible to extract significantly increased information for more accurate medical diagnoses. With support from NIH under the SBIR program, we have been developing a range of such instruments. One of these supported by the NIDCD is capable of providing detailed spatial information on the vibratory response of the tympanic membrane (TM). This instrument involves the examination of the TM by means of high speed electronic speckle pattern interferometry (ESPI). This provides a real time view of the vibration patterns of the TM for clinical diagnosis. This Interferometric Otoscope consists of mode conserving fiber optics, miniature diode lasers and high speed solid state detector arrays. We present the current status of the research including holography and ESPI of TM models and excised temporal bone preparations. A second instrument, also developed with support from NIDCD, is for application to the larynx. This system is also ESPI based but will incorporate features for direct vocal cord (VC) examination. By careful examination of the vibratory response of the VC during phonation, the characteristics of the mucosal wave may be examined. Adynamic regions of the cords can signal the start of lesions or cysts. Results of surgery can be evaluated in a quantitative manner. The design of a clinical prototype and preliminary electro-optic experiments on excised larynges and VC models will be presented.

  6. Advance of the National Program of Radiological Protection and Safety for medical diagnostic with X-rays

    International Nuclear Information System (INIS)

    Verdejo S, M.

    1999-01-01

    The National Program of Radiological Protection and Safety for medical diagnostic with X-ray (Programa Nacional de Proteccion y Seguridad Radiologica para diagnostico medico con rayos X) was initiated in the General Direction of Environmental Health (Direccion General de Salud Ambiental) in 1995. Task coordinated with different dependences of the Public Sector in collaboration between the Secretary of Health (Secretaria de Salud), the National Commission of Nuclear Safety and Safeguards (Comision Nacional de Seguridad Nuclear y Salvaguardias) and, the National Institute of Nuclear Research (Instituto Nacional de Investigaciones Nucleares). The surveillance to the fulfilment of the standardization in matter of Radiological Protection and Safety in the medical diagnostic with X-rays has been obtained for an important advance in the Public sector and it has been arousing interest in the Private sector. (Author)

  7. 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.

  8. Prognostic factors in advanced breast cancer: Race and receptor status are significant after development of metastasis.

    Science.gov (United States)

    Ren, Zhiyong; Li, Yufeng; Shen, Tiansheng; Hameed, Omar; Siegal, Gene P; Wei, Shi

    2016-01-01

    Prognostic factors are well established in early-stage breast cancer (BC), but less well-defined in advanced disease. We analyzed 323 BC patients who had distant relapse during follow-up from 1997 to 2010 to determine the significant clinicopathologic factors predicting survival outcomes. By univariate analysis, race, tumor grade, estrogen and progesterone receptors (ER/PR) and HER2 status were significantly associated with overall survival (OS) and post-metastasis survival (PMS). Applying a Cox regression model revealed that all these factors remained significant for PMS, while race, tumor grade and HER2 were independent factors for OS. Tumor grade was the only significant factor for metastasis-free survival by univariate and multivariate analyses. Our findings demonstrated that being Caucasian, hormonal receptor positive (HR+) and HER2 positive (HER2+) were all associated with a decreased hazard of death and that patients with HR+/HER2+ tumors had superior outcomes to those with HR+/HER2- disease. Further, PR status held a prognostic value over ER, thus reflecting the biologic mechanism of the importance of the functional ER pathway and the heterogeneity in the response to endocrine therapy. These observations indicate that the patients' genetic makeup and the intrinsic nature of the tumor principally govern BC progression and prognosticate the long-term outcomes in advanced disease. Copyright © 2015 Elsevier GmbH. All rights reserved.

  9. An ethnographic study exploring the role of ward-based Advanced Nurse Practitioners in an acute medical setting.

    Science.gov (United States)

    Williamson, Susan; Twelvetree, Timothy; Thompson, Jacqueline; Beaver, Kinta

    2012-07-01

    This article is a report of a study that aimed to examine the role of ward-based Advanced Nurse Practitioners and their impact on patient care and nursing practice. Revised doctor/nurse skill mix combined with a focus on improving quality of care while reducing costs has had an impact on healthcare delivery in the western world. Diverse advanced nursing practice roles have developed and their function has varied globally over the last decade. However, roles and expectations for ward-based Advanced Nurse Practitioners lack clarity, which may hinder effective contribution to practice. An ethnographic approach was used to explore the advanced nurse practitioner role. Participant observation and interviews of five ward-based Advanced Nurse Practitioners working in a large teaching hospital in the North West of England during 2009 were complemented by formal and informal interviews with staff and patients. Data were descriptive and broken down into themes, patterns and processes to enable interpretation and explanation. The overarching concept that ran through data analysis was that of Advanced Nurse Practitioners as a lynchpin, using their considerable expertise, networks and insider knowledge of health care not only to facilitate patient care but to develop a pivotal role facilitating nursing and medical practice. Sub-themes included enhancing communication and practice, acting as a role model, facilitating the patients' journey and pioneering the role. Ward-based Advanced Nurse Practitioners are pivotal and necessary for providing quality holistic patient care and their role can be defined as more than junior doctor substitutes. © 2012 Blackwell Publishing Ltd.

  10. Dispatch of Helicopter Emergency Medical Services Via Advanced Automatic Collision Notification.

    Science.gov (United States)

    Matsumoto, Hisashi; Mashiko, Kunihiro; Hara, Yoshiaki; Yagi, Takanori; Hayashida, Kazuyuki; Mashiko, Kazuki; Saito, Nobuyuki; Iida, Hiroaki; Motomura, Tomokazu; Yasumatsu, Hiroshi; Kameyama, Daisuke; Hirabayashi, Atsushi; Yokota, Hiroyuki; Ishikawa, Hirotoshi; Kunimatsu, Takaji

    2016-03-01

    Advanced automatic collision notification (AACN) is a system for predicting occupant injury from collision information. If the helicopter emergency medical services (HEMS) physician can be alerted by AACN, it may be possible to reduce the time to patient contact. The purpose of this study was to validate the feasibility of early HEMS dispatch via AACN. A full-scale validation study was conducted. A car equipped with AACN was made to collide with a wall. Immediately after the collision, the HEMS was alerted directly by the operation center, which received the information from AACN. Elapsed times were recorded and compared with those inferred from the normal, real-world HEMS emergency request process. AACN information was sent to the operation center only 7 s after the collision; the HEMS was dispatched after 3 min. The helicopter landed at the temporary helipad 18 min later. Finally, medical intervention was started 21 min after the collision. Without AACN, it was estimated that the HEMS would be requested 14 min after the collision by fire department personnel. The start of treatment was estimated to be at 32 min, which was 11 min later than that associated with the use of AACN. The dispatch of the HEMS using the AACN can shorten the start time of treatment for patients in motor vehicle collisions. This study demonstrated that it is feasible to automatically alert and activate the HEMS via AACN. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Outcomes from peptic ulcer surgery have not benefited from advances in medical therapy.

    Science.gov (United States)

    Towfigh, Shirin; Chandler, Charles; Hines, Oscar J; McFadden, David W

    2002-04-01

    Given the advancements in medical treatment of peptic ulcer disease such as Helicobacter pylori eradication and proton-pump inhibitors, we sought to assess their impact on the need for surgical intervention. Patients who underwent peptic ulcer surgery between 1981 and 1998 were evaluated in a retrospective chart review from a tertiary-care hospital (n = 222). The number of operations performed for peptic ulcers decreased annually (24 vs 11.3). Seventy-seven per cent of all cases were done urgently; most were performed for acute perforated ulcers. The overall 30-day mortality rate was 13 per cent, which remained unchanged over the past two decades. The highest mortality rate (82%) was in the transplanted population (n = 11). Our institutional experience demonstrates that despite the lower volume of patients requiring operative management a greater percentage of these patients are presenting with urgent need for surgery. Also despite the aggressive endoscopic management of acutely bleeding ulcers there was no change in the percentage of patients taken to the operating room for uncontrollable hemorrhage. Improvements in medical management of peptic ulcer disease have decreased the surgical volume; nevertheless we show a rising proportion of urgent operations performed annually, and mortality remains high.

  12. Clinical Impact of Education Provision on Determining Advance Care Planning Decisions among End Stage Renal Disease Patients Receiving Regular Hemodialysis in University Malaya Medical Centre.

    Science.gov (United States)

    Hing Wong, Albert; Chin, Loh Ee; Ping, Tan Li; Peng, Ng Kok; Kun, Lim Soo

    2016-01-01

    Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States. To assess the clinical impact of education provision on determining ACP decisions among end-stage renal disease patients on regular hemodialysis at University Malaya Medical Centre (UMMC). To study the knowledge and attitude of patients toward ACP and end-of-life issues. Fifty-six patients were recruited from UMMC. About 43 questions pretest survey adapted from Lyon's ACP survey and Moss's cardiopulmonary resuscitation (CPR) attitude survey was given to patients to answer. An educational brochure is then introduced to these patients, and a posttest survey carried out after that. The results were analyzed using SPSS version 22.0. Opinion on ACP, including CPR decisions, showed an upward trend on the importance percentage after the educational brochure exposure, but this was statistically not significant. Seventy-five percent of participants had never heard of ACP before, and only 3.6% had actually prepared a written advanced directive. The ACP educational brochure clinically impacts patients' preferences and decisions toward end-of-life care; however, this is statistically not significant. Majority of patients have poor knowledge on ACP. This study lays the foundation for execution of future larger scale clinical trials, and ultimately, the incorporation of ACP into clinical practice in Malaysia.

  13. Tanzania Medical Journal

    African Journals Online (AJOL)

    The journal publishes any contribution that advances medical science or ... these core objectives the journal publishes papers on original scientific research, short ... The Tanzania Medical Journal is an international Journal - ISSN: 0856-0719 ...

  14. Clinical findings and survival time in dogs with advanced heart failure.

    Science.gov (United States)

    Beaumier, Amelie; Rush, John E; Yang, Vicky K; Freeman, Lisa M

    2018-04-10

    Dogs with advanced heart failure are a clinical challenge for veterinarians but there are no studies reporting clinical features and outcome of this population. To describe clinical findings and outcome of dogs with advanced heart failure caused by degenerative mitral valve disease (DMVD). Fifty-four dogs with advanced heart failure because of DMVD. For study purposes, advanced heart failure was defined as recurrence of congestive heart failure signs despite receiving the initially prescribed dose of pimobendan, angiotensin-converting-enzyme inhibitor (ACEI), and furosemide >4 mg/kg/day. Data were collected for the time of diagnosis of Stage C heart failure and time of diagnosis of advanced heart failure. Date of death was recorded. At the diagnosis of advanced heart failure, doses of pimobendan (n = 30), furosemide (n = 28), ACEI (n = 13), and spironolactone (n = 4) were increased, with ≥1 new medications added in most dogs. After initial diagnosis of advanced heart failure, 38 (70%) dogs had additional medications adjustments (median = 2 [range, 0-27]), with the final total medication number ranging from 2-10 (median = 5). Median survival time after diagnosis of advanced heart failure was 281 days (range, 3-885 days). Dogs receiving a furosemide dose >6.70 mg/kg/day had significantly longer median survival times (402 days [range, 3-885 days] versus 129 days [range 9-853 days]; P = .017). Dogs with advanced heart failure can have relatively long survival times. Higher furosemide dose and non-hospitalization were associated with longer survival. Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  15. Otolaryngology--head and neck surgery in undergraduate medical education: advances and innovations.

    Science.gov (United States)

    Fung, Kevin

    2015-02-01

    Medical students graduate with the knowledge and skills to be undifferentiated general physicians. Otolaryngology-head and neck surgery (OtoHNS) is an essential component of primary healthcare, but is disproportionately under-represented in undergraduate medical education (UME). Advances and innovations in educational technology may represent an exciting and creative solution to this important problem. Failure to meet this educational need will result in substantial downstream effects in primary healthcare delivery. The objectives of this study were to 1) demonstrate current deficits in OtoHNS teaching at the UME level; 2) develop, validate, and critically appraise educational innovations that may enrich OtoHNS teaching in medical school curricula; and 3) propose a process for standardization of learning objectives for OtoHNS in UME as it relates to development and deployment of such educational tools. A white paper, prepared as a Triological Society thesis, which consolidates a prospective 10-year investigation of the problem of and potential solutions for under-representation of OtoHNS in UME. Cited datasets include multicenter surveys, cohort studies, and prospective, randomized controlled trials. A series of published and unpublished data were synthesized that addresses the following: 1) the current state of OtoHNS teaching at the UME level with respect to content, volume, structure, and methods; and 2) educational innovations including e-learning and simulation with emphasis on validity and learning effectiveness. Educational innovations specific to postgraduate (residency) training were excluded. Data support the observation that there is uniformly disproportionate under-representation of OtoHNS within UME curricula. Medical school graduates, especially those pursuing primary care specialties, report poor overall comfort levels in managing OtoHNS problems. A series of novel teaching methods were developed and validated using e-learning and simulation

  16. California Dental Hygiene Educators' Perceptions of an Application of the ADHA Advanced Dental Hygiene Practitioner (ADHP) Model in Medical Settings.

    Science.gov (United States)

    Smith, Lauren; Walsh, Margaret

    2015-12-01

    To assess California dental hygiene educators' perceptions of an application of the American Dental Hygienists' Association's (ADHA) advanced dental hygiene practitioner model (ADHP) in medical settings where the advanced dental hygiene practitioner collaborates in medical settings with other health professionals to meet clients' oral health needs. In 2014, 30 directors of California dental hygiene programs were contacted to participate in and distribute an online survey to their faculty. In order to capture non-respondents, 2 follow-up e-mails were sent. Descriptive analysis and cross-tabulations were analyzed using the online survey software program, Qualtrics™. The educator response rate was 18% (70/387). Nearly 90% of respondents supported the proposed application of the ADHA ADHP model and believed it would increase access to care and reduce oral health disparities. They also agreed with most of the proposed services, target populations and workplace settings. Slightly over half believed a master's degree was the appropriate educational level needed. Among California dental hygiene educators responding to this survey, there was strong support for the proposed application of the ADHA model in medical settings. More research is needed among a larger sample of dental hygiene educators and clinicians, as well as among other health professionals such as physicians, nurses and dentists. Copyright © 2015 The American Dental Hygienists’ Association.

  17. How Can Medical Students Add Value? Identifying Roles, Barriers, and Strategies to Advance the Value of Undergraduate Medical Education to Patient Care and the Health System.

    Science.gov (United States)

    Gonzalo, Jed D; Dekhtyar, Michael; Hawkins, Richard E; Wolpaw, Daniel R

    2017-09-01

    As health systems evolve, the education community is seeking to reimagine student roles that combine learning with meaningful contributions to patient care. The authors sought to identify potential stakeholders regarding the value of student work, and roles and tasks students could perform to add value to the health system, including key barriers and associated strategies to promote value-added roles in undergraduate medical education. In 2016, 32 U.S. medical schools in the American Medical Association's (AMA's) Accelerating Change in Education Consortium met for a two-day national meeting to explore value-added medical education; 121 educators, systems leaders, clinical mentors, AMA staff leadership and advisory board members, and medical students were included. A thematic qualitative analysis of workshop discussions and written responses was performed, which extracted key themes. In current clinical roles, students can enhance value by performing detailed patient histories to identify social determinants of health and care barriers, providing evidence-based medicine contributions at the point-of-care, and undertaking health system research projects. Novel value-added roles include students serving as patient navigators/health coaches, care transition facilitators, population health managers, and quality improvement team extenders. Six priority areas for advancing value-added roles are student engagement, skills, and assessments; balance of service versus learning; resources, logistics, and supervision; productivity/billing pressures; current health systems design and culture; and faculty factors. These findings provide a starting point for collaborative work to positively impact clinical care and medical education through the enhanced integration of value-added medical student roles into care delivery systems.

  18. Striving for Better Medical Education: the Simulation Approach.

    Science.gov (United States)

    Sakakushev, Boris E; Marinov, Blagoi I; Stefanova, Penka P; Kostianev, Stefan St; Georgiou, Evangelos K

    2017-06-01

    Medical simulation is a rapidly expanding area within medical education due to advances in technology, significant reduction in training hours and increased procedural complexity. Simulation training aims to enhance patient safety through improved technical competency and eliminating human factors in a risk free environment. It is particularly applicable to a practical, procedure-orientated specialties. Simulation can be useful for novice trainees, experienced clinicians (e.g. for revalidation) and team building. It has become a cornerstone in the delivery of medical education, being a paradigm shift in how doctors are educated and trained. Simulation must take a proactive position in the development of metric-based simulation curriculum, adoption of proficiency benchmarking definitions, and should not depend on the simulation platforms used. Conversely, ingraining of poor practice may occur in the absence of adequate supervision, and equipment malfunction during the simulation can break the immersion and disrupt any learning that has occurred. Despite the presence of high technology, there is a substantial learning curve for both learners and facilitators. The technology of simulation continues to advance, offering devices capable of improved fidelity in virtual reality simulation, more sophisticated procedural practice and advanced patient simulators. Simulation-based training has also brought about paradigm shifts in the medical and surgical education arenas and ensured that the scope and impact of simulation will continue to broaden.

  19. Advances in the physics of radiation oncology - 50 years of contributions by US Medical Physicists

    International Nuclear Information System (INIS)

    Suntharalingam, N.

    2008-01-01

    Medical Physicists have a long standing record in the advancement of the discipline of Radiation Oncology, not only in the United States but world-wide, going back to the pre-world war II era. In the United States the contributions of Failla and Quimby, first at Memorial Hospital and then at Columbia University in New York, laid the foundation for the Profession of Medical Physics in the US. Radiation Therapy first used low and high kilovoltage machines for external beam therapy. Radium (Parker) and radon seeds (Quimby) were used for brachytherapy. Subsequently, clinical Van-de-Graaff machines (Trump and Wright) and the Betatron (Kerst, Adams and Skaggs) provided the required photon beams and also made available clinically useful electron beams. The work of John Laughlin, Larry Lanzl, Jacques Ovadia together with Gail Adams and Lester Skaggs, needs to be recognized for their pioneering efforts. With the introduction of Cobalt-60 Teletherapy (Harold Johns and the Canadian Group, Gilbert Fletcher and the MD Anderson Group) and Linear Accelerators (Henry Kaplan and the Stanford Group, and Varian), in the late 1950s ∼ 1960, there was even a greater need for the strong participation of medical physicists, as a useful technical resource to the physicians

  20. Estimation of population doses from diagnostic medical examinations in Japan, 1974. II. Estimation of genetically significant dose

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, T; Maruyama, T; Kumamoto, Y [National Inst. of Radiological Sciences, Chiba (Japan)

    1976-03-01

    The genetically significant dose from radiographic and fluoroscopic examination in Japan has been estimated based on a 1974 nation wide survey of randomly sampled hospitals and clinics. The gonad dose during x-ray diagnosis was determined with an ionization chamber placed at the positions of ovary and testis in a Rando phantom. The instrumented phantom was irradiated with medical diagnostic x-rays on the basis of the exposure data on the patients selected in the nation wide survey. In the calculation of the genetically significant dose, the child expectancy of the patients that undergo each particular type of examination was assumed to be same as that of the general population. The resultant genetically significant dose was 11.1 and 5.43 mrad per person per year for radiography and fluoroscopy, respectively. These values were compared with those of 1960 and 1969. Though the number of examinations per year shows a yearly increase, the genetically significant dose is gradually on the decrease. This may be due to technical improvements in medical radiological practices.

  1. An In-home Advanced Robotic System to Manage Elderly Home-care Patients' Medications: A Pilot Safety and Usability Study.

    Science.gov (United States)

    Rantanen, Pekka; Parkkari, Timo; Leikola, Saija; Airaksinen, Marja; Lyles, Alan

    2017-05-01

    We examined the safety profile and usability of an integrated advanced robotic device and telecare system to promote medication adherence for elderly home-care patients. There were two phases. Phase I aimed to verify under controlled conditions in a single nursing home (n = 17 patients) that no robotic malfunctions would hinder the device's safe use. Phase II involved home-care patients from 3 sites (n = 27) who were on long-term medication. On-time dispensing and missed doses were recorded by the robotic system. Patients' and nurses' experiences were assessed with structured interviews. The 17 nursing home patients had 457 total days using the device (Phase I; mean, 26.9 per patient). On-time sachet retrieval occurred with 97.7% of the alerts, and no medication doses were missed. At baseline, Phase II home-dwelling patients reported difficulty remembering to take their medicines (23%), and 18% missed at least 2 doses per week. Most Phase II patients (78%) lived alone. The device delivered and patients retrieved medicine sachets for 99% of the alerts. All patients and 96% of nurses reported the device was easy to use. This trial demonstrated the safety profile and usability of an in-home advanced robotic device and telecare system and its acceptability to patients and nurses. It supports individualized patient dosing schedules, patient-provider communications, and on-time, in-home medication delivery to promote adherence. Real time dose-by-dose monitoring and communication with providers if a dose is missed provide oversight generally not seen in home care. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. The distribution of P-values in medical research articles suggested selective reporting associated with statistical significance.

    Science.gov (United States)

    Perneger, Thomas V; Combescure, Christophe

    2017-07-01

    Published P-values provide a window into the global enterprise of medical research. The aim of this study was to use the distribution of published P-values to estimate the relative frequencies of null and alternative hypotheses and to seek irregularities suggestive of publication bias. This cross-sectional study included P-values published in 120 medical research articles in 2016 (30 each from the BMJ, JAMA, Lancet, and New England Journal of Medicine). The observed distribution of P-values was compared with expected distributions under the null hypothesis (i.e., uniform between 0 and 1) and the alternative hypothesis (strictly decreasing from 0 to 1). P-values were categorized according to conventional levels of statistical significance and in one-percent intervals. Among 4,158 recorded P-values, 26.1% were highly significant (P values values equal to 1, and (3) about twice as many P-values less than 0.05 compared with those more than 0.05. The latter finding was seen in both randomized trials and observational studies, and in most types of analyses, excepting heterogeneity tests and interaction tests. Under plausible assumptions, we estimate that about half of the tested hypotheses were null and the other half were alternative. This analysis suggests that statistical tests published in medical journals are not a random sample of null and alternative hypotheses but that selective reporting is prevalent. In particular, significant results are about twice as likely to be reported as nonsignificant results. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Radiation protection in medical imaging and radiation oncology

    CERN Document Server

    Stoeva, Magdalena S

    2016-01-01

    Radiation Protection in Medical Imaging and Radiation Oncology focuses on the professional, operational, and regulatory aspects of radiation protection. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This book summarizes evidence supporting changes in consensus recommendations, regulations, and health physics practices associated with these recent advances in radiology, nuclear medicine, and radiation oncology. It supports intelligent and practical methods for protection of personnel, the public, and patients. The book is based on current recommendations by the International Commission on Radiological Protection and is complemented by detailed practical sections and professional discussions by the world’s leading medical and health physics professionals. It also ...

  4. Advances in imaging for oncology guidance

    International Nuclear Information System (INIS)

    Amies, Christopher J.

    2008-01-01

    Over the last 30 years major improvements in medical imaging have played a significant role to help advance the management of oncology diseases. These advances have covered the continuum of care from screening, diagnosis, staging, treatment planning and intervention. More recently image guided radiation therapy (IGRT) has placed sophisticated imaging closer to the treatment event. The opportunity to improve care seems obvious; however the clinical benefits of IGRT are at present not easily proven and yet contribute to the complexity of treatment and the rising costs of care. It is proposed that this is in part due to the present immaturity of IGRT technology development, which is predominantly determined by the challenge of achieving precise delivery of radiation in one or many episodes (fractions) for very different diseases. There is no single type or mode of imaging that will be suitable to address all radiotherapy guidance challenges whether defined by the general criteria identified for a specific disease or the unique characteristics encountered with an individual patient. Finally the wide adoption of this or any medical technology general requires the attainment of a sufficient degree of safety and efficiency. I present the challenges faced by industry as well as select interesting technology based solutions and concepts that may help advance the field of oncology guidance

  5. Economical impact of orchiectomy for advanced prostate cancer

    Directory of Open Access Journals (Sweden)

    Paula Adriano A. P. de

    2003-01-01

    Full Text Available PURPOSE: To demonstrate the economical impact of surgical castration in comparison to the medical castration for patients with advanced prostate cancer. MATERIAL AND METHODS: Between January 2001 and December 2001, 32 patients with advanced prostate cancer underwent bilateral sub-capsular orchiectomy at our Hospital. The costs of this procedure were compared to the costs of medical castration with LH-RH analogues. RESULTS: The costs of the surgical procedure were extremely reduced when compared to published data on the medical treatment. Surgical castration did not have any stronger negative impact on the evolution of these patients when compared to medical castration. CONCLUSION: Surgical castration is an efficient and low cost treatment for advanced prostate cancer.

  6. Virtual reality in advanced medical immersive imaging: a workflow for introducing virtual reality as a supporting tool in medical imaging

    KAUST Repository

    Knodel, Markus M.

    2018-02-27

    Radiologic evaluation of images from computed tomography (CT) or magnetic resonance imaging for diagnostic purposes is based on the analysis of single slices, occasionally supplementing this information with 3D reconstructions as well as surface or volume rendered images. However, due to the complexity of anatomical or pathological structures in biomedical imaging, innovative visualization techniques are required to display morphological characteristics three dimensionally. Virtual reality is a modern tool of representing visual data, The observer has the impression of being “inside” a virtual surrounding, which is referred to as immersive imaging. Such techniques are currently being used in technical applications, e.g. in the automobile industry. Our aim is to introduce a workflow realized within one simple program which processes common image stacks from CT, produces 3D volume and surface reconstruction and rendering, and finally includes the data into a virtual reality device equipped with a motion head tracking cave automatic virtual environment system. Such techniques have the potential to augment the possibilities in non-invasive medical imaging, e.g. for surgical planning or educational purposes to add another dimension for advanced understanding of complex anatomical and pathological structures. To this end, the reconstructions are based on advanced mathematical techniques and the corresponding grids which we can export are intended to form the basis for simulations of mathematical models of the pathogenesis of different diseases.

  7. Application of a latent variables model for the medical images analysis; Aplicacion de un modelo de variables latentes para el analisis de imagenes medicas

    Energy Technology Data Exchange (ETDEWEB)

    Campos S, Y.; Ruiz C, S. [Centro de Investigacion en Matematica, A.C. Jalisco s/n, Col. Valenciana, Guanajuato (Mexico)

    2008-07-01

    In recent years the technological advance has allowed the significant advance in diverse research fields, the medicine has not been exempt of this technology and the use of this technology has allowed a significant advance in the equipment that are used to obtain medical images. The quantity of information that is generated with this equipment has grown in exponential form and it is a difficult task to carry out a quantitative analysis of the data also the manipulation of big quantities of information makes the medical images analysis a complicated task. It is in fact this complexity what motivates this work where one of the main objectives is the analysis of techniques that allow to work with the complexity of the data generated with medical equipment. Likewise, it is wanted to illustrate an application of the peaceful uses of the nuclear energy to treat a medical problem where the diagnostic it depends essentially on the current medical equipment to give an appropriate treatment to the patients. (Author)

  8. Furthering Medical Education in Texas.

    Science.gov (United States)

    Varma, Surendra K; Jennings, John

    2016-02-01

    Medical education in Texas is moving in the right direction. The Texas Medical Association has been a major partner in advancing medical education initiatives. This special symposium issue on medical education examines residency training costs, the Next Accreditation System, graduate medical education in rural Texas, Texas' physician workforce needs, the current state of education reform, and efforts to retain medical graduates in Texas.

  9. Paper versus computer: Feasibility of an electronic medical record in general pediatrics

    NARCIS (Netherlands)

    J. Roukema (Jolt); R.K. Los (Renske); S.E. Bleeker (Sacha); A.M. van Ginneken (Astrid); J. van der Lei (Johan); H.A. Moll (Henriëtte)

    2006-01-01

    textabstractBACKGROUND. Implementation of electronic medical record systems promises significant advances in patient care, because such systems enhance readability, availability, and data quality. Structured data entry (SDE) applications can prompt for completeness, provide greater accuracy and

  10. Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres.

    Science.gov (United States)

    Stipulante, Samuel; Tubes, Rebecca; El Fassi, Mehdi; Donneau, Anne-Francoise; Van Troyen, Barbara; Hartstein, Gary; D'Orio, Vincent; Ghuysen, Alexandre

    2014-02-01

    Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liégeois d'Encadrement à la Réanimation par Téléphone) algorithm has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of this protocol in a non-Advanced Medical Priority Dispatch System area. We designed a before and after study based on a 3-month retrospective assessment of victims of OHCA in 2009, before the implementation of the ALERT protocol in Liege emergency medical communication centre (EMCC), and the prospective evaluation of the same 3 months in 2011, immediately after the implementation. At the moment of the call, dispatchers were able to identify 233 OHCA in the first period and 235 in the second. Victims were predominantly male (59%, both periods), with mean ages of 64.1 and 63.9 years, respectively. In 2009, only 9.9% victims benefited from bystander CPR, this increased to 22.5% in 2011 (p<0.0002). The main reasons for protocol under-utilisation were: assistance not offered by the dispatcher (42.3%), caller physically remote from the victim (20.6%). Median time from call to first compression, defined here as no flow time, was 253s in 2009 and 168s in 2011 (NS). Ten victims were admitted to hospital after ROSC in 2009 and 13 in 2011 (p=0.09). From the beginning and despite its under-utilisation, the ALERT protocol significantly improved the number of patients in whom bystander CPR was attempted. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. A pilot study of a Medication Rationalization (MERA) intervention.

    Science.gov (United States)

    Whitty, Rachel; Porter, Sandra; Battu, Kiran; Bhatt, Pranjal; Koo, Ellen; Kalocsai, Csilla; Wu, Peter; Delicaet, Kendra; Bogoch, Isaac I; Wu, Robert; Downar, James

    2018-02-16

    Many seriously ill and frail inpatients receive potentially inappropriate or harmful medications and do not receive medications for symptoms of advanced illness. We developed and piloted an interprofessional Medication Rationalization (MERA) approach to deprescribing inappropriate medications and prescribing appropriate comfort medications. We conducted a single-centre pilot study of inpatients at risk of 6-month mortality from advanced age or morbidity. The MERA team reviewed the patients' medications and made recommendations on the basis of guidelines. We measured end points for feasibility, acceptability, efficiency and effectiveness. We enrolled 61 of 115 (53%) eligible patients with a mean age of 79.6 years (standard deviation [SD] 11.7 yr). Patients were taking an average of 11.5 (SD 5.2) medications before admission and had an average of 2.1 symptoms with greater than 6/10 severity on the revised Edmonton Symptom Assessment System. The MERA team recommended 263 medication changes, of which 223 (85%) were accepted by both the medical team and the patient. MERA team's recommendations resulted in the discontinuation of 162 medications (mean 3.1 per patient), dose changes for 48 medications (mean 0.9 per patient) and the addition of 13 medications (mean 0.2 per patient). Patients who received the MERA intervention stopped significantly more inappropriate medications than similar non-MERA comparison patients for whom data were collected retrospectively (3.1 v. 0.9 medications per patient, p < 0.01). The MERA approach was highly acceptable to patients and medical team members. The MERA intervention is feasible, acceptable, efficient and possibly effective for changing medication use among seriously ill and frail elderly inpatients. Scalability and effectiveness may be improved through automation and integration with medication reconciliation programs. Copyright 2018, Joule Inc. or its licensors.

  12. Advanced polymers in medicine

    CERN Document Server

    Puoci, Francesco

    2014-01-01

    The book provides an up-to-date overview of the diverse medical applications of advanced polymers. The book opens by presenting important background information on polymer chemistry and physicochemical characterization of polymers. This serves as essential scientific support for the subsequent chapters, each of which is devoted to the applications of polymers in a particular medical specialty. The coverage is broad, encompassing orthopedics, ophthalmology, tissue engineering, surgery, dentistry, oncology, drug delivery, nephrology, wound dressing and healing, and cardiology. The development of polymers that enhance the biocompatibility of blood-contacting medical devices and the incorporation of polymers within biosensors are also addressed. This book is an excellent guide to the recent advances in polymeric biomaterials and bridges the gap between the research literature and standard textbooks on the applications of polymers in medicine.

  13. Applications of VLSI circuits to medical imaging

    International Nuclear Information System (INIS)

    O'Donnell, M.

    1988-01-01

    In this paper the application of advanced VLSI circuits to medical imaging is explored. The relationship of both general purpose signal processing chips and custom devices to medical imaging is discussed using examples of fabricated chips. In addition, advanced CAD tools for silicon compilation are presented. Devices built with these tools represent a possible alternative to custom devices and general purpose signal processors for the next generation of medical imaging systems

  14. [Involvement of medical representatives in team medical care].

    Science.gov (United States)

    Hirotsu, Misaki; Sohma, Michiro; Takagi, Hidehiko

    2009-04-01

    In recent years, chemotherapies have been further advanced because of successive launch of new drugs, introduction of molecular targeting, etc., and the concept of so-called Team Medical Care ,the idea of sharing interdisciplinary expertise for collaborative treatment, has steadily penetrated in the Japanese medical society. Dr. Naoto Ueno is a medical oncologist at US MD Anderson Cancer Center, the birthplace of the Team Medical Care. He has advocated the concept of ABC of Team Oncology by positioning pharmaceutical companies as Team C. Under such team practice, we believe that medical representatives of a pharmaceutical company should also play a role as a member of the Team Medical Care by providing appropriate drug use information to healthcare professionals, supporting post-marketing surveillance of treated patients, facilitating drug information sharing among healthcare professionals at medical institutions, etc.

  15. Religiousness and Spiritual Support Among Advanced Cancer Patients and Associations With End-of-Life Treatment Preferences and Quality of Life

    Science.gov (United States)

    Balboni, Tracy A.; Vanderwerker, Lauren C.; Block, Susan D.; Paulk, M. Elizabeth; Lathan, Christopher S.; Peteet, John R.; Prigerson, Holly G.

    2008-01-01

    Purpose Religion and spirituality play a role in coping with illness for many cancer patients. This study examined religiousness and spiritual support in advanced cancer patients of diverse racial/ethnic backgrounds and associations with quality of life (QOL), treatment preferences, and advance care planning. Methods The Coping With Cancer study is a federally funded, multi-institutional investigation examining factors associated with advanced cancer patient and caregiver well-being. Patients with an advanced cancer diagnosis and failure of first-line chemotherapy were interviewed at baseline regarding religiousness, spiritual support, QOL, treatment preferences, and advance care planning. Results Most (88%) of the study population (N = 230) considered religion to be at least somewhat important. Nearly half (47%) reported that their spiritual needs were minimally or not at all supported by a religious community, and 72% reported that their spiritual needs were supported minimally or not at all by the medical system. Spiritual support by religious communities or the medical system was significantly associated with patient QOL (P = .0003). Religiousness was significantly associated with wanting all measures to extend life (odds ratio, 1.96; 95% CI, 1.08 to 3.57). Conclusion Many advanced cancer patients' spiritual needs are not supported by religious communities or the medical system, and spiritual support is associated with better QOL. Religious individuals more frequently want aggressive measures to extend life. PMID:17290065

  16. Prehospital ECG transmission: comparison of advanced mobile phone and facsimile devices in an urban Emergency Medical Service System.

    Science.gov (United States)

    Väisänen, Olli; Mäkijärvi, Markku; Silfvast, Tom

    2003-05-01

    To compare the speed and reliability of electrocardiogram (ECG) transmissions from the prehospital setting to a conventional table facsimile device and to an advanced mobile phone in a Helicopter Emergency Medical Service System (HEMS). Eighteen authentic ECGs stored in the memory module of a monitor defibrillator were used. The ECGs were (1) sent directly from the monitor defibrillator to a table fax and an advanced mobile phone at the HEMS base; (2) printed out and sent from a mobile fax connected to an ordinary mobile phone to the table fax and the advanced mobile phone at the HEMS base; (3) printed out and sent from an ordinary table fax as well as from a table fax connected to a satellite phone system to the receiving devices at the HEMS base. When the ECGs were sent from the table fax via satellite, the transmission times were longer to the advanced mobile phone than to the table fax at the HEMS base (1 min 54 s+/-0 min 21 s vs. 1 min 37 s+/-0 min 20 s, (mean+/-SD), (Ptransmission from the other fax devices, there were no differences in transmission times between the two receiving devices. The fastest way to transmit ECGs to the advanced mobile phone was to send it from conventional table fax (1 min 22 s+/-0 min 18 s) and the longest transmission times were with mobile fax connected to mobile phone (5 min 23 s+/-3 min 5 s). In all ECGs transmitted except one the cardiac rhythm and ST-changes could be recognised. An advanced mobile phone is as fast and reliable as a conventional table fax in receiving ECGs. A mobile phone with advanced features is a practical tool for HEMS physicians who need to evaluate ECGs in the prehospital setting.

  17. Advances in medical diagnostic technology

    CERN Document Server

    Lai, Khin Wee; Mohamad Salim, Maheza Irna; Ong, Sang-Bing; Utama, Nugraha Priya; Myint, Yin Mon; Mohd Noor, Norliza; Supriyanto, Eko

    2014-01-01

    This book provides the most recent findings and knowledge in advanced diagnostics technology, covering a wide spectrum including brain activity analysis, breast and lung cancer detection, echocardiography, computer aided skeletal assessment to mitochondrial biology imaging at the cellular level. The authors explored magneto acoustic approaches and tissue elasticity imaging for the purpose of breast cancer detection. Perspectives in fetal echocardiography from an image processing angle are included. Diagnostic imaging in the field of mitochondrial diseases as well as the use of Computer-Aided System (CAD) are also discussed in the book. This book will be useful for students, lecturers or professional researchers in the field of biomedical sciences and image processing.

  18. Combining medical informatics and bioinformatics toward tools for personalized medicine.

    Science.gov (United States)

    Sarachan, B D; Simmons, M K; Subramanian, P; Temkin, J M

    2003-01-01

    Key bioinformatics and medical informatics research areas need to be identified to advance knowledge and understanding of disease risk factors and molecular disease pathology in the 21 st century toward new diagnoses, prognoses, and treatments. Three high-impact informatics areas are identified: predictive medicine (to identify significant correlations within clinical data using statistical and artificial intelligence methods), along with pathway informatics and cellular simulations (that combine biological knowledge with advanced informatics to elucidate molecular disease pathology). Initial predictive models have been developed for a pilot study in Huntington's disease. An initial bioinformatics platform has been developed for the reconstruction and analysis of pathways, and work has begun on pathway simulation. A bioinformatics research program has been established at GE Global Research Center as an important technology toward next generation medical diagnostics. We anticipate that 21 st century medical research will be a combination of informatics tools with traditional biology wet lab research, and that this will translate to increased use of informatics techniques in the clinic.

  19. Significance of gender in the attitude towards doctor-patient communication in medical students and physicians.

    Science.gov (United States)

    Löffler-Stastka, Henriette; Seitz, Tamara; Billeth, Sabrina; Pastner, Barbara; Preusche, Ingrid; Seidman, Charles

    2016-09-01

    Gender-specific differences in the attitudes towards doctor-patient communication among medical students and physicians were assessed. A total of 150 medical students and 51 physicians from different departments took part in the study. The association, attitude and experiences regarding doctor-patient communication were assessed with a series of tools and questionnaires. Female doctors and students tended to describe the doctor-patient communication with positive attributes, such as "helpful", "sentimental", "voluble", "sociable", "gentle", "yielding" and "peaceful". Male students and physicians, on the other hand, described doctor-patient communication as "overbearing", "robust" and "inhibited". The most frequent associations females had with the term doctor-patient communication were "empathy", "confidence", "openess", while the most frequent association of the male colleagues was "medical history". Female doctors reported speaking about the psychosocial situation of the patient significantly more often and believed in higher patient satisfaction by sharing more information. Furthermore, they reported having longer conversations with a more equal partnership than their male colleagues. Compared to male students, female students were willing to take part in training their communication skills more often and had more interest in research about doctor-patient communication. Male medical students reported self-doubt during conversations with female patients, while one third of the male physicians talked about "the power over the patient". This study indicates a gender-dependent communication style influenced by stereotypes. At the establishment of communication training these differences should be taken into account, especially to strengthen male communication skills and improve their attitudes.

  20. PATTERNS OF INTERNET USE AND THEIR IMPLICATIONS IN INDIAN MEDICAL STUDENTS: A STUDY FROM A SOUTH INDIAN MEDICAL COLLEGE

    Directory of Open Access Journals (Sweden)

    Ravi Kishore

    2016-05-01

    Full Text Available BACKGROUND Internet has become a platform for recent advances, innovative learning methods and self-assessment. Medical students spend significant time using Internet for academic and non-academic purposes. There is a dearth of clear evidence regarding patterns of internet use among Indian Medical students. An internet usage patterns study in First Year Medical students would help identify the necessity to train students in Internet access in the initial phase of Medical course. AIM To assess the Internet usage patterns in First Year Indian Medical Students. MATERIALS AND METHODS A cross-sectional study in which 132 students studying in First Year undergraduate medical course at MVJ Medical College and Research Hospital, Bangalore, a cosmopolitan city in South India, participated. Data related to internet use was captured using a pretested questionnaire. Statistical analysis was performed using Microsoft Excel version 2007. RESULTS 70% of students used internet for academic and non-academic purposes. Slow internet speed (31% and lack of time (23% were most common amongst impediments to internet use. Majority of students (57% used internet for greater than 7 hours per week. Understanding a topic better (62% seems to be most important motive for academic use of internet. 36% of students did not use any academic website. CONCLUSIONS First Year Indian Medical students spent significant amounts of time using internet for multiple purposes. There is a lack of awareness regarding academic websites and online animations among significant portion of students. Students in our study may be guided appropriately by Internet training sessions at the beginning of the Medical course to enable the best use of internet for academic purpose.

  1. Ethical analysis of non-medical fetal ultrasound.

    Science.gov (United States)

    Leung, John Lai Yin; Pang, Samantha Mei Che

    2009-09-01

    Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as 'keepsake' ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed.

  2. [Biofilms and their significance in medical microbiology].

    Science.gov (United States)

    Cernohorská, L; Votava, M

    2002-11-01

    Microorganisms are able to adhere to various surfaces and to form there a three-dimensional structure known as biofilm. In biofilms, microbial cells show characteristics and behaviours different from those of plankton cells. Intercellular signalizations of the quorum-sensing type regulate interaction between members of the biofilm. Bacteria embedded in the biofilm can escape and form well known planktonic forms, that are obviously only a part of the bacterial life cycle. Bacteria adhere also to medically important surfaces such as catheters, either urinary or intravenous ones, artificial heart valves, orthopedic implants and so on and contribute to device-related infections like cystitis, catheter-related sepsis, endocarditis etc. Once a biofilm has been established on a surface, the bacteria harboured inside are less exposed to the host's immune response and less susceptible to antibiotics. As an important cause of nosocomial infections the biofilm must remain in the centre of the microbiologist's attention.

  3. [Advances in the application of smart phones in modern medicine].

    Science.gov (United States)

    Wang, Lin; Hu, Jie; Li, Fei; Wei, Huilin; Li, Ying; Lu, Tianjian; Wang, Shuqi; Xu, Feng

    2014-02-01

    Since smart phones have been developed, significant advances in the function of mobile phone due to the development of software, hardware and accessories have been reached. Till now, smart phones have been engaged in daily life with an increasing impact. As a new medical model, mobile phone medicine is emerging and has found wide spread applications in medicine, especially in diagnosing, monitoring and screening various diseases. In addition, mo bile phone medical application shows great potential trend to improve healthcare in resource-limited regions due to its advantageous features of portability and information communication capability. Nowadays, the scientific and technological issues related to mobile phone medicine have attracted worldwide attention. In this review, we summarize state-of-the-art advances of mobile phone medicine with focus on its diagnostics applications in order to expand the fields of their applications and promote healthcare informatization.

  4. Biases in medication prescribing: the case of second-generation antipsychotics.

    Science.gov (United States)

    Makhinson, Michael

    2010-01-01

    The shift from first-generation antipsychotic medications to second-generation antipsychotic medications initially caused a wave of excitement about the potential for improved and broader efficacy of these medications concurrent with an improved side-effect profile. Recent data from high-quality research analyses have subsequently raised significant questions about these claims. This research evidence has, however, not altered prescribing behavior in a way that would be expected from fully rational evaluation of the evidence. Prescribing decisions represent poorly understood, complex behaviors influenced by a number of external and internal forces, some of which may be elucidated by advances in social and cognitive psychology. In this article, the decision to prescribe first- versus second-generation antipsychotic medications is examined, and specific social psychological biases and individual cognitive biases are hypothesized to be significant influences on clinicians. These biases may perpetuate disparity between research evidence and clinical practice.

  5. Interaction between FOXO1A-209 Genotype and Tea Drinking is Significantly Associated with Reduced Mortality at Advanced Ages

    DEFF Research Database (Denmark)

    Zeng, Yi; Chen, Huashuai; Ni, Ting

    2016-01-01

    Based on the genotypic/phenotypic data from Chinese Longitudinal Healthy Longevity Survey (CLHLS) and Cox proportional hazard model, the present study demonstrates that interactions between carrying FOXO1A-209 genotypes and tea drinking are significantly associated with lower risk of mortality...... at advanced ages. Such significant association is replicated in two independent Han Chinese CLHLS cohorts (p =0.028-0.048 in the discovery and replication cohorts, and p =0.003-0.016 in the combined dataset). We found the associations between tea drinking and reduced mortality are much stronger among carriers...... of the FOXO1A-209 genotype compared to non-carriers, and drinking tea is associated with a reversal of the negative effects of carrying FOXO1A-209 minor alleles, that is, from a substantially increased mortality risk to substantially reduced mortality risk at advanced ages. The impacts are considerably...

  6. Medical image registration for analysis

    International Nuclear Information System (INIS)

    Petrovic, V.

    2006-01-01

    Full text: Image registration techniques represent a rich family of image processing and analysis tools that aim to provide spatial correspondences across sets of medical images of similar and disparate anatomies and modalities. Image registration is a fundamental and usually the first step in medical image analysis and this paper presents a number of advanced techniques as well as demonstrates some of the advanced medical image analysis techniques they make possible. A number of both rigid and non-rigid medical image alignment algorithms of equivalent and merely consistent anatomical structures respectively are presented. The algorithms are compared in terms of their practical aims, inputs, computational complexity and level of operator (e.g. diagnostician) interaction. In particular, the focus of the methods discussion is placed on the applications and practical benefits of medical image registration. Results of medical image registration on a number of different imaging modalities and anatomies are presented demonstrating the accuracy and robustness of their application. Medical image registration is quickly becoming ubiquitous in medical imaging departments with the results of such algorithms increasingly used in complex medical image analysis and diagnostics. This paper aims to demonstrate at least part of the reason why

  7. Information Technologies (ITs) in Medical Education.

    Science.gov (United States)

    Masic, Izet; Pandza, Haris; Toromanovic, Selim; Masic, Fedja; Sivic, Suad; Zunic, Lejla; Masic, Zlatan

    2011-09-01

    Advances in medicine in recent decades are in significant correlation with the advances in the information technology. Modern information technologies (IT) have enabled faster, more reliable and comprehensive data collection. These technologies have started to create a large number of irrelevant information, which represents a limiting factor and a real growing gap, between the medical knowledge on one hand, and the ability of doctors to follow its growth on the other. Furthermore, in our environment, the term technology is generally reserved for its technical component. Education means, learning, teaching, or the process of acquiring skills or behavior modification through various exercises. Traditionally, medical education meant the oral, practical and more passive transferring of knowledge and skills from the educators to students and health professionals. For the clinical disciplines, of special importance are the principles, such as, "learning at bedside," aided by the medical literature. In doing so, these techniques enable students to contact with their teachers, and to refer to the appropriate literature. The disadvantage of these educational methods is in the fact, that teachers often do not have enough time. Additionally they are not very convenient to the horizontal and vertical integration of teaching, create weak or almost no self education, as well as, low skill levels and poor integration of education with a real social environment. In this paper authors describe application of modern IT in medical education - their advantages and disadvantages comparing with traditional ways of education.

  8. Advancing medication infusion safety through the clinical integration of technology.

    Science.gov (United States)

    Gerhart, Donald; O'Shea, Kristen; Muller, Sharon

    2013-01-01

    Adverse drug events resulting from errors in prescribing or administering medications are preventable. Within a hospital system, numerous technologies are employed to address the common sources of medication error, including the use of electronic medical records, physician order entry, smart infusion pumps, and barcode medication administration systems. Infusion safety is inherently risky because of the high-risk medications administered and the lack of integration among the stand-alone systems in most institutions. Intravenous clinical integration (IVCI) is a technology that connects electronic medical records, physician order entry, smart infusion pumps, and barcode medication administration systems. It combines the safety features of an automatically programmed infusion pump (drug, concentration, infusion rate, and patient weight, all auto-programmed into the device) with software that provides visibility to real-time clinical infusion data. Our article describes the characteristics of IVCI at WellSpan Health and its impact on patient safety. The integrated infusion system has the capability of reducing medication errors, improving patient care, reducing in-facility costs, and supporting asset management. It can enhance continuous quality improvement efforts and efficiency of clinical work flow. After implementing IVCI, the institution realized a safer patient environment and a more streamlined work flow for pharmacy and nursing.

  9. Frontiers in medical imaging technology

    International Nuclear Information System (INIS)

    Iinuma, Takeshi

    1992-01-01

    At present many medical images are used for diagnostics and treatment. After the advent of X-ray computer tomography (XCT), the violent development of medical images has continued. Medical imaging technology can be defined as the field of technology that deals with the production, processing, display, transmission, evaluation and so on of medical images, and it can be said that the present development of medical imaging diagnostics has been led by medical imaging technology. In this report, the most advanced technology of medical imaging is explained. The principle of XCT is shown. The feature of XCT is that it can image the delicate difference in the X-ray absorption factor of the cross section being measured. The technical development has been advanced to reduce the time for imaging and to heighten the resolution. The technology which brings about a large impact to future imaging diagnostics is computed radiography. Magnetic resonance imaging is the method of imaging the distribution of protons in human bodies. Positron CT is the method of measurement by injecting a positron-emitting RI. These methods are explained. (K.I.)

  10. Design considerations for medical devices in the home environment.

    Science.gov (United States)

    Kaufman-Rivi, Diana; Collins-Mitchell, Janette; Jetley, Raoul

    2010-01-01

    Patient demographics, economic forces, and technological advancements contribute to the rise in home care services. Advanced medical devices and equipment originally designed for use by trained personnel in hospitals and clinics are increasingly migrating into the home. Unlike the clinical setting, the home is an uncontrolled environment with additional hazards. The compatibility of the device with the recipient's knowledge, abilities, lifestyle, and home environment plays a significant role in their therapy and rehabilitation. The advent of new device technologies such as wireless devices and interoperability of systems lends a new and complex perspective for medical device use in the home that must also be addressed. Adequately assessing and matching the patient and their caregiver with the appropriate device technology while considering the suitability of the home environment for device operation and maintenance is a challenge that relies on good human factors principles. There is a need to address these challenges in the growing home care sector In this article, the authors take a look at some important considerations and design issues for medical devices used in the home care environment.

  11. A Korean perspective on developing a global policy for advance directives.

    Science.gov (United States)

    Kim, Soyoon; Hahm, Ki-Hyun; Park, Hyoung Wook; Kang, Hyun Hee; Sohn, Myongsei

    2010-03-01

    Despite the wide and daunting array of cross-cultural obstacles that the formulation of a global policy on advance directives will clearly pose, the need is equally evident. Specifically, the expansion of medical services driven by medical tourism, just to name one important example, makes this issue urgently relevant. While ensuring consistency across national borders, a global policy will have the additional and perhaps even more important effect of increasing the use of advance directives in clinical settings and enhancing their effectiveness within each country, regardless of where that country's state of the law currently stands. One cross-cultural issue that may represent a major obstacle in formulating, let alone applying, a global policy is whether patient autonomy as the underlying principle for the use of advance directives is a universal norm or a construct of western traditions that must be reconciled with alternative value systems that may place lesser significance on individual choice. A global policy, at a minimum, must emphasize respect for patient autonomy, provision of medical information, limits to the obligations for physicians, and portability. And though the development of a global policy will be no easy task, active engagement in close collaboration with the World Health Organization can make it possible.

  12. Medical photography: current technology, evolving issues and legal perspectives.

    Science.gov (United States)

    Harting, M T; DeWees, J M; Vela, K M; Khirallah, R T

    2015-04-01

    Medical photographic image capture and data management has undergone a rapid and compelling change in complexity over the last 20 years. This is because of multiple factors, including significant advances in ease of photograph capture, alongside an evolution of mechanisms of data portability/dissemination, combined with governmental focus on health information privacy. Literature to guide medical, legal, governmental and business professionals when dealing with issues related to medical photography is virtually nonexistent. Herein, we will address the breadth of uses of medical photography, device properties/specific devices utilised for image capture, methods of data transfer and dissemination and patient perceptions and attitudes regarding photography in a medical setting. In addition, we will address the legal implications, including legal precedent, copyright and privacy law, informed consent, protected health information and the Health Insurance Portability and Accountability Act (HIPAA), as they pertain to medical photography. © 2015 John Wiley & Sons Ltd.

  13. Factors influencing diagnosis delay of advanced breast cancer in Moroccan women.

    Science.gov (United States)

    Maghous, A; Rais, F; Ahid, S; Benhmidou, N; Bellahamou, K; Loughlimi, H; Marnouche, E; Elmajjaoui, S; Elkacemi, H; Kebdani, T; Benjaafar, N

    2016-06-07

    Delay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women. A group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records. In all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p Diagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by

  14. Port Harcourt Medical Journal: Submissions

    African Journals Online (AJOL)

    Port Harcourt Medical Journal (PMJ) is a general medical journal that will consider any original contribution that advances or illuminates medical science or ... The covering letter must include information on prior or duplicate publication and a statement of financial or other relationships that might lead to a conflict of interest.

  15. Humanization of medical education: Need of the hour

    Directory of Open Access Journals (Sweden)

    K. A. Kumar

    2014-01-01

    Full Text Available Though the importance of psychological factors in maintenance of health, as well as etiology and prognosis of diseases have been recognized in ancient medicine by discerning and thoughtful clinicians in all ages, for the large majority of the practitioners such a perception has not been there. A cross-sectional, organ-based, and symptom-centered clinical approach was largely prevalent in day-to-day medicine. Medical training also followed more or less the same path. The positive psychological and behavioral qualities needed in the physician are left to the individual student to develop on his own during studies or to the physician afterwards. Some do, many do not. The importance of communication, doctor-patient relationship, empathy and psychological sensitivity in the making of a physician started getting identified in advanced medical universities in western countries by the middle of the last century. Since then behavioral science and medical humanities have been incorporated as important modules in the graduate medical training curriculum not only in advanced western medical universities, but also in good universities elsewhere. The situation in India, till now has been quite unsatisfactory. The undergraduate medical students had only 2 weeks of clinical posting and few hours of lectures, allotted for psychiatry: Even these were not actually carried out in many institutions properly. Responding to repeated representations from mental health experts in the country and abroad, medical universities and educationists, the Medical Council of India in 2012 has made 2 weeks of Residential Internship in Psychiatry (CRRI mandatory, and also recommended incorporation of medical humanities in the MBBS curriculum. The paper presents a brief outline of how a Clinical Behavioral Sciences Training Program l incorporating medical humanities can be developed and carried out as a mainstream component for the undergraduate medical training in the country. The

  16. Medical Applications

    OpenAIRE

    Biscari, C.; Falbo, L.

    2016-01-01

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on ...

  17. Mechanical circulatory treatment of advanced heart failure

    DEFF Research Database (Denmark)

    Løgstrup, Brian B; Vase, Henrik; Gjedsted, Jakob

    2016-01-01

    Heart failure is one of the most common causes of morbidity and mortality worldwide. When patients cease to respond adequately to optimal medical therapy mechanical circulatory support has been promising. The advent of mechanical circulatory support devices has allowed significant improvements...... in patient survival and quality of life for those with advanced or end-stage heart failure. We provide a general overview of current mechanical circulatory support devices encompassing options for both short- and long-term ventricular support....

  18. Visual presentation of a medical physiology seminar modifies dental students' perception of its clinical significance.

    Science.gov (United States)

    Vuletic, L; Spalj, S; Peros, K

    2016-02-01

    The primary objective of this study was to assess whether exposing dental students to visual stimuli related to dental profession during the medical physiology seminar could affect their perception of the clinical relevance of the topic. A self-administered questionnaire on attitudes towards medical physiology was conducted amongst 105 students of the School of Dental Medicine in Zagreb, Croatia, aged 19-24 years (80% females) following a seminar on respiratory system physiology. Power-point presentation accompanying the seminar for a total of 52 students (study group) was enriched with pictures related to dental practice in order to assess whether these pictures could make the topic appear more clinically relevant for a future dentist. The results of the survey indicated that dental students in the study group perceived the topic of the seminar as more important for them as future dentists when compared to the perception of the control group (P = 0.025). The results of this survey encourage physiology lecturers to present medical physiology as clinically relevant for dental students whenever possible as this could increase students' interest in the subject and their motivation for learning. Such an approach could be particularly beneficial if there is a significant time gap between basic courses and involvement of students into clinical training for it could promote meaningful learning. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Simulation training in neurosurgery: advances in education and practice

    Science.gov (United States)

    Konakondla, Sanjay; Fong, Reginald; Schirmer, Clemens M

    2017-01-01

    The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the “real-life” feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training. The technologies can be directed at achieving early resident milestones placed by the Accreditation Council for Graduate Medical Education. We discuss various aspects of neurosurgery disciplines with specific technologic advances of simulation software. An overview of the scholarly landscape of the recent publications in the realm of medical simulation and virtual reality pertaining to neurologic surgery is provided. We analyze concurrent concept overlap between PubMed headings and provide a graphical overview of the associations between these terms. PMID:28765716

  20. Eldercare at Home: Advanced Directives

    Science.gov (United States)

    ... permanently? Helping the person fill out a living will (advance directive) A living will states a person's wishes about medical care if ... never be in a situation where another person will have to make decisions ... it is to have an advance directive. However, don't assume that your loved ...

  1. [Research in medical education

    DEFF Research Database (Denmark)

    Ringsted, Charlotte Vibeke

    2008-01-01

    Research in medical education is a relatively new discipline. Over the past 30 years, the discipline has experienced a tremendous growth, which is reflected in an increase in the number of publications in both medical education journals and medical science journals. However, recent reviews...... of articles on medical education studies indicate a need for improvement of the quality of medical education research in order to contribute to the advancement of educational practice as well as educational research. In particular, there is a need to embed studies in a conceptual theoretical framework...

  2. The Economics of Academic Advancement Within Surgery.

    Science.gov (United States)

    Baimas-George, Maria; Fleischer, Brian; Korndorffer, James R; Slakey, Douglas; DuCoin, Christopher

    The success of an academic surgeon's career is often viewed as directly related to academic appointment; therefore, the sequence of promotion is a demanding, rigorous process. This paper seeks to define the financial implication of academic advancement across different surgical subspecialties. Data was collected from the Association of American Medical College's 2015 report of average annual salaries. Assumptions included 30 years of practice, 5 years as assistant professor, and 10 years as associate professor before advancement. The base formula used was: (average annual salary) × (years of practice [30 years - fellowship/research years]) + ($50,000 × years of fellowship/research) = total adjusted lifetime salary income. There was a significant increase in lifetime salary income with advancement from assistant to associate professor in all subspecialties when compared to an increase from associate to full professor. The greatest increase in income from assistant to associate professor was seen in transplant and cardiothoracic surgery (35% and 27%, respectively). Trauma surgery and surgical oncology had the smallest increases of 8% and 9%, respectively. With advancement to full professor, the increase in lifetime salary income was significantly less across all subspecialties, ranging from 1% in plastic surgery to 8% in pediatric surgery. When analyzing the economics of career advancement in academic surgery, there is a substantial financial benefit in lifetime income to becoming an associate professor in all fields; whereas, advancement to full professor is associated with a drastically reduced economic benefit. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. Machine medical ethics

    CERN Document Server

    Pontier, Matthijs

    2015-01-01

    The essays in this book, written by researchers from both humanities and sciences, describe various theoretical and experimental approaches to adding medical ethics to a machine in medical settings. Medical machines are in close proximity with human beings, and getting closer: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. In such contexts, machines are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for e...

  4. Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies.

    LENUS (Irish Health Repository)

    Sills, Eric Scott

    2008-01-01

    Surrogacy involves one woman (surrogate mother) carrying a child for another person\\/s (commissioning person\\/couple), based on a mutual agreement requiring the child to be handed over to the commissioning person\\/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or absent reproductive organs, or as a remedy for recurrent pregnancy loss. Additionally, surrogacy may find application in any medical context where pregnancy is contraindicated, or where a couple consisting of two males seek to become parents through oocyte donation. Gestational surrogacy is one of the main issues at the forefront of bioethics and the advanced reproductive technologies, representing an important challenge to medical law. This analysis reviews the history of surrogacy and clinical and legal issues pertaining to this branch of reproductive medicine. Interestingly, the Medical Council of Ireland does not acknowledge surrogacy in its current practice guidelines, nor is there specific legislation addressing surrogacy in Ireland at present. We therefore have developed a contract-based model for surrogacy in which, courts in Ireland may consider when confronted with a surrogacy dispute, and formulated a system to resolve any potential dispute arising from a surrogacy arrangement. While the 2005 report by the Commission on Assisted Human Reproduction (CAHR) is an expert opinion guiding the Oireachtas\\' development of specific legislation governing assisted human reproduction and surrogacy, our report represents independent scholarship on the contractual elements of surrogacy with particular focus on how Irish courts might decide on surrogacy matters in a modern day Ireland. This joint medico-legal collaborative also reviews the contract for services arrangement between the commissioning person\\/s and the surrogate, and the extent to which the contract may be enforced.

  5. Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies

    Science.gov (United States)

    Sills, Eric Scott; Healy, Clifford M

    2008-01-01

    Surrogacy involves one woman (surrogate mother) carrying a child for another person/s (commissioning person/couple), based on a mutual agreement requiring the child to be handed over to the commissioning person/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or absent reproductive organs, or as a remedy for recurrent pregnancy loss. Additionally, surrogacy may find application in any medical context where pregnancy is contraindicated, or where a couple consisting of two males seek to become parents through oocyte donation. Gestational surrogacy is one of the main issues at the forefront of bioethics and the advanced reproductive technologies, representing an important challenge to medical law. This analysis reviews the history of surrogacy and clinical and legal issues pertaining to this branch of reproductive medicine. Interestingly, the Medical Council of Ireland does not acknowledge surrogacy in its current practice guidelines, nor is there specific legislation addressing surrogacy in Ireland at present. We therefore have developed a contract-based model for surrogacy in which, courts in Ireland may consider when confronted with a surrogacy dispute, and formulated a system to resolve any potential dispute arising from a surrogacy arrangement. While the 2005 report by the Commission on Assisted Human Reproduction (CAHR) is an expert opinion guiding the Oireachtas' development of specific legislation governing assisted human reproduction and surrogacy, our report represents independent scholarship on the contractual elements of surrogacy with particular focus on how Irish courts might decide on surrogacy matters in a modern day Ireland. This joint medico-legal collaborative also reviews the contract for services arrangement between the commissioning person/s and the surrogate, and the extent to which the contract may be enforced. PMID:18983640

  6. Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies

    Directory of Open Access Journals (Sweden)

    Healy Clifford M

    2008-11-01

    Full Text Available Abstract Surrogacy involves one woman (surrogate mother carrying a child for another person/s (commissioning person/couple, based on a mutual agreement requiring the child to be handed over to the commissioning person/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or absent reproductive organs, or as a remedy for recurrent pregnancy loss. Additionally, surrogacy may find application in any medical context where pregnancy is contraindicated, or where a couple consisting of two males seek to become parents through oocyte donation. Gestational surrogacy is one of the main issues at the forefront of bioethics and the advanced reproductive technologies, representing an important challenge to medical law. This analysis reviews the history of surrogacy and clinical and legal issues pertaining to this branch of reproductive medicine. Interestingly, the Medical Council of Ireland does not acknowledge surrogacy in its current practice guidelines, nor is there specific legislation addressing surrogacy in Ireland at present. We therefore have developed a contract-based model for surrogacy in which, courts in Ireland may consider when confronted with a surrogacy dispute, and formulated a system to resolve any potential dispute arising from a surrogacy arrangement. While the 2005 report by the Commission on Assisted Human Reproduction (CAHR is an expert opinion guiding the Oireachtas' development of specific legislation governing assisted human reproduction and surrogacy, our report represents independent scholarship on the contractual elements of surrogacy with particular focus on how Irish courts might decide on surrogacy matters in a modern day Ireland. This joint medico-legal collaborative also reviews the contract for services arrangement between the commissioning person/s and the surrogate, and the extent to which the contract may be enforced.

  7. Academic Medical Centers as digital health catalysts.

    Science.gov (United States)

    DePasse, Jacqueline W; Chen, Connie E; Sawyer, Aenor; Jethwani, Kamal; Sim, Ida

    2014-09-01

    Emerging digital technologies offer enormous potential to improve quality, reduce cost, and increase patient-centeredness in healthcare. Academic Medical Centers (AMCs) play a key role in advancing medical care through cutting-edge medical research, yet traditional models for invention, validation and commercialization at AMCs have been designed around biomedical initiatives, and are less well suited for new digital health technologies. Recently, two large bi-coastal Academic Medical Centers, the University of California, San Francisco (UCSF) through the Center for Digital Health Innovation (CDHI) and Partners Healthcare through the Center for Connected Health (CCH) have launched centers focused on digital health innovation. These centers show great promise but are also subject to significant financial, organizational, and visionary challenges. We explore these AMC initiatives, which share the following characteristics: a focus on academic research methodology; integration of digital technology in educational programming; evolving models to support "clinician innovators"; strategic academic-industry collaboration and emergence of novel revenue models. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Prognostic significance of mediastinal {sup 18}F-FDG uptake in PET/CT in advanced ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bats, Anne-Sophie; Lecuru, Fabrice [Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine, Paris (France); Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Chirurgie Gynecologique et Cancerologique, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, INSERM UMR-S 747, Paris (France); Hugonnet, Florent; Faraggi, Marc [Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine, Paris (France); Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Medecine Nucleaire, Paris (France); Huchon, Cyrille [Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine, Paris (France); Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Chirurgie Gynecologique et Cancerologique, Paris (France); Bensaid, Cherazade [Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Chirurgie Gynecologique et Cancerologique, Paris (France); Pierquet-Ghazzar, Nadia [Hopital Europeen Georges-Pompidou, Assistance Publique-Hopitaux de Paris, Service de Medecine Nucleaire, Paris (France)

    2012-03-15

    To evaluate the prognostic significance of increased mediastinal {sup 18}F-FDG uptake in PET/CT for the staging of advanced ovarian cancer. We retrospectively evaluated patients managed for FIGO stage III/IV ovarian cancer between 1 January 2006 and 1 June 2009. Patients were included if they had undergone {sup 18}F-FDG PET/CT and surgery for initial staging. Exclusion criteria were age younger than 18 years, inability to undergo general anaesthesia, recurrent ovarian cancer, and borderline or nonepithelial malignancy. Whole-body PET/CT was performed after intravenous {sup 18}F-FDG injection. The location of abnormal hot spots and {sup 18}F-FDG maximal standard uptake values (SUV{sub max}) were recorded. We compared the complete cytoreduction and survival rates in groups defined based on mediastinal {sup 18}F-FDG uptake and SUV{sub max} values. Kaplan-Meier curves of overall survival and disease-free survival were compared using the log-rank test. Hazard ratios with their 95% confidence intervals were computed. Adjusted hazard ratios were obtained using a multivariate Cox model. We included 53 patients, of whom 17 (32%) had increased mediastinal {sup 18}F-FDG uptake. Complete cytoreduction was achieved in 14 (87.5%) of the 16 patients managed with primary surgery and in 21 (75%) of the 28 patients managed with interval surgery. Complete cytoreduction was achieved significantly more often among patients without increased mediastinal {sup 18}F-FDG uptake (80.6% vs. 35.3%; p = 0.001). Disease-free survival was comparable between the two groups. By univariate analysis, overall mortality was significantly higher among patients with increased mediastinal {sup 18}F-FDG uptake (hazard ratio 5.70, 95% confidence interval 1.74-18.6). The only factor significantly associated with overall survival by multivariate analysis was complete cytoreduction (adjusted hazard ratio 0.24, 95% confidence interval 0.07-0.89). Increased mediastinal {sup 18}F-FDG uptake was common in patients

  9. A study to determine whether targeted education significantly improves the perception of human torture in medical students in India.

    Science.gov (United States)

    Husain, Munawwar; Ghaffar, Usama B; Usmani, Jawed Ahmad; Rivzi, Shameem Jahan

    2010-08-01

    This study was undertaken to find out the knowledge of torture in MBBS students. A fair comparison was done by selecting two groups of medical students; one, to whom torture was not taught ie, pretaught group (PrTG, n = 125), and second, to whom torture was taught in classroom ie, post-taught group (PoTG, n = 110) in more than one sessions. The topic on torture was taught under many headings maximising the effort to cover as much as possible; namely, definition, geographical distribution, types of torture (physical, psychological and sexual), post-torture sequelae, sociopolitical environment prevailing in the country, doctors' involvement in torture, rehabilitation of torture victims and the UNO's role in containment of torture. In all a questionnaire was designed having MCQ types on these aspects. It was found that significant level of difference in perception and knowledge about torture existed amongst the groups, and this was further accentuated in medical and non-medical intratopics. 'P' value of each question was computed separately. It was found that the study was statistically significant and reestablished the need of fortifying the gossameric firmament of education specific to torture.

  10. Current Status of Simulation-Based Training in Graduate Medical Education.

    Science.gov (United States)

    Willis, Ross E; Van Sickle, Kent R

    2015-08-01

    The use of simulation in Graduate Medical Education has evolved significantly over time, particularly during the past decade. The applications of simulation include introductory and basic technical skills, more advanced technical skills, and nontechnical skills, and simulation is gaining acceptance in high-stakes assessments. Simulation-based training has also brought about paradigm shifts in the medical and surgical education arenas and has borne new and exciting national and local consortia that will ensure that the scope and impact of simulation will continue to broaden. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Medical Services - A Significant Component of the Economic Activity

    Directory of Open Access Journals (Sweden)

    Mihalache Patricia

    2017-01-01

    The current consumer of health services is more educated and more concerned with health needs than in the past. The marketing of these services has begun to be viewed from a new perspective, more aggressive and more marketing-oriented and business oriented. The most important methods of promoting medical services refer to advertising in mass media, the Internet, social networks, professional advertising vs. institutional advertising. Private healthcare services are very well promoted in comparison with the health services in the public health system.

  12. Significant renoprotective effect of telbivudine during preemptive antiviral therapy in advanced liver cancer patients receiving cisplatin-based chemotherapy: a case-control study.

    Science.gov (United States)

    Lin, Chih-Lang; Chien, Rong-Nan; Yeh, Charisse; Hsu, Chao-Wei; Chang, Ming-Ling; Chen, Yi-Cheng; Yeh, Chau-Ting

    2014-12-01

    Cisplatin is a known nephrotoxic agent requiring vigorous hydration before use. However, aggressive hydration could be life-threatening. Therefore, in cirrhotic patients with advanced hepatocellular carcinoma (HCC) under cisplatin-based chemotherapy, the risk of nephrotoxicity increased. Because previous studies showed that long-term telbivudine treatment improved renal function in chronic hepatitis B virus (HBV) infected patients, we conducted a case-control study to evaluate the clinical outcome of telbivudine preemptive therapy in HBV-related advanced HCC patients treated by combination chemotherapy comprising 5-fluorouracil, mitoxantrone and cisplatin (FMP). From June 2007 to March 2012, 60 patients with HBV-related advanced HCC, all receiving the same FMP chemotherapy protocol, were enrolled. Of them, 20 did not receive any antiviral therapy, whereas the remaining 40 patients (sex and age matched) received telbivudine preemptive therapy. Progressive decrease of aminotransferase levels (p 100 ml/min (n = 34), the median overall survival was significantly longer in the telbivudine-treated group (12.1 vs. 4.9 months; p = 0.042). Preemptive use of telbivudine significantly prevented eGFR deterioration caused by cisplatin-based chemotherapy in HBV-related advanced HCC. In patients with initially sufficient eGFR level, telbivudine treatment was associated with a longer overall survival.

  13. Significant variables associated with epilepsy

    International Nuclear Information System (INIS)

    Cheema, F.A.; Qayyum, K.; Ahmad, N.; Makhdoomi, A.; Safdar, A.; Asif, A.; Chaudhry, H.R.

    2003-01-01

    Objective: To study the characteristics of the epileptics and the risk factors contributing to the development of epilepsy. Results: Majority of the subjects were single (77.84%), 1st born among their siblings (25.95%), belonged to low social class (50.63%), and unemployed(25.31%). The major risk factors were family history of illness (23.52%) and positive medical problem around birth (12.66%). The presence of family history of illness, positive medical problem around birth and advanced maternal age at birth were associated with early onset of epilepsy. Vulnerability for the epilepsy also increases among hospital deliveries. Conclusion: Although the present study has identified various risk factors, yet the results need to be further confirmed through case-control studies. (author)

  14. Late presentation of chronic viral hepatitis for medical care

    DEFF Research Database (Denmark)

    Mauss, Stefan; Pol, Stanislas; Buti, Maria

    2017-01-01

    , and relevant stakeholders including patient advocacy groups, health policy-makers, international health organisations and surveillance experts, met in 2014 and 2015 to develop a draft consensus definition of late presentation with viral hepatitis for medical care. This was refined through subsequent...... consultations among the group. RESULTS: Two definitions were agreed upon. Presentation with advanced liver disease caused by chronic viral hepatitis for medical care is defined as a patient with chronic hepatitis B and C and significant fibrosis (≥ F3 assessed by either APRI score > 1.5, FIB-4 > 3.25, Fibrotest...

  15. Advancing Ethical Neuroscience Research.

    Science.gov (United States)

    Borah, B Rashmi; Strand, Nicolle K; Chillag, Kata L

    2016-12-01

    As neuroscience research advances, researchers, clinicians, and other stakeholders will face a host of ethical challenges. The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has published two reports that provide recommendations on how to advance research endeavors ethically. The commission addressed, among other issues, how to prioritize different types of neuroscience research and how to include research participants who have impaired consent capacity. The Bioethics Commission's recommendations provide a foundation for ethical guidelines as neuroscience research advances and progresses. © 2016 American Medical Association. All Rights Reserved.

  16. Medical Cyclotrons

    Science.gov (United States)

    Friesel, D. L.; Antaya, T. A.

    Particle accelerators were initially developed to address specific scientific research goals, yet they were used for practical applications, particularly medical applications, within a few years of their invention. The cyclotron's potential for producing beams for cancer therapy and medical radioisotope production was realized with the early Lawrence cyclotrons and has continued with their more technically advanced successors — synchrocyclotrons, sector-focused cyclotrons and superconducting cyclotrons. While a variety of other accelerator technologies were developed to achieve today's high energy particles, this article will chronicle the development of one type of accelerator — the cyclotron, and its medical applications. These medical and industrial applications eventually led to the commercial manufacture of both small and large cyclotrons and facilities specifically designed for applications other than scientific research.

  17. Archives: Continuing Medical Education

    African Journals Online (AJOL)

    Items 51 - 88 of 88 ... Archives: Continuing Medical Education. Journal Home > Archives: Continuing Medical Education. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 51 - 88 of 88 ...

  18. Medical education in Ecuador.

    Science.gov (United States)

    Joffre, Carrillo P; Delgado, Belgica; Kosik, Russell Olive; Huang, Lei; Zhao, Xudong; Su, Tung-Ping; Wang, Shuu-Jiun; Chen, Qi; Fan, Angela Pei-Chen

    2013-12-01

    Ecuador, the smallest of the Andean countries, is located in the northwest portion of South America. The nation's 14.5 million people have a tremendous need for high quality primary care. To describe the profound advances as well as the persistent needs in medical education in Ecuador that have occurred with globalization and with the modernization of the country. Through an extensive search of the literature; medical school data; reports from the Ecuador Ministry of Public Health and Ministry of Education; and information from the National Secretary of Higher Education, Science, and Innovation (SENESCYT), the medical education system in Ecuador has been thoroughly examined. The National System of Higher Education in Ecuador has experienced significant growth over the last 20 years. As of 2009 the system boasts 19 medical schools, all of which offer the required education needed to obtain the title of Physician, but only 12 of which offer postgraduate clinical training. Of these 19 universities, nine are public, five are private and self-financed, and five are private and co-financed. Post-graduate options for medical students include: (1) Clinical specialization, (2) Higher diploma, (3) Course specialization, (4) Master's degree, and (5) PhD degree. The rapid growth of Ecuador's system of medical education has led to inevitable gaps that threaten its ability to sustain itself. Chief among these is the lack of well-trained faculty to supply its medical schools. To ensure an adequate supply of faculty exists, the creation of sufficient postgraduate, sub-specialization, and PhD training positions must be created and maintained.

  19. Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study.

    Science.gov (United States)

    Walker, Judith H; Dewitt, Dawn E; Pallant, Julie F; Cunningham, Christine E

    2012-01-01

    Health workforce shortages are a major problem in rural areas. Australian medical schools have implemented a number of rural education and training interventions aimed at increasing medical graduates' willingness to work in rural areas. These initiatives include recruiting students from rural backgrounds, delivering training in rural areas, and providing all students with some rural exposure during their medical training. However there is little evidence regarding the impact of rural exposure versus rural origin on workforce outcomes. The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools (RCS) Program. Questionnaires were distributed to 166 medical students who had completed their RCS term in 2006; 125 (75%) responded. Medical students were asked about their preferred location and specialty for future practice, their beliefs about rural work and life, and the impact of the RCS experience on their future rural training and practice preferences. Almost half the students (47%; n=58) self-reported a 'rural background'. Significantly, students from rural backgrounds were 10 times more likely to prefer to work in rural areas when compared with other students (ppreferring general practice, 80% (n=24) wished to do so rurally. Eighty-five per cent (n=105) of students agreed that their RCS experience increased their interest in rural training and practice with 62% (n=75) of students indicating a preference for rural internship/basic training after their RCS experience. A substantial percentage (86%; n=108) agreed they would consider rural practice after their RCS experience. This baseline study provides significant evidence to support rural medical recruitment and retention through education and training, with important insights into the factors affecting preference for future rural practice. By far the most significant predictor of rural practice

  20. Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: a retrospective medical record study.

    Science.gov (United States)

    Kao, Yee-Hsin; Liu, Yao-Ting; Koo, Malcolm; Chiang, Jui-Kun

    2018-03-12

    For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. This case-control study was based on a retrospective medical chart review (January 2010 to December 2012) of advanced cancer patients who were receiving palliative home care in a community hospital in south Taiwan. The use of emergency medical services by these patients was dichotomized into either normal hours (8 a.m. to midnight, Monday to Friday, excluding public holidays) of palliative home care or outside normal hours. Logistic regression analyses were performed to evaluate factors associated with emergency services use during out-of-hours period of palliative home care. Of the 94 patients receiving palliative home care, 65 had used emergency services at least once during the 3-year study period. Of these 65 patients, 40% used emergency services during out-of-hours of palliative home care. Patients with distressing conditions (defined as the occurrence of any two conditions of dyspnea, change of consciousness, or gastrointestinal bleeding) were significantly more likely to use emergency services during out-of-hours of palliative home care. Patients at risk of developing dyspnea, change of consciousness, or gastrointestinal bleeding should be provided with relevant information regarding these symptoms and signs.

  1. Archives: Malawi Medical Journal

    African Journals Online (AJOL)

    Items 1 - 50 of 72 ... Archives: Malawi Medical Journal. Journal Home > Archives: Malawi Medical Journal. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 50 of 72 Items, 1 2 > >> ...

  2. [THE SIGNIFICANCE OF THE LEGAL PERSPECTIVE - THE LEGAL WORLD'S CONTRIBUTION TO THE MEDICAL WORLD].

    Science.gov (United States)

    Sigler-Harcavi, Alona; Cohen Ashkenazi, Limor

    2018-04-01

    Working with medical and paramedical teams has taught us that the medical staff does not fully utilize the potential of judicial decisions and precedents as a source for learning, drawing conclusions and motivating progress. Judicial ruling is an essential part of the toolbox used by medical administrators in general, and healthcare risk managers in particular. Knowing the relevant legal rulings, before you embark on any given path, is the equivalent of looking before you leap. This is not necessarily an issue of "holy scripture", but should mainly be considered as a source for expanding your perspective. Knowledge of the relevant rulings has many advantages that stem from the unique characteristics of the legal system. While the medical world has a clear and unequivocal advantage regarding knowledge and experience with respect to medicine, the legal world has various other advantages: a different and wider perspective with respect to economic and/or political considerations; universal fundamental principles, such as autonomy, equality, distributive justice, human dignity, the state's obligations to its citizens; complex systems of checks and balances, such as: desirable vs. available, the benefit of few vs. the good of the many, etc. These tools, typical of the legal world, are especially relevant to medicolegal issues, usually associated with medical administration, such as: the obligation of consultation, obligation of follow-up, treatment continuity, priorities, resource distribution, patient rights, etc. The contribution of the legal world to these issues is both unique and essential. Those who question the ability of judges to understand the medical world and to materially contribute to medical thinking and practice, claiming that they lack medical training and experience, should recognize the diverse contribution of the legal world to the medical world.

  3. Power Approaches for Implantable Medical Devices

    Directory of Open Access Journals (Sweden)

    Achraf Ben Amar

    2015-11-01

    Full Text Available Implantable medical devices have been implemented to provide treatment and to assess in vivo physiological information in humans as well as animal models for medical diagnosis and prognosis, therapeutic applications and biological science studies. The advances of micro/nanotechnology dovetailed with novel biomaterials have further enhanced biocompatibility, sensitivity, longevity and reliability in newly-emerged low-cost and compact devices. Close-loop systems with both sensing and treatment functions have also been developed to provide point-of-care and personalized medicine. Nevertheless, one of the remaining challenges is whether power can be supplied sufficiently and continuously for the operation of the entire system. This issue is becoming more and more critical to the increasing need of power for wireless communication in implanted devices towards the future healthcare infrastructure, namely mobile health (m-Health. In this review paper, methodologies to transfer and harvest energy in implantable medical devices are introduced and discussed to highlight the uses and significances of various potential power sources.

  4. Simulation training in neurosurgery: advances in education and practice

    Directory of Open Access Journals (Sweden)

    Konakondla S

    2017-07-01

    Full Text Available Sanjay Konakondla, Reginald Fong, Clemens M Schirmer Department of Neurosurgery and Neuroscience Institute, Geisinger Medical Center, Geisinger Health System, Danville, PA, USA Abstract: The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the “real-life” feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training. The technologies can be directed at achieving early resident milestones placed by the Accreditation Council for Graduate Medical Education. We discuss various aspects of neurosurgery disciplines with specific technologic advances of simulation software. An overview of the scholarly landscape of the recent publications in the realm of medical simulation and virtual reality pertaining to neurologic surgery is provided. We analyze concurrent concept overlap between PubMed headings and provide a graphical overview of the associations between these terms. Keywords: residency education, simulation, neurosurgery training, virtual reality, haptic feedback, task analysis, ACGME 

  5. Increased superior frontal gyrus activation during working memory processing in psychosis: Significant relation to cumulative antipsychotic medication and to negative symptoms.

    Science.gov (United States)

    Vogel, Tobias; Smieskova, Renata; Schmidt, André; Walter, Anna; Harrisberger, Fabienne; Eckert, Anne; Lang, Undine E; Riecher-Rössler, Anita; Graf, Marc; Borgwardt, Stefan

    2016-08-01

    Impairment in working memory (WM) is a core symptom in schizophrenia. However, little is known about how clinical features influence functional brain activity specific to WM processing during the development of first-episode psychosis (FEP) to schizophrenia (SZ). We compared functional WM-specific brain activity in FEP and SZ patients, including the effects of the duration of illness, psychopathological factors and antipsychotic medication. Cross-sectional study of male FEP (n=22) and SZ (n=20) patients performing an n-back task when undergoing functional magnetic resonance imaging (fMRI). Clinical features were collected by semi-structured interviews and medical records. The SZ group performed significantly worse than the FEP group in the 2-back condition. The SZ group also showed significantly higher activation in the left superior frontal gyrus in the 2-back versus 0-back condition (2-back>0-back). This frontal activation correlated positively with negative symptoms and with cumulative antipsychotic medication during the year before the fMRI examination. There were no significant correlations between activation and duration of illness. There was greater frontal neural activation in SZ than in FEP. This indicated differences in WM processing, and was significantly related to cumulative antipsychotic exposure and negative symptoms, but not to the duration of illness. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Helicopter Emergency Medical Services: effects, costs and benefits

    NARCIS (Netherlands)

    A.N. Ringburg (Akkie)

    2009-01-01

    textabstractAdvanced prehospital medical care with air transport was introduced in the Netherlands in May 1995. The fi rst helicopter Mobile Medical Team, also called Helicopter Emergency Medical Service (HEMS) was a joint venture initiative of the VU Medical Center in Amsterdam and the Algemene

  7. Self-medication as adaptive plasticity: increased ingestion of plant toxins by parasitized caterpillars.

    Directory of Open Access Journals (Sweden)

    Michael S Singer

    Full Text Available Self-medication is a specific therapeutic behavioral change in response to disease or parasitism. The empirical literature on self-medication has so far focused entirely on identifying cases of self-medication in which particular behaviors are linked to therapeutic outcomes. In this study, we frame self-medication in the broader realm of adaptive plasticity, which provides several testable predictions for verifying self-medication and advancing its conceptual significance. First, self-medication behavior should improve the fitness of animals infected by parasites or pathogens. Second, self-medication behavior in the absence of infection should decrease fitness. Third, infection should induce self-medication behavior. The few rigorous studies of self-medication in non-human animals have not used this theoretical framework and thus have not tested fitness costs of self-medication in the absence of disease or parasitism. Here we use manipulative experiments to test these predictions with the foraging behavior of woolly bear caterpillars (Grammia incorrupta; Lepidoptera: Arctiidae in response to their lethal endoparasites (tachinid flies. Our experiments show that the ingestion of plant toxins called pyrrolizidine alkaloids improves the survival of parasitized caterpillars by conferring resistance against tachinid flies. Consistent with theoretical prediction, excessive ingestion of these toxins reduces the survival of unparasitized caterpillars. Parasitized caterpillars are more likely than unparasitized caterpillars to specifically ingest large amounts of pyrrolizidine alkaloids. This case challenges the conventional view that self-medication behavior is restricted to animals with advanced cognitive abilities, such as primates, and empowers the science of self-medication by placing it in the domain of adaptive plasticity theory.

  8. Effectively incorporating selected multimedia content into medical publications.

    Science.gov (United States)

    Ziegler, Alexander; Mietchen, Daniel; Faber, Cornelius; von Hausen, Wolfram; Schöbel, Christoph; Sellerer, Markus; Ziegler, Andreas

    2011-02-17

    Until fairly recently, medical publications have been handicapped by being restricted to non-electronic formats, effectively preventing the dissemination of complex audiovisual and three-dimensional data. However, authors and readers could significantly profit from advances in electronic publishing that permit the inclusion of multimedia content directly into an article. For the first time, the de facto gold standard for scientific publishing, the portable document format (PDF), is used here as a platform to embed a video and an audio sequence of patient data into a publication. Fully interactive three-dimensional models of a face and a schematic representation of a human brain are also part of this publication. We discuss the potential of this approach and its impact on the communication of scientific medical data, particularly with regard to electronic and open access publications. Finally, we emphasise how medical teaching can benefit from this new tool and comment on the future of medical publishing.

  9. Artificial intelligence in medicine and cardiac imaging: harnessing big data and advanced computing to provide personalized medical diagnosis and treatment.

    Science.gov (United States)

    Dilsizian, Steven E; Siegel, Eliot L

    2014-01-01

    Although advances in information technology in the past decade have come in quantum leaps in nearly every aspect of our lives, they seem to be coming at a slower pace in the field of medicine. However, the implementation of electronic health records (EHR) in hospitals is increasing rapidly, accelerated by the meaningful use initiatives associated with the Center for Medicare & Medicaid Services EHR Incentive Programs. The transition to electronic medical records and availability of patient data has been associated with increases in the volume and complexity of patient information, as well as an increase in medical alerts, with resulting "alert fatigue" and increased expectations for rapid and accurate diagnosis and treatment. Unfortunately, these increased demands on health care providers create greater risk for diagnostic and therapeutic errors. In the near future, artificial intelligence (AI)/machine learning will likely assist physicians with differential diagnosis of disease, treatment options suggestions, and recommendations, and, in the case of medical imaging, with cues in image interpretation. Mining and advanced analysis of "big data" in health care provide the potential not only to perform "in silico" research but also to provide "real time" diagnostic and (potentially) therapeutic recommendations based on empirical data. "On demand" access to high-performance computing and large health care databases will support and sustain our ability to achieve personalized medicine. The IBM Jeopardy! Challenge, which pitted the best all-time human players against the Watson computer, captured the imagination of millions of people across the world and demonstrated the potential to apply AI approaches to a wide variety of subject matter, including medicine. The combination of AI, big data, and massively parallel computing offers the potential to create a revolutionary way of practicing evidence-based, personalized medicine.

  10. What is the significance of the circumferential margin in locally advanced rectal cancer after neoadjuvant chemoradiotherapy?

    Science.gov (United States)

    Trakarnsanga, Atthaphorn; Gonen, Mithat; Shia, Jinru; Goodman, Karyn A; Nash, Garrett M; Temple, Larissa K; Guillem, José G; Paty, Philip B; Garcia-Aguilar, Julio; Weiser, Martin R

    2013-04-01

    The circumferential resection margin (CRM) is highly prognostic for local recurrence in rectal cancer surgery without neoadjuvant treatment. However, its significance in the setting of long-course neoadjuvant chemoradiotherapy (nCRT) is not well defined. Review of a single institution's prospectively maintained database from 1998 to 2007 identified 563 patients with locally advanced rectal cancer (T3/T4 and/or N1) receiving nCRT, followed after 6 weeks by total mesorectal excision (TME). Kaplan-Meier, Cox regression, and competing risk analysis were performed. The authors noted that 75 % of all patients had stage III disease as determined by endorectal ultrasound (ERUS) and/or magnetic resonance imaging (MRI). With median follow-up of 39 months after resection, local and distant relapse were noted in 12 (2.1 %) and 98 (17.4 %) patients, respectively. On competing risk analysis, the optimal cutoff point of CRM was 1 mm for local recurrence and 2 mm for distant metastasis. Factors independently associated with local recurrence included CRM ≤1 mm, and high-grade tumor (p = 0.012 and 0.007, respectively). CRM ≤2 mm, as well as pathological, nodal, and overall tumor stage are also significant independent risk factors for distant metastasis (p = 0.025, 0.010, and dataset of locally advanced rectal cancer treated with nCRT followed by TME, CRM ≤1 mm is an independent risk factor for local recurrence and is considered a positive margin. CRM ≤2 mm was associated with distant recurrence, independent of pathological tumor and nodal stage.

  11. Medical Applications

    CERN Document Server

    Biscari, C.

    2014-12-19

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field.

  12. Medical Applications

    International Nuclear Information System (INIS)

    Biscari, C; Falbo, L

    2014-01-01

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field

  13. Regression methods for medical research

    CERN Document Server

    Tai, Bee Choo

    2013-01-01

    Regression Methods for Medical Research provides medical researchers with the skills they need to critically read and interpret research using more advanced statistical methods. The statistical requirements of interpreting and publishing in medical journals, together with rapid changes in science and technology, increasingly demands an understanding of more complex and sophisticated analytic procedures.The text explains the application of statistical models to a wide variety of practical medical investigative studies and clinical trials. Regression methods are used to appropriately answer the

  14. Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy

    International Nuclear Information System (INIS)

    Wen, Bixiu; Zhang, Luning; Wang, Chengtao; Huang, Rong; Peng, Haihua; Zhang, Tian; Dong, Jun; Xiao, Weiwei; Zeng, Zhifan; Liu, Mengzhong; Gao, Yuanhong

    2015-01-01

    To investigate prognostic significance of clinical and pathological stages in patients with locally advanced rectal carcinoma treated with neoadjuvant chemoradiotherapy (neo-CRT) and total mesorectal excision. 210 patients with locally advanced rectal carcinoma (cT3-4 or cN+) treated with neo-CRT followed by total mesorectal excision. Treatment outcomes were compared according to clinical and pathological stage. Overall survival (OS), disease free survival (DFS) among patients with different clinical stage and pathological stage after neo-CRT. The median follow-up time was 47 months (range, 14–98 months). Clinical T stage was associated with 5 year OS (p = 0.042) and 5 year DFS (p = 0.014) while clinical N stage was not associated with 5 year OS (p = 0.440), 5 year DFS (p = 0.711). Pathological T stage was associate with 5 year OS (p = 0.001) and 5 year DFS (p = 0.046); and N stage was associated with 5 year OS (p = 0.001), 5 year DFS (p = 0.002). The pathological stage was further classified into three groups: ypT0–2N0 in 91 patients (43.3 %), ypT3–4N0 in 69 patients (32.9 %) and ypT0–4N+ in 50 patients (23.8 %). While pathological stage (ypT0–2 vs ypT3–4N0 vs ypT0–4N+) was associated with 5 year OS (87.9 %, 75.5 %, 56.7 %, p = 0.000), 5 year DFS (74.5 %, 77.4 %, 50.5 %, p = 0.003). Multivariate analysis showed that ypN stage was an independent prognostic factor for patients 5 year DFS. Pathological stage is strongly associated with treatment outcomes in patients with locally advanced rectal carcinoma treated with neo-CRT followed by total mesorectal excision, which may be used as guidance for further individualized treatment

  15. Medical physics. The application of physics to medicine

    International Nuclear Information System (INIS)

    Ka Weibo

    2002-01-01

    Physics has been applied to medicine for several hundred years, and has greatly spurred the development of medical science. Two important examples are medical imaging and radiation oncology. A review of the state-of-the-art of these two fields is presented for physicists. The combination of physics and medicine has not only provided advanced techniques for clinical diagnosis and treatment but has also advanced physics itself

  16. Continuing Medical Education

    African Journals Online (AJOL)

    Continuing Medical Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 25, No 9 (2007) >. Log in or Register to get access to full text downloads.

  17. Enforcement actions: Significant actions resolved material licensees (non-medical). Quarterly progress report, October 1994--December 1994

    International Nuclear Information System (INIS)

    1995-02-01

    This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (October - December 1994) and includes copies of letters, Notices, and Orders sent by the Nuclear Regulatory Commission to material licensees (non-medical) with respect to these enforcement actions. It is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication

  18. Enforcement actions: Significant actions resolved material licensees (non-medical). Quarterly progress report, October 1994--December 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-02-01

    This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (October - December 1994) and includes copies of letters, Notices, and Orders sent by the Nuclear Regulatory Commission to material licensees (non-medical) with respect to these enforcement actions. It is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication.

  19. Labour analgesia: Recent advances

    Science.gov (United States)

    Pandya, Sunil T

    2010-01-01

    Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients. Technological advances like use of ultrasound to localize epidural space in difficult cases minimizes failed epidurals and introduction of novel drug delivery modalities like patient-controlled epidural analgesia (PCEA) pumps and computer-integrated drug delivery pumps have improved the overall maternal satisfaction rate and have enabled us to customize a suitable analgesic regimen for each parturient. Recent randomized controlled trials and Cochrane studies have concluded that the association of epidurals with increased caesarean section and long-term backache remains only a myth. Studies have also shown that the newer, low-dose regimes do not have a statistically significant impact on the duration of labour and breast feeding and also that these reduce the instrumental delivery rates thus improving maternal and foetal safety. Advances in medical technology like use of ultrasound for localizing epidural space have helped the clinicians to minimize the failure rates, and many novel drug delivery modalities like PCEA and computer-integrated PCEA have contributed to the overall maternal satisfaction and safety. PMID:21189877

  20. Tutorial on Computing: Technological Advances, Social Implications, Ethical and Legal Issues

    OpenAIRE

    Debnath, Narayan

    2012-01-01

    Computing and information technology have made significant advances. The use of computing and technology is a major aspect of our lives, and this use will only continue to increase in our lifetime. Electronic digital computers and high performance communication networks are central to contemporary information technology. The computing applications in a wide range of areas including business, communications, medical research, transportation, entertainments, and education are transforming lo...

  1. Assisted Medical Procedures (AMP)

    Data.gov (United States)

    National Aeronautics and Space Administration — DOCUMENTATION, DEVELOPMENT, AND PROGRESS The AMP was initially being developed as part the Advanced Integrated Clinical System (AICS)-Guided Medical Procedure System...

  2. [Significant increase in the colonisation of Staphylococcus aureus among medical students during their hospital practices].

    Science.gov (United States)

    Rodríguez-Avial, Carmen; Alvarez-Novoa, Andrea; Losa, Azucena; Picazo, Juan J

    2013-10-01

    Staphylococcus aureus is a pathogen of major concern. The emergence of methicillin-resistant S. aureus (MRSA) has increasingly complicated the therapeutic approach of hospital-acquired infections. Surveillance of MRSA and control measures must be implemented in different healthcare settings, including screening programs for carriers. Our first aim was to determine the prevalence of methicillin-susceptible S. aureus (MSSA) and MRSA nasal carriage in medical students from the Clínico San Carlos Hospital (Madrid). As the MRSA carrier rate in healthcare workers is higher than in the general population, we hypothesised that carrier rate could be increased during their clinical practice in their last three years. We performed an epidemiologic al study of the prevalence of S. aureus colonisation among a group of medical students, who were sampled in 2008 in their third-year, and in 2012 when this class was in its sixth year. We have found a significant increase in MSSA carriage, from 27% to 46%. There were no MRSA colonisations in the third-year, but one was found in the sixth-year group. The large majority of strains (89%) of strains were resistant to penicillin, and 27% to erythromycin and clindamycin. As 19 coagulase-negative Staphylococcus MR were also identified, a horizontal transfer of genes, such as mecA gene to S. aureus, could have occurred. Medical students are both, at risk for acquiring, and a potential source of nosocomial pathogens, mainly MSSA. Therefore, they should take special care for hygienic precautions, such as frequent and proper hand washing, while working in the hospital. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  3. Technologies for Medical Sciences

    CERN Document Server

    Tavares, João; Barbosa, Marcos; Slade, AP

    2012-01-01

    This book presents novel and advanced technologies for medical sciences in order to solidify knowledge in the related fields and define their key stakeholders.   The fifteen papers included in this book were written by invited experts of international stature and address important technologies for medical sciences, including: computational modeling and simulation, image processing and analysis, medical imaging, human motion and posture, tissue engineering, design and development medical devices, and mechanic biology. Different applications are treated in such diverse fields as biomechanical studies, prosthesis and orthosis, medical diagnosis, sport, and virtual reality.   This book is of interest to researchers, students and manufacturers from  a wide range of disciplines related to bioengineering, biomechanics, computational mechanics, computational vision, human motion, mathematics, medical devices, medical image, medicine and physics.

  4. Can Individualized Learning Plans in an advanced clinical experience course for fourth year medical students foster Self-Directed Learning?

    Science.gov (United States)

    Chitkara, Maribeth B; Satnick, Daniel; Lu, Wei-Hsin; Fleit, Howard; Go, Roderick A; Chandran, Latha

    2016-09-01

    Residency programs have utilized Individualized Learning Plans (ILPs) to customize resident education while undergraduate medical education has not done so in a meaningful way. We discuss the use of ILPs within a fourth year medical school course to facilitate self-directed learning (SDL). At Stony Brook University School of Medicine, an ILP component was added to the Advanced Clinical Experience (ACE) course for fourth year students. Each completed an ILP outlining personal learning goals and strategies to achieve them. An adaptation of the Motivated Strategies for Learning Questionnaire (MSLQ) (Duncan T and McKeachie W, Educ Psych 40(2):117-128, 2005 and Cook DA et al., Med Ed 45:1230-1240, 2011) was used to measure success of ILPs in improving SDL. Qualitative data analysis was conducted on the ILPs and self-reflections. Forty-eight students participated. Two of the four SDL sub-domains identified on the MSLQ showed improvement; self-efficacy (p = .001) and self-regulation (p = .002). 'Medical Knowledge' was the competency most frequently identified as an area of concentration (90 %) and professionalism was selected least frequently (4 %). A higher percentage (83 %) of students who reported complete achievement of their ILP goals also reported feeling better prepared for entering residency. ILPs improve SDL strategies among medical students and may serve as useful tools to help shape future learning goals as they transition to residency training.

  5. Body Implanted Medical Device Communications

    Science.gov (United States)

    Yazdandoost, Kamya Yekeh; Kohno, Ryuji

    The medical care day by day and more and more is associated with and reliant upon concepts and advances of electronics and electromagnetics. Numerous medical devices are implanted in the body for medical use. Tissue implanted devices are of great interest for wireless medical applications due to the promising of different clinical usage to promote a patient independence. It can be used in hospitals, health care facilities and home to transmit patient measurement data, such as pulse and respiration rates to a nearby receiver, permitting greater patient mobility and increased comfort. As this service permits remote monitoring of several patients simultaneously it could also potentially decrease health care costs. Advancement in radio frequency communications and miniaturization of bioelectronics are supporting medical implant applications. A central component of wireless implanted device is an antenna and there are several issues to consider when designing an in-body antenna, including power consumption, size, frequency, biocompatibility and the unique RF transmission challenges posed by the human body. The radiation characteristics of such devices are important in terms of both safety and performance. The implanted antenna and human body as a medium for wireless communication are discussed over Medical Implant Communications Service (MICS) band in the frequency range of 402-405MHz.

  6. Future Directions in Medical Physics

    Science.gov (United States)

    Jeraj, Robert

    Medical Physics is a highly interdisciplinary field at the intersection between physics and medicine and biology. Medical Physics is aiming at development of novel applications of physical processes and techniques in various areas of medicine and biology. Medical Physics had and continues to have profound impact by developing improved imaging and treatment technologies, and helping to advance our understanding of the complexity of the disease. The general trend in medicine towards personalized therapy, and emphasis on accelerated translational research is having a profound impact on medical physics as well. In the traditional stronghold for medical physicists - radiation therapy - the new reality is shaping in the form of biologically conformal and combination therapies, as well as advanced particle therapy approaches, such as proton and ion therapies. Rapid increase in faster and more informative multi-modality medical imaging is bringing a wealth of information that is being complemented with data obtained from genomic profiling and other biomarkers. Novel data analysis and data mining approaches are proving grounds for employment of various artificial intelligence methods that will help further improving clinical decision making for optimization of various therapies as well as better understanding of the disease properties and disease evolution, ultimately leading to improved clinical outcomes.

  7. MEDication reminder APPs to improve medication adherence in Coronary Heart Disease (MedApp-CHD) Study: a randomised controlled trial protocol.

    Science.gov (United States)

    Santo, Karla; Chow, Clara K; Thiagalingam, Aravinda; Rogers, Kris; Chalmers, John; Redfern, Julie

    2017-10-08

    The growing number of smartphone health applications available in the app stores makes these apps a promising tool to help reduce the global problem of non-adherence to long-term medications. However, to date, there is limited evidence that available medication reminder apps are effective. This study aims to determine the impact of medication reminder apps on adherence to cardiovascular medication when compared with usual care for people with coronary heart disease (CHD) and to determine whether an advanced app compared with a basic app is associated with higher adherence. Randomised controlled trial with follow-up at 3 months to evaluate the feasibility and effectiveness of medication reminder apps on medication adherence compared with usual care. An estimated sample size of 156 patients with CHD will be randomised to one of three groups (usual care group, basic medication reminder app group and advanced medication reminder app group). The usual care group will receive standard care for CHD with no access to a medication reminder app. The basic medication reminder app group will have access to a medication reminder app with a basic feature of providing simple daily reminders with no interactivity. The advanced medication reminder app group will have access to a medication reminder app with additional interactive and customisable features. The primary outcome is medication adherence measured by the eight-item Morisky Medication Adherence Scale at 3 months. Secondary outcomes include clinical measurements of blood pressure and cholesterol levels, and medication knowledge. A process evaluation will also be performed to assess the feasibility of the intervention by evaluating the acceptability, utility and engagement with the apps. Ethical approval has been obtained from the Western Sydney Local Health Network Human Research Ethics Committee (AU/RED/HREC/1/WMEAD/3). Study findings will be disseminated via usual scientific forums. ACTRN12616000661471; Pre-results.

  8. Advanced computational approaches to biomedical engineering

    CERN Document Server

    Saha, Punam K; Basu, Subhadip

    2014-01-01

    There has been rapid growth in biomedical engineering in recent decades, given advancements in medical imaging and physiological modelling and sensing systems, coupled with immense growth in computational and network technology, analytic approaches, visualization and virtual-reality, man-machine interaction and automation. Biomedical engineering involves applying engineering principles to the medical and biological sciences and it comprises several topics including biomedicine, medical imaging, physiological modelling and sensing, instrumentation, real-time systems, automation and control, sig

  9. Genetically significant dose assessments of occupationally exposed individuals involved in industrial and medical radiographic procedures in certain establishments in Nigeria

    International Nuclear Information System (INIS)

    Jibiri, N.N.; Oguntade, G. T.

    2007-01-01

    The main source of radiation doses received by humans from man-made sources of ionizing radiation in medicine and industry comes from X-rays. The genetic risks of ionizing radiation effects on an individual who is occupationally exposed largely depend on the magnitude of the radiation dose received, period of practice, work load and radio logical procedures involved. In this work, using the linear non-thresh old model, we have attempted to assess the level of genetic risk of occupationally exposed individuals in two medical and industrial establishments in Nigeria by estimating their genetically significant dose values. The estimation was based on continuous personnel radiation dose monitoring data for the individuals in each of the establishments over a three year period (1998-2001). The estimated genetically significant dose values in the years considered were 12 mSv for the medical, and 29 mSv for the industrial personnel. Appropriate radiation protection precautions should be taken by the personnel to adhere to standard operational practices in order to minimize the genetically significant dose resulting from radio logical practices

  10. [Application of advanced engineering technologies to medical and rehabilitation fields].

    Science.gov (United States)

    Fujie, Masakatsu

    2012-07-01

    The words "Japan syndrome" can now be heard increasingly through the media. Facing the approach of an elderly-dominated society, Robot Technology(RT)is expected to play an important role in Japan's medical, rehabilitation, and daily support fields. The industrial robot, which has already spread through the world with a great success in certain isolated environments by doing the work which is specialized for the thing with the hard known characteristic. By comparison, in the medical and rehabilitation fields, environments always change intricately, and individual characteristics differ from person to person. Furthermore, there are many times when a robot will be asked to directly interact with people. Moreover, the relation between a robot and a person turns into a relation which should involve contact flexibly according to a situation, and also turns into a relation which should avoid contact. In our group, we have so far developed practical rehabilitation and medical robots which can respond to difficulties such as environmental change and individual specificity. In developing rehabilitation robots, it is especially important to consider intuitive operability and individual differences. In addition, in developing medical robots, it is important to replace the experimental knowledge of surgeons to the mechanical quantitative properties. In this article, we introduce some practical examples of rehabilitation and medical robots interweaving several detailed technologies we have so far developed.

  11. [Truth telling and advance care planning at the end of life].

    Science.gov (United States)

    Hu, Wen-Yu; Yang, Chia-Ling

    2009-02-01

    One of the core values in terminal care the respect of patient 'autonomy'. This essay begins with a discussion of medical ethics principles and the Natural Death Act in Taiwan and then summarizes two medical ethical dilemmas, truth telling and advance care planning (ACP), faced in the development of hospice and palliative care in Taiwan. The terminal truth telling process incorporates the four basic principles of Assessment and preparation, Communication with family, Truth-telling process, and Support and follow up (the so-called "ACTs"). Many experts suggest practicing ACP by abiding by the following five steps: (1) presenting and illustrating topics; (2) facilitating a structured discussion; (3) completing documents with advanced directives (ADs); (4) reviewing and updating ADs; and (5) applying ADs in clinical circumstances. Finally, the myths and challenges in truth telling and ADs include the influence of healthcare system procedures and priorities, inadequate communication skills, and the psychological barriers of medical staffs. Good communication skills are critical to truth telling and ACP. Significant discussion about ACP should help engender mutual trust between patients and the medical staffs who take the time to establish such relationships. Promoting patient autonomy by providing the opportunity of a good death is an important goal of truth telling and ACP in which patients have opportunities to choose their terminal treatment.

  12. Living Wills and Advance Directives for Medical Decisions

    Science.gov (United States)

    ... own thoughts and having conversations with others about medical care and end-of-life care are available through the American Bar Association, the Conversation Project and the Center for Practical Bioethics. You should address a number of possible end- ...

  13. Archives: Medical Journal of Zambia

    African Journals Online (AJOL)

    Items 1 - 39 of 39 ... Archives: Medical Journal of Zambia. Journal Home > Archives: Medical Journal of Zambia. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 39 of 39 Items ...

  14. Archives: Pan African Medical Journal

    African Journals Online (AJOL)

    Items 1 - 28 of 28 ... Archives: Pan African Medical Journal. Journal Home > Archives: Pan African Medical Journal. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 28 of 28 Items ...

  15. Educational leadership during a decade of medical curricular innovation and renewal.

    Science.gov (United States)

    Pinder, Karen E; Shabbits, Jennifer A

    2018-03-05

    The past decade has witnessed successful expansion, distribution and curricular renewal at the University of British Columbia (UBC) medical school. The expansion and distribution of the medical program doubled enrollment and established the first North American medical school training students across multiple geographical locations. The more recent competency-based curriculum renewal demonstrates sustained innovation within UBC medicine. This paper describes that a significant contributor to these successes has been a team of teaching faculty whose exclusive roles have been providing curricular support. Over the past decade, this group has evolved into a vital component of the day-to-day operations and performance of the distributed medical curriculum; they now provide continuity in leadership and innovation across multiple educational facets of the program. This paper reports on the evolution and significance of these faculty members. The descriptions establish the success of an investment in teaching faculty and underscore the importance of engaging faculty whose primary commitments are to teaching, educational pedagogy, and student support. This efficacious model of supporting and advancing a complex distributed medical program over more than a decade of pivotal change will be of interest to faculties and programs that are contemplating or navigating similar pursuits.

  16. Advances in asthma in 2016: Designing individualized approaches to management.

    Science.gov (United States)

    Anderson, William C; Apter, Andrea J; Dutmer, Cullen M; Searing, Daniel A; Szefler, Stanley J

    2017-09-01

    In this year's Advances in Asthma review, we discuss viral infections in asthmatic patients and potential therapeutic agents, the microbiome, novel genetic associations with asthma, air quality and climate effects on asthma, exposures during development and long-term sequelae of childhood asthma, patient-centered outcomes research, and precision medicine. In addition, we discuss application of biomarkers to precision medicine and new information on asthma medications. New evidence indicates that rhinovirus-triggered asthma exacerbations become more severe as the degree of sensitization to dust mite and mouse increase. The 2 biggest drivers of asthma severity are an allergy pathway starting with allergic sensitization and an environmental tobacco smoke pathway. In addition, allergic sensitization and blood eosinophils can be used to select medications for management of early asthma in young children. These current findings, among others covered in this review, represent significant steps toward addressing rapidly advancing areas of knowledge that have implications for asthma management. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. Introducing quality assurance and medical audit into the UCSF medical center curriculum.

    Science.gov (United States)

    Barbaccia, J C

    1976-05-01

    The experience gained by a medical school faculty in developing and piloting a course for undergraduate medical students in medical care evaluation led to a similar effort for house staff. It is recognized that if the profession is to fulfill the demand by society for social accountability in the use of resources for health care, medical care assessment and quality assurance mechanisms must become an intimate part of the clinical experience of medical students and house officers. Teaching these subjects requires a theoretical framework; introduction of content and skills appropriate to the level of the student and continuation of progressively more advanced training throughout medical education; use of assessment and quality assurance techniques by clinician-teachers themselves to provide models for the student; and continued evolution of pedagogic approach and course content based on developments in the area.

  18. Selenium: environmental significance, pollution, and biological treatment technologies.

    Science.gov (United States)

    Tan, Lea Chua; Nancharaiah, Yarlagadda V; van Hullebusch, Eric D; Lens, Piet N L

    2016-01-01

    Selenium is an essential trace element needed for all living organisms. Despite its essentiality, selenium is a potential toxic element to natural ecosystems due to its bioaccumulation potential. Though selenium is found naturally in the earth's crust, especially in carbonate rocks and volcanic and sedimentary soils, about 40% of the selenium emissions to atmospheric and aquatic environments are caused by various industrial activities such as mining-related operations. In recent years, advances in water quality and pollution monitoring have shown that selenium is a contaminant of potential environmental concern. This has practical implications on industry to achieve the stringent selenium regulatory discharge limit of 5μgSeL(-1) for selenium containing wastewaters set by the United States Environmental Protection Agency. Over the last few decades, various technologies have been developed for the treatment of selenium-containing wastewaters. Biological selenium reduction has emerged as the leading technology for removing selenium from wastewaters since it offers a cheaper alternative compared to physico-chemical treatments and is suitable for treating dilute and variable selenium-laden wastewaters. Moreover, biological treatment has the advantage of forming elemental selenium nanospheres which exhibit unique optical and spectral properties for various industrial applications, i.e. medical, electrical, and manufacturing processes. However, despite the advances in biotechnology employing selenium reduction, there are still several challenges, particularly in achieving stringent discharge limits, the long-term stability of biogenic selenium and predicting the fate of bioreduced selenium in the environment. This review highlights the significance of selenium in the environment, health, and industry and biotechnological advances made in the treatment of selenium contaminated wastewaters. The challenges and future perspectives are overviewed considering recent

  19. Ethical Conflicts Experienced by Medical Students

    Directory of Open Access Journals (Sweden)

    Márcia Mendes Menezes

    Full Text Available ABSTRACT The current study aimed to identify and analyze the prevalence of ethical conflicts experienced by medical students. This study is a cross-sectional and analytical research that was conducted in a public school in the state of Minas Gerais, Brazil. The instrument used for the data collection was a self-administered questionnaire. The data collected were presented in absolute and percentage values. For the analytical statistical treatment of the data, the level of significance was considered p <0.05. The outcome variables were: Experiences of ethical conflicts in interpersonal relations within the medical course and Ethical conduct in health care. The identification of the prevalence of ethical conflicts in the undergraduate program adopted the perspective of different interpersonal relations (academic-teaching, academic-academic, academic-employee, academic-patient, teacher-teacher, teacher-patient, teacher-employee and employee-patient. (Importance of identifying themselves to the health services user and requesting consent to perform the physical examination, assistance without the supervision of the teacher, issuance of health documents without the signature of the professional responsible and use of social networks to share data Of patient. It was verified the association of the outcome variables with sex, year of graduation and course evaluation. A total of 281 undergraduate students enrolled in all undergraduate courses in Medicine of both sexes, with a predominance of female (52.7%. The students reported having experienced conflicting situations in interpersonal relations with teachers (59.6%, provided assistance without proper supervision of a teacher (62.6%, reported having issued health documents without the accompaniment of teachers (18, 5%. The highest frequency was observed among those enrolled in the most advanced years of the undergraduate program (p <0.05. The use of social networks for the purpose of sharing patient

  20. New journals for publishing medical case reports.

    Science.gov (United States)

    Akers, Katherine G

    2016-04-01

    Because they do not rank highly in the hierarchy of evidence and are not frequently cited, case reports describing the clinical circumstances of single patients are seldom published by medical journals. However, many clinicians argue that case reports have significant educational value, advance medical knowledge, and complement evidence-based medicine. Over the last several years, a vast number (∼160) of new peer-reviewed journals have emerged that focus on publishing case reports. These journals are typically open access and have relatively high acceptance rates. However, approximately half of the publishers of case reports journals engage in questionable or "predatory" publishing practices. Authors of case reports may benefit from greater awareness of these new publication venues as well as an ability to discriminate between reputable and non-reputable journal publishers.

  1. Advances in phage display technology for drug discovery.

    Science.gov (United States)

    Omidfar, Kobra; Daneshpour, Maryam

    2015-06-01

    Over the past decade, several library-based methods have been developed to discover ligands with strong binding affinities for their targets. These methods mimic the natural evolution for screening and identifying ligand-target interactions with specific functional properties. Phage display technology is a well-established method that has been applied to many technological challenges including novel drug discovery. This review describes the recent advances in the use of phage display technology for discovering novel bioactive compounds. Furthermore, it discusses the application of this technology to produce proteins and peptides as well as minimize the use of antibodies, such as antigen-binding fragment, single-chain fragment variable or single-domain antibody fragments like VHHs. Advances in screening, manufacturing and humanization technologies demonstrate that phage display derived products can play a significant role in the diagnosis and treatment of disease. The effects of this technology are inevitable in the development pipeline for bringing therapeutics into the market, and this number is expected to rise significantly in the future as new advances continue to take place in display methods. Furthermore, a widespread application of this methodology is predicted in different medical technological areas, including biosensing, monitoring, molecular imaging, gene therapy, vaccine development and nanotechnology.

  2. Advances in medical education and practice: what millennial medical students say about flipped learning

    Directory of Open Access Journals (Sweden)

    Baig MS

    2017-09-01

    Full Text Available Mirza Shaheer Baig, Habeeba Suleman MalluBarts and The London School of Medicine and Dentistry, London, UKWe thank Pettit et al1 for their study, which explores the opinions of millennial medicalstudents with regards to “flipped learning”. As penultimate year medical students, weplace great value in the analysis of feedback from students to develop an improvedcurriculum. We share the view that our generation has a desire for variety and flexibilityin pedagogical formats. It must be noted, however, that student preference maychange as they progress through medical school and a key factor in developing aneffective curriculum is assessing the impact on attainment in addition to collectingstudent feedback.View the original paper by Pettit and colleagues

  3. Impact of treatment for depression on desire for hastened death in patients with advanced AIDS.

    Science.gov (United States)

    Breitbart, William; Rosenfeld, Barry; Gibson, Christopher; Kramer, Michael; Li, Yuelin; Tomarken, Alexis; Nelson, Christian; Pessin, Hayley; Esch, Julie; Galietta, Michele; Garcia, Nerina; Brechtl, John; Schuster, Michael

    2010-01-01

    Despite the development of multi-drug regimens for HIV, palliative care and quality-of-life issues in patients with advanced AIDS remain important areas of clinical investigation. Authors assessed the impact of treatment for depression on desire for hastened death in patients with advanced AIDS. Patients with advanced AIDS (N=372) were interviewed shortly after admission to a palliative-care facility, and were reinterviewed monthly for the next 2 months. Patients diagnosed with a major depressive syndrome were provided with antidepressant treatment and reinterviewed weekly. Desire for hastened death was assessed with two questionnaire measures. Desire for death was highly associated with depression, and it decreased dramatically in patients who responded to antidepressant treatment. Little change in desire for hastened death was observed in patients whose depression did not improve. Although improved depression was not significantly associated with the use of antidepressant medication, those individuals prescribed antidepressant medication showed the largest decreases in desire for hastened death. Successful treatment for depression appears to substantially decrease desire for hastened death in patients with advanced AIDS. The authors discuss implications of these findings for palliative-care treatment and the physician-assisted suicide debate.

  4. Deep Learning in Medical Image Analysis.

    Science.gov (United States)

    Shen, Dinggang; Wu, Guorong; Suk, Heung-Il

    2017-06-21

    This review covers computer-assisted analysis of images in the field of medical imaging. Recent advances in machine learning, especially with regard to deep learning, are helping to identify, classify, and quantify patterns in medical images. At the core of these advances is the ability to exploit hierarchical feature representations learned solely from data, instead of features designed by hand according to domain-specific knowledge. Deep learning is rapidly becoming the state of the art, leading to enhanced performance in various medical applications. We introduce the fundamentals of deep learning methods and review their successes in image registration, detection of anatomical and cellular structures, tissue segmentation, computer-aided disease diagnosis and prognosis, and so on. We conclude by discussing research issues and suggesting future directions for further improvement.

  5. Implications of Medical Tourism.

    Science.gov (United States)

    Cesario, Sandra K

    2018-06-01

    Medical tourism is an emerging industry that facilitates travel to another country for people who seek medical, surgical, or dental care that is unavailable or more affordable than in their home countries. Rapid advances in electronic communication and the ease of international travel have fueled the growth of this industry. More than half of medical travelers are women, especially for services related to cosmetic or reproductive conditions. Medical tourism creates both opportunities and challenges for nurses and other health care providers. Consumers' increased access to the global health care market necessitates the development of a structure that shapes the medical tourism industry and addresses evolving ethical, political, and human rights concerns related to this industry. Copyright © 2018 AWHONN. Published by Elsevier Inc. All rights reserved.

  6. Journal of the Obafemi Awolowo University Medical Student's ...

    African Journals Online (AJOL)

    Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. IFEMED Journal is the official publication of Obafemi Awolowo University Medical Students' Association, Ile-Ife , Nigeria . The Journal Club periodically publishes articles on medical and medically related topics ...

  7. Advanced Industrial Materials (AIM) Program: Compilation of project summaries and significant accomplishments, FY 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-04-01

    In many ways, the Advanced Industrial Materials (AIM) Program underwent a major transformation in Fiscal Year 1995 and these changes have continued to the present. When the Program was established in 1990 as the Advanced Industrial Concepts (AIC) Materials Program, the mission was to conduct applied research and development to bring materials and processing technologies from the knowledge derived from basic research to the maturity required for the end use sectors for commercialization. In 1995, the Office of Industrial Technologies (OIT) made radical changes in structure and procedures. All technology development was directed toward the seven ``Vision Industries`` that use about 80% of industrial energy and generated about 90% of industrial wastes. The mission of AIM has, therefore, changed to ``Support development and commercialization of new or improved materials to improve productivity, product quality, and energy efficiency in the major process industries.`` Though AIM remains essentially a National Laboratory Program, it is essential that each project have industrial partners, including suppliers to, and customers of, the seven industries. Now, well into FY 1996, the transition is nearly complete and the AIM Program remains reasonably healthy and productive, thanks to the superb investigators and Laboratory Program Managers. This report contains the technical details of some very remarkable work by the best materials scientists and engineers in the world. Subject areas covered are: advanced metals and composites; advanced ceramics and composites; polymers and biobased materials; and new materials and processes.

  8. The "medication interest model": an integrative clinical interviewing approach for improving medication adherence-part 2: implications for teaching and research.

    Science.gov (United States)

    Shea, Shawn Christopher

    2009-01-01

    Over the past several decades, exciting advances have been made in the art and science of teaching clinical interviewing, which are supported by an ever-growing evidence base documenting their effectiveness. In this second article in a 2-part series, the training and research implications of an innovative approach to improving medication adherence based on these educational advances--the medication interest model (MIM)--are described. The objective is to provide an "insider's view" of how to creatively teach the MIM to case managers, as well as design state-of-the-art courses and research platforms dedicated to improving medication adherence through improved clinical interviewing skills in both nursing and medical student education. The teaching and research design concepts are applicable to all primary care settings as well as specialty areas from endocrinology and cardiology to psychiatry. Evidence-based advances in the teaching of clinical interviewing skills such as response-mode research, facilic supervision, microtraining, and macrotraining lend a distinctive quality and integrative power to the MIM. The model delineates several new platforms for training and research regarding the enhancement of medication adherence including an approach for collecting individual interviewing techniques into manageable "learning modules" amenable to competency evaluation and potential certification.

  9. Laser direct writing of micro- and nano-scale medical devices

    Science.gov (United States)

    Gittard, Shaun D; Narayan, Roger J

    2010-01-01

    Laser-based direct writing of materials has undergone significant development in recent years. The ability to modify a variety of materials at small length scales and using short production times provides laser direct writing with unique capabilities for fabrication of medical devices. In many laser-based rapid prototyping methods, microscale and submicroscale structuring of materials is controlled by computer-generated models. Various laser-based direct write methods, including selective laser sintering/melting, laser machining, matrix-assisted pulsed-laser evaporation direct write, stereolithography and two-photon polymerization, are described. Their use in fabrication of microstructured and nanostructured medical devices is discussed. Laser direct writing may be used for processing a wide variety of advanced medical devices, including patient-specific prostheses, drug delivery devices, biosensors, stents and tissue-engineering scaffolds. PMID:20420557

  10. Advanced medical students' experiences and views on professionalism at Kuwait University.

    Science.gov (United States)

    Al-Abdulrazzaq, Dalia; Al-Fadhli, Amani; Arshad, Andleeb

    2014-07-23

    Professionalism is a core competency in the medical profession worldwide. Numerous studies investigate how this competency is taught and learned. However, there are few reports on the students' views and experiences with professionalism especially in the Arab world. Our aim was to explore the experiences and views of Kuwait final-year medical students on professionalism. This was a questionnaire study of final-year medical students at Kuwait University (n = 95). Open- and close-ended questions were used to determine the students' experiences and views on: definition, teaching, learning, and assessment of professionalism. Eighty-five of the students completed the questionnaire (89.5%). A total of 252 attributes defining professionalism were listed by our respondents. The majority (98.0%) of these attributes were categorized under the CanMEDS theme describing professionalism as commitment to patients, profession, and society through ethical practice. The most helpful methods in learning about professionalism for the students were contact with positive role models, patients and families, and with their own families, relatives and peers. The students' rating of the quality and quantity of teaching professionalism in the institution was quite variable. Despite this, 68.2% of the students felt very or somewhat comfortable explaining the meaning of medical professionalism to junior medical students. Almost half of the students felt that their education had always or sometimes helped them deal with professionally-challenging situations. Majority (77.6%) of the students thought that their academic assessments should include assessment of professionalism and should be used as a selection criterion in their future academic careers (62.3%). Most of the students discussed and sought advice regarding professionally-challenging situations from their fellow medical students and colleagues. Seventy-five (88.2%) students did not know which organizational body in the institution

  11. Perspectives on electronic medical records adoption: electronic medical records (EMR in outcomes research

    Directory of Open Access Journals (Sweden)

    Dan Belletti

    2010-04-01

    Full Text Available Dan Belletti1, Christopher Zacker1, C Daniel Mullins21Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; 2University of Maryland School of Pharmacy, Baltimore, MD, USAAbstract: Health information technology (HIT is engineered to promote improved quality and efficiency of care, and reduce medical errors. Healthcare organizations have made significant investments in HIT tools and the electronic medical record (EMR is a major technological advance. The Department of Veterans Affairs was one of the first large healthcare systems to fully implement EMR. The Veterans Health Information System and Technology Architecture (VistA began by providing an interface to review and update a patient’s medical record with its computerized patient record system. However, since the implementation of the VistA system there has not been an overall substantial adoption of EMR in the ambulatory or inpatient setting. In fact, only 23.9% of physicians were using EMRs in their office-based practices in 2005. A sample from the American Medical Association revealed that EMRs were available in an office setting to 17% of physicians in late 2007 and early 2008. Of these, 17% of physicians with EMR, only 4% were considered to be fully functional EMR systems. With the exception of some large aggregate EMR databases the slow adoption of EMR has limited its use in outcomes research. This paper reviews the literature and presents the current status of and forces influencing the adoption of EMR in the office-based practice, and identifies the benefits, limitations, and overall value of EMR in the conduct of outcomes research in the US.Keywords: electronic medical records, health information technology, medical errors

  12. [Qualitative research of self-management behavior in patients with advanced schistosomiasis].

    Science.gov (United States)

    Wang, Jian-ping; Wang, Xing-ju; Bao, Hui-hong; Zhang, Hong; Xu, Zheng-rong

    2013-10-01

    To explore the self-management behavior of patients with advanced schistosomiasis, so as to provide the evidence for improving clinical nursing. A total of 18 patients with advanced schistosomiasis were interviewed in depth by using a semi structured interview method. The results were analyzed with Miles and Huberman content analysis method. Most of the patients with advanced schistosomiasis had self-management control behavior and were cooperated with medical assistance because of their seriously illness. Based on data analysis, the symptom management, follow-up management, a healthy lifestyle, medication awareness, and emotional management were obtained. The patients with advanced schistosomiasis have self management control behavior. Health care workers should promote the patients, their families and social people to participate in the self-management behavior of advanced schistosomiasis patients.

  13. State-of-the-art radiation detectors for medical imaging: Demands and trends

    International Nuclear Information System (INIS)

    Darambara, Dimitra G.

    2006-01-01

    Over the last half-century a variety of significant technical advances in several scientific fields has been pointing to an exploding growth in the field of medical imaging leading to a better interpretation of more specific anatomical, biochemical and molecular pathways. In particular, the development of novel imaging detectors and readout electronics has been critical to the advancement of medical imaging allowing the invention of breakthrough platforms for simultaneous acquisition of multi-modality images at molecular level. The present paper presents a review of the challenges, demands and constraints on radiation imaging detectors imposed by the nature of the modality and the physics of the imaging source. This is followed by a concise review and perspective on various types of state-of-the-art detector technologies that have been developed to meet these requirements. Trends, prospects and new concepts for future imaging detectors are also highlighted

  14. State-of-the-art radiation detectors for medical imaging: Demands and trends

    Energy Technology Data Exchange (ETDEWEB)

    Darambara, Dimitra G. [Joint Department of Physics, Royal Marsden Foundation Trust and Institute of Cancer Research, Fulham Road, London SW3 6JJ (United Kingdom)]. E-mail: dimitra.darambara@icr.ac.uk

    2006-12-20

    Over the last half-century a variety of significant technical advances in several scientific fields has been pointing to an exploding growth in the field of medical imaging leading to a better interpretation of more specific anatomical, biochemical and molecular pathways. In particular, the development of novel imaging detectors and readout electronics has been critical to the advancement of medical imaging allowing the invention of breakthrough platforms for simultaneous acquisition of multi-modality images at molecular level. The present paper presents a review of the challenges, demands and constraints on radiation imaging detectors imposed by the nature of the modality and the physics of the imaging source. This is followed by a concise review and perspective on various types of state-of-the-art detector technologies that have been developed to meet these requirements. Trends, prospects and new concepts for future imaging detectors are also highlighted.

  15. Asthma-COPD overlap syndrome: recent advances in diagnostic criteria and prognostic significance.

    Science.gov (United States)

    Sorino, Claudio; Scichilone, Nicola; D'Amato, Maria; Patella, Vincenzo; DI Marco, Fabiano

    2017-06-01

    The term asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has been proposed for individuals with features of both asthma and COPD. Several attempts have been done to define ACOS on the basis of medical history, symptoms, and functional findings. The main diagnostic criteria include airflow obstruction with a strong although incomplete reversibility to bronchodilation tests, a significant exposure to cigarette or biomass smoke, and a history of atopy or asthma. Additional diagnostic elements include eosinophilic airway and systemic inflammation, a good response to corticosteroid treatment, and a high concentration of exhaled nitric oxide. ACOS should be distinguished from asthma with not fully reversible bronchial obstruction due to airway remodeling, thus the lack of smoking exposure should exclude the diagnosis of ACOS. In patients without a documented history of asthma before 40 years of age, an increase in FEV1 after bronchodilator >400 mL should be required to diagnose ACOS. ACOS has been found to be associated with impaired physical performance, functional ability, and health-related quality of life. The prevalence of ACOS increases with aging, then it is relatively stable in elderly individuals (>65 years). Long-term mortality of subjects with ACOS is similar to COPD, and worse than asthma and healthy controls. Future research is still needed to improve the understanding and management of ACOS.

  16. 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)

  17. The biochemistry and medical significance of the flavonoids.

    Science.gov (United States)

    Havsteen, Bent H

    2002-01-01

    Flavonoids are plant pigments that are synthesised from phenylalanine, generally display marvelous colors known from flower petals, mostly emit brilliant fluorescence when they are excited by UV light, and are ubiquitous to green plant cells. The flavonoids are used by botanists for taxonomical classification. They regulate plant growth by inhibition of the exocytosis of the auxin indolyl acetic acid, as well as by induction of gene expression, and they influence other biological cells in numerous ways. Flavonoids inhibit or kill many bacterial strains, inhibit important viral enzymes, such as reverse transcriptase and protease, and destroy some pathogenic protozoans. Yet, their toxicity to animal cells is low. Flavonoids are major functional components of many herbal and insect preparations for medical use, e.g., propolis (bee's glue) and honey, which have been used since ancient times. The daily intake of flavonoids with normal food, especially fruit and vegetables, is 1-2 g. Modern authorised physicians are increasing their use of pure flavonoids to treat many important common diseases, due to their proven ability to inhibit specific enzymes, to simulate some hormones and neurotransmitters, and to scavenge free radicals.

  18. [Recent advances in internal medicine].

    Science.gov (United States)

    Von Düring, Stephan; Mavrakanas, Thomas; Muller, Halima; Primmaz, Steve; Grosgurin, Olivier; Louis Simonet, Martine; Marti, Christophe; Nendaz, Mathieu; Serratrice, Jacques; Stirnemann, Jérome; Carballo, Sebastian; Darbellay Farhoumand, Pauline

    2018-01-17

    In medicine, there are progresses which radically transform practices, change recommendations and win unanimous support in the medical community. There are some which divide, questioning principles that seemed established. There are also small advances, which can answer the questions that internists ask themselves in the daily care of their patients. Here are several articles published in 2017, read and commented for you by hospitalists, selected according to their impact on the medical world.

  19. Risk assessment of medically assisted reproduction and advanced maternal ages in the development of Prader-Willi syndrome due to UPD(15)mat.

    Science.gov (United States)

    Matsubara, K; Murakami, N; Fukami, M; Kagami, M; Nagai, T; Ogata, T

    2016-05-01

    Recent studies have suggested that disomic oocyte-mediated uniparental disomy 15 (UPD(15)mat) is increased in patients with Prader-Willi syndrome (PWS) born after medically assisted reproduction (MAR). However, it remains unknown whether the increase is primarily due to MAR procedure itself or advanced maternal childbearing ages as a predisposing factor for the disomic oocyte production. To examine this matter, we studied 122 naturally conceived PWS patients (PWS-NC group) and 13 MAR-conceived patients (PWS-MAR group). The relative frequency of disomic oocyte-mediated UPD(15)mat was significantly higher in PWS-MAR group than in PWS-NC group (7/13 vs 20/122, p = 0.0045), and the maternal childbearing ages were significantly higher in PWS-MAR group than in PWS-NC group [median (range), 38 (26-45) vs 30 (19-42), p = 0.0015]. However, the logistic regression analysis revealed no significant association between the occurrence of disomic oocyte-mediated UPD(15)mat and MAR, after adjusting for childbearing age (p = 0.25). Consistent with this, while the frequency of assisted reproductive technology (ART)-conceived livebirths was higher in the PWS patients than in the Japanese general population (6.4% vs 1.1%, p = 0.00018), the distribution of childbearing ages was significantly skewed to the increased ages in the PWS patients (p < 2.2 × 10(-16) ). These results argue against a positive association of MAR procedure itself with the development of UPD(15)mat. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Medical and pharmacy students’ attitudes towards physician-pharmacist collaboration in Kuwait

    Directory of Open Access Journals (Sweden)

    Katoue MG

    2017-09-01

    Full Text Available Objective: To assess and compare the attitudes of medical and pharmacy students towards physician-pharmacist collaboration and explore their opinions about the barriers to collaborative practice in Kuwait. Methods: A cross-sectional survey of pharmacy and medical students (n=467 was conducted in Faculties of Medicine and Pharmacy, Kuwait University. Data were collected via self-administered questionnaire from first-year pharmacy and medical students and students in the last two professional years of the pharmacy and medical programs. Descriptive and comparative analyses were performed using SPSS, version 22. Statistical significance was accepted at p<0.05. Results: The response rate was 82.4%. Respondents had overall positive attitudes towards physician-pharmacist collaboration. Pharmacy students expressed significantly more positive attitudes than medical students (p< 0.001. Medical students rated the three most significant barriers to collaboration to be: pharmacists’ separation from patient care areas (n=100, 70.0%, lack of pharmacists’ access to patients’ medical record (n=90, 63.0% and physicians assuming total responsibility for clinical decision-making (n=87, 60.8%. Pharmacy students’ top three perceived barriers were: lack of pharmacists’ access to patients’ medical record (n=80, 84.2%, organizational obstacles (n=79, 83.2%, and pharmacists’ separation from patient care areas (n=77, 81.1%. Lack of interprofessional education was rated the fourth-largest barrier by both medical (n=79, 55.2% and pharmacy (n=76, 80.0% students. Conclusions: Medical and pharmacy students in Kuwait advocate physician-pharmacist collaborative practice, but both groups identified substantial barriers to implementation. Efforts are needed to enhance undergraduate/postgraduate training in interprofessional collaboration, and to overcome barriers to physician-pharmacist collaboration to advance a team approach to patient care.

  1. Advancing resident assessment in graduate medical education.

    Science.gov (United States)

    Swing, Susan R; Clyman, Stephen G; Holmboe, Eric S; Williams, Reed G

    2009-12-01

    The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007-2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008.

  2. The Frequency of Academic Burnout and Related Factors among Medical Students at Shahid Beheshti University of Medical Sciences, Tehran, in 2016

    Directory of Open Access Journals (Sweden)

    Hadi Azimi

    2016-03-01

    Full Text Available Abstract  Background: Academic burnout is the state of negative emotions and low motivation in one’s education. Understanding the status of academic burnout is the primary step to make proper decisions. The present study, therefore, was conducted to investigate comparative degrees of academic burnout among medical students in their first five semesters of medical education at Shahid Beheshti University of Medical Sciences, Tehran, Iran.  Methods: In the present cross-sectional study, a total of 525 medical students at the School of Medicine filled out the Persian version of Maslach Burnout Inventory – Student Survey from January 15 to February 5, 2016. Chi-square, Mantel-Haenszel, and Kruskal–Wallis tests were run in SPSS for data analysis. P-value<0.05 was considered significant.  Results: Based on the collected data, it was shown that 49.2% of the participants were male and 50.8% were female. Only 8 (1.5% participants were married. No statistically significant difference was observed between the variables investigated and academic burnout (P>0.05. It was also observed that only four (0.8% medical students (all new-comers were in low academic burnout group and 521 (99.2% were categorized in medium academic burnout group. Finally, it was found that academic burnout of the students increase as their educational level advance, making the first-semester students having the lowest and fifth-semester students the highest academic burnout indices (P<0.001.  Conclusion: It is concluded that, from among the variables studied, only students’ educational level made a difference in medical students’ academic burnout.Keywords: Academic efficacy; Burnout; Cynicism; Exhaustion; Medical Students 

  3. Teaching medical students to express empathy by exploring patient emotions and experiences in standardized medical encounters.

    Science.gov (United States)

    Ruiz-Moral, Roger; Pérula de Torres, Luis; Monge, Diana; García Leonardo, Cristina; Caballero, Fernando

    2017-09-01

    To increase medical students' ability to detect contextual and emotional cues and to respond empathetically to patients. a training course in communication skills and patient-centered care with different teaching activities (didactic, reflective and interactive: workshops and encounters with simulated patients) was delivered to third-year medical students just before their clerkships. The program was evaluated by an external observer (OE) and simulated patients (SP) in 2 or 3 videotaped encounters. Students improved significantly from baseline to 3rd interview in all communicative skills and domains explored both in OE (32.4%) and SP (38.3%) measurement. At the end of the course students detected significantly more clues and made more empathetic expressions. The course seems to improve the ability of students to explore the illness experience, showing more empathy in a more genuine way. This was carried out in consultations lasting 10min. The program is effective and feasible to be applied as a regular formative activity. Further research is needed to assess whether this training program is applicable to students in more advanced educational levels and if it has any additional outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. 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.

  5. Making reasonable decisions: a qualitative study of medical decision making in the care of patients with a clinically significant haemoglobin disorder.

    Science.gov (United States)

    Crowther, Helen J; Kerridge, Ian

    2015-10-01

    Therapies utilized in patients with clinically significant haemoglobin disorders appear to vary between clinicians and units. This study aimed to investigate the processes of evidence implementation and medical decision making in the care of such patients in NSW, Australia. Using semi-structured interviews, 11 haematologists discussed their medical decision-making processes with particular attention paid to the use of published evidence. Transcripts were thematically analysed by a single investigator on a line-by-line basis. Decision making surrounding the care of patients with significant haemoglobin disorders varied and was deeply contextual. Three main determinants of clinical decision making were identified - factors relating to the patient and to their illness, factors specific to the clinician and the institution in which they were practising and factors related to the notion of evidence and to utility and role of evidence-based medicine in clinical practice. Clinicians pay considerable attention to medical decision making and evidence incorporation and attempt to tailor these to particular patient contexts. However, the patient context is often inferred and when discordant with the clinician's own contexture can lead to discomfort with decision recommendations. Clinicians strive to improve comfort through the use of experience and trustworthy evidence. © 2015 John Wiley & Sons, Ltd.

  6. End-of-life costs of medical care for advanced stage cancer patients

    Directory of Open Access Journals (Sweden)

    Kovačević Aleksandra

    2015-01-01

    Full Text Available Background/Aim. Cancer, one of the leading causes of mortality in the world, imposes a substantial economic burden on each society, including Serbia. The aim of this study was to evaluate the major cancer cost drivers in Serbia. Methods. A retrospective, indepth, bottom-up analysis of two combined databases was performed in order to quantify relevant costs. End-of-life data were obtained from patients with cancer, who deceased within the first year of the established diagnose, including basic demographics, diagnosis, tumour histology, medical resource use and related costs, time and cause of death. All costs were allocated to one of the three categories of cancer health care services: primary care (included home care, hospital outpatient and hospital inpatient care. Results. Exactly 114 patients were analyzed, out of whom a high percent (48.25% had distant metastases at the moment of establishing the diagnosis. Malignant neoplasms of respiratory and intrathoracic organs were leading causes of morbidity. The average costs per patient were significantly different according to the diagnosis, with the highest (13,114.10 EUR and the lowest (4.00 EUR ones observed in the breast cancer and melanoma, respectively. The greatest impact on total costs was observed concerning pharmaceuticals, with 42% of share (monoclonal antibodies amounted to 34% of all medicines and 14% of total costs, followed by oncology medical care (21%, radiation therapy and interventional radiology (11%, surgery (9%, imaging diagnostics (9% and laboratory costs (8%. Conclusion. Cancer treatment incurs high costs, especially for end-of-life pharmaceutical expenses, ensued from medical personnel tendency to improve such patients’ quality of life in spite of nearing the end of life. Reimbursement policy on monoclonal antibodies, in particular at end-stage disease, should rely on cost-effectiveness evidence as well as documented clinical efficiency. [Projekat Ministarstva nauke

  7. See one, do one, teach one: advanced technology in medical education.

    Science.gov (United States)

    Vozenilek, John; Huff, J Stephen; Reznek, Martin; Gordon, James A

    2004-11-01

    The concept of "learning by doing" has become less acceptable, particularly when invasive procedures and high-risk care are required. Restrictions on medical educators have prompted them to seek alternative methods to teach medical knowledge and gain procedural experience. Fortunately, the last decade has seen an explosion of the number of tools available to enhance medical education: web-based education, virtual reality, and high fidelity patient simulation. This paper presents some of the consensus statements in regard to these tools agreed upon by members of the Educational Technology Section of the 2004 AEM Consensus Conference for Informatics and Technology in Emergency Department Health Care, held in Orlando, Florida. Web-based teaching: 1) Every ED should have access to medical educational materials via the Internet, computer-based training, and other effective education methods for point-of-service information, continuing medical education, and training. 2) Real-time automated tools should be integrated into Emergency Department Information Systems [EDIS] for contemporaneous education. Virtual reality [VR]: 1) Emergency physicians and emergency medicine societies should become more involved in VR development and assessment. 2) Nationally accepted protocols for the proper assessment of VR applications should be adopted and large multi-center groups should be formed to perform these studies. High-fidelity simulation: Emergency medicine residency programs should consider the use of high-fidelity patient simulators to enhance the teaching and evaluation of core competencies among trainees. Across specialties, patient simulation, virtual reality, and the Web will soon enable medical students and residents to... see one, simulate many, do one competently, and teach everyone.

  8. The experience of medical training and expectations regarding future medical practice of medical students in the Cuban-supported Medical School in Timor-Leste.

    Science.gov (United States)

    Ferrinho, Paulo; Valdes, Ana C; Cabral, Jorge

    2015-03-28

    The purpose of this paper is to describe and analyse the professional expectations and profile of medical students at the Cuban-supported School of General Medicine, in the Faculty of Medicine and Health Sciences of the National University of Timor-Leste. A piloted, standardized questionnaire, with closed- and open-ended questions, was distributed to registered medical students attending classes on the day of the survey. All data were analysed using SPSS. The statistical analysis is mostly descriptive. Students decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor. The degree of feminization of the student population is high. Medical students are in general satisfied with the training received, though demanding improvements in terms of systems to support their studies and training (e.g. libraries, laboratories, access to computers and the Internet). Medical students know that they will be needed in the public sector and that it would represent their opportunity to contribute to the public's welfare. Nonetheless, they report that they expect to combine public sector practice with private work, probably, in order to improve their earnings. This may be explained by their expectations for salaries, which are much higher than the current level of public sector salaries. A significant proportion of students are unsure about their future area of specialization. Of those that have determined their desired specialization, most intend to train as hospital specialists and to follow a hospital-based career. For many, specialization is equated with migration to study abroad. There are important differences between students at the start of their training compared with more advanced students. This paper gives an overview of student expectations for alignment with stated national human resources for health priorities for Timor-Leste.

  9. Accelerator development for medical applications

    International Nuclear Information System (INIS)

    Tanabe, Eiji

    2007-01-01

    Electron linear accelerators have been widely used in medical applications, especially in radiation therapy for cancer treatment. There are more than 7,000 medical electron linear accelerators in the world, treating over 250,000 patients per day. This paper reviews the current status of accelerator applications and technologies in radiation therapy, and presents the anticipated requirements for advanced radiation therapy technology in the foreseeable future. (author)

  10. [Projects to accelerate the practical use of innovative medical devices to collaborate with TWIns, Center for Advanced Biomedical Sciences, Waseda University and School of Engineering, The University of Tokyo].

    Science.gov (United States)

    Niimi, Shingo; Umezu, Mitsuo; Iseki, Hiroshi; Harada, Hiroshi Kasanuki Noboru; Mitsuishi, Mamoru; Kitamori, Takehiko; Tei, Yuichi; Nakaoka, Ryusuke; Haishima, Yuji

    2014-01-01

    Division of Medical Devices has been conducting the projects to accelerate the practical use of innovative medical devices to collaborate with TWIns, Center for Advanced Biomedical Sciences, Waseda University and School of Engineering, The University of Tokyo. The TWIns has been studying to aim at establishment of preclinical evaluation methods by "Engineering Based Medicine", and established Regulatory Science Institute for Medical Devices. School of Engineering, The University of Tokyo has been studying to aim at establishment of assessment methodology for innovative minimally invasive therapeutic devices, materials, and nanobio diagnostic devices. This report reviews the exchanges of personnel, the implement systems and the research progress of these projects.

  11. AAPM Medical Physics Practice Guideline 3.a: Levels of supervision for medical physicists in clinical training.

    Science.gov (United States)

    Seibert, J Anthony; Clements, Jessica B; Halvorsen, Per H; Herman, Michael G; Martin, Melissa C; Palta, Jatinder; Pfeiffer, Douglas E; Pizzutiello, Robert J; Schueler, Beth A; Shepard, S Jeff; Fairobrent, Lynne A

    2015-05-08

    The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

  12. Wearable medical systems for p-Health.

    Science.gov (United States)

    Teng, Xiao-Fei; Zhang, Yuan-Ting; Poon, Carmen C Y; Bonato, Paolo

    2008-01-01

    Driven by the growing aging population, prevalence of chronic diseases, and continuously rising healthcare costs, the healthcare system is undergoing a fundamental transformation, from the conventional hospital-centered system to an individual-centered system. Current and emerging developments in wearable medical systems will have a radical impact on this paradigm shift. Advances in wearable medical systems will enable the accessibility and affordability of healthcare, so that physiological conditions can be monitored not only at sporadic snapshots but also continuously for extended periods of time, making early disease detection and timely response to health threats possible. This paper reviews recent developments in the area of wearable medical systems for p-Health. Enabling technologies for continuous and noninvasive measurements of vital signs and biochemical variables, advances in intelligent biomedical clothing and body area networks, approaches for motion artifact reduction, strategies for wearable energy harvesting, and the establishment of standard protocols for the evaluation of wearable medical devices are presented in this paper with examples of clinical applications of these technologies.

  13. An atlas of the (near) future: cognitive computing applications for medical imaging (Conference Presentation)

    Science.gov (United States)

    LeGrand, Anne

    2017-02-01

    The role of medical imaging in global health systems is literally fundamental. Like labs, medical images are used at one point or another in almost every high cost, high value episode of care. CT scans, mammograms, and x-rays, for example, "atlas" the body and help chart a course forward for a patient's care team. Imaging precision has improved as a result of technological advancements and breakthroughs in related medical research. Those advancements also bring with them exponential growth in medical imaging data. As IBM trains Watson to "see" medical images, Ms. Le Grand will discuss recent advances made by Watson Health and explore the potential value of "augmented intelligence" to assist healthcare providers like radiologists and cardiologists, as well as the patients they serve.

  14. The preference of radiology as a postgraduate medical specialty ...

    African Journals Online (AJOL)

    Background: Recruitment into medical specialties outside the core clinical departments remains a stumbling block to advancing medical practice in Nigeria. We set out to determine the factors influencing choice of diagnostic radiology as a field of specialization by the final year medical students in Usmanu Danfodiyo ...

  15. The medical community's need for a BRC policy

    International Nuclear Information System (INIS)

    Brown, R.W.

    1992-01-01

    The quality of medical care in the United States is among the best in the world. The use of radioactive materials in medicine has led to advances in biomedical research, medical diagnostic procedures, and therapeutic procedures. Radioactive materials in medicine offer modalities that would not otherwise be available. With advances in nuclear medicine, positron emission tomography, and monoclonal antibodies, it is clear that the use of radioactive materials in medicine will be prevalent for quite some time into the future. Disposal of both by-product and naturally occurring and accelerator-produced radioactive material below-regulatory-concern (BRC) waste has been occurring for years. It is a safe and effective method for disposing of this medical radioactive waste. Without an effective, nationwide BRC policy, the medical community may be forced to send this waste to a LLW landfill, which is unnecessary and extremely costly. These additional costs for waste disposal will divert needed money for medical research programs and increase the cost of medical care while providing no increased protection of the public

  16. Journal of Ethiopian Medical Practice

    African Journals Online (AJOL)

    Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. A biannual scientific journal published by the Ethiopian Society of General Medical Practice ...

  17. Promoting advance directives among African Americans: a faith-based model.

    Science.gov (United States)

    Bullock, Karen

    2006-02-01

    Studies show that African Americans are less likely than other ethnic groups to complete advance directives. However, what influences African Americans' decisions to complete or not complete advance directives is unclear. Using a faith-based promotion model, 102 African Americans aged 55 years or older were recruited from local churches and community-based agencies to participate in a pilot study to promote advance care planning. Focus groups were used to collect data on participants' preferences for care, desire to make personal choices, values and attitudes, beliefs about death and dying, and advance directives. A standardized interview was used in the focus groups, and the data were organized and analyzed using NUDIST 4 software (QRS Software, Victoria, Australia). Three fourths of the participants refused to complete advance directives. The following factors influenced the participants' decisions about end-of-life care and completion of an advance directive: spirituality; view of suffering, death, and dying; social support networks; barriers to utilization; and mistrust of the health care system. The dissemination of information apprises individuals of their right to self-determine about their care, but educational efforts may not produce a significant change in behavior toward completion of advance care planning. Thus, ongoing efforts are needed to improve the trust that African Americans have in medical and health care providers.

  18. Prognostic Significance of p16 Expression in Advanced Cervical Cancer Treated With Definitive Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, Julie K., E-mail: jschwarz@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Lewis, James S. [Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO (United States); Department of Otolaryngology, Washington University School of Medicine, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Pfeifer, John [Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States); Huettner, Phyllis [Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States); Grigsby, Perry [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO (United States)

    2012-09-01

    Purpose: The purpose of this study was to evaluate the prognostic significance of p16 immunohistochemistry (IHC) in patients with advanced cervical cancer treated with radiation therapy. Materials and Methods: This was a retrospective study of 126 patients with International Federation of Gynecology and Obstetrics Stages Ib1-IVb cervical cancer treated with radiation. Concurrent cisplatin chemotherapy was given to 108 patients. A tissue microarray (TMA) was constructed from the paraffin-embedded diagnostic biopsy specimens. Immunoperoxidase staining was performed on the TMA and a p16 monoclonal antibody was utilized. IHC p16 extent was evaluated and scored in quartiles: 0 = no staining, 1 = 1-25% of cells staining, 2 = 26 to 50%, 3 = 51 to 75%, and 4 = 76 to 100%. Results: The p16 IHC score was 4 in 115 cases, 3 in 1, 2 in 3 and 0 in 7. There was no relationship between p16 score and tumor histology. Patients with p16-negative tumors were older (mean age at diagnosis 65 vs. 52 years for p16-positive tumors; p = 0.01). The 5-year cause-specific survivals were 33% for p16-negative cases (score = 0) compared with 63% for p16-positive cases (scores 1, 2, 3 or 4; p = 0.07). The 5-year recurrence-free survivals were 34% for those who were p16-negative vs. 57% for those who were p16-positive (p = 0.09). In addition, patients with p16-positive tumors (score > 0) were more likely to be complete metabolic responders as assessed by the 3-month posttherapy 18 [F]-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomograph compared with patients with p16-negative tumors (p = 0.03). Conclusion: p16 expression is predictive of improved survival outcome after chemoradiation therapy for advanced-stage invasive cervical carcinoma. Further testing will be needed to evaluate p16-negative cervical tumors.

  19. 78 FR 18837 - Revised Medical Criteria for Evaluating Visual Disorders

    Science.gov (United States)

    2013-03-28

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

  20. Emergency Medical Service (EMS): Rotorcraft Technology Workshop

    Science.gov (United States)

    Bauchspies, J. S.; Adams, R. J.

    1981-01-01

    A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

  1. Advances in medical education and practice: student perceptions of the flipped classroom.

    Science.gov (United States)

    Ramnanan, Christopher J; Pound, Lynley D

    2017-01-01

    The flipped classroom (FC) approach to teaching has been increasingly employed in undergraduate medical education in recent years. In FC applications, students are first exposed to content via online resources. Subsequent face-to-face class time can then be devoted to student-centered activities that promote active learning. Although the FC has been well received by students in other contexts, the perceptions of medical students regarding this innovation are unclear. This review serves as an early exploration into medical student perceptions of benefits and limitations of the FC. Medical students have generally expressed strong appreciation for the pre-class preparation activities (especially when facilitated by concise, readily accessed online tools) as well as for interactive, engaging small group classroom activities. Some students have expressed concerns with the FC and noted that suboptimal student preparation and insufficient direction and structure during active learning sessions may limit the student-centered benefits. Although students generally perceive that FC approaches can improve their learning and knowledge, this has not been conclusively shown via performances on assessment tools, which may be related to caveats with the assessment tools used. In any case, lifelong self-directed learning skills are perceived by medical students to be enhanced by the FC. In conclusion, medical students have generally expressed strong satisfaction with early applications of the FC to undergraduate medical education, and generally prefer this method to lecture-based instruction.

  2. Raising the Bar: Significant Advances and Future Needs for Promoting Learning for Students with Severe Disabilities

    Science.gov (United States)

    Spooner, Fred; Browder, Diane M.

    2015-01-01

    This essay describes major advances in educating students with severe disabilities. The authors propose that applied behavior analysis, the focus on functional life skills, and the promotion of academic content have been the major advances in the "how" and "what" of learning for this population. An increased focus on literacy,…

  3. Introducing systematic dispatcher-assisted cardiopulmonary resuscitation (telephone-CPR) in a non-Advanced Medical Priority Dispatch System (AMPDS): implementation process and costs.

    Science.gov (United States)

    Dami, Fabrice; Fuchs, Vincent; Praz, Laurent; Vader, John-Paul

    2010-07-01

    In order to improve the quality of our Emergency Medical Services (EMS), to raise bystander cardiopulmonary resuscitation rates and thereby meet what is becoming a universal standard in terms of quality of emergency services, we decided to implement systematic dispatcher-assisted or telephone-CPR (T-CPR) in our medical dispatch center, a non-Advanced Medical Priority Dispatch System. The aim of this article is to describe the implementation process, costs and results following the introduction of this new "quality" procedure. This was a prospective study. Over an 8-week period, our EMS dispatchers were given new procedures to provide T-CPR. We then collected data on all non-traumatic cardiac arrests within our state (Vaud, Switzerland) for the following 12 months. For each event, the dispatchers had to record in writing the reason they either ruled out cardiac arrest (CA) or did not propose T-CPR in the event they did suspect CA. All emergency call recordings were reviewed by the medical director of the EMS. The analysis of the recordings and the dispatchers' written explanations were then compared. During the 12-month study period, a total of 497 patients (both adults and children) were identified as having a non-traumatic cardiac arrest. Out of this total, 203 cases were excluded and 294 cases were eligible for T-CPR. Out of these eligible cases, dispatchers proposed T-CPR on 202 occasions (or 69% of eligible cases). They also erroneously proposed T-CPR on 17 occasions when a CA was wrongly identified (false positive). This represents 7.8% of all T-CPR. No costs were incurred to implement our study protocol and procedures. This study demonstrates it is possible, using a brief campaign of sensitization but without any specific training, to implement systematic dispatcher-assisted cardiopulmonary resuscitation in a non-Advanced Medical Priority Dispatch System such as our EMS that had no prior experience with systematic T-CPR. The results in terms of T-CPR delivery

  4. Faculty development programs for medical teachers in India

    Directory of Open Access Journals (Sweden)

    SANJAY ZODPEY

    2016-04-01

    Full Text Available Introduction: India has the highest number of medical colleges in the world and subsequently the higher number of medical teachers. There is a dire need of adopting a systematic approach to faculty development to enhance quality education to meet health challenges for 21st Century. This manuscript provides a landscape of faculty development programs in India, identifying gaps and opportunities for reforms in faculty development. Methods: Conventionally, FDPs are organized by medical colleges and universities through Basic Courses and Advanced Courses focusing on pedagogy. Medical Council of India is facilitating FDPs through 18 selected regional centers to enable medical teachers to avail modern education technology for teaching from July 2009. Foundation for Advancement of International Medical Education and Research has three Regional Institutes in India. Results: Recommendations include the need for formulating a national strategy for faculty development to not only enhance the quantity of medical teachers but also the quality of medical education; providing support for Departments of Medical Education/Regional Centers in terms of finance and staffing and incorporation of teaching skills in postgraduate training. Conclusion: Distance learning courses focusing on educational leadership and pedagogy for medical teachers can be an option to reach a wider audience. FDPs can be an asset in recruiting and retaining teachers as they offer valued professional development opportunities.

  5. Use of Portfolios by Medical Students: Significance of Critical Thinking

    Directory of Open Access Journals (Sweden)

    Samy A. Azer

    2008-07-01

    Full Text Available Portfolios have been used in the medical curriculum to evaluate difficult-to-assess areas such as students' attitudes, professionalism and teamwork. However, their use early in a problem-based learning (PBL course to foster deep learning and enhance students' self-directed learning has not been adequately studied. The aims of this paper are to: (1 understand the uses of portfolios and the rationale for using reflection in the early years of a PBL curriculum; (2 discuss how to introduce portfolios and encourage students' critical thinking skills, not just reflection; and (3 provide students with tips that could enhance their skills in constructing good portfolios.

  6. Processing of medical images

    International Nuclear Information System (INIS)

    Restrepo, A.

    1998-01-01

    Thanks to the innovations in the technology for the processing of medical images, to the high development of better and cheaper computers, and, additionally, to the advances in the systems of communications of medical images, the acquisition, storage and handling of digital images has acquired great importance in all the branches of the medicine. It is sought in this article to introduce some fundamental ideas of prosecution of digital images that include such aspects as their representation, storage, improvement, visualization and understanding

  7. Implementation of a pharmacist-managed heart failure medication titration clinic.

    Science.gov (United States)

    Martinez, Amanda S; Saef, Jerold; Paszczuk, Anna; Bhatt-Chugani, Hetal

    2013-06-15

    The development, implementation, and initial results of a pharmacist-managed heart failure (HF) medication titration clinic are described. In a quality-improvement initiative at a Veterans Affairs health care system, clinical pharmacists were incorporated into the hospital system's interprofessional outpatient HF clinic. In addition, a separate pharmacist-managed HF medication titration clinic was established, in which pharmacists were granted an advanced scope of practice and prescribing privileges, enabling them to initiate and adjust medication dosages under specific protocols jointly established by cardiology and pharmacy staff. Pharmacists involved in the titration clinic tracked patients' daily body weight, vital signs, and volume status using telephone-monitoring technology and via patient interviews. A retrospective chart review comparing achievement of target doses of angiotensin-converting enzyme inhibitor (ACEI), angiotensin-receptor blocker (ARB), and β-blocker therapies in a group of patients (n = 28) whose dosage titrations were carried out by nurses or physicians prior to implementation of the pharmacist-managed HF medication titration clinic and a group of patients (n = 27) enrolled in the medication titration clinic during its first six months of operation indicated that target ACEI and ARB doses were achieved in a significantly higher percentage of pharmacist-managed titration clinic enrollees (52.9% versus 31%, p = 0.007). Patients enrolled in the pharmacist-managed HF medication titration clinic also had a significantly higher rate of attainment of optimal β-blocker doses (49% versus 24.7%, p = 0.012). Implementation of a pharmacist-managed HF medication titration clinic increased the percentage of patients achieving optimal ACEI, ARB, and β-blocker dosages.

  8. Advanced gadolinia core and Toshiba advanced reactor management system

    International Nuclear Information System (INIS)

    Miyamoto, Toshiki; Yoshioka, Ritsuo; Ebisuya, Mitsuo

    1988-01-01

    At the Hamaoka Nuclear Power Station, Unit No. 3, advanced core design and core management technology have been adopted, significantly improving plant availability, operability and reliability. The outstanding technologies are the advanced gadolinia core (AGC) which utilizes gadolinium for the axial power distribution control, and Toshiba advanced reactor management system (TARMS) which uses a three-dimensional core physics simulator to calculate the power distribution. Presented here are the effects of these advanced technologies as observed during field testing. (author)

  9. Systematic Review of Patient-Specific Surgical Simulation: Toward Advancing Medical Education.

    Science.gov (United States)

    Ryu, Won Hyung A; Dharampal, Navjit; Mostafa, Ahmed E; Sharlin, Ehud; Kopp, Gail; Jacobs, William Bradley; Hurlbert, Robin John; Chan, Sonny; Sutherland, Garnette R

    Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training. We performed a systematic review of the literature using Pubmed, Embase, and Scopus focusing on themes of simulation, patient-specific, surgical procedure, and education. The study included randomized controlled trials, cohort studies, and case-control studies published between 2005 and 2016. Two independent reviewers (W.H.R. and N.D) conducted the study appraisal, data abstraction, and quality assessment of the studies. The search identified 13 studies that met the inclusion criteria; 7 studies employed computer simulations and 6 studies used 3-dimensional (3D) synthetic models. A number of surgical specialties evaluated patient-specific simulation, including neurosurgery, vascular surgery, orthopedic surgery, and interventional radiology. However, most studies were small in size and primarily aimed at feasibility assessments and early validation. Early evidence has shown feasibility and utility of patient-specific simulation for surgical education. With further development of this technology, simulation-based education may be able to support training of higher-level competencies outside the clinical settingto aid learners in their development of surgical skills. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Work-Family Balance and Academic Advancement in Medical Schools

    Science.gov (United States)

    Fox, Geri; Schwartz, Alan; Hart, Katherine M.

    2006-01-01

    Objective: This study examines various options that a faculty member might exercise to achieve work-family balance in academic medicine and their consequences for academic advancement. Method: Three data sets were analyzed: an anonymous web-administered survey of part-time tenure track-eligible University of Illinois College of Medicine (UI-COM)…

  11. Prevalence and Contents of Advance Directives of Patients with ESRD Receiving Dialysis.

    Science.gov (United States)

    Feely, Molly A; Hildebrandt, Daniel; Edakkanambeth Varayil, Jithinraj; Mueller, Paul S

    2016-12-07

    ESRD requiring dialysis is associated with increased morbidity and mortality rates, including increased rates of cognitive impairment, compared with the general population. About one quarter of patients receiving dialysis choose to discontinue dialysis at the end of life. Advance directives are intended to give providers and surrogates instruction on managing medical decision making, including end of life situations. The prevalence of advance directives is low among patients receiving dialysis. Little is known about the contents of advance directives among these patients with advance directives. We retrospectively reviewed the medical records of all patients receiving maintenance in-center hemodialysis at a tertiary academic medical center between January 1, 2007 and January 1, 2012. We collected demographic data, the prevalence of advance directives, and a content analysis of these advance directives. We specifically examined the advance directives for instructions on management of interventions at end of life, including dialysis. Among 808 patients (mean age of 68.6 years old; men =61.2%), 49% had advance directives, of which only 10.6% mentioned dialysis and only 3% specifically addressed dialysis management at end of life. Patients who had advance directives were more likely to be older (74.5 versus 65.4 years old; Phydration (34.3%), and pain management (43.4%) than dialysis (10.6%). Although one-half of the patients receiving dialysis in our study had advance directives, end of life management of dialysis was rarely addressed. Future research should focus on improving discernment and documentation of end of life values, goals, and preferences, such as dialysis-specific advance directives, among these patients. Copyright © 2016 by the American Society of Nephrology.

  12. A special designed library for medical imaging applications

    International Nuclear Information System (INIS)

    Lymberopoulos, D.; Kotsopoulos, S.; Zoupas, V.; Yoldassis, N.; Spyropoulos, C.

    1994-01-01

    The present paper deals with a sophisticated and flexible library of medical purpose image processing routines. It contains modules for simple as well as advanced gray or colour image processing. This library offers powerful features for medical image processing and analysis applications, thus providing the physician with a means of analyzing and estimating medical images in order to accomplish their diagnostic procedures

  13. MO-DE-202-00: Image-Guided Interventions: Advances in Intraoperative Imaging, Guidance, and An Emerging Role for Medical Physics in Surgery

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  14. Recent Advances of Individual BODIPY and BODIPY-Based Functional Materials in Medical Diagnostics and Treatment.

    Science.gov (United States)

    Marfin, Yuriy S; Solomonov, Alexey V; Timin, Alexander S; Rumyantsev, Evgeniy V

    2017-01-01

    The group of fluorophores on boron dipyrrin platform (4,4- difluoro-4-bora3a,4a-diaza-s-indacene, also known as BODIPY) has attracted much attention in the field of molecular sensorics, including sensing of biomolecules and bioprocesses. Structural diversity of existing BODIPY with ample opportunities of directed modification of compounds makes this class of fluorophores attractive for medical and biological purposes. The recent progress in the design and functionalization of BODIPY allows using them for modification of drug micro- and nanocarriers in order to improve their therapeutic effect in cancer treatment. At the same time, integration of BODIPY into drug carriers provides the possibility of in vitro and in vivo real time imaging of used drug carriers. The high fluorescent intensity and low toxicity of BODIPY granted for conjugation with different biomolecules. The present review focuses on the recent advances for application of individual BODIPY in medical diagnostics, antimicrobial activity, as well as establishing the role of BODIPY in labeling of biomolecules (e.g. proteins, hormones and DNA). Also the review highlights the potential of BODIPY in functionalization of drug micro- and nanocarriers in order to achieve better therapeutic efficiency compared with non-modified materials. The advantages derived from the use of BODIPY for preparation and modification of drug carriers are critically evaluated and potential for future challenges, especially concerning the design of innovative multi-functional BODIPY-based nanocarriers, is discussed in detail using representative examples from literature. Our objective was to show that BODIPY are powerful tools for bioimaging, labeling of biomolecules and construction of new multifunctional drug carriers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  15. Fraud and deceit in medical research

    Directory of Open Access Journals (Sweden)

    Umran Sarwar

    2012-01-01

    Full Text Available Publication of medical research is the cornerstone for the propagation and dissemination of medical knowledge, culminating in significant effects on the health of the world′s population. However, instances of individuals and institutions subverting the ethos of honesty and integrity on which medical research is built in order to advance personal ambitions have been well documented. Many definitions to describe this unethical behavior have been postulated, although the most descriptive is the "FFP" (fabrication, falsification, and plagiarism model put forward by the United States′ Office of Research Integrity. Research misconduct has many ramifications of which the world′s media are all too keen to demonstrate. Many high-profile cases the world over have demonstrated this lack of ethics when performing medical research. Many esteemed professionals and highly regarded world institutions have succumbed to the ambitions of a few, who for personal gains, have behaved unethically in pursuit of their own ideals. Although institutions have been set up to directly confront these issues, it would appear that a lot more is still required on the part of journals and their editors to combat this behavioral pattern. Individuals starting out at very junior positions in medical research ought to be taught the basics of medical research ethics so that populations are not failed by the very people they are turning to for assistance at times of need. This article provides a review of many of the issues of research misconduct and allows the reader to reflect and think through their own experiences of research. This hopefully will allow individuals to start asking questions on, what is an often, a poorly discussed topic in medical research.

  16. Evaluation of medically significant bacteria in colonoscopes after 8 weeks of shelf life in open air storage.

    Science.gov (United States)

    Ingram, Jackie; Gaines, Peggy; Kite, Roberta; Morgan, Marcia; Spurling, Sheila; Winsett, Rebecca P

    2013-01-01

    The purpose of this study was to examine bacterial growth in colonoscopes in a series of graduated shelf times. There is no conclusive evidence on the length of time colonoscopes can be safely stored before requiring redisinfection. Standards for processing scopes after use are described and supported by the professional organizations of gastroenterology and infection control; however, shelf life varies from 3 to 5 days and most recommendations are based on clinical consensus. In this study, four colonoscopes were used in a clinical procedure, underwent automated high-level disinfection with 2.6% buffered glutaraldehyde, and cultured after 3, 5, 7, 14, 21, 28, 42, and 56 days of shelf time. Two investigators collected all the cultures after interrater reliability was established. Cultures were processed in the microbiology laboratory. No medically significant growth was detected at any of the culture points. At Day 14 and Day 42, one of four scopes grew fewer than two colony-forming units of a medically insignificant bacterium. Using professional standards for high-level disinfection growth was suppressed for up to 8 weeks. Further evidence to assess fungal or viral growth is needed to be able to make suggestions for colonoscope shelf life.

  17. [A medical consumable material management information system].

    Science.gov (United States)

    Tang, Guoping; Hu, Liang

    2014-05-01

    Medical consumables material is essential supplies to carry out medical work, which has a wide range of varieties and a large amount of usage. How to manage it feasibly and efficiently that has been a topic of concern to everyone. This article discussed about how to design a medical consumable material management information system that has a set of standardized processes, bring together medical supplies administrator, suppliers and clinical departments. Advanced management mode, enterprise resource planning (ERP) applied to the whole system design process.

  18. Machine learning and medical imaging

    CERN Document Server

    Shen, Dinggang; Sabuncu, Mert

    2016-01-01

    Machine Learning and Medical Imaging presents state-of- the-art machine learning methods in medical image analysis. It first summarizes cutting-edge machine learning algorithms in medical imaging, including not only classical probabilistic modeling and learning methods, but also recent breakthroughs in deep learning, sparse representation/coding, and big data hashing. In the second part leading research groups around the world present a wide spectrum of machine learning methods with application to different medical imaging modalities, clinical domains, and organs. The biomedical imaging modalities include ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), histology, and microscopy images. The targeted organs span the lung, liver, brain, and prostate, while there is also a treatment of examining genetic associations. Machine Learning and Medical Imaging is an ideal reference for medical imaging researchers, industry scientists and engineers, advanced undergraduate and graduate students, a...

  19. Medical imaging

    International Nuclear Information System (INIS)

    Elliott, Alex

    2005-01-01

    Diagnostic medical imaging is a fundamental part of the practice of modern medicine and is responsible for the expenditure of considerable amounts of capital and revenue monies in healthcare systems around the world. Much research and development work is carried out, both by commercial companies and the academic community. This paper reviews briefly each of the major diagnostic medical imaging techniques-X-ray (planar and CT), ultrasound, nuclear medicine (planar, SPECT and PET) and magnetic resonance. The technical challenges facing each are highlighted, with some of the most recent developments. In terms of the future, interventional/peri-operative imaging, the advancement of molecular medicine and gene therapy are identified as potential areas of expansion

  20. Why support a women's medical college? Philadelphia's early male medical pro-feminists.

    Science.gov (United States)

    Peitzman, Steven J

    2003-01-01

    The male founders and early faculty of Philadelphia's Woman's Medical College were mostly abolitionist physicians, zealous moralists for whom medical feminism formed only one of the cherished causes they could "manfully" and righteously defend. Male faculty of the late nineteenth century comprised "self-made" men, mostly new specialists, for whom strict sexism probably seemed inconsistent with progressive medicine. For some of these physicians-obviously a small minority-defending medical women and breaking the barriers of fraternity could be consistent with "manly" responsibility. The outcome of the collaboration of women and the dissident men physicians in nineteenth-century Philadelphia amounted to another seeming paradox: the majority of the male medical profession, both locally and nationally, tyrannically hindered women's entry into the profession, yet medicine opened its doors in advance of law and the clergy; and where this first occurred, such as in the community centered on Woman's Medical College, a novel gender rearrangement arose based on collaboration and friendship.

  1. Medication and finance management among HIV-infected adults: the impact of age and cognition.

    Science.gov (United States)

    Thames, April D; Kim, Michelle S; Becker, Brian W; Foley, Jessica M; Hines, Lindsay J; Singer, Elyse J; Heaton, Robert K; Castellon, Steven A; Hinkin, Charles H

    2011-02-01

    This study examined the effects of aging and cognitive impairment on medication and finance management in an HIV sample. We observed main effects of age (older finance management. The interaction of advancing age and cognitive impairment may confer significant functional limitations for HIV individuals that may be better detected by performance-based measures of functional abilities rather than patient self-report.

  2. An overview of medical image data base

    International Nuclear Information System (INIS)

    Nishihara, Eitaro

    1992-01-01

    Recently, the systematization using computers in medical institutions has advanced, and the introduction of hospital information system has been almost completed in the large hospitals with more than 500 beds. But the objects of the management of the hospital information system are text information, and do not include the management of images of enormous quantity. By the progress of image diagnostic equipment, the digitization of medical images has advanced, but the management of images in hospitals does not utilize the merits of digital images. For the purpose of solving these problems, the picture archiving and communication system (PACS) was proposed about ten years ago, which makes medical images into a data base, and enables the on-line access to images from various places in hospitals. The studies have been continued to realize it. The features of medical image data, the present status of utilizing medical image data, the outline of the PACS, the image data base for the PACS, the problems in the realization of the data base and the technical trend, and the state of actual construction of the PACS are reported. (K.I.)

  3. Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

    Science.gov (United States)

    Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam

    2013-06-01

    Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.

  4. Examining the link between burnout and medical error: A checklist approach

    Directory of Open Access Journals (Sweden)

    Evangelia Tsiga

    2017-09-01

    Conclusions: The Medical Error Checklists developed in this study advance the study of medical errors by proposing a comprehensive, valid and reliable self-assessment tool. The results highlight the importance of hospital organizational factors in preventing medical errors.

  5. The Medical Ethics of Clinical Therapeutic Trials*

    African Journals Online (AJOL)

    carried out to advance knowledge, but from which the subject cannot be expected to receive any direct personal benefit. The Judicial Code of the American Medical Association' laid down only three requirements for human experimen- tation, to conform to its medical ethics. They are (i) the voluntary consent of the person on ...

  6. Outcomes of an Advanced Ultrasound Elective: Preparing Medical Students for Residency and Practice.

    Science.gov (United States)

    Prats, Michael I; Royall, Nelson A; Panchal, Ashish R; Way, David P; Bahner, David P

    2016-05-01

    Many medical specialties have adopted the use of ultrasound, creating demands for higher-quality ultrasound training at all levels of medical education. Little is known about the long-term benefit of integrating ultrasound training during undergraduate medical education. This study evaluated the effect of a longitudinal fourth-year undergraduate medical education elective in ultrasound and its impact on the future use of ultrasound in clinical practice. A cross-sectional survey of medical graduates from The Ohio State University College of Medicine (2006-2011) was done, comparing those who participated and those who did not participate in a rigorous ultrasound program for fourth-year medical students. A 38-item questionnaire queried graduates concerning ultrasound education in residency, their proficiency, and their current use of ultrasound in clinical practice. Surveys were completed by 116 respondents, for a return rate of 40.8% (116 of 284). The participants of the undergraduate medical education ultrasound elective (n = 61) reported more hours of ultrasound training after graduation (hands-on training, bedside scanning, and number of scans performed; P practice (P medical education ultrasound elective produced physicians who were more likely to seek additional training in residency, evaluate themselves as more proficient, and use ultrasound in their clinical practice. Early training in bedside ultrasound during undergraduate medical education yields physicians who are better prepared for integration of ultrasound into clinical practice. © 2016 by the American Institute of Ultrasound in Medicine.

  7. [The significance of the experience in organizing medical support for the troops during the war years for the development of the modern military medical infrastructure].

    Science.gov (United States)

    Pogodin, Iu I; Gurov, A N

    1995-05-01

    In the present period when combat activities are being carried out at the territory of Russia, namely in Chechnya, it is very important to solve the problem of the improvement of the infrastructure of medical service as a basis of territorial system of medical support of troops. That's why we are looking at the experience of medical support of troops in the period of the Great Patriotic war in order to determine the basic characteristic features of military medical infrastructure (MMI) of that time. Using the experience of medical support in the period of the Great Patriotic war it is necessary to draw the main attention on studying the medico-geographical aspects of the Armed Forces deployment over the whole territory of the country, state of health service system (taking into account its reformation), influence of natural, socio-economic and ecological factors of different regions upon the health of servicemen, organization of medical support of troops, proliferation of infectious and parasitic diseases, local resources and availability of medication materials, medical supplies, equipment and technique, as well as other indices which must be taken into consideration in routine situations or during disaster relief. All this information is very valuable for the process of the formation of an adequate MMF in the zone of responsibility of medical support of troops.

  8. MO-FG-BRB-02: Debater [medical physics education

    Energy Technology Data Exchange (ETDEWEB)

    Hazle, J. [UT MD Anderson Cancer Center (United States)

    2016-06-15

    Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusion of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.

  9. MO-FG-BRB-03: Debater [medical physics education

    Energy Technology Data Exchange (ETDEWEB)

    Herman, M. [Mayo Clinic (United States)

    2016-06-15

    Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusion of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.

  10. WE-H-202-04: Advanced Medical Image Registration Techniques

    International Nuclear Information System (INIS)

    Christensen, G.

    2016-01-01

    Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

  11. WE-H-202-04: Advanced Medical Image Registration Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Christensen, G. [University of Iowa (United States)

    2016-06-15

    Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

  12. Commercializing medical technology.

    Science.gov (United States)

    Scanlon, Kevin J; Lieberman, Mark A

    2007-04-01

    As medicine moves into the 21st century, life saving therapies will move from inception into medical products faster if there is a better synergy between science and business. Medicine appears to have 50-year innovative cycles of education and scientific discoveries. In the 1880's, the chemical industry in Germany was faced with the dilemma of modernization to exploit the new scientific discoveries. The solution was the spawning of novel technical colleges for training in these new chemical industries. The impact of those new employees and their groundbreaking compounds had a profound influence on medicine and medical education in Germany between 1880 and 1930. Germany dominated international science during this period and was a training center for scientists worldwide. This model of synergy between education and business was envied and admired in Europe, Asia and America. British science soon after evolved to dominate the field of science during the prewar and post World War (1930's-1970's) because the German scientists fled Hitler's government. These expatriated scientists had a profound influence on the teaching and training of British scientists, which lead to advances in medicine such as antibiotics. After the Second World War, the US government wisely funded the development of the medical infrastructure that we see today. British and German scientists in medicine moved to America because of this bountiful funding for their research. These expatriated scientists helped drive these medical advances into commercialized products by the 1980's. America has been the center of medical education and advances of biotechnology but will it continue? International scientists trained in America have started to return to Europe and Asia. These American-trained scientists and their governments are very aware of the commercial potential of biotechnology. Those governments are now more prepared to play an active role this new science. Germany, Ireland, Britain, Singapore

  13. Expression and significance of GRHL2 in esophageal cancer

    Directory of Open Access Journals (Sweden)

    Shao CC

    2017-04-01

    Full Text Available Chengcheng Shao,1 Chushu Ji,1 Xiaoqiu Wang,2 Bing Hu1 1Department of Medical Oncology, 2Department of Pathology, Anhui Provincial Hospital, Anhui Medical University, Hefei, People’s Republic of China Abstract: Esophageal cancer (EC is one of the most common causes of cancer-related mortality in the world. Although much effort has been made to improve the 5-year survival rate of patients with EC, it still remains low due to diagnosis at an advanced stage, aggressive local invasion, early metastasis, and resistance to chemotherapy. Although grainyhead-like 2 (GRHL2 has attracted interest since it has been recently identified as a novel suppressor of the epithelial–mesenchymal transition, clinical values of GRHL2 and its relationship with the metastasis-related factors, such as hypoxia-inducible factor 1α (HIF-1α and vascular endothelial growth factor (VEGF, remain unclear. In order to investigate the expression of GRHL2, HIF-1α, and VEGF, and their correlation with angiogenesis in EC, 63 patients with EC were examined. The expression of GRHL2, HIF-1α, and VEGF in tumor tissues was higher than that in adjacent tissues and was associated with tumor differentiation. GRHL2 expression was significantly correlated with lymph node metastasis and invasion depth, whereas VEGF expression was associated with tumor (TNM stage. A significant correlation was found between the expression of GRHL2 and HIF-1α. The patients expressing low GRHL2 and high HIF-1α showed significant reduction in both overall survival rate and disease-free survival rate. The results demonstrated that abnormal expression of GRHL2 is common in EC, and low expression of GRHL2 accompanied by a high expression of HIF-1α indicates poor prognosis. Keywords: esophageal neoplasms, GRHL2, HIF-1α, VEGF, MVD

  14. 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.

  15. Advances in medical education and practice: student perceptions of the flipped classroom

    Directory of Open Access Journals (Sweden)

    Sait MS

    2017-05-01

    Full Text Available Mohammed Salik Sait,1 Zohaib Siddiqui,2 Yasir Ashraf3 1Barts and the London School of Medicine and Dentistry, 2King’s College School of Medicine, 3School of Medicine, Imperial College London, London, UK  We read with great interest the article by Ramnanan and Pound which reviews the benefits and limitation of the “flipped classroom” (FC approach to teaching in medical schools.1 As fifth-year medical students from three separate UK medical institutions, we appreciate the emphasis placed on the development of an effective medical school curriculum that enables students to critically engage with the both scientific and clinical concepts. We hence share our views on the development of the FC approach to teaching. View the original paper by Ramnanan and Pound 

  16. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia.

    Science.gov (United States)

    Mehmood, Syed Imran; Norcini, John J; Borleffs, Jan C C

    2013-01-01

    Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to identify cross-cultural similarities and differences. A cross-sectional design study was conducted using a questionnaire to elicit the responses of participants from newly qualified doctors concerning the availability and significance of career advice. SPSS (version 11.0; Chicago, IL) was used to analyze the data and statistical tests, such as chi-square and unpaired t tests, were used to analyze the observations. A response rate of 94.7% was obtained. Among this group, 102 were males and 78 were females. Only 53% did receive career advice. The majority of men felt that career advice during medical studies was inadequate, while women were less negative (69% versus 32%; p = 0.0001). Furthermore, men were more disappointed about the possibilities for career advice after graduating than women (34% versus 13%, p = 0.0001). The results show that only half of newly graduated doctors had received any career advice during medical training. As the health care system cannot afford the potential waste of time and resources for doctors, career guidance should begin in undergraduate training so that the process of thinking about their future career starts longtime before they make their career choice.

  17. Deciding upon a career within the medical field

    NARCIS (Netherlands)

    Guntern, Sabine

    2016-01-01

    The admission procedure for medical programs is a challenging topic. The challenge for universities is to accept those applicants who have the best chances of successfully completing the medical studies and who will also enter the advanced training programs after graduation. The overall goal of this

  18. A special designed library for medical imaging applications

    Energy Technology Data Exchange (ETDEWEB)

    Lymberopoulos, D; Kotsopoulos, S; Zoupas, V; Yoldassis, N [Departmeent of Electrical Engineering, University of Patras, Patras 26 110 Greece (Greece); Spyropoulos, C [School of Medicine, Regional University Hospital, University of Patras, Patras 26 110 Greece (Greece)

    1994-12-31

    The present paper deals with a sophisticated and flexible library of medical purpose image processing routines. It contains modules for simple as well as advanced gray or colour image processing. This library offers powerful features for medical image processing and analysis applications, thus providing the physician with a means of analyzing and estimating medical images in order to accomplish their diagnostic procedures. 6 refs, 1 figs.

  19. Quality assessment of medical education and use of information technology.

    Science.gov (United States)

    Masic, Izet; Ciric, Damir; Pulja, Artan; Kulasin, Igor; Pandza, Haris

    2009-01-01

    Extensive and fast advancements in biomedical sciences created a significant delay in receiving relevant and updated information in medical practice - physicians use old techniques and treat patients incorrectly. Bosnia and Herzegovina signed the Bologna Declaration on 18 September 2003, and in the light of this new approach to university education, and the process of joining The European Union, the authors set the following aims: to determine the current level of knowledge among medical students at the Medical Faculty of the University of Sarajevo, to determine the level of knowledge among medical students before their enrolment at the faculty, and to find out students opinion on their needs for further education. Students also left their suggestions on what should be changed in the curriculum. 203 students were included in the survey and results show that they demand more practical work, direct contact with patients and presentation of interesting clinical cases. Many of them use the internet as professional education means. Professional papers are rarely used. At present, the availability of learning material is insufficient at the faculty library.

  20. Role of accelerator science and technology in medical science

    International Nuclear Information System (INIS)

    Uesaka, Mitsuru

    2006-01-01

    Updated status of compact and advanced-compact medical accelerator development is reviewed. In their applications, medical physics and medical physicist are necessary. Their educational programs have started in several universities and institutes. As one important new trend on life-science, the research on the synergy of DDS (Drug Delivery System) and physical energies are proposed. (author)

  1. The Therapy Beneath the Fun: Medical Clowning During Invasive Examinations on Children.

    Science.gov (United States)

    Ofir, Shoshi; Tener, Dafna; Lev-Wiesel, Rachel; On, Avi; Lang-Franco, Nessia

    2016-01-01

    The qualitative research presented here is part of a larger project on the significance of medical clowning during invasive examinations in children in the Department of Gastroenterology and the Center for the Sexually Abused in a hospital in Israel. It investigated what makes up the essence of medical clowning, what skills and techniques are used by medical clowns, and whether their work contains therapeutic elements. A total of 9 children undergoing invasive examinations and 9 of their accompanying parents participated in semistructured interviews, which were analyzed using a thematic analysis methodology assisted by an Atlas-ti software program. The interviews revealed that the medical clowning intervention during invasive examinations was essentially therapeutic, with the clown using theatrical and clowning tools to incorporate therapeutic elements such as empowerment, reversal of role, reframing, and building a therapeutic alliance. In addition, during the invasive examinations, the medical clowning followed the model of brief crisis intervention therapy. The study advances the need to incorporate medical clowns as an integral part of medical teams performing invasive procedures and to include clowns in all stages of the hospital visit when children undergo invasive examinations. © The Author(s) 2015.

  2. Pediatric Tape: Accuracy and Medication Delivery in the National Park Service

    Directory of Open Access Journals (Sweden)

    Danielle D. Campagne

    2015-10-01

    Full Text Available Introduction: The objective is to evaluate the accuracy of medication dosing and the time to medication administration in the prehospital setting using a novel length-based pediatric emergency resuscitation tape. Methods: This study was a two-period, two-treatment crossover trial using simulated pediatric patients in the prehospital setting. Each participant was presented with two emergent scenarios; participants were randomized to which case they encountered first, and to which case used the National Park Service (NPS emergency medical services (EMS length-based pediatric emergency resuscitation tape. In the control (without tape case, providers used standard methods to determine medication dosing (e.g. asking parents to estimate the patient’s weight; in the intervention (with tape case, they used the NPS EMS length-based pediatric emergency resuscitation tape. Each scenario required dosing two medications (Case 1 [febrile seizure] required midazolam and acetaminophen; Case 2 [anaphylactic reaction] required epinephrine and diphenhydramine. Twenty NPS EMS providers, trained at the Parkmedic/Advanced Emergency Medical Technician level, served as study participants. Results: The only medication errors that occurred were in the control (no tape group (without tape: 5 vs. with tape: 0, p=0.024. Time to determination of medication dose was significantly shorter in the intervention (with tape group than the control (without tape group, for three of the four medications used. In case 1, time to both midazolam and acetaminophen was significantly faster in the intervention (with tape group (midazolam: 8.3 vs. 28.9 seconds, p=0.005; acetaminophen: 28.6 seconds vs. 50.6 seconds, p=0.036. In case 2, time to epinephrine did not differ (23.3 seconds vs. 22.9 seconds, p=0.96, while time to diphenhydramine was significantly shorter in the intervention (with tape group (13 seconds vs. 37.5 seconds, p<0.05. Conclusion: Use of a length-based pediatric emergency

  3. Accessing patient-centered care using the advanced access model.

    Science.gov (United States)

    Tantau, Catherine

    2009-01-01

    Waits and delays for healthcare are legendary. These delays are not only frustrating and potentially hazardous for patients and providers but also represent significant cost to office practices. The traditional medical model that defines urgent care versus routine care is a vain and futile attempt to sort demand. This approach is at constant odds with patients' definition of urgency. Trusting patients to determine when and how they want to access care makes sense from a customer service perspective. If approached systematically using the principles of Advanced Access, patient demand patterns can be tracked to forecast demand. These demand patterns become the template for deploying the resources necessary to meet patients' needs. Although not a simple journey, the transformation to Advanced Access provides an entree to patient-centered care where patients can say, "I get exactly the care I want and need, when I want and need it."

  4. Definitive concurrent chemoradiotherapy in locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Kwak, Yoo Kang; Lee, Jong Hoon; Lee, Myung Ah; Chun, Hoo Geun; Kim, Dong Goo; You, Young Kyoung; Hong, Tae Ho; Jang, Hong Seok

    2014-01-01

    Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.

  5. Definitive concurrent chemoradiotherapy in locally advanced pancreatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Yoo Kang; Lee, Jong Hoon; Lee, Myung Ah; Chun, Hoo Geun; Kim, Dong Goo; You, Young Kyoung; Hong, Tae Ho; Jang, Hong Seok [Seoul St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.

  6. Clinical Experience in Advanced Practice Nursing: A Canadian Perspective.

    Science.gov (United States)

    Donnelly, Glenn

    2003-01-01

    The role of advanced practice (AP) nurses must be clearly articulated and defined and not overshadowed by medical functions. Consensus on their educational preparation and explication of the nature of expertise in advanced practice are needed if AP nurses are to realize the full scope of their practice. (Contains 35 references.) (SK)

  7. [Career planning for explanation of clinical test results and program of inspections: developing medical technologists for team medical care].

    Science.gov (United States)

    Uchida, Misuko

    2013-04-01

    Current medical care is subdivided according to medical advances, and sophistication and new techniques are necessary. In this setting, doctors and nurses have been explaining to and consulting patients about their medical examinations; however, in recent years, medical technologists have performed these duties at the start of the team's medical care. Therefore, we think it is possible for patients to receive clear and convincing explanations. Most patients cannot understand their examination data, which are written using numbers and charts, etc. Recently, the Nagano Medical Technologist Society has been developing technologists who could explain examination results to patients. This development training included hospitality and communication. The certificate of completion will be issued in March when the program starts.

  8. 78 FR 7967 - Revised Medical Criteria for Evaluating Respiratory System Disorders

    Science.gov (United States)

    2013-02-04

    ... medical terminology for this disorder. We explain the nature of the disorder and our documentation... cause, to reflect current medical terminology. We propose to remove the criterion for arterial hypoxemia... evaluate it?). The change would reflect current medical terminology. There have been advances in the...

  9. Medical Imaging System

    Science.gov (United States)

    1991-01-01

    The MD Image System, a true-color image processing system that serves as a diagnostic aid and tool for storage and distribution of images, was developed by Medical Image Management Systems, Huntsville, AL, as a "spinoff from a spinoff." The original spinoff, Geostar 8800, developed by Crystal Image Technologies, Huntsville, incorporates advanced UNIX versions of ELAS (developed by NASA's Earth Resources Laboratory for analysis of Landsat images) for general purpose image processing. The MD Image System is an application of this technology to a medical system that aids in the diagnosis of cancer, and can accept, store and analyze images from other sources such as Magnetic Resonance Imaging.

  10. Advances in chemical physics advances in liquid crystals

    CERN Document Server

    Prigogine, Ilya; Vij, Jagdish K

    2009-01-01

    Prigogine and Rice's highly acclaimed series, Advances in Chemical Physics, provides a forum for critical, authoritative reviews of current topics in every area of chemical physics. Edited by J.K. Vij, this volume focuses on recent advances in liquid crystals with significant, up-to-date chapters authored by internationally recognized researchers in the field.

  11. Relationships between beliefs about medications and nonadherence to prescribed chronic medications.

    Science.gov (United States)

    Phatak, Hemant M; Thomas, Joseph

    2006-10-01

    Medication beliefs of patients with a specific medical condition have been associated with nonadherence to drugs used to treat that condition. However, associations between medication beliefs and nonadherence of individuals on chronic, multiple medications have not been studied. To investigate associations between patients' medication beliefs and nonadherence to chronic drug therapy. A cross-sectional, self-administered survey of patients waiting to see pharmacists at an outpatient pharmacy in a primary care clinic was conducted. Participants' medication beliefs were assessed using the Beliefs about Medicines Questionnaire, and nonadherence was assessed using the Morisky Medication Adherence Scale. Pearson correlation analysis was used to assess bivariate associations between medication beliefs and nonadherence. Regression was used to assess relative strength of associations between various medication beliefs and nonadherence and also to assess the significance of the interactions between those beliefs and nonadherence. There were positive bivariate associations between specific concerns about medications (p harmful effects of medications (p belief and nonadherence was assessed, while controlling for other medication beliefs, specific-necessity (p = 0.02) and specific-concerns (p = 0.01) exhibited significant negative and positive associations with nonadherence, respectively. All two-way interactions between variables in the model were insignificant. A model consisting of age, total number of drugs used, and medication beliefs, that is, specific-necessity, specific-concerns, general-overuse, and general-harm, accounted for 26.5% of variance. Medication beliefs alone explained 22.4% of variation in nonadherence to chronic drug therapy. Patients' medication beliefs explained a significant portion of variation in medication nonadherence.

  12. High satisfaction and low decisional conflict with advance care planning among chronically ill patients with advanced chronic obstructive pulmonary disease or heart failure using an online decision aid: A pilot study.

    Science.gov (United States)

    Van Scoy, Lauren J; Green, Michael J; Dimmock, Anne Ef; Bascom, Rebecca; Boehmer, John P; Hensel, Jessica K; Hozella, Joshua B; Lehman, Erik B; Schubart, Jane R; Farace, Elana; Stewart, Renee R; Levi, Benjamin H

    2016-09-01

    Many patients with chronic illnesses report a desire for increased involvement in medical decision-making. This pilot study aimed to explore how patients with exacerbation-prone disease trajectories such as advanced heart failure or chronic obstructive pulmonary disease experience advance care planning using an online decision aid and to compare whether patients with different types of exacerbation-prone illnesses had varied experiences using the tool. Pre-intervention questionnaires measured advance care planning knowledge. Post-intervention questionnaires measured: (1) advance care planning knowledge; (2) satisfaction with tool; (3) decisional conflict; and (4) accuracy of the resultant advance directive. Comparisons were made between patients with heart failure and chronic obstructive pulmonary disease. Over 90% of the patients with heart failure (n = 24) or chronic obstructive pulmonary disease (n = 25) reported being "satisfied" or "highly satisfied" with the tool across all satisfaction domains; over 90% of participants rated the resultant advance directive as "very accurate." Participants reported low decisional conflict. Advance care planning knowledge scores rose by 18% (p < 0.001) post-intervention. There were no significant differences between participants with heart failure and chronic obstructive pulmonary disease. Patients with advanced heart failure and chronic obstructive pulmonary disease were highly satisfied after using an online advance care planning decision aid and had increased knowledge of advance care planning. This tool can be a useful resource for time-constrained clinicians whose patients wish to engage in advance care planning. © The Author(s) 2016.

  13. A framework for interactive visualization of digital medical images.

    Science.gov (United States)

    Koehring, Andrew; Foo, Jung Leng; Miyano, Go; Lobe, Thom; Winer, Eliot

    2008-10-01

    The visualization of medical images obtained from scanning techniques such as computed tomography and magnetic resonance imaging is a well-researched field. However, advanced tools and methods to manipulate these data for surgical planning and other tasks have not seen widespread use among medical professionals. Radiologists have begun using more advanced visualization packages on desktop computer systems, but most physicians continue to work with basic two-dimensional grayscale images or not work directly with the data at all. In addition, new display technologies that are in use in other fields have yet to be fully applied in medicine. It is our estimation that usability is the key aspect in keeping this new technology from being more widely used by the medical community at large. Therefore, we have a software and hardware framework that not only make use of advanced visualization techniques, but also feature powerful, yet simple-to-use, interfaces. A virtual reality system was created to display volume-rendered medical models in three dimensions. It was designed to run in many configurations, from a large cluster of machines powering a multiwalled display down to a single desktop computer. An augmented reality system was also created for, literally, hands-on interaction when viewing models of medical data. Last, a desktop application was designed to provide a simple visualization tool, which can be run on nearly any computer at a user's disposal. This research is directed toward improving the capabilities of medical professionals in the tasks of preoperative planning, surgical training, diagnostic assistance, and patient education.

  14. Medical physics, 1984

    International Nuclear Information System (INIS)

    Schmidt, T.

    1985-01-01

    The papers presented at the 15th Scientific Conference of the Deutsche Gesellschaft fuer Medizinische Physik, held from September 27-28, 1984 in Nuernberg, F.R.G., give an account of the advances made with regard to quality control and management and to radiological safety problems and requirements in the fields of radiological and nuclear medical diagnostics and radiotherapy. (WU) [de

  15. The significance of tumoral ERCC1 status in patients with locally advanced cervical cancer treated with chemoradiation therapy: a multicenter clinicopathologic analysis.

    Science.gov (United States)

    Doll, Corinne M; Aquino-Parsons, Christina; Pintilie, Melania; Klimowicz, Alexander C; Petrillo, Stephanie K; Milosevic, Michael; Craighead, Peter S; Clarke, Blaise; Lees-Miller, Susan P; Fyles, Anthony W; Magliocco, Anthony M

    2013-03-01

    ERCC1 (excision repair cross-complementation group 1) expression has been shown to be a molecular marker of cisplatin resistance in many tumor sites, but has not been well studied in cervical cancer patients. The purpose of this study was to measure tumoral ERCC1 in patients with locally advanced cervical cancer treated with chemoradiation therapy (CRT) in a large multicenter cohort, and to correlate expression with clinical outcome parameters. A total of 264 patients with locally advanced cervical cancer, treated with curative-intent radical CRT from 3 major Canadian cancer centers were evaluated. Pretreatment formalin-fixed, paraffin-embedded tumor specimens were retrieved, and tissue microarrays were constructed. Tumoral ERCC1 (FL297 antibody) was measured using AQUA (R) technology. Statistical analysis was performed to determine the significance of clinical factors and ERCC1 status with progression-free survival (PFS) and overall survival (OS) at 5 years. The majority of patients had International Federation of Gynecology and Obstetrics (FIGO) stage II disease (n=119, 45%); median tumor size was 5 cm. OS was associated with tumor size (HR 1.16, P=.018), pretreatment hemoglobin status (HR 2.33, P=.00027), and FIGO stage. In addition, tumoral ERCC1 status (nuclear to cytoplasmic ratio) was associated with PFS (HR 2.33 [1.05-5.18], P=.038) and OS (HR 3.13 [1.27-7.71], P=.013). ERCC1 status was not significant on multivariate analysis when the model was adjusted for the clinical factors: for PFS (HR 1.49 [0.61-3.6], P=.38); for OS (HR 2.42 [0.94-6.24] P=.067). In this large multicenter cohort of locally advanced cervical cancer patients treated with radical CRT, stage, tumor size, and pretreatment hemoglobin status were significantly associated with PFS and OS. ERCC1 status appears to have prognostic impact on univariate analysis in these patients, but was not independently associated with outcome on multivariate analysis. Copyright © 2013. Published by Elsevier

  16. The Significance of Tumoral ERCC1 Status in Patients With Locally Advanced Cervical Cancer Treated With Chemoradiation Therapy: A Multicenter Clinicopathologic Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Doll, Corinne M., E-mail: Corinne.Doll@albertahealthservices.ca [Department of Oncology, University of Calgary, Calgary, AB (Canada); Aquino-Parsons, Christina [Department of Radiation Oncology, University of British Columbia, Vancouver, BC (Canada); Pintilie, Melania [Department of Biostatistics, Ontario Cancer Institute/Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Klimowicz, Alexander C. [Department of Oncology, University of Calgary, Calgary, AB (Canada); Petrillo, Stephanie K. [Department of Pathology, University of Calgary, Calgary, AB (Canada); Milosevic, Michael [Department of Radiation Oncology, University Health Network, University of Toronto, Toronto, ON (Canada); Craighead, Peter S. [Department of Oncology, University of Calgary, Calgary, AB (Canada); Clarke, Blaise [Department of Pathology, University of Toronto, Toronto, ON (Canada); Lees-Miller, Susan P. [Departments of Biochemistry and Molecular Biology, and Oncology, University of Calgary, Calgary, AB (Canada); Fyles, Anthony W. [Department of Radiation Oncology, University Health Network, University of Toronto, Toronto, ON (Canada); Magliocco, Anthony M. [Department of Pathology, Lee Moffitt Cancer Center, Tampa, Florida (United States)

    2013-03-01

    Purpose: ERCC1 (excision repair cross-complementation group 1) expression has been shown to be a molecular marker of cisplatin resistance in many tumor sites, but has not been well studied in cervical cancer patients. The purpose of this study was to measure tumoral ERCC1 in patients with locally advanced cervical cancer treated with chemoradiation therapy (CRT) in a large multicenter cohort, and to correlate expression with clinical outcome parameters. Methods and Materials: A total of 264 patients with locally advanced cervical cancer, treated with curative-intent radical CRT from 3 major Canadian cancer centers were evaluated. Pretreatment formalin-fixed, paraffin-embedded tumor specimens were retrieved, and tissue microarrays were constructed. Tumoral ERCC1 (FL297 antibody) was measured using AQUA (R) technology. Statistical analysis was performed to determine the significance of clinical factors and ERCC1 status with progression-free survival (PFS) and overall survival (OS) at 5 years. Results: The majority of patients had International Federation of Gynecology and Obstetrics (FIGO) stage II disease (n=119, 45%); median tumor size was 5 cm. OS was associated with tumor size (HR 1.16, P=.018), pretreatment hemoglobin status (HR 2.33, P=.00027), and FIGO stage. In addition, tumoral ERCC1 status (nuclear to cytoplasmic ratio) was associated with PFS (HR 2.33 [1.05-5.18], P=.038) and OS (HR 3.13 [1.27-7.71], P=.013). ERCC1 status was not significant on multivariate analysis when the model was adjusted for the clinical factors: for PFS (HR 1.49 [0.61-3.6], P=.38); for OS (HR 2.42 [0.94-6.24] P=.067). Conclusions: In this large multicenter cohort of locally advanced cervical cancer patients treated with radical CRT, stage, tumor size, and pretreatment hemoglobin status were significantly associated with PFS and OS. ERCC1 status appears to have prognostic impact on univariate analysis in these patients, but was not independently associated with outcome on

  17. The Significance of Tumoral ERCC1 Status in Patients With Locally Advanced Cervical Cancer Treated With Chemoradiation Therapy: A Multicenter Clinicopathologic Analysis

    International Nuclear Information System (INIS)

    Doll, Corinne M.; Aquino-Parsons, Christina; Pintilie, Melania; Klimowicz, Alexander C.; Petrillo, Stephanie K.; Milosevic, Michael; Craighead, Peter S.; Clarke, Blaise; Lees-Miller, Susan P.; Fyles, Anthony W.; Magliocco, Anthony M.

    2013-01-01

    Purpose: ERCC1 (excision repair cross-complementation group 1) expression has been shown to be a molecular marker of cisplatin resistance in many tumor sites, but has not been well studied in cervical cancer patients. The purpose of this study was to measure tumoral ERCC1 in patients with locally advanced cervical cancer treated with chemoradiation therapy (CRT) in a large multicenter cohort, and to correlate expression with clinical outcome parameters. Methods and Materials: A total of 264 patients with locally advanced cervical cancer, treated with curative-intent radical CRT from 3 major Canadian cancer centers were evaluated. Pretreatment formalin-fixed, paraffin-embedded tumor specimens were retrieved, and tissue microarrays were constructed. Tumoral ERCC1 (FL297 antibody) was measured using AQUA (R) technology. Statistical analysis was performed to determine the significance of clinical factors and ERCC1 status with progression-free survival (PFS) and overall survival (OS) at 5 years. Results: The majority of patients had International Federation of Gynecology and Obstetrics (FIGO) stage II disease (n=119, 45%); median tumor size was 5 cm. OS was associated with tumor size (HR 1.16, P=.018), pretreatment hemoglobin status (HR 2.33, P=.00027), and FIGO stage. In addition, tumoral ERCC1 status (nuclear to cytoplasmic ratio) was associated with PFS (HR 2.33 [1.05-5.18], P=.038) and OS (HR 3.13 [1.27-7.71], P=.013). ERCC1 status was not significant on multivariate analysis when the model was adjusted for the clinical factors: for PFS (HR 1.49 [0.61-3.6], P=.38); for OS (HR 2.42 [0.94-6.24] P=.067). Conclusions: In this large multicenter cohort of locally advanced cervical cancer patients treated with radical CRT, stage, tumor size, and pretreatment hemoglobin status were significantly associated with PFS and OS. ERCC1 status appears to have prognostic impact on univariate analysis in these patients, but was not independently associated with outcome on

  18. [Medical cybernetics in Czechoslovakia--the first steps].

    Science.gov (United States)

    Wünsch, Z

    1998-09-01

    During fifties there were at most few tens of persons in this country who believed in the future of computers and cybernetics. One group of such enthusiasts, headed by Antonín Svoboda, was working at a construction of the first Czech computer SAPO. The other group tried to analyse, anticipate, and prepare in advance various applications for the new systemic conceptions and for the information processing machines. Members of both groups met for discussions which opened prospects to the future and influenced many of other activities for a long time. At the early sixties, the Czechoslovak Cybernetic Society was established at the Czechoslovak Academy of Sciences and in 1962 the Main Problem Committee for the Medical Cybernetics was founded at the Department of Health. It coordinated majority of the research programmes in the medical cybernetics and informatics. In 1967-1969 the Committee prepared an extensive project of a medical information system (ZIS), but its accomplishment was finally blocked by the then authorities. However, interests for that topics kept growing and the new working places equipped with available computer technology were formed at the health and clinical centres. The first tentative lectures in medical cybernetics and biocybernetics at our faculty were introduced into the students curricula in the late sixties. Thematically, medical cybernetics subsequently differentiated into the medical informatics, simulations of biological and medical systems, and the biosignal analysis. The growing interest enabled to hold conferences since the middle of seventies, some of which were held periodically, sometimes with international participation. It is not possible in brevity to include the whole spectrum to those goal-directed activities nor to appraise adequately their future significance.

  19. Advances in Retinal Optical Imaging

    Directory of Open Access Journals (Sweden)

    Yanxiu Li

    2018-04-01

    Full Text Available Retinal imaging has undergone a revolution in the past 50 years to allow for better understanding of the eye in health and disease. Significant improvements have occurred both in hardware such as lasers and optics in addition to software image analysis. Optical imaging modalities include optical coherence tomography (OCT, OCT angiography (OCTA, photoacoustic microscopy (PAM, scanning laser ophthalmoscopy (SLO, adaptive optics (AO, fundus autofluorescence (FAF, and molecular imaging (MI. These imaging modalities have enabled improved visualization of retinal pathophysiology and have had a substantial impact on basic and translational medical research. These improvements in technology have translated into early disease detection, more accurate diagnosis, and improved management of numerous chorioretinal diseases. This article summarizes recent advances and applications of retinal optical imaging techniques, discusses current clinical challenges, and predicts future directions in retinal optical imaging.

  20. Employment status, medical support and Income as significant ...

    African Journals Online (AJOL)

    significant differences in affordability between individuals who had full time paid employment and those who ... Studies have shown that the direct costs of healthcare services2, travel time, patients' income, and ..... and age was their real ages.

  1. MO-FG-BRB-01: Debater [medical physics education

    Energy Technology Data Exchange (ETDEWEB)

    Bayouth, J. [University of Wisconsin (United States)

    2016-06-15

    Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusion of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.

  2. Human rights and the requirement for international medical aid.

    Science.gov (United States)

    Tolchin, Benjamin

    2008-08-01

    Every year approximately 18 million people die prematurely from treatable medical conditions including infectious diseases and nutritional deficiencies. The deaths occur primarily amongst the poorest citizens of poor developing nations. Various groups and individuals have advanced plans for major international medical aid to avert many of these unnecessary deaths. For example, the World Health Organization's Commission on Macroeconomics and Health estimated that eight million premature deaths could be prevented annually by interventions costing roughly US$57 bn per year. This essay advances an argument that human rights require high-income nations to provide such aid. The essay briefly examines John Rawls' obligations of justice and the reasons that their applicability to cases of international medical aid remains controversial. Regardless, the essay argues that purely humanitarian obligations bind the governments and citizens of high-income liberal democracies at a minimum to provide major medical aid to avert premature deaths in poor nations. In refusing to undertake such medical relief efforts, developed nations fail to adequately protect a fundamental human right to life.

  3. The First Attempt at Initiating Problem-Based Learning as A Method of Teaching–Learning at the University of Medical Sciences in Poznan, Poland

    Directory of Open Access Journals (Sweden)

    Malgorzata Grzeskowiak

    2009-05-01

    Full Text Available The main objective of problem-based learning (PBL is to provoke students to solve a new problem by themselves. The aim of this study was to investigate whether PBL was a better method of teaching basic and advanced life support to medical students compared with the classical method. The research was undertaken in 2002 in accordance with the European Guidelines 2000 and involved 36 medical students in year 4. The students were divided into two groups: experimental PBL group (17 students and the control-classical method group (19 students. After the advanced life support course, the students wrote two tests to assess their knowledge on how to open the airway and how to perform basic and advanced resuscitation. The questions contained true or false answers. The students' skills of basic and advanced methods of opening the airway and advanced resuscitation were checked by practical tests. The Mann-Whitney test was used for statistical analysis. The experimental PBL group received significantly better results: 30–45 points (mean, 38.29 points and 30–47 points (mean, 40.94 points for the written and practical tests, respectively, compared with the control-classical group (22–34 points [mean, 29.36 points] and 22–35 points [mean, 28.63 points], respectively. Therefore, PBL offers a better method for teaching basic and advanced life support to medical students compared with the classical method.

  4. Establishing radiation therapy advanced practice in New Zealand

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, Karen; Jasperse, Marieke; Herst, Patries [Department of Radiation Therapy, University of Otago, Wellington (New Zealand); Yielder, Jill [University of Auckland, Auckland (New Zealand); Department of Radiation Therapy, University of Otago, Wellington (New Zealand)

    2014-02-15

    Introduction: Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods: All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results: RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion: The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board.

  5. Establishing radiation therapy advanced practice in New Zealand

    International Nuclear Information System (INIS)

    Coleman, Karen; Jasperse, Marieke; Herst, Patries; Yielder, Jill

    2014-01-01

    Introduction: Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods: All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results: RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion: The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board

  6. Managing perceived conflicts of interest while ensuring the continued innovation of medical technology.

    Science.gov (United States)

    Van Haute, Andrew

    2011-09-01

    If it were not for the ongoing collaboration between vascular surgeons and the medical technology industry, many of these advanced treatments used every day in vascular interventional surgery would not exist. The flip side of this coin is that these vital relationships create multiple roles for surgeons and must be appropriately managed. The dynamic process of innovation, along with factors such as product delivery technique refinement, education, testing and clinical trials, and product support, all make it necessary for ongoing and close collaboration between surgeons and the device industry. This unique relationship sometimes leads to the perception of conflicts of interest for physicians, in part because the competing pressures from the multiple, overlapping roles as clinician/caregiver/investigator/innovator/customer are significant. To address this issue, the Advanced Medical Technology Association (AdvaMed), the nation's largest medical technology association representing medical device and diagnostics companies, developed a Code of Ethics to guide medical technology companies in their interactions with health care professionals. First introduced in 1993, the AdvaMed Code strongly encourages both industry and physicians to commit to openness and high ethical standards in the conduct of their business interactions. The AdvaMed Code addresses many of the types of interactions that can occur between companies and health care professionals, including training, consulting agreements, the provision of demonstration and evaluation units, and charitable donations. By following the Code, companies send a strong message that treatment decisions must always be based on the best interest of the patient. Copyright © 2011. Published by Mosby, Inc.

  7. Biological and medical sensor technologies

    CERN Document Server

    Iniewski, Krzysztof

    2012-01-01

    Biological and Medical Sensor Technologies presents contributions from top experts who explore the development and implementation of sensors for various applications used in medicine and biology. Edited by a pioneer in the area of advanced semiconductor materials, the book is divided into two sections. The first part covers sensors for biological applications. Topics include: Advanced sensing and communication in the biological world DNA-derivative architectures for long-wavelength bio-sensing Label-free silicon photonics Quartz crystal microbalance-based biosensors Lab-on-chip technologies fo

  8. Enforcement actions: Significant actions resolved, medical licensees. Quarterly progress report, July--September 1994: Volume 13, Number 3, Part 2

    International Nuclear Information System (INIS)

    1994-12-01

    This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (July--September 1994) and includes copies of letters, Notices, and Orders sent by the Nuclear Regulatory Commission to medical licensees with respect to these enforcement actions. It is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication

  9. Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer.

    Science.gov (United States)

    Grob, Charles S; Danforth, Alicia L; Chopra, Gurpreet S; Hagerty, Marycie; McKay, Charles R; Halberstadt, Adam L; Greer, George R

    2011-01-01

    Researchers conducted extensive investigations of hallucinogens in the 1950s and 1960s. By the early 1970s, however, political and cultural pressures forced the cessation of all projects. This investigation reexamines a potentially promising clinical application of hallucinogens in the treatment of anxiety reactive to advanced-stage cancer. To explore the safety and efficacy of psilocybin in patients with advanced-stage cancer and reactive anxiety. A double-blind, placebo-controlled study of patients with advanced-stage cancer and anxiety, with subjects acting as their own control, using a moderate dose (0.2 mg/kg) of psilocybin. A clinical research unit within a large public sector academic medical center. Twelve adults with advanced-stage cancer and anxiety. In addition to monitoring safety and subjective experience before and during experimental treatment sessions, follow-up data including results from the Beck Depression Inventory, Profile of Mood States, and State-Trait Anxiety Inventory were collected unblinded for 6 months after treatment. Safe physiological and psychological responses were documented during treatment sessions. There were no clinically significant adverse events with psilocybin. The State-Trait Anxiety Inventory trait anxiety subscale demonstrated a significant reduction in anxiety at 1 and 3 months after treatment. The Beck Depression Inventory revealed an improvement of mood that reached significance at 6 months; the Profile of Mood States identified mood improvement after treatment with psilocybin that approached but did not reach significance. This study established the feasibility and safety of administering moderate doses of psilocybin to patients with advanced-stage cancer and anxiety. Some of the data revealed a positive trend toward improved mood and anxiety. These results support the need for more research in this long-neglected field. clinicaltrials.gov Identifier: NCT00302744.

  10. Predicting meaningful outcomes to medication and self-help treatments for binge-eating disorder in primary care: The significance of early rapid response.

    Science.gov (United States)

    Grilo, Carlos M; White, Marney A; Masheb, Robin M; Gueorguieva, Ralitza

    2015-04-01

    We examined rapid response among obese patients with binge-eating disorder (BED) in a randomized clinical trial testing antiobesity medication and self-help cognitive-behavioral therapy (shCBT), alone and in combination, in primary-care settings. One hundred four obese patients with BED were randomly assigned to 1 of 4 treatments: sibutramine, placebo, shCBT + sibutramine, or shCBT + placebo. Treatments were delivered by generalist primary-care physicians and the medications were given double-blind. Independent assessments were performed by trained and monitored doctoral research clinicians monthly throughout treatment, posttreatment (4 months), and at 6- and 12-month follow-ups (i.e., 16 months after randomization). Rapid response, defined as ≥65% reduction in binge eating by the fourth treatment week, was used to predict outcomes. Rapid response characterized 47% of patients, was unrelated to demographic and baseline clinical characteristics, and was significantly associated, prospectively, with remission from binge eating at posttreatment (51% vs. 9% for nonrapid responders), 6-month (53% vs. 23.6%), and 12-month (46.9% vs. 23.6%) follow-ups. Mixed-effects model analyses revealed that rapid response was significantly associated with greater decreases in binge-eating or eating-disorder psychopathology, depression, and percent weight loss. Our findings, based on a diverse obese patient group receiving medication and shCBT for BED in primary-care settings, indicate that patients who have a rapid response achieve good clinical outcomes through 12-month follow-ups after ending treatment. Rapid response represents a strong prognostic indicator of clinically meaningful outcomes, even in low-intensity medication and self-help interventions. Rapid response has important clinical implications for stepped-care treatment models for BED. clinicaltrials.gov: NCT00537810 (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  11. Medical genetics teaching in Iranian medical schools, especially Ahvaz, south of Iran

    Directory of Open Access Journals (Sweden)

    MAHDI BIJANZADEH

    2014-04-01

    Full Text Available Introduction: Physicians have to visit, diagnose and refer patients with genetic disorders, so they need to be familiar with the basics and indications of genetic tests. In other words, they should have effective theoretical and practical knowledge about medical genetics before they do their job. Medical genetics courses at Medical Universities of Iran are generally presented as a theoretical subject in the first period of medical education. Methods: In this descriptive research, the results of interviews with teachers of medical genetics in 30 medical schools in Islamic Republic of Iran and responses to a questionnaire by 125 medical students of Ahvaz Jundishapur University of medical sciences, about presentation time, curricula and also efficacy of medical genetics courses were analyzed. The interviews with teachers were done on phone and the students’ comments were collected by a researcher-made questionnaire. The data were analyzed, using SPSS software, version 14. Results: In two thirds of medical universities, medical genetics is taught in the third or fourth semester and in 5 universities in the fifth semester. 86% of the students believed that the quality of genetics courses is moderate and such courses are same as clinical manifestation of genetic disorders are benefitial to medical students. Conclusion: This article suggests that medical genetics be offered in the second or third period of medical education (physiopathology or stagger period. Furthermore, in teaching such courses advanced educational methods (animation presentation, case-based learning, problem-based learning, etc. should be used, together with simple genetic tests in laboratories, the visit of genetic patients in hospitals, and the genetics consult.

  12. Communicating with adolescents | Campbell | Continuing Medical ...

    African Journals Online (AJOL)

    Continuing Medical Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 25, No 5 (2007) >. Log in or Register to get access to full text downloads.

  13. Understanding Medications and What They Do

    Science.gov (United States)

    ... only in hospitals. What Are Medicines? Medicines are chemicals or compounds used to cure, halt, or prevent disease; ease symptoms; or help in the diagnosis of illnesses. Advances in medications have enabled doctors to cure many ...

  14. Applications of Particle Accelerators in Medical Physics

    CERN Document Server

    Cuttone, G

    2008-01-01

    Particle accelerators are often associated to high energy or nuclear physics. As well pointed out in literature [1] if we kindly analyse the number of installation worldwide we can easily note that about 50% is mainly devoted to medical applications (radiotherapy, medical radioisotopes production, biomedical research). Particle accelerators are also playing an important indirect role considering the improvement of the technical features of medical diagnostic. In fact the use of radionuclide for advanced medical imaging is strongly increasing either in conventional radiography (CT and MRI) and also in nuclear medicine for Spect an PET imaging. In this paper role of particle accelerators for medical applications will be presented together with the main solutions applied.

  15. "Political co-authorships" in medical science journals.

    Science.gov (United States)

    Johal, Jaspreet; Loukas, Marios; Oskouian, Rod J; Tubbs, R Shane

    2017-09-01

    The issue of co-author relationships on medical sciences journal publications has become more pronounced as advances in technology have enabled collaboration across countries and institutions to occur much more efficiently. These relationships often have underlying political motivations and outcomes, including career advancement, attempting to increase prestige of a project, and maintaining research grants. Some authors may be listed as senior or honorary authors despite offering little or no contribution to the original research project. This may be done in an effort to enhance the gravitas of a research project, and attain publication in a highly regarded medical journal. The current review covers the topic of political co-authorship and germane literature and lists strategies to combat this phenomenon. Such co-authorship practices corrupt the integrity of the research process as they attempt to bypass the safeguard that medical journals and institutions have put in place to prevent fraud and falsification. A number of strategies have been proposed to combat the practice of co-authorship, but it may ultimately be an unavoidable feature of contemporary medical research publishing that is difficult to police. Clin. Anat. 30:831-834, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Prioritizing health disparities in medical education to improve care

    Science.gov (United States)

    Awosogba, Temitope; Betancourt, Joseph R.; Conyers, F. Garrett; Estapé, Estela S.; Francois, Fritz; Gard, Sabrina J.; Kaufman, Arthur; Lunn, Mitchell R.; Nivet, Marc A.; Oppenheim, Joel D.; Pomeroy, Claire; Yeung, Howa

    2015-01-01

    Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. PMID:23659676

  17. Prioritizing health disparities in medical education to improve care.

    Science.gov (United States)

    Awosogba, Temitope; Betancourt, Joseph R; Conyers, F Garrett; Estapé, Estela S; Francois, Fritz; Gard, Sabrina J; Kaufman, Arthur; Lunn, Mitchell R; Nivet, Marc A; Oppenheim, Joel D; Pomeroy, Claire; Yeung, Howa

    2013-05-01

    Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. © 2013 New York Academy of Sciences.

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

    Science.gov (United States)

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

    1996-03-01

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

  19. Light ion linacs for medical applications

    International Nuclear Information System (INIS)

    Bradbury, J.N.; Knapp, E.A.; Nagle, D.E.

    1975-01-01

    Recent advances in linear accelerator technology point to the feasibility of designing and developing practical medical linacs for producing protons, neutrons, or π mesons for the radiation therapy of cancer. Additional uses of such linacs could include radioisotope production and charged particle radiography. For widespread utilization medical linacs must exhibit reasonable cost, compactness, reliability, and simplicity of operation. Possible extensions of current accelerator technology which might provide these characteristics are discussed in connection with linac design, fabrication techniques, materials, power sources, injectors, and particle collection and delivery systems. Parameters for a medical proton linac for producing pions are listed. (U.S.)

  20. MINDS - Medical Information Network Decision Support System

    National Research Council Canada - National Science Library

    Armenian, H. K

    2008-01-01

    .... The increase in and complexity of medical data at various levels of resolution has increased the need for system level advancements in clinical decision support systems that provide computer-aided...

  1. Anti-EGFR Therapy: Mechanism and Advances in Clinical Efficacy in Breast Cancer

    Directory of Open Access Journals (Sweden)

    John F. Flynn

    2009-01-01

    Full Text Available This review will focus on recent advances in the application of antiepidermal growth factor receptor (anti-EGFR for the treatment of breast cancer. The choice of EGFR, a member of the ErbB tyrosine kinase receptor family, stems from evidence pinpointing its role in various anti-EGFR therapies. Therefore, an increase in our understanding of EGFR mechanism and signaling might reveal novel targets amenable to intervention in the clinic. This knowledge base might also improve existing medical treatment options and identify research gaps in the design of new therapeutic agents. While the approved use of drugs like the dual kinase inhibitor Lapatinib represents significant advances in the clinical management of breast cancer, confirmatory studies must be considered to foster the use of anti-EGFR therapies including safety, pharmacokinetics, and clinical efficacy.

  2. Evaluation of ExPress glaucoma filtration device in Indian patients with advanced glaucoma

    Directory of Open Access Journals (Sweden)

    Dewang Angmo

    2015-01-01

    Full Text Available ExPress glaucoma filtration device (GFD has recently become available in India as a surgical option for glaucoma patients. We retrospectively evaluated the outcome of ExPress GFD in 12 eyes with advanced glaucoma with intraocular pressures (IOPs not controlled on maximal tolerable medical therapy. The mean preoperative IOP of 29.58 ± 7.13 mmHg decreased to 17.0 ± 2.67 and 17.40 ± 0.89 mmHg at 6 and 12 months after surgery. Absolute success (IOP ≤ 18 mmHg, with no additional glaucoma medications was achieved in eight cases (66.7% and qualified success (IOP ≤ 18 mmHg, with additional glaucoma medications in two cases (16.7% at 1-year after surgery. Early intervention was needed in 4 patients; two underwent anterior chamber reformation while the other two required needling. Two patients required resurgery. There was no significant change in the best corrected visual acuity postoperatively (P = 0.37. ExPress GFD does not seem to offer a benefit over standard trabeculectomy in patients with advanced glaucomatous disease in terms of IOP control or complication rate. However, due to the small sample size with a heterogeneous mixture of primary and secondary glaucoma′s, we await further studies with a larger sample size and long-term follow-up, to see how the device performs.

  3. Evaluation of ExPress glaucoma filtration device in Indian patients with advanced glaucoma.

    Science.gov (United States)

    Angmo, Dewang; Sharma, Reetika; Temkar, Shreyas; Dada, Tanuj

    2015-05-01

    ExPress glaucoma filtration device (GFD) has recently become available in India as a surgical option for glaucoma patients. We retrospectively evaluated the outcome of ExPress GFD in 12 eyes with advanced glaucoma with intraocular pressures (IOPs) not controlled on maximal tolerable medical therapy. The mean preoperative IOP of 29.58 ± 7.13 mmHg decreased to 17.0 ± 2.67 and 17.40 ± 0.89 mmHg at 6 and 12 months after surgery. Absolute success (IOP ≤ 18 mmHg, with no additional glaucoma medications) was achieved in eight cases (66.7%) and qualified success (IOP ≤ 18 mmHg, with additional glaucoma medications) in two cases (16.7%) at 1-year after surgery. Early intervention was needed in 4 patients; two underwent anterior chamber reformation while the other two required needling. Two patients required resurgery. There was no significant change in the best corrected visual acuity postoperatively (P = 0.37). ExPress GFD does not seem to offer a benefit over standard trabeculectomy in patients with advanced glaucomatous disease in terms of IOP control or complication rate. However, due to the small sample size with a heterogeneous mixture of primary and secondary glaucoma's, we await further studies with a larger sample size and long-term follow-up, to see how the device performs.

  4. Integration of advanced technologies to enhance problem-based learning over distance: Project TOUCH.

    Science.gov (United States)

    Jacobs, Joshua; Caudell, Thomas; Wilks, David; Keep, Marcus F; Mitchell, Steven; Buchanan, Holly; Saland, Linda; Rosenheimer, Julie; Lozanoff, Beth K; Lozanoff, Scott; Saiki, Stanley; Alverson, Dale

    2003-01-01

    Distance education delivery has increased dramatically in recent years as a result of the rapid advancement of communication technology. The National Computational Science Alliance's Access Grid represents a significant advancement in communication technology with potential for distance medical education. The purpose of this study is to provide an overview of the TOUCH project (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) with special emphasis on the process of problem-based learning case development for distribution over the Access Grid. The objective of the TOUCH project is to use emerging Internet-based technology to overcome geographic barriers for delivery of tutorial sessions to medical students pursuing rotations at remote sites. The TOUCH project also is aimed at developing a patient simulation engine and an immersive virtual reality environment to achieve a realistic health care scenario enhancing the learning experience. A traumatic head injury case is developed and distributed over the Access Grid as a demonstration of the TOUCH system. Project TOUCH serves as an example of a computer-based learning system for developing and implementing problem-based learning cases within the medical curriculum, but this system should be easily applied to other educational environments and disciplines involving functional and clinical anatomy. Future phases will explore PC versions of the TOUCH cases for increased distribution. Copyright 2003 Wiley-Liss, Inc.

  5. Future Directions in Medical Physics: Models, Technology, and Translation to Medicine

    Science.gov (United States)

    Siewerdsen, Jeffrey

    The application of physics in medicine has been integral to major advances in diagnostic and therapeutic medicine. Two primary areas represent the mainstay of medical physics research in the last century: in radiation therapy, physicists have propelled advances in conformal radiation treatment and high-precision image guidance; and in diagnostic imaging, physicists have advanced an arsenal of multi-modality imaging that includes CT, MRI, ultrasound, and PET as indispensible tools for noninvasive screening, diagnosis, and assessment of treatment response. In addition to their role in building such technologically rich fields of medicine, physicists have also become integral to daily clinical practice in these areas. The future suggests new opportunities for multi-disciplinary research bridging physics, biology, engineering, and computer science, and collaboration in medical physics carries a strong capacity for identification of significant clinical needs, access to clinical data, and translation of technologies to clinical studies. In radiation therapy, for example, the extraction of knowledge from large datasets on treatment delivery, image-based phenotypes, genomic profile, and treatment outcome will require innovation in computational modeling and connection with medical physics for the curation of large datasets. Similarly in imaging physics, the demand for new imaging technology capable of measuring physical and biological processes over orders of magnitude in scale (from molecules to whole organ systems) and exploiting new contrast mechanisms for greater sensitivity to molecular agents and subtle functional / morphological change will benefit from multi-disciplinary collaboration in physics, biology, and engineering. Also in surgery and interventional radiology, where needs for increased precision and patient safety meet constraints in cost and workflow, development of new technologies for imaging, image registration, and robotic assistance can leverage

  6. Advanced case of glioblastoma multiforme and pregnancy. An ethical dilemma.

    Science.gov (United States)

    Al-Rasheedy, Intisar M; Al-Hameed, Fahad M

    2015-10-01

    Glioblastoma multiforme (GBM) is the most common and malignant form of the glial tumors. Advanced and treated GBM is rarely associated with pregnancy for many reasons. Glioblastoma multiforme presenting during pregnancy carries unique challenges to the patient, baby, family, and health care providers. We describe an unusual case of advanced GBM that was treated with maximum doses of chemotherapy and radiations, and she became pregnant and presented at eighteenth weeks of gestation. Her medical management was associated with a significant ethical dilemma. We managed to deliver the baby safely through cesarean section at week 28 despite the critical condition of the mother. Unfortunately, the mother died 2 weeks post delivery. We concluded that although recurrent and treated GBM is rarely associated with pregnancy and carries dismal prognosis, but if it occurs, it can still be carried, and a multidisciplinary team work is the key for successful outcome.

  7. The Mobile Modular Surgical Hospital: the Army Medical Department’s Future Unit of Action

    Science.gov (United States)

    2005-06-17

    requirements. Paula C. Lodi in her monogram “The Army Medical Department and Full Spectrum Operations” written for the School of Advanced Military...Center, 2004), 2.1-2.10. 14Paula C. Lodi, The Army Medical Department and Full Spectrum Operations, ( Monogram , School of Advanced Military Studies...paper in the past ten years on the level III hospital. Paula C. Lodi in her monogram “The Army Medical Department and Full Spectrum Operations” written

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

    Science.gov (United States)

    Khan, Lateef M.

    2015-01-01

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

  9. New medical schools in the United States: forces of change past and present.

    Science.gov (United States)

    Smith, Lawrence

    2009-01-01

    The new millennium has ushered in a growth phase in the number of American medical schools. Historically the United States has built schools during bursts of activity with relative quiescence in between these periods. We had a twenty-two year period with no growth in medical school size or number. During that time there were significant changes in patient characteristics, student culture, financial reimbursement, quality, and manpower needs that have put stress on medical schools, hospitals, clinical practice and healthcare systems. In addition, there have been remarkable new opportunities in the way we teach, including changes in teaching methodology, educational technology, and a better understanding of how students actually learn. All of these advances have taken place during a period of enormous pressure to change residency programs, reorganize medical and clinical science, and question the very need for traditional departmental structures. It is likely that the new medical schools will emerge looking different from the older schools and they are likely to catalyze a period of curricular change.

  10. Simulation training for medical emergencies in the dental setting using an inexpensive software application.

    Science.gov (United States)

    Kishimoto, N; Mukai, N; Honda, Y; Hirata, Y; Tanaka, M; Momota, Y

    2017-11-09

    Every dental provider needs to be educated about medical emergencies to provide safe dental care. Simulation training is available with simulators such as advanced life support manikins and robot patients. However, the purchase and development costs of these simulators are high. We have developed a simulation training course on medical emergencies using an inexpensive software application. The purpose of this study was to evaluate the educational effectiveness of this course. Fifty-one dental providers participated in this study from December 2014 to March 2015. Medical simulation software was used to simulate a patient's vital signs. We evaluated participants' ability to diagnose and treat vasovagal syncope or anaphylaxis with an evaluation sheet and conducted a questionnaire before and after the scenario-based simulation training. The median evaluation sheet score for vasovagal syncope increased significantly from 7/9 before to 9/9 after simulation training. The median score for anaphylaxis also increased significantly from 8/12 to 12/12 (P simulation training. This simulation course improved participants' ability to diagnose and treat medical emergencies and improved their confidence. This course can be offered inexpensively using a software application. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Significant Risk Factors for Postoperative Enlargement of Basal Ganglia Hematoma after Frameless Stereotactic Aspiration: Antiplatelet Medication and Concomitant IVH.

    Science.gov (United States)

    Son, Wonsoo; Park, Jaechan

    2017-09-01

    Frameless stereotactic aspiration of a hematoma can be the one of the treatment options for spontaneous intracerebral hemorrhage in the basal ganglia. Postoperative hematoma enlargement, however, can be a serious complication of intracranial surgery that frequently results in severe neurological deficit and even death. Therefore, it is important to identify the risk factors of postoperative hematoma growth. During a 13-year period, 101 patients underwent minimally invasive frameless stereotactic aspiration for basal ganglia hematoma. Patients were classified into two groups according to whether or not they had postoperative hematoma enlargement in a computed tomography scan. Baseline demographic data and several risk factors, such as hypertension, preoperative hematoma growth, antiplatelet medication, presence of concomitant intraventricular hemorrhage (IVH), were analysed via a univariate statistical study. Nine of 101 patients (8.9%) showed hematoma enlargement after frameless stereotactic aspiration. Among the various risk factors, concomitant IVH and antiplatelet medication were found to be significantly associated with postoperative enlargement of hematomas. In conclusion, our study revealed that aspirin use and concomitant IVH are factors associated with hematoma enlargement subsequent to frameless stereotactic aspiration for basal ganglia hematoma.

  12. Prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy for locally advanced breast carcinoma.

    Science.gov (United States)

    Machiavelli, M R; Romero, A O; Pérez, J E; Lacava, J A; Domínguez, M E; Rodríguez, R; Barbieri, M R; Romero Acuña, L A; Romero Acuña, J M; Langhi, M J; Amato, S; Ortiz, E H; Vallejo, C T; Leone, B A

    1998-01-01

    The prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy was assessed in patients with noninflammatory locally advanced breast carcinoma. Between January 1989 and April 1995, 148 consecutive patients with locally advanced breast carcinoma participated in the study. Of these, 140 fully evaluable patients (67, stage IIIA; 73, stage IIIB) were treated with three courses of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC), followed by modified radical mastectomy when technically feasible or definitive radiation therapy. The median age was 53 years (range, 26 to 75 years); 55% of patients were postmenopausal. Objective response was recorded in 99 of 140 patients (71%; 95% confidence interval, 63% to 79%). Complete response occurred in 11 patients (8%), and partial response occurred in 88 patients (63%). No change was recorded in 37 patients (26%), and progressive disease occurred in 4 patients (3%). One hundred and thirty-six patients underwent the planned surgery. Maximal pathological response of the primary tumor (in situ carcinoma or minimal microscopic residual tumor) was observed in 24 (18%); 112 patients (82%) presented minimal pathological response of the primary tumor (gross residual tumor). The number of metastatic axillary nodes after neoadjuvant chemotherapy was as follows: N0, 39 patients (29%); N1-N3, 35 patients (26%); > N3, 62 patients (45%). Considering the initial TNM status, 75% of the patients had decreases in tumor compartment after neoadjuvant chemotherapy. Also, 31% and 23% of patients with clinical N1 and N2, respectively, showed uninvolved axillary lymph nodes. A significant correlation was noted between pathological response of primary tumor and the number of metastatic axillary lymph nodes. Median disease-free survival was 34 months, whereas median overall survival was 66 months. Pathological responses of both primary tumor and metastatic axillary lymph nodes

  13. Towards the systematic development of medical networking technology.

    Science.gov (United States)

    Faust, Oliver; Shetty, Ravindra; Sree, S Vinitha; Acharya, Sripathi; Acharya U, Rajendra; Ng, E Y K; Poo, Chua Kok; Suri, Jasjit

    2011-12-01

    Currently, there is a disparity in the availability of doctors between urban and rural areas of developing countries. Most experienced doctors and specialists, as well as advanced diagnostic technologies, are available in urban areas. People living in rural areas have less or sometimes even no access to affordable healthcare facilities. Increasing the number of doctors and charitable medical hospitals or deploying advanced medical technologies in these areas might not be economically feasible, especially in developing countries. We need to mobilize science and technology to master this complex, large scale problem in an objective, logical, and professional way. This can only be achieved with a collaborative effort where a team of experts works on both technical and non-technical aspects of this health care divide. In this paper we use a systems engineering framework to discuss hospital networks which might be solution for the problem. We argue that with the advancement in communication and networking technologies, economically middle class people and even some rural poor have access to internet and mobile communication systems. Thus, Hospital Digital Networking Technologies (HDNT), such as telemedicine, can be developed to utilize internet, mobile and satellite communication systems to connect primitive rural healthcare centers to well advanced modern urban setups and thereby provide better consultation and diagnostic care to the needy people. This paper describes requirements and limitations of the HDNTs. It also presents the features of telemedicine, the implementation issues and the application of wireless technologies in the field of medical networking.

  14. Handbook on advanced design and manufacturing technologies for biomedical devices

    CERN Document Server

    2013-01-01

    The last decades have seen remarkable advances in computer-aided design, engineering and manufacturing technologies, multi-variable simulation tools, medical imaging, biomimetic design, rapid prototyping, micro and nanomanufacturing methods and information management resources, all of which provide new horizons for the Biomedical Engineering fields and the Medical Device Industry. Handbook on Advanced Design and Manufacturing Technologies for Biomedical Devices covers such topics in depth, with an applied perspective and providing several case studies that help to analyze and understand the key factors of the different stages linked to the development of a novel biomedical device, from the conceptual and design steps, to the prototyping and industrialization phases. Main research challenges and future potentials are also discussed, taking into account relevant social demands and a growing market already exceeding billions of dollars. In time, advanced biomedical devices will decisively change methods and resu...

  15. Discrepancies between perceptions of students and deans regarding the consequences of restricting students' use of electronic medical records on quality of medical education.

    Science.gov (United States)

    Solarte, Ivan; Könings, Karen D

    2017-03-13

    Electronic medical records (EMR) are more used in university hospitals, but the use of EMR by medical students at the workplace is still a challenge, because the conflict of interest between medical accountability for hospitals and quality of medical education programs for students. Therefore, this study investigates the use of EMR from the perspective of medical school deans and students, and determines their perceptions and concerns about consequences of restricted use of EMR by students on quality of education and patient care. We administered a large-scale survey about the existence of EMR, existing policies, students' use for learning, and consequences on patient care to 42 deans and 789 Residency Physician Applicants in a private university in Colombia. Data from 26 deans and 442 former graduated students were compared with independent t tests and chi square tests. Only half of medical schools had learning programs and policies about the use of EMR by students. Deans did not realize that students have less access to EMR than to paper-based MR. Perceptions of non-curricular learning opportunities how to write in (E)MR were significantly different between deans and students. Limiting students use of EMR has negative consequences on medical education, according to both deans and students, while deans worried significantly more about impact on patient care than students. Billing issues and liability aspects were their major concerns. There is a need for a clear policy and educational program on the use of EMR by students. Discrepancies between the planned curriculum by deans and the real clinical learning environment as experienced by students indicate suboptimal learning opportunities for students. Creating powerful workplace-learning experiences and resolving concerns on students use of EMR has to be resolved in a constructive collaboration way between the involved stakeholders, including also EMR designers and hospital administrators. We recommend intense

  16. Novel user interface design for medication reconciliation: an evaluation of Twinlist.

    Science.gov (United States)

    Plaisant, Catherine; Wu, Johnny; Hettinger, A Zach; Powsner, Seth; Shneiderman, Ben

    2015-03-01

    The primary objective was to evaluate time, number of interface actions, and accuracy on medication reconciliation tasks using a novel user interface (Twinlist, which lays out the medications in five columns based on similarity and uses animation to introduce the grouping - www.cs.umd.edu/hcil/sharp/twinlist) compared to a Control interface (where medications are presented side by side in two columns). A secondary objective was to assess participant agreement with statements regarding clarity and utility and to elicit comparisons. A 1 × 2 within-subjects experimental design was used with interface (Twinlist or Control) as an independent variable; time, number of clicks, scrolls, and errors were used as dependent variables. Participants were practicing medical providers with experience performing medication reconciliation but no experience with Twinlist. They reconciled two cases in each interface (in a counterbalanced order), then provided feedback on the design of the interface. Twenty medical providers participated in the study for a total of 80 trials. The trials using Twinlist were statistically significantly faster (18%), with fewer clicks (40%) and scrolls (60%). Serious errors were noted 12 and 31 times in Twinlist and Control trials, respectively. Trials using Twinlist were faster and more accurate. Subjectively, participants rated Twinlist more favorably than Control. They valued the novel layout of the drugs, but indicated that the included animation would be valuable for novices, but not necessarily for advanced users. Additional feedback from participants provides guidance for further development and clinical implementations. Cognitive support of medication reconciliation through interface design can significantly improve performance and safety. © 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.

  17. A comparison of laparoscopic and open surgery following pre-operative chemoradiation therapy for locally advanced lower rectal cancer

    International Nuclear Information System (INIS)

    Kusano, Toru; Inomata, Masafumi; Hiratsuka, Takahiro

    2014-01-01

    Although pre-operative chemoradiation therapy for advanced lower rectal cancer is a controversial treatment modality, it is increasingly used in combination with surgery. Few studies have considered the combination of chemoradiation therapy followed by laparoscopic surgery for locally advanced lower rectal cancer; therefore, this study aimed to assess the usefulness of this therapeutic combination. We retrospectively reviewed the medical records of patients with locally advanced lower rectal cancer treated by pre-operative chemoradiation therapy and surgery from February 2002 to November 2012 at Oita University. We divided patients into an open surgery group and a laparoscopic surgery group and evaluated various parameters by univariate and multivariate analyses. In total, 33 patients were enrolled (open surgery group, n=14; laparoscopic surgery group, n=19). Univariate analysis revealed that compared with the open surgery group, operative time was significantly longer, whereas intra-operative blood loss and intra-operative blood transfusion requirements were significantly less in the laparoscopic surgery group. There were no significant differences in post-operative complication and recurrence rates between the two groups. According to multivariate analysis, operative time and intra-operative blood loss were significant predictors of outcome in the laparoscopic surgery group. This study suggests that laparoscopic surgery after chemoradiation therapy for locally advanced lower rectal cancer is a safe procedure. Further prospective investigation of the long-term oncological outcomes of laparoscopic surgery after chemoradiation therapy for locally advanced lower rectal cancer is required to confirm the advantages of laparoscopic surgery over open surgery. (author)

  18. Medical Cannabis in Arizona: Patient Characteristics, Perceptions, and Impressions of Medical Cannabis Legalization.

    Science.gov (United States)

    Troutt, William D; DiDonato, Matthew D

    2015-01-01

    Many advances have been made toward understanding the benefits of medical cannabis. However, less is known about medical cannabis patients themselves. Prior research has uncovered many important patient characteristics, but most of that work has been conducted with participants in California, who may not represent medical cannabis patients throughout the United States. Furthermore, it is unknown if medical cannabis legalization, which typically imposes strict regulations on cannabis cultivation and sale, impacts patients' experiences acquiring and using cannabis. The goal of this study was to address these limitations by (1) examining the characteristics, perceptions, and behaviors of medical cannabis patients in Arizona; and (2) questioning participants with a history of cannabis use regarding their experiences with cannabis before and after legalization. Patients in Arizona share many characteristics with those in California, but also key differences, such as average age and degree of cannabis consumption. Participants also had positive perceptions of the effect of medical cannabis legalization, reporting that feelings of safety and awareness were higher after legalization compared to before. The results are discussed in relation to evidence from patients in other states and in terms of their potential policy implications.

  19. Linking medical faculty stress/burnout to willingness to implement medical school curriculum change: a preliminary investigation.

    Science.gov (United States)

    Arvandi, Zeinab; Emami, Amirhossein; Zarghi, Nazila; Alavinia, Seyed Mohammad; Shirazi, Mandana; Parikh, Sagar V

    2016-02-01

    Balancing administrative demands from the medical school while providing patient support and seeking academic advancement can cause personal hardship that ranges from high stress to clinically recognizable conditions such as burnout. Regarding the importance of clinical faculties' burnout and its effects on different aspects of their professional career, this study was conducted and aimed to evaluate the relationship between willingness to change teaching approaches as characterized by a modified stage-of-change model and measures of stress and burnout. This descriptive analytic study was conducted on 143 clinical faculty members of Tehran University of Medical Sciences in Iran. Participants were asked to complete three questionnaires: a modified stages of change questionnaire the Maslach Burnout Inventory and the General Health Questionnaire. Data were analysed by SPSS: 16 using non-parametric statistical tests such as multiple regression and ICC (intra-class coefficient) and Spearman correlation coefficient test. A significant relationship was found between faculty members' readiness to change teaching approaches and the subscales of occupational burnout. Specifically, participants with low occupational burnout were more likely to be in the action stage, while those with high burnout were in the attitude or intention stage, which could be understood as not being ready to implement change. There was no significant correlation between general health scores and stage of change. We found it feasible to measure stages of change as well as stress/burnout in academic doctors. Occupational burnout directly reduces the readiness to change. To have successful academic reform in medical schools, it therefore would be beneficial to assess and manage occupational burnout among clinical faculty members. © 2015 John Wiley & Sons, Ltd.

  20. Personality and Values as Predictors of Medical Specialty Choice

    Science.gov (United States)

    Taber, Brian J.; Hartung, Paul J.; Borges, Nicole J.

    2011-01-01

    Research rarely considers the combined influence of personality traits and values in predicting behavioral outcomes. We aimed to advance a germinal line of inquiry that addresses this gap by separately and simultaneously examining personality traits and physician work values to predict medical specialty choice. First-year medical students (125…

  1. Strengthening medical education in haematology and blood transfusion: postgraduate programmes in Tanzania.

    Science.gov (United States)

    Makani, Julie; Lyimo, Magdalena; Magesa, Pius; Roberts, David J

    2017-06-01

    Haematology and blood transfusion, as a clinical and laboratory discipline, has a far-reaching impact on healthcare both through direct patient care as well as provision of laboratory and transfusion services. Improvement of haematology and blood transfusion may therefore be significant in achieving advances in health in Africa. In 2005, Tanzania had one of the lowest distributions of doctors in the world, estimated at 2·3 doctors per 100 000 of population, with only one haematologist, a medical doctor with postgraduate medical education in haematology and blood transfusion. Here, we describe the establishment and impact of a postgraduate programme centred on Master of Medicine and Master of Science programmes to build the capacity of postgraduate training in haematology and blood transfusion. The programme was delivered through Muhimbili University of Health and Allied Sciences (MUHAS) with partnership from visiting medical and laboratory staff from the UK and complemented by short-term visits of trainees from Tanzania to Haematology Departments in the UK. The programme had a significant impact on the development of human resources in haematology and blood transfusion, successfully training 17 specialists with a significant influence on delivery of health services and research. This experience shows how a self-sustaining, specialist medical education programme can be developed at low cost within Lower and Middle Income Countries (LMICs) to rapidly enhance delivery of capacity to provide specialist services. © 2017 John Wiley & Sons Ltd.

  2. Differences of smoking knowledge, attitudes, and behaviors between medical and non-medical students.

    Science.gov (United States)

    Han, Min-Yan; Chen, Wei-Qing; Wen, Xiao-Zhong; Liang, Cai-Hua; Ling, Wen-Hua

    2012-03-01

    Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education.

  3. [Emergency Medical Technician profile in Spain].

    Science.gov (United States)

    Martínez-Isasi, Santiago; Rodríguez-Lorenzo, María José; Vázquez-Santamariña, David; Abella-Lorenzo, Javier; Castro Dios, Diana Josefa; Fernández García, Daniel

    2017-12-11

    The emergency medical technician plays a fundamental role and is the most important figure quantitatively in pre-hospital emergencies. The aim was to asses the socio-demographic, work-related, health characteristics and technical skills of an Emergency Medical Technician in Spain. Cross-sectional descriptive study. An ad hoc questionnaire was managed using Google Docs® that was delivered between April-June 2014 via email and social networks. A total of 705 questionnaires were collected. Statistical analysis was performed with SPSS ® 20.0 Windows version. A significance level p≤0.05 was used for all analyzes. The data analyzed show that the profile of the Emergency Medical Technician in Spain is an 39 year-old man, married or living as a couple and has a child. The average BMI is 27 kg/m2, does regular exercise, does not smoke. His seniority in the company is 10 years and has the Medium Cycle of Emergency Medical Technician. The analysis for gender shows that men have an average of 40, an average BMI of 27, 5 kg/m2 and work in an advanced life support unit; while women have an average of 36,5 years, an average BMI of 24,7 kg/m2, mainly work in Basic Life Support Unit and her seniority in the company is 6,76 years. Emergency Medical Technician profile is a overweight men, who refer to practise regular exercise, his seniority in the company is 10 years and is in possession of CMTES; differences were observed according to gender in BMI, resource where they perform their work, seniority and age.

  4. Shaping the future through innovations: From medical imaging to precision medicine.

    Science.gov (United States)

    Comaniciu, Dorin; Engel, Klaus; Georgescu, Bogdan; Mansi, Tommaso

    2016-10-01

    Medical images constitute a source of information essential for disease diagnosis, treatment and follow-up. In addition, due to its patient-specific nature, imaging information represents a critical component required for advancing precision medicine into clinical practice. This manuscript describes recently developed technologies for better handling of image information: photorealistic visualization of medical images with Cinematic Rendering, artificial agents for in-depth image understanding, support for minimally invasive procedures, and patient-specific computational models with enhanced predictive power. Throughout the manuscript we will analyze the capabilities of such technologies and extrapolate on their potential impact to advance the quality of medical care, while reducing its cost. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Advances in the medical management of the severe cutaneous radiation syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Carsin, H.; Stephannazi, J. [Percy Hospital, Clamart (France). Burn Treatment Centre; Gourmelon, P.

    2000-05-01

    The cutaneous radiation syndrome is a dose dependant complex pathological syndrome which follows a brief localized exposure and characterized by erythema, swelling, moist desquamation, ulceration and necrosis (25-30 Gy). Highly penetrating gamma radiation induces severe dose dependent lesions involving skin, subcutaneous tissue, muscle, vessels, nerves and occasionally, bony structures. The classical treatment of this syndrome includes the debridement of devitalized tissues, the application of bacteriostatic agents coated in non-adherent dressings, opiate-based drugs and in some cases the use of non-steroidal anti-inflammatory drugs. For ulceration and necrosis treatment, the classical surgery is ulcerectomy, necrectomy and amputation for the distal extremity injuries. For the profound et large necrosis, the lesion should be excised and the wound bed covered with a good quality, full-thickness skin graft. Unfortunately the delayed of appearance of this syndrome results often in non specialized medical treatment. Furthermore, because of the chronic evolution (months or years) the management of the cutaneous radiation syndrome has not been considered as a priority for the medical management. Recent accident like the Georgian accident demonstrated that new techniques such as artificial skin graft could change significantly patient prognosis. This technique is routinely used for thermal burn in specialized burn units. We realized the first application of this methodology in the field of radiopathology. An important factor of this technique is that in the case of recurrence of radionecrosis. Often observed, using this technique further grafting may be employed. However the success of this procedure depends on an effective control of the infection. These has sadly been illustrated in the last accident case in Peru where it was impossible to perform the artificial skin graft due to the persistence of a non-eradicated local infection. Whether this particular approach has a

  6. Advances in the medical management of the severe cutaneous radiation syndrome

    International Nuclear Information System (INIS)

    Carsin, H.; Stephannazi, J.; Gourmelon, P.

    2000-01-01

    The cutaneous radiation syndrome is a dose dependant complex pathological syndrome which follows a brief localized exposure and characterized by erythema, swelling, moist desquamation, ulceration and necrosis (25-30 Gy). Highly penetrating gamma radiation induces severe dose dependent lesions involving skin, subcutaneous tissue, muscle, vessels, nerves and occasionally, bony structures. The classical treatment of this syndrome includes the debridement of devitalized tissues, the application of bacteriostatic agents coated in non-adherent dressings, opiate-based drugs and in some cases the use of non-steroidal anti-inflammatory drugs. For ulceration and necrosis treatment, the classical surgery is ulcerectomy, necrectomy and amputation for the distal extremity injuries. For the profound et large necrosis, the lesion should be excised and the wound bed covered with a good quality, full-thickness skin graft. Unfortunately the delayed of appearance of this syndrome results often in non specialized medical treatment. Furthermore, because of the chronic evolution (months or years) the management of the cutaneous radiation syndrome has not been considered as a priority for the medical management. Recent accident like the Georgian accident demonstrated that new techniques such as artificial skin graft could change significantly patient prognosis. This technique is routinely used for thermal burn in specialized burn units. We realized the first application of this methodology in the field of radiopathology. An important factor of this technique is that in the case of recurrence of radionecrosis. Often observed, using this technique further grafting may be employed. However the success of this procedure depends on an effective control of the infection. These has sadly been illustrated in the last accident case in Peru where it was impossible to perform the artificial skin graft due to the persistence of a non-eradicated local infection. Whether this particular approach has a

  7. Pharmacists' perceptions of advancing public health priorities through medication therapy management

    Directory of Open Access Journals (Sweden)

    Casserlie LM

    2016-09-01

    Full Text Available Background: Public health priorities can be addressed by pharmacists through channels such as medication therapy management (MTM to optimize patient and population outcomes. However, no studies have specifically assessed pharmacists’ perceptions of addressing public health priorities through MTM. Objective: The objective of this study was to assess pharmacists’ opinions regarding the feasibility and appropriateness of addressing seven areas of public health priority through MTM services to impact public health in direct patient care settings. Methods: An anonymous 37-question electronic survey was conducted to evaluate Ohio pharmacists’ opinions of advancing seven public health priorities identified from Healthy People 2020 (family planning, preconception care, smoking cessation, immunizations, nutrition/biometric wellness assessments, point-of-care testing, fall prevention through MTM activities; to identify potential barriers; and to collect demographic information. The cross-sectional survey was sent to a random sample of 500 pharmacists registered with the Ohio State Board of Pharmacy. Results: Seventy-six pharmacists responded to the survey, resulting in a 16% response rate. On average, it took respondents 5-10 minutes to complete the survey. The majority of respondents thought that each of the seven public health priorities were “important” or “very important” to patient health; the most commonly identified areas included smoking cessation, immunizations, and fall prevention (97.5%. When asked to indicate which of the seven areas they thought they could potentially have a role to provide services through MTM, on average pharmacists picked 4 of the priority areas. Only 6.6% indicated there was no role for pharmacists to provide MTM services for any of the listed categories. Staffing, time, and reimbursement represented the most commonly perceived barriers for pharmacists in providing MTM services. Fifty-seven percent indicated

  8. Image processing for medical diagnosis of human organs

    International Nuclear Information System (INIS)

    Tamura, Shin-ichi

    1989-01-01

    The report first describes expectations and needs for diagnostic imaging in the field of clinical medicine, radiation medicine in particular, viewed by the author as an image processing expert working at a medical institute. Then, medical image processing techniques are discussed in relation to advanced information processing techniques that are currently drawing much attention in the field of engineering. Finally, discussion is also made of practical applications of image processing techniques to diagnosis. In the field of clinical diagnosis, advanced equipment such as PACS (picture archiving and communication system) has come into wider use, and efforts have been made to shift from visual examination to more quantitative and objective diagnosis by means of such advanced systems. In clinical medicine, practical, robust systems are more useful than sophisticated ones. It is difficult, though important, to develop completely automatized diagnostic systems. The urgent, realistic goal, therefore, is to develop effective diagnosis support systems. In particular, operation support systems equipped with three-dimensional displays will be very useful. (N.K.)

  9. MO-FG-BRB-00: AAPM Presidential Debate [medical physics education

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusion of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.

  10. MO-FG-BRB-04: Debater [Medical physics education

    Energy Technology Data Exchange (ETDEWEB)

    Seibert, J. [UC Davis Medical Center (United States)

    2016-06-15

    Building on the energy and excitement of Washington DC in a presidential election year, AAPM will host its own Presidential Debate to better understand the views of the AAPM membership! Past presidents of the AAPM, Drs. Bayouth, Hazle, Herman, and Seibert, will debate hot topics in medical physics including issues facing education, professional practice, and the advancement of science. The moderators, Drs. Brock and Stern, will also draw in topics from Point-Counterpoint articles from the Medical Physics Journals. Wrapping up the debate, the audience will have the opportunity to question the candidates in a town hall format. At the conclusion of this lively debate, the winner will be decided by the audience, so bring your Audience Response Units! Be part of Medical Physics - Decision 2016! Learning Objectives: Understand AAPM members’ views and opinions on issues facing medical physics education Learn AAPM members’ views and opinions on issues facing professional practice Identify AAPM members’ view and opinions on issues facing the advancement of science in medical physics J. Bayouth, Funding support from NCI;Scientific Advisory Board member - ViewRay.

  11. Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria.

    Science.gov (United States)

    Luckett, Tim; Bhattarai, Priyanka; Phillips, Jane; Agar, Meera; Currow, David; Krastev, Yordanka; Davidson, Patricia M

    2015-11-01

    A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Frameworkfor Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment--the Dying with Dignity Victoria Advance Healthcare Directive. More research is needed to understand how online resources can optimally elicit and record consumers' individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement.

  12. Pretreatment advanced lung cancer inflammation index (ALI) for predicting early progression in nivolumab-treated patients with advanced non-small cell lung cancer.

    Science.gov (United States)

    Shiroyama, Takayuki; Suzuki, Hidekazu; Tamiya, Motohiro; Tamiya, Akihiro; Tanaka, Ayako; Okamoto, Norio; Nakahama, Kenji; Taniguchi, Yoshihiko; Isa, Shun-Ichi; Inoue, Takako; Imamura, Fumio; Atagi, Shinji; Hirashima, Tomonori

    2018-01-01

    Programmed death-ligand 1 (PD-L1) expression status is inadequate for indicating nivolumab in patients with non-small cell lung cancer (NSCLC). Because the baseline advanced lung cancer inflammation index (ALI) is reportedly associated with patient outcomes, we investigated whether the pretreatment ALI is prognostic in NSCLC patients treated with nivolumab. We retrospectively reviewed the medical records of all patients treated with nivolumab for advanced NSCLC between December 2015 and May 2016 at three Japanese institutes. Multivariate logistic regression and Cox proportional hazards models were used to assess the impact of the pretreatment ALI (and other inflammation-related parameters) on progression-free survival (PFS) and early progression (i.e., within 8 weeks after starting nivolumab). A total of 201 patients were analyzed; their median age was 68 years (range, 27-87 years), 67% were men, and 24% had an Eastern Cooperative Oncology Group (ECOG) performance status of 2 or higher. An ECOG performance status ≥2, serum albumin ALI ALI ALI was found to be a significant independent predictor of early progression in patients with advanced NSCLC receiving nivolumab, and may help identify patients likely to benefit from continued nivolumab treatment in routine clinical practice. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  13. Migration of doctors for undergraduate medical education.

    Science.gov (United States)

    Hallock, James A; McKinley, Danette W; Boulet, John R

    2007-03-01

    Global shortages of healthcare workers in both developed and developing countries are of great concern. Research on physician migration typically focuses on medical school graduates, most often those seeking postgraduate training opportunities elsewhere. An overview of medical school migration patterns is presented in this paper. To put this phenomenon into the broader context of global physician migration, data is also presented on the distribution of medical schools, physician density, the flow of international medical graduates to the US, and the present composition of the US physician workforce. Results of the study indicate that many individuals leave their home country for undergraduate medical education. Given the movement of students and physicians, both for medical school and for advanced training opportunities, it is evident that some medical schools in the world are training doctors for their home country as well as for the international labor market. Overall, given the internationalization of medical education, collaborative efforts will be needed to develop an adequate, balanced, and well-trained global physician workforce.

  14. Health Resource Utilization in Patients with Advanced Non-Small Cell Lung Cancer Receiving Chemotherapy in China.

    Science.gov (United States)

    Shi, Jing; Zhu, Jun

    2016-01-01

    Chemotherapy is the preferred treatment regimen for advanced lung cancer patients. This study investigated the health resources utilized by and medical expenses of patients with non-small cell lung cancer (NSCLC) as well as the influence of various chemotherapy regimens on the final medical costs in China. The aim of this study was to provide physicians with a reference to use as the basis for their choice of treatment. Data were collected from the Shanghai Chest Hospital's medical charts and billing database. The collected patient information included the baseline characteristics, medical history, chemotherapy regimens, and medical costs, which were used to estimate the health resources utilized by patients and the cost of treatment. This study included 328 patients, and the average total medical cost was $US14,165. This cost included drugs, which accounted for as much as 78.91% of the total cost, and chemotherapy drugs, which accounted for 51.58% of total drug expenses. The most frequently utilized chemotherapy drug was carboplatin, and the most expensive chemotherapy drug was erlotinib. In drug combinations, gemcitabine was utilized most frequently, the combination of gemcitabine and paclitaxel was the most expensive, and cisplatin was the least expensive drug. Epidermal growth factor receptor-positive patients were treated with targeted drug therapy (icotinib, erlotinib, and gefitinib). The use of recombinant human endostatin was often combined with a vinorelbine plus cisplatin regimen. Traditional Chinese medicines were the most frequently utilized non-chemotherapy drugs, and these drugs were also the most expensive. The final cost significantly depended on the specific chemotherapy regimen; thus, the rationale and cost of the chemotherapy regimen and adjuvant chemotherapy should be considered in patients with advanced NSCLC.

  15. Emergency radiology curriculum at Medical University - Plovdiv

    International Nuclear Information System (INIS)

    Velkova, K.; Hilendarov, A.; Cvetkova, S.; Stoeva, M.; Petrova, A.; Stefanov, P.; Simova, E.; Georgieva, V.; Sirakov, N.

    2012-01-01

    Full text: Introduction: Recent advances in contemporary radiology turn it into one of the major sources for patient information with improved emergency techniques. Emergency Radiology (EP) focuses on acute diagnosing conditions in ER patients. Objectives: The main objective of this paper is to present the ER curriculum at Medical Imaging Department, Medical University - Plovdiv, aiming to deliver knowledge about the indications, possibilities and diagnostic value of the contemporary imaging methods in ER cases. Material and methods: The curriculum covers various aspects of ER Radiology - diagnostic imaging methods, contrast enhanced examinations, imaging topography, traumatic and acute conditions, physical and technical aspects. It includes 6 lectures and 12 practical classes. Results and discussion: The educational course in Emergency Radiology is available for medical students in their 8-th and 9-th semester. Therapeutic methods under imaging control are also covered by the course. Conclusion: Being one of the most advanced areas of radiology, ER improves the quality of care and treatment of patients and of the emergency medicine as a whole

  16. Web-Based Medical Service: Technology Attractiveness, Medical Creditability, Information Source, and Behavior Intention.

    Science.gov (United States)

    Wang, Shan Huei

    2017-08-02

    Web-based medical service (WBMS), a cooperative relationship between medical service and Internet technology, has been called one of the most innovative services of the 21st century. However, its business promotion and implementation in the medical industry have neither been expected nor executed. Few studies have explored this phenomenon from the viewpoint of inexperienced patients. The primary goal of this study was to explore whether technology attractiveness, medical creditability, and diversified medical information sources could increase users' behavior intention. This study explored the effectiveness of web-based medical service by using three situations to manipulate sources of medical information. A total of 150 questionnaires were collected from people who had never used WBMS before. Hierarchical regression was used to examine the mediation and moderated-mediation effects. Perceived ease of use (P=.002) and perceived usefulness (P=.001) significantly enhance behavior intentions. Medical credibility is a mediator (P=.03), but the relationship does not significantly differ under diverse manipulative information channels (P=.39). Medical credibility could explain the extra variation between technology attractiveness and behavior intention, but not significant under different moderating effect of medical information sources. ©Shan Huei Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.08.2017.

  17. Enhanced identification of eligibility for depression research using an electronic medical record search engine.

    Science.gov (United States)

    Seyfried, Lisa; Hanauer, David A; Nease, Donald; Albeiruti, Rashad; Kavanagh, Janet; Kales, Helen C

    2009-12-01

    Electronic medical records (EMRs) have become part of daily practice for many physicians. Attempts have been made to apply electronic search engine technology to speed EMR review. This was a prospective, observational study to compare the speed and clinical accuracy of a medical record search engine vs. manual review of the EMR. Three raters reviewed 49 cases in the EMR to screen for eligibility in a depression study using the electronic medical record search engine (EMERSE). One week later raters received a scrambled set of the same patients including 9 distractor cases, and used manual EMR review to determine eligibility. For both methods, accuracy was assessed for the original 49 cases by comparison with a gold standard rater. Use of EMERSE resulted in considerable time savings; chart reviews using EMERSE were significantly faster than traditional manual review (p=0.03). The percent agreement of raters with the gold standard (e.g. concurrent validity) using either EMERSE or manual review was not significantly different. Using a search engine optimized for finding clinical information in the free-text sections of the EMR can provide significant time savings while preserving clinical accuracy. The major power of this search engine is not from a more advanced and sophisticated search algorithm, but rather from a user interface designed explicitly to help users search the entire medical record in a way that protects health information.

  18. A cloud medication safety support system using QR code and Web services for elderly outpatients.

    Science.gov (United States)

    Tseng, Ming-Hseng; Wu, Hui-Ching

    2014-01-01

    Drug is an important part of disease treatment, but medication errors happen frequently and have significant clinical and financial consequences. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. Because of the global aging society, outpatients need to improve medication safety more than inpatients. The elderly with multiple chronic conditions face the complex task of medication management. To reduce the medication errors for the elder outpatients with chronic diseases, a cloud medication safety supporting system is designed, demonstrated and evaluated. The proposed system is composed of a three-tier architecture: the front-end tier, the mobile tier and the cloud tier. The mobile tier will host the personalized medication safety supporting application on Android platforms that provides some primary functions including reminders for medication, assistance with pill-dispensing, recording of medications, position of medications and notices of forgotten medications for elderly outpatients. Finally, the hybrid technology acceptance model is employed to understand the intention and satisfaction level of the potential users to use this mobile medication safety support application system. The result of the system acceptance testing indicates that this developed system, implementing patient-centered services, is highly accepted by the elderly. This proposed M-health system could assist elderly outpatients' homecare in preventing medication errors and improving their medication safety.

  19. XIV Mediterranean Conference on Medical and Biological Engineering and Computing

    CERN Document Server

    Christofides, Stelios; Pattichis, Constantinos

    2016-01-01

    This volume presents the proceedings of Medicon 2016, held in Paphos, Cyprus. Medicon 2016 is the XIV in the series of regional meetings of the International Federation of Medical and Biological Engineering (IFMBE) in the Mediterranean. The goal of Medicon 2016 is to provide updated information on the state of the art on Medical and Biological Engineering and Computing under the main theme “Systems Medicine for the Delivery of Better Healthcare Services”. Medical and Biological Engineering and Computing cover complementary disciplines that hold great promise for the advancement of research and development in complex medical and biological systems. Research and development in these areas are impacting the science and technology by advancing fundamental concepts in translational medicine, by helping us understand human physiology and function at multiple levels, by improving tools and techniques for the detection, prevention and treatment of disease. Medicon 2016 provides a common platform for the cross fer...

  20. Is medical students' moral orientation changeable after preclinical medical education?

    Science.gov (United States)

    Lin, Chaou-Shune; Tsou, Kuo-Inn; Cho, Shu-Ling; Hsieh, Ming-Shium; Wu, Hsi-Chin; Lin, Chyi-Her

    2012-03-01

    Moral orientation can affect ethical decision-making. Very few studies have focused on whether medical education can change the moral orientation of the students. The purpose of the present study was to document the types of moral orientation exhibited by medical students, and to study if their moral orientation was changed after preclinical education. From 2007 to 2009, the Mojac scale was used to measure the moral orientation of Taiwan medical students. The students included 271 first-year and 109 third-year students. They were rated as a communitarian, dual, or libertarian group and followed for 2 years to monitor the changes in their Mojac scores. In both first and third-year students, the dual group after 2 years of preclinical medical education did not show any significant change. In the libertarian group, first and third-year students showed a statistically significant increase from a score of 99.4 and 101.3 to 103.0 and 105.7, respectively. In the communitarian group, first and third-year students showed a significant decline from 122.8 and 126.1 to 116.0 and 121.5, respectively. During the preclinical medical education years, students with communitarian orientation and libertarian orientation had changed in their moral orientation to become closer to dual orientation. These findings provide valuable hints to medical educators regarding bioethics education and the selection criteria of medical students for admission.

  1. Medical Doctors Perceptions of Genetically Modified Foods

    Directory of Open Access Journals (Sweden)

    Hasan Savas

    2014-12-01

    Full Text Available Aim: Recombinant DNA and with similar technical changes made on genes or transferred isolated gene the living organisms have been named genetically modified organisms (GMOs. Thanks to advances in genetic technology, the advancement of enzyme and fermentation techniques result obtained by the use of GMOs in food industry products of genetically modified (GM foods are named. In this study, GM foods about the possible harmful effects have information and community advice on this matter to be medical doctors on this issue perceptions, knowledge, attitudes and behaviors aimed to measure.Material and Method: The study was made on including 200 medical doctors aged 23-65, 118 men (59%, 82 women (41%. In the statistical analysis based on the responses of medical doctors, against GM food risk perception, knowledge, attitudes and behaviors were assessed. Results: 80.5% of the participants’ think that GM foods are harmful. 22% of the participants were expressed that their knowledge are ‘’good’’ and ‘’very good’’ about GM food. While 38% of the participants use internet and 23.5% of the participants  use media, only 4.5% of the participants use medical schools as a source of sufficient information about GM foods. Discussion: While the risk perception of medical doctors about GM foods is high, the knowledge on this issue is observed low. Though the consumption and the prevelance of GM foods are increasing, medical doctors should have more information about this issue to enlighten and guide the community.

  2. The current and future role of the medical oncologist in the professional care for cancer patients: a position paper by the European Society for Medical Oncology (ESMO).

    Science.gov (United States)

    Popescu, R A; Schäfer, R; Califano, R; Eckert, R; Coleman, R; Douillard, J-Y; Cervantes, A; Casali, P G; Sessa, C; Van Cutsem, E; de Vries, E; Pavlidis, N; Fumasoli, K; Wörmann, B; Samonigg, H; Cascinu, S; Cruz Hernández, J J; Howard, A J; Ciardiello, F; Stahel, R A; Piccart, M

    2014-01-01

    The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer care should be provided by a multidisciplinary team (MDT) of highly qualified healthcare professionals. Cancer patients also have the right to benefit from medical progress by receiving optimal treatment from adequately trained and highly skilled medical professionals. Built on the highest standards of professional training and continuing medical education, medical oncology is recognised as an independent medical specialty in many European countries. Medical oncology is a core member of the MDT and offers cancer patients a comprehensive and systemic approach to treatment and care, while ensuring evidence-based, safe and cost-effective use of cancer drugs and preserving the quality of life of cancer patients through the entire 'cancer journey'. Medical oncologists are also engaged in clinical and translational research to promote innovation and new therapies and they contribute to cancer diagnosis, prevention and research, making a difference for patients in a dynamic, stimulating professional environment. Medical oncologists play an important role in shaping the future of healthcare through innovation and are also actively involved at the political level to ensure a maximum contribution of the profession to Society and to tackle future challenges. This position paper summarises the multifarious and vital contributions of medical oncology and medical oncologists to today's and tomorrow's professional cancer care.

  3. Advanced methods in diagnosis and therapy

    International Nuclear Information System (INIS)

    1987-01-01

    This important meeting covers the following topics: use and optimization of monoclonal antibobies in oncology: - Tumor markers: Clinical follow-up of patients through tumor marker serum determinations. - Cancer and medical imaging: The use of monoclonal antibodies in immunoscintigraphy. - Immunoradiotherapy: Monoclonal antibodies as therapeutic vectors. Advanced methods in diagnosis: - Contribution of monoclonal antibodies in modern immunochemistry (RIA, EIA). - Interest of monoclonal antibody in immunohistochemical pathology diagnosis. - In vitro diagnosis future prospects: with receptors and oncogenes. - Immunofluoroassay: a new sensitive immunoanalytical procedure with broad applications. Recent advances in brachitherapy: - Interest of computer processing. Blood products irradiation: - Interest in transfusion and bone marrow transplantations [fr

  4. Ethics of emergent information and communication technology applications in humanitarian medical assistance.

    Science.gov (United States)

    Hunt, Matthew; Pringle, John; Christen, Markus; Eckenwiler, Lisa; Schwartz, Lisa; Davé, Anushree

    2016-07-01

    New applications of information and communication technology (ICT) are shaping the way we understand and provide humanitarian medical assistance in situations of disaster, disease outbreak or conflict. Each new crisis appears to be accompanied by advancements in humanitarian technology, leading to significant improvements in the humanitarian aid sector. However, ICTs raise ethical questions that warrant attention. Focusing on the context of humanitarian medical assistance, we review key domains of ICT innovation. We then discuss ethical challenges and uncertainties associated with the development and application of new ICTs in humanitarian medical assistance, including avoiding harm, ensuring privacy and security, responding to inequalities, demonstrating respect, protecting relationships, and addressing expectations. In doing so, we emphasize the centrality of ethics in humanitarian ICT design, application and evaluation. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Enforcement actions: Significant actions resolved medical licensees. Quarterly progress report, January 1995--March 1995. Volume 14, No. 1, Part 2

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (January-March 1995) and includes copies of letters, Notices, and Orders sent by the Nuclear Regulatory Commission to medical licensees with respect to these enforcement actions. It is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication.

  6. Enforcement actions: Significant actions resolved medical licensees. Quarterly progress report, January 1995--March 1995. Volume 14, No. 1, Part 2

    International Nuclear Information System (INIS)

    1995-05-01

    This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (January-March 1995) and includes copies of letters, Notices, and Orders sent by the Nuclear Regulatory Commission to medical licensees with respect to these enforcement actions. It is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication

  7. CORRECTION OF CROOKED NOSE | Zaher | Scientific Medical ...

    African Journals Online (AJOL)

    Scientific Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 12, No 2 (2000) >. Log in or Register to get access to full text downloads.

  8. Impact of group psychotherapy in chemotherapy induced vomiting for treatment of advanced breast and lungs cancer

    International Nuclear Information System (INIS)

    Pervez, T.; Mein, F.D.; Alharbi, T.M.

    2007-01-01

    To assess the effect of group psychotherapy in the management of the side effects of chemotherapy treatment in advanced breast and lung cancer. One hundred patients treated with chemotherapy for advanced stage (IIIB and IV) breast and lung cancer were selected with ECOG performance status of 0 or 1. All patients received anti-emetic medications half an hour before chemotherapy. All those patients in this category who completed fist line chemotherapy with 6 cycles were included. Fifty were subjected to group discussions with other patients, family members and medical staff. This was labeled group A. The other 50 were not included in group discussion and were labeled group B. Both the group received similar standard chemotherapy and pre-medication for vomiting as per their disease and chemotherapy schedule. Breast and lung cancer patients were 29 and 21 in each arm respectively. At the end of the discharge, grade 2 and above of vomiting, according to common terminology criteria for adverse events (CTCAE) was counted for all patients in both the arms A and B, over full length of treatment for 6 cycles, and then were compared statistically. Mean with standard deviation for adverse event (vomiting) in group A and B was 6.2 + 2.6 and 13.4 + 3.8 respectively per cycle of treatment. It was observed that group psychotherapy had statistically significant effect (p-value <0.05) on the management of vomiting. Group psychotherapy can be used to reduce the incidence of vomiting in advanced breast and lung cancer patients treated with chemotherapy. (author)

  9. Advanced training as a specialized physician for medical radiology in Switzerland

    International Nuclear Information System (INIS)

    Bessler, W.

    1982-01-01

    The complex subject of advanced training of physicians in radiology in Switzerland is treated in this contribution. There is a report on the reorganisation, new guidelines, educational centers, educational catalogues, the specialiced physician's examination and nuclear medicine. (APR) [de

  10. Synchronous advanced gastric adenocarcinoma and advanced esophageal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Fernando Augusto Mardiros Herbella

    2002-01-01

    Full Text Available CONTEXT: Synchronous associations of esophageal and gastric cancers are not a common finding, especially with differing histological types and both tumors in advanced forms. A case with such an association is presented, in which an unusual therapy was proposed: palliative gastrectomy and esophageal intubation. CASE REPORT: A 75-year-old white man was referred to our service complaining of malaise and weight loss for one year and dysphagia and vomiting for 2 months. The patient had sought out medical consultation as a result of the latter two complaints.

  11. Engagement of the medical-technology sector with society.

    Science.gov (United States)

    Williams, David; Edelman, Elazer R; Radisic, Milica; Laurencin, Cato; Untereker, Darrel

    2017-04-12

    The medical-technology sector must educate society in an unbiased rational way about the successes and benefits of biotechnology innovation. Copyright © 2017, American Association for the Advancement of Science.

  12. Comparison of medication reconciliation and medication review: errors and clinical importance

    DEFF Research Database (Denmark)

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

    2013-01-01

    in the patient record and the EMS. 15% of the discrepancies were potentially serious or fatal, 62% were potentially significant and 23% were potentially non-significant. A total of 129 DRPs were identified by medication review, 1.7 per patient. The most frequent DRPs were sub therapeutic dosage, inappropriate......Introduction: The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-re­lated problems (DRPs), denoted errors. Material and methods: This was a retrospective study conducted at the Department...... of Cardiology, Hillerød Hos­pital. Medication reconciliation compared the prescriptions in patient records, an electronic medication system (EMS) and in discharge summaries (DS). The medication review was based on the EMS. The two methods were performed on the same data material. To assess the clinical...

  13. PS-022 Complex automated medication systems reduce medication administration error rates in an acute medical ward

    DEFF Research Database (Denmark)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    2017-01-01

    Background Medication errors have received extensive attention in recent decades and are of significant concern to healthcare organisations globally. Medication errors occur frequently, and adverse events associated with medications are one of the largest causes of harm to hospitalised patients...... cabinet, automated dispensing and barcode medication administration; (2) non-patient specific automated dispensing and barcode medication administration. The occurrence of administration errors was observed in three 3 week periods. The error rates were calculated by dividing the number of doses with one...

  14. Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits

    Directory of Open Access Journals (Sweden)

    Betsy Sleath

    2014-01-01

    Full Text Available Objective. The purpose of this study was to examine how patient, physician, and situational factors are associated with the extent to which providers educate patients about glaucoma and glaucoma medications, and which patient and provider characteristics are associated with whether providers educate patients about glaucoma and glaucoma medications. Methods. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited and a cross-sectional study was conducted at six ophthalmology clinics. Patients’ visits were videotape recorded and patients were interviewed after visits. Generalized estimating equations were used to analyze the data. Results. Two hundred and seventy-nine patients participated. Providers were significantly more likely to educate patients about glaucoma and glaucoma medications if they were newly prescribed glaucoma medications. Providers were significantly less likely to educate African American patients about glaucoma. Providers were significantly less likely to educate patients of lower health literacy about glaucoma medications. Conclusion. Eye care providers did not always educate patients about glaucoma or glaucoma medications. Practice Implications. Providers should consider educating more patients about what glaucoma is and how it is treated so that glaucoma patients can better understand their disease. Even if a patient has already been educated once, it is important to reinforce what has been taught before.

  15. A medical facility proposal to use the SSC linac

    International Nuclear Information System (INIS)

    Funk, L.W.

    1994-01-01

    A consortium organized by the Texas National Research Laboratory Commission under a Department of Energy grant proposes to build and operate a Regional Medical Technology Center to function as a combined medical radioisotope production complex and proton cancer therapy facility using the Linear Accelerator (Linac) assets of the Superconducting Super Collider (SSC). The radioisotope production complex will serve as a domestic source of radioisotopes critically needed by the U.S. pharmaceutical industry and nuclear medicine facilities throughout North America. Presently, more than 70 percent of radioisotopes used in U.S. nuclear medicine procedures are produced outside the country. The Center's state-of-the-art proton cancer therapy facility will serve the Central United States, providing advanced capabilities and augmenting facilities in California and Massachusetts. Long-term, it is anticipated that the RMTC also will stimulate nuclear medicine research, advance medical diagnostic technologies, and generate new industrial applications for linear accelerator technology

  16. Self-perceived competence among medical residents in skills needed to care for patients with advanced dementia versus metastatic cancer.

    Science.gov (United States)

    Manu, Erika; Marks, Adam; Berkman, Cathy S; Mullan, Patricia; Montagnini, Marcos; Vitale, Caroline A

    2012-06-01

    To examine medical residents' perceived competence in caring for patients with dementia we conducted an online survey of all 120 second, third and fourth-year residents in Internal Medicine, Medicine/Pediatrics, and Family Medicine at University of Michigan. A structured survey elicited residents' training, experience, confidence, and perceived career needs for skills in estimating prognosis, symptom management, and communication in caring for patients with dementia, compared to patients with metastatic cancer. Among the 61 (51 %) respondents, a majority report lower confidence in assessing prognosis and eliciting treatment wishes in patients with dementia (vs. metastatic cancer), and in performing skills integral to the care of patients with dementia, including the ability to assess caregiver needs, decisional capacity, advise on place of care, and manage agitation, despite viewing these skills as important to their future careers. These findings support the need for enhanced education on optimal care of patients with advanced dementia.

  17. Scientific Communication | Okolo | East African Medical Journal

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 92, No 2 (2015) >. Log in or Register to get access to full text downloads.

  18. Medical technology update - a Canadian perspective

    International Nuclear Information System (INIS)

    Lee, J.

    2005-01-01

    Major advances in medical equipment and the expanding utility of clinical applications have contributed to imaging procedures fast becoming an integral part of standard patient care in hospitals and clinics worldwide. The medical imaging market is based on the integration of at least three critical market segments using cutting-edge technologies: Image-generating equipment; contrast agents and imaging labels, including radionuclides; and associated hardware and software to process, evaluate, store, and transmit the images, which are either digitally generated or digitized from conventional film. (author)

  19. Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists

    Directory of Open Access Journals (Sweden)

    Ricci LH

    2017-06-01

    Full Text Available Lucas Holderegger Ricci,1 Caroline Amaral Ferraz2 1Department of Ophthalmology, School of Medicine, Laureate International Universities, São Paulo (SP, Brazil; 2Department of Ophthalmology, Federal University of São Paulo (UNIFESP, São Paulo (SP, Brazil Objective: To describe and appraise the latest simulation models for direct and indirect ophthalmoscopy as a learning tool in the medical field. Methods: The present review was conducted using four national and international databases – PubMed, Scielo, Medline and Cochrane. Initial set of articles was screened based on title and abstracts, followed by full text analysis. It comprises of articles that were published in the past fifteen years (2002–2017.Results: Eighty-three articles concerning simulation models for medical education were found in national and international databases, with only a few describing important aspects of ophthalmoscopy training and current application of simulation in medical education. After secondary analysis, 38 articles were included.Conclusion: Different ophthalmoscopy simulation models have been described, but only very few studies appraise the effectiveness of each individual model. Comparison studies are still required to determine best approaches for medical education and skill enhancement through simulation models, applied to both medical students as well as young ophthalmologists in training. Keywords: direct ophthalmoscopy, indirect ophthalmoscopy, skills, simulator, simulation models

  20. Medical speciality choice: does personality matter?

    LENUS (Irish Health Repository)

    Lydon, S

    2015-03-01

    There has been increasing interest in the personalities of doctors. This study examined whether personality differed based upon gender, level of training or medical speciality among 200 physicians and 134 medical students. Post-internship doctors scored significantly higher on conscientiousness (p = .001) than those pursuing basic medical training. Among those pursuing basic medical training, females scored significantly higher than males on agreeableness (p < .001) and conscientiousness (p = .001). Among post-internship respondents, females scored significantly higher on agreeableness (p = .004). There were no personality differences between post-internship doctors working in different specialities. However, among those pursuing basic medical training, those interested in person-focused medical specialities scored significantly higher on extraversion (p < .001), conscientiousness (p = .001), and lower on neuroticism (p = .01) than those who had no strong preference. These results suggest that there is no unique personality profile associated with medical practice, or medical speciality. Instead, it appears that medical school may shape personality.

  1. Advance Provision of Emergency Contraception for Adolescents

    Science.gov (United States)

    Adamji, Jehan-Marie; Swartwout, Kathryn

    2010-01-01

    Emergency contraception is most effective at preventing unintended pregnancy when taken as early as possible following unprotected sexual intercourse. Advance provision of this medication supports more timely and effective use. In the midst of rising teen pregnancy rates, current policies often limit access to emergency contraception for…

  2. Medical Tourism: Globalization of the Healthcare Marketplace

    Science.gov (United States)

    Horowitz, Michael D.; Rosensweig, Jeffrey A.; Jones, Christopher A.

    2007-01-01

    The citizens of many countries have long traveled to the United States and to the developed countries of Europe to seek the expertise and advanced technology available in leading medical centers. In the recent past, a trend known as medical tourism has emerged wherein citizens of highly developed countries choose to bypass care offered in their own communities and travel to less developed areas of the world to receive a wide variety of medical services. Medical tourism is becoming increasingly popular, and it is projected that as many as 750,000 Americans will seek offshore medical care in 2007. This phenomenon is driven by marketplace forces and occurs outside of the view and control of the organized healthcare system. Medical tourism presents important concerns and challenges as well as potential opportunities. This trend will have increasing impact on the healthcare landscape in industrialized and developing countries around the world. PMID:18311383

  3. Medical tourism: globalization of the healthcare marketplace.

    Science.gov (United States)

    Horowitz, Michael D; Rosensweig, Jeffrey A; Jones, Christopher A

    2007-11-13

    The citizens of many countries have long traveled to the United States and to the developed countries of Europe to seek the expertise and advanced technology available in leading medical centers. In the recent past, a trend known as medical tourism has emerged wherein citizens of highly developed countries choose to bypass care offered in their own communities and travel to less developed areas of the world to receive a wide variety of medical services. Medical tourism is becoming increasingly popular, and it is projected that as many as 750,000 Americans will seek offshore medical care in 2007. This phenomenon is driven by marketplace forces and occurs outside of the view and control of the organized healthcare system. Medical tourism presents important concerns and challenges as well as potential opportunities. This trend will have increasing impact on the healthcare landscape in industrialized and developing countries around the world.

  4. Prognostic significance of total lesion glycolysis in patients with advanced non-small cell lung cancer receiving chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zaizen, Yoshiaki [Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume (Japan); Azuma, Koichi, E-mail: azuma@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume (Japan); Kurata, Seiji [Department of Radiology, Kurume University School of Medicine, Kurume (Japan); Sadashima, Eiji; Hattori, Satoshi [Biostatistics Center, Kurume University, Kurume (Japan); Sasada, Tetsuro [Department of Immunology and Immunotherapy, Kurume University School of Medicine, Kurume (Japan); Imamura, Yohei [Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume (Japan); Kaida, Hayato [Department of Radiology, Kurume University School of Medicine, Kurume (Japan); Kawahara, Akihiko [Department of Pathology, Kurume University School of Medicine, Kurume (Japan); Kinoshita, Takashi [Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume (Japan); Ishibashi, Masatoshi [Department of Radiology, Kurume University School of Medicine, Kurume (Japan); Hoshino, Tomoaki [Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume (Japan)

    2012-12-15

    Background: [{sup 18}F]fluorodeoxyglucose positron emission tomography (FDG-PET) imaging has been employed as a non-invasive diagnostic tool for malignant tumors. Total lesion glycolysis (TLG) on FDG-PET is calculated by multiplying the mean standardized uptake value (SUVmean) by the tumor volume. Unlike the maximum standardized uptake value (SUVmax), which represents the point of greatest metabolic activity within tumors, TLG has been suggested to reflect global metabolic activity in whole tumors. Methods: We retrospectively examined whether or not FDG-PET measurements, including SUVmean, SUVmax, and TLG, could predict progression-free survival (PFS) or overall survival (OS) in patients with non-small cell lung cancer (NSCLC) receiving chemotherapy. Results: This study involved 81 consecutive patients with NSCLC who received chemotherapy. All of the patients underwent FDG-PET examination before treatment. SUVmean, SUVmax, and TLG on FDG-PET were significantly associated with gender, smoking status, and tumor histology. With adjustment for several other variables, Cox regression analysis showed that TLG was significantly prognostic for both PFS [hazard ratio = 2.34; 95% confidence interval, 1.18–4.64; P = 0.015] and OS (hazard ratio = 2.80; 95% confidence interval, 1.12–6.96; P = 0.003), whereas SUVmean and SUVmax had no significant association with PFS (P = 0.693 and P = 0.322, respectively) or OS (P = 0.587 and P = 0.214, respectively). Conclusions: Our findings suggest that TLG may be more useful than SUVmean and SUVmax for predicting PFS and OS in NSCLC patients receiving chemotherapy. The TLG measurement on FDG-PET imaging could be routinely recommended to advanced NSCLC patients.

  5. Advanced radiographic practice - the legal aspects

    International Nuclear Information System (INIS)

    Alderson, C.J.; Hogg, P.

    2003-01-01

    Allied health and nursing professionals are continuing to expand their responsibilities into clinical areas outside their traditional spheres of interest; typically, many of these new responsibilities are found within the medical (doctor) domain. Such responsibilities are often at an advanced clinical level and consequently higher demands are placed upon the professionals, not least in terms of clinical updating, competence to practice and also legal liability. This article explores the legal implications of practising at an advanced clinical level with particular reference to legal claims. The first part of the article commences with an outline of pertinent law in England and Wales. The latter part of the article explores actual cases from which allied health professionals (eg radiographers) can gain valuable information. Throughout the article suggestions for good practice are indicated. Examples of good practice include: the need to base your practice on evidence and peer practice; the need to keep detailed records (protocols) of such practice; the need to know when you are at the limit of your ability; and as such when to ask for advice from a medical practitioner/radiologist

  6. Advanced intelligent computational technologies and decision support systems

    CERN Document Server

    Kountchev, Roumen

    2014-01-01

    This book offers a state of the art collection covering themes related to Advanced Intelligent Computational Technologies and Decision Support Systems which can be applied to fields like healthcare assisting the humans in solving problems. The book brings forward a wealth of ideas, algorithms and case studies in themes like: intelligent predictive diagnosis; intelligent analyzing of medical images; new format for coding of single and sequences of medical images; Medical Decision Support Systems; diagnosis of Down’s syndrome; computational perspectives for electronic fetal monitoring; efficient compression of CT Images; adaptive interpolation and halftoning for medical images; applications of artificial neural networks for real-life problems solving; present and perspectives for Electronic Healthcare Record Systems; adaptive approaches for noise reduction in sequences of CT images etc.

  7. Predicting epileptic seizures in advance.

    Directory of Open Access Journals (Sweden)

    Negin Moghim

    Full Text Available Epilepsy is the second most common neurological disorder, affecting 0.6-0.8% of the world's population. In this neurological disorder, abnormal activity of the brain causes seizures, the nature of which tend to be sudden. Antiepileptic Drugs (AEDs are used as long-term therapeutic solutions that control the condition. Of those treated with AEDs, 35% become resistant to medication. The unpredictable nature of seizures poses risks for the individual with epilepsy. It is clearly desirable to find more effective ways of preventing seizures for such patients. The automatic detection of oncoming seizures, before their actual onset, can facilitate timely intervention and hence minimize these risks. In addition, advance prediction of seizures can enrich our understanding of the epileptic brain. In this study, drawing on the body of work behind automatic seizure detection and prediction from digitised Invasive Electroencephalography (EEG data, a prediction algorithm, ASPPR (Advance Seizure Prediction via Pre-ictal Relabeling, is described. ASPPR facilitates the learning of predictive models targeted at recognizing patterns in EEG activity that are in a specific time window in advance of a seizure. It then exploits advanced machine learning coupled with the design and selection of appropriate features from EEG signals. Results, from evaluating ASPPR independently on 21 different patients, suggest that seizures for many patients can be predicted up to 20 minutes in advance of their onset. Compared to benchmark performance represented by a mean S1-Score (harmonic mean of Sensitivity and Specificity of 90.6% for predicting seizure onset between 0 and 5 minutes in advance, ASPPR achieves mean S1-Scores of: 96.30% for prediction between 1 and 6 minutes in advance, 96.13% for prediction between 8 and 13 minutes in advance, 94.5% for prediction between 14 and 19 minutes in advance, and 94.2% for prediction between 20 and 25 minutes in advance.

  8. Thoracoscopy: medical versus surgical—in the management of pleural diseases

    Science.gov (United States)

    2015-01-01

    Diseases of the pleura continue to affect a large population of patients worldwide and in the United States. Pleural fluid analysis and accompanying imaging of the pleura including chest X-rays, chest computed tomography (CT) scan and chest ultrasonography are among the first steps in the management of pleural effusions. When further diagnostic or therapeutic work up is necessary, open thoracotomy and thoracoscopy come to mind. However, given the significant morbidity and mortality associated with open thoracotomy, and the advances in medicine and medical instruments, thoracoscopy has now become a routine procedure in the management of the disease of the chest including pleura. Debates about surgical vs. medical thoracoscopy (MT) are ongoing. In the following pages we review the literature and discuss the similarities and differences between the two procedures, as well as their indications, contraindications, complications and efficacy in the management of pleural diseases. PMID:26807282

  9. Textural features of pretreatment 18F-FDG PET/CT images: prognostic significance in patients with advanced T-stage oropharyngeal squamous cell carcinoma.

    Science.gov (United States)

    Cheng, Nai-Ming; Fang, Yu-Hua Dean; Chang, Joseph Tung-Chieh; Huang, Chung-Guei; Tsan, Din-Li; Ng, Shu-Hang; Wang, Hung-Ming; Lin, Chien-Yu; Liao, Chun-Ta; Yen, Tzu-Chen

    2013-10-01

    Previous studies have shown that total lesion glycolysis (TLG) may serve as a prognostic indicator in oropharyngeal squamous cell carcinoma (OPSCC). We sought to investigate whether the textural features of pretreatment (18)F-FDG PET/CT images can provide any additional prognostic information over TLG and clinical staging in patients with advanced T-stage OPSCC. We retrospectively analyzed the pretreatment (18)F-FDG PET/CT images of 70 patients with advanced T-stage OPSCC who had completed concurrent chemoradiotherapy, bioradiotherapy, or radiotherapy with curative intent. All of the patients had data on human papillomavirus (HPV) infection and were followed up for at least 24 mo or until death. A standardized uptake value (SUV) of 2.5 was taken as a cutoff for tumor boundary. The textural features of pretreatment (18)F-FDG PET/CT images were extracted from histogram analysis (SUV variance and SUV entropy), normalized gray-level cooccurrence matrix (uniformity, entropy, dissimilarity, contrast, homogeneity, inverse different moment, and correlation), and neighborhood gray-tone difference matrix (coarseness, contrast, busyness, complexity, and strength). Receiver-operating-characteristic curves were used to identify the optimal cutoff values for the textural features and TLG. Thirteen patients were HPV-positive. Multivariate Cox regression analysis showed that age, tumor TLG, and uniformity were independently associated with progression-free survival (PFS) and disease-specific survival (DSS). TLG, uniformity, and HPV positivity were significantly associated with overall survival (OS). A prognostic scoring system based on TLG and uniformity was derived. Patients who presented with TLG > 121.9 g and uniformity ≤ 0.138 experienced significantly worse PFS, DSS, and OS rates than those without (P 121.9 g or uniformity ≤ 0.138 were further divided according to age, and different PFS and DSS were observed. Uniformity extracted from the normalized gray

  10. Medication regimen complexity in ambulatory older adults with heart failure

    Directory of Open Access Journals (Sweden)

    Cobretti MR

    2017-04-01

    Full Text Available Michael R Cobretti,1 Robert L Page II,2 Sunny A Linnebur,2 Kimberly M Deininger,1 Amrut V Ambardekar,3 JoAnn Lindenfeld,4 Christina L Aquilante1 1Department of Pharmaceutical Sciences, 2Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, 3Division of Cardiology, School of Medicine, University of Colorado, Aurora, CO, 4Advanced Heart Failure and Cardiac Transplant Program, Vanderbilt Heart and Vascular Institute, Nashville, TN, USA Purpose: Heart failure prevalence is increasing in older adults, and polypharmacy is a major problem in this population. We compared medication regimen complexity using the validated patient-level Medication Regimen Complexity Index (pMRCI tool in “young-old” (60–74 years versus “old-old” (75–89 years patients with heart failure. We also compared pMRCI between patients with ischemic cardiomyopathy (ISCM versus nonischemic cardiomyopathy (NISCM.Patients and methods: Medication lists were retrospectively abstracted from the electronic medical records of ambulatory patients aged 60–89 years with heart failure. Medications were categorized into three types – heart failure prescription medications, other prescription medications, and over-the-counter (OTC medications – and scored using the pMRCI tool.Results: The study evaluated 145 patients (n=80 young-old, n=65 old-old, n=85 ISCM, n=60 NISCM, mean age 73±7 years, 64% men, 81% Caucasian. Mean total pMRCI scores (32.1±14.4, range 3–84 and total medication counts (13.3±4.8, range 2–30 were high for the entire cohort, of which 72% of patients were taking eleven or more total medications. Total and subtype pMRCI scores and medication counts did not differ significantly between the young-old and old-old groups, with the exception of OTC medication pMRCI score (6.2±4 young-old versus 7.8±5.8 old-old, P=0.04. With regard to heart failure etiology, total pMRCI scores and medication

  11. The role of medical education in the development of the scientific practice of medicine.

    Science.gov (United States)

    Cardinal, Lucien; Kaell, Alan

    2017-01-01

    The authors describe the important role of medical schools and graduate medical education programs (residencies) in relationship to the advances in Medicine witnessed during the twentieth century; diagnosis, prognosis and treatment were revolutionized. This historical essay details the evolution of the education system and the successful struggle to introduce a uniform, science-based curriculum and bedside education. The result was successive generations of soundly educated physicians prepared with a broad knowledge in science, an understanding of laboratory methods and the ability to practice medicine at the bedside. These changes in medical education created a foundation for the advancement of medicine.

  12. Undergraduate medical education in Germany

    Directory of Open Access Journals (Sweden)

    Chenot, Jean-François

    2009-04-01

    Full Text Available The purpose of this article is to give international readers an overview of the organisation, structure and curriculum, together with important advances and problems, of undergraduate medical education in Germany. Interest in medical education in Germany has been relatively low but has gained momentum with the new "Regulation of the Licensing of Doctors" which came into effect in 2003. Medical education had required substantial reform, particularly with respect to improving the links between theoretical and clinical teaching and the extension of interdisciplinary and topic-related instruction. It takes six years and three months to complete the curriculum and training is divided into three sections: basic science (2 years, clinical science (3 years and final clinical year. While the reorganisation of graduate medical education required by the new "Regulation of the Licensing of Doctors" has stimulated multiple excellent teaching projects, there is evidence that some of the stipulated changes have not been implemented. Indeed, whether the medical schools have complied with this regulation and its overall success remains to be assessed systematically. Mandatory external accreditation and periodic reaccreditation of medical faculties need to be established in Germany.

  13. Awareness of cardiopulmonary resuscitation in medical-students and doctors in Rawalpindi-Islamabad, Pakistan

    International Nuclear Information System (INIS)

    Zamir, Q.; Nadeem, A.; Rizvi, A.H.

    2012-01-01

    Objective: To assess the level of awareness regarding basic and practical knowledge of cardiopulmonary resuscitation and its importance in the eyes of medical/dental students and doctors. Methods: The cross-sectional study was conducted in medical and dental colleges as well as hospitals of Rawalpindi and Islamabad, Pakistan, from June to September 2011. Non-probability convenience sampling was used and structured questionnaires on basic and practical knowledge of the procedure were distributed. The questionnaire had 26 items related to basic and advanced knowledge of the required skills. Doctors were divided into two groups based on their years of service and practice. Those with less than 5 years' experience were grouped as junior doctors, while rest as senior doctors. Descriptive statistics were employed to analyse the data using SPPS version 17 and Microsoft Excel. Percentages were worked out and the results were interpreted. Result: Of the 1000 questionnaires distributed, 646 (64.6%) were received duly filled and represented the study sample. Of the 646 participants, 34 (5.26%) were dentists, 424 (65.63%) were medical students, 92 (14.24%) were doctors and 96 (14.86%) were dental students. Basic knowledge of doctors was found to be better than that of dentists (n=96; 50% vs. n=8; 23%). Similarly, the advance knowledge of doctors was better than the dentists (n=53; 58% vs. n=11; 31%). The basic knowledge of junior doctors was found to be almost equal to the senior doctors (n=26; 44.75% vs. n=15; 45.5%). The advance knowledge of junior doctors was found to be better than the senior doctors (n=27; 45.37% vs. n=10; 29.48%). Among the students, 157 (37%) of the medical students had basic knowledge of CPR, while 36 (38%) dental students had basic knowledge of the topic. Medical students had more advanced knowledge (n=157; 37%) than dental students (n=34; 35%). Conclusion: The awareness of basic and advance knowledge of cardiopulmonary resuscitation skills in medical

  14. Marijuana: modern medical chimaera.

    Science.gov (United States)

    Lamarine, Roland J

    2012-01-01

    Marijuana has been used medically since antiquity. In recent years there has been a resurgence of interest in medical applications of various cannabis preparations. These drugs have been cited in the medical literature as potential secondary treatment agents for severe pain, muscle spasticity, anorexia, nausea, sleep disturbances, and numerous other uses. This article reviews the research literature related to medical applications of various forms of cannabis. Benefits related to medical use of cannabinoids are examined and a number of potential risks associated with cannabis use, both medical and recreational, are considered. There is a clearly identified need for further research to isolate significant benefits from the medical application of cannabinoids and to establish dosage levels, appropriate delivery mechanisms and formulations, and to determine what role, if any, cannabinoids might play in legitimate medical applications. It is also imperative to determine if reported dangers pose a significant health risks to users.

  15. The Study on Virtual Medical Instrument based on LabVIEW.

    Science.gov (United States)

    Chengwei, Li; Limei, Zhang; Xiaoming, Hu

    2005-01-01

    With the increasing performance of computer, the virtual instrument technology has greatly advanced over the years, and then virtual medical instrument technology becomes available. This paper presents the virtual medical instrument, and then as an example, an application of a signal acquisition, processing and analysis system using LabVIEW is also given.

  16. Medical Mapping: The Revolution in Teaching--and Using--Maps for the Analysis of Medical Issues

    Science.gov (United States)

    Koch, Tom; Denike, Ken

    2004-01-01

    As a result of advances in GIS, students from a range of disciplines (epidemiology, public health, medical sociology, and anthropology) are seeking to learn how to apply a mapped, spatial perspective to issues of disease and health. This paper describes a pilot program whose intent has been to develop an interdisciplinary, skill-based course in…

  17. GxE Interactions Between FOXO Genotypes and Tea Drinking Significantly Affect Cognitive Disability at Advanced Ages in China

    DEFF Research Database (Denmark)

    Zeng, Yi; Chen, Huashuai; Ni, Ting

    2015-01-01

    Logistic regression analysis based on data from 822 Han Chinese oldest old aged 92+ demonstrated that interactions between carrying FOXO1A-266 or FOXO3-310 or FOXO3-292 and tea drinking at around age 60 or at present time were significantly associated with lower risk of cognitive disability...... at advanced ages. Associations between tea drinking and reduced cognitive disability were much stronger among carriers of the genotypes of FOXO1A-266 or FOXO3-310 or FOXO3-292 compared with noncarriers, and it was reconfirmed by analysis of three-way interactions across FOXO genotypes, tea drinking at around...... age 60, and at present time. Based on prior findings from animal and human cell models, we postulate that intake of tea compounds may activate FOXO gene expression, which in turn may positively affect cognitive function in the oldest old population. Our empirical findings imply that the health...

  18. Recent technological advances in computed tomography and the clinical impact therein.

    Science.gov (United States)

    Runge, Val M; Marquez, Herman; Andreisek, Gustav; Valavanis, Anton; Alkadhi, Hatem

    2015-02-01

    Current technological advances in CT, specifically those with a major impact on clinical imaging, are discussed. The intent was to provide for both medical physicists and practicing radiologists a summary of the clinical impact of each advance, offering guidance in terms of utility and day-to-day clinical implementation, with specific attention to radiation dose reduction.

  19. Advanced Surface Technology

    DEFF Research Database (Denmark)

    Møller, Per; Nielsen, Lars Pleht

    of the components. It covers everything from biocompatible surfaces of IR absorbent or reflective surfaces to surfaces with specific properties within low friction, hardness, corrosion, colors, etc. The book includes more than 400 pages detailing virtually all analysis methods for examining at surfaces.......This new significant book on advanced modern surface technology in all its variations, is aimed at both teaching at engineering schools and practical application in industry. The work covers all the significant aspects of modern surface technology and also describes how new advanced techniques make...

  20. Clinical judgement and the medical profession

    Science.gov (United States)

    Kienle, Gunver S; Kiene, Helmut

    2011-01-01

    Objectives Clinical judgment is a central element of the medical profession, essential for the performance of the doctor, and potentially generating information also for other clinicians and for scientists and health care managers. The recently renewed interest in clinical judgement is primarily engaged with its role in communication, diagnosis and decision making. Beyond this issue, the present article highlights the interrelations between clinical judgement, therapy assessment and medical professionalism. Methods Literature review and theory development. Results The article presents different methodological approaches to causality assessment in clinical studies and in clinical judgement, and offers criteria for clinical single case causality. The article outlines models of medical professionalism such as technical rationality and practice epistemology, and characterizes features of professional expertise such as tacit knowledge, reflection in action, and gestalt cognition. Conclusions Consequences of a methodological and logistical advancement of clinical judgment are discussed, both in regard to medical progress and to the renewel of the cognitive basis of the medical profession. PMID:20973873

  1. Medical Significance of Microorganisms in Spacecraft Environment

    Science.gov (United States)

    Pierson, Duane L.; Ott, C. Mark

    2007-01-01

    Microorganisms can spoil food supplies, contaminate drinking water, release noxious volatile compounds, initiate allergic responses, contaminate the environment, and cause infectious diseases. International acceptability limits have been established for bacterial and fungal contaminants in air and on surfaces, and environmental monitoring is conducted to ensure compliance. Allowable levels of microorganism in water and food have also been established. Environmental monitoring of the space shuttle, the Mir, and the ISS have allowed for some general conclusions. Generally, the bacteria found in air and on interior surfaces are largely of human origin such as Staphylococcus spp., Micrococcus spp. Common environmental genera such as Bacillus spp. are the most commonly isolated bacteria from all spacecraft. Yeast species associated with humans such as Candida spp. are commonly found. Aspergillus spp., Penicillium spp., and Cladosporium spp. are the most commonly isolated filamentous fungi. Microbial levels in the environment differ significantly depending upon humidity levels, condensate accumulation, and availability of carbon sources. However, human "normal flora" of bacteria and fungi can result in serious, life-threatening diseases if human immunity is compromised. Disease incidence is expected to increase as mission duration increases.

  2. Role of Religiosity in Psychological Well-Being Among Medical and Non-medical Students.

    Science.gov (United States)

    Saleem, Shemaila; Saleem, Tamkeen

    2017-08-01

    Religion has been generally considered as a protective factor for the psychological health of the people. As many studies have publicized a high prevalence of psychological morbidities among the medical students during their academic stages of medical schools, it is significant to investigate whether religiosity functions as a protective factor, to explore religiosity as a predictor of psychological well-being in a sample of medical students, and to compare the results of medical students as well as non-medical students with respect to religiosity and psychological well-being. The study is carried out in Federal Medical and Dental College and International Islamic University, Islamabad. The present study examined a sample of 120 medical students from Federal Medical and Dental College and 120 non-medical students from International Islamic University, Islamabad. Purposive sampling was used. The respondents completed religious orientation scale and scale of psychological well-being scale along with a demographic data sheet. In order to measure the study variables, linear regression and t test were used. The findings revealed that religiosity is a strong predictor of psychological well-being. Extrinsic and intrinsic religiosity predicts psychological well-being among the students. The results indicated a significant difference in psychological well-being between medical and non-medical students. No significant difference was found in religiosity of medical and non-medical students. The gender differences in religiosity and psychological well-being were found to be insignificant. The results emphasize that psychological well-being is prophesied by religiosity. The present research suggests further investigations and also endows with trends for psychological evaluation, development of religious beliefs, and interventions for augmenting psychological well-being among the medical students.

  3. Effect of the Tool to Reduce Inappropriate Medications on Medication Communication and Deprescribing.

    Science.gov (United States)

    Fried, Terri R; Niehoff, Kristina M; Street, Richard L; Charpentier, Peter A; Rajeevan, Nallakkandi; Miller, Perry L; Goldstein, Mary K; O'Leary, John R; Fenton, Brenda T

    2017-10-01

    To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. Randomized clinical trial. Primary care clinics at a Veterans Affairs Medical Center. Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128). TRIM extracts information on medications and chronic conditions from the EHR and contains data entry screens for information obtained from brief chart review and telephonic patient assessment. These data serve as input for automated algorithms identifying medication reconciliation discrepancies, potentially inappropriate medications (PIMs), and potentially inappropriate regimens. Clinician feedback reports summarize discrepancies and provide recommendations for deprescribing. Patient feedback reports summarize discrepancies and self-reported medication problems. Primary: subscales of the Patient Assessment of Care for Chronic Conditions (PACIC) related to shared decision-making; clinician and patient communication. Secondary: changes in medications. 29.7% of TRIM participants and 15.6% of control participants provided the highest PACIC ratings; this difference was not significant. Adjusting for covariates and clustering of patients within clinicians, TRIM was associated with significantly more-active patient communication and facilitative clinician communication and with more medication-related communication among patients and clinicians. TRIM was significantly associated with correction of medication discrepancies but had no effect on number of medications or reduction in PIMs. TRIM improved communication about medications and accuracy of documentation. Although there was no association with prescribing, the small sample size provided limited power to examine medication-related outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The

  4. The Competencies, Roles and Scope of Practice of Advanced Psychiatric Nursing in Indonesia

    Directory of Open Access Journals (Sweden)

    Yulia Wardani

    2014-01-01

    Full Text Available The graduate advanced psychiatric nursing (psychiatric nursing specialist from master degree in Indonesia are about 70 nurses, 67 nurses were graduated from University of Indonesia. They are working at mental health services and educational setting around Indonesia and yet seem not ready to perform some specific advanced competencies in clinical area. The mastery on mental health assessment, neurochemical perspectives, medical management and psychotherapy have not yet performed by the psychiatric nurse specialist in the clinical area or community.To have those competencies and its performances, therefore the curriculum in a psychiatric nursing graduate program must include advanced courses in physiopsychology, psychopathology, advanced psychopharmacology, neurobehavioral science, advanced mental health assessment, and advanced treatment interventions such as psychotherapy and prescription and management of psychotropic medications as their core and major courses in the curriculum. Those courses should be performed in their clinical practice courses or other related learning experiences. When those qualifications are met, then they are competent to be called advanced psychiatric nurse.As advanced practice registered nurses, the advanced psychiatric nurses should be able to demonstrate their direct expertise and roles in advanced mental health assessment, diagnostic evaluation, psychopharmacology management, psychotherapy with individuals, group and families, case management, millieu management, liason and counselling from prevention, promotion until psychiatric rehabilitation. Meanwhile the skill such as psycho-education, teaching, unit management, research and staff development can be added as their indirect roles.

  5. Endotracheal intubation skill acquisition by medical students

    Directory of Open Access Journals (Sweden)

    Henry E. Wang MD MS

    2011-08-01

    Full Text Available During the course of their training, medical students may receive introductory experience with advanced resuscitation skills. Endotracheal intubation (ETI – the insertion of a breathing tube into the trachea is an example of an important advanced resuscitation intervention. Only limited data characterize clinical ETI skill acquisition by medical students. We sought to characterize medical student acquisition of ETI procedural skill.11Presented as a poster discussion on 17 October 2007 at the annual meeting of the American Society of Anesthesiologists in San Francisco, CA.The study included third-year medical students participating in a required anesthesiology clerkship. Students performed ETI on operating room patients under the supervision of attending anesthesiologists. Students reported clinical details of each ETI effort, including patient age, sex, Mallampati score, number of direct laryngoscopies and ETI success. Using mixed-effects regression, we characterized the adjusted association between ETI success and cumulative ETI experience.ETI was attempted by 178 students on 1,646 patients (range 1–23 patients per student; median 9 patients per student, IQR 6–12. Overall ETI success was 75.0% (95% CI 72.9–77.1%. Adjusted for patient age, sex, Mallampati score and number of laryngoscopies, the odds of ETI success improved with cumulative ETI encounters (odds ratio 1.09 per additional ETI encounter; 95% CI 1.04–1.14. Students required at least 17 ETI encounters to achieve 90% predicted ETI success.In this series medical student ETI proficiency was associated with cumulative clinical procedural experience. Clinical experience may provide a viable strategy for fostering medical student procedural skills.

  6. A medical facility proposal to use the SSC linac

    International Nuclear Information System (INIS)

    Funk, L.W.

    1995-01-01

    A consortium organized by the Texas National Research Laboratory Commission (TNRLC) under a Department of Energy (DOE) grant proposes to build and operate a Regional Medical Technology Center (RMTC) to function as a combined medical radioisotope production complex and proton cancer therapy facility using the linear accelerator (linac) assets of the cancelled Superconducting Super Collider (SSC). The radioisotope production complex will serve as a domestic source of radioisotopes critically needed by the U.S. pharmaceutical industry and nuclear medicine facilities throughout North America. Presently, more than 70 percent of radioisotopes used in U.S. nuclear medicine procedures are produced outside the country. The Center's state-of-the-art proton cancer therapy facility will serve the Central United States, providing advanced capabilities and augmenting facilities in California and Massachusetts. Long-term, it is anticipated that the RMTC also will stimulate nuclear medicine research, advance medical diagnostic technologies, and generate new industrial applications of linear accelerator technology. (orig.)

  7. A medical facility proposal to use the SSC linac

    Science.gov (United States)

    Warren Funk, L.

    1995-05-01

    A consortium organized by the Texas National Research Laboratory Commission (TNRLC) under a Department of Energy (DOE) grant proposes to build and operate a Regional Medical Technology Center (RMTC) to function as a combined medical radioisotope production complex and proton cancer therapy facility using the linear accelerator (linac) assets of the cancelled Superconducting Super Collider (SSC). The radioisotope production complex will serve as a domestic source of radioisotopes critically needed by the U.S. pharmaceutical industry and nuclear medicine facilities throughout North America. Presently, more than 70 percent of radioisotopes used in U.S. nuclear medicine procedures are produced outside the country. The Center's state-of-the-art proton cancer therapy facility will serve the Central United States, providing advanced capabilities and augmenting facilities in California and Massachusetts. Long-term, it is anticipated that the RMTC also will stimulate nuclear medicine research, advance medical diagnostic technologies, and generate new industrial applications of linear accelerator technology.

  8. Diagnostic imaging in undergraduate medical education: an expanding role

    International Nuclear Information System (INIS)

    Miles, K.A.

    2005-01-01

    Radiologists have been involved in anatomy instruction for medical students for decades. However, recent technical advances in radiology, such as multiplanar imaging, 'virtual endoscopy', functional and molecular imaging, and spectroscopy, offer new ways in which to use imaging for teaching basic sciences to medical students. The broad dissemination of picture archiving and communications systems is making such images readily available to medical schools, providing new opportunities for the incorporation of diagnostic imaging into the undergraduate medical curriculum. Current reforms in the medical curriculum and the establishment of new medical schools in the UK further underline the prospects for an expanding role for imaging in medical education. This article reviews the methods by which diagnostic imaging can be used to support the learning of anatomy and other basic sciences

  9. Did you seek assistance for writing your advance directive? A qualitative study.

    Science.gov (United States)

    Becker, Matthias; Jaspers, Birgit; King, Claudius; Radbruch, Lukas; Voltz, Raymond; Nauck, Friedemann

    2010-11-01

    the completion of an advanced directive is paired with a high degree of self-responsibility of the signatory. It requires anticipation of probably complex medical situations. In the literature, the family physician is often seen as the most important person for advice when writing an advance directive. But little is known about whether or not patients want to involve medical advisors and to what extent physicians are willing to give advice. The aim of this study was to analyse whether or not individuals approached advisors for the completion of their advance directive, whom they chose and which reasons were given for seeking or foregoing assistance. semi-structured interviews with healthy individuals, chronically ill individuals and patients in palliative care including questions associated with advice for completing an advance directive (8/2008-7/2009). age 55-70 years and advance directive ≥ 3 months old. The interviews were fully transcribed according to standard transcription rules and analysed applying an inductive category development. interviews were conducted with 53 probands (healthy n = 20, chronically ill n = 17, palliative care patients n = 16); 18 probands were male. Mean age was 63.2 ± 4.4 years (range 55-70 years). Professional advice was sought by 12 probands (physician = 2, nurse = 1, lawyer/notary = 8, self-employed advisor = 1), another 8 probands included family members. In 17 cases, the physician knew the proband's advance directive, 36 probands never told their doctor about its existence. Categories of reasons for seeking or foregoing advice were trust/lack of trust, autonomy, rejection and financial considerations. information about the medical implications concerning patient preferences for end-of-life care seems not to be the main focus of interest when individuals write an advance directive. Autonomy and trust into notarially certified documents seem to be more important matters. If family physicians want to have a role in their

  10. Beyond accreditation: excellence in medical education.

    Science.gov (United States)

    Ahn, Eusang; Ahn, Ducksun

    2014-01-01

    Medical school accreditation is a relatively new phenomenon in Korea. The development of an accreditation body and standards for a two-tiered "Must" and "Should" system in 1997 eventually led to the implementation of a third "Excellence" level of attainment. These standards were conceived out of a desire to be able to first recognize and promote outstanding performance of medical schools, second to provide role models in medical education, and furthermore to preview the third level as potential components of the pre-existing second level for the next accreditation cycle. It is a quality-assurance mechanism that, while not required for accreditation itself, pushes medical schools to go beyond the traditional requirements of mere pass-or-fail accreditation adequacy, and encourages schools to deliver an unprecedented level of medical education. The Association for Medical Education in Europe developed its own third-tier system of evaluation under the ASPIRE project, with many similar goals. Due to its advanced nature and global scope, the Korean accreditation body has decided to implement the ASPIRE system in Korea as well.

  11. Islamic medical jurisprudence syllabus: A Review in Saudi Arabia.

    Science.gov (United States)

    Chamsi-Pasha, H; Albar, M A

    2017-10-01

    The ever-increasing technological advances of Western medicine have created new ethical issues awaiting answers and response. The use of genetic therapy, organ transplant, milk-banking, end-of-life care and euthanasia are of paramount importance to the medical students and need to be addressed. A series of searches were conducted of Medline databases published in English between January 2000 and January 2017 with the following keywords: medical ethics, syllabus, Islam, jurisprudence. Islamic medical jurisprudence is gaining more attention in some medical schools. However, there is still lack of an organised syllabus in many medical colleges. The outlines of a syllabus in Islamic medical jurisprudence including Islamic values and moral principles related to both the practice and research of medicine are explored.

  12. Methodology, theoretical framework and scholarly significance: An ...

    African Journals Online (AJOL)

    Methodology, theoretical framework and scholarly significance: An overview ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... Keywords: Legal Research, Methodology, Theory, Pedagogy, Legal Training, Scholarship ...

  13. The somatically significant dose, SSD, and analog of the GSD, the genetically significant dose

    International Nuclear Information System (INIS)

    Beentjes, L.B.; Duijsings, J.H.

    1992-01-01

    The medical applications of radiation comprise three main fields namely: Diagnostic Radiology, Radiotherapy and Nuclear Medicine. With the new weighting factors of ICRP (IC91a) the effective dose due to medical applications can be established. I is common to separate the effective dose into the genetic part and the somatic part, SED. In dealing with gonad doses it is important to account for the age of the person at the time of exposure as this will influence the number of children still to be expected from that person. The resulting dose will then be called the genetically significant dose, GSD. In a similar fashion this age factor will be important in considering the chance of tumor induction. The age of patients differs considerably from the average age of the general population. This age difference has to be accounted for if a comparison is to be made with other sources of radiation. This justifies establishing a somatically significant dose, SSD. The reduction of the SED value to a SSD for the medical field due to this phenomenon is .6 for diagnostic radiology, .5 for nuclear medicine and .3 for radiotherapy. Also the extension to more organs at risk, which result in a larger number of weighting factors published by ICRP (IC91a) tends to lower the calculated effective doses. (author)

  14. Intelligent distributed medical image management

    Science.gov (United States)

    Garcia, Hong-Mei C.; Yun, David Y.

    1995-05-01

    The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

  15. Achieving Accreditation Council for Graduate Medical Education duty hours compliance within advanced surgical training: a simulation-based feasibility assessment.

    Science.gov (United States)

    Obi, Andrea; Chung, Jennifer; Chen, Ryan; Lin, Wandi; Sun, Siyuan; Pozehl, William; Cohn, Amy M; Daskin, Mark S; Seagull, F Jacob; Reddy, Rishindra M

    2015-11-01

    Certain operative cases occur unpredictably and/or have long operative times, creating a conflict between Accreditation Council for Graduate Medical Education (ACGME) rules and adequate training experience. A ProModel-based simulation was developed based on historical data. Probabilistic distributions of operative time calculated and combined with an ACGME compliant call schedule. For the advanced surgical cases modeled (cardiothoracic transplants), 80-hour violations were 6.07% and the minimum number of days off was violated 22.50%. There was a 36% chance of failure to fulfill any (either heart or lung) minimum case requirement despite adequate volume. The variable nature of emergency cases inevitably leads to work hour violations under ACGME regulations. Unpredictable cases mandate higher operative volume to ensure achievement of adequate caseloads. Publically available simulation technology provides a valuable avenue to identify adequacy of case volumes for trainees in both the elective and emergency setting. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. A study of stress in medical students at Seth G.S. Medical College.

    Directory of Open Access Journals (Sweden)

    Supe A

    1998-01-01

    Full Text Available BACKGROUND: It is usually observed that medical students undergo tremendous stress during various stages of the MBBS course. There is a high rate of suicide among them. METHODS: To determine incidence of stress and factors controlling stress in medical students at various stages of MBBS course at Seth G S Medical college, 238 students (First year 98, Second 76, Third 64 were asked to complete a questionnaire on personal data (gender, stay at hostel, mode of travel, time spent in travel every day, medium of study in school, place of school education., Stress inducing factors, Zung′s depression scale, ways of coping, stress relievers, perceived social support and personality type. Statistical tests used were ANOVA, critical ratio and Student′s ′t′ test. RESULTS: Majority of medical students (175/238--73% perceived stress. Stress was found to be significantly more in Second and Third MBBS students rather than First MBBS levels (p < 0.05. Stress was not found to differ significantly on the basis of sex, stay at hostel, model of travel, time spent in travel every day, medium of study in school, place of school education. Stress was found to be significantly more in students having more than 95% of marks at 12th Standard as compared to others. Academic factors were greater perceived cause of stress in medical students. There was no significant difference in the students at different levels of MBBS regarding academic factors and social factors as a stress inducing factors. Physical factors were found to be significantly more in Second and Third MBBS students as compared to First MBBS students. Emotional factors were found to be significantly more in First MBBS students as compared to Second & Third MBBS students. Stress was more common in medical students who have dominant strategy of coping as positive reappraisal, accepting responsibility and planful problem solving. Stress was less common in medical students at Seth G S Medical College who

  17. Report of the Study Group on Medical Uses of Accelerators

    International Nuclear Information System (INIS)

    1978-01-01

    Medical uses of accelerators to raise the welfare of peoples are advancing rapidly due to the improvement of using technology. Under the situation, the Study Group on Medical Uses of Accelerators set up in the Science and Technology Agency has surveyed the status in Japan of radiation therapy of cancers and nuclear medicine with accelerators, and has studied on the future research and development in this field. The present report should contribute to the plans by the Government for the future. The results obtained by the study Group are described: the trends of medicine for the next ten years, especially the advances of cancer diagnosis and treatment and nuclear medicine; and medical radiation sources and the accelerators as their generators expected to be in practical utilization. As for the particles from accelerators used for medical purposes, there are fast neutrons, protons, helium particles, charged heavy particles, and π-mesons. For diagnosis and treatment, the radiation sources must be chosen according to the purposes, and their combination becomes necessary. (Mori, K.)

  18. Implementation and outcome evaluation of the Medical Education ...

    African Journals Online (AJOL)

    Implementation and outcome evaluation of the Medical Education ... the pretest median score was 55% (interquartile range (IQR) 40 - 62%) and the posttest ... This education mode offers the opportunity for health researchers to advance their ...

  19. The Integration of Children Dependent on Medical Technology into Public Schools

    Science.gov (United States)

    Raymond, Jill A.

    2009-01-01

    Advances in medicine have increased the survival rates of children with complex medical conditions, including those who are dependent on technology such as ventilators and tracheostomies. The process of integrating children dependent on medical technology into public schools requires the collaboration of a multidisciplinary team to ensure that…

  20. Aero-medical evacuation from the second Israel-Lebanon war: a descriptive study.

    Science.gov (United States)

    Schwartz, Dagan; Resheff, Avram; Geftler, Alex; Weiss, Aviram; Birenbaum, Erez; Lavon, Ophir

    2009-05-01

    The second Lebanon war started as a limited operation and progressed to a large-scale campaign. Most of the fighting took place in mountainous villages and small towns inhabited with civilians. The Israeli Defense Forces (IDF) Airborne rescue and evacuation unit is charged with air evacuation of soldiers and civilians in times of peace, limited conflict, and war. We describe this unit's activities in the second Lebanon war, analyzing injury, treatment, and evacuation characteristics Data were collected from flight medical reports, debriefings of aero-medical team members (usually immediately upon return from mission), ground units medical reports and debriefings, and hospital records. 725 IDF soldiers were injured and 117 killed either in Lebanon or near the Israeli-Lebanese border during the war. A total of 338 (46%) were evacuated in 95 airlifts (averaging 4.5 evacuees per airlift) from the fighting zones or the border. Air evacuation used dedicated helicopters with advanced care capacities, and most victims were evacuated straight from the battlefield, as the fighting was ensuing. Many wounded first received advanced medical care upon the arrival of the aero-medical teams. In military operations within civilian populated areas with threats to ground transport, air evacuation can sometimes be the only readily available option. Providing timely ground advanced medical care proved difficult in many instances. Thus, for many, the rescue helicopter was the first point of access to such care. Aero-medical aircrafts and personnel faced threats from gunfire and missiles, causing both delays in evacuation and a high average number of evacuees per airlift. This article proposes ways of coping with situations in which similar rescue and evacuation problems are likely.

  1. Effectiveness of Advanced Illness Care Teams for Nursing Home Residents with Dementia

    Science.gov (United States)

    Chapman, Dennis G.; Toseland, Ronald W.

    2007-01-01

    This study evaluated the effectiveness of advanced illness care teams (AICTs) for nursing home residents with advanced dementia. The AICTs used a holistic approach that focused on four domains: (1) medical, (2) meaningful activities, (3) psychological, and (4) behavioral. The authors recruited 118 residents in two nursing homes for this study and…

  2. IMPRESS: medical location-aware decision making during emergencies

    Science.gov (United States)

    Gkotsis, I.; Eftychidis, G.; Leventakis, G.; Mountzouris, M.; Diagourtas, D.; Kostaridis, A.; Hedel, R.; Olunczek, A.; Hahmann, S.

    2017-09-01

    Emergency situations and mass casualties involve several agencies and public authorities, which need to gather data from the incident scene and exchange geo-referenced information to provide fast and accurate first aid to the people in need. Tracking patients on their way to the hospitals can prove critical in taking lifesaving decisions. Increased and continuous flow of information combined by vital signs and geographic location of emergency victims can greatly reduce the response time of the medical emergency chain and improve the efficiency of disaster medicine activity. Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware medical applications. IMPRESS is an advanced ICT platform based on adequate technologies for developing location-aware medical response during emergencies. The system incorporates mobile and fixed components that collect field data from diverse sources, support medical location and situation-based services and share information on the patient's transport from the field to the hospitals. In IMPRESS platform tracking of victims, ambulances and emergency services vehicles is integrated with medical, traffic and crisis management information into a common operational picture. The Incident Management component of the system manages operational resources together with patient tracking data that contain vital sign values and patient's status evolution. Thus, it can prioritize emergency transport decisions, based on medical and location-aware information. The solution combines positioning and information gathered and owned by various public services involved in MCIs or large-scale disasters. IMPRESS solution, were validated in field and table top exercises in cooperation with emergency services and hospitals.

  3. Professional fulfillment and parenting work-life balance in female physicians in Basic Sciences and medical research: a nationwide cross-sectional survey of all 80 medical schools in Japan.

    Science.gov (United States)

    Yamazaki, Yuka; Uka, Takanori; Marui, Eiji

    2017-09-15

    In Japan, the field of Basic Sciences encompasses clinical, academic, and translational research, as well as the teaching of medical sciences, with both an MD and PhD typically required. In this study, it was hypothesized that the characteristics of a Basic Sciences career path could offer the professional advancement and personal fulfillment that many female medical doctors would find advantageous. Moreover, encouraging interest in Basic Sciences could help stem shortages that Japan is experiencing in medical fields, as noted in the three principal contributing factors: premature resignation of female clinicians, an imbalance of female physicians engaged in research, and a shortage of medical doctors in the Basic Sciences. This study examines the professional and personal fulfillment expressed by Japanese female medical doctors who hold positions in Basic Sciences. Topics include career advancement, interest in medical research, and greater flexibility for parenting. A cross-sectional questionnaire survey was distributed at all 80 medical schools in Japan, directed to 228 female medical doctors whose academic rank was assistant professor or higher in departments of Basic Sciences in 2012. Chi-square tests and the binary logistic regression model were used to investigate the impact of parenthood on career satisfaction, academic rank, salary, etc. The survey response rate of female physicians in Basic Sciences was 54.0%. Regardless of parental status, one in three respondents cited research interest as their rationale for entering Basic Sciences, well over twice other motivations. A majority had clinical experience, with clinical duties maintained part-time by about half of respondents and particularly parents. Only one third expressed afterthoughts about relinquishing full-time clinical practice, with physicians who were parents expressing stronger regrets. Parental status had little effect on academic rank and income within the Basic Sciences, CONCLUSION

  4. Skills Required for Nursing Career Advancement: A Qualitative Study.

    Science.gov (United States)

    Sheikhi, Mohammad Reza; Fallahi-Khoshnab, Masoud; Mohammadi, Farahnaz; Oskouie, Fatemeh

    2016-06-01

    Nurses require certain skills for progression in their field. Identifying these skills can provide the context for nursing career advancement. This study aimed to identify the skills needed for nurses' career advancement. A qualitative approach using content analysis was adopted to study a purposive sample of eighteen nurses working in teaching hospitals affiliated with the Qazvin, Shahid Beheshti, and Iran Universities of Medical Sciences. The data were collected through semi-structured interviews, and analyzed using conventional content analysis. The three themes extracted from the data included interpersonal capabilities, competency for career success, and personal capacities. The results showed that acquiring a variety of skills is essential for career advancement. The findings showed that personal, interpersonal, and functional skills can facilitate nurses' career advancement. The effects of these skills on career advancement depend on a variety of conditions that require further studies.

  5. Efficacy of Gefitinib for Young Patients with Unknown EGFR Gene Mutation 
in Advanced Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Yutao LIU

    2014-05-01

    Full Text Available Background and objective Lung cancer in young patients (less or equal to 45 years is relatively rare. We explored the efficacy and survival of Gefitinib for young patients with unknown epidermal growth factor receptor (EGFR gene mutation of advanced lung adenocarcinoma. Methods The clinical data of 55 young patients with unknown EGFR gene mutation in advanced lung adenocarcinoma referred to the Cancer Hospital & Institute, Chinese Academy of Medical Sciences from Jan 2006 through Dec 2010 were analyzed retrospectively. Results Of 55 young patients enrolled, the median age was 41 years. The objective response rate and disease control rate were 43.6% and 90.9%, respectively.. The median progression-free survival (PFS was 9.0 months. Among the factors analyzed, brain metastasis had significant effect on PFS (P=0.017. The median overall survival (OS was 24.0 months. The independent prognostic factors to significantly improve OS included non-smoking history (P=0.028 and receiving other anti-cancer treatment after Gefitinib therapy (P<0.001. Conclusion The median PFS and OS of the young patients with Unknown EGFR gene mutation in advanced lung adenocarcinoma were similar with general population.

  6. Current Trends on Medical and Pharmaceutical Applications of Inkjet Printing Technology.

    Science.gov (United States)

    Scoutaris, Nicolaos; Ross, Steven; Douroumis, Dennis

    2016-08-01

    Inkjet printing is an attractive material deposition and patterning technology that has received significant attention in the recent years. It has been exploited for novel applications including high throughput screening, pharmaceutical formulations, medical devices and implants. Moreover, inkjet printing has been implemented in cutting-edge 3D-printing healthcare areas such as tissue engineering and regenerative medicine. Recent inkjet advances enabled 3D printing of artificial cartilage and skin, or cell constructs for transplantation therapies. In the coming years inkjet printing is anticipated to revolutionize personalized medicine and push the innovation portfolio by offering new paths in patient - specific treatments.

  7. Medical imaging

    CERN Document Server

    Townsend, David W

    1996-01-01

    Since the introduction of the X-ray scanner into radiology almost 25 years ago, non-invasive imaging has become firmly established as an essential tool in the diagnosis of disease. Fully three-dimensional imaging of internal organs is now possible, b and for studies which explore the functional status of the body. Powerful techniques to correlate anatomy and function are available, and scanners which combine anatomical and functional imaging in a single device are under development. Such techniques have been made possible through r ecent technological and mathematical advances. This series of lectures will review both the physical basis of medical imaging techniques using X-rays, gamma and positron emitting radiosiotopes, and nuclear magnetic resonance, and the mathematical methods used to reconstruct three-dimentional distributions from projection data. The lectures will trace the development of medical imaging from simple radiographs to the present-day non-invasive measurement of in vivo biochemistry. They ...

  8. Practical questions of organization of medical aid and treatment in specialized medical care facilities to the people exposed to radiation

    International Nuclear Information System (INIS)

    Baranov, A.E.; Bad'in, V.I.; Gasteva, G.N.

    1995-01-01

    Basing on the accident at the Chernobyl Nuclear Power Plant, the paper studied practical questions of organization of medical aid and treatment in specialized medical establishments prepared well in advance, and in temporary arranged specialized medical institutions. The requirements to such medical treatment establishments are studied herein: the aims and structure of the admission department; the measures of decontamination and emergency medical aid in case of acute intake of certain radionuclides; control of radioactive contamination of human organism of the injured persons and dosimetry of medical personnel; minimum degree of clinical examinations; schemes of therapy of various forms of acute radiation disease with combined effects. The authors indicated a list of the necessary drug preparations for treatment of patients with acute radiation disease of 3-4 degree of severity and the regulations of autopsy and taking samples for biophysical investigations of persons who died from radiation disease. 5 tabs

  9. INEEL Advanced Radiotherapy Research Program Annual Report 2002

    Energy Technology Data Exchange (ETDEWEB)

    Venhuizen, J.R.

    2003-05-23

    This report summarizes the activities and major accomplishments for the Idaho National Engineering and Environmental Laboratory (INEEL) Advanced Radiotherapy Research Program for calendar year 2002. Topics covered include computational dosimetry and treatment planning software development, medical neutron source development and characterization, and boron analytical chemistry.

  10. Enforcement actions: Significant actions resolved, material licensees (non-medical). Quarterly progress report, July--September 1994: Volume 13, Number 3, Part 3

    International Nuclear Information System (INIS)

    1994-12-01

    This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (July--September 1994) and includes copies of letters, Notices, and Orders sent by the Nuclear Regulatory Commission to material licensees (non-medical) with respect to these enforcement actions. It is anticipated that the information in this publication will be widely disseminated the managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication

  11. Enforcement actions: Significant actions resolved material licensees (non-medical). Volume 14, No. 1, Part 3, Quarterly progress report, January--March 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (January--March 1995) and includes copies of letters, Notices, and Orders sent by the Nuclear Regulatory Commission to Material Licensees (non-Medical) with respect to these enforcement actions. It is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication.

  12. Enforcement actions: Significant actions resolved material licensees (non-medical). Volume 14, No. 1, Part 3, Quarterly progress report, January--March 1995

    International Nuclear Information System (INIS)

    1995-05-01

    This compilation summarizes significant enforcement actions that have been resolved during one quarterly period (January--March 1995) and includes copies of letters, Notices, and Orders sent by the Nuclear Regulatory Commission to Material Licensees (non-Medical) with respect to these enforcement actions. It is anticipated that the information in this publication will be widely disseminated to managers and employees engaged in activities licensed by the NRC, so that actions can be taken to improve safety by avoiding future violations similar to those described in this publication

  13. Review of Advanced Accelerator Concepts R & D in Japan

    Science.gov (United States)

    Kitagawa, Yoneyoshi; Uesaka, Mitsuru; Koyama, Kazuyoshi; Nakajima, Kaszuhisa; Tajima, Toshiki; Daido, Hiroyuki; Ogata, Atsushi; Nemoto, Koshichi; Nishida, Yasushi; Yugami, Noboru; Miyamoto, Shuji; Dobashi, Katsuhiro

    2004-12-01

    More than 15 Japanese laboratories are dedicated to the advanced and compact accelerator development. Some use ultra-intense lasers and others use microwave concepts. As for the laser electron accleration, the topics are the capillary acceleration and the mono-energetic acceleration. The laser ion acceleration is also active. As well, the compatization is proceeding of the current rf accelerator. The National Institute for Radiological Science is promoting an advanced accelerator concept project mainly for the medical application.

  14. Aeromedical Hazard Comparison of FAA Medically Certified Third-Class and Medically Uncertified Pilots.

    Science.gov (United States)

    Ricaurte, Eduard M; Mills, William D; DeJohn, Charles A; Laverde-Lopez, Maria C; Porras-Sanchez, Daniel F

    2016-07-01

    Since 2004, in the United States, light sport aircraft (LSA) and some aircraft with standard airworthiness certificates can be operated for recreational purposes with a valid state driver's license rather than a Federal Aviation Administration (FAA)-issued aeromedical certificate. There have been recent efforts to allow operation of much larger, heavier, faster, and more complex aircraft without requiring a medical certificate. The primary objective of this research was to compare hazards to flight safety identified in fatally injured pilots required to possess a valid FAA third-class medical certificate to hazards in fatally injured pilots who were not required to possess a valid medical certificate. A search of all fatal U.S. aircraft accidents in the FAA Medical ANalysis and TRAcking (MANTRA) registry between January 1, 2011, and April 30, 2014, identified 1084 individuals. A review of accident pilots' medical, autopsy, and toxicological data was conducted. After applying exclusion criteria, 467 pilots remained, including 403 medically certified and 64 medically uncertified pilots. A significant difference was found in a surrogate measure for risk between medically certified and uncertified pilots (25% vs. 59%). This difference remained significant after adjustment for age. No significant difference was found in the proportions of hazards identified on toxicological review. The results of this study suggest that the risk of an adverse medical event is reduced in pilots required to possess a valid medical certificate. Ricaurte EM, Mills WD, DeJohn CA, Laverde-Lopez MC, Porras-Sanchez DF. Aeromedical hazard comparison of FAA medically certified third-class and medically uncertified pilots. Aerosp Med Hum Perform. 2016; 87(7):618-621.

  15. Current pain education within undergraduate medical studies across Europe: Advancing the Provision of Pain Education and Learning (APPEAL) study

    Science.gov (United States)

    Briggs, Emma V; Battelli, Daniele; Gordon, David; Kopf, Andreas; Ribeiro, Sofia; Puig, Margarita M; Kress, Hans G

    2015-01-01

    Objectives Unrelieved pain is a substantial public health concern necessitating improvements in medical education. The Advancing the Provision of Pain Education and Learning (APPEAL) study aimed to determine current levels and methods of undergraduate pain medicine education in Europe. Design and methods Using a cross-sectional design, publicly available curriculum information was sought from all medical schools in 15 representative European countries in 2012–2013. Descriptive analyses were performed on: the provision of pain teaching in dedicated pain modules, other modules or within the broader curriculum; whether pain teaching was compulsory or elective; the number of hours/credits spent teaching pain; pain topics; and teaching and assessment methods. Results Curriculum elements were publicly available from 242 of 249 identified schools (97%). In 55% (133/242) of schools, pain was taught only within compulsory non-pain-specific modules. The next most common approaches were for pain teaching to be provided wholly or in part via a dedicated pain module (74/242; 31%) or via a vertical or integrated approach to teaching through the broader curriculum, rather than within any specific module (17/242; 7%). The curricula of 17/242 schools (7%) showed no evidence of any pain teaching. Dedicated pain modules were most common in France (27/31 schools; 87%). Excluding France, only 22% (47/211 schools) provided a dedicated pain module and in only 9% (18/211) was this compulsory. Overall, the median number of hours spent teaching pain was 12.0 (range 4–56.0 h; IQR: 12.0) for compulsory dedicated pain modules and 9.0 (range 1.0–60.0 h; IQR: 10.5) for other compulsory (non-pain specific) modules. Pain medicine was principally taught in classrooms and assessed by conventional examinations. There was substantial international variation throughout. Conclusions Documented pain teaching in many European medical schools falls far short of what might be expected given the

  16. Early-career researchers in medical applications @ CERN | 6 June | Main Auditorium

    CERN Multimedia

    2016-01-01

      Discover how technological advances for high-energy physics have become essential tools for modern medicine. CERN seeks to answer fundamental questions about the Universe, and this mission naturally contributes to advancing the frontiers of technology. State-of-the-art techniques developed for particle accelerators, detectors, and physics computing have applications beyond the high-energy physics community in the medical field. These applications now have an essential role in clinical practices and medical research centres: from imaging devices, accelerator-technology dedicated to cancer therapy, to simulations and data science tools. This knowledge transfer from the high energy physics community to innovation in other fields is an inherent component of CERN’s mission and culture. It fuels scientific collaboration and technological advances, and drives innovation. In addition, it motivates future generations of scientists, and contributes to the public awareness of the impact of fu...

  17. A survey of medical diagnostic imaging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today`s more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  18. A survey of medical diagnostic imaging technologies

    International Nuclear Information System (INIS)

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities

  19. Psychotherapy in general practice | Beyers | South African Medical ...

    African Journals Online (AJOL)

    South African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 47, No 8 (1973) >. Log in or Register to get access to full text downloads.

  20. Survey of advanced radiation technologies used at designated cancer care hospitals in Japan

    International Nuclear Information System (INIS)

    Shikama, Naoto; Tsujino, Kayoko; Nakamura, Katsumasa; Ishikura, Satoshi

    2014-01-01

    Our survey assessed the use of advanced radiotherapy technologies at the designated cancer care hospitals in Japan, and we identified several issues to be addressed. We collected the data of 397 designated cancer care hospitals, including information on staffing in the department of radiation oncology (e.g. radiation oncologists, medical physicists and radiation therapists), the number of linear accelerators and the implementation of advanced radiotherapy technologies from the Center for Cancer Control and Information Services of the National Cancer Center, Japan. Only 53% prefectural designated cancer care hospitals and 16% regional designated cancer care hospitals have implemented intensity-modulated radiotherapy for head and neck cancers, and 62% prefectural designated cancer care hospitals and 23% regional designated cancer care hospitals use intensity-modulated radiotherapy for prostate cancer. Seventy-four percent prefectural designated cancer care hospitals and 40% regional designated cancer care hospitals employ stereotactic body radiotherapy for lung cancer. Our multivariate analysis of prefectural designated cancer care hospitals which satisfy the institute's qualifications for advanced technologies revealed the number of radiation oncologists (P=0.01) and that of radiation therapists (P=0.003) were significantly correlated with the implementation of intensity-modulated radiotherapy for prostate cancer, and the number of radiation oncologists (P=0.02) was correlated with the implementation of stereotactic body radiotherapy. There was a trend to correlate the number of medical physicists with the implementation of stereotactic body radiotherapy (P=0.07). Only 175 (51%) regional designated cancer care hospitals satisfy the institute's qualification of stereotactic body radiotherapy and 76 (22%) satisfy that of intensity-modulated radiotherapy. Seventeen percent prefectural designated cancer care hospitals and 13% regional designated cancer care hospitals

  1. Workplace etiquette for the medical practice employee.

    Science.gov (United States)

    Hills, Laura

    2010-01-01

    Medical practice workplace etiquette is slowly being modified and fine-tuned. New workplace etiquette rules have become necessary because of advances in communications technology, shifting norms, and expectations of what constitutes good manners. Today's medical practice employees must concern themselves with traditional workplace manners but also the manners that come into play when they make or receive cell phone calls, text messages, and e-mails, and when they use social networking media outside of work. This article offers 25 rules for good manners in the medical practice that relate to the ways employees interact with people today, whether face-to-face or when using electronic communications technologies. It offers practical guidelines for making introductions both inside and outside the medical practice. This article also provides a self-quiz to help medical practice employees assess their workplace etiquette intelligence and 12 tips for good workplace table manners.

  2. Systematic review of psychosocial outcomes for patients with advanced melanoma.

    Science.gov (United States)

    Dunn, Jeff; Watson, Maggie; Aitken, Joanne F; Hyde, Melissa K

    2017-11-01

    New advanced melanoma therapies are associated with improved survival; however, quality of survivorship, particularly psychosocial outcomes, for patients overall and those treated with newer therapies is unclear. Synthesize qualitative and quantitative evidence about psychosocial outcomes for advanced (stage III/IV) melanoma patients. Five databases were searched (01/01/1980 to 31/01/2016). Inclusion criteria were as follows: advanced melanoma patients or sub-group analysis; assessed psychosocial outcomes; and English language. Fifty-two studies met review criteria (4 qualitative, 48 quantitative). Trials comprise mostly medical not psychosocial interventions, with psychosocial outcomes assessed within broader quality of life measures. Patients receiving chemotherapy or IFN-alpha showed decreased emotional and social function and increased distress. Five trials of newer therapies appeared to show improvements in emotional and social function. Descriptive studies suggest that patients with advanced, versus localized disease, had decreased emotional and social function and increased distress. Contributors to distress were largely unexplored, and no clear framework described coping/adjustment trajectories. Patients with advanced versus localized disease had more supportive care needs, particularly amount, quality, and timing of melanoma-related information, communication with and emotional support from clinicians. Limitations included: lack of theoretical underpinnings guiding study design; inconsistent measurement approaches; small sample sizes; non-representative sampling; and cross-sectional design. Quality trial evidence is needed to clarify the impact of treatment innovations for advanced melanoma on patients' psychosocial well-being. Survivorship research and subsequent translation of that knowledge into programs and services currently lags behind gains in the medical treatment of advanced melanoma, a troubling circumstance that requires immediate and focused

  3. Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency

    Science.gov (United States)

    Zeger, Scott L.; Kolars, Joseph C.

    2007-01-01

    BACKGROUND Knowledge acquisition is a goal of residency and is measurable by in-training exams. Little is known about factors associated with medical knowledge acquisition. OBJECTIVE To examine associations of learning habits on medical knowledge acquisition. DESIGN, PARTICIPANTS Cohort study of all 195 residents who took the Internal Medicine In-Training Examination (IM-ITE) 421 times over 4 years while enrolled in the Internal Medicine Residency, Mayo Clinic, Rochester, MN. MEASUREMENTS Score (percent questions correct) on the IM-ITE adjusted for variables known or hypothesized to be associated with score using a random effects model. RESULTS When adjusting for demographic, training, and prior achievement variables, yearly advancement within residency was associated with an IM-ITE score increase of 5.1% per year (95%CI 4.1%, 6.2%; p international medical school graduation, −3.4% (95%CI −6.5%, −0.36%; p = .03). CONCLUSIONS Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training. PMID:17468889

  4. Canada's ongoing role in global medical isotope supply

    International Nuclear Information System (INIS)

    Wiens, R.A.

    2014-01-01

    Canada has been a leader in the production of medical isotopes, most notably Molybednum-99 (Mo-99) and Cobalt-60 (Co-60) used for diagnosis, prevention and treatment of disease, since the inception of the technology in the 1950s. These products have become critical components of healthcare, impacting the daily lives of millions of people around the world. The technological, political, social and commercial climate for production of these isotopes has changed dramatically over the many decades since their use began. Canada's role in assuring long-term stability of supply continues to evolve, and at Nordion we are identifying ways to meet the new and significant challenges associated with these changes. As a supplier to this global industry, Canada is presented with not only high expectations, but also unique opportunities for advancement of policy, science and technology in support of the longevity of the medical isotope and gamma sterilization industries. This paper will examine the current drivers for change in the global medical isotope supply chain, provide an overview of new and enhanced technology options, and identify the steps necessary for Canada to maintain and expand its strong position in this critical industry. (author)

  5. Advances in pediatric asthma and atopic dermatitis.

    Science.gov (United States)

    Foroughi, Shabnam; Thyagarajan, Ananth; Stone, Kelly D

    2005-10-01

    Allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, food allergy, and urticaria are common in general pediatric practice. This review highlights several significant advances in pediatric allergy over the past year, focusing on asthma and atopic dermatitis. With increasing options for the treatment of allergic diseases, much work is now focused on methods for individualizing treatments to a patient's phenotype and genotype. Progress over the past year includes the characterization of effects of regular albuterol use in patients with genetic variations in the beta-adrenergic receptor. Maintenance asthma regimens for children in the first years of life are also an ongoing focus. The relation between upper airway allergic inflammation and asthma has continued to accumulate support and now extends to the middle ear. Environmental influences on asthma and interventions have been described, including environmental controls for asthma and the role of air pollution on lung development in children. Finally, concerns have been raised regarding the use of topical immunomodulators in young children with atopic dermatitis. Progress continues in the care of children with atopic diseases. Attention to treatment with appropriate medications, patient-individualized environmental controls, and extensive education are the keys to successfully treating atopic children. This review highlights several recent advances but is not intended to be a comprehensive review.

  6. Cost Analysis of Medical versus Surgical Management of Glaucoma in Nigeria

    Directory of Open Access Journals (Sweden)

    Afekhide E Omoti

    2010-01-01

    Full Text Available Purpose: To analyze the cost of glaucoma medical therapy and compare it with that of surgical management in Nigeria. Methods: The cost of glaucoma drugs and that of surgical therapy in patients who attended the eye clinic of the University of Benin Teaching Hospital, Benin City, Nigeria, between December 2002 and November 2008 were calculated over a 3 year period of follow-up. Costs of medical and surgical therapy were compared based on November 2008 estimates. Results: One hundred and eight patients met the inclusion criteria of the study, of which, 90 patients (83.33% received medical therapy and 18 patients (16.67% underwent surgery. The most expensive drugs were the prostaglandin analogues, travoprost (Travatan and latanoprost (Xalatan. The least expensive topical drugs were beta-blockers and miotics. The mean annual cost of medical treatment was US$ 273.47΁174.42 (range, $41.54 to $729.23 while the mean annual cost of surgical treatment was US$ 283.78΁202.95 (range, $61.33 to $592.63. There was no significant difference between the mean costs of medical and surgical therapy over the 3-year period (P = 0.37. Older age (P = 0.02 and advanced glaucoma (P < 0.001 were associated with higher costs of therapy. Conclusion: The cost of medical therapy was comparable to that of surgical therapy for glaucoma in Nigeria over a 3-year period.

  7. Listeriosis in animals, its public health significance (food-borne zoonosis) and advances in diagnosis and control: a comprehensive review.

    Science.gov (United States)

    Dhama, Kuldeep; Karthik, Kumaragurubaran; Tiwari, Ruchi; Shabbir, Muhammad Zubair; Barbuddhe, Sukhadeo; Malik, Satya Veer Singh; Singh, Raj Kumar

    2015-01-01

    Listeriosis is an infectious and fatal disease of animals, birds, fish, crustaceans and humans. It is an important food-borne zoonosis caused by Listeria monocytogenes, an intracellular pathogen with unique potential to spread from cell to cell, thereby crossing blood-brain, intestinal and placental barriers. The organism possesses a pile of virulence factors that help to infect the host and evade from host immune machinery. Though disease occurrence is sporadic throughout the world, it can result in severe damage during an outbreak. Listeriosis is characterized by septicaemia, encephalitis, meningitis, meningoencephalitis, abortion, stillbirth, perinatal infections and gastroenteritis with the incubation period varying with the form of infection. L. monocytogenes has been isolated worldwide from humans, animals, poultry, environmental sources like soil, river, decaying plants, and food sources like milk, meat and their products, seafood and vegetables. Since appropriate vaccines are not available and infection is mainly transmitted through foods in humans and animals, hygienic practices can prevent its spread. The present review describes etiology, epidemiology, transmission, clinical signs, post-mortem lesions, pathogenesis, public health significance, and advances in diagnosis, vaccines and treatment of this disease. Special attention has been given to novel as well as prospective emerging therapies that include bacteriophage and cytokine therapy, avian egg yolk antibodies and herbal therapy. Various vaccines, including advances in recombinant and DNA vaccines and their modes of eliciting immune response, are also discussed. Due focus has also been given regarding appropriate prevention and control strategies to be adapted for better management of this zoonotic disease.

  8. Advances in Applied Mechanics

    OpenAIRE

    2013-01-01

    Advances in Applied Mechanics draws together recent significant advances in various topics in applied mechanics. Published since 1948, Advances in Applied Mechanics aims to provide authoritative review articles on topics in the mechanical sciences, primarily of interest to scientists and engineers working in the various branches of mechanics, but also of interest to the many who use the results of investigations in mechanics in various application areas, such as aerospace, chemical, civil, en...

  9. Advanced fuels safety comparisons

    International Nuclear Information System (INIS)

    Grolmes, M.A.

    1977-01-01

    The safety considerations of advanced fuels are described relative to the present understanding of the safety of oxide fueled Liquid Metal Fast Breeder Reactors (LMFBR). Safety considerations important for the successful implementation of advanced fueled reactors must early on focus on the accident energetics issues of fuel coolant interactions and recriticality associated with core disruptive accidents. It is in these areas where the thermal physical property differences of the advanced fuel have the greatest significance

  10. Proposed medical applications of the National Accelerator Centre facilities

    International Nuclear Information System (INIS)

    Jones, D.T.L.

    1982-01-01

    The National Accelerator Centre is at present under construction at Faure, near Cape Town. The complex will house a 200 MeV separated-sector cyclotron which will provide high quality beams for nuclear physics and related diciplines as well as high intensity beams for medical use. The medical aspects catered for will include particle radiotherapy, isotope production and possibly proton radiography. A 30-bed hospital is to be constructed on the site. Building operations are well advanced and the medical facilities should be available for use by the end of 1984

  11. [VR and AR Applications in Medical Practice and Education].

    Science.gov (United States)

    Hsieh, Min-Chai; Lin, Yu-Hsuan

    2017-12-01

    As technology advances, mobile devices have gradually turned into wearable devices. Furthermore, virtual reality (VR), augmented reality (AR), and mixed reality (MR) are being increasingly applied in medical fields such as medical education and training, surgical simulation, neurological rehabilitation, psychotherapy, and telemedicine. Research results demonstrate the ability of VR, AR, and MR to ameliorate the inconveniences that are often associated with traditional medical care, reduce incidents of medical malpractice caused by unskilled operations, and reduce the cost of medical education and training. What is more, the application of these technologies has enhanced the effectiveness of medical education and training, raised the level of diagnosis and treatment, improved the doctor-patient relationship, and boosted the efficiency of medical execution. The present study introduces VR, AR, and MR applications in medical practice and education with the aim of helping health professionals better understand the applications and use these technologies to improve the quality of medical care.

  12. Tuberous sclerosis complex: Recent advances in manifestations and therapy.

    Science.gov (United States)

    Wataya-Kaneda, Mari; Uemura, Motohide; Fujita, Kazutoshi; Hirata, Haruhiko; Osuga, Keigo; Kagitani-Shimono, Kuriko; Nonomura, Norio

    2017-09-01

    Tuberous sclerosis complex is an autosomal dominant inherited disorder characterized by generalized involvement and variable manifestations with a birth incidence of 1:6000. In a quarter of a century, significant progress in tuberous sclerosis complex has been made. Two responsible genes, TSC1 and TSC2, which encode hamartin and tuberin, respectively, were discovered in the 1990s, and their functions were elucidated in the 2000s. Hamartin-Tuberin complex is involved in the phosphoinositide 3-kinase-protein kinase B-mammalian target of rapamycin signal transduction pathway, and suppresses mammalian target of rapamycin complex 1 activity, which is a center for various functions. Constitutive activation of mammalian target of rapamycin complex 1 causes variable manifestations in tuberous sclerosis complex. Recently, genetic tests were launched to diagnose tuberous sclerosis complex, and mammalian target of rapamycin complex 1 inhibitors are being used to treat tuberous sclerosis complex patients. As a result of these advances, new diagnostic criteria have been established and an indispensable new treatment method; that is, "a cross-sectional medical examination system," a system to involve many experts for tuberous sclerosis complex diagnosis and treatments, was also created. Simultaneously, the frequency of genetic tests and advances in diagnostic technology have resulted in new views on symptoms. The numbers of tuberous sclerosis complex patients without neural symptoms are increasing, and for these patients, renal manifestations and pulmonary lymphangioleiomyomatosis have become important manifestations. New concepts of tuberous sclerosis complex-associated neuropsychiatric disorders or perivascular epithelioid cell tumors are being created. The present review contains a summary of recent advances, significant manifestations and therapy in tuberous sclerosis complex. © 2017 The Japanese Urological Association.

  13. Joint crisis plans and psychiatric advance directives in German psychiatric practice.

    Science.gov (United States)

    Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred

    2014-05-01

    This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive.

  14. Analyzing the Relationship of Geographic Mobility and Institutional Prestige to Career Advancement of Women in Academic Medicine Pursuing Midcareer-, Senior-, or Executive-Level Administrative Positions: Implications for Career Advancement Strategies

    Science.gov (United States)

    McLean, Marsha Renee

    2010-01-01

    The purpose of this study was to explore the relationship of geographic mobility and institutional prestige to career advancement defined as administrative promotions of women seeking midcareer-, senior-, or executive-level positions at academic health centers (AHCs) and their medical schools or in non-AHC related medical schools in the United…

  15. Medication deserts: survey of neighborhood disparities in availability of prescription medications

    Science.gov (United States)

    2012-01-01

    Background Only a small amount of research has focused on the relationship between socio-economic status (SES) and geographic access to prescription medications at community pharmacies in North America and Europe. To examine the relationship between a community’s socio-economic context and its residents’ geographic access to common medications in pharmacies, we hypothesized that differences are present in access to pharmacies across communities with different socio-economic environments, and in availability of commonly prescribed medications within pharmacies located in communities with different socio-economic status. Methods We visited 408 pharmacies located in 168 socio-economically diverse communities to assess the availability of commonly prescribed medications. We collected the following information at each pharmacy visited: hours of operation, pharmacy type, in-store medication availability, and the cash price of the 13 most commonly prescribed medications. We calculated descriptive statistics for the sample and fitted a series of hierarchical linear models to test our hypothesis that the in-stock availability of medications differs by the socio-economic conditions of the community. This was accomplished by modeling medication availability in pharmacies on the socio-economic factors operating at the community level in a socio-economically devise urban area. Results Pharmacies in poor communities had significantly higher odds of medications being out of stock, OR=1.24, 95% CI [1.02, 1.52]. There was also a significant difference in density of smaller, independent pharmacies with very limited stock and hours of operation, and larger, chain pharmacies in poor communities as compared to the middle and low-poverty communities. Conclusions The findings suggest that geographic access to a neighborhood pharmacy, the type of pharmacy, and availability of commonly prescribed medications varies significantly across communities. In extreme cases, entire communities

  16. [Medical student perception of physician values in practice by individual characteristics and preferred medical specialty field].

    Science.gov (United States)

    Park, Kwi Hwa; Yoo, Hyo Hyun; Yim, Jun

    2014-12-01

    Medical students' values figure prominently in their choice of medical specialty; yet, little research has been performed on this topic. The purpose of this study was to analyze the differences in values according to medical students' individual characteristics (medical educational system, gender, and grade) and preferred medical specialty. A total of 905 medical students participated in the study; 426 were graduate-entry medical students (GEMS), and 479 were undergraduate medical students (UMS). Further, 561 were male and 316 were female; 356 were in year 1, 219 were in year 2, 230 were in year 3, and 100 were in year 4. Students completed the Physician Values in Practice Scale (PVIPS). The PVIPS comprises six dimensions: autonomy, management, prestige, service, lifestyle, and scholarly pursuits. The data were analyzed by t-test and analysis of variance. GEMS had higher scores for service, management, and scholarly pursuits than UMS. Males had higher scores for prestige, lifestyle, and management, whereas female scored higher on service and scholarly pursuits. Higher grade was associated with increased scores for prestige, lifestyle, and management. The differences in lifestyle and scholarly pursuits were significant between preferred specialties. Students in support specialties scored significantly higher on lifestyle. With regard to scholarly pursuits, basic science specialties scored significantly higher than other specialties. There were significant differences in PVIPS according to individual characteristics and preferred medical specialty. This result could be useful in developing a medical specialty choice program for medical students.

  17. Efficiency improvement of nuclear power plant operation: the significant role of advanced nuclear fuel technologies

    International Nuclear Information System (INIS)

    Velde Van de, A.; Burtak, F.

    2001-01-01

    Due to the increased liberalisation of the power markets, nuclear power generation is being exposed to high cost reduction pressure. In this paper we highlight the role of advanced nuclear fuel technologies to reduce the fuel cycle costs and therefore increase the efficiency of nuclear power plant operation. The key factor is a more efficient utilisation of the fuel and present developments at Siemens are consequently directed at (i) further increase of batch average burnup, (ii) improvement of fuel reliability, (iii) enlargement of fuel operation margins and (iv) improvement of methods for fuel design and core analysis. As a result, the nuclear fuel cycle costs for a typical LWR have been reduced during the past decades by about US$ 35 million per year. The estimated impact of further burnup increases on the fuel cycle costs is expected to be an additional saving of US$10 - 15 million per year. Due to the fact that the fuel will operate closer to design limits, a careful approach is required when introducing advanced fuel features in reload quantities. Trust and co-operation between the fuel vendors and the utilities is a prerequisite for the common success. (authors)

  18. Memory accessibility and medical decision-making for significant others: The role of socially-shared retrieval induced forgetting

    OpenAIRE

    Dora M Coman; Alin eComan; William eHirst

    2013-01-01

    Medical decisions will often entail a broad search for relevant information. No sources alone may offer a complete picture, and many may be selective in their presentation. This selectivity may induce forgetting for previously learned material, thereby adversely affecting medical decision-making. In the study phase of two experiments, participants learned information about a fictitious disease and advantages and disadvantages of four treatment options. In the subsequent practice phase, the...

  19. Treatment results of incomplete chemoradiotherapy in locally advanced cervical cancer

    Directory of Open Access Journals (Sweden)

    Gao Y

    2013-04-01

    Full Text Available Ying Gao,1,* Fei Gao,2,* Zi Liu,1 Li-ping Song1 1Department of Radiotherapy Oncology, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Second Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, People’s Republic of China *These authors contributed equally to this work Objective: Regimens that combine chemotherapy and radiotherapy increase toxicity and compromise a patient’s ability to adhere to the treatment plan. We evaluated the efficacy and safety of a partially completed chemoradiation regimen prescribed for locally advanced carcinoma of the cervix. Methods: Medical records of 156 patients with locally advanced cervical cancer stage IIB–IVA who received chemoradiation with cisplatin (40 mg/m2 and 5-fluorouracil (500 mg/m2 from October 2006 to October 2008 were collected. The treatment protocol called for two cycles of chemotherapy. External beam radiation therapy was administered using a 10-MeV electron beam. Local control, disease free survival, overall survival, and toxicities were evaluated. Results: With a median follow-up of 37.5 months, 89 patients (57% completed the planned protocol. Sixty seven patients (43% completed fewer than two cycles. The 3-year local control rate was significantly better in the patient group that completed the prescribed plan (92.1% compared to 80.6%; P = 0.033. No statistical significance was observed between the groups that completed or did not complete the two cycle protocol with regard to disease free survival (80.9% and 73.2%, respectively; P = 0.250, overall survival (84.3% and 79.1%; P = 0.405, and progression survival (3.4% and 3.0%; P = 0.892. Differences in acute hematologic toxicity and subcutaneous toxicity were observed between the two groups. Conclusions: Completion of two cycles of 5-fluorouracil and cisplatin with radiotherapy was effective, safe, and responsible for better local control

  20. E-LEARNING READINESS AMONG MEDICAL EDUCATORS IN UNIVERSITI SAINS ISLAM MALAYSIA

    OpenAIRE

    Salleha Khalid; Tengku Madeehah Tengku Mohd; Khadijah Hassanah; Suhaila Sanip; Muhammad Shamsir Aris; Khaironi Sharif; Mohd Mokthar

    2014-01-01

    Recent advances in information technology has made e-learning feasible in many fields of education. Medical education is not any different. This survey is conducted among all the medical educators in Universiti Sains Islam Malaysia (USIM) assessing their readiness and attitudes towards e-learning. A cross-sectional questionnaires assessing the IT skills, Internet usage, attitude, perceived benefits and usage of e-learning among USIM medical lecturers were used. Data gained were then analyzed....