WorldWideScience

Sample records for sought medical assistance

  1. The pattern of clinical advice sought by general practitioners from a medical consultant in clinical biochemistry.

    Science.gov (United States)

    Bhatnagar, D

    1997-01-01

    Clinical biochemistry departments can be a valuable source of clinical advice for further investigations and the need for referral to specialist clinics. This paper outlines the pattern of clinical advice sought by general practitioners in a district hospital setting, and addresses some of the issues regarding seeking such advice and the implications for continuing medical education and training. PMID:9196966

  2. 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...

  3. 75 FR 28249 - Comment Sought on Measures Designed To Assist U.S. Wireless Consumers To Avoid “Bill Shock”

    Science.gov (United States)

    2010-05-20

    ... FEDERAL COMMUNICATIONS COMMISSION [CG Docket No. 09-158; DA 10-803] Comment Sought on Measures... Filing System (ECFS), through the Commission's Web site: http://www.fcc.gov/cgb/ecfs/ , or the Federal e...-mail. To get filing instructions, filers should send an e-mail to [email protected]fcc.gov , and include the...

  4. Is medically assisted death a special obligation?

    Science.gov (United States)

    Rivera-López, Eduardo

    2017-06-01

    Several distinct arguments conclude that terminally ill patients have a right to a medically assisted death; two are especially influential: the autonomy argument and the non-harm argument. Both have proven convincing to many, but not to those who view the duty not to kill as an (almost) absolute constraint. Some philosophers see the source of such a constraint in general (deontological) moral principles, other in the nature of the medical profession. My aim in this paper is not to add one further argument in favour of medically assisted death. Rather, I want to shed light on a kind of reason that, to my mind, has not been previously highlighted or defended, and that might shake the principled conviction that doctors are never allowed to actively assist their patients to die. Specifically, my purpose is to show that doctors (as members of the medical profession) have a special duty to provide medically assisted death to consenting terminally ill patients, because (and insofar as) they have been participants in the process leading to the situation in which a patient can reasonably ask to die. In some specific ways (to be explained), they are involved in the tragic fate of those patients and, therefore, are not morally allowed to straightforwardly refuse to assist them to die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Medical anthropology and the physician assistant profession.

    Science.gov (United States)

    Henry, Lisa R

    2015-01-01

    Medical anthropology is a subfield of anthropology that investigates how culture influences people's ideas and behaviors regarding health and illness. Medical anthropology contributes to the understanding of how and why health systems operate the way they do, how different people understand and interact with these systems and cultural practices, and what assets people use and challenges they may encounter when constructing perceptions of their own health conditions. The goal of this article is to highlight the methodological tools and analytical insights that medical anthropology offers to the study of physician assistants (PAs). The article discusses the field of medical anthropology; the advantages of ethnographic and qualitative research; and how medical anthropology can explain how PAs fit into improved health delivery services by exploring three studies of PAs by medical anthropologists.

  6. Medication-assisted therapy for opioid addiction

    OpenAIRE

    Tai, Betty; Saxon, Andrew J.; Ling, Walter

    2013-01-01

    The “Medication-Assisted Therapy for Opioid Addiction” session was chaired by Dr. Betty Tai and had three presenters. The presenters (and their topics) were: Dr. Andrew J. Saxon (Methadone and Buprenorphine for Treatment of Opioid Addiction and HIV Risk Reduction), Dr. Walter Ling (Opioid Antagonist Treatment for Opioid Addiction), and Dr. Betty Tai (Chronic Care Model for Substance Use Disorder).

  7. Medical Laboratory Assistant. Laboratory Occupations Cluster.

    Science.gov (United States)

    Michigan State Univ., East Lansing. Coll. of Agriculture and Natural Resources Education Inst.

    This task-based curriculum guide for medical laboratory assistant is intended to help the teacher develop a classroom management system where students learn by doing. Introductory materials include a Dictionary of Occupational Titles job code and title sheet, a career ladder, a matrix relating duty/task numbers to job titles, and a task list. Each…

  8. [MEDICALLY ASSISTED PROCREATION AND HOMOSEXUAL COUPLES].

    Science.gov (United States)

    Caire, Anne-Blandine

    2015-07-01

    With the legalization of the same-sex marriage in France, the medically assisted procreation has returned to the heart of discussions relating to the family. So far, the French legislator has strictly limited access to such medical techniques to sterile heterosexual couples only. Thus, the possibility of giving birth is denied to people who are in a "social" sterility position, such as singles or gays. Is such decision still ethically and socially acceptable? Should the French Legislator on the contrary widen access to the MPA? The debate is revived and raises important ans interesting questions that this article intends to address.

  9. Medically assisted reproduction and ethical challenges

    International Nuclear Information System (INIS)

    Kaeaeriaeinen, Helena; Evers-Kiebooms, Gerry; Coviello, Domenico

    2005-01-01

    Many of the ethical challenges associated with medically assisted reproduction are societal. Should the technique be restricted to only ordinary couples or could it be used also to single females or couples of same sex? Should the future child be entitled to know the identity of the gamete donor? Should there be age limits? Can embryos or gametes be used after the death of the donor? Can surrogate mothers be part of the process? Can preimplantation diagnostics be used to select the future baby's sex? In addition, there are several clearly medical questions that lead to difficult ethical problems. Is it safe to use very premature eggs or sperms? Is the risk for some rare syndromes caused by imprinting errors really increased when using these techniques? Do we transfer genetic infertility to the offspring? Is the risk for multiple pregnancies too high when several embryos are implanted? Does preimplantation diagnosis cause some extra risks for the future child? Should the counselling of these couples include information of all these potential but unlikely risks? The legislation and practices differ in different countries and ethical discussion and professional guidelines are still needed

  10. Cost analysis of medical assistance in dying in Canada.

    Science.gov (United States)

    Trachtenberg, Aaron J; Manns, Braden

    2017-01-23

    The legalization of medical assistance in dying will affect health care spending in Canada. Our aim was to determine the potential costs and savings associated with the implementation of medical assistance in dying. Using published data from the Netherlands and Belgium, where medically assisted death is legal, we estimated that medical assistance in dying will account for 1%-4% of all deaths; 80% of patients will have cancer; 50% of patients will be aged 60-80 years; 55% will be men; 60% of patients will have their lives shortened by 1 month; and 40% of patients will have their lives shortened by 1 week. We combined current mortality data for the Canadian population with recent end-of-life cost data to calculate a predicted range of savings associated with the implementation of medical assistance in dying. We also estimated the direct costs associated with offering medically assisted death, including physician consultations and drug costs. Medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million, exceeding the $1.5-$14.8 million in direct costs associated with its implementation. In sensitivity analyses, we noted that even if the potential savings are overestimated and costs underestimated, the implementation of mdedical assistance in dying will likely remain at least cost neutral. Providing medical assistance in dying in Canada should not result in any excess financial burden to the health care system, and could result in substantial savings. Additional data on patients who choose medical assistance in dying in Canada should be collected to enable more precise estimates of the impact of medically assisted death on health care spending and to enable further economic evaluation. © 2017 Canadian Medical Association or its licensors.

  11. Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative

    Science.gov (United States)

    2007-06-01

    AD_________________ Award Number: W81XWH-06-2-0045 TITLE: Mass Medication Clinic (MMC) Patient ...SUBTITLE 5a. CONTRACT NUMBER Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative 5b. GRANT NUMBER W81XWH-06-2...sections will describe the events, results, and accomplishments of this study. With validation through this project the Patient Medical Assistant

  12. Association between workarounds and medication administration errors in bar-code-assisted medication administration in hospitals

    NARCIS (Netherlands)

    van der Veen, Willem; van den Bemt, Patricia M L A; Wouters, Hans; Bates, David W; Twisk, Jos W R; de Gier, Johan J; Taxis, Katja

    Objective: To study the association of workarounds with medication administration errors using barcode-assisted medication administration (BCMA), and to determine the frequency and types of workarounds and medication administration errors. Materials and Methods: A prospective observational study in

  13. [Historical succour of poverty and medical assistance in rural China.].

    Science.gov (United States)

    Chen, Wen-Xian; Li, Ning-Xiu; Ren, Xiao-Hui

    2009-11-01

    There was considerable attention paid to the succour of poverty with widespread practice in China's history. Succour of poverty and medical assistance in rural areas were closely connected with famine relief carried out by the rulers. The mutual assistance of emotional and moral support long-term in rural communities is the most important form of medical assistance. A succour of poverty and medical assistance system in the modern sense should inherit and learn from the past consideration of poverty assistance and bring in the fine tradition of multiple forces to participate, in order to establish a succour of poverty and medical assistance system compatible with economic and social development. This is not only an important component of anti-poverty strategy in rural areas but also an inevitable requirement of historical development.

  14. Medical assistance in case of nuclear accident

    International Nuclear Information System (INIS)

    Dodig, D.; Tezak, S.; Kasal, B.; Huic, D.; Medvedec, M.; Loncaric, S.; Grosev, D.; Rozman, B.; Popovic, S.

    1996-01-01

    Medical service is a prerequisite for work license of nuclear installation. Every nuclear installation incorporate in their safety procedure also medical emergency plan. Usually the medical emergency plan consists of several degrees of action: 1. First aid, 2. First medical treatment, 3. Treatment in regional hospital, 4. Treatment in special institution (centre for radiation medicine). This paper discusses organization and activities of Centre for Radiation Medicine and Protection - Clinical Hospital Centre Zagreb

  15. Field Organization and Disaster Medical Assistance Teams

    Directory of Open Access Journals (Sweden)

    Ibrahim ARZIMAN

    2015-10-01

    Full Text Available SUMMARY: Disasters cause an acute deterioration in all stages of life. An area affected by the disaster in which the normal activities of life are disrupted is described as a “Field” in disaster terminology. Although it is not easy to define the borders of this zone, the area where there is normally functioning society is accepted as the boundary. Disaster management is the responsibility of the local government. However, in many large disaster responses many non-governmental and international organizations play a role. A Disaster Medical Team is a trained, mobile, self-contained, self-sufficient, multidisciplinary medical team that can act in the acute phase of a sudden-onset disaster (48 to 72 hours after its occurrence to provide medical treatment in the affected area. The medical team can include physicians, nurses, paramedics and EMTS, technicians, personnel to manage logistics, security and others. Various models of Disaster Medical Teams can be observed around the world. There is paucity of evidence based literature regarding DMTs. There is a need for epidemiological studies with rigorous designs and sampling. In this section of the special edition of the journal, field organizations in health management during disasters will be summarized, with emphasis on preparedness and response phases, and disaster medical teams will be discussed. Keywords: Field organization, disaster, medical team, DMAT

  16. The medical physics of ventricular assist devices

    International Nuclear Information System (INIS)

    Wood, Houston G; Throckmorton, Amy L; Untaroiu, Alexandrina; Song Xinwei

    2005-01-01

    Millions of patients, from infants to adults, are diagnosed with congestive heart failure each year all over the world. A limited number of donor hearts available for these patients results in a tremendous demand for alternative, supplemental circulatory support in the form of artificial heart pumps or ventricular assist devices (VADs). The development procedure for such a device requires careful consideration of biophysical factors, such as biocompatibility, haemolysis, thrombosis, implantability, physiologic control feasibility and pump performance. Conventional pump design equations based on Newton's law and computational fluid dynamics (CFD) are readily used for the initial design of VADs. In particular, CFD can be employed to predict the pressure-flow performance, hydraulic efficiencies, flow profile through the pump, stress levels and biophysical factors, such as possible blood cell damage. These computational flow simulations may involve comprehensive steady and transient flow analyses. The transient simulations involve time-varying boundary conditions and virtual modelling of the impeller rotation in the blood pumps. After prototype manufacture, laser flow measurements with sophisticated optics and mock circulatory flow loop testing assist with validation of pump design and identification of irregular flow patterns for optimization. Additionally, acute and chronic animal implants illustrate the blood pump's ability to support life physiologically. These extensive design techniques, coupled with fundamental principles of physics, ensure a reliable and effective VAD for thousands of heart failure patients each year

  17. National emergency medical assistance program for commercial nuclear power plants

    International Nuclear Information System (INIS)

    Linnemann, R.E.; Berger, M.E.

    1987-01-01

    Radiation Management Consultant's Emergency Medical Assistance Program (EMAP) for nuclear facilities provides a twenty-four hour emergency medical and health physics response capability, training of site and off-site personnel, and three levels of care for radiation accident victims: first air and rescue at an accident site, hospital emergency assessment and treatment, and definitive evaluation and treatment at a specialized medical center. These aspects of emergency preparedness and fifteen years of experience in dealing with medical personnel and patients with real or suspected radiation injury will be reviewed

  18. Patterns of Relating Between Physicians and Medical Assistants in Small Family Medicine Offices

    Science.gov (United States)

    Elder, Nancy C.; Jacobson, C. Jeffrey; Bolon, Shannon K.; Fixler, Joseph; Pallerla, Harini; Busick, Christina; Gerrety, Erica; Kinney, Dee; Regan, Saundra; Pugnale, Michael

    2014-01-01

    PURPOSE The clinician-colleague relationship is a cornerstone of relationship-centered care (RCC); in small family medicine offices, the clinician–medical assistant (MA) relationship is especially important. We sought to better understand the relationship between MA roles and the clinician-MA relationship within the RCC framework. METHODS We conducted an ethnographic study of 5 small family medicine offices (having informed by clinicians’ roles in hiring and managing MAs and the social familiarity of MAs and clinicians. Within the RCC framework, these findings can be seen as previously undefined constraints and freedoms in what is known as the Complex Responsive Process of Relating between clinicians and MAs. CONCLUSIONS Improved understanding of clinician-MA relationships will allow a better appreciation of how clinicians and MAs function in family medicine teams. Our findings may assist small offices undergoing practice transformation and guide future research to improve the education, training, and use of MAs in the family medicine setting. PMID:24615311

  19. May Christians request medically assisted suicide and euthanasia?

    Directory of Open Access Journals (Sweden)

    D. Etienne de Villiers

    2016-11-01

    Full Text Available The article deals with the question: ‘Is it morally acceptable for terminally ill Christians to voluntarily request medically assisted suicide or euthanasia?’ After a brief discussion of relevant changes in the moral landscape over the last century, two influential, but opposite views on the normative basis for the Christian ethical assessment of medically assisted suicide and voluntary euthanasia are critically discussed. The inadequacy of both the view that the biblical message entails an absolute prohibition against these two practices, and the view that Christians have to decide on them on the basis of their own autonomy, is argued. An effort is made to demonstrate that although the biblical message does not entail an absolute prohibition it does have normative ethical implications for deciding on medically assisted suicide and voluntary euthanasia. Certain Christian beliefs encourage terminally ill Christians to live a morally responsible life until their death and cultivate a moral prejudice against taking the life of any human being. This moral prejudice can, however, in exceptional cases be outweighed by moral considerations in favour of medically assisted suicide or voluntary euthanasia.

  20. Reporting multiple cycles in trials on medically assisted reproduction

    NARCIS (Netherlands)

    Scholten, Irma; Braakhekke, Miriam; Limpens, Jacqueline; Hompes, Peter G. A.; van der Veen, Fulco; Mol, Ben W. J.; Gianotten, Judith

    2016-01-01

    Trials assessing effectiveness in medically assisted reproduction (MAR) should aim to study the desired effect over multiple cycles, as this reflects clinical practice and captures the relevant perspective for the couple. The aim of this study was to assess the extent to which multiple cycles are

  1. The Use of Technology in the Medical Assisting Classroom

    Science.gov (United States)

    Kozielski, Tracy L.

    2014-01-01

    The growing presence of technology in health care has infiltrated educational institutions. Numerous software and hardware technologies have been designed to improve student learning; however, their use in the classroom is unclear. The purpose of this qualitative case study was to examine the experiences of medical assisting faculty using…

  2. Variables of job satisfaction in medical assistant profession.

    Science.gov (United States)

    Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Manole, Alina; Constantin, Brânduşa

    2013-01-01

    To identify the key favorable issues, showing a high degree of job satisfaction, and also the adverse issues that may affect the work performance among medical assistants. This research is a type of inquiry-based opinion survey carried out by administering a self-managed, anonymous questionnaire, consisting of five sections with 25 items. The study group included 175 medical assistants from all specialties, working in public hospitals in the city of Iasi, who answered the questionnaires. A number of 167 subjects have responded, the return rate being of 95.4%. The respondents were asked to indicate the amount of agreement or disagreement on a typical five-level Likert scale. The study has identified some positive aspects: positive perception of the medical assistant profession (76.6%); concern about personal growth and career development (86.3%); good rel ationships established with other colleagues (71.2%), and some negative aspects: inappropriate work conditions and equipments (70%); the income compared to the volume of work was perceived by majority as an important source of dissatisfaction (80.8%); willingness to work abroad (53.9%). The findings of the present research focused on the variables of job satisfaction in the medical assistant profession and should be a real concern for managers, because the job dissatisfaction may affect the employee's productivity.

  3. A Medical Student Perspective on Physician-Assisted Suicide.

    Science.gov (United States)

    Rhee, John Y; Callaghan, Katharine A; Allen, Philip; Stahl, Amanda; Brown, Martin T; Tsoi, Alexandra; McInerney, Grace; Dumitru, Ana-Maria G

    2017-09-01

    Physician-assisted suicide and euthanasia (PAS/E) has been increasingly discussed and debated in the public arena, including in professional medical organizations. However, the medical student perspective on the debate has essentially been absent. We present a medical student perspective on the PAS/E debate as future doctors and those about to enter the profession. We argue that PAS/E is not in line with the core principles of medicine and that the focus should be rather on providing high-quality end-of-life and palliative care. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  4. Radiation emergency medical preparedness and assistance network in China

    International Nuclear Information System (INIS)

    Su, Xu

    2008-01-01

    Full text: Rapid economic growth in demand has given rise to power shortage in China. The installed capacity of nuclear power has been scheduled to reach 36-40 GW in preliminary plans, which is about 4% of China's energy supply by 2020. On the other hand, the number of radiation facilities rises 7% annually, while this figure for medical accelerators and CT is 15%. With the application of radiation sources increasing, the possibility of accidents exposure is growing. The radiation emergency medical preparedness is increasingly practically challenging. CCMRRE (Chinese Center for Medical Response to Radiation Emergency), which functions as a national and professional institute with departments for clinic, monitoring and evaluating and technical supporting, was established in 1992. Clinic departments of haematological and surgical centres, and specialists in the radiation diagnosis and therapy, is responsible for the medical assistance in radiation accidents. The monitoring and evaluating department with bio-dosimetry, physical dosimetry and radiation monitoring laboratory, concentrates in radiation monitoring, dose estimating of accident exposure. Technical support department with advisors and experts in exposure dose estimating, radiation protecting and injury treating, provides technical instruction in case of nuclear and radiological accidents. In addition, around whole country, local organization providing first assistance, regional clinic treatment and radiation protection in nuclear accidents has been established. To strengthen the capability of radiation emergency medical response and to improve the cooperation with local organization, the managers and involved staffs were trained in skill frequently. The medical preparedness exercise, which mimics the nuclear accidents condition, was organized by CCMRRE and performed in 2007. The performances demonstrated that the radiation emergency medical preparedness and assistance system is prompt, functional and

  5. Radiation emergency medical preparedness and assistance network in Korea

    International Nuclear Information System (INIS)

    Kim, E. S.; Kong, H. J.; Noh, J. H.; Lim, Y. K.; Kim, C. S.

    2003-01-01

    Nationwide Medical Preparedness for Nuclear Accidents as an integral part of nuclear safety system has been discussed for several years and Radiation Health Research Institute (RHRI) of Korea Hydro and Nuclear Power Co. was established on July, 1999. The National Radiation Emergency Medical Center (NREMC) of Korea Cancer Center Hospital was also founded on September, 2002. Two organizations have established Radiation Emergency Medical Preparedness and Assistance Network in Korea to cope with accidental situations in nuclear power plants and also in handling sites of radionuclides. In order to construct an effective Nationwide Emergency Medical Network System they maintain good cooperation among regional hospitals. RHRI is going to make three types of medical groups, that is to say, the collaboration of the regional (primary appointed) hospital group around the nuclear power plants, the regional core (secondary appointed) hospital group and the central core hospital (RHRI). NREMC is also playing a central role in collaboration with 10 regional hospitals. Two cores are working key role for the maintenance of the network. Firstly, They maintain a radiological emergency response team consisting of physicians, nurses, health physicists, coordinators, and necessary support personnel to provide first-line responders with consultative or direct medical and radiological assistance at their facility or at the accident site. Secondly, they serves educational programs for the emergency personnel of collaborating hospitals not only as a treatment facility but also as a central training and demonstration unit. Regularly scheduled courses for the physician and nurse, and health/medical physicists are conducted. Therefore, to activate Nationwide Emergency Medical Network System and to maintain it for a long time, well-trained specialists and budgetary supports are indispensable

  6. Physician assistants and the disclosure of medical error.

    Science.gov (United States)

    Brock, Douglas M; Quella, Alicia; Lipira, Lauren; Lu, Dave W; Gallagher, Thomas H

    2014-06-01

    Evolving state law, professional societies, and national guidelines, including those of the American Medical Association and Joint Commission, recommend that patients receive transparent communication when a medical error occurs. Recommendations for error disclosure typically consist of an explanation that an error has occurred, delivery of an explicit apology, an explanation of the facts around the event, its medical ramifications and how care will be managed, and a description of how similar errors will be prevented in the future. Although error disclosure is widely endorsed in the medical and nursing literature, there is little discussion of the unique role that the physician assistant (PA) might play in these interactions. PAs are trained in the medical model and technically practice under the supervision of a physician. They are also commonly integrated into interprofessional health care teams in surgical and urgent care settings. PA practice is characterized by widely varying degrees of provider autonomy. How PAs should collaborate with physicians in sensitive error disclosure conversations with patients is unclear. With the number of practicing PAs growing rapidly in nearly all domains of medicine, their role in the error disclosure process warrants exploration. The authors call for educational societies and accrediting agencies to support policy to establish guidelines for PA disclosure of error. They encourage medical and PA researchers to explore and report best-practice disclosure roles for PAs. Finally, they recommend that PA educational programs implement trainings in disclosure skills, and hospitals and supervising physicians provide and support training for practicing PAs.

  7. Nursing delegation and medication administration in assisted living.

    Science.gov (United States)

    Mitty, Ethel; Resnick, Barbara; Allen, Josh; Bakerjian, Debra; Hertz, Judith; Gardner, Wendi; Rapp, Mary Pat; Reinhard, Susan; Young, Heather; Mezey, Mathy

    2010-01-01

    Assisted living (AL) residences are residential long-term care settings that provide housing, 24-hour oversight, personal care services, health-related services, or a combination of these on an as-needed basis. Most residents require some assistance with activities of daily living and instrumental activities of daily living, such as medication management. A resident plan of care (ie, service agreement) is developed to address the health and psychosocial needs of the resident. The amount and type of care provided, and the individual who provides that care, vary on the basis of state regulations and what services are provided within the facility. Some states require that an RN hold a leadership position to oversee medication management and other aspects of care within the facility. A licensed practical nurse/licensed vocational nurse can supervise the day-to-day direct care within the facility. The majority of direct care in AL settings is provided by direct care workers (DCWs), including certified nursing assistants or unlicensed providers. The scope of practice of a DCW varies by state and the legal structure within that state. In some states, the DCW is exempt from the nurse practice act, and in some states, the DCW may practice within a specific scope such as being a medication aide. In most states, however, the DCW scope of practice is conscribed, in part, by the delegation of responsibilities (such as medication administration) by a supervising RN. The issue of RN delegation has become the subject of ongoing discussion for AL residents, facilities, and regulators and for the nursing profession. The purpose of this article is to review delegation in AL and to provide recommendations for future practice and research in this area.

  8. Medical practitioners' attitudes towards animal assisted interventions. An Italian survey.

    Science.gov (United States)

    Pinto, Anna; De Santis, Marta; Moretti, Carlo; Farina, Luca; Ravarotto, Licia

    2017-08-01

    The present study had a dual purpose: to obtain a comprehensive picture of the Italian medical practitioners' opinions, professional experiences, training needs and knowledge of Animal Assisted Interventions (AAI); and to provide a detailed description of the medical practitioners who are characterized by a strongly positive attitude towards AAI. An online survey addressed to Italian medical practitioners was carried out using a 35-items structured questionnaire. Data obtained from the survey were analysed through appropriate summary statistics, analysis of variance (ANOVA) and logistic regression analysis. 670 medical practitioners participated in the online survey. Among them, 508 stated that they knew of AAI. 93.7% of these described themselves fully favourable towards the use of the human-animal relationship for therapeutic purposes, 84.4% defined themselves as confident and interested in studying the theme. A positive attitude towards AAI was greater in females, in people between 45 and 54 years old, in those who are pet owners and in those who believe that conferences are the most suitable tool to share information on AAI. The chance of having a positive attitude towards AAI is higher in respondents with specific characteristics. Data collected could be used as a starting point to promote and implement communication and training activities on AAI addressed to medical practitioners. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Medical guidelines for the patient: introducing the life assistance protocols.

    Science.gov (United States)

    Domínguez, David; Fernández, Carlos; Meneu, Teresa; Mocholí, Juan Bautista; Serafin, Riccardo

    2008-01-01

    This paper introduces our preliminary results in the modeling of Life Assistance Protocols, a new vision of medical guidelines and protocols through the lenses of p-Health. In this context the patient's role in the process is emphasized, the actions to be performed less defined and not only clinical situations considered, but also healthier lifestyle promotion processes accounted for, where the person's preferences and motivations play a key role. We propose a complete framework, balancing on classical clinical guideline models and covering both the theoretical and the practical aspects of the problem, describing it from conceptualization to the execution environment.

  10. Medical Assistant. [FasTrak Specialization Integrated Technical and Academic Competency (ITAC).] 2002 Revision.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Div. of Career-Technical and Adult Education.

    This curriculum for a medical assistant program is designed for students interested in caring for the sick, injured, convalescent, or disabled under the direction of the family, physicians, and credentialed nurses. The curriculum is divided into 12 units: orientation to medical assisting; principles of medical ethics; risk management; infection…

  11. 45 CFR 401.12 - Cuban and Haitian entrant cash and medical assistance.

    Science.gov (United States)

    2010-10-01

    ... cash and medical assistance (and related administrative costs) to Cuban and Haitian entrants according... 45 Public Welfare 2 2010-10-01 2010-10-01 false Cuban and Haitian entrant cash and medical... ENTRANT PROGRAM § 401.12 Cuban and Haitian entrant cash and medical assistance. Except as may be otherwise...

  12. Peer-assisted learning: a medical student perspective

    Directory of Open Access Journals (Sweden)

    Fallaha MA

    2018-03-01

    Full Text Available Mohammad Amre Fallaha, Aalia Pagarkar, Nicholas LucasFaculty of Medicine, Imperial College London, London, UKWe read the paper by Kazzazi et al1 with great interest. The original paper was informative, and as penultimate year medical students at Imperial College, we want to share our unique perspective regarding student learning and the benefits of peer-assisted learning (PAL. We find that many subjects, including embryology as outlined in the paper,1 are complex and typically taught through lecture-based formats. While this may be understandable to readers of respective specialties, students may find certain concepts abstract and not easily grasped through lectures alone.View the original paper by Kazzazi and Bartlett.

  13. Integrating medical, assistive, and universally designed products and technologies: assistive technology device classification (ATDC).

    Science.gov (United States)

    Bauer, Stephen; Elsaesser, Linda-Jeanne

    2012-09-01

    ISO26000:2010 International Guidance Standard on Organizational Social Responsibility requires that effective organizational performance recognize social responsibility, including the rights of persons with disabilities (PWD), engage stakeholders and contribute to sustainable development. Millennium Development Goals 2010 notes that the most vulnerable people require special attention, while the World Report on Disability 2011 identifies improved data collection and removal of barriers to rehabilitation as the means to empower PWD. The Assistive Technology Device Classification (ATDC), Assistive Technology Service Method (ATSM) and Matching Person and Technology models provide an evidence-based, standardized, internationally comparable framework to improve data collection and rehabilitation interventions. The ATDC and ATSM encompass and support universal design (UD) principles, and use the language and concepts of the International Classification of Functioning, Disability and Health (ICF). Use ATDC and ICF concepts to differentiate medical, assistive and UD products and technology; relate technology "types" to markets and costs; and support provision of UD products and technologies as sustainable and socially responsible behavior. Supply-side and demand-side incentives are suggested to foster private sector development and commercialization of UD products and technologies. Health and health-related professionals should be knowledgeable of UD principles and interventions.

  14. Technology-assisted education in graduate medical education: a review of the literature

    OpenAIRE

    Jwayyed, Sharhabeel; Stiffler, Kirk A; Wilber, Scott T; Southern, Alison; Weigand, John; Bare, Rudd; Gerson, Lowell W

    2011-01-01

    Studies on computer-aided instruction and web-based learning have left many questions unanswered about the most effective use of technology-assisted education in graduate medical education. Objective We conducted a review of the current medical literature to report the techniques, methods, frequency and effectiveness of technology-assisted education in graduate medical education. Methods A structured review of MEDLINE articles dealing with "Computer-Assisted Instruction," "Internet or World W...

  15. 30 CFR 75.1713 - Emergency medical assistance; first-aid.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. [Statutory Provisions] Each operator shall make arrangements in... trained in first-aid and first-aid training shall be made available to all miners. Each coal mine shall...

  16. Donaldson v. Van de Kamp: cryonics, assisted suicide, and the challenges of medical science.

    Science.gov (United States)

    Pommer, R W

    1993-01-01

    In recent years, advances in medical science have left the legal community with a wide array of social, ethical, and legal problems previously unimaginable. Historically, legislative and judicial responses to these advances lagged behind the rapid pace of such developments. The gap between the scientist's question, "Can we do it?," and the lawyer's question, "Should/may we do it?'" is most evident in the field of cryonics, with its technique of cryonic, or cryogenic, suspension. In cryonic suspension, a legally dead but biologically viable person is preserved at an extremely low temperature until advances in medical science make it possible to revive the person and implement an effective cure. The terminally ill patient who wishes to benefit from such treatment is faced with the dilemma that present life must be ceased with hope of future recovery. As a result, the process challenges our traditional notions of death and the prospects of immortality while raising a host of concomitant legal dilemmas. Some facets of this dilemma are exemplified by Donaldson v. Van de Kamp. In Donaldson, Thomas A. Donaldson sought the declaration of a constitutional right to premortem cryonic suspension of his body and the assistance of others in achieving that state. Donaldson, a forty-six-year-old mathematician and computer software scientist, suffers from a malignant brain tumor that was diagnosed by his physicians in 1988. This tumor is inoperable and continues to grow and invade his brain tissue. Donaldson's condition will gradually deteriorate into a persistent vegetative state and will ultimately result in death. Physicians predict his probable death by August 1993. Donaldson petitioned the California courts, seeking a declaration that he had a constitutional right to achieve cryonic suspension before his natural death. His doctors believe that if Donaldson waits until his natural death to be suspended, future reanimation will be futile because the tumor will have destroyed his

  17. Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school

    Directory of Open Access Journals (Sweden)

    Yu TC

    2011-06-01

    Full Text Available Tzu-Chieh Yu¹, Nichola C Wilson², Primal P Singh¹, Daniel P Lemanu¹, Susan J Hawken³, Andrew G Hill¹¹South Auckland Clinical School, University of Auckland, Auckland, New Zealand; ²Department of Surgery, University of Auckland, Auckland, New Zealand; ³Department of Psychological Medicine, University of Auckland, Auckland, New ZealandIntroduction: International interest in peer-teaching and peer-assisted learning (PAL during undergraduate medical programs has grown in recent years, reflected both in literature and in practice. There, remains however, a distinct lack of objective clarity and consensus on the true effectiveness of peer-teaching and its short- and long-term impacts on learning outcomes and clinical practice.Objective: To summarize and critically appraise evidence presented on peer-teaching effectiveness and its impact on objective learning outcomes of medical students.Method: A literature search was conducted in four electronic databases. Titles and abstracts were screened and selection was based on strict eligibility criteria after examining full-texts. Two reviewers used a standard review and analysis framework to independently extract data from each study. Discrepancies in opinions were resolved by discussion in consultation with other reviewers. Adapted models of “Kirkpatrick’s Levels of Learning” were used to grade the impact size of study outcomes.Results: From 127 potential titles, 41 were obtained as full-texts, and 19 selected after close examination and group deliberation. Fifteen studies focused on student-learner outcomes and four on student-teacher learning outcomes. Ten studies utilized randomized allocation and the majority of study participants were self-selected volunteers. Written examinations and observed clinical evaluations were common study outcome assessments. Eleven studies provided student-teachers with formal teacher training. Overall, results suggest that peer-teaching, in highly selective

  18. Team-based primary care: The medical assistant perspective.

    Science.gov (United States)

    Sheridan, Bethany; Chien, Alyna T; Peters, Antoinette S; Rosenthal, Meredith B; Brooks, Joanna Veazey; Singer, Sara J

    Team-based care has the potential to improve primary care quality and efficiency. In this model, medical assistants (MAs) take a more central role in patient care and population health management. MAs' traditionally low status may give them a unique view on changing organizational dynamics and teamwork. However, little empirical work exists on how team-based organizational designs affect the experiences of low-status health care workers like MAs. The aim of this study was to describe how team-based primary care affects the experiences of MAs. A secondary aim was to explore variation in these experiences. In late 2014, the authors interviewed 30 MAs from nine primary care practices transitioning to team-based care. Interviews addressed job responsibilities, teamwork, implementation, job satisfaction, and learning. Data were analyzed using a thematic networks approach. Interviews also included closed-ended questions about workload and job satisfaction. Most MAs reported both a higher workload (73%) and a greater job satisfaction (86%) under team-based primary care. Interview data surfaced four mechanisms for these results, which suggested more fulfilling work and greater respect for the MA role: (a) relationships with colleagues, (b) involvement with patients, (c) sense of control, and (d) sense of efficacy. Facilitators and barriers to these positive changes also emerged. Team-based care can provide low-status health care workers with more fulfilling work and strengthen relationships across status lines. The extent of this positive impact may depend on supporting factors at the organization, team, and individual worker levels. To maximize the benefits of team-based care, primary care leaders should recognize the larger role that MAs play under this model and support them as increasingly valuable team members. Contingent on organizational conditions, practices may find MAs who are willing to manage the increased workload that often accompanies team-based care.

  19. Association Between Workarounds and Medication Administration Errors in Bar Code-Assisted Medication Administration : Protocol of a Multicenter Study

    NARCIS (Netherlands)

    van der Veen, Willem; van den Bemt, Patricia Mla; Bijlsma, Maarten; de Gier, Han J; Taxis, Katja

    2017-01-01

    BACKGROUND: Information technology-based methods such as bar code-assisted medication administration (BCMA) systems have the potential to reduce medication administration errors (MAEs) in hospitalized patients. In practice, however, systems are often not used as intended, leading to workarounds.

  20. Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school

    Science.gov (United States)

    Yu, Tzu-Chieh; Wilson, Nichola C; Singh, Primal P; Lemanu, Daniel P; Hawken, Susan J; Hill, Andrew G

    2011-01-01

    Introduction International interest in peer-teaching and peer-assisted learning (PAL) during undergraduate medical programs has grown in recent years, reflected both in literature and in practice. There, remains however, a distinct lack of objective clarity and consensus on the true effectiveness of peer-teaching and its short- and long-term impacts on learning outcomes and clinical practice. Objective To summarize and critically appraise evidence presented on peer-teaching effectiveness and its impact on objective learning outcomes of medical students. Method A literature search was conducted in four electronic databases. Titles and abstracts were screened and selection was based on strict eligibility criteria after examining full-texts. Two reviewers used a standard review and analysis framework to independently extract data from each study. Discrepancies in opinions were resolved by discussion in consultation with other reviewers. Adapted models of “Kirkpatrick’s Levels of Learning” were used to grade the impact size of study outcomes. Results From 127 potential titles, 41 were obtained as full-texts, and 19 selected after close examination and group deliberation. Fifteen studies focused on student-learner outcomes and four on student-teacher learning outcomes. Ten studies utilized randomized allocation and the majority of study participants were self-selected volunteers. Written examinations and observed clinical evaluations were common study outcome assessments. Eleven studies provided student-teachers with formal teacher training. Overall, results suggest that peer-teaching, in highly selective contexts, achieves short-term learner outcomes that are comparable with those produced by faculty-based teaching. Furthermore, peer-teaching has beneficial effects on student-teacher learning outcomes. Conclusions Peer-teaching in undergraduate medical programs is comparable to conventional teaching when utilized in selected contexts. There is evidence to suggest

  1. Medical Applications of the PHITS Code (3): User Assistance Program for Medical Physics Computation.

    Science.gov (United States)

    Furuta, Takuya; Hashimoto, Shintaro; Sato, Tatsuhiko

    2016-01-01

    DICOM2PHITS and PSFC4PHITS are user assistance programs for medical physics PHITS applications. DICOM2PHITS is a program to construct the voxel PHITS simulation geometry from patient CT DICOM image data by using a conversion table from CT number to material composition. PSFC4PHITS is a program to convert the IAEA phase-space file data to PHITS format to be used as a simulation source of PHITS. Both of the programs are useful for users who want to apply PHITS simulation to verification of the treatment planning of radiation therapy. We are now developing a program to convert dose distribution obtained by PHITS to DICOM RT-dose format. We also want to develop a program which is able to implement treatment information included in other DICOM files (RT-plan and RT-structure) as a future plan.

  2. Planning principles for medical assistance of persons who have been overexposured to ionizing radiation

    International Nuclear Information System (INIS)

    Gisone, P.; Perez, M.R.; Dubner, D.; Di Trano, J.L.; Rojo, A.

    1995-01-01

    Planning of medical response in radiological accidents or incidents, plays an essential role in facing these sort of events. In the present communication, guidance on the organizational structure for medical assistance of overexposured persons along with a medical interconsult system is proposed. Finally, an integrated system of Radiopathology Groups in Latin America is proposed. (author). 3 refs

  3. Medical Students Teaching Medical Students Surgical Skills: The Benefits of Peer-Assisted Learning.

    Science.gov (United States)

    Bennett, Samuel Robert; Morris, Simon Rhys; Mirza, Salman

    2018-04-10

    Teaching surgical skills is a labor intensive process, requiring a high tutor to student ratio for optimal success, and teaching for undergraduate students by consultant surgeons is not always feasible. A surgical skills course was developed, with the aim of assessing the effectiveness of undergraduate surgical peer-assisted learning. Five surgical skills courses were conducted looking at eight domains in surgery, led by foundation year doctors and senior medical students, with a tutor to student ratio of 1:4. Precourse and postcourse questionnaires (Likert scales 0-10) were completed. Mean scores were compared precourse and postcourse. Surgical skills courses took place within clinical skills rooms in the Queen Elizabeth Hospital Birmingham (UK). Seventy students (59 medical, 2 dental, and 9 physician associate students) from a range of academic institutions across the UK completed the course. There was an overall increase in mean scores across all eight domains. Mean improvement score precourse and postcourse in WHO surgical safety checklist (+3.94), scrubbing (+2.99), gowning/gloving (+3.34), knot tying (+5.53), interrupted sutures (+5.89), continuous sutures (+6.53), vertical mattress sutures (+6.46), and local anesthesia (+3.73). Peer-assisted learning is an effective and feasible method for teaching surgical skills in a controlled environment, subsequently improving confidence among healthcare undergraduates. Such teaching may provide the basis for feasibly mass-producing surgical skills courses for healthcare students. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....

  5. 22 CFR 71.10 - Emergency medical assistance.

    Science.gov (United States)

    2010-04-01

    ...) Preventive or protective medications and medical supplies and equipment (vaccinations, inoculations, etc... effort to contact the ill or injured prisoner as soon as possible; (2) Take steps to obtain a...

  6. Army Medical Support for Peace Operations and Humanitarian Assistance,

    Science.gov (United States)

    1996-01-01

    or contractors. Some coalition troops may uti - lize the theater medical system in ways it was not intended. Coalition partners’ own medical assets...agencies, and the State Depart- ment often urge the Army to expand medical services and to uti - lize any excess capacity for purposes other than the...Psychologists (new 67D). Similar concerns involved comptrollers and preventive medicine officers, field medical pharmacists , and personnel managers

  7. Attitudes on euthanasia and physician-assisted suicide among medical students in Athens.

    Science.gov (United States)

    Kontaxakis, Vp; Paplos, K G; Havaki-Kontaxaki, B J; Ferentinos, P; Kontaxaki, M-I V; Kollias, C T; Lykouras, E

    2009-10-01

    Attitudes towards assisted death activities among medical students, the future health gatekeepers, are scarce and controversial. The aims of this study were to explore attitudes on euthanasia and physician-assisted suicide among final year medical students in Athens, to investigate potential differences in attitudes between male and female medical students and to review worldwide attitudes of medical students regarding assisted death activities. A 20- item questionnaire was used. The total number of participants was 251 (mean age 24.7±1.8 years). 52.0% and 69.7% of the respondents were for the acceptance of euthanasia and physician-assisted suicide, respectively. Women's attitudes were more often influenced by religious convictions as well as by the fact that there is a risk that physician-assisted suicide might be misused with certain disadvantaged groups. On the other hand, men more often believed that a request for physician-assisted suicide from a terminally ill patient is prima-facie evidence of a mental disorder, usually depression. Concerning attitudes towards euthanasia among medical students in various countries there are contradictory results. In USA, the Netherlands, Hungary and Switzerland most of the students supported euthanasia and physician-assisted suicide. However, in many other countries such as Norway, Sweden, Yugoslavia, Italy, Germany, Sudan, Malaysia and Puerto Rico most students expressed negative positions regarding euthanasia and physician assisted suicide.

  8. SuperAssist: A User-Assistant Collaborative Environment for the supervision of medical instrument use at home

    NARCIS (Netherlands)

    Blanson Henkemans, O.A.; Neerincx, M.A.; Lindenberg, J.; Mast, C.A.P.G. van der

    2007-01-01

    With the rise of Transmural care, patients increasingly use medical instruments at home. Maintenance and troubleshooting greatly determines the safety and accuracy of these instruments. For the supervision of these complex tasks, we developed a User-Assistant Collaborative Environment (U-ACE). We

  9. Emergency medical assistance programs for nuclear power reactors

    International Nuclear Information System (INIS)

    Linnemann, R.E.; Mettler, F.A. Jr.

    1977-01-01

    This paper deals with a simple but practical medical support of geographically distributed nuclear reactors in isolated areas. A staff of experts at a centre devote their full attention to accident prevention and preparedness at reactor sites. They establish and maintain emergency medical programs at reactor sites and nearby support hospitals. The emphasis is on first aid and emergency treatment by medical attendants who are not and cannot be experts in radiation but do know how to treat patients. (author)

  10. Ethics and regulation of inter-country medically assisted reproduction: a call for action

    OpenAIRE

    Shalev, Carmel; Moreno, Adi; Eyal, Hedva; Leibel, Michal; Schuz, Rhona; Eldar-Geva, Talia

    2016-01-01

    The proliferation of medically assisted reproduction (MAR) for the treatment of infertility has brought benefit to many individuals around the world. But infertility and its treatment continue to be a cause of suffering, and over the past decade, there has been a steady growth in a new global market of inter-country medically assisted reproduction (IMAR) involving ?third-party? individuals acting as surrogate mothers and gamete donors in reproductive collaborations for the benefit of other in...

  11. Physician Assisted Suicide: Knowledge and Views of Fifth-Year Medical Students in Germany

    Science.gov (United States)

    Schildmann, Jan; Herrmann, Eva; Burchardi, Nicole; Schwantes, Ulrich; Vollmann, Jochen

    2006-01-01

    Suicide and assisted suicide are not criminal acts in Germany. However, attempting suicide may create a legal duty for physicians to try to save a patient's life. This study presents data on medical students' legal knowledge and ethical views regarding physician assisted suicide (PAS). The majority of 85 respondents held PAS to be illegal. More…

  12. Medication Assisted Treatment for the 21st Century: Community Education Kit.

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

    The need to support the success of individuals in methadone-assisted recovery, and the recent availability of new pharmacologic treatment options for opioid dependence, calls for an information tool that underscores the evidence-based benefits of medication assisted treatment for opioid dependence. The U.S. Department of Health and Human Services'…

  13. Integrating Medical Simulation Into the Physician Assistant Physiology Curriculum.

    Science.gov (United States)

    Li, Lixin; Lopes, John; Zhou, Joseph Yi; Xu, Biao

    2016-12-01

    Medical simulation has recently been used in medical education, and evidence indicates that it is a valuable tool for teaching and evaluation. Very few studies have evaluated the integration of medical simulation in medical physiology education, particularly in PA programs. This study was designed to assess the value of integrating medical simulation into the PA physiology curriculum. Seventy-five students from the PA program at Central Michigan University participated in this study. Mannequin-based simulation was used to simulate a patient with hemorrhagic shock and congestive heart failure to demonstrate the Frank-Starling force and cardiac function curve. Before and after the medical simulation, students completed a questionnaire as a self-assessment. A knowledge test was also delivered after the simulation. Our study demonstrated a significant improvement in student confidence in understanding congestive heart failure, hemorrhagic shock, and the Frank-Starling curve after the simulation. Medical simulation may be an effective way to enhance basic science learning experiences for students and an ideal supplement to traditional, lecture-based teaching in PA education.

  14. Comparison of Transplant Waitlist Outcomes for Pediatric Candidates Supported by Ventricular Assist Devices Versus Medical Therapy.

    Science.gov (United States)

    Law, Sabrina P; Oron, Assaf P; Kemna, Mariska S; Albers, Erin L; McMullan, D Michael; Chen, Jonathan M; Law, Yuk M

    2018-05-01

    Ventricular assist devices have gained popularity in the management of refractory heart failure in children listed for heart transplantation. Our primary aim was to compare the composite endpoint of all-cause pretransplant mortality and loss of transplant eligibility in children who were treated with a ventricular assist device versus a medically managed cohort. This was a retrospective cohort analysis. Data were obtained from the Scientific Registry of Transplant Recipients. The at-risk population (n = 1,380) was less than 18 years old, either on a ventricular assist device (605 cases) or an equivalent-severity, intensively medically treated group (referred to as MED, 775 cases). None. The impact of ventricular assist devices was estimated via Cox proportional hazards regression (hazard ratio), dichotomizing 1-year outcomes to "poor" (22%: 193 deaths, 114 too sick) versus all others (940 successful transplants, 41 too healthy, 90 censored), while adjusting for conventional risk factors. Among children 0-12 months old, ventricular assist device was associated with a higher risk of poor outcomes (hazard ratio, 2.1; 95% CI, 1.5-3.0; p comparative study of ventricular assist devices versus medical therapy in children. Age is a significant modulator of waitlist outcomes for children with end-stage heart failure supported by ventricular assist device, with the impact of ventricular assist devices being more beneficial in adolescents.

  15. Medication administration errors in assisted living: scope, characteristics, and the importance of staff training.

    Science.gov (United States)

    Zimmerman, Sheryl; Love, Karen; Sloane, Philip D; Cohen, Lauren W; Reed, David; Carder, Paula C

    2011-06-01

    To compare rates of medication errors committed by assisted living staff with different training and to examine characteristics of errors. Observation of medication preparation and passes, chart review, interviews, and questionnaires. Stratified random sample of 11 assisted living communities in South Carolina (which permits nonnurses to administer medications) and Tennessee (which does not). All staff who prepared or passed medications: nurses (one registered nurse and six licensed practical nurses (LPNs)); medication aides (n=10); and others (n=19), including those with more and less training. Rates of errors related to medication, dose and form, preparation, route, and timing. Medication preparation and administration were observed for 4,957 administrations during 83 passes for 301 residents. The error rate was 42% (20% when omitting timing errors). Of all administrations, 7% were errors with moderate or high potential for harm. The odds of such an error by a medication aide were no more likely than by a LPN, but the odds of one by staff with less training was more than two times as great (odds ratio=2.10, 95% confidence interval=1.27-3.49). A review of state regulations found that 20 states restrict nonnurses to assisting with self-administration of medications. Medication aides do not commit more errors than LPNs, but other nonnurses who administered a significant number of medications and assisted with self-administration committed more errors. Consequently, all staff who handle medications should be trained to the level of a medication aide. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  16. Knowledge Is Power for Medical Assistants: Crystallized and Fluid Intelligence As Predictors of Vocational Knowledge.

    Science.gov (United States)

    Moehring, Anne; Schroeders, Ulrich; Wilhelm, Oliver

    2018-01-01

    Medical education research has focused almost entirely on the education of future physicians. In comparison, findings on other health-related occupations, such as medical assistants, are scarce. With the current study, we wanted to examine the knowledge-is-power hypothesis in a real life educational setting and add to the sparse literature on medical assistants. Acquisition of vocational knowledge in vocational education and training (VET) was examined for medical assistant students ( n = 448). Differences in domain-specific vocational knowledge were predicted by crystallized and fluid intelligence in the course of VET. A multiple matrix design with 3 year-specific booklets was used for the vocational knowledge tests of the medical assistants. The unique and joint contributions of the predictors were investigated with structural equation modeling. Crystallized intelligence emerged as the strongest predictor of vocational knowledge at every stage of VET, while fluid intelligence only showed weak effects. The present results support the knowledge-is-power hypothesis, even in a broad and more naturalistic setting. This emphasizes the relevance of general knowledge for occupations, such as medical assistants, which are more focused on learning hands-on skills than the acquisition of academic knowledge.

  17. Knowledge Is Power for Medical Assistants: Crystallized and Fluid Intelligence As Predictors of Vocational Knowledge

    Directory of Open Access Journals (Sweden)

    Anne Moehring

    2018-02-01

    Full Text Available Medical education research has focused almost entirely on the education of future physicians. In comparison, findings on other health-related occupations, such as medical assistants, are scarce. With the current study, we wanted to examine the knowledge-is-power hypothesis in a real life educational setting and add to the sparse literature on medical assistants. Acquisition of vocational knowledge in vocational education and training (VET was examined for medical assistant students (n = 448. Differences in domain-specific vocational knowledge were predicted by crystallized and fluid intelligence in the course of VET. A multiple matrix design with 3 year-specific booklets was used for the vocational knowledge tests of the medical assistants. The unique and joint contributions of the predictors were investigated with structural equation modeling. Crystallized intelligence emerged as the strongest predictor of vocational knowledge at every stage of VET, while fluid intelligence only showed weak effects. The present results support the knowledge-is-power hypothesis, even in a broad and more naturalistic setting. This emphasizes the relevance of general knowledge for occupations, such as medical assistants, which are more focused on learning hands-on skills than the acquisition of academic knowledge.

  18. PRESENT AND FUTURE PERSPECTIVES IN INTERNATIONAL MEDICAL ASSISTANCE

    Directory of Open Access Journals (Sweden)

    Carmen Stadoleanu

    2012-12-01

    Full Text Available Paneuropean development of patients’ rights represent a relatively recent concern, the legislative norms of which aim at granting to patients real-time access to all sorts of medical services. To this end, the European Union implemented a unitary normative professional and juridical background: Directive 2011/24/U.E. on the rights of patients to international treatments. Consequently, the patients are free to choose themselves the suppliers of medical services which do not include hospitalization, without a previous authorisation (country, doctor and medical institution while, in the case of long-term treatments, a principial authorisation will be necessary. In both cases, the carrier of the therapeutic service receives the payment for his actions at the level of those established at national level, the difference being usually payed by the patient.

  19. A medical assistant-based program to promote healthy behaviors in primary care.

    Science.gov (United States)

    Ferrer, Robert L; Mody-Bailey, Priti; Jaén, Carlos Roberto; Gott, Sherrie; Araujo, Sara

    2009-01-01

    Most primary care patients have at least 1 major behavioral risk: smoking, risky drinking, low physical activity, or unhealthy diet. We studied the effectiveness of a medical assistant-based program to identify and refer patients with risk behaviors to appropriate interventions. We undertook a randomized control trial in a practice-based research network. The trial included 864 adult patients from 6 primary care practices. Medical assistants screened patients for 4 risk behaviors and applied behavior-specific algorithms to link patients with interventions. Primary outcomes were improved risk behaviors on standardized assessments. Secondary outcomes included participation in a behavioral intervention and the program's effect on the medical assistants' workflow and job satisfaction. Follow-up data were available for 55% of participants at a mean of 12 months. The medical assistant referral arm referred a greater proportion of patients than did usual care (67.4 vs 21.8%; P effects on program adoption. Engaging more primary care team members to address risk behaviors improved referral rates. More extensive medical assistant training, changes in practice culture, and sustained behavioral interventions will be necessary to improve risk behavior outcomes.

  20. Towards automated assistance for operating home medical devices.

    Science.gov (United States)

    Gao, Zan; Detyniecki, Marcin; Chen, Ming-Yu; Wu, Wen; Hauptmann, Alexander G; Wactlar, Howard D

    2010-01-01

    To detect errors when subjects operate a home medical device, we observe them with multiple cameras. We then perform action recognition with a robust approach to recognize action information based on explicitly encoding motion information. This algorithm detects interest points and encodes not only their local appearance but also explicitly models local motion. Our goal is to recognize individual human actions in the operations of a home medical device to see if the patient has correctly performed the required actions in the prescribed sequence. Using a specific infusion pump as a test case, requiring 22 operation steps from 6 action classes, our best classifier selects high likelihood action estimates from 4 available cameras, to obtain an average class recognition rate of 69%.

  1. Pediatric radiology for medical-technical radiology assistants/radiologists

    International Nuclear Information System (INIS)

    Oppelt, Birgit

    2010-01-01

    The book on pediatric radiology includes the following chapter: differences between adults and children; psycho-social aspects concerning the patient child in radiology; relevant radiation doses in radiology; help for self-help: simple phantoms for image quality estimation in pediatric radiology; general information; immobilization of the patient; pediatric features for radiological settings; traumatology; contrast agents; biomedical radiography; computerized tomography; NMR imaging; diagnostic ultrasonography; handling of stress practical recommendations; medical displays.

  2. Peer-assisted learning in medical school: tutees’ perspective

    Directory of Open Access Journals (Sweden)

    Menezes A

    2016-01-01

    Full Text Available Audrey Menezes,1,2 Annette Burgess,1 Antonia J Clarke,1,3 Craig Mellis1 1Central Clinical School, Sydney Medical School, The University of Sydney; 2Hornsby Ku-ring-gai Hospital; 3Royal Prince Alfred Hospital, Sydney, NSW, Australia Purpose: Peer tutoring offers a valuable method of enhancing students’ learning experience in medical school. Junior students learn from senior peers to reinforce curriculum content in an engaging community environment. The aim of our study was to assess tutees’ perceptions of a formal peer tutoring program at the Central Clinical School of Sydney Medical School. We used the learning theory of the community of practice in order to understand tutees’ perspectives. Patients and methods: All Year 1 and Year 2 students within the Central Clinical School were invited to be tutored by Year 3 and Year 4 students, respectively. Tutor pairs taught a group of three to four tutees fortnightly, and the tutorials were largely clinically based. A questionnaire containing 13 closed items and four open-ended questions regarding their experiences in the program was distributed to the tutees. Descriptive statistics were used to analyze the data. Results: A total of 66 of 101 (65% Year 1 and Year 2 students took part as tutees and 42 of 106 (40% students as tutors. The tutees' response rate was 53% (35/66. Results were largely positive, with 97% of the tutees enjoying the program, 90% showing interest in tutorial topics, 91% feeling a sense of community, 100% wanting to take part next year, 97% finding small groups effective, and 97% and 91% feeling an improved understanding of medical concepts and clinical skills, respectively. Tutees perceived the most useful aspects to be learning and revision and advice from experienced peers. The most frequent suggestion for improvement was to resolve scheduling conflicts. Conclusion: Tutees found the peer tutoring program to be valuable in learning and revision, establishing a community, and

  3. Integrating medical, assistive, and universal design products and technologies: Assistive Technology Service Method (ATSM).

    Science.gov (United States)

    Elsaesser, Linda-Jeanne; Bauer, Stephen

    2012-07-01

    ISO26000 provides guidance on effective organizational performance that recognizes social responsibility (including rights of persons with disabilities (PWD)), engages stakeholders, and contributes to sustainable development [1]. Millennium Development Goals 2010 state: while progress has been made, insufficient dedication to sustainable development, and inequalities to the most vulnerable people require attention [2]. World Report on Disability 2011 recommendations includes improved data collection and removal of barriers to rehabilitation that empower PWD [3]. The Assistive Technology Service Method (ATSM), Assistive Technology Device Classification (ATDC) and Matching Person and Technology (MPT) provide an evidence-based, standardized, internationally comparable framework to improve rehabilitation interventions [4-6]. The ATSM and ATDC support universal design (UD) principles and provision of universal technology. The MPT assures interventions are effective and satisfactory to end-users [7]. The ICF conceptual framework and common language are used throughout [8]. Research findings on healthcare needs are translated. ATSM applications in support of these findings are presented. National initiatives demonstrate the need and value of the ATSM as an evidence-based, user-centric, interdisciplinary method to improve individual and organizational performance for rehabilitation [including AT] services. Two Disability & Rehabilitation: Assistive Technology articles demonstrate ATSM and ATDC use to strengthen rehabilitation services and integrate Universal Design principles for socially responsible behavior.

  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. Medical Assistant-based care management for high risk patients in small primary care practices

    DEFF Research Database (Denmark)

    Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

    2016-01-01

    Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

  6. Experiences Providing Medical Assistance during the Sewol Ferry Disaster Using Traditional Korean Medicine

    OpenAIRE

    Kim, Kyeong Han; Jang, Soobin; Lee, Ju Ah; Jang, Bo-Hyoung; Go, Ho-Yeon; Park, Sunju; Jo, Hee-Guen; Lee, Myeong Soo; Ko, Seong-Gyu

    2017-01-01

    Background. This study aimed to investigate medical records using traditional Korean medicine (TKM) in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation. Methods. After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM) in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone coul...

  7. Peculiarities of family doctors' medical assistance for persons with 'Chernobyl syndrome'

    International Nuclear Information System (INIS)

    Margine, Le.; Tintiuc, D.; Grejdeanu, T.; Margine, Lu.; Badan, V.

    2012-01-01

    Medical and social protection and rehabilitation of patients with 'Chernobyl syndrome' is provided by legislation of the Republic of Moldova, which is reflected in a comprehensive action plan for rehabilitation and protection of this category of citizens. This plan includes such medical activities as detailed medical ambulatory and stationary examination, purchase prescription drugs, annual sanatorium treatment, annual compensation recovery in the value of 2 average monthly salaries for health improvement. The role of family doctors' medical assistance for persons suffered due to the accident at the Chernobyl Nuclear Power Plant is very important in this plan implementation.

  8. The Potential of Nanotechnology in Medically Assisted Reproduction

    Directory of Open Access Journals (Sweden)

    Mariana H. Remião

    2018-01-01

    Full Text Available Reproductive medicine is a field of science which searches for new alternatives not only to help couples achieve pregnancy and preserve fertility, but also to diagnose and treat diseases which can impair the normal operation of the reproductive tract. Assisted reproductive technology (ART is a set of methodologies applied to cases related to infertility. Despite being highly practiced worldwide, ART presents some challenges, which still require special attention. Nanotechnology, as a tool for reproductive medicine, has been considered to help overcome some of those impairments. Over recent years, nanotechnology approaches applied to reproductive medicine have provided strategies to improve diagnosis and increase specificity and sensitivity. For in vitro embryo production, studies in non-human models have been used to deliver molecules to gametes and embryos. The exploration of nanotechnology for ART would bring great advances. In this way, experiments in non-human models to test the development and safety of new protocols using nanomaterials are very important for informing potential future employment in humans. This paper presents recent developments in nanotechnology regarding impairments still faced by ART: ovary stimulation, multiple pregnancy, and genetic disorders. New perspectives for further use of nanotechnology in reproductive medicine studies are also discussed.

  9. Teaching Laboratory Management Principles and Practices Through Mentorship and Graduated Responsibility: The Assistant Medical Directorship.

    Science.gov (United States)

    Hanley, Timothy; Sowder, Aleksandra M; Palmer, Cheryl Ann; Weiss, Ronald L

    2016-01-01

    With the changing landscape of medicine in general, and pathology in particular, a greater emphasis is being placed on laboratory management as a means of controlling spiraling medical costs and improving health-care efficiency. To meet this challenge, pathology residency programs have begun to incorporate formal laboratory management training into their curricula, using institutional curricula and/or online laboratory management courses offered by professional organizations. At the University of Utah, and its affiliated national reference laboratory, ARUP Laboratories, Inc, interested residents are able to supplement the departmental lecture-based and online laboratory management curriculum by participating in assistant medical directorship programs in one of several pathology subspecialty disciplines. The goals of many of the assistant medical directorship positions include the development of laboratory management skills and competencies. A survey of current and recent assistant medical directorship participants revealed that the assistant medical directorship program serves as an excellent means of improving laboratory management skills, as well as improving performance as a fellow and practicing pathologist.

  10. Should Health Care Aides Assist With Medications in Long-Term Care?

    Directory of Open Access Journals (Sweden)

    Mubashir Arain PhD

    2016-05-01

    Full Text Available Objective: The objective of the study was to determine whether health care aides (HCAs could safely assist in medication administration in long-term care (LTC. Method: We obtained medication error reports from LTC facilities that involve HCAs in oral medication assistance and we analyzed Resident Assessment Instrument (RAI data from these facilities. Standard ratings of error severity were “no apparent harm,” “minimum harm,” and “moderate harm.” Results: We retrieved error reports from two LTC facilities with 220 errors reported by all health care providers including HCAs. HCAs were involved in 137 (63% errors, licensed practical nurses (LPNs/registered nurses (RNs in 77 (35%, and pharmacy in four (2%. The analysis of error severity showed that HCAs were significantly less likely to cause errors of moderate severity than other nursing staff (2% vs. 7%, chi-square = 5.1, p value = .04. Conclusion: HCAs’ assistance in oral medications in LTC facilities appears to be safe when provided under the medication assistance guidelines.

  11. Reliability analysis framework for computer-assisted medical decision systems

    International Nuclear Information System (INIS)

    Habas, Piotr A.; Zurada, Jacek M.; Elmaghraby, Adel S.; Tourassi, Georgia D.

    2007-01-01

    We present a technique that enhances computer-assisted decision (CAD) systems with the ability to assess the reliability of each individual decision they make. Reliability assessment is achieved by measuring the accuracy of a CAD system with known cases similar to the one in question. The proposed technique analyzes the feature space neighborhood of the query case to dynamically select an input-dependent set of known cases relevant to the query. This set is used to assess the local (query-specific) accuracy of the CAD system. The estimated local accuracy is utilized as a reliability measure of the CAD response to the query case. The underlying hypothesis of the study is that CAD decisions with higher reliability are more accurate. The above hypothesis was tested using a mammographic database of 1337 regions of interest (ROIs) with biopsy-proven ground truth (681 with masses, 656 with normal parenchyma). Three types of decision models, (i) a back-propagation neural network (BPNN), (ii) a generalized regression neural network (GRNN), and (iii) a support vector machine (SVM), were developed to detect masses based on eight morphological features automatically extracted from each ROI. The performance of all decision models was evaluated using the Receiver Operating Characteristic (ROC) analysis. The study showed that the proposed reliability measure is a strong predictor of the CAD system's case-specific accuracy. Specifically, the ROC area index for CAD predictions with high reliability was significantly better than for those with low reliability values. This result was consistent across all decision models investigated in the study. The proposed case-specific reliability analysis technique could be used to alert the CAD user when an opinion that is unlikely to be reliable is offered. The technique can be easily deployed in the clinical environment because it is applicable with a wide range of classifiers regardless of their structure and it requires neither additional

  12. Using peer-assisted learning to teach basic surgical skills: medical students’ experiences

    Directory of Open Access Journals (Sweden)

    Mahdi Saleh

    2013-08-01

    Full Text Available Standard medical curricula in the United Kingdom (UK typically provide basic surgical-skills teaching before medical students are introduced into the clinical environment. However, these sessions are often led by clinical teaching fellows and/or consultants. Depending on the roles undertaken (e.g., session organizers, peer tutors, a peer-assisted learning (PAL approach may afford many benefits to teaching surgical skills. At the University of Keele's School of Medicine, informal PAL is used by the Surgical Society to teach basic surgical skills to pre-clinical students. As medical students who assumed different roles within this peer-assisted model, we present our experiences and discuss the possible implications of incorporating such sessions into UK medical curricula. Our anecdotal evidence suggests that a combination of PAL sessions – used as an adjunct to faculty-led sessions – may provide optimal learning opportunities in delivering a basic surgical skills session for pre-clinical students.

  13. Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature.

    Science.gov (United States)

    Wong, Kam Cheong

    2011-03-29

    Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries.In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learning settings.An Ishikawa diagram annotated with references to relevant medical cases and literature can be continually updated and can assist memory and retrieval of relevant medical cases and literature. It could also be used to cultivate a lifelong learning habit in medical professionals.

  14. Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature

    Directory of Open Access Journals (Sweden)

    Wong Kam Cheong

    2011-03-01

    Full Text Available Abstract Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries. In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learning settings. An Ishikawa diagram annotated with references to relevant medical cases and literature can be continually updated and can assist memory and retrieval of relevant medical cases and literature. It could also be used to cultivate a lifelong learning habit in medical professionals.

  15. Severe hypoglycaemia requiring the assistance of emergency medical services - frequency, causes and symptoms

    Czech Academy of Sciences Publication Activity Database

    Krnačová, V.; Kuběna, Aleš Antonín; Macek, K.; Bezděk, M.; Šmahelová, A.; Vlček, J.

    2012-01-01

    Roč. 156, č. 3 (2012), s. 271-277 ISSN 1213-8118 Grant - others:GA UK(CZ) SVV-2010-261-004 Keywords : regression trees * causes * symptoms * incidence * emergency medical service * severe hypoglycaemia Subject RIV: EI - Biotechnology ; Bionics Impact factor: 0.990, year: 2012 http://library.utia.cas.cz/separaty/2013/E/kubena-severe hypoglycaemia requiring the assistance of emergency medical services - frequency causes and symptoms.pdf

  16. The mixed message behind "Medication-Assisted Treatment" for substance use disorder.

    Science.gov (United States)

    Robinson, Sean M; Adinoff, Bryon

    2018-01-01

    The gap between treatment utilization and treatment need for substance use disorders (SUDs) remains a significant concern in our field. While the growing call to bridge this gap often takes the form of more treatment services and/or better integration of existing services, this perspective proposes that more effective labels for and transparent descriptions of existing services would also have a meaningful impact. Adopting the perspective of a consumer-based health-care model (wherein treatments and services are products and patients are consumers) allows us to consider how labels like Addiction-focused Medical Management, Medication-Assisted Treatment, Medication-Assisted Therapy, and others may actually be contributing to the underutilization problem rather than alleviating it. In this perspective, "Medication-Assisted Therapy" for opioid-use disorder (OUD) is singled out and discussed as inherently confusing, providing the message that pharmacotherapy for this disorder is a secondary treatment to other services which are generally regarded, in practice, as ancillary. That this mixed message is occurring amidst a nationwide "opioid epidemic" is a potential cause for concern and may actually serve to reinforce the longstanding, documented stigma against OUD pharmacotherapy. We recommend that referring to pharmacotherapy for SUD as simply "medication," as we do for other chronic medical disorders, will bring both clarity and precision to this effective treatment approach.

  17. 78 FR 32991 - Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable...

    Science.gov (United States)

    2013-06-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Part 433 [CMS-2327-CN] RIN 0938-AR38 Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable Care Act of 2010; Correction AGENCY: Centers for Medicare & Medicaid Services (CMS...

  18. Treatment outcome of alcohol use disorder outpatients with or without medically assisted detoxification

    NARCIS (Netherlands)

    Merkx, Maarten J. M.; Schippers, Gerard M.; Koeter, Maarten W. J.; de Wildt, Wencke A. J. M.; Vedel, Ellen; Goudriaan, Anna E.; van den Brink, Wim

    2014-01-01

    Little is known about the incremental effects of medically assisted detoxification on outpatient treatment for alcohol use disorders. The objective of this study was to compare drinking outcomes in a psychosocial treatment program between two groups of heavy drinking patients who had an alcohol use

  19. Enhancing human-animal relationships through veterinary medical instruction in animal-assisted therapy and animal-assisted activities.

    Science.gov (United States)

    Schaffer, Caroline Brunsman

    2008-01-01

    Instruction in animal-assisted therapy (AAT) and animal-assisted activities (AAAs) teaches veterinary medical students to confidently and assertively maximize the benefits and minimize the risks of this union of animals and people. Instruction in AAT/AAA also addresses requirements by the American Veterinary Medical Association Council on Education that accredited schools/colleges of veterinary medicine include in their standard curriculum the topics of the human-animal bond, behavior, and the contributions of the veterinarian to the overall public and professional health care teams. Entry-level veterinarians should be prepared to: (1) assure that animals who provide AAT/AAA are healthy enough to visit nursing homes, hospitals, or other institutions; (2) promote behavior testing that selects animals who will feel safe, comfortable, and connected; (3) advise facilities regarding infection control and ways to provide a safe environment where the animals, their handlers, and the people being visited will not be injured or become ill; and (4) advocate for their patients and show compassion for their clients when animals are determined to be inappropriate participants in AAT/AAA programs. This article presents AAT/AAA terminology, ways in which veterinarians can advocate for AAT/AAA, the advantages of being involved in AAT/AAA, a model AAT/AAA practicum from Tuskegee University's School of Veterinary Medicine (TUSVM), and examples of co-curricular activities in AAT/AAA by TUSVM's student volunteers.

  20. A Secure Cloud-Assisted Wireless Body Area Network in Mobile Emergency Medical Care System.

    Science.gov (United States)

    Li, Chun-Ta; Lee, Cheng-Chi; Weng, Chi-Yao

    2016-05-01

    Recent advances in medical treatment and emergency applications, the need of integrating wireless body area network (WBAN) with cloud computing can be motivated by providing useful and real time information about patients' health state to the doctors and emergency staffs. WBAN is a set of body sensors carried by the patient to collect and transmit numerous health items to medical clouds via wireless and public communication channels. Therefore, a cloud-assisted WBAN facilitates response in case of emergency which can save patients' lives. Since the patient's data is sensitive and private, it is important to provide strong security and protection on the patient's medical data over public and insecure communication channels. In this paper, we address the challenge of participant authentication in mobile emergency medical care systems for patients supervision and propose a secure cloud-assisted architecture for accessing and monitoring health items collected by WBAN. For ensuring a high level of security and providing a mutual authentication property, chaotic maps based authentication and key agreement mechanisms are designed according to the concept of Diffie-Hellman key exchange, which depends on the CMBDLP and CMBDHP problems. Security and performance analyses show how the proposed system guaranteed the patient privacy and the system confidentiality of sensitive medical data while preserving the low computation property in medical treatment and remote medical monitoring.

  1. In vivo bioprinting for computer- and robotic-assisted medical intervention: preliminary study in mice

    International Nuclear Information System (INIS)

    Keriquel, Virginie; Guillemot, Fabien; Arnault, Isabelle; Guillotin, Bertrand; Amedee, Joelle; Fricain, Jean-Christophe; Catros, Sylvain; Miraux, Sylvain

    2010-01-01

    We present the first attempt to apply bioprinting technologies in the perspective of computer-assisted medical interventions. A workstation dedicated to high-throughput biological laser printing has been designed. Nano-hydroxyapatite (n-HA) was printed in the mouse calvaria defect model in vivo. Critical size bone defects were performed in OF-1 male mice calvaria with a 4 mm diameter trephine. Prior to laser printing experiments, the absence of inflammation due to laser irradiation onto mice dura mater was shown by means of magnetic resonance imaging. Procedures for in vivo bioprinting and results obtained using decalcified sections and x-ray microtomography are discussed. Although heterogeneous, these preliminary results demonstrate that in vivo bioprinting is possible. Bioprinting may prove to be helpful in the future for medical robotics and computer-assisted medical interventions.

  2. In vivo bioprinting for computer- and robotic-assisted medical intervention: preliminary study in mice

    Energy Technology Data Exchange (ETDEWEB)

    Keriquel, Virginie; Guillemot, Fabien; Arnault, Isabelle; Guillotin, Bertrand; Amedee, Joelle; Fricain, Jean-Christophe; Catros, Sylvain [INSERM, U577, Bordeaux, F-33076 (France) and Universite Victor Segalen Bordeaux 2, UMR-S577 Bordeaux, F-33076 (France); Miraux, Sylvain [Centre de Resonance Magnetique des Systemes Biologiques, UMR 5536 (France)

    2010-03-15

    We present the first attempt to apply bioprinting technologies in the perspective of computer-assisted medical interventions. A workstation dedicated to high-throughput biological laser printing has been designed. Nano-hydroxyapatite (n-HA) was printed in the mouse calvaria defect model in vivo. Critical size bone defects were performed in OF-1 male mice calvaria with a 4 mm diameter trephine. Prior to laser printing experiments, the absence of inflammation due to laser irradiation onto mice dura mater was shown by means of magnetic resonance imaging. Procedures for in vivo bioprinting and results obtained using decalcified sections and x-ray microtomography are discussed. Although heterogeneous, these preliminary results demonstrate that in vivo bioprinting is possible. Bioprinting may prove to be helpful in the future for medical robotics and computer-assisted medical interventions.

  3. The role for peer-assisted ultrasound teaching in medical school.

    Science.gov (United States)

    Dickerson, Jonathan; Paul, Katie; Vila, Pierre; Whiticar, Rebecca

    2017-06-01

    Bedside ultrasonography has an increasing role in medicine yet medical students have limited exposure. Although countless hours are devoted to plain radiograph and electrocardiogram (ECG) interpretation, ultrasound is frequently glossed over. Yet this imaging modality could enhance students' understanding of anatomy, physiology and pathology, and may increase their integration into hospital teams. We aimed to investigate whether a peer-assisted ultrasound course has a place within the undergraduate medical curriculum. We describe the implementation of a course and discuss its acceptability and utility in student education. Bedside ultrasonography has an increasing role in medicine yet medical students have limited exposure METHODS: Following consultation with the medical school, an improved ultrasonography course was developed with expert guidance from an ultrasonographer and with new equipment. Sessions involved peer-tutors teaching ultrasonography techniques to medical students during emergency medicine placements. Tutees completed questionnaires to assess the quality and perceived benefits of the course and of learning ultrasonography. Both quantitative and thematic analyses of the responses were conducted by the authors. Over a period of 8 months, 105 medical students received teaching across four sessions. A total of 103 students (98%) returned questionnaires on their evaluation of the course and tutors, and on their confidence in using ultrasound. Ninety-eight per cent felt that the teaching was well delivered, 100 per cent felt that their knowledge of ultrasound had improved and 100 per cent would recommend the course. The peer-assisted ultrasound course described here enabled the majority of students to feel confident gaining elementary ultrasound views, and performing abdominal aneurysm screening and trauma assessments: techniques that they could hopefully put to use during their placements. The peer-assisted model has an acceptable role in teaching

  4. Experiences Providing Medical Assistance during the Sewol Ferry Disaster Using Traditional Korean Medicine.

    Science.gov (United States)

    Kim, Kyeong Han; Jang, Soobin; Lee, Ju Ah; Jang, Bo-Hyoung; Go, Ho-Yeon; Park, Sunju; Jo, Hee-Guen; Lee, Myeong Soo; Ko, Seong-Gyu

    2017-01-01

    This study aimed to investigate medical records using traditional Korean medicine (TKM) in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation. After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM) in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone could use on-site tent without restriction and TKM treatments including herb medicine were administered individually. The total of 1,860 patients were treated during the periods except for medical assistance on the barge. Most patients were diagnosed in musculoskeletal diseases (66.4%) and respiratory diseases (7.4%) and circulatory diseases (8.4%) followed. The most frequently used herbal medicines were Shuanghe decoction (80 days), Su He Xiang Wan (288 pills), and Wuji powder (73 days). TKM in medical assistance can be helpful to rescue worker or group life people in open shelter when national disasters occur. Therefore, it is important to construct a rapid respond system using TKM resources based on experience.

  5. Experiences Providing Medical Assistance during the Sewol Ferry Disaster Using Traditional Korean Medicine

    Directory of Open Access Journals (Sweden)

    Kyeong Han Kim

    2017-01-01

    Full Text Available Background. This study aimed to investigate medical records using traditional Korean medicine (TKM in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation. Methods. After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone could use on-site tent without restriction and TKM treatments including herb medicine were administered individually. Results. The total of 1,860 patients were treated during the periods except for medical assistance on the barge. Most patients were diagnosed in musculoskeletal diseases (66.4% and respiratory diseases (7.4% and circulatory diseases (8.4% followed. The most frequently used herbal medicines were Shuanghe decoction (80 days, Su He Xiang Wan (288 pills, and Wuji powder (73 days. Conclusions. TKM in medical assistance can be helpful to rescue worker or group life people in open shelter when national disasters occur. Therefore, it is important to construct a rapid respond system using TKM resources based on experience.

  6. Cloud-assisted mutual authentication and privacy preservation protocol for telecare medical information systems.

    Science.gov (United States)

    Li, Chun-Ta; Shih, Dong-Her; Wang, Chun-Cheng

    2018-04-01

     With the rapid development of wireless communication technologies and the growing prevalence of smart devices, telecare medical information system (TMIS) allows patients to receive medical treatments from the doctors via Internet technology without visiting hospitals in person. By adopting mobile device, cloud-assisted platform and wireless body area network, the patients can collect their physiological conditions and upload them to medical cloud via their mobile devices, enabling caregivers or doctors to provide patients with appropriate treatments at anytime and anywhere. In order to protect the medical privacy of the patient and guarantee reliability of the system, before accessing the TMIS, all system participants must be authenticated.  Mohit et al. recently suggested a lightweight authentication protocol for cloud-based health care system. They claimed their protocol ensures resilience of all well-known security attacks and has several important features such as mutual authentication and patient anonymity. In this paper, we demonstrate that Mohit et al.'s authentication protocol has various security flaws and we further introduce an enhanced version of their protocol for cloud-assisted TMIS, which can ensure patient anonymity and patient unlinkability and prevent the security threats of report revelation and report forgery attacks.  The security analysis proves that our enhanced protocol is secure against various known attacks as well as found in Mohit et al.'s protocol. Compared with existing related protocols, our enhanced protocol keeps the merits of all desirable security requirements and also maintains the efficiency in terms of computation costs for cloud-assisted TMIS.  We propose a more secure mutual authentication and privacy preservation protocol for cloud-assisted TMIS, which fixes the mentioned security weaknesses found in Mohit et al.'s protocol. According to our analysis, our authentication protocol satisfies most functionality features

  7. ACTIVITIES RESULTS AIMED AT IMPROVED MEDICAL ASSISTANCE TO THE VASCULAR PATIENTS IN TOMSK REGION

    Directory of Open Access Journals (Sweden)

    D. M. Plotnikov

    2013-01-01

    Full Text Available Acute disorders of cerebral circulation remain serious medical and social problem associated with high disability and mortality rates. Since 2011 Tomsk oblast is a participating member of the medical campaign aimed at improved medical services to the vascular patients. The preliminary implementation data analysis for 2012 revealed improvement of most of the indices of medical support to patients suffering from acute cerebral circulation; increased number of the in-patient cases (Regional Vascular Center and primary vascular department, decreased lethality rates from strokes, specifically hemorrhagic cases. Strict observance of the Regulations on Medical Assistance for stroke patients and the using of modern methods of therapy allowed to decrease hospital mortality in the Primary Vascular Departments and early mortality in the Regional Vascular Center. The active implementation of neurorehabilitation approaches resulted in the increased number of patients who do not require third parties’ assistance. Analysis of the work of the departments helped to identifying current problems and perspectives of further development of special medical care for stroke patients.

  8. Urinary Concentrations of Phthalate Metabolites and Pregnancy Loss Among Women Conceiving with Medically Assisted Reproduction.

    Science.gov (United States)

    Messerlian, Carmen; Wylie, Blair J; Mínguez-Alarcón, Lidia; Williams, Paige L; Ford, Jennifer B; Souter, Irene C; Calafat, Antonia M; Hauser, Russ

    2016-11-01

    Animal studies demonstrate that several phthalates are embryofetotoxic and are associated with increased pregnancy loss and malformations. Results from human studies on phthalates and pregnancy loss are inconsistent. We examined pregnancy loss prospectively in relation to urinary phthalate metabolite concentrations among women undergoing medically assisted reproduction. We used data from 256 women conceiving 303 pregnancies recruited between 2004 and 2012 from the Massachusetts General Hospital Fertility Center. We quantified 11 phthalate metabolite concentrations and calculated the molar sum of four di(2-ethylhexyl) phthalate (DEHP) metabolites (ΣDEHP). We estimated risk ratios (RRs) and 95% confidence intervals for biochemical loss and total pregnancy loss (assisted reproduction.

  9. Radiation protection during the medical assistance to the victims of the accident in Goiania

    International Nuclear Information System (INIS)

    Silva, L.H.C.; Fajardo, P.W.; Rosa, R.

    1989-01-01

    Some of the casualities of the radiological accident occured in Goiania (Brazil), consequence of the violation of a Cs-137 source were assisted at Marcillo Dias Naval Hospital. The risks associated to the contact with the patients were radioactive contamination and external exposure. To deal with this problem, a Radiation Protection Group was formed and a Radiation Protection Program was developed and implemented in order to assure that risks would be maintained as low as reasonably achievable. The objective of this paper is to present the acquired experience on the radiation protection support in case of emergency medical assistance in radiological accidents. (author). 1 ref.; 2 tabs

  10. Post-partum depressive symptoms and medically assisted conception: a systematic review and meta-analysis.

    Science.gov (United States)

    Gressier, F; Letranchant, A; Cazas, O; Sutter-Dallay, A L; Falissard, B; Hardy, P

    2015-11-01

    Does medically assisted conception increase the risk of post-partum depressive symptoms? Our literature review and meta-analysis showed no increased risk of post-partum depressive symptoms in women after medically assisted conception. Women who conceive with medically assisted conception, which can be considered as a stressful life event, could face an increased risk of depressive symptoms. However, no previous meta-analysis has been performed on the association between medically assisted conception and post-partum depressive symptoms. A systematic review with electronic searches of PubMed, ISI Web of Knowledge and PsycINFO databases up to December 2014 was conducted to identify articles evaluating post-partum depressive symptoms in women who had benefited from medically assisted conception compared with those with a spontaneous pregnancy. Meta-analyses were also performed on clinically significant post-partum depressive symptoms according to PRISMA guidelines. From 569 references, 492 were excluded on title, 42 on abstract and 17 others on full-text. Therefore, 18 studies were included in the review and 8 in the meta-analysis (2451 women) on clinically significant post-partum depressive symptoms after medically assisted conception compared with a spontaneous pregnancy. A sensitivity meta-analysis on assisted reproductive technologies and spontaneous pregnancy (6 studies, 1773 women) was also performed. The quality of the studies included in the meta-analyses was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology Statement for observational research. The data were pooled using RevMan software by the Cochrane Collaboration. Heterogeneity between studies was assessed from the results of the χ(2) and I(2) statistics. Biases were assessed with funnel plots and Egger's test. A fixed effects model was used for the meta-analyses because of the low level of heterogeneity between the studies. The systematic review of studies examining

  11. Perceived Relapse Risk and Desire for Medication Assisted Treatment among Persons Seeking Inpatient Opiate Detoxification

    Science.gov (United States)

    Bailey, Genie L; Herman, Debra S.; Stein, Michael D.

    2016-01-01

    Most patients with opioid addiction do not receive medication at the time of discharge from brief inpatient detoxification programs despite the high risk of relapse and the availability of three FDA-approved medications. We surveyed 164 inpatient opioid detoxification patients to assess desire for pharmacotherapy following detoxification program discharge. Participants were predominantly male (71.3%) and 80% had detoxed in the past. Reporting on their most recent previous inpatient detoxification, 27% had relapsed the day they were discharged, 65% within a month of discharge, and 90% within a year of discharge. 63% reported they wanted medication-assisted treatment (MAT) after discharge from the current admission. The odds of desiring a treatment medication increased by a factor of 1.02 for every 1% increase in perceived relapse risk (p detox abstinence. PMID:23786852

  12. Explanatory memorandum on European Community Document -mutual medical assistance in the case of a nuclear accident

    International Nuclear Information System (INIS)

    1987-01-01

    The report lists the Commissions proposals for further action on its suggestion of mutual health assistance in the event of a nuclear accident. These include surveys and studies, further research on the medical treatment of radiation casualties and the methodology of epidemiological investigations, the promotion of contacts between experts and the attempt to assemble a handbook listing facilities and procedures for mutual assistance. The memorandum explains some of the points further under the headings, ministerial responsibility, legal and procedural issues and policy implications. The United Kingdom position is then stated. The UK government welcomes the proposals provided there is no duplication of work already covered by the IAEA Convention on Assistance in the case of a Nuclear Accident or Radiological Emergency. (U.K.)

  13. 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.

  14. Bystander Intervention Prior to The Arrival of Emergency Medical Services: Comparing Assistance across Types of Medical Emergencies.

    Science.gov (United States)

    Faul, Mark; Aikman, Shelley N; Sasser, Scott M

    2016-01-01

    To determine the situational circumstances associated with bystander interventions to render aid during a medical emergency. This study examined 16.2 million Emergency Medical Service (EMS) events contained within the National Emergency Medical Services Information System. The records of patients following a 9-1-1 call for emergency medical assistance were analyzed using logistic regression to determine what factors influenced bystander interventions. The dependent variable of the model was whether or not a bystander intervened. EMS providers recorded bystander assistance 11% of the time. The logistic regression model correctly predicted bystander intervention occurrence 71.4% of the time. Bystanders were more likely to intervene when the patient was male (aOR = 1.12, 95% CI = 1.12-1.3) and if the patient was older (progressive aOR = 1.10, 1.46 age group 20-29 through age group 60-99). Bystanders were less likely to intervene in rural areas compared to urban areas (aOR = 0.58, 95% CI = 0.58-0.59). The highest likelihood of bystander intervention occurred in a residential institution (aOR = 1.86, 95% CI = 1.85-1.86) and the lowest occurred on a street or a highway (aOR = 0.96, 95% CI = 0.95-0.96). Using death as a reference group, bystanders were most likely to intervene when the patient had cardiac distress/chest pain (aOR = 11.38, 95% CI = 10.93-11.86), followed by allergic reaction (aOR = 7.63, 95% CI = 7.30-7.99), smoke inhalation (aOR = 6.65, 95% CI = 5.98-7.39), and respiration arrest/distress (aOR = 6.43, 95% CI = 6.17-6.70). A traumatic injury was the most commonly recorded known event, and it was also associated with a relatively high level of bystander intervention (aOR = 5.81, 95% CI = 5.58-6.05). The type of injury/illness that prompted the lowest likelihood of bystander assistance was Sexual Assault/Rape (aOR = 1.57, 95% CI = 1.32-1.84) followed by behavioral/psychiatric disorder (aOR = 1.64, 95% CI = 1.57-1.71). Bystander intervention varies greatly on

  15. A System Approach to Navy Medical Education and Training. Appendix 44. Competency Curriculum for Dental Assistant.

    Science.gov (United States)

    1974-08-31

    Apply medication/treat carious lesion g. Irrigate pericoroniti3 h. Drain periodontal abscess i. Apply temporary sedative crown to fractured tooth J...TASKS a. Educate patients regarding relationship of plaque, caries, periodontal disease and oral health b. Instruct patient in use of plaque...microorganisms, caries Causes and effects of periodontal disease 35 I| Competency: DENTAL ASSISTANT (DA) Unit: Preventive Dentistry ( MODULE 3: ORAL

  16. What the IOM Report on Graduate Medical Education Means for Physician Assistants.

    Science.gov (United States)

    Cawley, James F

    2015-06-01

    Graduate medical education (GME) is funded by taxpayers through Medicare subsidies that pay for physician residency training, primarily to teaching hospitals. The Institute of Medicine (IOM) recently conducted a study of US GME and issued a series of recommendations for future policy reform. This commentary examines the major elements of proposed reforms for GME and offers analysis of those that may pertain specifically to physician assistant education now and in the future.

  17. Access to healthcare for undocumented migrants in France: a critical examination of State Medical Assistance.

    Science.gov (United States)

    André, Jean-Marie; Azzedine, Fabienne

    2016-01-01

    In France in 2012, of the total population of 65.2 million, 8.7 % were migrants. After being the third principal host country, France is now the 6th highest host country in the OECD. Since the 1980's numerous Acts have been passed by parliament on immigration issues. In 2000 the Universal Health Cover (Couverture Maladie Universelle) was created as health coverage for all residents of France. At the same time the State Medical Assistance (Aide Médicale de l'Etat) was created as health protection for undocumented migrants. Since the creation of this scheme, it has been the object of many political debates which call it into question, on account of its cost, perceived fraud, and the legitimacy of a social protection for undocumented migrants. Recently, access to State Medical Assistance has been made difficult by introducing conditions of residence and financial contributions. After a reports' analysis on institutional, associative, research studies and European recommendations, we note that all reports converge on the necessity of health protection for undocumented migrants. The major reasons are humanitarian, respect of European and International conventions, for public health, and financial. Moreover, fraud allegations have proved to be unfounded. Finally, State Medical Assistance is underused: in 2014 data from Médecins du Monde shows that only 10.2 % of undocumented migrant patients in their health facilities have access to this scheme. We conclude that the political debate concerning the State Medical Assistance should be about its under-utilisation, its improvement, its merger with the Universal Health Cover, and not its elimination. Moreover, the current debates regarding this scheme stigmatize this population, which is already precarious, making it more difficult for migrants to access healthcare, and generally, weaken national social cohesion.

  18. [Euthanasia and/or medically assisted suicide: Reflection on the new responsibility of the hospital pharmacist].

    Science.gov (United States)

    Boissinot, L; Benamou, M; Léglise, P; Mancret, R-C; Huchon-Bécel, D

    2014-03-01

    Concern about euthanasia and medically assisted suicide is currently growing around the world and particularly in France. Though not authorized at present in France, the role of hospital pharmacist in this issue needs to be discussed. This article aims to gather medical and legal literature of European Union member states on these issues and particularly in France. To propose a practical thinking on the possible role of hospital pharmacist. Among European Union, euthanasia and/or assisted suicide have already been introduced in some member states' laws. In France, Leonetti law currently sets the legal framework for the management of end of life. To address the society's demand on these issues, French President F. Hollande made two ethics committees responsible for working on it. Both were mainly against euthanasia and assisted suicide. Though a bit forgotten in this debate, hospital pharmacist needs to be associated in the thinking, as the main "drug-keeper". Indeed, guidelines are necessary to outline and ensure a safe drug use, complying with professional ethics, if lethal doses are voluntarily prescribed. Pharmaceutical work is in constant evolution and is addressing new issues still unanswered, including assisted suicide and euthanasia. French pharmaceutical authorities should seize upon them, in order to guarantee pharmaceutical ethics. These practices, if authorized by law, should remain exceptional, and law strictly enforced. The pharmacist could be one of these "lawkeepers". Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. [Medical students' attitudes towards legalisation of euthanasia and physician-assisted suicide].

    Science.gov (United States)

    Nordstrand, Magnus Andreas; Nordstrand, Sven Jakob; Materstvedt, Lars Johan; Nortvedt, Per; Magelssen, Morten

    2013-11-26

    We wished to investigate prevailing attitudes among future doctors regarding legalisation of euthanasia and physician-assisted suicide. This issue is important, since any legalisation of these practices would confer a completely new role on doctors. Attitudes were identified with the aid of a questionnaire-based survey among medical students in their 5th and 6th year of study in the four Norwegian medical schools. Altogether 531 students responded (59.5% of all students in these cohorts). Of these, 102 (19%) were of the opinion that euthanasia should be legalised in the case of terminal illness, 164 (31%) responded that physician-assisted suicide should be permitted for this indication, while 145 (28%) did not know. A minority of the respondents would permit euthanasia and physician-assisted suicide in other situations. Women and those who reported that religion was important to them were less positive than men to permitting euthanasia or physician-assisted suicide. In most of the situations described, the majority of the students in this survey rejected legalisation. Opinions are more divided in the case of terminal illness, since a larger proportion is in favour of legalisation and more respondents are undecided.

  20. Measures against radiation disaster/terrorism and radiation emergency medical assistance team

    International Nuclear Information System (INIS)

    Tominaga, Takako; Akashi, Makoto

    2016-01-01

    The probability of occurrence of radiological terrorism and disaster in Japan is not low. For this reason, preparations for coping with the occurrence of radiological terrorism should be an urgent issue. This paper describes the radiation medical system and the threat of radiological terrorism and disaster in Japan, and introduces the Radiation Emergency Medical Assistance Team (REMAT), one of the radiation accident/disaster response organizations at the National Institute of Radiological Sciences. Radiation exposure medical systems in Japan are constructed only in the location of nuclear facilities and adjacent prefectures. These medical systems have been developed only for the purpose of medical correspondence at the time of nuclear disaster, but preparations are not made by assuming measures against radiological terrorism. REMAT of the National Institute of Radiological Sciences is obligated to dispatch persons to the requesting prefecture to support radiation medical care in case of nuclear disaster or radiation accident. The designation of nuclear disaster orientated hospitals in each region, and the training of nuclear disaster medical staffing team were also started, but preparations are not enough. In addition to enhancing and strengthening experts, specialized agencies, and special forces dealing with radiological terrorism, it is essential to improve regional disaster management capacity and terrorism handling capacity. (A.O.)

  1. Assisting IAEA Member States to Strengthen Regulatory Control, Particularly in the Medical Area

    International Nuclear Information System (INIS)

    Johnston, P.

    2016-01-01

    As per its Statue and Mandate, IAEA is developing Safety Standards and is also providing assistance for their application in Member States. One target and very large audience of this programme is the community of national regulatory bodies for radiation safety, expected to be established in all 168 Member States. Ionizing radiation is being used throughout the world in medical practices and medical exposure is the most significant manmade source of exposure to the population from ionizing radiation. Radiation accidents involving medical uses have accounted for more injuries and early acute health effects than any other type of radiation accident, including accidents at nuclear facilities. With the constant emerging of new technologies using ionizing radiation for medical diagnostic and treatment, there are on-going challenges for Regulatory bodies. The presentation will highlight some figures related to the medical exposure worldwide, and then it will introduce the main safety standards and other publications developed specifically for Regulatory Bodies and focusing on medical practices. It will also highlight the most important and recent mechanisms (tools, peer reviews and advisory services, training courses, networks) that the Agency is offering to its Member States in order to cope with the main challenges worldwide, contributing thus to the efficiency and effectiveness of the regulatory oversight of medical facilities and activities. (author)

  2. Reasons for medical evacuations of soldiers serving in International Security Assistance Force (ISAF) operation in Afghanistan.

    Science.gov (United States)

    Korzeniewski, Krzysztof; Gregulski, Robert

    2014-01-01

    The article presents the results of a research study into the reasons for medical evacuations of Polish military personnel taking part in the International Security Assistance Force (ISAF) operation in Afghanistan from 2007 to 2013. The authors have analysed medical records of 485 soldiers who were medically evacuated out of a combat zone in Afghanistan for battle injuries, non-battle injuries and diseases. Each medically evacuated Polish soldier was subjected to statistical analysis. The study population comprised 25,974 soldiers assigned to the Polish Military Contingent Afghanistan in the given period. From 2007 to 2013, 1.9% of the Polish military personnel (n = 485) participating in the ISAF operation in Afghanistan were evacuated for medical reasons before the scheduled termination of their contract. 40.6% of all medical evacuations were due to battle injuries, 32.4% due to non-battle injuries, and 27.0% due to diseases. ISAF is an example of a combat operation, in which battle injuries remain the leading health problem in mission participants. 3 of 4 Polish soldiers who were medically evacuated from Afghanistan were no longer fit for military service in the area of operations due to the traumas they had suffered.

  3. Needs, Acceptability, and Value of Humanitarian Medical Assistance in Remote Peruvian Amazon Riverine Communities

    Science.gov (United States)

    Sanchez, Juan F.; Halsey, Eric S.; Bayer, Angela M.; Beltran, Martin; Razuri, Hugo R.; Velasquez, Daniel E.; Cama, Vitaliano A.; Graf, Paul C. F.; Quispe, Antonio M.; Maves, Ryan C.; Montgomery, Joel M.; Sanders, John W.; Lescano, Andres G.

    2015-01-01

    Much debate exists regarding the need, acceptability, and value of humanitarian medical assistance. We conducted a cross-sectional study on 457 children under 5 years from four remote riverine communities in the Peruvian Amazon and collected anthropometric measures, blood samples (1–4 years), and stool samples. Focus groups and key informant interviews assessed perspectives regarding medical aid delivered by foreigners. The prevalence of stunting, anemia, and intestinal parasites was 20%, 37%, and 62%, respectively. Infection with multiple parasites, usually geohelminths, was detected in 41% of children. The prevalence of intestinal parasites both individual and polyparasitism increased with age. Participants from smaller communities less exposed to foreigners expressed lack of trust and fear of them. However, participants from all communities were positive about foreigners visiting to provide health support. Prevalent health needs such as parasitic infections and anemia may be addressed by short-term medical interventions. There is a perceived openness to and acceptability of medical assistance delivered by foreign personnel. PMID:25846293

  4. Peer-assisted learning--beyond teaching: How can medical students contribute to the undergraduate curriculum?

    Science.gov (United States)

    Furmedge, Daniel S; Iwata, Kazuya; Gill, Deborah

    2014-09-01

    Peer-assisted learning (PAL) has become increasingly popular over recent years with many medical schools now formally incorporating peer-teaching programs into the curriculum. PAL has a sound evidence base with benefit to both peer-teacher and peer-learner. Aside from in teaching delivery, empowering students to develop education in its broadest sense has been much less extensively documented. Five case studies with supportive evaluation evidence illustrate the success of a broad range of peer-led projects in the undergraduate medical curriculum, particularly where these have been embedded into formal teaching practices. These case studies identify five domains of teaching and support of learning where PAL works well: teaching and learning, resource development, peer-assessment, education research and evaluation and mentoring and support. Each case offers ways of engaging students in each domain. Medical students can contribute significantly to the design and delivery of the undergraduate medical program above and beyond the simple delivery of peer-assisted "teaching". In particular, they are in a prime position to develop resources and conduct research and evaluation within the program. Their participation in all stages enables them to feel involved in course development and education of their peers and ultimately leads to an increase in student satisfaction.

  5. Seventh Medical Image Computing and Computer Assisted Intervention Conference (MICCAI 2012)

    CERN Document Server

    Miller, Karol; Nielsen, Poul; Computational Biomechanics for Medicine : Models, Algorithms and Implementation

    2013-01-01

    One of the greatest challenges for mechanical engineers is to extend the success of computational mechanics to fields outside traditional engineering, in particular to biology, biomedical sciences, and medicine. This book is an opportunity for computational biomechanics specialists to present and exchange opinions on the opportunities of applying their techniques to computer-integrated medicine. Computational Biomechanics for Medicine: Models, Algorithms and Implementation collects the papers from the Seventh Computational Biomechanics for Medicine Workshop held in Nice in conjunction with the Medical Image Computing and Computer Assisted Intervention conference. The topics covered include: medical image analysis, image-guided surgery, surgical simulation, surgical intervention planning, disease prognosis and diagnostics, injury mechanism analysis, implant and prostheses design, and medical robotics.

  6. Adoption of computer-assisted learning in medical education: the educators' perspective.

    Science.gov (United States)

    Schifferdecker, Karen E; Berman, Norm B; Fall, Leslie H; Fischer, Martin R

    2012-11-01

    Computer-assisted learning (CAL) in medical education has been shown to be effective in the achievement of learning outcomes, but requires the input of significant resources and development time. This study examines the key elements and processes that led to the widespread adoption of a CAL program in undergraduate medical education, the Computer-assisted Learning in Paediatrics Program (CLIPP). It then considers the relative importance of elements drawn from existing theories and models for technology adoption and other studies on CAL in medical education to inform the future development, implementation and testing of CAL programs in medical education. The study used a mixed-methods explanatory design. All paediatric clerkship directors (CDs) using CLIPP were recruited to participate in a self-administered, online questionnaire. Semi-structured interviews were then conducted with a random sample of CDs to further explore the quantitative results. Factors that facilitated adoption included CLIPP's ability to fill gaps in exposure to core clinical problems, the use of a national curriculum, development by CDs, and the meeting of CDs' desires to improve teaching and student learning. An additional facilitating factor was that little time and effort were needed to implement CLIPP within a clerkship. The quantitative findings were mostly corroborated by the qualitative findings. This study indicates issues that are important in the consideration and future exploration of the development and implementation of CAL programs in medical education. The promise of CAL as a method of enhancing the process and outcomes of medical education, and its cost, increase the need for future CAL funders and developers to pay equal attention to the needs of potential adopters and the development process as they do to the content and tools in the CAL program. Important questions that remain on the optimal design, use and integration of CAL should be addressed in order to adequately inform

  7. Physician-assisted suicide, euthanasia and palliative sedation: attitudes and knowledge of medical students.

    Science.gov (United States)

    Anneser, Johanna; Jox, Ralf J; Thurn, Tamara; Borasio, Gian Domenico

    2016-01-01

    In November 2015, the German Federal Parliament voted on a new legal regulation regarding assisted suicide. It was decided to amend the German Criminal Code so that any "regular, repetitive offer" (even on a non-profit basis) of assistance in suicide would now be considered a punishable offense. On July 2, 2015, a date which happened to be accompanied by great media interest in that it was the day that the first draft of said law was presented to Parliament, we surveyed 4th year medical students at the Technical University Munich on "physician-assisted suicide," "euthanasia" and "palliative sedation," based on a fictitious case vignette study. The vignette study described two versions of a case in which a patient suffered from a nasopharyngeal carcinoma (physical suffering subjectively perceived as being unbearable vs. emotional suffering). The students were asked about the current legal norms for each respective course of action as well as their attitudes towards the ethical acceptability of these measures. Out of 301 students in total, 241 (80%) participated in the survey; 109 answered the version 1 questionnaire (physical suffering) and 132 answered the version 2 questionnaire (emotional suffering). The majority of students were able to assess the currently prevailing legal norms on palliative sedation (legal) and euthanasia (illegal) correctly (81.2% and 93.7%, respectively), while only a few students knew that physician-assisted suicide, at that point in time, did not constitute a criminal offense. In the case study that was presented, 83.3% of the participants considered palliative sedation and the simultaneous withholding of artificial nutrition and hydration as ethically acceptable, 51.2% considered physician-assisted suicide ethically legitimate, and 19.2% considered euthanasia ethically permissible. When comparing the results of versions 1 and 2, a significant difference could only be seen in the assessment of the legality of palliative sedation: it was

  8. Old, older and too old: age limits for medically assisted fatherhood?

    Science.gov (United States)

    Braverman, Andrea Mechanick

    2017-02-01

    How old is too old to be a father? Can you be a little bit older or "old-ish" to be a dad without being considered an "older dad"? At some point, does one simply become too old to be a father? Unless a man requires medical assistance in family building, that answer has historically turned solely on his opportunity to have a willing female partner of reproductive age. As with so many other aspects of family building, assisted reproductive technologies have transformed the possibilities for-and spawned heated debates about-maternal age. Much attention has been given to this contentious topic for potential mothers, with many programs putting age-related limitations in place for their female patients. This article considers whether there should also be limits-and how we should approach that question-for men who require and seek medical assistance to become fathers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. [Intelligent operating room suite : From passive medical devices to the self-thinking cognitive surgical assistant].

    Science.gov (United States)

    Kenngott, H G; Wagner, M; Preukschas, A A; Müller-Stich, B P

    2016-12-01

    Modern operating room (OR) suites are mostly digitally connected but until now the primary focus was on the presentation, transfer and distribution of images. Device information and processes within the operating theaters are barely considered. Cognitive assistance systems have triggered a fundamental rethinking in the automotive industry as well as in logistics. In principle, tasks in the OR, some of which are highly repetitive, also have great potential to be supported by automated cognitive assistance via a self-thinking system. This includes the coordination of the entire workflow in the perioperative process in both the operating theater and the whole hospital. With corresponding data from hospital information systems, medical devices and appropriate models of the surgical process, intelligent systems could optimize the workflow in the operating theater in the near future and support the surgeon. Preliminary results on the use of device information and automatically controlled OR suites are already available. Such systems include, for example the guidance of laparoscopic camera systems. Nevertheless, cognitive assistance systems that make use of knowledge about patients, processes and other pieces of information to improve surgical treatment are not yet available in the clinical routine but are urgently needed in order to automatically assist the surgeon in situation-related activities and thus substantially improve patient care.

  10. MEDIASSIST: medical assistance for intraoperative skill transfer in minimally invasive surgery using augmented reality

    Science.gov (United States)

    Sudra, Gunther; Speidel, Stefanie; Fritz, Dominik; Müller-Stich, Beat Peter; Gutt, Carsten; Dillmann, Rüdiger

    2007-03-01

    Minimally invasive surgery is a highly complex medical discipline with various risks for surgeon and patient, but has also numerous advantages on patient-side. The surgeon has to adapt special operation-techniques and deal with difficulties like the complex hand-eye coordination, limited field of view and restricted mobility. To alleviate with these new problems, we propose to support the surgeon's spatial cognition by using augmented reality (AR) techniques to directly visualize virtual objects in the surgical site. In order to generate an intelligent support, it is necessary to have an intraoperative assistance system that recognizes the surgical skills during the intervention and provides context-aware assistance surgeon using AR techniques. With MEDIASSIST we bundle our research activities in the field of intraoperative intelligent support and visualization. Our experimental setup consists of a stereo endoscope, an optical tracking system and a head-mounted-display for 3D visualization. The framework will be used as platform for the development and evaluation of our research in the field of skill recognition and context-aware assistance generation. This includes methods for surgical skill analysis, skill classification, context interpretation as well as assistive visualization and interaction techniques. In this paper we present the objectives of MEDIASSIST and first results in the fields of skill analysis, visualization and multi-modal interaction. In detail we present a markerless instrument tracking for surgical skill analysis as well as visualization techniques and recognition of interaction gestures in an AR environment.

  11. Improving Public Health Through Access to and Utilization of Medication Assisted Treatment

    Directory of Open Access Journals (Sweden)

    Thomas F. Kresina

    2011-10-01

    Full Text Available Providing access to and utilization of medication assisted treatment (MAT for the treatment of opioid abuse and dependence provides an important opportunity to improve public health. Access to health services comprising MAT in the community is fundamental to achieve broad service coverage. The type and placement of the health services comprising MAT and integration with primary medical care including human immunodeficiency virus (HIV prevention, care and treatment services are optimal for addressing both substance abuse and co-occurring infectious diseases. As an HIV prevention intervention, integrated (same medical record for HIV services and MAT services MAT with HIV prevention, care and treatment programs provides the best “one stop shopping” approach for health service utilization. Alternatively, MAT, medical and HIV services can be separately managed but co-located to allow convenient utilization of primary care, MAT and HIV services. A third approach is coordinated care and treatment, where primary care, MAT and HIV services are provided at distinct locations and case managers, peer facilitators, or others promote direct service utilization at the various locations. Developing a continuum of care for patients with opioid dependence throughout the stages MAT enhances the public health and Recovery from opioid dependence. As a stigmatized and medical disenfranchised population with multiple medical, psychological and social needs, people who inject drugs and are opioid dependent have difficulty accessing services and navigating medical systems of coordinated care. MAT programs that offer comprehensive services and medical care options can best contribute to improving the health of these individuals thereby enhancing the health of the community.

  12. ASSESSMENT OF KNOWLEDGE AND ATTITUDE OF COMPUTER ASSISTED LEARNING AMONG MEDICAL STUDENTS

    Directory of Open Access Journals (Sweden)

    Ravish

    2015-12-01

    Full Text Available INTRODUCTION: It is going truth globally that the medical course in medical college students are developed via computer mediated learning.1 Utilization of both the range upon online messages options must create study exciting, monetization, and likely as hired. We Hypothesized that survey will facilitate to permit us to be able to blueprint some on this necessary condition among my medical students and also to improve our study facilities a lot of automatically. A set of closed ended problems remained displayed on departmental website, to evaluate their computer skills and talents and their own assessment in computer and internet skills helping in learning. In the beginning months of 1st year MBBS college students 2014-15 batch taken up voluntarily to the study through MCQs questions provided to them in the form of departmental website. A batch of 50 college students surveyed on 3 different days. Although 80% students were confident with the operational skills of the computer, the opinion regarding the usage of computers for web based learning activities was not uniform i.e., 55% of the participants felt uncomfortable with web assisted activity in comparison to paper based activity. However, 49% were of the opinion that paper based activity might become redundant and websites will take over books in the future. Expansion on computer-assisted study requires traditional changes as well as thoughtful strategic planning, resource giving, staff benefits, Edutainment promotion by multidisciplinary working, and efficient quality control.

  13. Medical image computing and computer-assisted intervention - MICCAI 2005. Proceedings; Pt. 1

    International Nuclear Information System (INIS)

    Duncan, J.S.; Gerig, G.

    2005-01-01

    The two-volume set LNCS 3749 and LNCS 3750 constitutes the refereed proceedings of the 8th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2005, held in Palm Springs, CA, USA, in October 2005. Based on rigorous peer reviews the program committee selected 237 carefully revised full papers from 632 submissions for presentation in two volumes. The first volume includes all the contributions related to image analysis and validation, vascular image segmentation, image registration, diffusion tensor image analysis, image segmentation and analysis, clinical applications - validation, imaging systems - visualization, computer assisted diagnosis, cellular and molecular image analysis, physically-based modeling, robotics and intervention, medical image computing for clinical applications, and biological imaging - simulation and modeling. The second volume collects the papers related to robotics, image-guided surgery and interventions, image registration, medical image computing, structural and functional brain analysis, model-based image analysis, image-guided intervention: simulation, modeling and display, and image segmentation and analysis. (orig.)

  14. Initial activities of a radiation emergency medical assistance team to Fukushima from Nagasaki

    International Nuclear Information System (INIS)

    Matsuda, Naoki; Yoshida, Kouji; Nakashima, Kanami; Iwatake, Satoshi; Morita, Naoko; Ohba, Takashi; Yusa, Takeshi; Kumagai, Atsushi; Ohtsuru, Akira

    2013-01-01

    As an urgent response to serious radiological accidents in the Fukushima Daiichi nuclear power plant, the radiation emergency medical assistance team (REMAT) from Nagasaki University landed at Fukushima on March 14, 2011, two days after the initiation of radiation crisis by the hydrogen explosion at Unit-1 reactor. During a succession of unexpected disasters, REMAT members were involved in various activities for six days, such as setting the base for radiological triage at the Fukushima Medical University, considerations for administration of stable iodine, and risk communication with health care workers. This report briefly describes what happened around REMAT members and radiation doses measured during their activities. -- Highlights: ► The radiation emergency medical assistance team from Nagasaki was sent to Fukushima. ► The practical action level for body surface contamination was 100 kcpm. ► The ambient radiation dose in Fukushima drastically elevated on March 15, 2011. ► Higher than 10 kBq of I-131, Cs-134, and Cs-137 were detected in soil samples. ► The effective dose of the team members ranged between 51.7 and 127.8 μSv in 6 days

  15. Precepting the medical assistant practicum: expectations and rewards: an evaluation of preceptors' opinions.

    Science.gov (United States)

    Wilson, Adam B; Fegan, Frank; Romence, Blase; Uhe, Kendra; Dionne, Barbara

    2011-01-01

    This study investigated the opinions of preceptors on select topics relevant to the benefits and rewards of precepting medical assisting (MA) students. A 35-item questionnaire was distributed to volunteer MA preceptors over the course of 1 year. Survey items prompted participants for information concerning background and previous experiences with MA students, as well as gathered opinions on the benefits, issues, and rewards of preceptorships. Of the preceptors who gave evidence of their credentials, 98.43% were either practicing certified medical assistants (CMA-AAMA) or nurses. Respectively, 80.85% of CMAs and 80.00% of nurses felt that students provided the office with extra help and placed no financial burden on the practice. Approximately 44% ranked free continuing medical education (CME) credits as the most important reward. Written responses identified thank-you notes as an important demonstration of service, acknowledgment, and appreciation. MA preceptors consider students a beneficial aspect of their practice because they lighten strenuous workloads and stimulate preceptors to remain current in their professional fields. Noncompensated MA preceptors value both extrinsic (e.g., free CME credits) and intrinsic rewards (e.g., feedback and thank-you cards) and suggested that intrinsic rewards were of greater value.

  16. Medical image computing and computer-assisted intervention - MICCAI 2005. Proceedings; Pt. 1

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, J.S. [Yale Univ., New Haven, CT (United States). Dept. of Biomedical Engineering and Diagnostic Radiology; Gerig, G. (eds.) [North Carolina Univ., Chapel Hill (United States). Dept. of Computer Science

    2005-07-01

    The two-volume set LNCS 3749 and LNCS 3750 constitutes the refereed proceedings of the 8th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2005, held in Palm Springs, CA, USA, in October 2005. Based on rigorous peer reviews the program committee selected 237 carefully revised full papers from 632 submissions for presentation in two volumes. The first volume includes all the contributions related to image analysis and validation, vascular image segmentation, image registration, diffusion tensor image analysis, image segmentation and analysis, clinical applications - validation, imaging systems - visualization, computer assisted diagnosis, cellular and molecular image analysis, physically-based modeling, robotics and intervention, medical image computing for clinical applications, and biological imaging - simulation and modeling. The second volume collects the papers related to robotics, image-guided surgery and interventions, image registration, medical image computing, structural and functional brain analysis, model-based image analysis, image-guided intervention: simulation, modeling and display, and image segmentation and analysis. (orig.)

  17. 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

  18. Natural fertility, infertility and the role of medically assisted reproduction: The knowledge amongst women of reproductive age in North Queensland.

    Science.gov (United States)

    Cheung, Nicole K; Coffey, Anne; Woods, Cindy; de Costa, Caroline

    2018-04-16

    The demand for medically assisted reproduction continues to increase, with more women encountering challenges with fertility. Due to misconceptions and gaps in knowledge, women are often unaware of the risks related to delayed childbearing. Lack of understanding of natural fertility, infertility and the role of medically assisted reproduction can lead to emotional suffering and changes in family plans. To assess the understanding and knowledge that women of reproductive age in North Queensland have regarding natural fertility, infertility and the role of medically assisted reproduction. Data were collected from 120 women (30 nurses, 30 teachers, 30 university students and 30 Technical and Further Education students) via the distribution of a structured questionnaire. Participants were surveyed in person about their personal plans and opinions, knowledge about natural fertility, infertility and medically assisted reproduction, and their preferred source of information. Participants demonstrated suboptimal knowledge levels throughout all sections of the questionnaire, in particular when asked about medically assisted reproduction. When asked to identify their main source of information, 'friends and family' was the most popular choice. Results from this North Queensland study add to the existing international literature, highlighting the widespread nature of the problem. Without adequate understanding of natural fertility, the risks of infertility, and the role and limitations of medically assisted reproduction, women make uninformed decisions. Development of local reproductive health education programs need to be instigated in response. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  19. Successful Nicotine Intake in Medical Assisted Use of E-Cigarettes: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Roberta Pacifici

    2015-07-01

    Full Text Available The electronic cigarette (e-cig has gained popularity as an aid in smoking cessation programs mainly because it maintains the gestures and rituals of tobacco smoking. However, it has been shown in inexperienced e-cig users that ineffective nicotine delivery can cause tobacco craving that could be responsible for unsuccessful smoking reduction/cessation. Moreover, the incorrect use of an e-cig could also led to potential nicotine overdosage and intoxication. Medically assisted training on the proper use of an e-cig plus behavioral support for tobacco dependence could be a pivotal step in avoiding both issues. We performed an eight-month pilot study of adult smokers who started e-cig use after receiving a multi-component medically assisted training program with monitoring of nicotine intake as a biomarker of correct e-cig use. Participants were tested during follow-up for breath carbon monoxide (CO, plasma cotinine and trans-3’-hydroxycotinine, and number of tobacco cigarettes smoked. At the end of the first, fourth, and eighth month of follow-up, 91.1, 73.5, and 76.5% of participants respectively were e-cig users (‘only e-cig’ and ‘dual users’. They showed no significant variation in plasma cotinine and trans-3’-hydroxycotinine with respect to the start of the study when they smoked only tobacco cigarettes, but a significant reduction in breath CO. The proposed medically assisted training program of e-cig use led to a successful nicotine intake, lack of typical cigarette craving and overdosage symptoms and a significant decrease in the biomarker of cigarette combustion products.

  20. Successful Nicotine Intake in Medical Assisted Use of E-Cigarettes: A Pilot Study.

    Science.gov (United States)

    Pacifici, Roberta; Pichini, Simona; Graziano, Silvia; Pellegrini, Manuela; Massaro, Giuseppina; Beatrice, Fabio

    2015-07-08

    The electronic cigarette (e-cig) has gained popularity as an aid in smoking cessation programs mainly because it maintains the gestures and rituals of tobacco smoking. However, it has been shown in inexperienced e-cig users that ineffective nicotine delivery can cause tobacco craving that could be responsible for unsuccessful smoking reduction/cessation. Moreover, the incorrect use of an e-cig could also led to potential nicotine overdosage and intoxication. Medically assisted training on the proper use of an e-cig plus behavioral support for tobacco dependence could be a pivotal step in avoiding both issues. We performed an eight-month pilot study of adult smokers who started e-cig use after receiving a multi-component medically assisted training program with monitoring of nicotine intake as a biomarker of correct e-cig use. Participants were tested during follow-up for breath carbon monoxide (CO), plasma cotinine and trans-3'-hydroxycotinine, and number of tobacco cigarettes smoked. At the end of the first, fourth, and eighth month of follow-up, 91.1, 73.5, and 76.5% of participants respectively were e-cig users ('only e-cig' and 'dual users'). They showed no significant variation in plasma cotinine and trans-3'-hydroxycotinine with respect to the start of the study when they smoked only tobacco cigarettes, but a significant reduction in breath CO. The proposed medically assisted training program of e-cig use led to a successful nicotine intake, lack of typical cigarette craving and overdosage symptoms and a significant decrease in the biomarker of cigarette combustion products.

  1. Medication-assisted recovery from opioid addiction: historical and contemporary perspectives.

    Science.gov (United States)

    White, William L

    2012-01-01

    Recovery is being used as a conceptual fulcrum for the redesign of addiction treatment and related support services in the United States. Efforts by policy, research, and clinical leaders to define recovery and calls for assertive models of long-term recovery management raise critical questions about how transformation efforts of recovery-focused systems will affect the pharmacotherapeutic treatment of opioid addiction and the status of patients participating in such treatment. This article highlights recent work advocating a recovery-oriented approach to medication-assisted treatment.

  2. Technical assistance for Meharry Medical College Energy Efficiency Project. Final project status and technical report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-08

    This report presents the results of a program to provide technical assistance to Meharry Medical College. The purpose of the program is to facilitate Meharry`s effort to finance a campus-wide facility retrofit. The US Department of Energy (USDOE) funded the program through a grant to the Tennessee Department of Economic and Community Development (TECD). The University of Memphis-Technology and Energy Services (UM-TES), under contract to TECD, performed program services. The report has three sections: (1) introduction; (2) project definition, financing, and participants; and (3) opportunities for federal participation.

  3. Assessing Need for Medication-Assisted Treatment for Opiate-Dependent Prison Inmates

    Science.gov (United States)

    Albizu-García, Carmen E.; Caraballo, José Noel; Caraballo-Correa, Glorimar; Hernández-Viver, Adriana; Román-Badenas, Luis

    2012-01-01

    Individuals with a history of heroin dependence are overrepresented in American correctional facilities and 75% of inmates with a drug use disorder do not receive treatment during incarceration or after release. Medication-assisted treatment (MAT) with opiate agonists, such as methadone or buprenorphine, constitute standard of care; to guide planning for an expansion of drug treatment services in correctional facilities, a needs assessment was conducted at the Department of Correction and Rehabilitation (DCR) of Puerto Rico (PR). We report on the research process, the findings that informed our recommendations for the PCR to expand MAT for eligible inmates, and lessons learned. PMID:22263714

  4. A role for doctors in assisted dying? An analysis of legal regulations and medical professional positions in six European countries.

    Science.gov (United States)

    Bosshard, G; Broeckaert, B; Clark, D; Materstvedt, L J; Gordijn, B; Müller-Busch, H C

    2008-01-01

    To analyse legislation and medical professional positions concerning the doctor's role in assisted dying in western Europe, and to discuss their implications for doctors. This paper is based on country-specific reports by experts from European countries where assisted dying is legalised (Belgium, The Netherlands), or openly practiced (Switzerland), or where it is illegal (Germany, Norway, UK). Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide (but not euthanasia) is not illegal in either Germany or Switzerland, but a doctor's participation in Germany would violate the code of professional medical conduct and might contravene of a doctor's legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not. Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This "neutral" stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a "medical end-of-life decision" since the 1970s. A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions.

  5. The effectiveness of a computer-assisted instruction programme on communication skills of medical specialists in oncology.

    NARCIS (Netherlands)

    Hulsman, R.L.; Ros, W.J.G.; Winnubst, J.A.M.; Bensing, J.M.

    2002-01-01

    Although doctor-patient communication is important in health care, medical specialists are generally not well trained in communication skills. Conventional training programmes are generally time consuming and hard to fit into busy working schedules of medical specialists. A computer-assisted

  6. Computer-Assisted, Programmed Text, and Lecture Modes of Instruction in Three Medical Training Courses: Comparative Evaluation. Final Report.

    Science.gov (United States)

    Deignan, Gerard M.; And Others

    This report contains a comparative analysis of the differential effectiveness of computer-assisted instruction (CAI), programmed instructional text (PIT), and lecture methods of instruction in three medical courses--Medical Laboratory, Radiology, and Dental. The summative evaluation includes (1) multiple regression analyses conducted to predict…

  7. Clinical Assistant Diagnosis for Electronic Medical Record Based on Convolutional Neural Network.

    Science.gov (United States)

    Yang, Zhongliang; Huang, Yongfeng; Jiang, Yiran; Sun, Yuxi; Zhang, Yu-Jin; Luo, Pengcheng

    2018-04-20

    Automatically extracting useful information from electronic medical records along with conducting disease diagnoses is a promising task for both clinical decision support(CDS) and neural language processing(NLP). Most of the existing systems are based on artificially constructed knowledge bases, and then auxiliary diagnosis is done by rule matching. In this study, we present a clinical intelligent decision approach based on Convolutional Neural Networks(CNN), which can automatically extract high-level semantic information of electronic medical records and then perform automatic diagnosis without artificial construction of rules or knowledge bases. We use collected 18,590 copies of the real-world clinical electronic medical records to train and test the proposed model. Experimental results show that the proposed model can achieve 98.67% accuracy and 96.02% recall, which strongly supports that using convolutional neural network to automatically learn high-level semantic features of electronic medical records and then conduct assist diagnosis is feasible and effective.

  8. Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System

    Science.gov (United States)

    Carone, Marco; Al-Saedy, Huda; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Black, Robert E

    2012-01-01

    Abstract Objective To determine the range and burden of health services utilization among Iraqi refugees receiving health assistance in Jordan, a country of first asylum. Methods Medical conditions, diagnosed in accordance with the tenth revision of the International classification of diseases, were actively monitored from 1January to 31December 2010 using a pilot centralized database in Jordan called the Refugee Assistance Information System. Findings There were 27 166 medical visits by 7642 Iraqi refugees (mean age: 37.4 years; 49% male; 70% from Baghdad; 6% disabled; 3% with a history of torture). Chronic diseases were common, including essential hypertension (22% of refugees), visual disturbances (12%), joint disorders (11%) and type II diabetes mellitus (11%). The most common reasons for seeking acute care were upper respiratory tract infection (11%), supervision of normal pregnancy (4%) and urinary disorders (3%). The conditions requiring the highest number of visits per refugee were cerebrovascular disease (1.46 visits), senile cataract (1.46) and glaucoma (1.44). Sponsored care included 31 747 referrals or consultations to a specialty service, 18 432 drug dispensations, 2307 laboratory studies and 1090 X-rays. The specialties most commonly required were ophthalmology, dentistry, gynaecology and orthopaedic surgery. Conclusion Iraqi refugees in countries of first asylum and resettlement require targeted health services, health education and sustainable prevention and control strategies for predominantly chronic diseases. PMID:22690034

  9. Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System.

    Science.gov (United States)

    Mateen, Farrah J; Carone, Marco; Al-Saedy, Huda; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Black, Robert E

    2012-06-01

    To determine the range and burden of health services utilization among Iraqi refugees receiving health assistance in Jordan, a country of first asylum. Medical conditions, diagnosed in accordance with the tenth revision of the International classification of diseases, were actively monitored from 1 January to 31 December 2010 using a pilot centralized database in Jordan called the Refugee Assistance Information System. There were 27 166 medical visits by 7642 Iraqi refugees (mean age: 37.4 years; 49% male; 70% from Baghdad; 6% disabled; 3% with a history of torture). Chronic diseases were common, including essential hypertension (22% of refugees), visual disturbances (12%), joint disorders (11%) and type II diabetes mellitus (11%). The most common reasons for seeking acute care were upper respiratory tract infection (11%), supervision of normal pregnancy (4%) and urinary disorders (3%). The conditions requiring the highest number of visits per refugee were cerebrovascular disease (1.46 visits), senile cataract (1.46) and glaucoma (1.44). Sponsored care included 31 747 referrals or consultations to a specialty service, 18 432 drug dispensations, 2307 laboratory studies and 1090 X-rays. The specialties most commonly required were ophthalmology, dentistry, gynaecology and orthopaedic surgery. Iraqi refugees in countries of first asylum and resettlement require targeted health services, health education and sustainable prevention and control strategies for predominantly chronic diseases.

  10. Ethics and regulation of inter-country medically assisted reproduction: a call for action.

    Science.gov (United States)

    Shalev, Carmel; Moreno, Adi; Eyal, Hedva; Leibel, Michal; Schuz, Rhona; Eldar-Geva, Talia

    2016-01-01

    The proliferation of medically assisted reproduction (MAR) for the treatment of infertility has brought benefit to many individuals around the world. But infertility and its treatment continue to be a cause of suffering, and over the past decade, there has been a steady growth in a new global market of inter-country medically assisted reproduction (IMAR) involving 'third-party' individuals acting as surrogate mothers and gamete donors in reproductive collaborations for the benefit of other individuals and couples who wish to have children. At the same time there is evidence of a double standard of care for third-party women involved in IMAR, violations of human rights of children and women, and extreme abuses that are tantamount to reproductive trafficking. This paper is the report of an inter-disciplinary working group of experts who convened in Israel to discuss the complex issues of IMAR. In Israel too IMAR practices have grown rapidly in recent years, mainly because of restrictions on access to domestic surrogacy for same sex couples and a chronically insufficient supply of egg cells for the treatment of couples and singles in need. Drawing upon local expertise, the paper describes documented practices that are harmful, suggests principles of good practice based on an ethic of care, and calls for action at the international, national and professional levels to establish a human rights based system of international governance for IMAR based on three regulatory models: public health monitoring, inter-country adoption, and trafficking in human beings, organs and tissues.

  11. A Novel Approach to Medical Student Peer-assisted Learning Through Case-based Simulations.

    Science.gov (United States)

    Jauregui, Joshua; Bright, Steven; Strote, Jared; Shandro, Jamie

    2018-01-01

    Peer-assisted learning (PAL) is the development of new knowledge and skills through active learning support from peers. Benefits of PAL include introduction of teaching skills for students, creation of a safe learning environment, and efficient use of faculty time. We present a novel approach to PAL in an emergency medicine (EM) clerkship curriculum using an inexpensive, tablet-based app for students to cooperatively present and perform low-fidelity, case-based simulations that promotes accountability for student learning, fosters teaching skills, and economizes faculty presence. We developed five clinical cases in the style of EM oral boards. Fourth-year medical students were each assigned a unique case one week in advance. Students also received an instructional document and a video example detailing how to lead a case. During the 90-minute session, students were placed in small groups of 3-5 students and rotated between facilitating their assigned cases and participating as a team for the cases presented by their fellow students. Cases were supplemented with a half-mannequin that can be intubated, airway supplies, and a tablet-based app (SimMon, $22.99) to remotely display and update vital signs. One faculty member rotated among groups to provide additional assistance and clarification. Three EM faculty members iteratively developed a survey, based on the literature and pilot tested it with fourth-year medical students, to evaluate the course. 135 medical students completed the course and course evaluation survey. Learner satisfaction was high with an overall score of 4.6 on a 5-point Likert scale. In written comments, students reported that small groups with minimal faculty involvement provided a safe learning environment and a unique opportunity to lead a group of peers. They felt that PAL was more effective than traditional simulations for learning. Faculty reported that students remained engaged and required minimal oversight. Unlike other simulations, our

  12. Assisted Living Facilities, Locations of Assisted Living Facilities identifed visually and placed on the Medical Multi-Hazard Mitigation layer., Published in 2006, 1:1200 (1in=100ft) scale, Noble County Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Assisted Living Facilities dataset current as of 2006. Locations of Assisted Living Facilities identifed visually and placed on the Medical Multi-Hazard Mitigation...

  13. Physician-assisted suicide, euthanasia and palliative sedation: attitudes and knowledge of medical students

    Directory of Open Access Journals (Sweden)

    Anneser, Johanna

    2016-02-01

    Full Text Available Objectives: In November 2015, the German Federal Parliament voted on a new legal regulation regarding assisted suicide. It was decided to amend the German Criminal Code so that any “regular, repetitive offer” (even on a non-profit basis of assistance in suicide would now be considered a punishable offense. On July 2, 2015, a date which happened to be accompanied by great media interest in that it was the day that the first draft of said law was presented to Parliament, we surveyed 4th year medical students at the Technical University Munich on “physician-assisted suicide,” “euthanasia” and “palliative sedation,” based on a fictitious case vignette study. Method: The vignette study described two versions of a case in which a patient suffered from a nasopharyngeal carcinoma (physical suffering subjectively perceived as being unbearable vs. emotional suffering. The students were asked about the current legal norms for each respective course of action as well as their attitudes towards the ethical acceptability of these measures.Results: Out of 301 students in total, 241 (80% participated in the survey; 109 answered the version 1 questionnaire (physical suffering and 132 answered the version 2 questionnaire (emotional suffering. The majority of students were able to assess the currently prevailing legal norms on palliative sedation (legal and euthanasia (illegal correctly (81.2% and 93.7%, respectively, while only a few students knew that physician-assisted suicide, at that point in time, did not constitute a criminal offense. In the case study that was presented, 83.3% of the participants considered palliative sedation and the simultaneous withholding of artificial nutrition and hydration as ethically acceptable, 51.2% considered physician-assisted suicide ethically legitimate, and 19.2% considered euthanasia ethically permissible. When comparing the results of versions 1 and 2, a significant difference could only be seen in the

  14. Validation of an Improved Computer-Assisted Technique for Mining Free-Text Electronic Medical Records.

    Science.gov (United States)

    Duz, Marco; Marshall, John F; Parkin, Tim

    2017-06-29

    The use of electronic medical records (EMRs) offers opportunity for clinical epidemiological research. With large EMR databases, automated analysis processes are necessary but require thorough validation before they can be routinely used. The aim of this study was to validate a computer-assisted technique using commercially available content analysis software (SimStat-WordStat v.6 (SS/WS), Provalis Research) for mining free-text EMRs. The dataset used for the validation process included life-long EMRs from 335 patients (17,563 rows of data), selected at random from a larger dataset (141,543 patients, ~2.6 million rows of data) and obtained from 10 equine veterinary practices in the United Kingdom. The ability of the computer-assisted technique to detect rows of data (cases) of colic, renal failure, right dorsal colitis, and non-steroidal anti-inflammatory drug (NSAID) use in the population was compared with manual classification. The first step of the computer-assisted analysis process was the definition of inclusion dictionaries to identify cases, including terms identifying a condition of interest. Words in inclusion dictionaries were selected from the list of all words in the dataset obtained in SS/WS. The second step consisted of defining an exclusion dictionary, including combinations of words to remove cases erroneously classified by the inclusion dictionary alone. The third step was the definition of a reinclusion dictionary to reinclude cases that had been erroneously classified by the exclusion dictionary. Finally, cases obtained by the exclusion dictionary were removed from cases obtained by the inclusion dictionary, and cases from the reinclusion dictionary were subsequently reincluded using Rv3.0.2 (R Foundation for Statistical Computing, Vienna, Austria). Manual analysis was performed as a separate process by a single experienced clinician reading through the dataset once and classifying each row of data based on the interpretation of the free

  15. Understanding Transgender and Medically Assisted Gender Transition: Feminism as a Critical Resource.

    Science.gov (United States)

    Nelson, Jamie Lindemann

    2016-11-01

    Feminism has fought the trivialization of women's experiences, championed women's security, and insisted on respect for women's choices. In so doing, feminism has developed important perspectives on the complicated connections between what gender means as it plays itself in people's lives, and the inequalities of power and authority that structure much of human experience. Here, I put a few of these perspectives into contact with an issue where the interactions of gender and power are squarely in play: medicine's role in assisting gender transitioning generally and, specifically, the enduring controversy between medicine and many transgender people about the pathologization of transgender and the role of clinicians as gatekeepers to gender-transition interventions. © 2016 American Medical Association. All Rights Reserved.

  16. Medical image computing and computer-assisted intervention - MICCAI 2006. Pt. 1. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, R. [Technical Univ. of Denmark, Lyngby (Denmark). Informatics and Mathematical Modelling; Nielsen, M. [IT Univ. of Copenhagen (Denmark); Sporring, J. (eds.) [Copenhagen Univ. (Denmark). Dept. of Computer Science

    2006-07-01

    The two-volume set LNCS 4190 and LNCS 4191 constitute the refereed proceedings of the 9th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2006, held in Copenhagen, Denmark in October 2006. The program committee carefully selected 39 revised full papers and 193 revised poster papers from 578 submissions for presentation in two volumes, based on a rigorous peer reviews. The first volume includes 114 contributions related to bone shape analysis, robotics and tracking, segmentation, analysis of diffusion tensor MRI, shape analysis and morphometry, simulation and interaction, robotics and intervention, cardio-vascular applications, image analysis in oncology, brain atlases and segmentation, cardiac motion analysis, clinical applications, and registration. The second volume collects 118 papers related to segmentation, validation and quantitative image analysis, brain image processing, motion in image formation, image guided clinical applications, registration, as well as brain analysis and registration. (orig.)

  17. Medical image computing and computer-assisted intervention - MICCAI 2006. Pt. 2. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, R. [Technical Univ. of Denmark, Lyngby (Denmark). Informatics and Mathematical Modelling; Nielsen, M. [IT Univ. of Copenhagen (Denmark); Sporring, J. (eds.) [Copenhagen Univ. (Denmark). Dept. of Computer Science

    2006-07-01

    The two-volume set LNCS 4190 and LNCS 4191 constitute the refereed proceedings of the 9th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2006, held in Copenhagen, Denmark in October 2006. The program committee carefully selected 39 revised full papers and 193 revised poster papers from 578 submissions for presentation in two volumes, based on a rigorous peer reviews. The first volume includes 114 contributions related to bone shape analysis, robotics and tracking, segmentation, analysis of diffusion tensor MRI, shape analysis and morphometry, simulation and interaction, robotics and intervention, cardio-vascular applications, image analysis in oncology, brain atlases and segmentation, cardiac motion analysis, clinical applications, and registration. The second volume collects 118 papers related to segmentation, validation and quantitative image analysis, brain image processing, motion in image formation, image guided clinical applications, registration, as well as brain analysis and registration. (orig.)

  18. Medical image computing and computer-assisted intervention - MICCAI 2006. Pt. 2. Proceedings

    International Nuclear Information System (INIS)

    Larsen, R.; Sporring, J.

    2006-01-01

    The two-volume set LNCS 4190 and LNCS 4191 constitute the refereed proceedings of the 9th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2006, held in Copenhagen, Denmark in October 2006. The program committee carefully selected 39 revised full papers and 193 revised poster papers from 578 submissions for presentation in two volumes, based on a rigorous peer reviews. The first volume includes 114 contributions related to bone shape analysis, robotics and tracking, segmentation, analysis of diffusion tensor MRI, shape analysis and morphometry, simulation and interaction, robotics and intervention, cardio-vascular applications, image analysis in oncology, brain atlases and segmentation, cardiac motion analysis, clinical applications, and registration. The second volume collects 118 papers related to segmentation, validation and quantitative image analysis, brain image processing, motion in image formation, image guided clinical applications, registration, as well as brain analysis and registration. (orig.)

  19. Medical image computing and computer-assisted intervention - MICCAI 2006. Pt. 1. Proceedings

    International Nuclear Information System (INIS)

    Larsen, R.; Sporring, J.

    2006-01-01

    The two-volume set LNCS 4190 and LNCS 4191 constitute the refereed proceedings of the 9th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2006, held in Copenhagen, Denmark in October 2006. The program committee carefully selected 39 revised full papers and 193 revised poster papers from 578 submissions for presentation in two volumes, based on a rigorous peer reviews. The first volume includes 114 contributions related to bone shape analysis, robotics and tracking, segmentation, analysis of diffusion tensor MRI, shape analysis and morphometry, simulation and interaction, robotics and intervention, cardio-vascular applications, image analysis in oncology, brain atlases and segmentation, cardiac motion analysis, clinical applications, and registration. The second volume collects 118 papers related to segmentation, validation and quantitative image analysis, brain image processing, motion in image formation, image guided clinical applications, registration, as well as brain analysis and registration. (orig.)

  20. [Literature review and state of the art of the Italian law on medically assisted reproduction].

    Science.gov (United States)

    Ricci, G; Delbon, P; Conti, A; Sirignano, A

    2015-01-01

    This article analyzes the current situation of medically assisted reproduction in Italy after the promulgation of Law 40 in 2004. This law is actually completely different from the origin version. The controversial points like reproduction for couples who bear genetic diseases, prohibition of heterologous fertilization, cryoconservation of the embryos, obligation to perform just one and contemporaneous implant of all the embryos produced, are today definitively erased. This new situation is due to the jurisprudence of the Italian Courts but especially to the changes introduced by the European Court of Human Rights and by the questions of constitutionality raised by some Italian Courts. After analysis of the legislation, the views of various authors are compared, and the weaknesses and strong points of the law are considered from the point of view of legal medicine, science and bioethics. After ten years of operation of this law Italy has returned to a situation that existed before the law. In fact the old law was only full of prohibitions. Now is possible to do heterologous fertilization and this article photographs the current situation of hospitals for assisted procreation in Italy. The work also comments on procreative tourism, a direct consequence of this law, and on the status of women, who must be the subject and not the object of the legislation.

  1. 2014-2017. How medically assisted reproduction changed in Italy. A short comparative synthesis with European countries.

    Science.gov (United States)

    Malvasi, A; Signore, F; Napoletano, S; Bruti, V; Sestili, C; Di Luca, N M

    2017-01-01

    More than ten years after law n. 40 of February 19, 2004 became effective, regulation on medically assisted reproduction has dramatically changed outlook. The authors report on the steps that led to these changes through Courts' rulings, the Supreme Court's verdicts and the European Court of Human Rights' decisions, as well as ministerial regulations and guidelines concerning medically assisted reproduction. The aforementioned jurisprudential evolution was set to reach a new balance between the embryo's right to its own dignity and the woman's right to health and freedom of self-determination in reproduction. No court ruling denies that embryos have also to be safeguarded. In fact, there are still numerous prohibitions, including using embryos for experimental purposes. Judges aim primarily at avoiding that embryos' rights overcome the right to parenthood. The authors review the legislation of the various European countries: some have adopted a legislation to regulate medically assisted reproduction, while others have developed in this field some recommendations or guidelines. This is why they call for enactment of a European law governing the implementation/operational methods of medically assisted reproduction in order to avoid the scourge of procreative tourism to countries that have a more permissive law.

  2. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    Science.gov (United States)

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  3. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staffdagger

    NARCIS (Netherlands)

    Gameiro, S.; Boivin, J.; Dancet, E.; Klerk, C. de; Emery, M.; Lewis-Jones, C.; Thorn, P.; Broeck, U. Van den; Venetis, C.; Verhaak, C.M.; Wischmann, T.; Vermeulen, N.

    2015-01-01

    STUDY QUESTION: Based on the best available evidence in the literature, what is the optimal management of routine psychosocial care at infertility and medically assisted reproduction (MAR) clinics? SUMMARY ANSWER: Using the structured methodology of the Manual for the European Society of Human

  4. Risk of poor neonatal outcome at term after medically assisted reproduction: a propensity score-matched study

    NARCIS (Netherlands)

    Ensing, Sabine; Abu-Hanna, Ameen; Roseboom, Tessa J.; Repping, Sjoerd; van der Veen, Fulco; Mol, Ben Willem J.; Ravelli, Anita C. J.

    2015-01-01

    To study risk of birth asphyxia and related morbidity among term singletons born after medically assisted reproduction (MAR). Population cohort study. Not applicable. A total of 1,953,932 term singleton pregnancies selected from a national registry for 1999-2011. None. Primary outcome Apgar score

  5. Developing and Evaluating Medical Humanities Problem-Based Learning Classes Facilitated by the Teaching Assistants Majored in the Liberal Arts

    Science.gov (United States)

    Tseng, Fen-Yu; Shieh, Jeng-Yi; Kao, Tze-Wah; Wu, Chau-Chung; Chu, Tzong-Shinn; Chen, Yen-Yuan

    2016-01-01

    Abstract Although medical humanities courses taught by teachers from nonmedical backgrounds are not unusual now, few studies have compared the outcome of medical humanities courses facilitated by physicians to that by teaching assistants majored in the liberal arts. The objectives of this study were to (1) analyze the satisfaction of medical students with medical humanities problem-based learning (PBL) classes facilitated by nonmedical teaching assistants (TAF) majored in the liberal arts, and those facilitated by the attending physicians (APF) and (2) examine the satisfaction of medical students with clinical medicine-related and clinical medicine-unrelated medical humanities PBL classes. A total of 123 medical students, randomly assigned to 16 groups, participated in this study. There were 16 classes in the course: 8 of them were TAF classes; and the others were APF classes. Each week, each group rotated from 1 subject of the 16 subjects of PBL to another subject. All of the 16 groups went through all the 16 subjects in the 2013 spring semester. We examined the medical students’ satisfaction with each class, based on a rating score collected after each class was completed, using a scale from 0 (the lowest satisfaction) to 100 (the highest satisfaction). We also conducted multivariate linear regression analysis to examine the association between the independent variables and the students’ satisfaction. Medical students were more satisfied with the TAF (91.35 ± 7.75) medical humanities PBL classes than APF (90.40 ± 8.42) medical humanities PBL classes (P = 0.01). Moreover, medical students were more satisfied with the clinical medicine-unrelated topics (92.00 ± 7.10) than the clinical medicine-related topics (90.36 ± 7.99) in the medical humanities PBL course (P = 0.01). This medical humanities PBL course, including nonmedical subjects and topics, and nonmedical teaching assistants from the liberal arts as class facilitators, was

  6. Contemporary issues for experimental design in assessment of medical imaging and computer-assist systems

    Science.gov (United States)

    Wagner, Robert F.; Beiden, Sergey V.; Campbell, Gregory; Metz, Charles E.; Sacks, William M.

    2003-05-01

    The dialog among investigators in academia, industry, NIH, and the FDA has grown in recent years on topics of historic interest to attendees of these SPIE sub-conferences on Image Perception, Observer Performance, and Technology Assessment. Several of the most visible issues in this regard have been the emergence of digital mammography and modalities for computer-assisted detection and diagnosis in breast and lung imaging. These issues appear to be only the "tip of the iceberg" foreshadowing a number of emerging advances in imaging technology. So it is timely to make some general remarks looking back and looking ahead at the landscape (or seascape). The advances have been facilitated and documented in several forums. The major role of the SPIE Medical Imaging Conferences i well-known to all of us. Many of us were also present at the Medical Image Perception Society and co-sponsored by CDRH and NCI in September of 2001 at Airlie House, VA. The workshops and discussions held at that conference addressed some critical contemporary issues related to how society - and in particular industry and FDA - approach the general assessment problem. A great deal of inspiration for these discussions was also drawn from several workshops in recent years sponsored by the Biomedical Imaging Program of the National Cancer Institute on these issues, in particular the problem of "The Moving Target" of imaging technology. Another critical phenomenon deserving our attention is the fact that the Fourth National Forum on Biomedical Imaging in Oncology was recently held in Bethesda, MD., February 6-7, 2003. These forums are presented by the National Cancer Institute (NCI), the Food and Drug Administration (FDA), the Centers for Medicare and Medicaid Services (CMS), and the National Electrical Manufacturers Association (NEMA). They are sponsored by the National Institutes of Health/Foundation for Advanced Education in the Sciences (NIH/FAES). These forums led to the development of the NCI

  7. A comparison of physicians and medical assistants in interpreting verbal autopsy interviews for allocating cause of neonatal death in Matlab, Bangladesh: can medical assistants be considered an alternative to physicians?

    Science.gov (United States)

    2010-01-01

    Objective This study assessed the agreement between medical physicians in their interpretation of verbal autopsy (VA) interview data for identifying causes of neonatal deaths in rural Bangladesh. Methods The study was carried out in Matlab, a rural sub-district in eastern Bangladesh. Trained persons conducted the VA interview with the mother or another family member at the home of the deceased. Three physicians and a medical assistant independently reviewed the VA interviews to assign causes of death using the International Classification of Diseases - Tenth Revision (ICD-10) codes. A physician assigned cause was decided when at least two physicians agreed on a cause of death. Cause-specific mortality fraction (CSMF), kappa (k) statistic, sensitivity, specificity, and positive predictive values were applied to compare agreement between the reviewers. Results Of the 365 neonatal deaths reviewed, agreement on a direct cause of death was reached by at least two physicians in 339 (93%) of cases. Physician and medical assistant reviews of causes of death demonstrated the following levels of diagnostic agreement for the main causes of deaths: for birth asphyxia the sensitivity was 84%, specificity 93%, and kappa 0.77. For prematurity/low birth weight, the sensitivity, specificity, and kappa statistics were, respectively, 53%, 96%, and 0.55, for sepsis/meningitis they were 48%, 98%, and 0.53, and for pneumonia they were 75%, 94%, and 0.51. Conclusion This study revealed a moderate to strong agreement between physician- assigned and medical assistant- assigned major causes of neonatal death. A well-trained medical assistant could be considered an alternative for assigning major causes of neonatal deaths in rural Bangladesh and in similar settings where physicians are scarce and their time costs more. A validation study with medically confirmed diagnosis will improve the performance of VA for assigning cause of neonatal death. PMID:20712906

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

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    Keifenheim, Katharina Eva

    2017-08-01

    Full Text Available Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups.Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students’ self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students’ most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients’ emotional demands appropriately. By the end of the course, students’ self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student–patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.

  9. Assistência psicológica ao estudante de medicina: 21 anos de experiência Psychological assistance to medical students: 21 years of experience

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    Luiz Roberto Millan

    2008-02-01

    Full Text Available Este artigo tem como objetivo relatar a experiência de 21 anos do Grupo de Assistência Psicológica ao Aluno da Faculdade de Medicina da Universidade de São Paulo (GRAPAL. Inicialmente, é apresentada, de forma sucinta, uma introdução acerca do histórico da assistência psicológica ao estudante de medicina, seguida da criação do GRAPAL, em 1983, e do início de suas atividades, em 1986. São apresentados os principais motivos da procura psicológica pelos alunos, os obstáculos encontrados por parte da instituição, da equipe de trabalho e dos alunos. A seguir, são apresentados alguns trabalhos publicados pelo serviço, que abordam a personalidade do aluno de medicina, a escolha da profissão e o problema do suicídio. Finalmente, são apresentadas sugestões feitas pelos alunos para o aperfeiçoamento dos atendimentos e as providências tomadas pela equipe do GRAPAL para alcançar a realização destas sugestões.The purpose of this article is to report on the 21-year experience of the Group of Psychological Assistance to Students at the School of Medicine of the São Paulo University (GRAPAL. First, the authors briefly introduce historical aspects of the psychological assistance provided to medical students, followed by the organization of GRAPAL in 1983 and the beginning of activities in 1986. Major reasons for medical students to seek psychological assistance, obstacles found by the institution, the work team and students are presented. Then, several works published by the Service, which approach the personality traits of medical students, their choice for Medicine and the suicide problem, are listed. Finally, the authors present some suggestions made by students to improve assistance services and measures to be taken by the GRAPAL team to carry out such suggestions.

  10. Social-economic profile of asthmatic patients assisted at a Nucleus of Integrated Medical Assistance - doi:10.5020/18061230.2008.p180

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    Anisia Torquilho Praxedes

    2012-01-01

    Full Text Available Objective: To determine the social-economic profile of asthmatic patients who use the health services rendered by the Nucleus of Integrated Medical Assistance (NAMI, in Fortaleza- Ce. Methods: This descriptive, retrospective and cross-sectional study, of a quantitative approach, had a sample comprised by 40 asthmatic patients assisted at NAMI during the period of April to May, 2006. The data collection was accomplished by means of a standard semi-structured interview, with open and closed questions. Results: The age range between 0 to 5 years old represented the greater percentage of patients, thus obtaining 60.0% of the answered questionnaires. According to social-economic conditions, 55.0% were illiterate or were learning to read, 75.0% were using some drug prescribed at NAMI, 72.5% fully ignored the disease, 52.5% recognized the factors that triggered the asthmatic crisis and 55.0% said having often crisis. Seventy per cent (70.0% of the interviewed showed some difficulty related to the use of the drugs; 47.5% referred having different problems related to the access to the medications. Conclusion: By the analysis of the determined social-economic profile of asthmatics patients assisted at NAMI, it is concluded that great part of them are people with little instruction, due to the social exclusion in which they are found; being the majority of them children of female gender. NCT00722657

  11. Medical Assistance in Dying in Canada: An Ethical Analysis of Conscientious and Religious Objections

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    Christie, Timothy

    2016-08-01

    Full Text Available Background: The Supreme Court of Canada (SCC has ruled that the federal government is required to remove the provisions of the Criminal Code of Canada that prohibit medical assistance in dying (MAID. The SCC has stipulated that individual physicians will not be required to provide MAID should they have a religious or conscientious objection. Therefore, the pending legislative response will have to balance the rights of the patients with the rights of physicians, other health care professionals, and objecting institutions. Objective: The objective of this paper is to critically assess, within the Canadian context, the moral probity of individual or institutional objections to MAID that are for either religious or conscientious reasons. Methods: Deontological ethics and the Doctrine of Double Effect. Results: The religious or conscientious objector has conflicting duties, i.e., a duty to respect the “right to life” (section 7 of the Charter and a duty to respect the tenets of his or her religious or conscientious beliefs (protected by section 2 of the Charter. Conclusion: The discussion of religious or conscientious objections to MAID has not explicitly considered the competing duties of the conscientious objector. It has focussed on the fact that a conscientious objection exists and has ignored the normative question of whether the duty to respect one’s conscience or religion supersedes the duty to respect the patient’s right to life.

  12. Heroin refusal self-efficacy and preference for medication-assisted treatment after inpatient detoxification.

    Science.gov (United States)

    Kenney, Shannon R; Bailey, Genie L; Anderson, Bradley J; Stein, Michael D

    2017-10-01

    An individual's self-efficacy to refuse using heroin in high-risk situations is believed to minimize the likelihood for relapse. However, among individuals completing inpatient heroin detoxification, perceived refusal self-efficacy may also reduce one's perceived need for medication-assisted treatment (MAT), an effective and recommended treatment for opioid use disorder. In the current study, we examined the relationship between heroin refusal self-efficacy and preference for MAT following inpatient detoxification. Participants (N=397) were interviewed at the start of brief inpatient opioid detoxification. Multiple logistic regression was used to estimate the adjusted association of background characteristics, depressed mood, and perceived heroin refusal self-efficacy with preference for MAT. Controlling for other covariates, depressed mood and lower perceived refusal self-efficacy were associated with a significantly greater likelihood of expressing preference for MAT (versus no MAT). Perceived ability to refuse heroin after leaving detox is inversely associated with a heroin user's desire for MAT. An effective continuum of care model may benefit from greater attention to patient's perceived refusal self-efficacy during detoxification which may impact preference for MAT and long-term recovery. Copyright © 2017. Published by Elsevier Ltd.

  13. How psychosocial factors affect well-being of practice assistants at work in general medical care?--a questionnaire survey.

    Science.gov (United States)

    Goetz, Katja; Berger, Sarah; Gavartina, Amina; Zaroti, Stavria; Szecsenyi, Joachim

    2015-11-11

    Well-being at work is an important aspect of a workforce strategy. The aim of the study was to explore and evaluate psychosocial factors and health and work-related outcomes of practices assistants depending on their employment status in general medical practices. This observational study was based on a questionnaire survey to evaluate psychosocial aspects at work in general medical practices. A standardized questionnaire was used, the Copenhagen Psychosocial Questionnaire (COPSOQ). Beside descriptive analyses linear regression analyses were performed for each health and work-related outcome scale of the COPSOQ. 586 practice assistants out of 794 respondents (73.8 %) from 234 general medical practices completed the questionnaire. Practice assistants reported the highest scores for the psychosocial factor 'sense of community' (mean = 85.9) and the lower score for 'influence at work' (mean = 41.2). Moreover, practice assistants who worked part-time rated their psychosocial factors at work and health-related outcomes more positively than full-time employees. Furthermore, the two scales of health related outcomes 'burnout' and 'job satisfaction' showed strong associations between different psychosocial factors and socio-demographic variables. Psychosocial factors at work influence well-being at work and could be strong risk factors for poor health and work-related outcomes. Effective management of these issues could have an impact on the retention and recruitment of health care staff.

  14. Italian law on medically assisted reproduction: do women's autonomy and health matter?

    Science.gov (United States)

    Riezzo, Irene; Neri, Margherita; Bello, Stefania; Pomara, Cristoforo; Turillazzi, Emanuela

    2016-07-23

    In Italy in 2004, a very restrictive law was passed on medically assisted reproduction (MAR) (Law 40/2004) that placed Italy at the most conservative end of the European spectrum. The law was widely criticized and many couples seeking MAR brought their cases before the Italian Civil Courts with regard to pre-implantation genetic diagnosis (PGD), donor insemination and the issue of consent. Ten years on, having suffered the blows of the Italian Constitutional Court, little remains of law 40/2004. In 2009, the Constitutional Court declared the maximum limit of the number of embryos to be produced and transferred for each cycle (i.e. three), as stated in the original version of the law, to be constitutionally illegitimate. In 2014, the same Court declared as unconstitutional the ban on donor insemination, thus opening the way to heterologous assisted reproduction. Heterologous MAR is therefore perfectly legitimate in Italy. Finally, in 2015 a further ruling by the Constitutional Court granted the right to access MAR to couples who are fertile but carriers of genetic diseases. However, there is still much room for criticism. Many couples and groups are still, in fact, excluded from MAR. Same-sex couples, single women and those of advanced reproductive age are, at the present time, discriminated against in that Italian law denies these subjects access to MAR. The history of Law 40/2004 has been a particularly troubled one. Numerous rulings have, over the years, dismantled much of a law constructed in violation of the rights and autonomy of women and couples. However, a number of troubling issues still exist from what is left of the law and the debate is still open at national and transnational level regarding some of the contradictions and gaps in the law highlighted in this article. Only by abolishing the final prohibitions and adopting more liberal views on these controversial yet crucial issues will Law 40/2004 become what it should have been from the start, i.e. a

  15. Men Who Have Sex With Men in Peru: Acceptability of Medication-Assisted Therapy for Treating Alcohol Use Disorders.

    Science.gov (United States)

    Brown, Shan-Estelle; Vagenas, Panagiotis; Konda, Kelika A; Clark, Jesse L; Lama, Javier R; Gonzales, Pedro; Sanchez, Jorge; Duerr, Ann C; Altice, Frederick L

    2017-07-01

    In Peru, the HIV epidemic is concentrated in men who have sex with men (MSM) and transgender women (TGW). Multiple studies correlate alcohol use disorders (AUDs) with risky sexual behaviors among Peruvian MSM. Qualitative research was used to inform a clinical trial on the acceptability of medication-assisted therapies to assist management of AUDs and improve antiretroviral therapy (ART) adherence among MSM/TGW in Peru. Three focus groups involving HIV-infected or HIV-uninfected MSM/TGW ( n = 26) with AUDs (AUDIT ≥ 8) were transcribed, translated from Spanish into English, and analyzed using thematic content analysis. Despite having an AUD, participants considered themselves "social" drinkers, minimized their drinking behaviors, and differed about whether or not alcohol problems could be treated. Participants expressed skepticism about medication for treating AUDs. Three concepts emerged as necessary components of a treatment program for alcohol problems: cost, family support, and the potential to drink less alcohol without attaining total abstinence. This study reveals important areas of education to increase potential acceptability of a medication for treating AUDs among MSM/TGW. Given the social conditions and knowledge base of the participants, medication-assisted therapies using naltrexone may be a beneficial strategy for MSM with AUDs.

  16. Same-level peer-assisted learning in medical clinical placements: a narrative systematic review.

    Science.gov (United States)

    Tai, Joanna; Molloy, Elizabeth; Haines, Terry; Canny, Benedict

    2016-04-01

    Peer-assisted learning (PAL) is increasingly used in medical education, and the benefits of this approach have been reported. Previous reviews have focused on the benefits of peer tutoring of junior students by senior students. Forms of PAL such as discussion groups and role-playing have been neglected, as have alternative teacher-learner configurations (e.g. same-level PAL) and the effects on other stakeholders, including clinician educators and patients. This review examines the benefits of same-level PAL for students, clinician educators and patients in pre-registration clinical medical education. Medline, PsycINFO, CINAHL and ERIC were searched in March 2014. A total of 1228 abstracts were retrieved for review; 64 full-text papers were assessed. Data were extracted from empirical studies describing a same-level PAL initiative in a clinical setting, focusing on effects beyond academic performance and student satisfaction. Qualitative thematic analysis was employed to identify types of PAL and to cluster the reported PAL effects. Forty-three studies were included in the review. PAL activities were categorised into role-play, discussion, teaching and assessment. Only 50% of studies reported information beyond self-report and satisfaction with the PAL intervention. Benefits for students (including development of communication and professional skills) and clinician educators (developing less-used facilitation skills) were reported. Direct patient outcomes were not identified. Caveats to the use of PAL emerged, and guidelines for the use of PAL were perceived as useful. Many student-related benefits of PAL were identified. PAL contributes to the development of crucial skills required for a doctor in the workplace. Vertical integration of learning and teaching skills across the curriculum and tools such as feedback checklists may be required for successful PAL in the clinical environment. Benefits for patients and educators were poorly characterised within the

  17. Defining of medical and psychological assistance volume to women with physiological pregnancy

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    O. Bozhuk

    2015-05-01

    Summary. Mother and prenate are in close symbiotic relationship, which manifests itself in the interaction at physiological and psychological levels of organisms’ functioning. Reflexive accepting yourself as a pregnant woman depends also on the the motives of conception, planed / not planed parenthood, social situation and level of psychological and social support. The aim of the research is to determine the volume and structure of medical and psychological assistance. The research was conducted in maternity hospital prenatal consultation centre of Chernihiv City Council and Municipal nonprofit company "Consultation and Diagnostic Center" of Golosiivsky district in Kyiv in 2010-2014. The research involved 185 pregnant women whose age ranged from 17 to 36 years old (group 1 μ = 25,5 ± 0,27, group 2 -μ = 24,8 ± 0,27. Women of group 1 show some fear of future childbirth, which applies to both the woman herself and the unborn child. The course of psychological education was developed for women of group 1, which included not only the educational part regarding the physiology of pregnancy and childbirth, postpartum, etc. but also the part aimed at reducing anxiety and overcoming identified fears. For the women of group 2 psychological influence is required in all researched spheres (personal, psycho-social, psycho-emotional and reproductive if the fear of future birth is present and vivid. According to conducted research for women of group 2 there were found the next targets of psycho-therapeutic influence which have been taken into account when developing the course of psycho- correction: to normalize psycho-emotional state of the pregnant woman, to reduce anxiety level; to work with identified fears; to normalize emotional relation in the dyad "prenate - mother" and creating the triad "father-mother-prenate"; to normalize family relations and to construct optimal types of family systems; to harmonize personal traits of the pregnant woman. Based on the results of

  18. Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

    Science.gov (United States)

    Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

    2018-05-15

    MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

  19. Rapid access to information resources in clinical biochemistry: medical applications of Personal Digital Assistants (PDA).

    Science.gov (United States)

    Serdar, Muhittin A; Turan, Mustafa; Cihan, Murat

    2008-06-01

    Laboratory specialists currently need to access scientific-based information at anytime and anywhere. A considerable period of time and too much effort are required to access this information through existing accumulated data. Personal digital assistants (PDA) are supposed to provide an effective solution with commercial software for this problem. In this study, 11 commercial software products (UpToDate, ePocrates, Inforetrive, Pepid, eMedicine, FIRST Consult, and 5 laboratory e-books released by Skyscape and/or Isilo) were selected and the benefits of their use were evaluated by seven laboratory specialists. The assessment of the software was performed based on the number of the tests included, the software content of detailed information for each test-like process, method, interpretation of results, reference ranges, critical values, interferences, equations, pathophysiology, supplementary technical details such as sample collection principles, and additional information such as linked references, evidence-based data, test cost, etc. In terms of technique, the following items are considered: the amount of memory required to run the software, the graphical user interface, which is a user-friendly instrument, and the frequency of new and/or up-date releases. There is still no perfect program, as we have anticipated. Interpretation of laboratory results may require software with an integrated program. However, methodological data are mostly not included in the software evaluated. It seems that these shortcomings will be fixed in the near future, and PDAs and relevant medical applications will also become indispensable for all physicians including laboratory specialists in the field of training/education and in patient care.

  20. State-Targeted Funding and Technical Assistance to Increase Access to Medication Treatment for Opioid Use Disorder.

    Science.gov (United States)

    Abraham, Amanda J; Andrews, Christina M; Grogan, Colleen M; Pollack, Harold A; D'Aunno, Thomas; Humphreys, Keith; Friedmann, Peter D

    2018-04-01

    As the United States grapples with an opioid epidemic, expanding access to effective treatment for opioid use disorder is a major public health priority. Identifying effective policy tools that can be used to expand access to care is critically important. This article examines the relationship between state-targeted funding and technical assistance and adoption of three medications for treating opioid use disorder: oral naltrexone, injectable naltrexone, and buprenorphine. This study draws from the 2013-2014 wave of the National Drug Abuse Treatment System Survey, a nationally representative, longitudinal study of substance use disorder treatment programs. The sample includes data from 695 treatment programs (85.5% response rate) and representatives from single-state agencies in 49 states and Washington, D.C. (98% response rate). Logistic regression was used to examine the relationships of single-state agency targeted funding and technical assistance to availability of opioid use disorder medications among treatment programs. State-targeted funding was associated with increased program-level adoption of oral naltrexone (adjusted odds ratio [AOR]=3.14, 95% confidence interval [CI]=1.49-6.60, p=.004) and buprenorphine (AOR=2.47, 95% CI=1.31-4.67, p=.006). Buprenorphine adoption was also correlated with state technical assistance to support medication provision (AOR=1.18, 95% CI=1.00-1.39, p=.049). State-targeted funding for medications may be a viable policy lever for increasing access to opioid use disorder medications. Given the historically low rates of opioid use disorder medication adoption in treatment programs, single-state agency targeted funding is a potentially important tool to reduce mortality and morbidity associated with opioid disorders and misuse.

  1. Problematic use of social network sites: the interactive relationship between gratifications sought and privacy concerns.

    Science.gov (United States)

    Chen, Hsuan-Ting; Kim, Yonghwan

    2013-11-01

    Problematic Internet use has long been a matter of concern; however, few studies extend this line of research from general Internet use to the use of social network sites (SNSs), or explicate the problematic use of SNSs by understanding what factors may enhance or reduce users' compulsive behaviors and excessive form of use on SNSs. Building on literature that found a positive relationship between gratifications sought from the Internet and problematic Internet use, this study first explores the types of gratifications sought from SNSs and examines their relationship with problematic SNS use. It found that three types of gratifications-diversion, self-presentation, and relationship building-were positively related to problematic SNS use. In addition, with a growing body of research on SNS privacy, a moderating role of privacy concerns on SNSs has been proposed to understand how it can influence the relationship between gratifications sought from SNSs and problematic SNS use. The findings suggest that different subdimensions of privacy concerns interact with gratifications sought in different manners. In other words, privacy concerns, including unauthorized secondary use and improper access, play a more influential role in constraining the positive relationship between gratifications sought and problematic SNS use when individuals seek to build relationships on SNSs. However, if individuals seek to have diversion on SNSs, their privacy concerns will be overridden by their gratifications sought, which in turn leads to problematic SNS use. Implications of these findings for future research are discussed.

  2. Attitudes toward euthanasia, assisted suicide and termination of life-sustaining treatment of Puerto Rican medical students, medical residents, and faculty.

    Science.gov (United States)

    Ramirez Rivera, J; Rodríguez, R; Otero Igaravidez, Y

    2000-01-01

    To elicit the opinion of Puerto Rican medical students, residents and internal medicine faculty as to the appropriateness of euthanasia and physician-assisted suicide and end-of-life management. Survey using a 16-item questionnaire answered within a two-month period in the fall of 1996. Rounds or faculty meetings at teaching hospitals located in the north, south and southwest of the island of Puerto Rico. There were 424 participants. The questionnaires of 279 medical students, 75 medical residents, and 35 internal medicine faculty members were analyzed. Thirty-five questionnaires, which were incomplete or answered by non-Puerto Rican participants, were excluded. Frequency of support of active euthanasia, physician-assisted suicide, withholding or withdrawing life-sustaining treatment with informed consent was determined. Whether it was ethical to prescribe full doses of drugs needed to alleviate pain even if it would hasten death, or agree to limit or restrict resources for the terminally ill was also determined. Forty per cent of the students, 33% of the residents, and 20% of the faculty supported euthanasia. If physician-assisted suicide were legalized, 50 per cent of the students, 43 per cent of the residents and 45 percent of the faculty would not be opposed to it. Sixty-eight per cent of the students, 67 per cent of the residents and 88 per cent of the faculty would support withholding or withdrawing life-sustaining treatment for dying patients with informed consent. Seventy-nine per cent of residents, 80 per cent of the faculty but only 54 per cent of medical students would prescribe full doses of drugs needed to alleviate pain in dying patients even if they would hasten death. Thirty-six per cent of the residents and faculty would agree to limit the use of medical resources for the terminally ill but only sixteen per cent of medical students would do so. The acceptance of euthanasia was inversely proportional to the clinical experience of the respondents: 40

  3. [Assisted suicide in Germany: medical diagnoses and personal reasons of 117 decedents].

    Science.gov (United States)

    Bruns, F; Blumenthal, S; Hohendorf, G

    2016-02-01

    In Germany both scientific and public debates on physician assisted suicide often focus on patients with unbearable suffering in terminal condition. Proponents of physician assisted suicide bring forward the argument that there are end-of-life situations where only assisted suicide can bring relief from intolerable pain, dyspnea or other symptoms. But does focusing on unbearable symptoms in terminal condition reflect the reality of assisted suicide? Our data from 117 assisted suicides in Germany indicates that the reasons for assisted suicide are more complex than the current debate in Germany suggests. We analyzed diagnoses and reasons that prompted patients to suicide with the help of the German right-to-die organization "Sterbehilfe Deutschland" (StHD) between 2010 and 2013. 118 case reports of assisted suicide published by StHD were evaluated retrospectively. Between 2010 and 2013 StHD provided assistance in 118 suicides. 71 % of the deceased were women. 67 % were aged 70 years or older. 25,6 % suffered from metastasized cancer, 20,5 % had a severe neurological disease. 23 % suffered from age-associated diseases or disability. 14,5 % of the decedents had a predominant psychiatric diagnose, 7,7 % were physically and mentally healthy. The main reasons for suicide were loss of life perspective in the face of a severe disease (29 %), fear of care dependency (23,9 %), weariness of life without any severe disease (20,5 %). Only 12,8 % named non-treatable symptoms as a reason. Loss of life perspective in the face of a severe disease, fear of long-term care and weariness of life without any severe disease rather than unbearable suffering of non-treatable symptoms seem to be the most common reasons for members of StHD to commit suicide. These empirical findings should be mentioned in future debates on assisted suicide in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

  4. [Effective Techniques to Reduce Radiation Exposure to Medical Staff during Assist of X-ray Computed Tomography Examination].

    Science.gov (United States)

    Miyajima, Ryuichi; Fujibuchi, Toshioh; Miyachi, Yusuke; Tateishi, Satoshi; Uno, Yoshinori; Amakawa, Kazutoshi; Ohura, Hiroki; Orita, Shinichi

    2018-01-01

    Medical staffs like radiological technologists, doctors, and nurses are at an increased risk of exposure to radiation while assisting the patient in a position or monitor contrast medium injection during computed tomography (CT). However, methods to protect medical staff from radiation exposure and protocols for using radiological protection equipment have not been standardized and differ among hospitals. In this study, the distribution of scattered X-rays in a CT room was measured by placing electronic personal dosimeters in locations where medical staff stands beside the CT scanner gantry while assisting the patient and the exposure dose was measured. Moreover, we evaluated non-uniform exposure and revealed effective techniques to reduce the exposure dose to medical staff during CT. The dose of the scattered X-rays was the lowest at the gantry and at the examination table during both head and abdominal CT. The dose was the highest at the trunk of the upper body of the operator corresponding to a height of 130 cm during head CT and at the head corresponding to a height of 150 cm during abdominal CT. The maximum dose to the crystalline lens was approximately 600 μSv during head CT. We found that the use of volumetric CT scanning and X-ray protective goggles, and face direction toward the gantry reduced the exposure dose, particularly to the crystalline lens, for which lower equivalent dose during CT scan has been recently recommended in the International Commission on Radiological Protection Publication 118.

  5. Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature

    OpenAIRE

    Wong, Kam Cheong

    2011-01-01

    Abstract Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries. In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learni...

  6. Down syndrome screening in assisted conception twins: an iatrogenic medical challenge.

    Science.gov (United States)

    Ben-Ami, Ido; Maymon, Ron; Svirsky, Ran; Cuckle, Howard; Jauniaux, Eric

    2013-11-01

    The objective of this study was to provide a critical analysis of the impact of assisted conception on prenatal screening for Down syndrome (DS) in twin pregnancies and the value of various screening modalities for early detection of anomalies. The literature was searched using PubMed and the Cochrane Library focusing on prenatal screening and antenatal care of assisted-conception twin pregnancies. Serum screening alone is of limited value in detecting aneuploid twins, because the unaffected cotwin can "mask" the abnormal serum results of an affected one. In addition, this test can designate the pregnancy as at high risk but not identify the affected fetus. Nuchal translucency (NT) screening is the best available modality and a highly effective screening method for twin pregnancies. Among twins, NT alone has a 69% DS detection rate, first-trimester combined NT and serum biochemistry has a 72% DS detection rate, and an integrated screen will have an 80% DS detection rate at a 5% FPR. The data in the literature concerning the effect of assisted conception on maternal serum screening markers in twin pregnancies are scarce. Down syndrome screening in assisted-conception twins presents clinical and technical challenges. Therefore, assisted-conception twins need close monitoring from conception to delivery, by a practitioner familiar with the available screening modalities and their relative accuracy.

  7. Improved Medical Student Perception of Ultrasound Using a Paired Anatomy Teaching Assistant and Clinician Teaching Model

    Science.gov (United States)

    Smith, Jacob P.; Kendall, John L.; Royer, Danielle F.

    2018-01-01

    This study describes a new teaching model for ultrasound (US) training, and evaluates its effect on medical student attitudes toward US. First year medical students participated in hands-on US during human gross anatomy (2014 N = 183; 2015 N = 182). The sessions were facilitated by clinicians alone in 2014, and by anatomy teaching assistant…

  8. 6 CFR 5.45 - Procedure when testimony or production of documents is sought; general.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Procedure when testimony or production of... Procedure when testimony or production of documents is sought; general. (a) If official information is... requiring oral testimony, and identification of potentially relevant documents. (c) The appropriate...

  9. The Characteristics Sought by Public School Leaders of Applicants for Teaching Positions

    Science.gov (United States)

    Stultz, Sherry L.

    2015-01-01

    This study examined the characteristics of teacher applicants that are sought by public school systems in the Commonwealth of Kentucky. The Superintendents of each of the public school districts in the Commonwealth were surveyed. A total of 99 respondents completed the survey (n = 99). This response rate of 57.2% was well-above the average for…

  10. Necessity for Having a Medical Assistant in the Processes for the Success of the Hospital Information Systems

    Directory of Open Access Journals (Sweden)

    Harun Dumantepe

    2016-06-01

    Full Text Available In order to realize the objectives of the organization, first of all, they are required to have a healthy structure and process. Gaining competitive advantage by a health care facility should be managed with scientific methods in addition to providing good service. Accurate, reliable and prompt data entry in the information systems is under the responsibility of the medical personnel in the health institutions. This process causes heavy burden for doctors who work very busy and results in delays. It also causes completion time of works to increase and sometimes causes works not to be completed, economic losses, cause employee dissatisfaction and even losses of patients. This study will focus on the need of medical assistant in the success of Hospital Information System. The conceptual framework was created in this context, literature search was made and process improvement example was presented for an IVF embryology laboratory process.

  11. Computerized Decision Support Improves Medication Review Effectiveness : An Experiment Evaluating the STRIP Assistant's Usability

    NARCIS (Netherlands)

    Meulendijk, Michiel C; Spruit, Marco R; Drenth-van Maanen, A Clara; Numans, Mattijs E; Brinkkemper, Sjaak; Jansen, Paul A F; Knol, Wilma

    BACKGROUND: Polypharmacy poses threats to patients' health. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) is a drug optimization process for conducting medication reviews in primary care. To effectively and efficiently incorporate this method into daily practice, the STRIP

  12. Humanitarian and medical challenges of assisting new refugees in Lebanon and Iraq

    Directory of Open Access Journals (Sweden)

    Caroline Abu Sa’Da

    2013-09-01

    Full Text Available The massive and continuing flows of Syrian and Palestinian refugees to Syria’s neighbours have shown the limitations of humanitarian practice and present new challenges for medical and humanitarian interventions.

  13. Computer-assisted learning in anatomy at the international medical school in Debrecen, Hungary: a preliminary report.

    Science.gov (United States)

    Kish, Gary; Cook, Samuel A; Kis, Gréta

    2013-01-01

    The University of Debrecen's Faculty of Medicine has an international, multilingual student population with anatomy courses taught in English to all but Hungarian students. An elective computer-assisted gross anatomy course, the Computer Human Anatomy (CHA), has been taught in English at the Anatomy Department since 2008. This course focuses on an introduction to anatomical digital images along with clinical cases. This low-budget course has a large visual component using images from magnetic resonance imaging and computer axial tomogram scans, ultrasound clinical studies, and readily available anatomy software that presents topics which run in parallel to the university's core anatomy curriculum. From the combined computer images and CHA lecture information, students are asked to solve computer-based clinical anatomy problems in the CHA computer laboratory. A statistical comparison was undertaken of core anatomy oral examination performances of English program first-year medical students who took the elective CHA course and those who did not in the three academic years 2007-2008, 2008-2009, and 2009-2010. The results of this study indicate that the CHA-enrolled students improved their performance on required anatomy core curriculum oral examinations (P computer-assisted learning may play an active role in anatomy curriculum improvement. These preliminary results have prompted ongoing evaluation of what specific aspects of CHA are valuable and which students benefit from computer-assisted learning in a multilingual and diverse cultural environment. Copyright © 2012 American Association of Anatomists.

  14. Predicting help-seeking behavior: The impact of knowing someone close who has sought help.

    Science.gov (United States)

    Disabato, David J; Short, Jerome L; Lameira, Diane M; Bagley, Karen D; Wong, Stephanie J

    2018-02-15

    This study sought to replicate and extend research on social facilitators of college student's help seeking for psychological problems. We collected data on 420 ethnically diverse college students at a large public university (September 2008-May 2010). Students completed a cross-sectional online survey. We found that students who were aware of close others' (eg, family, friends) help seeking were two times more likely to have sought formal (eg, psychologist) and informal (eg, clergy) help themselves. Tests of moderation revealed the incremental effect (ie, controlling for help-seeking attitudes, internalizing symptoms, cultural demographics) of close others' formal help seeking was strong and significant for men (R 2 = 0.112), while it was negligible and nonsignificant for women (R 2 = .002). We discuss the importance for students-particularly men-to learn about close others' help seeking for facilitating their own help seeking during times of distress.

  15. Patient-centred care: using online personal medical records in IVF practice.

    NARCIS (Netherlands)

    Tuil, W.S.; Hoopen, A.J. ten; Braat, D.D.M.; Vries Robbé, P.F. de; Kremer, J.A.M.

    2006-01-01

    BACKGROUND: Generic patient-accessible medical records have shown promise in enhancing patient-centred care for patients with chronic diseases. We sought to design, implement and evaluate a patient-accessible medical record specifically for patients undergoing a course of assisted reproduction (IVF

  16. Building Partner Capacity and Strengthening Security Through Medical Security Force Assistance

    Science.gov (United States)

    2013-06-01

    initially .”..hailed by some as a creation as important to the theoretical development of the social sciences as the calculus had been to the...particularly medical and dental care, can have the unintended consequence of decreasing the population’s confidence in the

  17. 16th International Conference on Medical Image Computing and Computer Assisted Intervention

    CERN Document Server

    Klinder, Tobias; Li, Shuo

    2014-01-01

    This book contains the full papers presented at the MICCAI 2013 workshop Computational Methods and Clinical Applications for Spine Imaging. The workshop brought together researchers representing several fields, such as Biomechanics, Engineering, Medicine, Mathematics, Physics and Statistic. The works included in this book present and discuss new trends in those fields, using several methods and techniques in order to address more efficiently different and timely applications involving signal and image acquisition, image processing and analysis, image segmentation, image registration and fusion, computer simulation, image based modelling, simulation and surgical planning, image guided robot assisted surgical and image based diagnosis.

  18. 76 FR 2625 - Comment Sought on 2010 Review of Hearing Aid Compatibility Regulations

    Science.gov (United States)

    2011-01-14

    ... process; Accounting for technological feasibility and marketability in the Commission's rules pertaining... in existence or on the horizon, that may assist people with hearing loss in using wireless technology...

  19. Medication assisted treatment in US drug courts: results from a nationwide survey of availability, barriers and attitudes.

    Science.gov (United States)

    Matusow, Harlan; Dickman, Samuel L; Rich, Josiah D; Fong, Chunki; Dumont, Dora M; Hardin, Carolyn; Marlowe, Douglas; Rosenblum, Andrew

    2013-01-01

    Drug treatment courts are an increasingly important tool in reducing the census of those incarcerated for non-violent drug offenses; medication assisted treatment (MAT) is proven to be an effective treatment for opioid addiction. However, little is known about the availability of and barriers to MAT provision for opioid-addicted people under drug court jurisdiction. Using an online survey, we assessed availability, barriers, and need for MAT (especially agonist medication) for opioid addiction in drug courts. Ninety-eight percent reported opioid-addicted participants, and 47% offered agonist medication (56% for all MAT including naltrexone). Barriers included cost and court policy. Responses revealed significant uncertainty, especially among non-MAT providing courts. Political, judicial and administrative opposition appear to affect MAT's inconsistent use and availability in drug court settings. These data suggest that a substantial, targeted educational initiative is needed to increase awareness of the treatment and criminal justice benefits of MAT in the drug courts. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. The debate about physician assistance in dying: 40 years of unrivalled progress in medical ethics?

    Science.gov (United States)

    Holm, Søren

    2015-01-01

    Some issues in medical ethics have been present throughout the history of medicine, and thus provide us with an opportunity to ascertain: (1) whether there is progress in medical ethics; and (2) what it means to do good medical ethics. One such perennial issue is physician assistance in dying (PAD). This paper provides an account of the PAD debate in this journal over the last 40 years. It concludes that there is some (but limited) progress in the debate. The distinctions, analogies and hypothetical examples have proliferated, as have empirical studies, but very little has changed in terms of the basic arguments. The paper further argues that many of the contributions to the debate fail to engage fully with the concerns people have about the legal introduction of PAD in the healthcare system, perhaps because many of the contributions sit on the borderline between academic analysis and social activism. 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.

  1. iContraception(®): a software tool to assist professionals in choosing contraceptive methods according to WHO medical eligibility criteria.

    Science.gov (United States)

    Lopez, Ramón Guisado; Polo, Isabel Ramirez; Berral, Jose Eduardo Arjona; Fernandez, Julia Guisado; Castelo-Branco, Camil

    2015-04-01

    To design software to assist health care providers with contraceptive counselling. The Model-View-Controller software architecture pattern was used. Decision logic was incorporated to automatically compute the safety category of each contraceptive option. Decisions are made according to the specific characteristics or known medical conditions of each potential contraception user. The software is an app designed for the iOS and Android platforms and is available in four languages. iContraception(®) facilitates presentation of visual data on medical eligibility criteria for contraceptive treatments. The use of this software was evaluated by a sample of 54 health care providers. The general satisfaction with the use of the app was over 8 on a 0-10 visual analogue scale in 96.3% of cases. iContraception provides easy access to medical eligibility criteria of contraceptive options and may help with contraceptive counselling. 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.

  2. Breaking the language barrier: machine assisted diagnosis using the medical speech translator.

    Science.gov (United States)

    Starlander, Marianne; Bouillon, Pierrette; Rayner, Manny; Chatzichrisafis, Nikos; Hockey, Beth Ann; Isahara, Hitoshi; Kanzaki, Kyoko; Nakao, Yukie; Santaholma, Marianne

    2005-01-01

    In this paper, we describe and evaluate an Open Source medical speech translation system (MedSLT) intended for safety-critical applications. The aim of this system is to eliminate the language barriers in emergency situation. It translates spoken questions from English into French, Japanese and Finnish in three medical subdomains (headache, chest pain and abdominal pain), using a vocabulary of about 250-400 words per sub-domain. The architecture is a compromise between fixed-phrase translation on one hand and complex linguistically-based systems on the other. Recognition is guided by a Context Free Grammar Language Model compiled from a general unification grammar, automatically specialised for the domain. We present an evaluation of this initial prototype that shows the advantages of this grammar-based approach for this particular translation task in term of both reliability and use.

  3. Wireless Sensors Grouping Proofs for Medical Care and Ambient Assisted-Living Deployment.

    Science.gov (United States)

    Trček, Denis

    2016-01-02

    Internet of Things (IoT) devices are rapidly penetrating e-health and assisted living domains, and an increasing proportion among them goes on the account of computationally-weak devices, where security and privacy provisioning alone are demanding tasks, not to mention grouping proofs. This paper, therefore, gives an extensive analysis of such proofs and states lessons learnt to avoid possible pitfalls in future designs. It sticks with prudent engineering techniques in this field and deploys in a novel way the so called non-deterministic principle to provide not only grouping proofs, but (among other) also privacy. The developed solution is analyzed by means of a tangible metric and it is shown to be lightweight, and formally for security.

  4. Rules and economic features connected with adoption and medical assisted reproduction

    Directory of Open Access Journals (Sweden)

    Hemion Braho

    2015-07-01

    Full Text Available The aim of this brief study is to analyze the phenomenon of adoption and the assisted reproductive technologies, not from a social point of view as experts often do, but on an economic point of view. This could be possible analyzing first of all the laws regulating these “markets” and the influence of this regulation on the economic aspects. Although it could seem immoral to study this social aspects connected with filiation, we know that the social desire of some parents or some individuals to have children and their possibility is oriented by laws, economic possibilities and economy in general. This study is based on an empirical methodology, taking as study-case Italy and trying not to give any ethic orientation.

  5. Recent developments in genetics and medically assisted reproduction: from research to clinical applications.

    Science.gov (United States)

    Harper, J C; Aittomäki, K; Borry, P; Cornel, M C; de Wert, G; Dondorp, W; Geraedts, J; Gianaroli, L; Ketterson, K; Liebaers, I; Lundin, K; Mertes, H; Morris, M; Pennings, G; Sermon, K; Spits, C; Soini, S; van Montfoort, A P A; Veiga, A; Vermeesch, J R; Viville, S; Macek, M

    2018-01-01

    Two leading European professional societies, the European Society of Human Genetics and the European Society for Human Reproduction and Embryology, have worked together since 2004 to evaluate the impact of fast research advances at the interface of assisted reproduction and genetics, including their application into clinical practice. In September 2016, the expert panel met for the third time. The topics discussed highlighted important issues covering the impacts of expanded carrier screening, direct-to-consumer genetic testing, voiding of the presumed anonymity of gamete donors by advanced genetic testing, advances in the research of genetic causes underlying male and female infertility, utilisation of massively parallel sequencing in preimplantation genetic testing and non-invasive prenatal screening, mitochondrial replacement in human oocytes, and additionally, issues related to cross-generational epigenetic inheritance following IVF and germline genome editing. The resulting paper represents a consensus of both professional societies involved.

  6. Wireless Sensors Grouping Proofs for Medical Care and Ambient Assisted-Living Deployment

    Directory of Open Access Journals (Sweden)

    Denis Trček

    2016-01-01

    Full Text Available Internet of Things (IoT devices are rapidly penetrating e-health and assisted living domains, and an increasing proportion among them goes on the account of computationally-weak devices, where security and privacy provisioning alone are demanding tasks, not to mention grouping proofs. This paper, therefore, gives an extensive analysis of such proofs and states lessons learnt to avoid possible pitfalls in future designs. It sticks with prudent engineering techniques in this field and deploys in a novel way the so called non-deterministic principle to provide not only grouping proofs, but (among other also privacy. The developed solution is analyzed by means of a tangible metric and it is shown to be lightweight, and formally for security.

  7. Risk of poor neonatal outcome at term after medically assisted reproduction: a propensity score-matched study.

    Science.gov (United States)

    Ensing, Sabine; Abu-Hanna, Ameen; Roseboom, Tessa J; Repping, Sjoerd; van der Veen, Fulco; Mol, Ben Willem J; Ravelli, Anita C J

    2015-08-01

    To study risk of birth asphyxia and related morbidity among term singletons born after medically assisted reproduction (MAR). Population cohort study. Not applicable. A total of 1,953,932 term singleton pregnancies selected from a national registry for 1999-2011. None. Primary outcome Apgar score score score matching analysis was performed with matching on multiple maternal baseline covariates (maternal age, ethnicity, socioeconomic status, parity, year of birth, and preexistent diseases). Each MAR pregnancy was matched to three SC controls. Relative to SC, the MAR singletons had an increased risk of adverse neonatal outcomes including Apgar score score matching, the risk of an Apgar score Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Observed Mother- and Father-Child Interaction Differences in Families with Medically Assisted Reproduction-Conceived Twins and Singletons.

    Science.gov (United States)

    Anderson, Kayla N; Rueter, Martha A; Connor, Jennifer J; Koh, Bibiana D

    2017-12-01

    Increased medically assisted reproduction (MAR) use to treat infertility has resulted in a growing twin birth rate. Little is known about parent-child relationships for twin relative to singleton children in middle childhood. This study fills this gap by examining parent-child relationships in 57 families with eighty 6- to 12-year-old MAR twin and singleton children using observational data (warm and supportive communication, control, and hostility). Nested ANCOVAs indicate that while mothers exhibit similar interactional behaviors toward twins and singletons, fathers have less optimum behaviors toward twins relative to singletons. Twins displayed less engaged behavior with mothers and fathers relative to singletons. Given the vitality of parent-child relationships for family and child adjustment, future studies should examine determinants and outcomes of twin-singleton relationship differences to bolster twins' and their families' functioning. © 2016 Family Process Institute.

  9. Adopting evidence-based medically assisted treatments in substance abuse treatment organizations: roles of leadership socialization and funding streams.

    Science.gov (United States)

    Blum, Terry C; Davis, Carolyn D; Roman, Paul M

    2014-01-01

    This paper examines the organizational adoption of medically assisted treatments (MAT) for substance use disorders (SUDs) in a representative sample of 555 US for-profit and not-for-profit treatment centers. The study examines organizational adoption of these treatments in an institutionally contested environment that traditionally has valued behavioral treatment, using sociological and resource dependence frameworks. The findings indicate that socialization of leadership, measured by formal clinical education, is related to the adoption of MAT. Funding patterns also affect innovation adoption, with greater adoption associated with higher proportions of earned income from third party fees for services, and less adoption associated with funding from criminal justice sources. These findings may generalize to other social mission-oriented organizations where innovation adoption may be linked to private and public benefit values inherent in the type of socialization of leadership and different patterns of funding support.

  10. Response of the New Mexico Disaster Medical Assistance Team in St. Croix after Hurricane Hugo.

    Science.gov (United States)

    Lewis-Rakestraw, L

    1991-06-01

    Our DMAT pulled together with the energy, flexibility, and adaptability necessary to make things work. Sally Coan expressed it best, saying, "I was with a group of people who would do anything [that was] needed." Dedication and trust within the DMAT helped create lasting friendships. The islanders were appreciative and we formed attachments to them that made them too dear to leave without sadness. The DMAT did leave, but we left in place an established medical system that the island would not otherwise have had a standard of care of which we felt proud.

  11. ESHRE Task Force on Ethics and Law 23: medically assisted reproduction in singles, lesbian and gay couples, and transsexual people†.

    Science.gov (United States)

    De Wert, G; Dondorp, W; Shenfield, F; Barri, P; Devroey, P; Diedrich, K; Tarlatzis, B; Provoost, V; Pennings, G

    2014-09-01

    This Task Force document discusses ethical issues arising with requests for medically assisted reproduction from people in what may be called 'non-standard' situations and relationships. The document stresses that categorically denying access to any of these groups cannot be reconciled with a human rights perspective. If there are concerns about the implications of assisted reproduction on the wellbeing of any of the persons involved, including the future child, a surrogate mother or the applicants themselves, these concerns have to be considered in the light of the available scientific evidence. When doing so it is important to avoid the use of double standards. More research is needed into the psychosocial implications of raising children in non-standard situations, especially with regard to single women, male homosexual couples and transsexual people. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Physician-assisted suicide of patients with dementia. A medical ethical analysis with a special focus on patient autonomy.

    Science.gov (United States)

    Gather, Jakov; Vollmann, Jochen

    2013-01-01

    For many years there has been a controversial international debate on physician-assisted suicide (PAS). While proponents of PAS regularly refer to the unbearable suffering and the right of self-determination of incurably ill patients, critics often warn about the diverse risks of abuse. In our article, we aim to present ethical arguments for and against PAS for patients in an early stage of dementia. Our focus shall be on ethical questions of autonomy, conceptual and empirical findings on competence and the assessment of mental capacity to make health care decisions. While the capacity to make health care decisions represents an ethically significant precondition for PAS, it becomes more and more impaired in the course of the dementia process. We present conditions that should be met in order to ethically justify PAS for patients with dementia. From both a psychiatric and an ethical perspective, a thorough differential diagnosis and an adequate medical and psychosocial support for patients with dementia considering PAS and their relatives should be guaranteed. If, after due deliberation, the patient still wishes assistance with suicide, a transparent and documented assessment of competence should be conducted by a professional psychiatrist. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Computer-assisted teaching of skin flap surgery: validation of a mobile platform software for medical students.

    Science.gov (United States)

    de Sena, David P; Fabricio, Daniela D; Lopes, Maria Helena I; da Silva, Vinicius D

    2013-01-01

    The purpose of this study was to develop and validate a multimedia software application for mobile platforms to assist in the teaching and learning process of design and construction of a skin flap. Traditional training in surgery is based on learning by doing. Initially, the use of cadavers and animal models appeared to be a valid alternative for training. However, many conflicts with these training models prompted progression to synthetic and virtual reality models. Fifty volunteer fifth- and sixth-year medical students completed a pretest and were randomly allocated into two groups of 25 students each. The control group was exposed for 5 minutes to a standard text-based print article, while the test group used multimedia software describing how to fashion a rhomboid flap. Each group then performed a cutaneous flap on a training bench model while being evaluated by three blinded BSPS (Brazilian Society of Plastic Surgery) board-certified surgeons using the OSATS (Objective Structured Assessment of Technical Skill) protocol and answered a post-test. The text-based group was then tested again using the software. The computer-assisted learning (CAL) group had superior performance as confirmed by checklist scores (pmultimedia method as the best study tool. CAL learners exhibited better subjective and objective performance when fashioning rhomboid flaps as compared to those taught with standard print material. These findings indicate that students preferred to learn using the multimedia method.

  14. [Effect of sodium carbonate assisted hydrothermal process on heavy metals stabilization in medical waste incinerator fly ash].

    Science.gov (United States)

    Jin, Jian; Li, Xiao-dong; Chi, Yong; Yan, Jian-hua

    2010-04-01

    A sodium carbonate assisted hydrothermal process was induced to stabilize the fly ash from medical waste incinerator. The results showed that sodium carbonate assisted hydrothermal process reduced the heavy metals leachability of fly ash, and the heavy metal waste water from the process would not be a secondary pollution. The leachability of heavy metals studied in this paper were Cd 1.97 mg/L, Cr 1.56 mg/L, Cu 2.56 mg/L, Mn 17.30 mg/L, Ni 1.65 mg/L, Pb 1.56 mg/L and Zn 189.00 mg/L, and after hydrothermal process with the optimal experimental condition (Na2CO3/fly ash dosage = 5/20, reaction time = 8 h, L/S ratio = 10/1) the leachability reduced to < 0.02 mg/L for Cd, Cr, Cu, Mn, Ni, Pb, and 0.05 mg/L for Zn, according to GB 5085.3-2007. Meanwhile, the concentrations of heavy metals in effluent after hydrothermal process were less than 0.8 mg/L. The heavy metals leachability and concentration in effluent reduced with prolonged reaction time. Prolonged aging can affect the leachability of metals as solids become more crystalline, and heavy metals transferred inside of crystalline. The mechanism of heavy metal stabilization can be concluded to the co precipitation and adsorption effect of aluminosilicates formation, crystallization and aging process.

  15. [Glucocorticoid therapy: what is the information sought by patients? Traffic analysis of the website cortisone-info.fr].

    Science.gov (United States)

    Poisson, J; Six, M; Morin, C; Fardet, L

    2013-05-01

    About 1% of the general population are receiving systemic glucocorticoids. The information about this treatment sought by patients is unknown. The website www.cortisone-info.fr aims to provide therapeutic information about glucocorticoids and glucocorticoid therapy. It was posted on January 16, 2012. The information available on the website is documented and based on the recent medical literature. The website is made of 43 pages divided into five main sections (generalities about glucocorticoids, adverse events, measures associated with glucocorticoid therapy, discontinuation of glucocorticoids and, situations requiring attention). The website traffic between February 1st, 2012 and January 4, 2013 was analyzed using Google Analytics. During the study period, the website was visited by 67,496 people (average number of visitors per day: 33 in February 2012, 326 in December 2012). The number of page views was 230,496 or an average of 3.5 pages per visitor. Of these 230,496 page views, 145,431 (63.1%) were related to adverse events and 37,722 (16.4%) were related to generalities about glucocorticoids (e.g., what is cortisone? For which disease? How does it work?). Information particularly sought by visitors was related to the diet to follow during glucocorticoid therapy (page accessed 11,946 times), data about what cortisone is (page accessed 11,829 times) and the effects of glucocorticoids on weight (page accessed 10,442 times). Knowledge of glucocorticoid-treated patients' expectations may help physicians to optimize information they give, thereby helping to reduce patients' concerns about glucocorticoids and to improve adherence to the treatment. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  16. Biomimetic nanocrystalline apatite coatings synthesized by Matrix Assisted Pulsed Laser Evaporation for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Visan, A. [National Institute for Lasers, Plasma, and Radiation Physics, 409 Atomistilor Street, RO-77125, MG-36, Magurele-Ilfov (Romania); Grossin, D. [CIRIMAT – Carnot Institute, University of Toulouse, ENSIACET, 4 Allée Emile Monso, 31030 Toulouse Cedex 4 (France); Stefan, N.; Duta, L.; Miroiu, F.M. [National Institute for Lasers, Plasma, and Radiation Physics, 409 Atomistilor Street, RO-77125, MG-36, Magurele-Ilfov (Romania); Stan, G.E. [National Institute of Materials Physics, RO-077125, Magurele-Ilfov (Romania); Sopronyi, M.; Luculescu, C. [National Institute for Lasers, Plasma, and Radiation Physics, 409 Atomistilor Street, RO-77125, MG-36, Magurele-Ilfov (Romania); Freche, M.; Marsan, O.; Charvilat, C. [CIRIMAT – Carnot Institute, University of Toulouse, ENSIACET, 4 Allée Emile Monso, 31030 Toulouse Cedex 4 (France); Ciuca, S. [Politehnica University of Bucharest, Faculty of Materials Science and Engineering, Bucharest (Romania); Mihailescu, I.N., E-mail: ion.mihailescu@inflpr.ro [National Institute for Lasers, Plasma, and Radiation Physics, 409 Atomistilor Street, RO-77125, MG-36, Magurele-Ilfov (Romania)

    2014-02-15

    Highlights: • We report the deposition by MAPLE of biomimetic apatite coatings on Ti substrates. • This is the first report of MAPLE deposition of hydrated biomimetic apatite films. • Biomimetic apatite powder was synthesized by double decomposition process. • Non-apatitic environments, of high surface reactivity, are preserved post-deposition. • We got the MAPLE complete transfer as thin film of a hydrated, delicate material. -- Abstract: We report the deposition by Matrix Assisted Pulsed Laser Evaporation (MAPLE) technique of biomimetic nanocrystalline apatite coatings on titanium substrates, with potential application in tissue engineering. The targets were prepared from metastable, nanometric, poorly crystalline apatite powders, analogous to mineral bone, synthesized through a biomimetic approach by double decomposition process. For the deposition of thin films, a KrF* excimer laser source was used (λ = 248 nm, τ{sub FWHM} ≤ 25 ns). The analyses revealed the existence, in synthesized powders, of labile non-apatitic mineral ions, associated with the formation of a hydrated layer at the surface of the nanocrystals. The thin film analyses showed that the structural and chemical nature of the nanocrystalline apatite was prevalently preserved. The perpetuation of the non-apatitic environments was also observed. The study indicated that MAPLE is a suitable technique for the congruent transfer of a delicate material, such as the biomimetic hydrated nanohydroxyapatite.

  17. Biomimetic nanocrystalline apatite coatings synthesized by Matrix Assisted Pulsed Laser Evaporation for medical applications

    International Nuclear Information System (INIS)

    Visan, A.; Grossin, D.; Stefan, N.; Duta, L.; Miroiu, F.M.; Stan, G.E.; Sopronyi, M.; Luculescu, C.; Freche, M.; Marsan, O.; Charvilat, C.; Ciuca, S.; Mihailescu, I.N.

    2014-01-01

    Highlights: • We report the deposition by MAPLE of biomimetic apatite coatings on Ti substrates. • This is the first report of MAPLE deposition of hydrated biomimetic apatite films. • Biomimetic apatite powder was synthesized by double decomposition process. • Non-apatitic environments, of high surface reactivity, are preserved post-deposition. • We got the MAPLE complete transfer as thin film of a hydrated, delicate material. -- Abstract: We report the deposition by Matrix Assisted Pulsed Laser Evaporation (MAPLE) technique of biomimetic nanocrystalline apatite coatings on titanium substrates, with potential application in tissue engineering. The targets were prepared from metastable, nanometric, poorly crystalline apatite powders, analogous to mineral bone, synthesized through a biomimetic approach by double decomposition process. For the deposition of thin films, a KrF* excimer laser source was used (λ = 248 nm, τ FWHM ≤ 25 ns). The analyses revealed the existence, in synthesized powders, of labile non-apatitic mineral ions, associated with the formation of a hydrated layer at the surface of the nanocrystals. The thin film analyses showed that the structural and chemical nature of the nanocrystalline apatite was prevalently preserved. The perpetuation of the non-apatitic environments was also observed. The study indicated that MAPLE is a suitable technique for the congruent transfer of a delicate material, such as the biomimetic hydrated nanohydroxyapatite

  18. [End-of-life-care and euthanasia: medical assistance in dying or help to die].

    Science.gov (United States)

    Müller-Busch, H Christof

    2008-01-01

    The debate on euthanasia that has been started all over Europe, but especially in Germany has been particularly complicated by unclear and inconsistent definitions. Medical decisions in end-of-life care gain increasing importance not only for the time of death but also for the kind and quality of the dying process. Though legal regulations can help to diminish doubts about the permissibility of various measures in end-of-life care, teaching and knowledge of ethical principles, communication skills, respect, transparency and knowledge of palliative care options seem to be the most important factors in accompanying the dying professionally and with dignity and even in achieving a consented compromise when aid in hastening death is asked for.

  19. Model-based formalization of medical knowledge for context-aware assistance in laparoscopic surgery

    Science.gov (United States)

    Katić, Darko; Wekerle, Anna-Laura; Gärtner, Fabian; Kenngott, Hannes G.; Müller-Stich, Beat P.; Dillmann, Rüdiger; Speidel, Stefanie

    2014-03-01

    The increase of technological complexity in surgery has created a need for novel man-machine interaction techniques. Specifically, context-aware systems which automatically adapt themselves to the current circumstances in the OR have great potential in this regard. To create such systems, models of surgical procedures are vital, as they allow analyzing the current situation and assessing the context. For this purpose, we have developed a Surgical Process Model based on Description Logics. It incorporates general medical background knowledge as well as intraoperatively observed situational knowledge. The representation consists of three parts: the Background Knowledge Model, the Preoperative Process Model and the Integrated Intraoperative Process Model. All models depend on each other and create a concise view on the surgery. As a proof of concept, we applied the system to a specific intervention, the laparoscopic distal pancreatectomy.

  20. The mCME Project: A Randomized Controlled Trial of an SMS-Based Continuing Medical Education Intervention for Improving Medical Knowledge among Vietnamese Community Based Physicians' Assistants.

    Directory of Open Access Journals (Sweden)

    Christopher J Gill

    Full Text Available Community health workers (CHWs provide critical services to underserved populations in low and middle-income countries, but maintaining CHW's clinical knowledge through formal continuing medical education (CME activities is challenging and rarely occurs. We tested whether a Short Message Service (SMS-based mobile CME (mCME intervention could improve medical knowledge among a cadre of Vietnamese CHWs (Community Based Physician's Assistants-CBPAs who are the leading providers of primary medical care for rural underserved populations.The mCME Project was a three arm randomized controlled trial. Group 1 served as controls while Groups 2 and 3 experienced two models of the mCME intervention. Group 2 (passive model participants received a daily SMS bullet point, and were required to reply to the text to acknowledge receipt; Group 3 (interactive model participants received an SMS in multiple choice question format addressing the same thematic area as Group 2, entering an answer (A, B, C or D in their response. The server provided feedback immediately informing the participant whether the answer was correct. Effectiveness was based on standardized examination scores measured at baseline and endline (six months later. Secondary outcomes included job satisfaction and self-efficacy.638 CBPAs were enrolled, randomized, and tested at baseline, with 592 returning at endline (93.7%. Baseline scores were similar across all three groups. Over the next six months, participation of Groups 2 and 3 remained high; they responded to >75% of messages. Group 3 participants answered 43% of the daily SMS questions correctly, but their performance did not improve over time. At endline, the CBPAs reported high satisfaction with the mCME intervention, and deemed the SMS messages highly relevant. However, endline exam scores did not increase over baseline, and did not differ between the three groups. Job satisfaction and self-efficacy scores also did not improve. Average

  1. The Evolution of Legislation in the Field of Medically Assisted Reproduction and Embryo Stem Cell Research in European Union Members

    Directory of Open Access Journals (Sweden)

    Francesco Paolo Busardò

    2014-01-01

    Full Text Available Medically Assisted Reproduction (MAR, involving in vitro fertilisation (IVF, and research on embryos have created expectation to many people affected by infertility; at the same time it has generated a surplus of laws and ethical and social debates. Undoubtedly, MAR represents a rather new medical field and constant developments in medicine and new opportunities continue to defy the attempt to respond to those questions. In this paper, the authors reviewed the current legislation in the 28 EU member states trying to evaluate the different legislation paths adopted over the last 15 years and highlighting those EU countries with no specific legislation in place and MAR is covered by a general health Law and those countries in which there are no laws in this field but only “guidelines.” The second aim of this work has been to compare MAR legislation and embryo research in EU countries, which derive from different origins ranging from an extremely prohibitive approach versus a liberal one, going through a cautious regulatory approach.

  2. Evaluation of a Pilot Medication-Assisted Therapy Program in Kazakhstan: Successes, Challenges, and Opportunities for Scaleup

    Directory of Open Access Journals (Sweden)

    Azizbek A. Boltaev

    2012-01-01

    Full Text Available Study Aims. Evaluate the quality and effectiveness of the medication-assisted therapy (MAT pilot in Kazakhstan and review implementation context and related challenges. Methods. We performed a desk review of MAT policy and program documents and reviewed medical records at three MAT sites in Kazakhstan. MAT patients (n=93 were interviewed to assess their perceptions of the program and its impact on their health, criminal, drug use, and HIV risk related behaviors as well as expenditures on nonprescribed psychoactive drugs. Persons injecting drugs who are not in treatment, MAT program staff, and other stakeholders were interviewed to obtain their perspectives on MAT. Results. Legislation supports introducing MAT as a standard of care for treatment of opioid dependence; however, its progress has been hampered by active opposition. Inadequate access and coverage, insufficient supply management, scarce infrastructure of narcological facilities, limited opportunities for staff development, and restrictive methadone dispensing policies compromise the quality of the intervention and limit its potential benefits. There were significant reductions in criminal, drug use, and HIV risk related behaviors in patients receiving MAT. Conclusions. The MAT pilot in Kazakhstan demonstrated its feasibility and effectiveness in the local context and is recommended for scaleup throughout the country.

  3. Effects of the medication nursing assistant role on nurse job satisfaction and stress in long-term care.

    Science.gov (United States)

    Walker, Margaret J

    2008-01-01

    Long-term care nurses continue to struggle with increasing workloads, fulfilling regulatory requirements and limited staffing resources. One method of impacting the workload is the introduction of the new medication nursing assistant (MNA) role to alleviate the nurse from prolonged time intervals spent administering medications. An early step in MNA role implementation is to evaluate its impact by comparing agencies using the MNA and those not using the role. This article presents findings from a mixed method study examining the efficacy of the MNA role in relationship to job satisfaction and the degree of perceived stress experienced by long-term care nurses. Ninety-one nurses employed at 2 large New Hampshire facilities responded. Findings offer empirical evidence supporting the use of the MNA to reduce job stress and increase satisfaction for licensed nurses. The MNA role is accepted by nurse leaders and viewed as a benefit. Findings also support a correlation between empowerment and decision making in the nursing environment with levels of nurse satisfaction.

  4. Making environmental health interesting for medical students-internet assisted facilitated collaborative learning approach.

    Science.gov (United States)

    Sudharsanam, Manni Balasubramaniam

    2014-01-01

    Topics on environmental health are usually neglected by students and it is necessary for them to learn this area with a public health perspective as environment plays a vital role in multi-factorial causation of diseases. Hence there is a need for alternative teaching/learning methods to facilitate students in acquiring the required knowledge. To increase the student interest and enhance their participation in acquiring knowledge in public health perspective of environmental health. Teaching Objectives/Learning Were: At the end of the session students should know the importance of air as an environmental factor in disease causation in special reference to public health hazards, the major sources of air pollution, major pollutants causing the health hazards, the way to measure pollutants and control them. The whole class of students was divided into two batches and one session was planned for each batch. Each batch was divided into six small groups. The groups were given task of exploring the internet on the different topics mentioned in the learning objectives. All the students were asked to explore, compile information and collectively prepare a presentation and present their findings based on their reviews. Students' feedback was collected at the end of each session. Eighty five percent of them were clear about the learning objectives and interested about internet learning. Most of them gave a positive opinion about the newer teaching learning method. Internet assisted group study served as a valuable alternative, innovative, and interesting tool to teach and learn the environmental health as revealed by students' feedback.

  5. Virtual microscopy system at Chinese medical university: an assisted teaching platform for promoting active learning and problem-solving skills.

    Science.gov (United States)

    Tian, Yanping; Xiao, Wengang; Li, Chengren; Liu, Yunlai; Qin, Maolin; Wu, Yi; Xiao, Lan; Li, Hongli

    2014-04-09

    Chinese medical universities typically have a high number of students, a shortage of teachers and limited equipment, and as such histology courses have been taught using traditional lecture-based formats, with textbooks and conventional microscopy. This method, however, has reduced creativity and problem-solving skills training in the curriculum. The virtual microscope (VM) system has been shown to be an effective and efficient educational strategy. The present study aims to describe a VM system for undergraduates and to evaluate the effects of promoting active learning and problem-solving skills. Two hundred and twenty-nine second-year undergraduate students in the Third Military Medical University were divided into two groups. The VM group contained 115 students and was taught using the VM system. The light microscope (LM) group consisted of 114 students and was taught using the LM system. Post-teaching performances were assessed by multiple-choice questions, short essay questions, case analysis questions and the identification of structure of tissue. Students' teaching preferences and satisfaction were assessed using questionnaires. Test scores in the VM group showed a significant improvement compared with those in the LM group (p 0.05); however, there were notable differences in the mean score rate of case analysis questions and identification of structure of tissue (p effects of the VM system in terms of additional learning resources, critical thinking, ease of communication and confidence. The VM system is an effective tool at Chinese medical university to promote undergraduates' active learning and problem-solving skills as an assisted teaching platform.

  6. 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.

  7. Analysis of pharmaceutical assistance in the Taquari Valley, Rio Grande do Sul: profile of service users and access to medication

    Directory of Open Access Journals (Sweden)

    Carla Kauffmann

    2009-12-01

    Full Text Available Pharmaceutical assistance concerns actions developed by the pharmacist and other professionals with the purpose of promoting, protecting and restoring health. Medications are an essential tool in this process that focuses on the access to, and the rational use of, drugs. This study is aimed at evaluating the Pharmaceutical Assistance provided by Municipal Health Offices in the Taquari Valley, Rio Grande do Sul. For this purpose, 2,794 users of public pharmacies were interviewed and data was analyzed using descriptive statistics. The users of the public pharmacies were mainly female and individuals with low educational level and income. On average, 2.41 drugs were prescribed per medical prescription and 1.72 of these were procured. Out of the total medicines prescribed, 76.5% were listed in the municipal standard drug list (SDL. Medication was prescribed by its generic name in 81.8% of the prescriptions. Antibiotics and injections were prescribed in 11.9% and 4.0% of the prescriptions, respectively. Users' access to information is partial, which can impair adherence to the treatment. Thus, it is possible to conclude that review of the service is necessary for it to be effective.A Assistência Farmacêutica se preocupa com ações desenvolvidas pelo farmacêutico ou outros profissionais com o propósito de promover, proteger e restaurar a saúde. Medicamentos são ferramentas essenciais nesse processo, que se concentra no acesso e no uso racional de fármacos. Este estudo objetivou a avaliação da Assitência Farmacêutica suprida pela Secretaria Municipal da Saúde no Vale do Taquari, no Rio Grande do Sul. Com esse propósito, 2.794 usuários das farmácias públicas foram entrevistados e analisaram-se os dados usando estatística descritiva. Os usuários das farmácias públicas eram, principalmente, mulheres e indivíduos com baixo nível educacional e financeiro. Na média, 2,41 fármacos eram prescritos por prescrição médica e 1,72 destes

  8. Computer-assisted teaching of skin flap surgery: validation of a mobile platform software for medical students.

    Directory of Open Access Journals (Sweden)

    David P de Sena

    Full Text Available The purpose of this study was to develop and validate a multimedia software application for mobile platforms to assist in the teaching and learning process of design and construction of a skin flap. Traditional training in surgery is based on learning by doing. Initially, the use of cadavers and animal models appeared to be a valid alternative for training. However, many conflicts with these training models prompted progression to synthetic and virtual reality models. Fifty volunteer fifth- and sixth-year medical students completed a pretest and were randomly allocated into two groups of 25 students each. The control group was exposed for 5 minutes to a standard text-based print article, while the test group used multimedia software describing how to fashion a rhomboid flap. Each group then performed a cutaneous flap on a training bench model while being evaluated by three blinded BSPS (Brazilian Society of Plastic Surgery board-certified surgeons using the OSATS (Objective Structured Assessment of Technical Skill protocol and answered a post-test. The text-based group was then tested again using the software. The computer-assisted learning (CAL group had superior performance as confirmed by checklist scores (p<0.002, overall global assessment (p = 0.017 and post-test results (p<0.001. All participants ranked the multimedia method as the best study tool. CAL learners exhibited better subjective and objective performance when fashioning rhomboid flaps as compared to those taught with standard print material. These findings indicate that students preferred to learn using the multimedia method.

  9. The Text of the Instrument connected with the Agency's Assistance to the United Arab Republic in Establishing a Project for Training and Medical Applications

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1967-06-09

    The text of the Agreement between the Agency and the Government of the United Arab Republic in connection with the Agency's assistance to that Government in establishing a project for training and medical applications of atomic energy is reproduced in this document for the information of all Members.

  10. Posttraumatic stress disorder, anxiety and depression following pregnancies conceived through fertility treatments : the effects of medically assisted conception on postpartum well-being

    NARCIS (Netherlands)

    Warmelink, J Catja; Stramrood, Claire A I; Paarlberg, K Marieke; Haisma, Hinke H; Vingerhoets, A J J M; Schultz, Willibrord C M Weijmar; van Pampus, Maria G

    2012-01-01

    OBJECTIVE: To compare the postpartum prevalence of Posttraumatic Stress Disorder (PTSD), anxiety and depression in women who conceived via medically assisted conception (MAC) and women who conceived naturally. STUDY DESIGN: All women (n = 907) who delivered under supervision of four independent

  11. The Text of the Instrument connected with the Agency's Assistance to the United Arab Republic in Establishing a Project for Training and Medical Applications

    International Nuclear Information System (INIS)

    1967-01-01

    The text of the Agreement between the Agency and the Government of the United Arab Republic in connection with the Agency's assistance to that Government in establishing a project for training and medical applications of atomic energy is reproduced in this document for the information of all Members

  12. CERN Press Release: CERN experiments observe particle consistent with long-sought Higgs boson

    CERN Multimedia

    2012-01-01

    Geneva, 4 July 2012. At a seminar held at CERN today as a curtain raiser to the year’s major particle physics conference, ICHEP2012 in Melbourne, the ATLAS and CMS experiments presented their latest preliminary results in the search for the long sought Higgs particle. Both experiments observe a new particle in the mass region around 125-126 GeV.   CERN physicists await the start of the Higgs seminar. “We observe in our data clear signs of a new particle, at the level of 5 sigma, in the mass region around 126 GeV. The outstanding performance of the LHC and ATLAS and the huge efforts of many people have brought us to this exciting stage,” said ATLAS experiment spokesperson Fabiola Gianotti, “but a little more time is needed to prepare these results for publication.” "The results are preliminary but the 5 sigma signal at around 125 GeV we’re seeing is dramatic. This is indeed a new particle. We know it must be a boson and it&...

  13. Developing and Evaluating Medical Humanities Problem-Based Learning Classes Facilitated by the Teaching Assistants Majored in the Liberal Arts: A Longitudinal Crossover Study.

    Science.gov (United States)

    Tseng, Fen-Yu; Shieh, Jeng-Yi; Kao, Tze-Wah; Wu, Chau-Chung; Chu, Tzong-Shinn; Chen, Yen-Yuan

    2016-02-01

    Although medical humanities courses taught by teachers from nonmedical backgrounds are not unusual now, few studies have compared the outcome of medical humanities courses facilitated by physicians to that by teaching assistants majored in the liberal arts. The objectives of this study were to (1) analyze the satisfaction of medical students with medical humanities problem-based learning (PBL) classes facilitated by nonmedical teaching assistants (TAF) majored in the liberal arts, and those facilitated by the attending physicians (APF) and (2) examine the satisfaction of medical students with clinical medicine-related and clinical medicine-unrelated medical humanities PBL classes.A total of 123 medical students, randomly assigned to 16 groups, participated in this study. There were 16 classes in the course: 8 of them were TAF classes; and the others were APF classes. Each week, each group rotated from 1 subject of the 16 subjects of PBL to another subject. All of the 16 groups went through all the 16 subjects in the 2013 spring semester. We examined the medical students' satisfaction with each class, based on a rating score collected after each class was completed, using a scale from 0 (the lowest satisfaction) to 100 (the highest satisfaction). We also conducted multivariate linear regression analysis to examine the association between the independent variables and the students' satisfaction.Medical students were more satisfied with the TAF (91.35 ± 7.75) medical humanities PBL classes than APF (90.40 ± 8.42) medical humanities PBL classes (P = 0.01). Moreover, medical students were more satisfied with the clinical medicine-unrelated topics (92.00 ± 7.10) than the clinical medicine-related topics (90.36 ± 7.99) in the medical humanities PBL course (P = 0.01).This medical humanities PBL course, including nonmedical subjects and topics, and nonmedical teaching assistants from the liberal arts as class facilitators, was satisfactory. This

  14. Destroyed documents: uncovering the science that Imperial Tobacco Canada sought to conceal.

    Science.gov (United States)

    Hammond, David; Chaiton, Michael; Lee, Alex; Collishaw, Neil

    2009-11-10

    In 1992, British American Tobacco had its Canadian affiliate, Imperial Tobacco Canada, destroy internal research documents that could expose the company to liability or embarrassment. Sixty of these destroyed documents were subsequently uncovered in British American Tobacco's files. Legal counsel for Imperial Tobacco Canada provided a list of 60 destroyed documents to British American Tobacco. Information in this list was used to search for copies of the documents in British American Tobacco files released through court disclosure. We reviewed and summarized this information. Imperial Tobacco destroyed documents that included evidence from scientific reviews prepared by British American Tobacco's researchers, as well as 47 original research studies, 35 of which examined the biological activity and carcinogenicity of tobacco smoke. The documents also describe British American Tobacco research on cigarette modifications and toxic emissions, including the ways in which consumers adapted their smoking behaviour in response to these modifications. The documents also depict a comprehensive research program on the pharmacology of nicotine and the central role of nicotine in smoking behaviour. British American Tobacco scientists noted that ".. the present scale of the tobacco industry is largely dependent on the intensity and nature of the pharmacological action of nicotine," and that "... should nicotine become less attractive to smokers, the future of the tobacco industry would become less secure." The scientific evidence contained in the documents destroyed by Imperial Tobacco demonstrates that British American Tobacco had collected evidence that cigarette smoke was carcinogenic and addictive. The evidence that Imperial Tobacco sought to destroy had important implications for government regulation of tobacco.

  15. 76 FR 32204 - Adjusted Federal Medical Assistance Percentage (FMAP) Rates for the Second and Third Quarters of...

    Science.gov (United States)

    2011-06-03

    ... protect and maintain state Medicaid and certain other assistance programs in a period of economic downturn... State Medicaid and certain other assistance programs in a period of economic downturn, referred to as...

  16. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5-year follow-up cohort study.

    Science.gov (United States)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra; Ziebe, Søren; Mikkelsen Englund, Anne L; Hald, Finn; Boivin, Jacky; Schmidt, Lone

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Specialized public fertility clinics in Denmark. Seven hundred and thirty-nine couples having no child at study entry and with data on kind of treatment and live birth (yes/no) for each treatment attempt at the specialized public fertility clinic. Treatment data for medically assisted reproduction attempts conducted at the public fertility clinics were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottom-up procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis. Costs were adjusted to 2012 prices using a constructed medical price index. Live birth, costs. Total costs per live birth in 2012 prices were estimated to 10,755€. Costs per treated couple - irrespective of whether the treatment was terminated by a live birth or not - were estimated at 6607€. Costs per live birth of women <35 years at treatment initiation were 9338€ and 15,040€ for women ≥35 years. The public costs for live births after conception with medically assisted reproduction treatment are relatively modest. The results can be generalized to public fertility treatment in Denmark and to other public treatment settings with similar limitations in numbers of public treatment cycles offered. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Postoperative pain medication requirements in patients undergoing computer-assisted (“Robotic”) and standard laparoscopic procedures for newly diagnosed endometrial cancer.

    Science.gov (United States)

    Leitao, Mario M; Malhotra, Vivek; Briscoe, Gabriel; Suidan, Rudy; Dholakiya, Priyal; Santos, Kevin; Jewell, Elizabeth L; Brown, Carol L; Sonoda, Yukio; Abu-Rustum, Nadeem R; Barakat, Richard R; Gardner, Ginger J

    2013-10-01

    patients who had undergone an RBT hysterectomy compared to a standard total LSC hysterectomy for benign indications.13 A recent cost analysis suggested that patients experienced less pain and required less pain medication use after RBT procedures compared to LSC for endometrial cancer.14 Based on these reports, we sought to analyze postoperative pain and the use of pain medication in patients undergoing RBT compared to standard transperitoneal LSC procedures for newly diagnosed endometrial cancer during a concurrent time period. Of note, current RBT surgery is not truly robotic in that it is not autonomous. A more appropriate term is “computer-assisted surgery,” but to satisfy current convention, we refer to it as “robotic surgery” in this manuscript.

  18. Risk assessment and comparative effectiveness of left ventricular assist device and medical management in ambulatory heart failure patients: design and rationale of the ROADMAP clinical trial.

    Science.gov (United States)

    Rogers, Joseph G; Boyle, Andrew J; O'Connell, John B; Horstmanshof, Douglas A; Haas, Donald C; Slaughter, Mark S; Park, Soon J; Farrar, David J; Starling, Randall C

    2015-02-01

    Mechanical circulatory support is now a proven therapy for the treatment of patients with advanced heart failure and cardiogenic shock. The role for this therapy in patients with less severe heart failure is unknown. The objective of this study is to examine the impact of mechanically assisted circulation using the HeartMate II left ventricular assist device in patients who meet current US Food and Drug Administration-defined criteria for treatment but are not yet receiving intravenous inotropic therapy. This is a prospective, nonrandomized clinical trial of 200 patients treated with either optimal medical management or a mechanical circulatory support device. This trial will be the first prospective clinical evaluation comparing outcomes of patients with advanced ambulatory heart failure treated with either ongoing medical therapy or a left ventricular assist device. It is anticipated to provide novel insights regarding relative outcomes with each treatment and an understanding of patient and provider acceptance of the ventricular assist device therapy. This trial will also provide information regarding the risk of events in "stable" patients with advanced heart failure and guidance for the optimal timing of left ventricular assist device therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Laser-assisted skin closure at 1.32 microns: the use of a software-driven medical laser system

    Science.gov (United States)

    Dew, Douglas K.; Hsu, Tung M.; Hsu, Long S.; Halpern, Steven J.; Michaels, Charles E.

    1991-06-01

    This study investigated the use of a computerized 1 .3 micron Nd:YAG laser to seal approximated wound edges in pig skin. The medical laser system used was the DLS Type 1 , 1 .32 micron Nd:YAG laser (Laser Surgery Software, Inc.). The purpose of this study was to evaluate the effectiveness of laser assisted skin closure using the DLS YAG laser in a large animal model. Effectiveness was judged on the basis of wound dehiscence, infection, unusual healing result and consistency of results. Comparative cosmetic result was also evaluated. In this study, the DLS YAG laser was used to close scalpel-induced, full-thickness wounds. The pig model was chosen for its many integumentary similarities to man. Controls included scalpel-induced wounds closed using suture, staple and some with norepair. After adequate anesthesia was achieved, the dorsum of Yucutan pigs (approximately 75- 100 pounds) each was clipped with animal hair clippers from the shoulder area to the hind legs. The area was then shaved with a razor blade, avoiding any inadvertent cuts or abrasions of the skin. The dorsum was divided into four rows of four parallel incisions made by a #15 scalpel blade. Full-thickness incisions, 9 cm long, were placed over the dorsum of the pigs and then closed either with one loosely approximating Prolene" suture (the "no repair' group), multiple interrupted 6-0 nylon sutures, staples or laser. The experimental tissue sealing group consisted of 1 69 laser assisted closures on 1 3 pigs. Sutured control wounds were closed with 6-0 nylon, full thickness, simple, interrupted sutures. Eight sutures were placed 1 cm apart along the 9 cm incision. Stapled control wounds were approximated using two evenly spaced 3-0 VicryP' sub-dermal sutures and the dermis closed using Proximate' skin staples. Eight staples were placed 1 cm apart along the 9 cm incision. The no-repair incisions were grossly approximated using a single 2-0 Prolene full thickness, simple, interrupted suture located at the

  20. Composite biocompatible hydroxyapatite-silk fibroin coatings for medical implants obtained by Matrix Assisted Pulsed Laser Evaporation

    International Nuclear Information System (INIS)

    Miroiu, F.M.; Socol, G.; Visan, A.; Stefan, N.; Craciun, D.; Craciun, V.; Dorcioman, G.; Mihailescu, I.N.; Sima, L.E.; Petrescu, S.M.; Andronie, A.; Stamatin, I.; Moga, S.; Ducu, C.

    2010-01-01

    The aim of this study was to obtain biomimetic inorganic-organic thin films as coatings for metallic medical implants. These contain hydroxyapatite, the inorganic component of the bony tissues, and a natural biopolymer - silk fibroin - added in view to induce the surface functionalization. Hydroxyapatite (HA), silk fibroin (FIB) and composite HA-FIB films were obtained by Matrix Assisted Pulsed Laser Evaporation (MAPLE) in order to compare their physical and biological performances as coatings on metallic prostheses. We used an excimer laser source (KrF*, λ = 248 nm, τ = 25 ns) operated at 10 Hz repetition rate. Coatings were deposited on quartz, Si and Ti substrates and then subjected to physical (FTIR, XRD, AFM, SEM) analyses, correlated with the results of the cytocompatibility in vitro tests. The hybrid films were synthesized from frozen targets of aqueous suspensions with 3:2 or 3:4 weight ratio of HA:FIB. An appropriate stoichiometric and functional transfer was obtained for 0.4-0.5 J/cm 2 laser fluence. FTIR spectra of FIB and HA-FIB films exhibited distinctive absorption maxima, in specific positions of FIB random coil form: 1540 cm -1 amide II, 1654 cm -1 amide I, 1243 cm -1 amide III, while the peak from 1027 cm -1 appeared only for HA and composite films. Osteosarcoma SaOs2 cells cultured 72 h on FIB and HA-FIB films showed increased viability, good spreading and normal cell morphology. The well-elongated, flattened cells are a sign of an appropriate interaction with the MAPLE FIB and composite HA-FIB coatings.

  1. Composite biocompatible hydroxyapatite-silk fibroin coatings for medical implants obtained by Matrix Assisted Pulsed Laser Evaporation

    Energy Technology Data Exchange (ETDEWEB)

    Miroiu, F.M., E-mail: marimona.miroiu@inflpr.ro [National Institute for Lasers, Plasma, and Radiation Physics, 409 Atomistilor Street, RO-77125, MG-36, Magurele-Ilfov (Romania); Socol, G.; Visan, A.; Stefan, N.; Craciun, D.; Craciun, V.; Dorcioman, G.; Mihailescu, I.N. [National Institute for Lasers, Plasma, and Radiation Physics, 409 Atomistilor Street, RO-77125, MG-36, Magurele-Ilfov (Romania); Sima, L.E.; Petrescu, S.M. [Institute of Biochemistry, Romanian Academy, 296 Splaiul Independentei, 060031 Bucharest (Romania); Andronie, A.; Stamatin, I. [3Nano-SAE Alternative Energy Sources-University of Bucharest, Faculty of Physics, 409 Atomistilor Street, RO-77125, Magurele-Ilfov (Romania); Moga, S.; Ducu, C. [University of Pitesti, Targul din Vale Str, no. 1, 110040 Pitesti (Romania)

    2010-05-25

    The aim of this study was to obtain biomimetic inorganic-organic thin films as coatings for metallic medical implants. These contain hydroxyapatite, the inorganic component of the bony tissues, and a natural biopolymer - silk fibroin - added in view to induce the surface functionalization. Hydroxyapatite (HA), silk fibroin (FIB) and composite HA-FIB films were obtained by Matrix Assisted Pulsed Laser Evaporation (MAPLE) in order to compare their physical and biological performances as coatings on metallic prostheses. We used an excimer laser source (KrF*, {lambda} = 248 nm, {tau} = 25 ns) operated at 10 Hz repetition rate. Coatings were deposited on quartz, Si and Ti substrates and then subjected to physical (FTIR, XRD, AFM, SEM) analyses, correlated with the results of the cytocompatibility in vitro tests. The hybrid films were synthesized from frozen targets of aqueous suspensions with 3:2 or 3:4 weight ratio of HA:FIB. An appropriate stoichiometric and functional transfer was obtained for 0.4-0.5 J/cm{sup 2} laser fluence. FTIR spectra of FIB and HA-FIB films exhibited distinctive absorption maxima, in specific positions of FIB random coil form: 1540 cm{sup -1} amide II, 1654 cm{sup -1} amide I, 1243 cm{sup -1} amide III, while the peak from 1027 cm{sup -1} appeared only for HA and composite films. Osteosarcoma SaOs2 cells cultured 72 h on FIB and HA-FIB films showed increased viability, good spreading and normal cell morphology. The well-elongated, flattened cells are a sign of an appropriate interaction with the MAPLE FIB and composite HA-FIB coatings.

  2. Direct-to-consumer advertising of success rates for medically assisted reproduction: a review of national clinic websites.

    Science.gov (United States)

    Wilkinson, Jack; Vail, Andy; Roberts, Stephen A

    2017-01-12

    To establish how medically assisted reproduction (MAR) clinics report success rates on their websites. Websites of private and NHS clinics offering in vitro fertilisation (IVF) in the UK. We identified clinics offering IVF using the Choose a Fertility Clinic facility on the website of the Human Fertilisation and Embryology Authority (HFEA). Of 81 clinics identified, a website could not be found for 2, leaving 79 for inclusion in the analysis. Outcome measures reported by clinic websites. The numerator and denominator included in the outcome measure were of interest. 53 (67%) websites reported their performance using 51 different outcome measures. It was most common to report pregnancy (83% of these clinics) or live birth rates (51%). 31 different ways of reporting pregnancy and 9 different ways of reporting live birth were identified. 11 (21%) reported multiple birth or pregnancy rates. 1 clinic provided information on adverse events. It was usual for clinics to present results without relevant contextual information such as sample size, reporting period, the characteristics of patients and particular details of treatments. Many combinations of numerator and denominator are available for the purpose of reporting success rates for MAR. The range of reporting options available to clinics is further increased by the possibility of presenting results for subgroups of patients and for different time periods. Given the status of these websites as advertisements to patients, the risk of selective reporting is considerable. Binding guidance is required to ensure consistent, informative reporting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Implementing a bar-code assisted medication administration system: effects on the dispensing process and user perceptions.

    Science.gov (United States)

    Samaranayake, N R; Cheung, S T D; Cheng, K; Lai, K; Chui, W C M; Cheung, B M Y

    2014-06-01

    We assessed the effects of a bar-code assisted medication administration system used without the support of computerised prescribing (stand-alone BCMA), on the dispensing process and its users. The stand-alone BCMA system was implemented in one ward of a teaching hospital. The number of dispensing steps, dispensing time and potential dispensing errors (PDEs) were directly observed one month before and eight months after the intervention. Attitudes of pharmacy and nursing staff were assessed using a questionnaire (Likert scale) and interviews. Among 1291 and 471 drug items observed before and after the introduction of the technology respectively, the number of dispensing steps increased from five to eight and time (standard deviation) to dispense one drug item by one staff personnel increased from 0.8 (0.09) to 1.5 (0.12) min. Among 2828 and 471 drug items observed before and after the intervention respectively, the number of PDEs increased significantly (Psystem offered less benefit to the dispensing process (9/16). Nursing staff perceived the system as useful in improving the accuracy of drug administration (7/10). Implementing a stand-alone BCMA system may slow down and complicate the dispensing process. Nursing staff believe the stand-alone BCMA system could improve the drug administration process but pharmacy staff believes the technology would be more helpful if supported by computerised prescribing. However, periodical assessments are needed to identify weaknesses in the process after implementation, and all users should be educated on the benefits of using this technology. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting.

    Science.gov (United States)

    McClellan, Sean R; Wu, Frances M; Snowden, Lonnie R

    2012-06-01

    Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P language speaking persons. Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.

  5. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff.

    Science.gov (United States)

    Gameiro, S; Boivin, J; Dancet, E; de Klerk, C; Emery, M; Lewis-Jones, C; Thorn, P; Van den Broeck, U; Venetis, C; Verhaak, C M; Wischmann, T; Vermeulen, N

    2015-11-01

    Based on the best available evidence in the literature, what is the optimal management of routine psychosocial care at infertility and medically assisted reproduction (MAR) clinics? Using the structured methodology of the Manual for the European Society of Human Reproduction and Embryology (ESHRE) Guideline Development, 120 recommendations were formulated that answered the 12 key questions on optimal management of routine psychosocial care by all fertility staff. The 2002 ESHRE Guidelines for counselling in infertility has been a reference point for best psychosocial care in infertility for years, but this guideline needed updating and did not focus on routine psychosocial care that can be delivered by all fertility staff. This guideline was produced by a group of experts in the field according to the 12-step process described in the ESHRE Manual for Guideline Development. After scoping the guideline and listing a set of 12 key questions in PICO (Patient, Intervention, Comparison and Outcome) format, thorough systematic searches of the literature were conducted; evidence from papers published until April 2014 was collected, evaluated for quality and analysed. A summary of evidence was written in a reply to each of the key questions and used as the basis for recommendations, which were defined by consensus within the guideline development group (GDG). Patient and additional clinical input was collected during the scoping and the review phase of the guideline development. The guideline group, comprising psychologists, two medical doctors, a midwife, a patient representative and a methodological expert, met three times to discuss evidence and reach consensus on the recommendations. 120 recommendations that aim at guiding fertility clinic staff in providing optimal evidence-based routine psychosocial care to patients dealing with infertility and MAR. The guideline is written in two sections. The first section describes patients' preferences regarding the psychosocial

  6. Views of United States Physicians and Members of the American Medical Association House of Delegates on Physician-assisted Suicide.

    Science.gov (United States)

    Whitney, Simon N.; Brown, Byron W.; Brody, Howard; Alcser, Kirsten H.; Bachman, Jerald G.; Greely, Henry T.

    2001-01-01

    Ascertained the views of physicians and physician leaders toward legalization of physician-assisted suicide. Results indicated members of AMA House of Delegates strongly oppose physician-assisted suicide, but rank-and-file physicians show no consensus either for or against its legalization. Although the debate is adversarial, most physicians are…

  7. 75 FR 62395 - Calculation of Annual Federal Medical Assistance Percentages for Indian Tribes for Use in the...

    Science.gov (United States)

    2010-10-08

    ... IV-E plan development grants intended to assist Indian Tribes to develop their programs and prepare... the Social Security Act.) B. Calculation of FMAP for Indian Tribes The formula for calculating FMAP... Percentages for Indian Tribes for Use in the Title IV-E Foster Care, Adoption Assistance, and Kinship...

  8. The effectiveness of a computer-assisted instruction programme on communication skills of medical specialists in oncology

    NARCIS (Netherlands)

    Hulsman, Robert L.; Ros, Wynand J. G.; Winnubst, Jacques A. M.; Bensing, Jozien M.

    2002-01-01

    Background Although doctor-patient communication is important in health care, medical specialists are generally not well trained in communication skills. Conventional training programmes are generally time consuming and hard to fit into busy working schedules of medical specialists. A

  9. Using medical imaging for the detection of adverse events ("incidents") during the utilization of left ventricular assist devices in adult patients with advanced heart failure.

    Science.gov (United States)

    Kaufmann, Friedrich; Krabatsch, Thomas

    2016-05-01

    Ventricular assist devices (VAD) are used for mechanical support of the terminally failing heart. Failure of these life supporting systems can be fatal. Early and reliable detection of any upcoming problems is mandatory and is crucial for the outcome. Medical imaging methods are described within this review, which are not only essential for diagnosis of typically VAD-related complications but also for the detection or verification of technical issues. Within this review the utilization of medical imaging equipment for the diagnosis of technical malfunctions or damages of implanted system components is discussed. A newly developed specialized acoustic imaging method for pump thrombosis detection will also be described along with the most common VAD-related medical complications and their respective imaging methods and the limitations induced by the use of the VAD-system.

  10. 76 FR 5811 - Adjusted Federal Medical Assistance Percentage (FMAP) Rate for the First Quarter of Fiscal Year...

    Science.gov (United States)

    2011-02-02

    ... and certain other assistance programs in a period of economic downturn. The increased FMAP rates apply... a period of economic downturn, referred to as the ``recession adjustment period.'' The recession...

  11. Human resources issues and Australian Disaster Medical Assistance Teams: results of a national survey of team members.

    Science.gov (United States)

    Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel

    2012-01-01

    Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, this study was designed to evaluate Australian DMAT experience in relation to the human resources issues associated with deployment. Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. The response rate for this survey was 50% (59/118). Most personnel had deployed to the Asian Tsunami affected areas with DMAT members having significant clinical and international experience. While all except one respondent stated they received a full orientation prior to deployment, only 34% of respondents (20/59) felt their role was clearly defined pre deployment. Approximately 56% (33/59) felt their actual role matched their intended role and that their clinical background was well suited to their tasks. Most respondents were prepared to be available for deployment for 1 month (34%, 20/59). The most common period of notice needed to deploy was 6-12 hours for 29% (17/59) followed by 12-24 hours for 24% (14/59). The preferred period of overseas deployment was 14-21 days (46%, 27/59) followed by 1 month (25%, 15/59) and the optimum shift period was felt to be 12 hours by 66% (39/59). The majority felt that there was both adequate pay (71%, 42/59) and adequate indemnity (66%, 39/59). Almost half (49%, 29/59) stated it was better to work with people from the same hospital and, while most felt their deployment could be easily covered by staff from their workplace (56%, 33/59) and caused an inconvenience to their colleagues (51%, 30/59), it was less likely to interrupt service delivery in their workplace (10%, 6/59) or cause an inconvenience to patients (9%, 5/59). Deployment was felt to benefit the affected community by nearly all

  12. Health coaching by medical assistants to improve control of diabetes, hypertension, and hyperlipidemia in low-income patients: a randomized controlled trial.

    Science.gov (United States)

    Willard-Grace, Rachel; Chen, Ellen H; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Thom, David H

    2015-03-01

    Health coaching by medical assistants could be a financially viable model for providing self-management support in primary care if its effectiveness were demonstrated. We investigated whether in-clinic health coaching by medical assistants improves control of cardiovascular and metabolic risk factors when compared with usual care. We conducted a 12-month randomized controlled trial of 441 patients at 2 safety net primary care clinics in San Francisco, California. The primary outcome was a composite measure of being at or below goal at 12 months for at least 1 of 3 uncontrolled conditions at baseline as defined by hemoglobin A1c, systolic blood pressure, and low-density lipoprotein (LDL) cholesterol. Secondary outcomes were meeting all 3 goals and meeting individual goals. Data were analyzed using χ(2) tests and linear regression models. Participants in the coaching arm were more likely to achieve both the primary composite measure of 1 of the clinical goals (46.4% vs 34.3%, P = .02) and the secondary composite measure of reaching all clinical goals (34.0% vs 24.7%, P = .05). Almost twice as many coached patients achieved the hemoglobin A1c goal (48.6% vs 27.6%, P = .01). At the larger study site, coached patients were more likely to achieve the LDL cholesterol goal (41.8% vs 25.4%, P = .04). The proportion of patients meeting the systolic blood pressure goal did not differ significantly. Medical assistants serving as in-clinic health coaches improved control of hemoglobin A1c and LDL levels, but not blood pressure, compared with usual care. Our results highlight the need to understand the relationship between patients' clinical conditions, interventions, and the contextual features of implementation. © 2015 Annals of Family Medicine, Inc.

  13. Computer-Assisted Learning in Anatomy at the International Medical School in Debrecen, Hungary: A Preliminary Report

    Science.gov (United States)

    Kish, Gary; Cook, Samuel A.; Kis, Greta

    2013-01-01

    The University of Debrecen's Faculty of Medicine has an international, multilingual student population with anatomy courses taught in English to all but Hungarian students. An elective computer-assisted gross anatomy course, the Computer Human Anatomy (CHA), has been taught in English at the Anatomy Department since 2008. This course focuses on an…

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

    Science.gov (United States)

    Miller, R A

    2010-01-01

    The INTERNIST-1/Quick Medical Reference (QMR) diagnostic decision support project spans four decades, from 1971-onward. This paper describes the history of the project and details insights gained of relevance to the general clinical and informatics communities.

  15. A System Approach to Navy Medical Education and Training. Appendix 32- Competency Curricula for Ophthalmic Clinic Assistant and Ophthalmic Technician

    Science.gov (United States)

    1974-08-31

    chamber fluid, and gonioscopy exam (Conditions) With direct supervision (Criteria) In accordance with physician’s instructions (Consequence) Completion of...posterior chambers Gonioscopy techniques Slit-lamp biomicroscopy techniques Smear and culture techniques Accuracy in recording ard charting Manual...CILIARY BODY/ANGLE STRUCTURE TESTS I TASXS a. Assist with gonioscopy PERFO-RANCE OBJECTIVE (Stimulus) Upon physician’s orders (Behavior) The OPHTA

  16. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottomup procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis...

  17. NORD's Patient Assistance Programs

    Science.gov (United States)

    ... vsl3ds@rarediseases.org Fax: 1-203-349-8172 Urea Cycle Disorder | Accepting Applications Co-Pay Assistance Medical Assistance Medical ... this program here* *aprender más sobre este programa* Urea Cycle Disorders Diagnostic Testing Phone: 877-333-1860 Fax: 203- ...

  18. 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

  19. New bio-active, antimicrobial and adherent coatings of nanostructured carbon double-reinforced with silver and silicon by Matrix-Assisted Pulsed Laser Evaporation for medical applications

    Science.gov (United States)

    Duta, L.; Ristoscu, C.; Stan, G. E.; Husanu, M. A.; Besleaga, C.; Chifiriuc, M. C.; Lazar, V.; Bleotu, C.; Miculescu, F.; Mihailescu, N.; Axente, E.; Badiceanu, M.; Bociaga, D.; Mihailescu, Ion N.

    2018-05-01

    We report on Matrix-Assisted Pulsed Laser Evaporation (MAPLE) deposition of Carbon thin films, simple or reinforced with intended concentrations of Ag and Si. A KrF∗ (λ = 248 nm, τFWHM ≤ 25 ns, ν = 10 Hz) excimer laser was used for irradiation. The effect of a post-deposition thermal treatment in vacuum was studied. Besides detailed morphological, compositional, structural and pull-out adherence characterizations, the potential of the carbonaceous films for medical applications was investigated in vitro by anti-biofilm and cytocompatibility assays. The microscopic images evidenced no delaminations. Micro-Raman spectroscopy revealed a graphitization tendency depending on preparation conditions, thermal treatment and reinforcing agents' presence. Adherence values improved considerably after thermal treatment. In vitro biological evaluation showed that the films containing ∼1.85 at.% Ag were non-cytotoxic for MG63 cells, while eliciting a limited antimicrobial activity. The increase of Ag content to 3.6 at.% results in a significant enhancement of antimicrobial activity, whilst maintaining the cytotoxic action and adherence characteristics at acceptable levels. We propose a new class of metamaterials based on C reinforced with Ag and Si obtained by MAPLE for medical applications, i.e. the prevention and treatment of various infections associated with biofilms developed on implants and other medical equipments.

  20. Diabetes Medication Assistance Service: the pharmacist's role in supporting patient self-management of type 2 diabetes (T2DM) in Australia.

    Science.gov (United States)

    Mitchell, Bernadette; Armour, Carol; Lee, Mary; Song, Yun Ju; Stewart, Kay; Peterson, Greg; Hughes, Jeff; Smith, Lorraine; Krass, Ines

    2011-06-01

    To evaluate the capacity and effectiveness of trained community pharmacists in delivering the Diabetes Medication Assistance Service (DMAS) via (1) number and types of self-management support interventions (SMSIs); (2) number of goals set and attained by patients and (3) patient outcomes (glycaemic control, medication adherence and satisfaction). Pharmacists (n=109) from 90 community pharmacies in Australia were trained and credentialed to deliver the DMAS. The training focused on developing pharmacists' knowledge and skills in supporting patients' diabetes self-management. A total of 387 patients completed the trial. The mean number of SMSIs per patient was 35 (SD ±31) and the majority (87%) had at least one documented goal that was fully or partially attained. There were significant health benefits for patients including improved glycaemic control and a reduced risk of non-adherence to medications. Over 90% of DMAS patients reported improvements in their knowledge about diabetes self-management. The DMAS provides self management support in the community pharmacy for people with T2DM which may result in improved clinical outcomes. Given appropriate training in diabetes care and behavior change strategies, community pharmacists can offer programs which provide self-management support to their patients with T2DM and improve their health outcomes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Barriers to help-seeking for a gambling problem: the experiences of gamblers who have sought specialist assistance and the perceptions of those who have not.

    Science.gov (United States)

    Pulford, Justin; Bellringer, Maria; Abbott, Max; Clarke, Dave; Hodgins, David; Williams, Jeremy

    2009-03-01

    This paper presents barriers to help-seeking data as reported by users of a national gambling helpline (help-seekers, HS, N = 125) as well as data pertaining to perceived barriers to seeking help as reported by gamblers recruited from the general population (non-help-seekers, NHS, N = 104). All data were collected via a structured, multi-modal survey. When asked to identify actual or perceived barriers to seeking help, responses indicative of pride (78% of HS participants, 84% of NHS participants), shame (73% of HS participants, 84% of NHS participants) or denial (87% of NHS participants) were most frequently reported. These three factors were also most often identified as the real or perceived primary barrier to help-seeking (collectively accounting for 55% of HS, and 60% of NHS, responses to this question) and were the only barriers to be identified by more than 10% of either HS and NHS participants without prompting. It was of note, however, that participants in both groups identified multiple barriers to help-seeking (mean of 6.7 and 12.2, respectively) and that, when presented with a list of 21 possible barrier items, NHS participants endorsed 19 of the listed items significantly more often than their HS counterparts. The implications of these findings, with respect to promoting greater or earlier help-seeking activity amongst problem gamblers, are discussed.

  2. Demographics and complaints of university students who sought help at a campus mental health service between 1987 and 2004.

    Science.gov (United States)

    Oliveira, Maria Lilian Coelho de; Dantas, Clarissa de Rosalmeida; Azevedo, Renata Cruz Soares de; Banzato, Cláudio Eduardo Muller

    2008-01-02

    Client characterization is an important step in evaluating the services offered by campus counseling and mental health centers and in their further planning and development. The objectives here were to describe reported complaints and demographics among students who sought counseling/mental healthcare at a Brazilian campus mental health service over a 17-year period and to compare these characteristics with those of the general university student body. Retrospective study at the Psychological and Psychiatric Service for Students (SAPPE), Universidade Estadual de Campinas (Unicamp). The participants were all of the 2,194 students who sought counseling/mental health care at SAPPE from 1987 to 2004. Information was obtained from clients clinical charts. Unicamps database was consulted for general information on its students. The findings indicated overrepresentation, among the clients, of undergraduates, female students, students from Brazilian states other than São Paulo, students living in the campus residence hall and those whose main source of income was a scholarship grant. We also found overrepresentation of Humanities and Arts students among the clients. The most frequently reported complaints were difficulties in interpersonal relationships, family conflicts and poor academic performance. Course level (undergraduate or postgraduate), study field, living in a university residential facility and reliance on a scholarship grant were found to influence the behavior of seeking mental health counseling among Brazilian university students in this study. Course level was found to influence the pattern of complaints reported at first contact with the mental health service.

  3. Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy

    Science.gov (United States)

    Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

    2013-01-01

    In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation – ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and

  4. [Legal issues of physician-assisted euthanasia. Part III--Passive euthanasia, comparison of international legislation, conclusions for medical practice].

    Science.gov (United States)

    Laux, Johannes; Röbel, Andreas; Parzeller, Markus

    2013-01-01

    The generic term "passive euthanasia" includes different issues dealing with the omission, discontinuation or termination of life-sustaining or life-prolonging medical treatments. The debate around passive euthanasia focuses on the constitutional right of self-determination of every human being on the one hand and the constitutional mandate of the State to protect human life on the other. Issues of passive euthanasia always require a differentiated approach. Essentially, it comes down to the following: In Germany, the human right of self-determination includes the right to prohibit the performance of life-sustaining treatments, even if this leads to the death of the patient. A physician who does not take life-sustaining treatment measures because this is the free will expressed by the patient is not subject to prosecution. On the other hand, if the physician treats the patient against his will, this can be deemed a punishable act of bodily injury. The patient's will is decisive even if his concrete state of health does no longer allow him to freely express his will. In the Patient's Living Will Act of 2009, the German legislator clarified the juridical assessment of such constellations being of particular relevance in practice. A written living will of a person in which he requests to take or not to take certain medical treatment measures in case that he is no longer able to make the decision himself shall be binding for the people involved in the process of medical treatment. If there is no living will, the supposed will of the patient shall be relevant. In its judgment in the "Putz case", the German Federal Court of Justice ruled in 2010 that actions terminating a life-sustaining treatment that does not correspond to the patient's will must be limited to letting an already ongoing disease process run its course. In this context it is not important, however, whether treatment is discontinued by an active act or by omission. Under certain circumstances, the

  5. Decoupling of the minority PhD talent pool and assistant professor hiring in medical school basic science departments in the US

    Science.gov (United States)

    Gibbs, Kenneth D; Basson, Jacob; Xierali, Imam M; Broniatowski, David A

    2016-01-01

    Faculty diversity is a longstanding challenge in the US. However, we lack a quantitative and systemic understanding of how the career transitions into assistant professor positions of PhD scientists from underrepresented minority (URM) and well-represented (WR) racial/ethnic backgrounds compare. Between 1980 and 2013, the number of PhD graduates from URM backgrounds increased by a factor of 9.3, compared with a 2.6-fold increase in the number of PhD graduates from WR groups. However, the number of scientists from URM backgrounds hired as assistant professors in medical school basic science departments was not related to the number of potential candidates (R2=0.12, p>0.07), whereas there was a strong correlation between these two numbers for scientists from WR backgrounds (R2=0.48, pprofessors and posited no hiring discrimination. Simulations show that, given current transition rates of scientists from URM backgrounds to faculty positions, faculty diversity would not increase significantly through the year 2080 even in the context of an exponential growth in the population of PhD graduates from URM backgrounds, or significant increases in the number of faculty positions. Instead, the simulations showed that diversity increased as more postdoctoral candidates from URM backgrounds transitioned onto the market and were hired. DOI: http://dx.doi.org/10.7554/eLife.21393.001 PMID:27852433

  6. First experience using cultured epidermal autografts in Taiwan for burn victims of the Formosa Fun Coast Water Park explosion, as part of Japanese medical assistance.

    Science.gov (United States)

    Matsumura, Hajime; Harunari, Nobuyuki; Ikeda, Hiroto

    2016-05-01

    On June 27, 2015, a flammable starch-based powder exploded at Formosa Fun Coast in Taipei, Taiwan, injuring 499 people, and more than 200 people were in critical condition with severe burns. Although a cultured epidermal autograft (CEA) was not approved or used in clinical practice, the Taiwan Food and Drug Administration requested a Japanese CEA manufacturer to donate CEA for the burn victims as part of international medical assistance. The authors cooperated in this project and participated in the patient selection, wound bed management for CEA, and technical assistance for CEA use. Here, we provide an overview of the project. Nine patients were enrolled, and two patients were excluded from the skin biopsy; seven skin biopsies were collected approximately 1 month after the disaster. The average TBSA% burned was 81.0%, and the mean age was 20.1 years. CEA was grafted in five patients; wound closure had been obtained in one patient, and one patient was severely ill at the time of grafting. The CEA was combined with a wide split auto mesh graft or patch graft. The mean re-epithelization rate at 4 weeks after the grafting was 84.2% by patient, and all of the patients survived. Although this project had many obstacles to overcome, CEA grafting was successful and contributed to wound closure and survival. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  7. Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy.

    Science.gov (United States)

    Harper, Joyce; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo J; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

    2014-08-01

    How has the interface between genetics and assisted reproduction technology (ART) evolved since 2005? The interface between ART and genetics has become more entwined as we increase our understanding about the genetics of infertility and we are able to perform more comprehensive genetic testing. In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and ART and published an extended background paper, recommendations and two Editorials. An interdisciplinary workshop was held, involving representatives of both professional societies and experts from the European Union Eurogentest2 Coordination Action Project. In March 2012, a group of experts from the European Society of Human Genetics, the European Society of Human Reproduction and Embryology and the EuroGentest2 Coordination Action Project met to discuss developments at the interface between clinical genetics and ART. As more genetic causes of reproductive failure are now recognized and an increasing number of patients undergo testing of their genome prior to conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and PGD may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from RCTs to substantiate that the technique is both effective and efficient. Whole genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving, but still remains very

  8. Assisted reproduction involving gestational surrogacy: an analysis of the medical, psychosocial and legal issues: experience from a large surrogacy program.

    Science.gov (United States)

    Dar, Shir; Lazer, Tal; Swanson, Sonja; Silverman, Jan; Wasser, Cindy; Moskovtsev, Sergey I; Sojecki, Agata; Librach, Clifford L

    2015-02-01

    What are the medical, psychosocial and legal aspects of gestational surrogacy (GS), including pregnancy outcomes and complications, in a large series? Meticulous multidisciplinary teamwork, involving medical, legal and psychosocial input for both the intended parent(s) (IP) and the gestational carrier (GC), is critical to achieve a successful GS program. Small case series have described pregnancy rates of 17-50% for GS. There are no large case series and the medical, legal and psychological aspects of GS have not been addressed in most of these studies. To our knowledge, this is the largest reported GS case series. A retrospective cohort study was performed. Data were collected from 333 consecutive GC cycles between 1998 and 2012. There were 178 pregnancies achieved out of 333 stimulation cycles, including fresh and frozen transfers. The indications for a GC were divided into two groups. Those who have 'failed to carry', included women with recurrent implantation failure (RIF), recurrent pregnancy loss (RPL) and previous poor pregnancy outcome (n = 96; 132 cycles, pregnancy rate 50.0%). The second group consisted of those who 'cannot carry' including those with severe Asherman's syndrome, uterine malformations/uterine agenesis and maternal medical diseases (n = 108, 139 cycles, pregnancy rate 54.0%). A third group, of same-sex male couples and single men, were analyzed separately (n = 52, 62 cycles, pregnancy rate 59.7%). In 49.2% of cycles, autologous oocytes were used and 50.8% of cycles involved donor oocytes. The 'failed to carry' group consisted of 96 patients who underwent 132 cycles at a mean age of 40.3 years. There were 66 pregnancies (50.0%) with 17 miscarriages (25.8%) and 46 confirmed births (34.8%). The 'cannot carry pregnancy' group consisted of 108 patients who underwent 139 cycles at a mean age of 35.9 years. There were 75 pregnancies (54.0%) with 15 miscarriages (20.0%) and 56 confirmed births (40.3%). The pregnancy, miscarriage and live birth

  9. Demographics and complaints of university students who sought help at a campus mental health service between 1987 and 2004

    Directory of Open Access Journals (Sweden)

    Maria Lilian Coelho de Oliveira

    Full Text Available CONTEXT AND OBJECTIVE: Client characterization is an important step in evaluating the services offered by campus counseling and mental health centers and in their further planning and development. The objectives here were to describe reported complaints and demographics among students who sought counseling/mental healthcare at a Brazilian campus mental health service over a 17-year period and to compare these characteristics with those of the general university student body. DESIGN AND SETTING: Retrospective study at the Psychological and Psychiatric Service for Students (SAPPE, Universidade Estadual de Campinas (Unicamp. METHODS: The participants were all of the 2,194 students who sought counseling/mental health care at SAPPE from 1987 to 2004. Information was obtained from clients’ clinical charts. Unicamp’s database was consulted for general information on its students. RESULTS: The findings indicated overrepresentation, among the clients, of undergraduates, female students, students from Brazilian states other than São Paulo, students living in the campus residence hall and those whose main source of income was a scholarship grant. We also found overrepresentation of Humanities and Arts students among the clients. The most frequently reported complaints were difficulties in interpersonal relationships, family conflicts and poor academic performance. CONCLUSION: Course level (undergraduate or postgraduate, study field, living in a university residential facility and reliance on a scholarship grant were found to influence the behavior of seeking mental health counseling among Brazilian university students in this study. Course level was found to influence the pattern of complaints reported at first contact with the mental health service.

  10. Estimate of the exposition to the ionizing radiation of the medical veterinarians and its assistants in radiology examinations veterinary medicine

    Energy Technology Data Exchange (ETDEWEB)

    Lima, G.; Braz, D.; Lopez, R. [Rio de Janeiro Univ. Federal, COPPE (Brazil); Mauricia, C. [Rio de Janeiro Univ. Federal, Instituto de Radioprotecao e Dosimetria (Brazil); Barroso, R. [Rio de Janeiro Univ. Federal, Universidade Estadual do Rio de Janeiro (Brazil)

    2006-07-01

    The absorbed ionizing radiation outside of the permissible limits, can cause biological damages e, therefore it must necessarily be monitored. The dosimetry thermoluminescent is a technique very used to detect expositions in operatorserefore they are sensible crystals the ionizing radiation and allows to evaluate if the dose of radiation is or not below of the restriction levels. In scientific literature many information do not exist on the exposition of a medical veterinarian, with this do not have many data of the individual monitoring of these workers, becoming the work it important for posterior studies. Ahead of this, it was carried through measured of the doses, using the thermoluminescence dosemeters LiF: Mg, Cu, P (TLD-100 H) in the position of the crystalline lens, thyroid, hand and thorax, in three clinics of radiology veterinary medicine, different, having the objective to determine the dose distribution that the workers of radiology veterinary medicine are submitted in one day of work. (authors)

  11. Estimate of the exposition to the ionizing radiation of the medical veterinarians and its assistants in radiology examinations veterinary medicine

    International Nuclear Information System (INIS)

    Lima, G.; Braz, D.; Lopez, R.; Mauricia, C.; Barroso, R.

    2006-01-01

    The absorbed ionizing radiation outside of the permissible limits, can cause biological damages e, therefore it must necessarily be monitored. The dosimetry thermoluminescent is a technique very used to detect expositions in operators, therefore they are sensible crystals the ionizing radiation and allows to evaluate if the dose of radiation is or not below of the restriction levels. In scientific literature many information do not exist on the exposition of a medical veterinarian, with this do not have many data of the individual monitoring of these workers, becoming the work it important for posterior studies. Ahead of this, it was carried through measured of the doses, using the thermoluminescence dosemeters LiF: Mg, Cu, P (TLD-100 H) in the position of the crystalline lens, thyroid, hand and thorax, in three clinics of radiology veterinary medicine, different, having the objective to determine the dose distribution that the workers of radiology veterinary medicine are submitted in one day of work. (authors)

  12. Association between use of phthalate-containing medication and semen quality among men in couples referred for assisted reproduction

    DEFF Research Database (Denmark)

    Broe, Anne; Pottegård, A; Hallas, Jesper

    2018-01-01

    studies. One study has shown associations between medicinal phthalate exposure and poor semen quality, suggesting similar effects in humans. STUDY DESIGN, SIZE, DURATION: We included 18,515 males with poor semen quality (cases) and 31,063 males with normal semen quality (controls) registered in the Danish......STUDY QUESTION: Does phthalate exposure from prescription drugs affect semen quality? SUMMARY ANSWER: Exposure to phthalate-containing drugs is associated with poor semen quality. WHAT IS KNOWN ALREADY: Phthalates and their metabolites have been shown to disrupt the hormone signalling in animal...... to the International Statistical Classification of Diseases (ICD-10). The association between current use of phthalate-containing medications less than 90 days prior to semen sampling and reduced semen quality was analysed using unconditional logistic regression, adjusting for potential confounders. MAIN RESULTS...

  13. "For Their Own Good": A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) where Mental Illness Is the Sole Underlying Condition.

    Science.gov (United States)

    Dembo, Justine; Schuklenk, Udo; Reggler, Jonathan

    2018-01-01

    Canada is approaching its federal government's review of whether patients should be eligible for medical assistance in dying (MAID) where mental illness is the sole underlying medical condition, and when "natural death" is not "reasonably foreseeable". For those opposed, arguments involve the following themes: capacity, value of life, vulnerability, stigma, irremediability, and the role of physicians. It has also been suggested that those who are able-bodied should have to kill themselves, even though suicide may be painful, lonely, and violent. Opponents of MAID for severe, refractory suffering due to mental illness imply that it is acceptable to remove agency from such patients on paternalistic grounds. After years of efforts to destigmatise mental illness, these kinds of arguments effectively declare all patients with mental illness, regardless of capacity, unable to make considered choices for themselves. The current paper argues that decisions about capacity must be made on an individual-patient basis. Given the rightful importance granted to respect for patient autonomy in liberal democracies, the wholesale removal of agency advocated by opponents of a permissive MAID regime is difficult to reconcile with Canadian constitutional values.

  14. Inter-Rater Reliability of Historical Data Collected by Non-Medical Research Assistants and Physicians in Patients with Acute Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Mills, Angela M

    2009-02-01

    Full Text Available OBJECTIVES: In many academic emergency departments (ED, physicians are asked to record clinical data for research that may be time consuming and distracting from patient care. We hypothesized that non-medical research assistants (RAs could obtain historical information from patients with acute abdominal pain as accurately as physicians.METHODS: Prospective comparative study conducted in an academic ED of 29 RAs to 32 resident physicians (RPs to assess inter-rater reliability in obtaining historical information in abdominal pain patients. Historical features were independently recorded on standardized data forms by a RA and RP blinded to each others' answers. Discrepancies were resolved by a third person (RA who asked the patient to state the correct answer on a third questionnaire, constituting the "criterion standard." Inter-rater reliability was assessed using kappa statistics (kappa and percent crude agreement (CrA.RESULTS: Sixty-five patients were enrolled (mean age 43. Of 43 historical variables assessed, the median agreement was moderate (kappa 0.59 [Interquartile range 0.37-0.69]; CrA 85.9% and varied across data categories: initial pain location (kappa 0.61 [0.59-0.73]; CrA 87.7%, current pain location (kappa 0.60 [0.47-0.67]; CrA 82.8%, past medical history (kappa 0.60 [0.48-0.74]; CrA 93.8%, associated symptoms (kappa 0.38 [0.37-0.74]; CrA 87.7%, and aggravating/alleviating factors (kappa 0.09 [-0.01-0.21]; CrA 61.5%. When there was disagreement between the RP and the RA, the RA more often agreed with the criterion standard (64% [55-71%] than the RP (36% [29-45%].CONCLUSION: Non-medical research assistants who focus on clinical research are often more accurate than physicians, who may be distracted by patient care responsibilities, at obtaining historical information from ED patients with abdominal pain.

  15. [Results of two surveys of immigrants and natives in Southeast Spain: health, use of services, and need for medical assistance].

    Science.gov (United States)

    Tormo, María-José; Salmerón, Diego; Colorado-Yohar, Sandra; Ballesta, Mónica; Dios, Sofía; Martínez-Fernández, Carmen; Pérez-Flores, Domingo; García-Pérez, Vicenta; Palomar, Joaquín A; Torres, Alberto M; Navarro, Carmen

    2015-01-01

    To compare the self-perceived health, use of health services and unmet need for health care (UNHC) among immigrants and native populations of Southeast Spain. Cross-sectional study of two representative samples of 1150 immigrants, and 1303 native participants from the National Health Survey. A single database was created with specific weights for each sample, and prevalence ratios (PR) were estimated by multivariate regression. Moroccans, Ecuadorians and Eastern Europeans (EE) reported poorer health than the native population (PRs [CI95%]: 2.45 [1.91-3.15]; 1.51 [1.28-1.79] and 1.44 [1.08-1.93], respectively). Immigrants made greater use of emergencies that natives (except for EE) and had lower use of medication. Moroccan showed the greatest difference in the frequency of UNHC (PR [CI95%]:12.20 [5.25 - 28.37]), mainly because of working limitations (46%). The health status and use of health services among immigrants differ significantly from those of natives. Results highlight the higher frequency of UNHC among immigrants, especially high in Moroccans.

  16. Retention in medication-assisted treatment programs in Ukraine-Identifying factors contributing to a continuing HIV epidemic.

    Science.gov (United States)

    Dumchev, Kostyantyn; Dvoryak, Sergii; Chernova, Olena; Morozova, Olga; Altice, Frederick L

    2017-10-01

    Opioid agonist treatments (OAT) are widely-used, evidence-based strategies for treating opioid dependence and reducing HIV transmission. The positive benefits of OAT are strongly correlated with time spent in treatment, making retention a key indicator for program quality. This study assessed patient retention and associated factors in Ukraine, where OAT was first introduced in 2004. Data from clinical records of 2916 patients enrolled in OAT at thirteen sites from 2005 to 2012 were entered into an electronic monitoring system. Survival analysis methods were used to determine the probability of retention and its correlates. Twelve-month retention was 65.8%, improving from 27.7% in 2005, to 70.9% in 2011. In multivariable analyses, the correlates of retention were receiving medium and high doses of medication (compared to low doses, dropout aHR=0.57 for both medium and high doses), having not been tested for HIV and tuberculosis (compared to not being tested, dropout aHR=4.44 and 3.34, respectively), and among those who were tested-a negative TB test result (compared to receiving a positive test result, dropout aHR=0.67). Retention in Ukrainian OAT programs, especially in recent years, is comparable to other countries. The results confirm the importance of adequate OAT dosing (≥60mg of methadone, ≥8mg of buprenorphine). Higher dosing, however, will require interventions that address negative attitudes toward OAT by patients and providers. Interruption of OAT, in the case developing tuberculosis, should incorporate continuity of OAT for TB patients through integrated care delivery systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. 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.

  18. Impact of pharmacists assisting with prescribing and undertaking medication review on oxycodone prescribing and supply for patients discharged from surgical wards.

    Science.gov (United States)

    Tran, T; Taylor, S E; Hardidge, A; Findakly, D; Aminian, P; Elliott, R A

    2017-10-01

    Overprescribing of oxycodone is a contributor to the epidemic of prescription opioid misuse and deaths. Practice models to optimize oxycodone prescribing and supply need to be evaluated. We explored the impact of pharmacist-assisted discharge prescribing and medication review on oxycodone prescribing and supply for patients discharged from surgical wards. A retrospective audit was conducted on two surgical inpatient wards following a 16-week prospective pre- and post-intervention study. During the pre-intervention period, discharge prescriptions were prepared by hospital doctors and then reviewed by a ward pharmacist (WP) before being dispensed. Post-intervention, prescriptions were prepared by a project pharmacist in consultation with hospital doctors and then reviewed by a WP and dispensed. Proportion of patients who were prescribed, and proportion supplied, oxycodone on discharge; Median amount (milligrams) of oxycodone prescribed and supplied, for patients who were prescribed and supplied at least one oxycodone-containing preparation, respectively. A total of 320 and 341 patients were evaluated pre- and post-intervention, respectively. Pre-intervention, 75.6% of patients were prescribed oxycodone; after WP review, 60.3% were supplied oxycodone (Psupplied was 100 milligrams/patient. Post-intervention, 68.6% of patients were prescribed oxycodone; after WP review, 57.8% were supplied oxycodone (Psupplied was 50 milligrams/patient (difference in amount prescribed and supplied: 50 milligrams, Psupplied oxycodone but not the amount supplied/patient. Having a pharmacist assist with prescribing reduced the amount of oxycodone supplied. © 2017 John Wiley & Sons Ltd.

  19. Organ donation after medical assistance in dying or cessation of life-sustaining treatment requested by conscious patients: the Canadian context.

    Science.gov (United States)

    Allard, Julie; Fortin, Marie-Chantal

    2017-09-01

    In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many implications, including the possibility of combining this practice with organ donation through the controlled donation after cardiac death (cDCD) protocol. cDCD most often occurs in cases where the patient has a severe neurological injury but does not meet all the criteria for brain death. The donation is subsequent to the decision to withdraw life-sustaining treatment (LST). Cases where patients are conscious prior to the withdrawal of LST are unusual, and have raised doubts as to the acceptability of removing organs from individuals who are not neurologically impaired and who have voluntarily chosen to die. These cases can be compared with likely scenarios in which patients will request both MAID and organ donation. In both instances, patients will be conscious and competent. Organ donation in such contexts raises ethical issues regarding respect for autonomy, societal pressure, conscientious objections and the dead-donor rule. In this article, we look at relevant policies in other countries and examine the ethical issues associated with cDCD in conscious patients who choose to die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Reforming pathology teaching in medical college by peer-assisted learning and student-oriented interest building activities: A pilot study.

    Science.gov (United States)

    Grover, Sumit; Sood, Neena; Chaudhary, Anurag

    2017-01-01

    Peer-assisted learning (PAL) is a teaching-learning method in which students act as peer teachers and help other students to learn while also themselves learning by teaching. PAL through modified interest building activities (MIBAs) is seldom tried in teaching pathology in medical colleges. This study aimed to evaluate the usefulness of peer teaching using MIBA, obtain feedback from students, and compare different activities with each other and with traditional teaching-learning methods. An interventional pilot study was conducted in 2 months on the 2nd MBBS undergraduates learning pathology at a medical college in North India. Students acted as peer teachers and performed different MIBAs including role plays, demonstration of pathogenesis through props, student-led seminars such as PowerPoint teaching, blackboard teaching, multiple choice question seminars, case-based learning (CBL) exercises, and quizzes before teaching sessions. Feedback was obtained through structured questionnaires on a 5-point Likert scale. Paired t-test was used to compare traditional teaching with MIBAs, and Friedman test was used to compare among different MIBAs. Students found ease of understanding and the interaction and involvement of students as the most important benefits of PAL. MIBAs increased voluntary participation, coordination, teamwork, shared responsibility, and group dynamics among students. Quiz sessions followed by PowerPoint seminars and prop demonstrations received highest mean scores from students on most of the parameters. Quizzes, blackboard teaching, prop activities, and CBL helped students understand topics better and generated interest. Learners advocated for making MIBAs and PAL compulsory for future students. PAL complemented by MIBAs may be adopted to make teaching-learning more interesting and effective through the active involvement and participation of students.

  1. Medicosocial assistance to children in difficult situations

    Directory of Open Access Journals (Sweden)

    Petrova E.I.

    2012-06-01

    Full Text Available Provision of medical and social assistance to children at risk groups has been analyzed theoretically. Information of medical and social assistance to children in the city of Ryazan has been presented

  2. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    Science.gov (United States)

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Enriched adhesion of talc/ZnO nanocomposites on cotton fabric assisted by aloe-vera for bio-medical application

    Energy Technology Data Exchange (ETDEWEB)

    Selvakumar, D.; Yogamalar, N. R.; Jayavel, R., E-mail: rjvel@annauniv.edu [Centre for Nanoscience and Technology, Anna University, Chennai – 600025 (India); Thenammai, A. N.; Hemamalini, R. [Department of Physics, Queen Mary’s College, Chennai – 600004 (India)

    2015-06-24

    Synthesis and characterization of talc/ZnO nanocomposites with the assistance of aloe-vera are investigated by structural and morphological studies. The crystal structure and the phase analysis of ZnO and talc are characterized and confirmed by X-ray diffraction (XRD) analysis. The average crystallite size estimation from the Scherrer formula and the particle size analysis clearly predicts that the size of the ZnO declines when aloe-vera is used as a capping molecule in comparison to the commercially available ZnO. The reduced crystallite size of ZnO renders a stable cohesion with the talc composition and the presence of distinct functional group pyridines/ammonia in the synthesized nanocomposites enriches the good adhesion between the as-synthesized material and cotton fabric. The adhesion and homogeneous distribution of talc/ZnO nanocomposites on the cotton fabric are inferred from the scanning electron microscopy (SEM) results. The basic studies and characterizations would pave way for futuristic bio-medical application.

  4. Enriched adhesion of talc/ZnO nanocomposites on cotton fabric assisted by aloe-vera for bio-medical application

    International Nuclear Information System (INIS)

    Selvakumar, D.; Yogamalar, N. R.; Jayavel, R.; Thenammai, A. N.; Hemamalini, R.

    2015-01-01

    Synthesis and characterization of talc/ZnO nanocomposites with the assistance of aloe-vera are investigated by structural and morphological studies. The crystal structure and the phase analysis of ZnO and talc are characterized and confirmed by X-ray diffraction (XRD) analysis. The average crystallite size estimation from the Scherrer formula and the particle size analysis clearly predicts that the size of the ZnO declines when aloe-vera is used as a capping molecule in comparison to the commercially available ZnO. The reduced crystallite size of ZnO renders a stable cohesion with the talc composition and the presence of distinct functional group pyridines/ammonia in the synthesized nanocomposites enriches the good adhesion between the as-synthesized material and cotton fabric. The adhesion and homogeneous distribution of talc/ZnO nanocomposites on the cotton fabric are inferred from the scanning electron microscopy (SEM) results. The basic studies and characterizations would pave way for futuristic bio-medical application

  5. Enriched adhesion of talc/ZnO nanocomposites on cotton fabric assisted by aloe-vera for bio-medical application

    Science.gov (United States)

    Selvakumar, D.; Thenammai, A. N.; Yogamalar, N. R.; Hemamalini, R.; Jayavel, R.

    2015-06-01

    Synthesis and characterization of talc/ZnO nanocomposites with the assistance of aloe-vera are investigated by structural and morphological studies. The crystal structure and the phase analysis of ZnO and talc are characterized and confirmed by X-ray diffraction (XRD) analysis. The average crystallite size estimation from the Scherrer formula and the particle size analysis clearly predicts that the size of the ZnO declines when aloe-vera is used as a capping molecule in comparison to the commercially available ZnO. The reduced crystallite size of ZnO renders a stable cohesion with the talc composition and the presence of distinct functional group pyridines/ammonia in the synthesized nanocomposites enriches the good adhesion between the as-synthesized material and cotton fabric. The adhesion and homogeneous distribution of talc/ZnO nanocomposites on the cotton fabric are inferred from the scanning electron microscopy (SEM) results. The basic studies and characterizations would pave way for futuristic bio-medical application.

  6. Regulations Concerning the ‘Temporary Period’ in The New System Sought to be Established in Cyprus and Its Properties

    Directory of Open Access Journals (Sweden)

    Soyalp Tamçelik

    2014-12-01

    Full Text Available In this research, regulations concerning the ‘temporary period’ in the new system sought to be established in Cyprus and its properties have been addressed. From this point of view, as the main purpose of this research, the regulations required during the talks taking place between the parties in Cyprus before a federal state is established and how the institutions expected to fulfill these will be structured have been observed. As could be understood from its name, temporary period reflects a certain period and is the period assumed to continue in Cyprus until the formation envisioned to be established there is achieved. Therefore, it is also possible to call this period a ‘transition period’. Actually, the most consistent for-mula that could be brought forward towards this period seems to be the formula of ‘temporary joint administration based on the principle of equality’. This formula, which is important for providing the necessary element of trust for negotiation particularly on issues of territory and constitution and also for displaying whether or not the functional properties of the federal state to be established is based upon a true foundation, appears for now as the most realistic method. On the other hand, the regulations to be made during the temporary period will come into effect with the preparation of the Federal Constitution and the Electoral Law, installing federal bureaucracy, analyzing property claims, determining economic development and protective provisions, regulations regarding territorial adjustments and through Committees, formed by the two communities, in charge of preparing the activity programme. Before a Federal Republic is established, a new state of partnership will emerge after the ‘Temporary Regulations’ enter into force. This partnership will reveal itself as a new state system organized within a framework of a federation that consists of two communities from a constitutional aspect and of two

  7. The effect of bundling medication-assisted treatment for opioid addiction with mHealth: study protocol for a randomized clinical trial.

    Science.gov (United States)

    Gustafson, David H; Landucci, Gina; McTavish, Fiona; Kornfield, Rachel; Johnson, Roberta A; Mares, Marie-Louise; Westergaard, Ryan P; Quanbeck, Andrew; Alagoz, Esra; Pe-Romashko, Klaren; Thomas, Chantelle; Shah, Dhavan

    2016-12-12

    Opioid dependence has devastating and increasingly widespread consequences and costs, and the most common outcome of treatment is early relapse. People who inject opioids are also at disproportionate risk for contracting the human immunodeficiency virus (HIV) and hepatitis C virus (HCV). This study tests an approach that has been shown to improve recovery rates: medication along with other supportive services (medication-assisted treatment, or MAT) against MAT combined with a smartphone innovation called A-CHESS (MAT + A-CHESS). This unblinded study will randomly assign 440 patients to receive MAT + A-CHESS or MAT alone. Eligible patients will meet criteria for having an opioid use disorder of at least moderate severity and will be taking methadone, injectable naltrexone, or buprenorphine. Patients with A-CHESS will have smartphones for 16 months; all patients will be followed for 24 months. The primary outcome is the difference between patients in the two arms in percentage of days using illicit opioids during the 24-month intervention. Secondary outcomes are differences between patients receiving MAT + A-CHESS versus MAT in other substance use, quality of life, retention in treatment, health service use, and, related to HIV and HCV, screening and testing rates, medication adherence, risk behaviors, and links to care. We will also examine mediators and moderators of the effects of MAT + A-CHESS. We will measure variables at baseline and months 4, 8, 12, 16, 20, and 24. At each point, patients will respond to a 20- to 30-min phone survey; urine screens will be collected at baseline and up to twice a month thereafter. We will use mixed-effects to evaluate the primary and secondary outcomes, with baseline scores functioning as covariates, treatment condition as a between-subject factor, and the outcomes reflecting scores for a given assessment at the six time points. Separate analyses will be conducted for each outcome. A-CHESS has been shown to

  8. Information sought, information shared: exploring performance and image enhancing drug user-facilitated harm reduction information in online forums.

    Science.gov (United States)

    Tighe, Boden; Dunn, Matthew; McKay, Fiona H; Piatkowski, Timothy

    2017-07-21

    There is good evidence to suggest that performance and image enhancing drug (PIED) use is increasing in Australia and that there is an increase in those using PIEDs who have never used another illicit substance. Peers have always been an important source of information in this group, though the rise of the Internet, and the increased use of Internet forums amongst substance consumers to share harm reduction information, means that PIED users may have access to a large array of views and opinions. The aim of this study was to explore the type of information that PIED users seek and share on these forums. An online search was conducted to identify online forums that discussed PIED use. Three discussion forums were included in this study: aussiegymjunkies.com, bodybuildingforums.com.au, and brotherhoodofpain.com. The primary source of data for this study was the 'threads' from the online forums. Threads were thematically analysed for overall content, leading to the identification of themes. One hundred thirty-four threads and 1716 individual posts from 450 unique avatars were included in this analysis. Two themes were identified: (1) personal experiences and advice and (2) referral to services and referral to the scientific literature. Internet forums are an accessible way for members of the PIED community to seek and share information to reduce the harms associated with PIED use. Forum members show concern for both their own and others' use and, where they lack information, will recommend seeking information from medical professionals. Anecdotal evidence is given high credence though the findings from the scientific literature are used to support opinions. The engagement of health professionals within forums could prove a useful strategy for engaging with this population to provide harm reduction interventions, particularly as forum members are clearly seeking further reliable information, and peers may act as a conduit between users and the health and medical

  9. Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics.

    Science.gov (United States)

    Or, Calvin; Tong, Ellen; Tan, Joseph; Chan, Summer

    2018-05-29

    The health care reform initiative led by the Hong Kong government's Food and Health Bureau has started the implementation of an electronic sharing platform to provide an information infrastructure that enables public hospitals and private clinics to share their electronic medical records (EMRs) for improved access to patients' health care information. However, previous attempts to convince the private clinics to adopt EMRs to document health information have faced challenges, as the EMR adoption has been voluntary. The lack of electronic data shared by private clinics carries direct impacts to the efficacy of electronic record sharing between public and private healthcare providers. To increase the likelihood of buy-in, it is essential to proactively identify the users' and organizations' needs and capabilities before large-scale implementation. As part of the reform initiative, this study examined factors affecting the adoption of EMRs in small or solo private general practice clinics, by analyzing the experiences and opinions of the physicians and clinical assistants during the pilot implementation of the technology, with the purpose to learn from it before full-scale rollout. In-depth, semistructured interviews were conducted with 23 physicians and clinical assistants from seven small or solo private general practice clinics to evaluate their experiences, expectations, and opinions regarding the deployment of EMRs. Interview transcripts were content analyzed to identify key factors. Factors affecting the adoption of EMRs to record and manage health care information were identified as follows: system interface design; system functions; stability and reliability of hardware, software, and computing networks; financial and time costs; task and outcome performance, work practice, and clinical workflow; physical space in clinics; trust in technology; users' information technology literacy; training and technical support; and social and organizational influences. The

  10. High-throughput identification of bacteria and yeast by matrix-assisted laser desorption ionization-time of flight mass spectrometry in conventional medical microbiology laboratories.

    Science.gov (United States)

    van Veen, S Q; Claas, E C J; Kuijper, Ed J

    2010-03-01

    Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is suitable for high-throughput and rapid diagnostics at low costs and can be considered an alternative for conventional biochemical and molecular identification systems in a conventional microbiological laboratory. First, we evaluated MALDI-TOF MS using 327 clinical isolates previously cultured from patient materials and identified by conventional techniques (Vitek-II, API, and biochemical tests). Discrepancies were analyzed by molecular analysis of the 16S genes. Of 327 isolates, 95.1% were identified correctly to genus level, and 85.6% were identified to species level by MALDI-TOF MS. Second, we performed a prospective validation study, including 980 clinical isolates of bacteria and yeasts. Overall performance of MALDI-TOF MS was significantly better than conventional biochemical systems for correct species identification (92.2% and 83.1%, respectively) and produced fewer incorrect genus identifications (0.1% and 1.6%, respectively). Correct species identification by MALDI-TOF MS was observed in 97.7% of Enterobacteriaceae, 92% of nonfermentative Gram-negative bacteria, 94.3% of staphylococci, 84.8% of streptococci, 84% of a miscellaneous group (mainly Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella [HACEK]), and 85.2% of yeasts. MALDI-TOF MS had significantly better performance than conventional methods for species identification of staphylococci and genus identification of bacteria belonging to HACEK group. Misidentifications by MALDI-TOF MS were clearly associated with an absence of sufficient spectra from suitable reference strains in the MALDI-TOF MS database. We conclude that MALDI-TOF MS can be implemented easily for routine identification of bacteria (except for pneumococci and viridans streptococci) and yeasts in a medical microbiological laboratory.

  11. Medical management and planning for radiation emergencies

    International Nuclear Information System (INIS)

    Bongirwar, P.R.

    2001-01-01

    Radiation Emergencies which result as a consequence of nuclear or radiological accidents can produce a spectrum of different types of radiation injuries which could include cases of whole body irradiation causing Acute Radiation Syndrome, partial body irradiation, radiation burns (localized irradiation), radioactive contamination and combined injuries having component of conventional injuries. General principles of managing these cases entail doing triage, offering immediate emergency care and instituting definitive treatment. Infra-structural facilities which are required to facilitate their management include first aid post at plant site, personnel decontamination centre, site clinic and specialized hospital which can offer comprehensive investigational and treatment modalities. Training of medical and paramedical personnel is crucial as part of emergency preparedness programme and if needed, help can be sought from WHO's Radiation Emergency Medical Preparedness and Assistance Network Centres. (author)

  12. Assisted suicide and euthanasia.

    Science.gov (United States)

    van der Heide, Agnes

    2013-01-01

    Several countries have adopted laws that regulate physician assistance in dying. Such assistance may consist of providing a patient with a prescription of lethal medication that is self-administered by the patient, which is usually referred to as (physician) assistance in suicide, or of administering lethal medication to a patient, which is referred to as euthanasia. The main aim of regulating physician assistance in dying is to bring these practices into the open and to provide physicians with legal certainty. A key condition in all jurisdictions that have regulated either assistance in suicide or euthanasia is that physicians are only allowed to engage in these acts upon the explicit and voluntary request of the patient. All systems that allow physician assistance in dying have also in some way included the notion that physician assistance in dying is only accepted when it is the only means to address severe suffering from an incurable medical condition. Arguments against the legal regulation of physician assistance in dying include principled arguments, such as the wrongness of hastening death, and arguments that emphasize the negative consequences of allowing physician assistance in dying, such as a devaluation of the lives of older people, or people with chronic disease or disabilities. Opinion polls show that some form of accepting and regulating euthanasia and physician assistance in suicide is increasingly supported by the general population in most western countries. Studies in countries where physician assistance in dying is regulated suggest that practices have remained rather stable in most jurisdictions and that physicians adhere to the legal criteria in the vast majority of cases. © 2013 Elsevier B.V. All rights reserved.

  13. The impact of different benefit packages of Medical Financial Assistance Scheme on health service utilization of poor population in rural China.

    Science.gov (United States)

    Hao, Yanhua; Wu, Qunhong; Zhang, Zhenzhong; Gao, Lijun; Ning, Ning; Jiao, Mingli; Zakus, David

    2010-06-17

    Since 2003 and 2005, National Pilot Medical Financial Assistance Scheme (MFA) has been implemented in rural and urban areas of China to improve the poorest families' accessibility to health services. Local governments of the pilot areas formulated various benefit packages. Comparative evaluation research on the effect of different benefit packages is urgently needed to provide evidence for improving policy-making of MFA. This study was based on a MFA pilot project, which was one component of Health VIII Project conducted in rural China. This article aimed to compare difference in health services utilization of poor families between two benefit package project areas: H8 towns (package covering inpatient service, some designated preventive and curative health services but without out-patient service reimbursement in Health VIII Project,) and H8SP towns (package extending coverage of target population, covering out- patient services and reducing co-payment rate in Health VIII Supportive Project), and to find out major influencing factors on their services utilization. A cross-sectional survey was conducted in 2004, which used stratified cluster sampling method to select poor families who have been enrolled in MFA scheme in rural areas of ChongQing. All family members of the enrolled households were interviewed. 748 and 1129 respondents from two kinds of project towns participated in the survey. Among them, 625 and 869 respondents were included (age>/=15) in the analysis of this study. Two-level linear multilevel model and binomial regressions with a log link were used to assess influencing factors on different response variables measuring service utilization. In general, there was no statistical significance in physician visits and hospitalizations among all the respondents between the two kinds of benefit package towns. After adjusting for major confounding factors, poor families in H8SP towns had much higher frequency of MFA use (beta = 1.17) and less use of

  14. Can shoulder range of movement be measured accurately using the Microsoft Kinect sensor plus Medical Interactive Recovery Assistant (MIRA) software?

    Science.gov (United States)

    Wilson, James D; Khan-Perez, Jennifer; Marley, Dominic; Buttress, Susan; Walton, Michael; Li, Baihua; Roy, Bibhas

    2017-12-01

    This study compared the accuracy of measuring shoulder range of movement (ROM) with a simple laptop-sensor combination vs. trained observers (shoulder physiotherapists and shoulder surgeons) using motion capture (MoCap) laboratory equipment as the gold standard. The Microsoft Kinect sensor (Microsoft Corp., Redmond, WA, USA) tracks 3-dimensional human motion. Ordinarily used with an Xbox (Microsoft Corp.) video game console, Medical Interactive Recovery Assistant (MIRA) software (MIRA Rehab Ltd., London, UK) allows this small sensor to measure shoulder movement with a standard computer. Shoulder movements of 49 healthy volunteers were simultaneously measured by trained observers, MoCap, and the MIRA device. Internal rotation was assessed with the shoulder abducted 90° and external rotation with the shoulder adducted. Visual estimation and MIRA measurements were compared with gold standard MoCap measurements for agreement using Bland-Altman methods. There were 1670 measurements analyzed. The MIRA evaluations of all 4 cardinal shoulder movements were significantly more precise, with narrower limits of agreement, than the measurements of trained observers. MIRA achieved ±11° (95% confidence interval [CI], 8.7°-12.6°) for forward flexion vs. ±16° (95% CI, 14.6°-17.6°) by trained observers. For abduction, MIRA showed ±11° (95% CI, 8.7°-12.8°) against ±15° (95% CI, 13.4°-16.2°) for trained observers. MIRA attained ±10° (95% CI, 8.1°-11.9°) during external rotation measurement, whereas trained observers only reached ±21° (95% CI, 18.7°-22.6°). For internal rotation, MIRA achieved ±9° (95% CI, 7.2°-10.4°), which was again better than TOs at ±18° (95% CI, 16.0°-19.3°). A laptop combined with a Microsoft Kinect sensor and the MIRA software can measure shoulder movements with acceptable levels of accuracy. This technology, which can be easily set up, may also allow precise shoulder ROM measurement outside the clinic setting. Copyright © 2017

  15. Globalization and healthcare: understanding health and medical tourism.

    Science.gov (United States)

    Carrera, Percivil M; Bridges, John Fp

    2006-08-01

    Faced with long waiting lists, the high cost of elective treatment and fewer barriers to travel, the idea of availing healthcare in another country is gaining greater appeal to many. The objective of this review is to perform a literature review of health and medical tourism, to define health and medical tourism based on the medical literature and to estimate the size of trade in healthcare. The Medline database was used for our literature review. In our initial search for 'health tourism' and 'medical tourism' we found a paucity of formal literature as well as conceptual ambiguity in the literature. Subsequently, we reviewed the literature on 'tourism' in general and in the context of healthcare. On the basis of 149 papers, we then sought to conceptualize health tourism and medical tourism. Based on our definitions, we likewise sought to estimate market capacity internationally. We defined health tourism as "the organized travel outside one's local environment for the maintenance, enhancement or restoration of an individual's wellbeing in mind and body". A subset of this is medical tourism, which is "the organized travel outside one's natural healthcare jurisdiction for the enhancement or restoration of the individual's health through medical intervention". At the international level, health tourism is an industry sustained by 617 million individuals with an annual growth of 3.9% annually and worth US$513 billion. In conclusion, this paper underscored the issue of a severely limited formal literature that is compounded by conceptual ambiguity facing health and medical tourism scholarship. In clarifying the concepts and standardizing definitions, and providing evidence with regard to the scale of trade in healthcare, we hope to assist in furthering fundamental research tasks, including the further development of reliable and comparable data, the push and pull factors for engaging in health and medical tourism, and the impact of health tourism but, more so, medical

  16. Proceedings of the REMPAN 97: 7. Coordination meeting of World Health Organization collaborating centers in radiation emergency medical preparedness and assistance network

    International Nuclear Information System (INIS)

    1997-01-01

    Special reports and panels are presented in these proceedings covering the following subjects: emergency planning and preparedness, biology, biological effects, radiation effects and therapy, internal contamination and irradiation, and national programs and activities related to radiation accident preparedness and assistance

  17. 'First we go to the small doctor': First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India

    NARCIS (Netherlands)

    M. Gautham (Meenakshi); E. Binnendijk (Erica); R. Koren (Ruth); D.M. Dror (David)

    2011-01-01

    textabstractBackground & objectives: Against the backdrop of insufficient public supply of primary care and reports of informal providers, the present study sought to collect descriptive evidence on 1 st contact curative health care seeking choices among rural communities in two States of India -

  18. Computer-assisted radiology

    International Nuclear Information System (INIS)

    Lemke, H.U.

    1988-01-01

    New digital imaging modalities and more sophisticated image processing systems will have a profound effect on those areas of medicine concerned with imaging. This mainly means computer-assisted radiology (CAR) and implies a transition from analog film systems to digital imaging systems, integration of digital imaging modalities through picture archiving and communication systems (PACS) and the graduated employment of image-oriented medical work stations (MWS) for computer-assisted representation, communication, diagnosis, and therapy planning. (orig.) [de

  19. INTERACT-CANCER. The development and evaluation of a computer-assisted course on communication skills for medical specialists in oncology

    NARCIS (Netherlands)

    Hulsman, R. L.; Ros, W. J.; Janssen, M.; Winnubst, J. A.

    1997-01-01

    One of the main problems in training medical specialists in communication skills is the fact that very few specialists participate in such courses. Most courses on communication skills are hard to combine with a busy medical practice because of the course attendance requirement on working days.

  20. A Study to Evaluate the Organization and the Operating Procedures of the Patient Assistance Function at Brooke Army Medical Center, Fort Sam Houston, Texas

    Science.gov (United States)

    1979-08-01

    15 March 1979. 59Interview with Wendy L. Farace , Head Nurse, Obstetrics/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas, 8...6 February 1979. Farace , Wendy L. Head Nurse, Obstetrica/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas. Interview, 8 January

  1. 医学生对辅助生殖技术伦理问题认知的调查研究%Investigation on Medical Students' Ethical Cognition of Assisted Reproductive Technology

    Institute of Scientific and Technical Information of China (English)

    卢晓宁; 席稳燕; 符生鱼; 李向红; 韩强

    2017-01-01

    Objective:To investigate the medical students' cognition of ethical issues in assisted reproductive technology (ART) and discuss the importance of ethical education in medical colleges and universities.Methods:A questionnaire survey about the ethical cognition of assisted reproductive technology was conducted among 632 medical students.The questionnaire included the donation and management of gametes and embryos,and offspring problems.Results:Medical students agreed with most of the current ART-related laws and regulations.however,44.8% of medical students considered that criteria of donating eggs should be relaxed,such as allowing women who do not receive ART treatment be paid for eggs.In addition,a total of 39.0% of medical students supported the legalization of surrogacy technology in china.Conclusion:Medical students exists a certain misunderstanding in egg donation and surrogacy technology.We should give more training to medical students in ethical knowledge.In addition,our country can supplement and perfect the current laws and regulations to a certain extent.%目的 了解医学生对辅助生殖技术中伦理问题的认知情况,探讨医学院校相关伦理教育之重要性.方法 对623名医学生进行有关辅助生殖技术伦理认知的问卷调查.问卷包括配子和胚胎的捐献、处理及子代问题.结果 医学生对我国现行的多数ART相关的法律法规是认同的,但有44.8%的医学生认为需要放宽供卵的标准,比如允许未接受ART治疗的妇女有偿供卵;另外有39.0%医学生支持代孕技术在我国合法化.结论 医学生在卵子捐赠和代孕的问题存在一定的误区,需要对医学生进行更多的伦理知识相关培训.另外,我国在一定程度上可以就现行法律法规进行补充完善.

  2. Predicting Internet risks: a longitudinal panel study of gratifications-sought, Internet addiction symptoms, and social media use among children and adolescents

    OpenAIRE

    Leung, Louis

    2014-01-01

    This study used longitudinal panel survey data collected from 417 adolescents at 2 points in time 1 year apart. It examined relationships between Internet risks changes in Time 2 and social media gratifications-sought, Internet addiction symptoms, and social media use all measured at Time 1. By controlling for age, gender, education, and criterion variable scores in Internet addiction at Time 1, entertainment and instant messaging use at Time 1 significantly predicted increased Internet addic...

  3. What is sought from graphic designers? A first thematic analysis of job offers for graphic design positions in the United Kingdom

    OpenAIRE

    Nicoletti Dziobczenski, Paulo; Person, Oscar

    2016-01-01

    An empirically grounded understanding about which knowledge and skills that are sought from designers is missing for a number of professional subfields of design. This gap in research challenges i) design educators in planning their educational offerings and ii) design practitioners and students in articulating their contribution to clients and future employers. In this paper, we study the references that are made to knowledge and skills in job offers for graphic designers in UK. Based on a f...

  4. Predicting Internet risks: a longitudinal panel study of gratifications-sought, Internet addiction symptoms, and social media use among children and adolescents

    Science.gov (United States)

    Leung, Louis

    2014-01-01

    This study used longitudinal panel survey data collected from 417 adolescents at 2 points in time 1 year apart. It examined relationships between Internet risks changes in Time 2 and social media gratifications-sought, Internet addiction symptoms, and social media use all measured at Time 1. By controlling for age, gender, education, and criterion variable scores in Internet addiction at Time 1, entertainment and instant messaging use at Time 1 significantly predicted increased Internet addiction measured at Time 2. The study also controlled for demographics and scores of criterion variables in Internet risks: targeted for harassment, privacy exposed, and pornographic or violent content consumed in Time 1. Gratifications-sought (including status-gaining, expressing opinions, and identity experimentation), Internet addiction symptoms (including withdrawal and negative life consequences), and social media use (in particular, blogs, and Facebook) significantly predicted Internet risk changes in Time 2. These findings suggest that, with their predictive power, these predictors at Time 1 could be used to identify those adolescents who are likely to develop Internet addiction symptoms and the likelihood of experiencing Internet risks based on their previous gratifications-sought, previous addiction symptoms, and their habits of social media use at Time 1. PMID:25750792

  5. Predicting Internet risks: a longitudinal panel study of gratifications-sought, Internet addiction symptoms, and social media use among children and adolescents.

    Science.gov (United States)

    Leung, Louis

    2014-01-01

    This study used longitudinal panel survey data collected from 417 adolescents at 2 points in time 1 year apart. It examined relationships between Internet risks changes in Time 2 and social media gratifications-sought, Internet addiction symptoms, and social media use all measured at Time 1. By controlling for age, gender, education, and criterion variable scores in Internet addiction at Time 1, entertainment and instant messaging use at Time 1 significantly predicted increased Internet addiction measured at Time 2. The study also controlled for demographics and scores of criterion variables in Internet risks: targeted for harassment, privacy exposed, and pornographic or violent content consumed in Time 1. Gratifications-sought (including status-gaining, expressing opinions, and identity experimentation), Internet addiction symptoms (including withdrawal and negative life consequences), and social media use (in particular, blogs, and Facebook) significantly predicted Internet risk changes in Time 2. These findings suggest that, with their predictive power, these predictors at Time 1 could be used to identify those adolescents who are likely to develop Internet addiction symptoms and the likelihood of experiencing Internet risks based on their previous gratifications-sought, previous addiction symptoms, and their habits of social media use at Time 1.

  6. Assisted Suicide as a Remedy for Suffering? The End-of-Life Preferences of British "Suicide Tourists".

    Science.gov (United States)

    Richards, Naomi

    2017-01-01

    The highly charged debate about the moral status of assisted suicide features regularly in the news media in medically advanced countries. In the United Kingdom, the debate has been dominated in recent years by a new mode of death: assisted suicide in Switzerland, so-called suicide tourism. Drawing on in-depth interviews with people who were actively planning on 'going to Switzerland,' alongside participant-observation at a do-it-yourself self-deliverance workshop, I discuss how participants arrived at their decision to seek professionalized assistance. In doing so, I explore the constituent elements of people's suffering, examining how participants justified, rationalized, or sought authentication from a doctor for their decision to die in light of their own belief systems and aesthetic preferences for a good death.

  7. Lecture Based Versus peer Assisted Learning: Quasi-Experimental Study to Compare Knowledge Gain of Forth Year Medical Students in Community Health and Nutrition Course

    Directory of Open Access Journals (Sweden)

    Seema Daud

    2016-12-01

    Conclusion: The present study concludes that in terms of academic achievements, PAL was equally effective to lectures. Therefore, PAL can be incorporated as a supplement to lectures in medical school curricula.

  8. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  9. Medical taking-decisions in the health primary assistance context. Transcendence of a problem from a general comprehensive doctor´s perspective.

    OpenAIRE

    Luis Alberto Corona Martínez

    2003-01-01

    This article is aimed at deepening on the consequences of the deficient development of abilities in decision making in the speciality of medicine, analysed from the prospective of the Comprehensive General Doctor . A psychological and professional characterisation of the Comprehensive General Doctors are developed from the analysis of their environment and on these bases the paper presents how these problems are reflected in the professional assistance. The conclusions are good to recognise h...

  10. Assisted Living

    Science.gov (United States)

    ... it, too. Back to top What is the Cost for Assisted Living? Although assisted living costs less than nursing home ... Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies ...

  11. Is computer-assisted instruction more effective than other educational methods in achieving ECG competence among medical students and residents? Protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Viljoen, Charle André; Scott Millar, Rob; Engel, Mark E; Shelton, Mary; Burch, Vanessa

    2017-12-26

    Although ECG interpretation is an essential skill in clinical medicine, medical students and residents often lack ECG competence. Novel teaching methods are increasingly being implemented and investigated to improve ECG training. Computer-assisted instruction is one such method under investigation; however, its efficacy in achieving better ECG competence among medical students and residents remains uncertain. This article describes the protocol for a systematic review and meta-analysis that will compare the effectiveness of computer-assisted instruction with other teaching methods used for the ECG training of medical students and residents. Only studies with a comparative research design will be considered. Articles will be searched for in electronic databases (PubMed, Scopus, Web of Science, Academic Search Premier, CINAHL, PsycINFO, Education Resources Information Center, Africa-Wide Information and Teacher Reference Center). In addition, we will review citation indexes and conduct a grey literature search. Data extraction will be done on articles that met the predefined eligibility criteria. A descriptive analysis of the different teaching modalities will be provided and their educational impact will be assessed in terms of effect size and the modified version of Kirkpatrick framework for the evaluation of educational interventions. This systematic review aims to provide evidence as to whether computer-assisted instruction is an effective teaching modality for ECG training. It is hoped that the information garnered from this systematic review will assist in future curricular development and improve ECG training. As this research is a systematic review of published literature, ethical approval is not required. The results will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement and will be submitted to a peer-reviewed journal. The protocol and systematic review will be included in a PhD dissertation. CRD

  12. Assisted reproduction and child neurodevelopmental outcomes

    DEFF Research Database (Denmark)

    Bay, Bjørn; Mortensen, Erik Lykke; Kesmodel, Ulrik Schiøler

    2013-01-01

    To systematically review the existing literature on neurodevelopmental outcomes in children born after medically assisted reproduction compared with those of children born after spontaneous conception....

  13. Medical assistance in the management of nuclear power plant accidents. Guide for: medical personnel of emergency preparedness services, doctors of emergency departments, doctors for out-patient or in-patient treatment. 2. rev. ed.

    International Nuclear Information System (INIS)

    Gumprecht, D.; Haehnel, S.

    1995-01-01

    The guide explains the medical tasks and activities in the context of the emergency preparedness programmes and provisions established by the Laender. The medical expert for radiation injuries is a particularly important function in the radiologial accident management services. The provisions for medical care have been determined on the basis of knowledge drawn among other sources from the German Nuclear Power Plant Risk Study, Phase B. In addition, the guide's provisions are based on international knowledge about the consequences of enhanced radiation exposure, and the medical tasks and the required organisational infrastructure have been determined accordingly. A further source of reference for planning the activities are the data accumulated during emergency preparedness training activities in the various Laender. (orig./MG). 3 figs., 5 tabs [de

  14. How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide No. 59.

    Science.gov (United States)

    Ten Cate, Th J; Kusurkar, Rashmi A; Williams, Geoffrey C

    2011-01-01

    Self-determination Theory (SDT), designed by Edward Deci and Richard Ryan, serves among the current major motivational theories in psychology. SDT research has been conducted in many areas, among which are education and health care, but its applications in medical education are rare. The potential of SDT to help understand processes in medical education justifies this Guide. SDT is explained in seven principles, one of which is the distinction of three innate psychological needs of human beings: for competence, for autonomy and for relatedness. Further, SDT elaborates how humans tend to internalise regulation of behaviour that initially has been external, in order to develop autonomous, self-determined behaviour. Implications of SDT for medical education are discussed with reference to preparation and selection, curriculum structure, classroom teaching, assessments and examinations, self-directed learning, clinical teaching, students as teachers and researchers, continuing professional development, faculty development and stress among trainees.

  15. Computer assisted radiology

    International Nuclear Information System (INIS)

    Lemke, H.U.; Jaffe, C.C.; Felix, R.

    1993-01-01

    The proceedings of the CAR'93 symposium present the 126 oral papers and the 58 posters contributed to the four Technical Sessions entitled: (1) Image Management, (2) Medical Workstations, (3) Digital Image Generation - DIG, and (4) Application Systems - AS. Topics discussed in Session (1) are: picture archiving and communication systems, teleradiology, hospital information systems and radiological information systems, technology assessment and implications, standards, and data bases. Session (2) deals with computer vision, computer graphics, design and application, man computer interaction. Session (3) goes into the details of the diagnostic examination methods such as digital radiography, MRI, CT, nuclear medicine, ultrasound, digital angiography, and multimodality imaging. Session (4) is devoted to computer-assisted techniques, as there are: computer assisted radiological diagnosis, knowledge based systems, computer assisted radiation therapy and computer assisted surgical planning. (UWA). 266 figs [de

  16. Medical Computational Thinking

    DEFF Research Database (Denmark)

    Musaeus, Peter; Tatar, Deborah Gail; Rosen, Michael A.

    2017-01-01

    Computational thinking (CT) in medicine means deliberating when to pursue computer-mediated solutions to medical problems and evaluating when such solutions are worth pursuing in order to assist in medical decision making. Teaching computational thinking (CT) at medical school should be aligned...

  17. The effect of the computer-assisted interactive video training interact-cancer on the communication skills of medical specialists in oncology.

    NARCIS (Netherlands)

    Hulsman, R.L.; Ros, W.J.G.; Winnubst, J.A.M.; Bensing, J.M.

    1998-01-01

    Introduction. INTERACT-CANCER is an interactive course for training communication skills of medical specialists in oncology. The course aims at teaching patient-centred behaviour. It includes four main topics in doctor-patient communication: basic skills, communicating bad news, informing patients,

  18. 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

  19. [Surgeons' hope: expanding the professional role of co-medical staff and introducing the nurse practitioner/physician assistant and team approach to the healthcare system].

    Science.gov (United States)

    Maehara, Tadaaki; Nishida, Hiroshi; Watanabe, Takashi; Tominaga, Ryuji; Tabayashi, Koichi

    2010-07-01

    The healthcare system surrounding surgeons is collapsing due to Japan's policy of limiting health expenditure, market fundamentalism, shortage of healthcare providers, unfavorable working environment for surgeons, increasing risk of malpractice suits, and decreasing number of those who desire to pursue the surgery specialty. In the USA, nonphysician and mid-level clinicians such as nurse practitioners (NPs) and physician assistants (PAs) have been working since the 1960s, and the team approach to medicine which benefits patients is functioning well. One strategy to avoid the collapse of the Japanese surgical healthcare system is introducing the NP/PA system. The division of labor in medicine can provide high-quality, safe healthcare and increase the confidence of the public by contributing to: reduced postoperative complications; increased patient satisfaction; decreased length of postoperative hospital stay: and economic benefits. We have requested that the Ministry of Health, Labor and Welfare establish a Japanese NP/PA system to care for patients more efficiently perioperatively. The ministry has decided to launch a trial profession called "tokutei (specifically qualified) nurse" in February 2010. These nurses will be trained and educated at the Master's degree level and allowed to practice several predetermined skill sets under physician supervision. We hope that all healthcare providers will assist in transforming the tokutei nurse system into a Japanese NP/PA system.

  20. The impact of health coaching on medication adherence in patients with poorly controlled diabetes, hypertension, and/or hyperlipidemia: a randomized controlled trial.

    Science.gov (United States)

    Thom, David H; Willard-Grace, Rachel; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Chen, Ellen

    2015-01-01

    Lack of concordance between medications listed in the medical record and taken by the patient contributes to poor outcomes. We sought to determine whether patients who received health coaching by medical assistants improved their medication concordance and adherence. This was a nonblinded, randomized, controlled, pragmatic intervention trial. English- or Spanish-speaking patients, age 18 to 75 years, with poorly controlled type 2 diabetes, hypertension, and/or hyperlipidemia were enrolled from 2 urban safety net clinics and randomized to receive 12 months of health coaching versus usual care. Outcomes included concordance between medications documented in the medical record and those reported by the patient and adherence based on the patient-reported number of days (of the last 7) on which patient took all prescribed medications. The proportion of medications completely concordant increased in the coached group versus the usual care group (difference in change, 10%; P = .05). The proportion of medications listed in the chart but not taken significantly decreased in the coached group compared with the usual care group (difference in change, 17%; P = .013). The mean number of adherent days increased in the coached but not in the usual care group (difference in change, 1.08; P coaching by medical assistants significantly increases medication concordance and adherence. © Copyright 2015 by the American Board of Family Medicine.

  1. Navigating "Assisted Dying".

    Science.gov (United States)

    Schipper, Harvey

    2016-02-01

    Carter is a bellwether decision, an adjudication on a narrow point of law whose implications are vast across society, and whose impact may not be realized for years. Coupled with Quebec's Act Respecting End-of-life Care it has sharply changed the legal landscape with respect to actively ending a person's life. "Medically assisted dying" will be permitted under circumstances, and through processes, which have yet to be operationally defined. This decision carries with it moral assumptions, which mean that it will be difficult to reach a unifying consensus. For some, the decision and Act reflect a modern acknowledgement of individual autonomy. For others, allowing such acts is morally unspeakable. Having opened the Pandora's Box, the question becomes one of navigating a tolerable societal path. I believe it is possible to achieve a workable solution based on the core principle that "medically assisted dying" should be a very rarely employed last option, subject to transparent ongoing review, specifically as to why it was deemed necessary. My analysis is based on 1. The societal conditions in which have fostered demand for "assisted dying", 2. Actions in other jurisdictions, 3. Carter and Quebec Bill 52, 4. Political considerations, 5. Current medical practice. Leading to a series of recommendations regarding. 1. Legislation and regulation, 2. The role of professional regulatory agencies, 3. Medical professions education and practice, 4. Public education, 5. Health care delivery and palliative care. Given the burden of public opinion, and the legal steps already taken, a process for assisted-dying is required. However, those legal and regulatory steps should only be considered a necessary and defensive first step in a two stage process. The larger goal, the second step, is to drive the improvement of care, and thus minimize assisted-dying.

  2. Retrospective chart review of a referenced EEG database in assisting medication selection for treatment of depression in patients with eating disorders

    Directory of Open Access Journals (Sweden)

    Greenblatt JM

    2011-09-01

    Full Text Available James M Greenblatt1, Craig Sussman1, Mariko Jameson1, Lee Yuan1, Daniel A Hoffman2, Dan V Iosifescu31Comprehensive Psychiatric Resources, Waltham, MA, USA; 2Neuro-Therapy Clinic Inc, Denver, CO, USA; 3Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USABackground: A retrospective chart review was undertaken in a private clinic to examine the clinical outcomes for patients with an eating disorder comorbid with depression or bipolar illness who underwent a referenced electroencephalographic (EEG database analysis to help guide medication selection.Method: We examined 33 charts for patients with the primary psychiatric diagnosis of an eating disorder and comorbid major depressive disorder or bipolar disorder who underwent a quantitative EEG database assessment to provide additional information for choices of medication. The current analysis includes data from 22 subjects who accepted treatments based on information from the referenced-EEG medication database. Hamilton Depression Rating Scale, Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and hospitalization data were examined for these patients.Results: Patients whose EEG data was used for clinical treatment reported significant decreases in associated depressive symptoms (HDRS scores, overall severity of illness (Clinical Global Impression-Severity, and overall clinical global improvement (Clinical Global Impression-Improvement. This cohort also reported fewer inpatient, residential, and partial hospitalization program days following referenced-EEG compared with the two-year period prior to treatment.Conclusion: These findings are consistent with previously reported data for patients with eating disorders and suggest the need for future studies using EEG data correlated with those from other patients with similar quantitative EEG features.Keywords: eating disorders, anorexia, bulimia, depression, referenced-EEG, chart review

  3. Patient decision making in the face of conflicting medication information

    Directory of Open Access Journals (Sweden)

    Emily Elstad

    2012-08-01

    Full Text Available When patients consult more than one source of information about their medications, they may encounter conflicting information. Although conflicting information has been associated with negative outcomes, including worse medication adherence, little is known about how patients make health decisions when they receive conflicting information. The objective of this study was to explore the decision making strategies that individuals with arthritis use when they receive conflicting medication information. Qualitative telephone interviews were conducted with 20 men and women with arthritis. Interview vignettes posed scenarios involving conflicting information from different sources (e.g., doctor, pharmacist, and relative, and respondents were asked how they would respond to the situation. Data analysis involved inductive coding to identify emergent themes and deductive contextualization to make meaning from the emergent themes. In response to conflicting medication information, patients used rules of thumb, trial and error, weighed benefits and risks, and sought more information, especially from a doctor. Patients relied heavily on trial and error when there was no conflicting information involved in the vignette. In contrast, patients used rules of thumb as a unique response to conflicting information. These findings increase our understanding of what patients do when they receive conflicting medication information. Given that patient exposure to conflicting information is likely to increase alongside the proliferation of medication information on the Internet, patients may benefit from assistance in identifying the most appropriate decision strategies for dealing with conflicting information, including information about best information sources.

  4. MyHealthAssistant: an event-driven middleware for multiple medical applications on a smartphone-mediated body sensor network.

    Science.gov (United States)

    Seeger, Christian; Van Laerhoven, Kristof; Buchmann, Alejandro

    2015-03-01

    An ever-growing range of wireless sensors for medical monitoring has shown that there is significant interest in monitoring patients in their everyday surroundings. It however remains a challenge to merge information from several wireless sensors and applications are commonly built from scratch. This paper presents a middleware targeted for medical applications on smartphone-like platforms that relies on an event-based design to enable flexible coupling with changing sets of wireless sensor units, while posing only a minor overhead on the resources and battery capacity of the interconnected devices. We illustrate the requirements for such middleware with three different healthcare applications that were deployed with our middleware solution, and characterize the performance with energy consumption, overhead caused for the smartphone, and processing time under real-world circumstances. Results show that with sensing-intensive applications, our solution only minimally impacts the phone's resources, with an added CPU utilization of 3% and a memory usage under 7 MB. Furthermore, for a minimum message delivery ratio of 99.9%, up to 12 sensor readings per second are guaranteed to be handled, regardless of the number of applications using our middleware.

  5. Driver fitness medical guidelines.

    Science.gov (United States)

    2009-09-01

    This guide provides guidance to assist licensing agencies in making decisions about an individuals fitness for driving. This is the first attempt to produce a consolidated document covering medical conditions included in the task agreement between...

  6. Extraction of substances assisted by ultrasound (UAE)

    International Nuclear Information System (INIS)

    Azuola, Rocio; Vargas, Pedro

    2007-01-01

    Different compounds present in vegetables with functional or technological properties, have gained great importance in food, pharmaceutical and cosmetic markets. Efficient methods, economical and environment friendly are sought for the extraction of these substances. A literature review has been performanced of recent publications on different extraction methods and their comparison to the ultrasound assisted extraction (UAE) to assess their effectiveness and industrial viability. The ultrasound assisted extraction (UAE) has been found to be more efficient than traditional mining methods, and cheaper and easier than non-traditional extraction methods such as microwave-assisted extraction, so it checks its industrial viability. (author) [es

  7. Medically assisted recovery from opiate dependence within the context of the UK drug strategy: methadone and Suboxone (buprenorphine-naloxone) patients compared.

    Science.gov (United States)

    McKeganey, Neil; Russell, Christopher; Cockayne, Lucinda

    2013-01-01

    The focus of drug policy in the UK has shifted markedly in the past 5 years to move beyond merely emphasising drug abstinence towards maximising individuals' opportunities for recovery. The UK government continues to recognise the prescribing of narcotic medications indicated for opiate dependence as a key element of these individuals' recovery journey. This article describes a small, naturalistic comparison of the efficacy of the two most commonly prescribed opiate substitute medications in the UK--methadone hydrochloride (methadone oral solution) and Suboxone (buprenorphine-naloxone sublingual tablets)--for reducing current heroin users' (n = 34) days of heroin use, and preventing short-term abstainers (n = 37) from relapsing to regular heroin use. All patients had been prescribed either methadone or Suboxone for maintenance for 6 months prior to intake. Results showed that when controlling for a number of patient-level covariates, both methadone and Suboxone significantly reduced current users' days of heroin use between the 90 days prior to intake and at the 8-month follow-up, with Suboxone yielding a significantly larger magnitude reduction in heroin use days than methadone. Methadone and Suboxone were highly and equally effective for preventing relapse to regular heroin use, with all but 3 of 37 (91.9%) patients who were abstinent at intake reporting past 90-day point prevalence heroin abstinence at the 8-month follow-up. Overall, prescribing methadone or Suboxone for eight continuous months was highly effective for initiating abstinence from heroin use, and for converting short-term abstinence to long-term abstinence. However, the study design, which was based on a relatively small sample size and was not able randomise patients to medication and so could not control for the effects of potential prognostic factors inherent within each patient group, means that these conclusions can only be made tentatively. These positive but preliminary indications of the

  8. Medical basis for radiation accident preparedness

    International Nuclear Information System (INIS)

    Huebner, K.F.; Fry, S.A.

    1980-01-01

    The International Conference on The Medical Basis for Radiation Accident Preparedness was organized by the staff of the Radiation Emergency Assistance Center/Training Site (REAC/TS) of the Medical and Health Sciences Division of Oak Ridge Associated Universities (ORAU). The philosophical importance of relating, through investigation and education, the intellectual resources of higher education to the important social problems associated with energy, health, and the environment was the foundation of the meeting. The symposium, held under the auspices of the US Department of Energy, was the ninth since 1960 of a series of international conferences addressing the various aspects of radiation accidents. The approach of this most recent conference differed somewhat from that of those preceding it, in that it sought an international review of the gamut of the medical aspects of radiation injury, not only for the experts in the field, but also for other physicians and scientists who, in view of current events, have had the need to know thrust upon them. Individual entries were made for the separate papers

  9. International assistance. Licensing assistance project

    International Nuclear Information System (INIS)

    Aleev, A.

    1999-01-01

    Description of licensing assistance project for VATESI is presented. In licensing of unit No.1 of INPP VATESI is supported by many western countries. Experts from regulatory bodies or scientific organizations of those countries assist VATESI staff in reviewing documentation presented by INPP. Among bilateral cooperation support is provided by European Commission through Phare programme

  10. Proceedings of the 14. Coordination and Planning Meeting of the WHO-REMPAN: Radiation Emergency Medical Preparedness and Assistance Network, Wuerzburg, Germany, 07-09 May 2014

    International Nuclear Information System (INIS)

    Carr, Zhanat; Schneider, Rita

    2016-01-01

    The 14. WHO REMPAN Meeting addressed many of the current national and international discussions in the field of radiation emergency preparedness and response, pointed out the way forward and gave answers to open questions, including the following issues: - New strategies for planning response to radiation emergencies with the focus on public health issues. - Most recent lessons learnt for public health response from the Fukushima experience with the emphasis on psycho-social, ethical and mental health consequences. - Emphasizing and strengthening the role of risk communication in radiation emergency management. - Identification of knowledge gaps and further research needs concerning radiation induced thyroid cancer based on knowledge of Chernobyl and Fukushima. - Emphasizing the importance of competence networks based on latest developments and research in the field of biological dosimetry. - Importance of education, training programs, exercises and international knowledge and information exchange as key stones of successful radiation emergency preparedness and response. - Identification of new developments and gaps in research of new treatment options for radiation injuries management. - Reporting latest experience with medical management of radiation accidents. - Participation and increased engagement of international and national professional societies, non-governmental organizations, non-state actors and private sector. Recent experiences and lessons learnt from nuclear accidents (Chernobyl, Fukushima) highlighted the importance of the cross-sector coordination and the involvement of public health authorities in the planning and execution of urgent protective actions (e.g. evacuation, sheltering and iodine thyroid blocking), which may impose more risk than benefit, if administered late, inappropriately, or without proper coordination. This type of emergencies, i.e. a large-scale mass-casualty emergency requires effective and rapid public health interventions

  11. Medical Simulations for Exploration Medicine

    Science.gov (United States)

    Reyes, David; Suresh, Rahul; Pavela, James; Urbina, Michelle; Mindock, Jennifer; Antonsen, Erik

    2018-01-01

    Medical simulation is a useful tool that can be used to train personnel, develop medical processes, and assist cross-disciplinary communication. Medical simulations have been used in the past at NASA for these purposes, however they are usually created ad hoc. A stepwise approach to scenario development has not previously been used. The NASA Exploration Medical Capability (ExMC) created a medical scenario development tool to test medical procedures, technologies, concepts of operation and for use in systems engineering (SE) processes.

  12. Why not Commercial Assistance for Suicide? On the Question of Argumentative Coherence of Endorsing Assisted Suicide.

    Science.gov (United States)

    Kipke, Roland

    2015-09-01

    Most people who endorse physician-assisted suicide are against commercially assisted suicide - a suicide assisted by professional non-medical providers against payment. The article questions if this position - endorsement of physician-assisted suicide on the one hand and rejection of commercially assisted suicide on the other hand - is a coherent ethical position. To this end the article first discusses some obvious advantages of commercially assisted suicide and then scrutinizes six types of argument about whether they can justify the rejection of commercially assisted suicide while simultaneously endorsing physician-assisted suicide. The conclusion is that they cannot provide this justification and that the mentioned position is not coherent. People who endorse physician-assisted suicide have to endorse commercially assisted suicide as well, or they have to revise their endorsement of physician-assisted suicide. © 2014 John Wiley & Sons Ltd.

  13. Factors Associated With Medical School Entrants' Interest in Military Financial Assistance in Exchange for a Service Obligation: The Michigan State University College of Human Medicine Cohort.

    Science.gov (United States)

    Sienko, Dean G; Oberst, Kathleen

    2017-07-01

    The U.S. military offers comprehensive scholarships to medical students to help offset costs in exchange for either reserve or active duty service commitments. Our goal was to describe to what degree newly admitted students to Michigan State University's College of Human Medicine were aware of and interested in these opportunities. We surveyed 176 newly admitted students at the beginning and immediately following a presentation on military medicine opportunities. We collected anonymous paper surveys from program attendees and entered the data into Stata v13.1. The project was submitted for institutional review board review and deemed to not involve human subjects. Tests of association were performed using Chi-square test of independence and Fisher's exact test where needed. Our cohort was 49% female, 51% male, and over 90% were less than 30 years of age. Only 14% reported having family involved in the military. Our results indicated that over 90% of students were aware of these programs but less than 3% took advantage of the offerings. Despite 65% reporting somewhat or significant concerns over debt, financial concerns were not statistically associated with scholarship interest level. Instead, having a family member in the military was the most significant positive predictor of interest (47% compared with 17%, p benefits of military service aside from financial support. Career vignettes and summaries may offer better insight into the service experience for those lacking familiarity thereby potentially increasing interest and applications. Focus groups with current scholarship awardees may inform recruitment strategies. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  14. [Requests for assisted reproduction formulated by same-sex couples consulting physicians in France].

    Science.gov (United States)

    Jouannet, P; Spira, A

    2014-08-01

    In order to determine the characteristic features of requests for assisted reproduction formulated by same-sex couples consulting physicians in France, we conducted a study in collaboration with professional organizations, general practitioners, gynecologists and obstetricians who distributed an email questionnaire among their recruitment. In our sample, 191 physicians (71% of responders) reported that 1040 homosexual couples expressed desire to become parents in 2011-2012. Nearly all of the physicians (94%) reported that the couples sought assistance before participating in an assisted reproduction technology (ART) program in a foreign country, but 35% reported that advice was solicited concerning natural reproduction and 48.5% reported requests for advice concerning inseminations performed by the woman herself. Most of the physicians responded to all or part of the requests and 61% of those who had been consulted reported they had directly participated in preparing an ART program in a foreign country. Among the 270 physicians who participated in this study, 162 (60%) believed that ART should be assessable to homosexual couples in France, but less than half of them were in favor of reimbursement by the national health insurance fund. Although biased and non-representative, this study shows that assisted reproduction, with or without medical intervention, is a real-life phenomenon for many homosexual couples, and for many physicians, even before same-sex marriage became legal. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  15. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  16. The level of knowledge and radiation safety practice amongst cardiovascular technology, medical assistant, nursing and diagnostic radiography students and dose monitoring in radiography laboratory of Kolej Islam Sains dan Teknologi, Kelantan

    International Nuclear Information System (INIS)

    Ainul Fadhlin Othman; Amran Abdul Majid

    2013-01-01

    Full-text: This study investigated the knowledge level and practices regarding radiation safety among the cardiovascular technology, medical assistant nursing and radiography diagnostic students of Kolej Islam Sains dan Teknologi (KIST). The objectives of this study are to monitor the dose rate at radiography lab and to propose the guideline on radiation safety topics to improve the syllabus. 274 respondents including 30 psychology students acting as the control group were asked to answer questions from the questionnaires which cover the topics of basic knowledge of radiation and radiation safety practice. There was a significant difference (p < 0.05) between the correct answers and courses for 18 questions except for the question 4. There was a significant different (p < 0.05) between the correct answers and year of study for the questions 4, 5, 7, 12 to 15 and 18 to 20. There was a significance different (p < 0.05) between the correct answers and gender for questions 7, 11 and 19. For area dose monitoring in the radiography diagnostic lab, the assessment report on film batches of 4 walls in the lab were recorded and Victoreen451-RYR survey meter was used to monitor the dose rate for 7 selected areas with the exposure factors set for the chest, abdomen, upper extremity, lower extremity and skull radiography examinations. The dose rates at area 1 to 4, area 5 during the examination of chest, abdomen and skull, area 6 during the examination of abdomen and area 7 during the examination of abdomen, had exceeded the dose limit for radiation worker. The dose rate at the area 1 and 4 are slightly higher than the other areas. The contributing factors are the distance, tube potential, collimation and X-ray tube angulation. This study had shown that the cardiovascular technology and diagnostic radiography students have better knowledge and radiation safety practice level than the medical assistant and nursing students. In general, the level of knowledge and radiation safety

  17. 21 CFR 884.6130 - Assisted reproduction microtools.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction microtools. 884.6130 Section... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6130 Assisted reproduction microtools. (a) Identification. Assisted reproduction microtools are pipettes or...

  18. 21 CFR 884.6200 - Assisted reproduction laser system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction laser system. 884.6200... (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6200 Assisted reproduction laser system. (a) Identification. The assisted reproduction laser system is a device...

  19. Assisted Living

    Science.gov (United States)

    ... a resident's needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care. The Administration on Aging, a part of the U.S. Department of Health and Human Services (HHS), offers these suggestions to help you ...

  20. Assistive Devices

    Science.gov (United States)

    If you have a disability or injury, you may use a number of assistive devices. These are tools, products or types of equipment that help you perform tasks and activities. They may help you move around, see, communicate, eat, or get ...

  1. The Impact of Social Support and Attachment Style on Quality of Life and Readiness to Change in a Sample of Individuals Receiving Medication-Assisted Treatment for Opioid Dependence.

    Science.gov (United States)

    Cavaiola, Alan A; Fulmer, Barbara A; Stout, David

    2015-01-01

    A basic principle within the addictions treatment field is that social support is a vital ingredient in the recovery process. This study examines the nature of social support in a sample of opioid-dependent men and women who are currently being treated in a medication-assisted treatment program (methadone). This research examines the types of social support behaviors that the opioid-dependent individuals consider helpful and explores whether attachment style (i.e., secure, ambivalent, or anxious attachment) was a determining factor in whether social support was perceived as helpful. The dependent variables included readiness to change addictive behaviors and abstinence from other mood-altering drugs. Participants (N = 159) completed a demographic questionnaire, the Significant Others Scale, the Experiences in Close Relationships Scale, the Multidimensional Scale of Perceived Social Support Assessment, the Readiness to Change Scale, and an Attachment Style Questionnaire. The demographic questionnaire included subjective ratings of self-improvement. Social support predicted perceived improvement in all of the areas examined (e.g., health, family/social relationships) and abstinence; however, attachment style did not predict improvement or with readiness to change. Social support is an important factor in one's recovery from substance use disorders. Yet attachment style (i.e., anxious, avoidant, or secure) did not predict abstinence or overall improvement in functioning.

  2. Debates about assisted suicide in Switzerland.

    Science.gov (United States)

    Burkhardt, Sandra; La Harpe, Romano

    2012-12-01

    Assisted suicide is allowed in 3 states of the United States (Oregon, Washington, Montana) but only if performed by a physician.On the opposite, in Switzerland, at the beginning of the 20th century, the Swiss Penal Code referred to assisted suicide in the context of honor or an unhappy love affair. It was only in 1985 that Exit Deutsche Schweiz (Exit for German-speaking Switzerland) "medically" assisted the first patient to end his life.Even if authorized by the Swiss law upon certain conditions, assisted suicide is subject to debates for ethical reasons. The Swiss Academy of Medical Sciences described directives to guide physicians on this difficult subject.Different studies showed an increase in the number of medical-assisted suicide in Switzerland since the 1990s. Now, this number seems to be quite stable. Assisted suicide is authorized in a few hospitals under strict conditions (especially when returning home is impossible).Thus, according to the Swiss law, any person could perform assisted suicide; this is essentially performed by 3 main associations, using pentobarbital on medical prescription as lethal substance.Generally speaking, the Swiss population is rather in favor of assisted suicide. Among politics, the debate has been tough until 2010, when the Federal Council decided not to modify the Swiss Penal Code concerning assisted suicide.

  3. Medical Readers' Theater: Relevance to Geriatrics Medical Education

    Science.gov (United States)

    Shapiro, Johanna; Cho, Beverly

    2011-01-01

    Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required…

  4. Stakeholders' Perceptions Sought to Inform the Development of a Low-Cost Mobile Robot for Older Adults: A Qualitative Descriptive Study.

    Science.gov (United States)

    Sefcik, Justine S; Johnson, Michelle J; Yim, Mark; Lau, Tessa; Vivio, Nicholas; Mucchiani, Caio; Cacchione, Pamela Z

    2018-02-01

    Creative solutions are needed to support community-dwelling older adults residing in a variety of settings including their house, apartment, or Supportive Apartment Living (SAL) to promote independence and reduce the risk of nursing home replacement. The objective of this study was to gain an understanding of older adults' needs for physical, mental, and social activities to support the design and functionality of a low-cost mobile assistive robot. A qualitative descriptive study was designed which included three stakeholder focus groups (caregivers, clinicians, and older adults). We held three focus groups with a total of 19 participants: one with paid caregivers ( n = 6), one with interdisciplinary clinicians ( n = 8), and one with older adults residing in SAL ( n = 5). Conventional content analysis was the analytical technique. Four themes emerged: (a) Accomplishing Everyday Tasks: activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were important from the perspectives of all three groups for the older adults to accomplish daily, as well as the "use it or lose it" attitude of the older adults; (b) Personal Connections and Meaningful Activities: for the older adults, it was important for them to engage in socialization and leisure activities, and for the caregivers and clinicians, they work to build personal relationships with the older adults; (c) Cognitive Interventions: the clinicians provided cognitive tools (including reminders, routine and designing interventions) to older adults so they can remain as safe and independent as possible in the SAL; and (d) Safety Measures: encompassed clinicians addressing safety and injury prevention and the caregivers checking in on the older adults in their SAL apartments. This work contributed to the design and functionality specifications for an autonomous low-cost mobile robot for deployment to increase the independence of older adults.

  5. Foreign assistance

    International Nuclear Information System (INIS)

    1991-07-01

    This paper reports that providing energy assistance to developing countries remains a relatively low priority of the Agency for International Development. AID is helping some developing countries meet their energy needs, but this assistance varies substantially because of the agency's decentralized structure. Most AID energy funding has gone to a handful of countries-primarily Egypt and Pakistan. With limited funding in most other countries, AID concentrates on providing technical expertise and promoting energy policy reforms that will encourage both energy efficiency and leverage investment by the private sector and other donors. Although a 1989 congressional directive to pursue a global warming initiative has had a marginal impact on the agency's energy programming, many AID energy programs, including those directed at energy conservation, help address global warming concerns

  6. Effect of an interactive cardiopulmonary resuscitation assist device with an automated external defibrillator synchronised with a ventilator on the CPR performance of emergency medical service staff: a randomised simulation study.

    Science.gov (United States)

    Nitzschke, Rainer; Doehn, Christoph; Kersten, Jan F; Blanz, Julian; Kalwa, Tobias J; Scotti, Norman A; Kubitz, Jens C

    2017-04-04

    The present study evaluates whether the quality of advanced cardiac life support (ALS) is improved with an interactive prototype assist device. This device consists of an automated external defibrillator linked to a ventilator and provides synchronised visual and acoustic instructions for guidance through the ALS algorithm and assistance for face-mask ventilations. We compared the cardiopulmonary resuscitation (CPR) quality of emergency medical system (EMS) staff members using the study device or standard equipment in a mannequin simulation study with a prospective, controlled, randomised cross-over study design. Main outcome was the effect of the study device compared to the standard equipment and the effect of the number of prior ALS trainings of the EMS staff on the CPR quality. Data were analysed using analyses of covariance (ANCOVA) and binary logistic regression, accounting for the study design. In 106 simulations of 56 two-person rescuer teams, the mean hands-off time was 24.5% with study equipment and 23.5% with standard equipment (Difference 1.0% (95% CI: -0.4 to 2.5%); p = 0.156). With both types of equipment, the hands-off time decreased with an increasing cumulative number of previous CPR trainings (p = 0.042). The study equipment reduced the mean time until administration of adrenaline (epinephrine) by 23 s (p = 0.003) and that of amiodarone by 17 s (p = 0.016). It also increased the mean number of changes in the person doing chest compressions (0.6 per simulation; p < 0.001) and decreased the mean number of chest compressions (2.8 per minute; p = 0.022) and the mean number of ventilations (1.8 per minute; p < 0.001). The chance of administering amiodarone at the appropriate time was higher, with an odds ratio of 4.15, with the use of the study equipment CPR.com compared to the standard equipment (p = 0.004). With an increasing number of prior CPR trainings, the time intervals in the ALS algorithm until the

  7. 9th Ambient Assisted Living Congress

    CERN Document Server

    Mand, Beate

    2017-01-01

    In this book, leading authors in the field discuss the habitats of tomorrow. These habitats will be connected through autonomous and assistive systems, turning habitats into health resorts. This book discusses how assistance technologies enable a smooth transition from comfortable health support to medical or nursing care. The contributions have been chosen and invited at the 9th AAL congress, Frankfurt. .

  8. Assisted Reproductive Technologies : Implications for Women's ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Assisted Reproductive Technologies : Implications for Women's Reproductive Rights and Social Citizenship. There is a general perception that assisted reproductive technologies (ARTs) affect only a small number of affluent women in India. However, the ART industry - tied as it is to the vigorously pushed medical tourism ...

  9. Mutual emergency assistance for radiation accidents

    International Nuclear Information System (INIS)

    1971-01-01

    This document presents the result of a questionnaire survey conducted in order to assess what type of emergency assistance IAEA member states could provide in the event of radiation accidents. The survey covers resources like skilled personnel in collection, analysis and interpretation of data, surveying and radiation protection equipment, radiochemical analysis facilities, and medical assistance capacities

  10. Why do patients engage in medical tourism?

    NARCIS (Netherlands)

    Runnels, V.; Carrera, Percivil Melendez

    2012-01-01

    Medical tourism is commonly perceived and popularly depicted as an economic issue, both at the system and individual levels. The decision to engage in medical tourism, however, is more complex, driven by patients¿ unmet need, the nature of services sought and the manner by which treatment is

  11. Traditional healers, faith healers and medical practitioners

    DEFF Research Database (Denmark)

    Moshabela, Mosa; Bukenya, Dominic; Darong, Gabriel

    2017-01-01

    Objectives: There are concerns that medical pluralism may delay patients’ progression through the HIV cascade-of-care. However, the pathways of impact through which medical pluralism influence the care of people living with HIV (PLHIV) in African settings remain unclear. We sought to establish...

  12. 6 Tips to Avoid Medication Mistakes

    Science.gov (United States)

    ... use. Computerized Medication Box FDA has cleared for marketing the Electronic Medication Management Assistant (EMMA), a programmable ... for You Sign up for Consumer Updates by E-mail Page Last Updated: 04/02/2018 Note: If ...

  13. Situação da assistência médico-sanitária e hospitalar no Estado do Ceará, Brasil Medical care situation in the State of Ceara, Brazil

    Directory of Open Access Journals (Sweden)

    João Yunes

    1973-06-01

    laboratórios, 31,1% com aparelhos de Raios X e 11,6% com eletrocardiografia. A maior carência destes recursos encontram-se no Interior do Estado. Mais de 50% dos hospitais não contam com profissionais de saúde tais como enfermagem, nutricionistas, assistente social e técnicos. Dos 141 municípios, 62,7% (89 não possuem nenhum hospital, fazendo com que cerca de 1.300.000 habitantes estejam teoricamente descobertos da assistência hospitalar. Em relação às 86 unidades para-hospitalares existentes, embora a carência de dados seja maior, a situação é bastante semelhante à da assistência hospitalar. No Estado existem 1.207 médicos que proporcionam um padrão somente de 0,3/1000 habitantes quando o teoricamente recomendado é em média de 1/1000 habitantes. Além do número ser insuficiente há má distribuição, pois 77,7% destes profissionais estão concentrados na Capital do Estado (1,1/1000 habitantes. Somente 45,4% dos municípios contam com médicos residentes. Em relação a dentistas encontra-se um padrão quantitativo baixo de 0,28 profissionais por 2000 habitantes quando o geralmente aceito é de 1/2000 habitantes. Em relação ao pessoal paramédico, predominam, nos serviços oficiais de Saúde Pública, as atendentes e nos hospitais, como já foi mencionado mais de 50% não possue pessoal qualificado.The situation of medical care in the State of Ceara (Brazil was estimated through the analysis of the offering of the official services on public health, hospital and "para-hospital" care and by the existent human resources as well. This region has 141 towns and aproximately 4,000.000 inhabitants. The official services on Public Health are concerned to State public expense in 59.6% of the sanitary units; Federal government gives its participation in 26.9% and the city council helps in 13.5%. The quantitative standard observed was considered as been satisfactory, since as a rule there is one sanitary unit per each 23,002 inhabitants. This average is very

  14. New developments in employee assistance programs.

    Science.gov (United States)

    White, R K; McDuff, D R; Schwartz, R P; Tiegel, S A; Judge, C P

    1996-04-01

    Employee assistance programs have developed from alcoholism assessment and referral centers to specialized behavioral health programs. Comprehensive employee assistance programs are defined by six major components: identification of problems based on job performance, consultation with supervisors, constructive confrontation, evaluation and referral, liaison with treatment providers, and substance abuse expertise. Other services have been added as enhancements to the basic model and include managed behavioral health activities and professional assistance committees, which provide services for impaired professionals and executives. Recent developments in the field are illustrated through examples from the experience of the employee assistance program at the University of Maryland Medical System in Baltimore.

  15. Medical Trends: An Evaluation of Medical Support Given in Vietnam, Grenada, Panama and Vietnam

    National Research Council Canada - National Science Library

    Richards, Donn

    1999-01-01

    .... This paper reviews medical support given in four previous conflicts. Analysis includes predeployment, logistics, communication, patient evacuation, preventive medicine, veterinary services, civilian assistance and post-deployment...

  16. Medical robotics.

    Science.gov (United States)

    Ferrigno, Giancarlo; Baroni, Guido; Casolo, Federico; De Momi, Elena; Gini, Giuseppina; Matteucci, Matteo; Pedrocchi, Alessandra

    2011-01-01

    Information and communication technology (ICT) and mechatronics play a basic role in medical robotics and computer-aided therapy. In the last three decades, in fact, ICT technology has strongly entered the health-care field, bringing in new techniques to support therapy and rehabilitation. In this frame, medical robotics is an expansion of the service and professional robotics as well as other technologies, as surgical navigation has been introduced especially in minimally invasive surgery. Localization systems also provide treatments in radiotherapy and radiosurgery with high precision. Virtual or augmented reality plays a role for both surgical training and planning and for safe rehabilitation in the first stage of the recovery from neurological diseases. Also, in the chronic phase of motor diseases, robotics helps with special assistive devices and prostheses. Although, in the past, the actual need and advantage of navigation, localization, and robotics in surgery and therapy has been in doubt, today, the availability of better hardware (e.g., microrobots) and more sophisticated algorithms(e.g., machine learning and other cognitive approaches)has largely increased the field of applications of these technologies,making it more likely that, in the near future, their presence will be dramatically increased, taking advantage of the generational change of the end users and the increasing request of quality in health-care delivery and management.

  17. 21 CFR 884.6150 - Assisted reproduction micromanipulators and microinjectors.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction micromanipulators and... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6150 Assisted reproduction micromanipulators and microinjectors. (a) Identification...

  18. 21 CFR 884.6140 - Assisted reproduction micropipette fabrication instruments.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction micropipette fabrication... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Assisted Reproduction Devices § 884.6140 Assisted reproduction micropipette fabrication instruments. (a) Identification...

  19. Euthanasia and assisted suicide: a Christian ethical perspective | De ...

    African Journals Online (AJOL)

    This article introduces and compares the contrasting views of two well-known theologians, Gilbert Meilaender and Harry Kuitert, on euthanasia and medically assisted suicide. Meilaender rejects euthanasia and medically assisted suicide, but accepts refusal of treatment, as long as it is not done with the intention to cause ...

  20. Assistência médico-sanitária na região Taquari-Antas, Rio Grande do Sul, Brasil Health medical care in Taquari-Antas Region, Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    João Yunes

    1972-06-01

    Full Text Available A assistência médico-sanitária foi estudada para a Região Taquari-Antas, composta de 50 municípios, com uma população aproximada de 1.300.000 habitantes e cerca de 20% da população do Estado do Rio Grande do Sul. A rede sanitária da região é composta de 47 unidades não havendo homogeneidade na sua distribuição, pois a 13.ª Região Sanitária a que se encontra em condições mais favoráveis, apresenta uma unidade sanitária para cada 22.300 habitantes, enquanto que, em outras regiões, esta proporção varia de 53.500 a 73.500 habitantes. O atendimento médico foi bastante baixo, de 0,4 consultas por hora, por médico, enquanto que em Porto Alegre, embora tenha sido também baixo, foi de 1,5. A rede estadual de dispensários de tuberculose conta com 27 unidades e exceto num único caso funciona junto a centros de saúde, integrando a unidade polivalente. A proporção da população por cada dispensário é de 631.450 habitantes enquanto que para Porto Alegre e para o Estado é de respectivamente 238.060 e 255.220 habitantes. A rede de dispensários de hanseníase é composta de 37 unidades, havendo uma proporção de 123.900 habitantes por unidade. A Região Taquari-Antas apresenta melhor proporção que o Estado e Porto Alegre uma vez que o número de habitantes por unidade é de respectivamente 186.243 e 315.530 habitantes. Os serviços de saúde mental funcionam integrados às unidades sanitárias, através de seus 10 ambulatórios contando cada um deles com um médico psiquiatra. Para a Região verifica-se a relação de um ambulatório para 681.454 habitantes, enquanto no Estado é de um para 689.100 e em Porto Alegre de um para 233.250 habitantes. Em relação aos recursos humanos existe um médico para cada 2.655 habitantes, variando esta proporção, por região sanitária, de 1.778 e 4.528 habitantes por médico. Esta proporção é bastante baixa quando comparada com o padrão proposto pela OMS de um médico para cada

  1. Geocachers: Benefits sought and environmental attitudes

    Science.gov (United States)

    Ingrid E. Schneider; Kenneth E. Silverberg; Deborah Chavez

    2011-01-01

    Geocaching, an outdoor recreation activity that uses handheld Global Positioning Systems (GPS) to find hidden treasures demarcated on the Internet, emerged in 2000 and has engaged more than 5 million participants in more than 200 countries (www.geocaching.com). Agency responses to geocaching range from collaborative management to...

  2. Best Minds Sought for Central Office, Startups

    Science.gov (United States)

    Maxwell, Lesli A.

    2009-01-01

    The central office isn't being overlooked in the movement to find and develop top talent for school districts. Although ways to recruit, groom, and keep top teachers and strong principals tend to dominate discussions of "human capital" needs in education, a handful of nonprofit organizations and foundations also see providing smart managers as…

  3. Using the Existential Criterion for Assessing the Personality of Overprotective and Overly Demanding Parents in the Families of Patients Who Have Sought Psychological Counseling for Parent-Child Problems

    Science.gov (United States)

    Kapustin, S. A.

    2016-01-01

    The article presents the results of applying the existential criterion of normal and abnormal personalities for assessing the personality of overprotective and overly demanding parents in 176 families of patients who have sought psychological counseling. It is shown that the position of overprotective parents is one-sided in relation to the…

  4. Perbandingan Gratification Sought Dan Gratification Obtained Pendengar Terhadap Program Stasiun Radio (Studi Komparatif tentang Motif dan Kepuasan Pendengar terhadap Program Stasiun Radio Kiss FM dan Prambors Medan di Kalangan Mahasiswa FISIP USU

    OpenAIRE

    Hutapea, Darma Lestari

    2011-01-01

    Penelitian ini bertujuan untuk membandingkan kepuasan ynag dicari (gratification sought) dan kepuasan yang diperoleh (gratification obtained) pendengar radio Kiss FM dan Prambors FM Medan dengan menggunakan perspektif Uses and Gratification. Model ini menekankan bahwa khalayak adalah pihak yang aktif terhadap penggunaan media. Khalayak bebas mengkonsumsi media yang disukainya. Sampel dalam penelitian ini adalah mahasiswa Fakultas Ilmu Sosial dan Ilmu Politik. Jumlah sampel y...

  5. Teaching Teenagers with Autism to Answer Cell Phones and Seek Assistance When Lost

    OpenAIRE

    Hoch, Hannah; Taylor, Bridget A; Rodriguez, Angela

    2009-01-01

    Three participants with autism were taught to answer a cell phone and to follow directions to seek assistance when lost in community settings. During baseline, none of the participants answered a cell phone or sought assistance. Following instruction at school and in the community, all participants learned to answer the cell phone and follow instructions to seek assistance from a naïve adult by exchanging a communication card. Generalization probes were conducted in non-training community sit...

  6. “Exporting” medical education

    Directory of Open Access Journals (Sweden)

    Vinod Shah

    2016-01-01

    Full Text Available A commentary on four reports of the pre-conference on medical education in low and middle income countries and efforts by mainly North American physicians to provide assistance held November, 2015. The authors address issues of participatory learning and developing critical thinking; mutual learning and leadership; and professionalism and ethics in medical education.

  7. Substitution of Assisted Living Services by Assistive Technology - Experts Opinions and Technical Feasibility.

    Science.gov (United States)

    Schwartze, Jonas; Prekazi, Arianit; Schrom, Harald; Marschollek, Michael

    2017-01-01

    Ambient assisted living (AAL) may support ageing in place but is primarily driven by technology. The aim of this work is, to identifying reasons to move into assisted living institutions, their range of service and possible substitutability. We did semi-structured interviews with five experts from assisted living institutions and used results to design and implement assistive technologies in an AAL environment using BASIS, a cross domain bus system for smart buildings. Reasons for moving to assisted living institutions are expected benefits for chronic health problems, safety, social isolation and carefree living. We implemented six application systems for inactivity monitoring, stove shutdown, air quality monitoring, medication and appointment reminders, detection of unwanted situations before leaving and optical ringing of the doorbell. Substitution of selected assisted living services is feasible and has potential to delay necessity to move into assisted living institution if complement social services are installed.

  8. Assisted Vaginal Delivery

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Assisted Vaginal Delivery Home For Patients Search FAQs Assisted Vaginal ... Vaginal Delivery FAQ192, February 2016 PDF Format Assisted Vaginal Delivery Labor, Delivery, and Postpartum Care What is ...

  9. Review of "Handbook of Human Factors in Medical Device Design", edited by Matthew B. Weinger, Michael E. Wiklund and Daryle J. Gardner-Bonneau, Assistant Editor Loir M. Kelly

    Directory of Open Access Journals (Sweden)

    Gaev Jonathan A

    2011-06-01

    Full Text Available Abstract Human factors is the study of the relationship between people and devices or systems. The goal of considering human factors in the design of medical devices is to create devices that take into consideration the way people use technology and process information to create a man-machine interface that leads to the best possible performance. This text describes the significant aspects of human factors issues related to medical device design. It is well written and is useful for medical device designers and for others who use or evaluate medical equipment.

  10. Canine assisted reading

    OpenAIRE

    Sever, Jerneja

    2016-01-01

    The diploma thesis presents various aspects of animals included in animal-assisted interventions. In theoretical part, I introduced different possible ways of animal-assisted interventions: animal-assisted therapy, animal-assisted activities and animal-assisted education. Animals became common visitors in educational settings all over the world. I presented positive influences on various aspects of human life, as well limitations when animal-assisted interventions are not possible to perform ...

  11. Psychiatry in American Medical Education: The Case of Harvard's Medical School, 1900-1945.

    Science.gov (United States)

    Abraham, Tara H

    2018-01-01

    As American psychiatrists moved from the asylum to the private clinic during the early twentieth century, psychiatry acquired a growing presence within medical school curricula. This shift in disciplinary status took place at a time when medical education itself was experiencing a period of reform. By examining medical school registers at Harvard University, records from the Dean's office of Harvard's medical school, and oral histories, this paper examines the rise in prominence of psychiatry in medical education. Three builders of Harvard psychiatry - Elmer E. Southard, C. Macfie Campbell, and Harry C. Solomon - simultaneously sought to mark territory for psychiatry and its relevance. In doing so, they capitalized on three related elements: the fluidity that existed between psychiatry and neurology, the new venues whereby medical students gained training in psychiatry, and the broader role of patrons, professional associations, and certification boards, which sought to expand psychiatry's influence in the social and cultural life of twentieth-century America.

  12. Improving patient safety and efficiency of medication reconciliation through the development and adoption of a computer-assisted tool with automated electronic integration of population-based community drug data: the RightRx project.

    Science.gov (United States)

    Tamblyn, Robyn; Winslade, Nancy; Lee, Todd C; Motulsky, Aude; Meguerditchian, Ari; Bustillo, Melissa; Elsayed, Sarah; Buckeridge, David L; Couture, Isabelle; Qian, Christina J; Moraga, Teresa; Huang, Allen

    2018-05-01

    Many countries require hospitals to implement medication reconciliation for accreditation, but the process is resource-intensive, thus adherence is poor. We report on the impact of prepopulating and aligning community and hospital drug lists with data from population-based and hospital-based drug information systems to reduce workload and enhance adoption and use of an e-medication reconciliation application, RightRx. The prototype e-medical reconciliation web-based software was developed for a cluster-randomized trial at the McGill University Health Centre. User-centered design and agile development processes were used to develop features intended to enhance adoption, safety, and efficiency. RightRx was implemented in medical and surgical wards, with support and training provided by unit champions and field staff. The time spent per professional using RightRx was measured, as well as the medication reconciliation completion rates in the intervention and control units during the first 20 months of the trial. Users identified required modifications to the application, including the need for dose-based prescribing, the role of the discharge physician in prescribing community-based medication, and access to the rationale for medication decisions made during hospitalization. In the intervention units, both physicians and pharmacists were involved in discharge reconciliation, for 96.1% and 71.9% of patients, respectively. Medication reconciliation was completed for 80.7% (surgery) to 96.0% (medicine) of patients in the intervention units, and 0.7% (surgery) to 82.7% of patients in the control units. The odds of completing medication reconciliation were 9 times greater in the intervention compared to control units (odds ratio: 9.0, 95% confidence interval, 7.4-10.9, P < .0001) after adjusting for differences in patient characteristics. High rates of medication reconciliation completion were achieved with automated prepopulation and alignment of community and hospital

  13. Religious aspects of assisted reproduction

    Science.gov (United States)

    Sallam, H N; Sallam, N H

    2016-03-28

    Human response to new developments regarding birth, death, marriage and divorce is largely shaped by religious beliefs. When assisted reproduction was introduced into medical practice in the last quarter of the twentieth century, it was fiercely attacked by some religious groups and highly welcomed by others. Today, assisted reproduction is accepted in nearly all its forms by Judaism, Hinduism and Buddhism, although most Orthodox Jews refuse third party involvement. On the contrary assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants, Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not involve gamete or embryo donation. Orthodox Christians are less strict than Catholic Christians but still refuse third party involvement. Interestingly, in contrast to Sunni Islam, Shi'a Islam accepts gamete donation and has made provisions to institutionalize it. Chinese culture is strongly influenced by Confucianism, which accepts all forms of assisted reproduction that do not involve third parties. Other communities follow the law of the land, which is usually dictated by the religious group(s) that make(s) the majority of that specific community. The debate will certainly continue as long as new developments arise in the ever-evolving field of assisted reproduction.

  14. Religious aspects of assisted reproduction

    Science.gov (United States)

    Sallam, HN; Sallam, NH

    2016-01-01

    Abstract Human response to new developments regarding birth, death, marriage and divorce is largely shaped by religious beliefs. When assisted reproduction was introduced into medical practice in the last quarter of the twentieth century, it was fiercely attacked by some religious groups and highly welcomed by others. Today, assisted reproduction is accepted in nearly all its forms by Judaism, Hinduism and Buddhism, although most Orthodox Jews refuse third party involvement. On the contrary assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants, Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not involve gamete or embryo donation. Orthodox Christians are less strict than Catholic Christians but still refuse third party involvement. Interestingly, in contrast to Sunni Islam, Shi’a Islam accepts gamete donation and has made provisions to institutionalize it. Chinese culture is strongly influenced by Confucianism, which accepts all forms of assisted reproduction that do not involve third parties. Other communities follow the law of the land, which is usually dictated by the religious group(s) that make(s) the majority of that specific community. The debate will certainly continue as long as new developments arise in the ever-evolving field of assisted reproduction. PMID:27822349

  15. 2009 Mississippi Curriculum Framework: Postsecondary Medical Assisting Technology. (Program CIP-51.0801 - Medical /Clinical Assisting)

    Science.gov (United States)

    Roberson, Kaye; King, Christine

    2009-01-01

    As the world economy continues to evolve, businesses and industries must adopt new practices and processes in order to survive. Quality and cost control, work teams and participatory management, and an infusion of technology are transforming the way people work and do business. Employees are now expected to read, write, and communicate…

  16. A prospective comparison of postoperative pain and quality of life in robotic assisted vs conventional laparoscopic gynecologic surgery.

    Science.gov (United States)

    Zechmeister, Jenna R; Pua, Tarah L; Boyd, Leslie R; Blank, Stephanie V; Curtin, John P; Pothuri, Bhavana

    2015-02-01

    We sought to compare robotic vs laparoscopic surgery in regards to patient reported postoperative pain and quality of life. This was a prospective study of patients who presented for treatment of a new gynecologic disease requiring minimally invasive surgical intervention. All subjects were asked to take the validated Brief Pain Inventory-Short Form at 3 time points to assess pain and its effect on quality of life. Statistical analyses were performed using Pearson x(2) and Student's t test. One hundred eleven were included in the analysis of which 56 patients underwent robotic assisted surgery and 55 patients underwent laparoscopic surgery. There was no difference in postoperative pain between conventional laparoscopy and robotic assisted surgery for gynecologic procedures. There was a statistically significant difference found at the delayed postoperative period when evaluating interference of sleep, favoring laparoscopy (ROB 2.0 vs LSC 1.0; P = .03). There were no differences found between the robotic and laparoscopic groups of patients receiving narcotics (56 vs 53, P = .24, respectively), route of administration of narcotics (47 vs 45, P > .99, respectively), or administration of nonsteroidal antiinflammatory medications (27 vs 21, P = .33, respectively). Our results demonstrate no difference in postoperative pain between conventional laparoscopy and robotic assisted surgery for gynecologic procedures. Furthermore, pain did not appear to interfere consistently with any daily activity of living. Interference of sleep needs to be further evaluated after controlling for bilateral salpingo-oophorectomy. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Dementia prevalence and care in assisted living.

    Science.gov (United States)

    Zimmerman, Sheryl; Sloane, Philip D; Reed, David

    2014-04-01

    Assisted living residences have become prominent sites of long-term residential care for older adults with dementia. Estimates derived from national data indicate that seven out of ten residents in these residences have some form of cognitive impairment, with 29 percent having mild impairment, 23 percent moderate impairment, and 19 percent severe impairment. More than one-third of residents display behavioral symptoms, and of these, 57 percent have a medication prescribed for their symptoms. Only a minority of cognitively impaired residents reside in a dementia special care unit, where admission and discharge policies are more supportive of their needs. Policy-relevant recommendations from our study include the need to examine the use of psychotropic medications and cultures related to prescribing, better train assisted living staff to handle medications and provide nonpharmacological treatments, use best practices in caring for people with dementia, and promote consumer education regarding policies and practices in assisted living.

  18. Job Analysis Techniques for Restructuring Health Manpower Education and Training in the Navy Medical Department. Attachment 4. Clinic QPCB Task Sort for Clinical Physician Assistants--Dermatology, ENT, Opththalmology, Orthopedics, and Urology.

    Science.gov (United States)

    Technomics, Inc., McLean, VA.

    This publication is Attachment 4 of a set of 16 computer listed QPCB task sorts, by career level, for the entire Hospital Corps and Dental Technician fields. Statistical data are presented in tabular form for a detailed listing of job duties for clinical physician assistants. (BT)

  19. Sources of population and family planning assistance.

    Science.gov (United States)

    1983-01-01

    This document assesses the current status of population and family planning assistance throughout the world and provides brief sketches of the available sources including national governments, intergovernmental agencies such as the UNFPA and other UN entities, and nongovernmental funding, technical assistance, or funding and technical assistance organizations. The descriptions of aid-granting organizations describe their purposes, sources of funding, and activities, and give addresses where further information may be sought. At present about $100 million of the US $1 billion spent for family planning in developing countries each year comes from individuals paying for their own supplies and services, over $400 million is spent by national governments on their own programs, and about $450 million comes from developed country governments and private agencies. Over half of external assistance appears to be channeled through international agencies, and only a few countries provide a substantial proportion of aid bilaterally. In the past decade several governments, particularly in Asia, significantly increased the share of program costs they assumed themselves, and the most populous developing countries, China, India, and Indonesia, now contribute most of the funding for their own programs. Although at least 130 countries have provided population aid at some time, most is given by 12 industrialized countries. The US Agency for International Development (USAID) is the largest single donor, but the US share of population assistance has declined to 50% of all assistance in 1981 from 60% in the early 1970s. Governments of Communist bloc countries have made only small contributions to international population assistance. Most governmental asistance is in cash grant form, but loans, grants in kind, and technical assistance are also provided. Private organizations give assistance primarily to other private organizations in developing countries, and have been major innovators in

  20. Childhood accidents: the relationship of family size to incidence, supervision, and rapidity of seeking medical care.

    Science.gov (United States)

    Schwartz, Shepard; Eidelman, Arthur I; Zeidan, Amin; Applebaum, David; Raveh, David

    2005-09-01

    Large family size may be a risk factor for childhood accidents. A possible association with quality of child supervision and rapidity of seeking medical care has not been fully evaluated. To determine whether children with multiple siblings are at increased risk for accidents, to assess whether quality of child supervision varies with family size, and to evaluate the relationship of family size with the rapidity of seeking medical care after an accident. We prospectively studied 333 childhood accidents treated at TEREM (emergency care station) or the Shaare Zedek Medical Center. Details on family composition and the accident were obtained through parental interview. Family size of the study population was compared with that of the Jerusalem population. Families with one to three children (Group 1) and four or more children (Group 2) were compared with regard to type of supervision and different "Gap times" - the time interval from when the accident occurred until medical assistance was sought ("Gap 1"), the time from that medical contact until arrival at Shaare Zedek ("Gap 2"), and the time from the accident until arrival at Shaare Zedek for those children for whom interim medical assistance either was ("Gap 3A") or was not ("Gap 3B") sought. Children from families with 1, 2, 3, 4 and > or =5 children comprised 7.2%, 18.3%, 14.4%, 18.6% and 41.4% of our sample compared to 20.4%, 21.8%, 18.4%, 14.7% and 24.7% in the general population respectively. Children from Group 2 were less often attended to by an adult (44.5% vs. 62.0%) and more often were in the presence only of other children at the time of the accident (27.0% vs. 10.5%). Gaps 1, 2 and 3A in Group 2 (6.3 hours, 16.5 hours, 27.8 hours respectively) were longer than for Group 1 (2.7, 10.7, 13.3 hours respectively). The risk for accidents is increased among children from families with four or more children. The adequacy of child supervision in large families is impaired. There is a relative delay from the time

  1. MEDIC: medical embedded device for individualized care.

    Science.gov (United States)

    Wu, Winston H; Bui, Alex A T; Batalin, Maxim A; Au, Lawrence K; Binney, Jonathan D; Kaiser, William J

    2008-02-01

    Presented work highlights the development and initial validation of a medical embedded device for individualized care (MEDIC), which is based on a novel software architecture, enabling sensor management and disease prediction capabilities, and commercially available microelectronic components, sensors and conventional personal digital assistant (PDA) (or a cell phone). In this paper, we present a general architecture for a wearable sensor system that can be customized to an individual patient's needs. This architecture is based on embedded artificial intelligence that permits autonomous operation, sensor management and inference, and may be applied to a general purpose wearable medical diagnostics. A prototype of the system has been developed based on a standard PDA and wireless sensor nodes equipped with commercially available Bluetooth radio components, permitting real-time streaming of high-bandwidth data from various physiological and contextual sensors. We also present the results of abnormal gait diagnosis using the complete system from our evaluation, and illustrate how the wearable system and its operation can be remotely configured and managed by either enterprise systems or medical personnel at centralized locations. By using commercially available hardware components and software architecture presented in this paper, the MEDIC system can be rapidly configured, providing medical researchers with broadband sensor data from remote patients and platform access to best adapt operation for diagnostic operation objectives.

  2. Le problème des limites à la procréation assistée dans les lois des principaux pays européens The issue of the limits to medical assistance to procreation in the main European countries’legislation

    Directory of Open Access Journals (Sweden)

    Paolo Zatti

    2009-04-01

    Full Text Available A travers l’étude des limites à la procréation assistée dans les législations des principaux pays européens, l’article soulève différentes questions. Tout d’abord celle de savoir si la procréation assistée doit être un choix des individus ou si elle doit être réservée à des fins thérapeutiques. Ensuite celle de savoir si la femme seule peut accéder à la procréation assistée. Enfin la question de l’autorisation ou de l’interdiction de la fécondation post mortem, de la maternité de substitution et de la fécondation hétérologue. Ces questions doivent être abordées en tenant compte de la liberté de gérer son corps, de l’intérêt de l’enfant à naître et des limites de la compétence de l’Etat.This study of assisted reproduction limits in legislation of the main European countries raises various issues. The first one is to know whether assisted reproduction should be an individual choice or be reserved for therapeutic purpose. Then, there is the question whether a single woman can access to assisted reproduction. Finally the issue of allowance or prohibition of post mortem fertilization, of biological pregnancy and of hétérological fertilization. These issues must be analysed taking into account the freedom to control one’s body, the protection of the unborn child and the limits of State power.

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

    Science.gov (United States)

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

    2012-03-01

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

  4. Abortion - medical

    Science.gov (United States)

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  5. Emergency Physician Awareness of Prehospital Procedures and Medications

    Directory of Open Access Journals (Sweden)

    Rachel Waldron

    2014-07-01

    Full Text Available Introduction: Maintaining patient safety during transition from prehospital to emergency department (ED care depends on effective handoff communication between providers. We sought to determine emergency physicians’ (EP knowledge of the care provided by paramedics in terms of both procedures and medications, and whether the use of a verbal report improved physician accuracy. Methods: We conducted a 2-phase observational survey of a convenience sample of EPs in an urban, academic ED. In this large ED paramedics have no direct contact with physicians for non-critical patients, giving their report instead to the triage nurse. In Phase 1, paramedics gave verbal report to the triage nurse only. In Phase 2, a research assistant (RA stationed in triage listened to this report and then repeated it back verbatim to the EPs caring for the patient. The RA then queried the EPs 90 minutes later regarding their patients’ prehospital procedures and medications. We compared the accuracy of these 2 reporting methods. Results: There were 163 surveys completed in Phase 1 and 116 in Phase 2. The oral report had no effect on EP awareness that the patient had been brought in by ambulance (86% in Phase 1 and 85% in Phase 2. The oral report did improve EP awareness of prehospital procedures, from 16% in Phase 1 to 45% in Phase 2, OR=4.28 (2.5-7.5. EPs were able to correctly identify all oral medications in 18% of Phase 1 cases and 47% of Phase 2 cases, and all IV medications in 42% of Phase 1 cases and 50% of Phase 2 cases. The verbal report led to a mild improvement in physician awareness of oral medications given, OR=4.0 (1.09-14.5, and no improvement in physician awareness of IV medications given, OR=1.33 (0.15-11.35. Using a composite score of procedures plus oral plus IV medications, physicians had all three categories correct in 15% of Phase 1 and 39% of Phase 2 cases (p<0.0001. Conclusion: EPs in our ED were unaware of many prehospital procedures and

  6. Assistive technologies for brain-injured gamers

    OpenAIRE

    Colman, Jason; Gnanayutham, Paul

    2013-01-01

    This chapter surveys assistive technologies which make video games more accessible for people who have an acquired brain injury (ABI). As medical care improves, an increasing number of people survive ABI. Video games have been shown to provide therapeutic benefits in many medical contexts, and rehabilitation for ABI survivors has been shown to be facilitated by playing some types of video game. Therefore, technologies which improve the accessibility of games have the potential to bring a form...

  7. Exploration Medical System Demonstration

    Science.gov (United States)

    Rubin, D. A.; Watkins, S. D.

    2014-01-01

    BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

  8. O atendimento dermatológico integrativo: uma contextualização do atendimento médico sob a ótica integrativa Integrative dermatological consultation: contextualizing medical assistance within an integrative perspective

    Directory of Open Access Journals (Sweden)

    Tânia Nely Rocha

    2003-10-01

    Full Text Available A riqueza e a amplitude da dermatologia integrativa despertam o desejo de buscar novos conhecimentos, dos quais, neste texto, os autores destacam a psicoterapia integrativa e ecológica que, acreditam, acrescenta idéias e práticas muito significativas, que ajudam a aprimorar o relacionamento médico/paciente. Ao atender o paciente, a dermatologia integrativa privilegia as dimensões do funcionamento humano, baseando-se em seis abordagens: fisiológica, comportamental, cognitiva, afetiva, sistêmica e ecológica. Nesse atendimento integrativo considera-se o paciente como um todo, procurando-se atingir a excelência no relacionamento interpessoal médico/paciente.The wealth and breadth of integrative dermatology has motivated the search for further knowledge, regarding which the authors draw attention to integrative and ecological psychotherapy that they consider contributes highly significant concepts and techniques, which help optimize the physician/patient relationship. In attending patients, integrative dermatology underscores the dimensions of human function based on six approaches: physiological, behavioral, cognitive, affective, systemic and ecological. Integrative Dermatology views patients as a whole, and excellency is sought in the physician-patient interpersonal relationship.

  9. Euthanasia, assisted suicide and end-of-life care: attitudes of students, residents and attending physicians.

    Science.gov (United States)

    Ramírez-Rivera, José; Cruz, Juan; Jaume-Anselmi, Francisco

    2006-12-01

    Attitudes in regard to end-of life issues are evolving in Western societies. We have sought to trace this evolution in the relatively homogeneous cultural setting of Puerto Rico. One hundred fifty-two medical students, 62 medical residents and 84 members of three medical faculties were asked whether in terminally ill patients they: 1) would support a request for euthanasia(E); 2) if legalized, would engage in, would oppose or would not be opposed to others engaging physician-assisted suicide(PAS); 3) would consider ethical to prescribe full doses of drugs needed to alleviate pain, even if they knew it would hasten death; 4) would agree to limit certain resources for the terminally ill. Gender and religious affiliation were also requested. Twenty-eight percent of the students, 26% of the residents and 31% of the faculty supported E. Only 13% of the students, 18% of the residents and 11% of the faculty would engage in PAS. Men were more willing than women to acquiesce to a request for E or PAS. Religious affiliation or its absence did not influence the support or opposition to E and PAS. If it would hasten death, 86% of the residents, but only 65% of the faculty considered ethical to prescribe the dose of drugs needed to alleviate pain. More than 2/3 of the students, residents and faculty favored the limiting of certain resources for the terminally ill. In our cultural and medical environment, men are more willing than women to engage in E or PAS. The attitude towards E and PAS is not influenced by religious affiliation. If it hastens death, some still consider unethical to prescribe full doses of drugs needed to alleviate pain in the dying patient.

  10. Institutionalizing Security Force Assistance

    National Research Council Canada - National Science Library

    Binetti, Michael R

    2008-01-01

    .... It looks at the manner in which security assistance guidance is developed and executed. An examination of national level policy and the guidance from senior military and civilian leaders highlights the important role of Security Force Assistance...

  11. ForeignAssistance.gov

    Data.gov (United States)

    US Agency for International Development — ForeignAssistance.gov provides a view of U.S. Government foreign assistance funds across agencies and enables users to explore, analyze, and review aid investments...

  12. Partnership for Prescription Assistance

    Science.gov (United States)

    ... may use our name without our permission. The Partnership for Prescription Assistance will help you find the ... Events Blog Facebook Twitter Start living better. The Partnership for Prescription Assistance helps qualifying patients without prescription ...

  13. Assisted delivery with forceps

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000509.htm Assisted delivery with forceps To use the sharing features on ... called vacuum assisted delivery . When is a Forceps Delivery Needed? Even after your cervix is fully dilated ( ...

  14. Vacuum-assisted delivery

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000514.htm Vacuum-assisted delivery To use the sharing features on this page, ... through the birth canal. When is Vacuum-assisted Delivery Needed? Even after your cervix is fully dilated ( ...

  15. Secret et anonymat dans l’assistance médicale à la procréation avec donneurs de gamètes, ou le dogme de l’anonymat « à la française » Secret and anonymity in medical assistance to procreation with gamete donors or the anonymity dogma « à la française »

    Directory of Open Access Journals (Sweden)

    Geneviève Delaisi de Parseval

    2009-04-01

    Full Text Available La France s’est dotée d’un système législatif qui, en matière d’assistance médicale à la procréation avec donneurs (I.A.D., F.I.V. -D, dons d’ovocytes, dons d’embryons, a fait de la filiation biologique un secret désormais juridiquement protégé par la loi. Les lois votées par le Parlement français le 29 Juillet 1994 ont en effet choisi de rattacher la filiation des enfants nés avec la participation des donneurs de gamètes à la filiation charnelle (légitime ou naturelle, et non à la filiation fond��e sur la volonté, comme l’est la filiation adoptive. Ces positions sont discutées au plan de la métapsychologie et comparées à d’autres systèmes législatifs qui, pour l’auteur, prennent mieux en compte l’intérêt de toutes les parties concernées.France has a legislative system which, as far as medical assistance to procreation with donors (insemination with donor, in vitro fertilization with donor, gifts of oocytes, gift of embryos is concerned, has transformed biological filiation into a secret now protected by the law. Laws adopted by the French Parliament on July 29, 1994 chose to attach the filiation of children born with the participation of gamete donors to blood filiation (legitimate or natural and not to filiation based on will such as adoptive filiation. These positions are discussed from a metapsychological perspective and are compared with other legislative systems which, for the author, better take into consideration the interest of all persons concerned.

  16. Exploration Medical System Demonstration Project

    Science.gov (United States)

    Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

    2011-01-01

    A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

  17. Functional Vision Observation. Technical Assistance Paper.

    Science.gov (United States)

    Florida State Dept. of Education, Tallahassee. Bureau of Education for Exceptional Students.

    Technical assistance is provided concerning documentation of functional vision loss for Florida students with visual impairments. The functional vision observation should obtain enough information for determination of special service eligibility. The observation is designed to supplement information on the medical eye examination, and is conducted…

  18. Foreign Assistance: Treasury's Technical Assistance Program

    National Research Council Canada - National Science Library

    Ford, Jess

    1999-01-01

    After the collapse of communism in Central Europe and the dissolution of the Soviet Union, the United States developed programs of technical assistance to help countries transition to market economies and democracy...

  19. Automedicação em Bairro Assistido por Equipe de Saúde da Família em Itajubá, Minas Gerais/Self-medication in a District Assisted by Family Health Team in Itajubá, Minas Gerais

    Directory of Open Access Journals (Sweden)

    José Henrique Gomes Torres

    2014-03-01

    Full Text Available Objetivo: Verificar a utilização da automedicação pela população residente em um bairro de Itajubá, Minas Gerais, atendida por Equipe de Saúde da Família, e identificar suas características socioepidemiológicas. Materiais e métodos: Foram visitadas 238 famílias e aplicou-se um questionário, elaborado pelos pesquisadores, apenas aos indivíduos que utilizaram medicamento sem prescrição nos 30 dias anteriores ao dia da pesquisa. Resultados: Entre as 839 pessoas selecionadas (238 famílias visitadas, 183 indivíduos (21,8% utilizaram, no mínimo, um medicamento sem prescrição nos últimos 30 dias anteriores à entrevista. Destes, 66,1% eram mulheres e 87,4% tinham mais de 18 anos. Os analgésicos foram os medicamentos mais utilizados (62,2% e a cefaleia, a condição mais comum (50,8%. O medicamento foi escolhido pelo próprio indivíduo, em 32% dos casos. Conclusão: A automedicação em população assistida por Equipe de Saúde da Família foi menor do que em população sem a mesma assistência, porém mais estudos com a abordagem adotada são necessários. Objective: To investigate the use of self-medication by the population of a district of Itajubá, Minas Gerais, attended by the Family Health Team, and to identify their socio-epidemiological characteristics. Materials and methods: 238 families were visited and a questionnaire, developed by the researchers was applied only to the individuals who used drugs without prescription in the 30 days before the day of the survey. Results: Among the 839 people selected (visited 238 families, 183 people (21.8% used at least one drug without prescription in the previous 30 days. Of these, 66.1% were women and 87.4% were over 18 years of age. The painkillers were the most frequently used medications (62.2% and headache was the most common condition (50.8%. The drug was chosen on account of the own individual in 32% of cases. Conclusion: The self-medication in a population assisted by

  20. Technical assistance in Latin America

    International Nuclear Information System (INIS)

    Oteiza-Quirno, A.

    1976-01-01

    As in the other regions, nuclear technology development in Latin America reflects mainly the degree of technological development already existing in each country. It is quite significant that in nearly all countries in Latin America the medical profession has been the first to show interest in using nuclear techniques. As a result, a country such as Uruguay has become a source of recruitment for technical assistance experts in nuclear medicine to other developing countries, while at the same time it continues to receive assistance for new sophisticated techniques from the IAEA. Part of this assistance, in turn, comes from the neighbouring countries, Argentina and Brazil. For example, an expert from Uruguay is currently assigned under an Agency programme to Costa Rica, El Salvador and Guatemala, and experts from Argentina and Brazil have been sent to Uruguay. This is an example of 'horizontal' development, meaning mutual assistance between developing countries under programmes supported by the United Nations Agencies, which is now being emphasized by the United Nations Development Programme (UNDP). Still in the field of nuclear medicine, another significant model is provided by Bolivia. With assistance from the IAEA, and thanks to the availability of a good professional infrastructure in that country, a net of nuclear medicine services has been started, consisting of a well-developed nuclear medicine centre in La Paz and regional centres in Cochabamba, Sucre and Santa Cruz. Because of its great variations in altitude, Bolivia is in the position of being able to conduct research on the adaptation of man to diverse environmental conditions. The Agency has contributed, and continues to do so, to these programmes by sending experts, providing for training abroad of Bolivian doctors under its fellowship programmes, and providing basic equipment for all four centres. Independently of the cases described above, the IAEA has implemented or is implementing a considerable

  1. Nuclear physics and medical work in Burma

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1967-02-15

    Useful information connected with environmental radioactivity has already been obtained by the Rangoon Nuclear Physics Laboratory, Burma, the setting up of which was helped by the Agency's Technical Assistance Programme. Other assistance has helped the Rangoon General Hospital to install a scanning unit with which medical diagnosis and treatment can be aided

  2. Public Health Effects of Medical Marijuana Legalization in Colorado.

    Science.gov (United States)

    Davis, Jonathan M; Mendelson, Bruce; Berkes, Jay J; Suleta, Katie; Corsi, Karen F; Booth, Robert E

    2016-03-01

    The public health consequences of the legalization of marijuana, whether for medical or recreational purposes, are little understood. Despite this, numerous states are considering medical or recreational legalization. In the context of abrupt changes in marijuana policy in 2009 in Colorado, the authors sought to investigate corresponding changes in marijuana-related public health indicators. This observational, ecologic study used an interrupted time-series analysis to identify changes in public health indicators potentially related to broad policy changes that occurred in 2009. This was records-based research from the state of Colorado and Denver metropolitan area. Data were collected to examine frequency and trends of marijuana-related outcomes in hospital discharges and poison center calls between time periods before and after 2009 and adjusted for population. Analyses were conducted in 2014. Hospital discharges coded as marijuana-dependent increased 1% per month (95% CI=0.8, 1.1, pcenter calls mentioning marijuana (pcenter calls increased 0.8% per month (95% CI=0.2, 1.4, pcenter calls also increased 56% (95% CI=49%, 63%, p<0.001) in the period following the policy change. Further, there was one hospital discharge coded as dependent for every 3,159 (95% CI=2465, 3853, p<0.001) medical marijuana registrant applications. The abrupt nature of these changes suggests public health effects related to broad policy changes associated with marijuana. This report may be used to assist in policy decisions regarding the short-term public health effects of marijuana legalization. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Women involved in assisted reproductive treatments: a qualitative study in the medical context / Mujeres castellano-manchegas y reproducción asistida: un estudio cualitativo desde el ámbito sanitario

    Directory of Open Access Journals (Sweden)

    Beatriz Mañas Ramírez

    2014-10-01

    Full Text Available This research emerges from the necessity of facing health problems in a holistic way, able to capture the subjects’ perspective about their situation and context, and the way they are perceived and understood. This paper presents the qualitative research we have developed about women living in Castilla-La Mancha who start or are already involved in Assisted Reproductive Treatments (ART. The implementation and analysis of discussion groups provide a rich understanding of these women’s perceptions and representations about a series of dimensions that structure their own self-concept, their relations and their experience of a process which can provide or frustrate a whole vital project. In this context, where social, cultural, symbolic and biomedical aspects are involved, the cooperative work of social scientists and healthcare professionals can contribute to the advancement of both fields of knowledge, and to their mutual integration.

  4. Medical tourism.

    Science.gov (United States)

    Leggat, Peter

    2015-01-01

    Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.

  5. Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy. European Society of Human Genetics and European Society of Human Reproduction and Embryology.

    Science.gov (United States)

    Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

    2013-11-01

    In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation - ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and provide

  6. Systematic Review Methodology for the Fatigue in Emergency Medical Services Project

    Science.gov (United States)

    2018-01-11

    Background: Guidance for managing fatigue in the Emergency Medical Services (EMS) setting is limited. The Fatigue in EMS Project sought to complete multiple systematic reviews guided by seven explicit research questions, assemble the best available e...

  7. A Medical Logistics Officer Training Needs Assessment Utilizing Feedback from Operation Iraqi Freedom

    National Research Council Canada - National Science Library

    Waddick, James L

    2004-01-01

    ... their missions during the initial Operation Iraqi Freedom deployment (OIF 1). Additionally, the study sought to identify the potential benefit of additional training on key medical logistics tasks and training events...

  8. Detecting New Evidences for Evidence-Based Medical Guidelines with Journal Filtering

    NARCIS (Netherlands)

    Hu, Qing; Huang, Zisheng; ten Teije, Annette; van Harmelen, Frank; Riaño, David; Lenz, Richard; Reichert, Manfred

    2017-01-01

    Evidence-based medical guidelines are systematically developed recommendations with the aim to assist practitioner and patients decisions regarding appropriate health care for specific clinical circumstances, and are based on evidence described in medical research papers. Evidence-based medical

  9. Efficient adders for assistive devices

    Directory of Open Access Journals (Sweden)

    Mansi Jhamb

    2017-02-01

    Full Text Available The Body sensor network [IEEE 802.15] is a wireless communication network consisting of assistive devices which are of prime importance in medical applications. The delay critical and power hungry blocks in these assistive devices are designed so that they consume less power, have low latency and require a lesser area on chip. In this paper, we present a qualitative as well as a quantitative analysis of an asynchronous pipelined adder design with two latest computation completion sensing approaches based on Pseudo NMOS logic and other based on C-element. The Pseudo NMOS based completion sensing approach provides a maximum improvement of 76.92% in critical path delay at supply voltage of 1.2 V and the maximum drop in power dissipation has been observed at a supply voltage of 1.1 V which is 85.60% as compared to C-element based completion sensing approach. Even at low voltages such as 0.8 V, there is a significant improvement in speed and power which is 75.64% and 74.79% respectively. Since the adder is the most widely used component in all present day assistive devices, this analysis acts as a pointer for the application of asynchronous pipelined circuits with efficient Pseudo NMOS based completion sensing approach in low voltage/low power rehabilitative devices.

  10. Medical Management

    Science.gov (United States)

    ... org Close Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  11. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

  12. [Medical negligence].

    Science.gov (United States)

    Zipper, St G

    2016-06-01

    Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.

  13. Medical Illustration

    Science.gov (United States)

    ... as medical books, journals, magazines, pharma or biotech marketing, films, online video, exhibits, posters, wall charts, educational ... of the health career profession with strong communication skills, medical illustrators work closely with clients to interpret ...

  14. Improving third-year medical students' competency in clinical moral reasoning : two interventions

    NARCIS (Netherlands)

    Cummins, P.J.; Mendis, K.J.; Fallar, R.; Favia, A.; Frank, L.E.; Plunkett, C.; Gligorov, N.; Rhodes, R.

    2016-01-01

    Background: This article reports on the impact of two ethics interventions implemented for third-year medical students. Previous research validated our institution's model for assessing medical students' competency in medical ethics. Confident in our assessment model, the bioethics faculty sought to

  15. Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

    OpenAIRE

    Joslin, Jeremy D.; Lloyd, Jarem B.; Copeli, Nikoli; Cooney, Derek R.

    2017-01-01

    Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6%) ...

  16. Euthanasia is not medical treatment.

    Science.gov (United States)

    Boudreau, J Donald; Somerville, Margaret A

    2013-01-01

    The public assumes that if euthanasia and assisted suicide were to be legalized they would be carried out by physicians. In furthering critical analysis, we supplement the discourse in the ethics and palliative care literature with that from medical education and evolving jurisprudence. Both proponents and opponents agree that the values of respect for human life and for individuals' autonomy are relevant to the debate. Advocates of euthanasia and assisted suicide give priority to the right to personal autonomy and avoid discussions of harmful impacts of these practices on medicine, law and society. Opponents give priority to respect for life and identify such harmful effects. These both require euthanasia to remain legally prohibited. Proposals are emerging that if society legalizes euthanasia it should not be mandated to physicians. The impact of characterizing euthanasia as 'medical treatment' on physicians' professional identity and on the institutions of medicine and law should be examined in jurisdictions where assisted suicide and euthanasia have been de-criminalized.

  17. Patient-centered communication in digital medical encounters.

    Science.gov (United States)

    Alpert, Jordan M; Dyer, Karen E; Lafata, Jennifer Elston

    2017-10-01

    Patients are increasingly using the secure messaging function available through online patient portals to communicate with their health care providers, yet little is known about the characteristics of conversations that occur. The goal of this study is to describe the types of messages initiated by patients communicating via patient portals and to assess whether providers employ patient-centered strategies in their electronic responses. A total of 193 messages from 58 message threads between patients and providers were collected during a one-week period in a large health care system. Content analysis of patient messages was conducted and deductive analysis of provider responses was employed for two types of patient-centered communication, provider use of supportive talk and partnership building. Patients sent nearly double the number of messages compared to providers (65% versus 35%). Patient messages expressed concern, sought medical solutions and requested assistance with administrative tasks. Over half (53.4%) of provider replies did not contain language reflective of either partnership building or supportive talk. Partnership building language and supportive talk occurred at lower rates than documented in the literature on in-person encounters. This may represent a lost opportunity to strengthen the patient-provider relationship. As secure messaging is increasingly utilized as a form of patient-provider communication, it is important to understand how aspects of this communication channel, including the patient-centeredness of the language used by providers, impact patient-provider relationships and patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. 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

  19. Comparative evaluation of matrix-assisted laser desorption ionisation-time of flight mass spectrometry and conventional phenotypic-based methods for identification of clinically important yeasts in a UK-based medical microbiology laboratory.

    Science.gov (United States)

    Fatania, Nita; Fraser, Mark; Savage, Mike; Hart, Jason; Abdolrasouli, Alireza

    2015-12-01

    Performance of matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS) was compared in a side-by side-analysis with conventional phenotypic methods currently in use in our laboratory for identification of yeasts in a routine diagnostic setting. A diverse collection of 200 clinically important yeasts (19 species, five genera) were identified by both methods using standard protocols. Discordant or unreliable identifications were resolved by sequencing of the internal transcribed spacer region of the rRNA gene. MALDI-TOF and conventional methods were in agreement for 182 isolates (91%) with correct identification to species level. Eighteen discordant results (9%) were due to rarely encountered species, hence the difficulty in their identification using traditional phenotypic methods. MALDI-TOF MS enabled rapid, reliable and accurate identification of clinically important yeasts in a routine diagnostic microbiology laboratory. Isolates with rare, unusual or low probability identifications should be confirmed using robust molecular methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. [Births and children after assisted reproductive technologies. A retrospective analysis with special regard to multiple pregnancies at the Department of Obstetrics and Gynecology, Paracelsus Medical University Salzburg (2000-2009) with an extrapolation for Austria].

    Science.gov (United States)

    Maier, B; Reitsamer-Tontsch, S; Weisser, C; Schreiner, B

    2011-10-01

    Austria still lacks a baby-take-home rate after assisted reproductive technologies (ART) and therefore an adequate quality management of ART. This paper extrapolates data about births/infants after ART at the University Clinic of Obstetrics and Gynaecology (PMU/SALK) in Salzburg for Austria, especially in regard to multiple births/infants collected between 2000 and 2009. On average 2 271 infants were born per year during the last 10 years. Among them, 76 infants (3.34% of all children) were born after ART. Of all children conceived by ART and born (759) at the University Clinic of Obstetrics and Gynaecology 368 are multiples. This is 48.5% of all children born after ART. 31.6% of all multiples born were conceived through ART. The extrapolation of data concerning multiples results in 1 255 multiples/year after ART for Austria. Without a baby-take-home rate, serious quality management of reproductive medicine is impossible. Online registration of deliveries and infants is the only adequate approach. The data of this statistical extrapolation from a single perinatal center not only provide a survey about the situation in Austria, but also support the claim of a quantitative (numbers) as well as qualitative (condition of infants) baby-take-home rate after ART. © Georg Thieme Verlag KG Stuttgart · New York.

  1. [Medical technology and medical education].

    Science.gov (United States)

    von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F

    2010-08-01

    The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.

  2. Stent-assisted angioplasty for intracranial atherosclerosis

    International Nuclear Information System (INIS)

    Nakahara, Toshinori; Sakamoto, Shigeyuki; Hamasaki, Osamu; Sakoda, Katsuaki

    2002-01-01

    We report on two patients with intracranial atherosclerosis of the carotid artery or vertebral artery treated with stent-assisted angioplasty. Both patients have severe intracranial atherosclerosis (>70%) with refractory symptoms despite optimal medical treatment. In both patients, a coronary balloon-expandable stent was successfully placed using a protective balloon technique without procedural complications. The patients were asymptomatic and neurologically intact at a mean clinical follow-up of 13 months. Follow-up angiograms did not show restenosis 3 or 4 months after procedure, respectively. Stent-assisted angioplasty for intracranial atherosclerosis in the elective patient has proven effective, with an acceptable low rate of morbidity and mortality. (orig.)

  3. Advances in bioartificial liver assist devices.

    Science.gov (United States)

    Patzer, J F

    2001-11-01

    Rapid advances in development of bioartificial liver assist devices (BLADs) are exciting clinical interest in the application of BLAD technology for support of patients with acute liver failure. Four devices (Circe Biomedical HepatAssist, Vitagen ELAD, Gerlach BELS, and Excorp Medical BLSS) that rely on hepatocytes cultured in hollow-fiber membrane technology are currently in various stages of clinical evaluation. Several alternative approaches for culture and perfusion of hepatocytes have been evaluated in preclinical, large animal models of liver failure, or at a laboratory scale. Engineering design issues with respect to xenotransplantation, BLAD perfusion, hepatocyte functionality and culture maintenance, and ultimate distribution of a BLAD to a clinical site are delineated.

  4. Animal Assisted Therapy and Trauma Survivors.

    Science.gov (United States)

    Mims, Debra; Waddell, Rhondda

    2016-01-01

    Animal therapy is making strides in the treatment of posttraumatic stress disorder (PTSD). For years, animals have been used with great benefit in the treatment of the aged and the terminally ill. Now animal assisted therapy is benefitting sufferers of PTSD. The results of animal assisted therapy in the treatment of PTSD patients have seen significant results. In one study of the effect of dogs with patients, psychologists noted an 82% reduction in symptoms. One particular case noted that interacting with the dog for as little as one week, enabled a patient to decrease the amount of anxiety and sleep medications by half.

  5. Medical Data Architecture Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2018-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

  6. Medical aspects of the treatment of irradiated persons

    International Nuclear Information System (INIS)

    Carpaij, W.J.M.

    1976-01-01

    The possibilities of a medical assistance of patients after a nuclear accident and also the specific demands that supposes such an assistance, are discussed. On the basis of literary subjects, prevention as well as diagnostic and treatment are examined. It appears that such a medical assistance program cannot be drafted in detail beforehand, but must be fixed on the basis of the accidental situation. (author)

  7. Do assisted-reproduction twin pregnancies require additional antenatal care?

    Science.gov (United States)

    Jauniaux, E; Ben-Ami, I; Maymon, R

    2013-02-01

    Iatrogenic twinning has become the main side-effect assisted reproduction treatment. We have evaluated the evidence for additional care that assisted-reproduction twins may require compared with spontaneous twins. Misacarriages are increased in women with tubal problems and after specific treatments. Assisted-reproduction twin pregnancies complicated by a vanishing twin after 8 weeks have an increased risk of preterm delivery and of low and very low birthweight compared with singleton assisted-reproduction pregnancies. Monozygotic twin pregnancies occur at a higher rate after assisted reproduction treatment and are associated with a higher risk of perinatal complications. The incidence of placenta praevia and vasa praevia is increased in assisted-reproduction twin pregnancies. Large cohort studies do not indicate a higher rate of fetal congenital malformations in assisted-reproduction twins. Overall, assisted-reproduction twins in healthy women assisted-reproduction twins is only increased in women with a pre-existing medical condition such as hypertensive disorders and diabetes and most of these risks can be avoided with single-embryo transfer. Following the birth of the first IVF baby, rumours started to spread in both the medical literature and the media about the long-term health effects for children born following assisted reproduction treatment. However, after more than 30 years, the most common complications associated with IVF treatment remain indirect and technical such as the failure of treatment and ovarian hyperstimulation. Iatrogenic twinning has become the main side-effect of assisted reproduction treatment and the increasing number of twin pregnancies, in particular in older women, has generated numerous debates on the need for additional healthcare provision. In this review, we have evaluated the evidence for additional care that assisted-conception twin pregnancies may require compared with spontaneous twin pregnancies. Twin pregnancies are

  8. Assisted suicide for prisoners? Stakeholder and prisoner perspectives.

    Science.gov (United States)

    Shaw, David M; Elger, Bernice S

    2016-09-01

    For a wider project on aging in prison, the authors interviewed 35 older prisoners and 24 stakeholders (prison staff, prison healthcare professionals, and policy makers) about healthcare for prisoners. In all, 6 prisoners and 3 stakeholders spontaneously expressed their attitudes concerning assisted suicide. Some prisoners seek assisted suicide for medical reasons and others because they regard spending the rest of their lives in prison as undignified. However, stakeholders identified several ethical and practical challenges in providing assisted suicide to prisoners. This article presents these perspectives on assisted suicide in prison and provides an ethical analysis of the issues raised.

  9. Medical education teaching resources.

    Science.gov (United States)

    Jibson, Michael D; Seyfried, Lisa S; Gay, Tamara L

    2014-02-01

    Numerous monographs on psychiatry education have appeared without a review specifically intended to assist psychiatry faculty and trainees in the selection of appropriate volumes for study and reference. The authors prepared this annotated bibliography to fill that gap. The authors identified titles from web-based searches of the topics "academic psychiatry," "psychiatry education," and "medical education," followed by additional searches of the same topics on the websites of major publishers. Forty-nine titles referring to psychiatry education specifically and medical education generally were identified. The authors selected works that were published within the last 10 years and remain in print and that met at least one of the following criteria: (1) written specifically about psychiatry or for psychiatric educators; (2) of especially high quality in scholarship, writing, topic selection and coverage, and pertinence to academic psychiatry; (3) covering a learning modality deemed by the authors to be of particular interest for psychiatry education. The authors reviewed 19 books pertinent to the processes of medical student and residency education, faculty career development, and education administration. These included 11 books on medical education in general, 4 books that focus more narrowly on the field of psychiatry, and 4 books addressing specific learning modalities of potential utility in the mental health professions. Most of the selected works proved to be outstanding contributions to the medical education literature.

  10. Intelligent medical information filtering.

    Science.gov (United States)

    Quintana, Y

    1998-01-01

    This paper describes an intelligent information filtering system to assist users to be notified of updates to new and relevant medical information. Among the major problems users face is the large volume of medical information that is generated each day, and the need to filter and retrieve relevant information. The Internet has dramatically increased the amount of electronically accessible medical information and reduced the cost and time needed to publish. The opportunity of the Internet for the medical profession and consumers is to have more information to make decisions and this could potentially lead to better medical decisions and outcomes. However, without the assistance from professional medical librarians, retrieving new and relevant information from databases and the Internet remains a challenge. Many physicians do not have access to the services of a medical librarian. Most physicians indicate on surveys that they do not prefer to retrieve the literature themselves, or visit libraries because of the lack of recent materials, poor organisation and indexing of materials, lack of appropriate and available material, and lack of time. The information filtering system described in this paper records the online web browsing behaviour of each user and creates a user profile of the index terms found on the web pages visited by the user. A relevance-ranking algorithm then matches the user profiles to the index terms of new health care web pages that are added each day. The system creates customised summaries of new information for each user. A user can then connect to the web site to read the new information. Relevance feedback buttons on each page ask the user to rate the usefulness of the page to their immediate information needs. Errors in relevance ranking are reduced in this system by having both the user profile and medical information represented in the same representation language using a controlled vocabulary. This system also updates the user profiles

  11. Academic Medical Library Services Contribute to Scholarship in Medical Faculty and Residents

    Directory of Open Access Journals (Sweden)

    Peace Ossom Williamson

    2017-09-01

    Full Text Available A Review of: Quesenberry, A. C., Oelschlegel, S., Earl, M., Leonard, K., & Vaughn, C. J. (2016. The impact of library resources and services on the scholarly activity of medical faculty and residents. Medical Reference Services Quarterly, 35(3, 259-265. http://dx.doi.org/10.1080/02763869.2016.1189778 Abstract Objective – To assess the impact of academic medical library services and resources on information-seeking behaviours during the academic efforts of medical faculty and residents. Design – Value study derived from a 23-item survey. Setting – Public medical residency program and training hospital in Tennessee, USA. Subjects – 433 faculty and residents currently employed by or completing residency in an academic medical centre. Methods – Respondents completed a 23-question survey about their use of library resources and services in preparation for publishing, presenting, and teaching. The library services in the survey included literature searches completed by librarians and document delivery for preparation of publications, presentations, and lecture material. The survey also included questions about how resources were being accessed in preparation for scholarship. The survey sought information on whether respondents published articles or chapters or presented papers or posters in the previous three years. If respondents answered in the affirmative to one of the aforementioned methods of scholarship, they were provided with further questions about how they access library resources and whether they sought mediated literature search and document delivery services in preparation for their recent presentations and publications. The survey also included questions concerning what types of scholarly activity prompt faculty and residents to use online library resources. Main Results – The study was provided to 433 subjects, including 220 faculty and 213 residents, contacted through an email distribution list. The response rate to the

  12. Steering and evasion assist

    NARCIS (Netherlands)

    Dang, T.; Desens, J.; Franke, U.; Gavrila, D.; Schäfers, L.; Ziegler, W.; Eskandarian, A.

    2012-01-01

    Steering and evasion assistance defines a new and future class of driver assistance systems to avoid an impending collision with other traffic participants. Dynamic and kinematic considerations reveal that an evasive steering maneuver has high potential for collision avoidance in many driving

  13. Training Teaching Assistants.

    Science.gov (United States)

    Rava, Susan

    1987-01-01

    Washington University's (Missouri) Department of Romance Languages and Literature requires its graduate teaching assistants to take a one-semester pedagogy course to ensure their competence and effectiveness as teaching assistants. The course features seminars in which goals, expectations, and learning theories are discussed and practice teaching…

  14. Competition for Assistance Agreements

    Science.gov (United States)

    It is EPA policy to promote competition in the award of assistance agreements to the maximum extent practicable.When assistance agreements are awarded competitively, it is EPA policy that the competitive process be fair and open & that no applicant receive

  15. Medical marijuana.

    OpenAIRE

    Marmor, J B

    1998-01-01

    Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several...

  16. A Correlational Study of Self-Directed Learning Readiness and Learning Activity Preference for Continuing Medical Education among Family Physicians

    Science.gov (United States)

    Barrett, Theresa J.

    2014-01-01

    This quantitative, nonexperimental, correlational study sought to determine whether a relationship exists between family physicians' levels of self-directed learning readiness (SDLR) and their preferences for continuing medical education (CME) activities. The study also sought to determine whether years in clinical practice or size of clinical…

  17. Global health education in Swedish medical schools.

    Science.gov (United States)

    Ehn, S; Agardh, A; Holmer, H; Krantz, G; Hagander, L

    2015-11-01

    Global health education is increasingly acknowledged as an opportunity for medical schools to prepare future practitioners for the broad health challenges of our time. The purpose of this study was to describe the evolution of global health education in Swedish medical schools and to assess students' perceived needs for such education. Data on global health education were collected from all medical faculties in Sweden for the years 2000-2013. In addition, 76% (439/577) of all Swedish medical students in their final semester answered a structured questionnaire. Global health education is offered at four of Sweden's seven medical schools, and most medical students have had no global health education. Medical students in their final semester consider themselves to lack knowledge and skills in areas such as the global burden of disease (51%), social determinants of health (52%), culture and health (60%), climate and health (62%), health promotion and disease prevention (66%), strategies for equal access to health care (69%) and global health care systems (72%). A significant association was found between self-assessed competence and the amount of global health education received (pcurriculum. Most Swedish medical students have had no global health education as part of their medical school curriculum. Expanded education in global health is sought after by medical students and could strengthen the professional development of future medical doctors in a wide range of topics important for practitioners in the global world of the twenty-first century. © 2015 the Nordic Societies of Public Health.

  18. Cost-Effectiveness of Ventricular Assist Device Destination Therapy for Advanced Heart Failure in Duchenne Muscular Dystrophy.

    Science.gov (United States)

    Magnetta, Defne A; Kang, JaHyun; Wearden, Peter D; Smith, Kenneth J; Feingold, Brian

    2018-05-17

    Destination ventricular assist device therapy (DT-VAD) is well accepted in select adults with medically refractory heart failure (HF) who are not transplant candidates; however, its use in younger patients with progressive diseases is unclear. We sought to evaluate the cost-effectiveness of DT-VAD in Duchenne muscular dystrophy (DMD) patients with advanced HF. We created a Markov-state transition model (5-year horizon) to compare survival, costs, and quality of life (QOL) between medical management and DT-VAD in DMD with advanced HF. Model input parameters were derived from the literature. We used sensitivity analyses to explore uncertainty around model assumptions. DT-VAD had higher costs ($435,602 vs. $125,696), survival (3.13 vs. 0.60 years), and quality-adjusted survival (1.99 vs. 0.26 years) than medical management. The incremental cost-effectiveness ratio (ICER) for DT-VAD was $179,086 per quality-adjusted life year (QALY). In sensitivity analyses that were widely varied to account for uncertainty in model assumptions, the DT-VAD strategy generally remained more costly and effective than medical management. Only when VAD implantation costs were <$113,142 did the DT-VAD strategy fall below the $100,000/QALY willingness-to-pay threshold commonly considered to be "cost-effective." In this exploratory analysis, DT-VAD for patients with DMD and advanced HF exceeded societal expectations for cost-effectiveness but had an ICER similar to the accepted practice of DT-VAD in adult HF patients. While more experience and research in this population is needed, our analysis suggests that DT-VAD for advanced HF in DMD should not be dismissed solely based on cost.

  19. Detection of psychiatric morbidity in the primary medical care setting in Brazil Distúrbios psiquiátricos e assistência primária à saúde no Brasil

    Directory of Open Access Journals (Sweden)

    Jair de Jesus Mari

    1987-12-01

    Full Text Available The aims of this study were a to assess the ability of primary care doctors to make accurate ratings of psychiatric disturbance and b to evaluate the use of a case-finding questionnaire in the detection of psychiatric morbidity. The estudy took place in three primary care clinics in the city of São Paulo, Brazil, during a six-month survey. A time sample of consecutive adult attenders were asked to complete a case-finding questionnaire for psychiatric disorders (the Self Report Questionnaire - SRQ and a subsample were selected for a semi-structured psychiatric interview (the Clinical Interview Schedule - CIS. At the end of the consultation the primary care doctors were asked to assess, in a standardized way, the presence or absence of psychiatric disorder; these assessments were then compared with that ratings obtained in the psychiatric interview. A considerable proportion of minor psychiatric morbidity remained undetected by the three primary care doctors: the hidden morbidity ranged from 22% to 79%. When these were compared to those of the case-finding questionnaire, they were consistently lower, indicating that the use of these instruments can enhance the recognition of psychiatric disorders in primary care settings. Four strategies for adopting the questionnaire are described, and some of the clinical consequences of its use are discussed.Objetivou-se avaliar a habilidade de clínicos gerais em diagnosticar distúrbios emocionais na assistência primária, e investigar a possibilidade de se introduzir um questionário de "screening" para auxiliar o diagnóstico de doenças psiquiátricas. O estudo foi realizado em dois centros de saúde e um ambulatório de clínica geral na cidade de São Paulo (Brasil, por um período de 6 meses. Uma amostra representativa de pacientes adultos (16 anos atendidos por clínico geral preencheu um questionário de "screening" para distúrbios psiquiátricos menores. Uma sub-amostra foi selecionada para

  20. Medical Terminology.

    Science.gov (United States)

    Mercer County Community Coll., Trenton, NJ.

    This document is one of a series of student workbooks developed for workplace skill development courses or workshops by Mercer County Community College (New Jersey) and its partners. Designed to help employees of medical establishments learn medical terminology, this course provides information on basic word structure, body parts, suffixes and…

  1. Robotic assisted laparoscopic colectomy.

    LENUS (Irish Health Repository)

    Pandalai, S

    2010-06-01

    Robotic surgery has evolved over the last decade to compensate for limitations in human dexterity. It avoids the need for a trained assistant while decreasing error rates such as perforations. The nature of the robotic assistance varies from voice activated camera control to more elaborate telerobotic systems such as the Zeus and the Da Vinci where the surgeon controls the robotic arms using a console. Herein, we report the first series of robotic assisted colectomies in Ireland using a voice activated camera control system.

  2. FEMA Hazard Mitigation Assistance Flood Mitigation Assistance (FMA) Data

    Data.gov (United States)

    Department of Homeland Security — This dataset contains closed and obligated projects funded under the following Hazard Mitigation Assistance (HMA) grant programs: Flood Mitigation Assistance (FMA)....

  3. Computer-Assisted Evaluation of Videokymographic Data

    Czech Academy of Sciences Publication Activity Database

    Novozámský, Adam; Sedlář, Jiří; Zita, A.; Švec, J. G.; Zitová, Barbara; Flusser, Jan; Hauzar, D.

    2013-01-01

    Roč. 1, č. 1 (2013), s. 49-49 ISSN 1805-8698. [EFMI STC Prague Data and Knowledge for Medical Decision Support. 17.04.2013-19.04.2013, Praha] Institutional support: RVO:67985556 Keywords : videokymography * image process ing * computerassisted evaluation Subject RIV: JD - Computer Applications, Robotics http://library.utia.cas.cz/separaty/2013/ZOI/novozamsky-computer-assisted evaluation of videokymographic data.pdf

  4. Assisted reproduction and distributive justice.

    Science.gov (United States)

    Panitch, Vida

    2015-02-01

    The Canadian province of Quebec recently amended its Health Insurance Act to cover the costs of In Vitro Fertilization (IVF). The province of Ontario recently de-insured IVF. Both provinces cited cost-effectiveness as their grounds, but the question as to whether a public health insurance system ought to cover IVF raises the deeper question of how we should understand reproduction at the social level, and whether its costs should be a matter of individual or collective responsibility. In this article I examine three strategies for justifying collective provisions in a liberal society and assess whether public reproductive assistance can be defended on any of these accounts. I begin by considering, and rejecting, rights-based and needs-based approaches. I go on to argue that instead we ought to address assisted reproduction from the perspective of the contractarian insurance-based model for public health coverage, according to which we select items for inclusion based on their unpredictability in nature and cost. I argue that infertility qualifies as an unpredictable incident against which rational agents would choose to insure under ideal conditions and that assisted reproduction is thereby a matter of collective responsibility, but only in cases of medical necessity or inability to pay. The policy I endorse by appeal to this approach is a means-tested system of coverage resembling neither Ontario nor Quebec's, and I conclude that it constitutes a promising alternative worthy of serious consideration by bioethicists, political philosophers, and policy-makers alike. © 2013 John Wiley & Sons Ltd.

  5. Electives during Medical Internship

    International Nuclear Information System (INIS)

    Al-Sultan, Ali I.; Parashar, Shyam K; Al-Ghamdi, Abulmohsin A.

    2003-01-01

    The purpose of study was to find out the reasons for selecting elective rotations during a rotating medical internship.One hundred and seventy-eight medical interns in the College of Medicine, King Faisal University,Dammam, Kingdom of Saudi Arabia during the period March 2001 to August 2002 completed a questionnaire for their selection reasons with responses on a scale of 1-5.The study comprised 60% males and 98.3% Saudis. The most frequently chosen elective is Dermatology 28.1% ,radiology 20.8%, anesthesia 9.6% and otorhinolaryngology (ear, nose and throat [ENT]) 9%. Significantly, more males (89.2%) chose radiology rotation and more females (75%) chose ENT rotation.The leading reasons to choose an elective rotations are;1, to gain broad medical training and education,2, to assist in choice of future speciality and,3, being relevant to future speciality .The mean score for ENT and dermatology is higher than radiology and anesthesia for the response to participate in medical practice in different institute , while dermatology is higher than anesthesia for response to help for getting aceptance for job in the same instituteand radiology is higher than ENT and anesthesia for the response i t has infrequent or no night duties . The reason chosen reflect the educational value of electives and their important role in choosing future career. Dermatology and radiology rotations are most popular electives ,with additional and though different reasons. (author)

  6. The state of leadership education in US medical schools: results of a national survey.

    Science.gov (United States)

    Neeley, Sabrina M; Clyne, Brian; Resnick-Ault, Daniel

    2017-01-01

    Over the past two decades, there have been increasing calls for physicians to develop the capabilities to lead health care transformation. Many experts and authors have suggested that leadership education should begin during medical school; however, little information exists regarding the presence or nature of undergraduate medical education leadership curricula in the USA. This study sought to determine the prevalence of formal leadership education in US undergraduate medical schools, as well as the delivery methods and degree of student participation. A web-based survey of medical education deans from US allopathic medical schools (N = 144) was administered from November 2014 to February 2015. The survey included questions on the presence of leadership curricula, delivery format, student participation rates, and forms of recognition. Eighty-eight surveys were completed; the majority (85%) of respondents were associate or assistant deans for medical education. Approximately half (54.5%) of respondents reported leadership curricula within their medical schools. Of those, 34.8% (16/46) were required; 32.6% (15/46) were elective; and 32.6% (15/46) indicated both required and elective components. Of schools with formal leadership curricula ​(n = 48), the common forms of content delivery were: mentoring programs (65.1%); dual degree programs (54.5%); workshops (48.8%); seminar/lecture series (41.9%); courses (41.9%); or single seminars (18.6%). Nineteen percent of institutions offer longitudinal leadership education throughout medical school. Common forms of recognition for leadership education were: course credit (48.8%); dual degrees (37.2%); certificates of completion (18.6%); and transcript notations (7.0%). This study indicates that formal leadership education exists in more than half of US allopathic medical schools, suggesting it is an educational priority. Program format, student participation, delivery methods, and recognition varied considerably

  7. A qualitative exploration of how Canadian informal caregivers in medical tourism use experiential resources to cope with providing transnational care.

    Science.gov (United States)

    Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy

    2017-01-01

    Canadians travelling abroad for privately arranged surgeries paid for out-of-pocket are engaging in what has come to be known as medical tourism. They are often accompanied by friends or family members, who we call caregiver-companions. Caregiver-companions provide care in and across a variety of formal and informal settings, such as in hotels, airplanes and at home. This qualitative study examines the experiences of informal caregivers in medical tourism to learn more about the lived experiences or 'experiential resources' they draw upon to cope with providing care and avoiding caregiver burden. The care-giving literature has demonstrated that such burden can negatively impact caregivers' well-being. The unique, transnational context of care-giving in medical tourism and recent growth in popularity of this practice means that there are few supports or resources currently in place to assist informal caregivers. In this article, we report on an analysis that sought to detail how caregiver-companions draw upon their previous lived experiences to cope with providing transnational care and to minimise or avoid the onset of caregiver burden. We conducted semi-structured telephone interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery between September 2013 and January 2014. Thematic analysis revealed the ways that participants had developed practical strategies to deal with the challenges they faced in medical tourism. The interviews revealed three important experiential resources drawn upon by participants: (i) previous experiences of international travel; (ii) previous experiences of informal care-giving; and (iii) dimensions of the existing relationship with the care recipient. Differences in access to and use of these experiential resources related to participants' perspectives on medical tourism and the outcomes of the trip. By identifying the experiential resources drawn upon by informal caregivers in medical tourism

  8. Access to medical-assisted reproduction and pgd in Italian law: a deadly blow to an illiberal statute? commentary to the European Court on Human Rights's decision Costa and Pavan v Italy (ECtHR, 28 August 2012, App. 54270/2010).

    Science.gov (United States)

    Biondi, Stefano

    2013-01-01

    This article provides an account of the European Court on Human Rights' Second Section decision in the case Costa and Pavan v Italy. The judgment found that the Italian Statute on Assisted Reproduction (Law 40/2004), and particularly its prohibition to use in vitro fertilisation and pre-implantation genetic diagnosis (PGD) to prevent the birth of children affected by genetically transmissible conditions, breached Article 8 of the European Convention on Human Rights (ECHR). In fact, the statute in question permits only infertile people to access medically assisted reproduction techniques and forbids PGD and embryo selection. The Court regarded that the rationale of these prohibitions-identified by the Italian Government with the need to prevent eugenic practices as well as to protect the health of the unborn and of the woman-was at odds with the fact that Italian law allows pre-natal screening and therapeutic abortions in case foetal abnormalities are diagnosed. In order to clarify the decision's significance, the paper goes on to analyse the rationale of Law 40/2004 in the Italian legal and political context. Emphasis is placed on the fact that this statute is extremely controversial at domestic level, because many of its provisions-including those considered by the Strasbourg Court-are inherently contradictory and contrast with the settled constitutional principles on abortion, as many domestic authorities highlighted. In this context, should the commented decision be confirmed by the Grand Chamber, it may provide a basis to bring consistency back to the Italian regulation of assisted reproduction. Finally, the paper considers the appeal lodged by the Italian Government to the Grand Chamber, and in particular the contention that the European Court had failed to respect Italy's margin of appreciation. In this regard, it is argued that, under Law 40/2004, individuals face illogical and discriminatory restrictions to their right to private and family life and that

  9. Computer assisted roentgenology

    International Nuclear Information System (INIS)

    Trajkova, N.; Velkova, K.

    1999-01-01

    This is a report on the potentials and superiorities of computer tomography (CT), assumed as an up-to-date imaging examination method in medicine. The current trend in the development of computer assisted roentgenology consists in the implementation of new computer and communication systems promoting diagnostic and therapeutic activities. CT-study application is discussed with special reference to diagnosis and treatment of brain, lung, mediastinal and abdominal diseases. The new trends in the particular implementation of CT are presented, namely: CT-assisted biopsy, CT-assisted abscess drainage, drug administration under CT control, as well as the wide use of CT in orthopaedic surgery, otorinolaryngology etc. Also emphasis is laid on the important role played by three-dimensional technologies in computer-assisted surgery, leading to qualitatively new stage in the surgical therapeutic approach to patients

  10. Technical Assistance Plan (TAP)

    Science.gov (United States)

    A Technical Assistance Plan (TAP) enables community groups to retain the services of an independent technical advisor and to provide resources for a community group to help inform other community members about site decisions.

  11. Superfund Technical Assistance Grants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This asset includes data related to the Superfund Technical Assistance Grant program, including grant number, award amounts, award dates, period of performance,...

  12. Computer Assisted Instruction

    Science.gov (United States)

    Higgins, Paul

    1976-01-01

    Methodology for developing a computer assisted instruction (CAI) lesson (scripting, programing, and testing) is reviewed. A project done by Informatics Education Ltd. (IEL) for the Department of National Defense (DND) is used as an example. (JT)

  13. Dental Assisting Program Standards.

    Science.gov (United States)

    Georgia Univ., Athens. Dept. of Vocational Education.

    This publication contains statewide standards for the dental assisting program in Georgia. The standards are divided into 12 categories: foundations (philosophy, purpose, goals, program objectives, availability, evaluation); admissions (admission requirements, provisional admission requirements, recruitment, evaluation and planning); program…

  14. Computer assisted radiology and surgery. CARS 2010

    International Nuclear Information System (INIS)

    Anon.

    2010-01-01

    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  15. Computer assisted radiology and surgery. CARS 2010

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2010-06-15

    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  16. Medical Student Perceptions of Radiology Use in Anatomy Teaching

    Science.gov (United States)

    Murphy, Kevin P.; Crush, Lee; O'Malley, Eoin; Daly, Fergus E.; Twomey, Maria; O'Tuathaigh, Colm M. P.; Maher, Michael M.; Cryan, John F.; O'Connor, Owen J.

    2015-01-01

    The use of radiology in the teaching of anatomy to medical students is gaining in popularity; however, there is wide variation in how and when radiology is introduced into the curriculum. The authors sought to investigate students' perceptions regarding methods used to depict and teach anatomy and effects of integrated radiology instruction on…

  17. Medical cost of Lassa fever treatment in Irrua Specialist Teaching ...

    African Journals Online (AJOL)

    This cross-sectional study sought to estimate the direct medical cost of Lassa fever treatment on patients in South-South Nigeria. All the 73 confirmed Lassa fever cases admitted in the isolation ward of the Institute Of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital (ISTH) Irrua, in Edo State, Nigeria, ...

  18. Cardiac Medications

    Science.gov (United States)

    ... cholesterol from circulating in the blood. Watch an animation of how statins work. Reason for Medication Used ... Kindle Fire Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  19. Medication Guide

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Where the Money Goes Have ...

  20. 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.

  1. Medical imaging

    International Nuclear Information System (INIS)

    Loshkajian, A.

    2000-01-01

    This didactical book presents the medical imaging techniques: radiography, scanner, nuclear magnetic resonance (NMR). Examples are given for the most common pathologies in all domains of medicine. (J.S.)

  2. Medical Imaging.

    Science.gov (United States)

    Barker, M. C. J.

    1996-01-01

    Discusses four main types of medical imaging (x-ray, radionuclide, ultrasound, and magnetic resonance) and considers their relative merits. Describes important recent and possible future developments in image processing. (Author/MKR)

  3. Medical education.

    Science.gov (United States)

    Krishnan, P

    1992-01-01

    In theory, the Medical Council of India (MCI) determines the standards and qualifications of medical schools. It also sanctions curricula and ensures standards. Yet no standards exist on the mode of selection in medical schools, duration of study, course content, student stipends or period of internship. It takes 4.5 years to finish medical school. Students undergo preclinical, paraclinical, and clinical training. Most courses are in English which tends to favor the urban elite. Students cannot always communicate with patients in local languages. Textbooks often provide medical examples unrelated to India. Pedagogy consists mainly of lectures and rote learning predominates. Curricula tend not to provide courses in community health. Students pick up on the elitist attitudes of the faculty. For example, faculty do not put much emphasis on community health, individual health, equity in health care delivery, and teamwork. Further the education system is not patient oriented, but hospital or disease oriented. Faculty should train students in creating sanitation programs, knowing local nutritious foods, and in making community diagnoses. Yet they tend to be practitioners 1st then educators. Further faculty are not paid well and are not always invited to take part in improving curriculum, so morale is often low. Moreover experience in health planning and management issues is not required for administrators. In addition, medical schools are not well equipped with learning aids, libraries, or teaching staff. Tax revenues finance medical education. 75% of graduating physicians set up a private practice. Further many physicians go to urban areas. 34-57% emigrate to other countries. The problems of medical education will not be solved until the political and economic system becomes more responsive to the health needs of the people.

  4. Medical tourism

    OpenAIRE

    Abbas Ghanbari; Khadijeh Zirak Moradlu; Morteza Ramazani

    2014-01-01

    Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism pot...

  5. 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 ...

  6. Medical radiation

    International Nuclear Information System (INIS)

    1992-01-01

    This leaflet in the At-a-Glance Series describes the medical use of X-rays, how X-rays help in diagnosis, radiation protection of the patient, staff protection, how radioactive materials in nuclear medicine examinations help in diagnosis and the use of radiation in radiotherapy. Magnetic resonance imaging, a diagnostic technique involving no ionizing radiation, is also briefly examined. The role of the NRPB in the medical use of radiation is outlined. (UK)

  7. Medical negligence.

    OpenAIRE

    Rosen, M.

    1992-01-01

    The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malpractice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the standard of care the law required of him in the particular circumstances and that he acted with guilt and therefore can be blamed for the deed. This paper describes medical practitioner negligence and reviews relevant cases.

  8. Becoming 'ward smart' medical students.

    Science.gov (United States)

    Walker, Beth; Wallace, Deirdre; Mangera, Zaheer; Gill, Deborah

    2017-10-01

    A small number of medical students elect to work as health care assistants (HCAs) during or prior to their undergraduate training. There is a significant body of evidence in the literature regarding the impact of HCA experience on student nurses; however, little research has examined the effects of such experience on medical students. All fourth-year medical students with self-declared experience as HCAs from a single UK medical school were invited to participate in focus groups to explore their experiences and perceptions. Ten students from the year group took part. Participants felt that their experience as HCAs enhanced their learning in the workplace through becoming 'ward smart', helping them to become socialised into the world of health care, providing early meaningful and humanised patient interaction, and increasing their understanding of multidisciplinary team (MDT) members' roles. Little research has examined the effects of [HCA] experience on medical students DISCUSSION: Becoming 'ward smart' and developing a sense of belonging are central to maximising learning in, from and through work on the ward. Experience as a HCA provides a range of learning and social opportunities for medical students, and legitimises their participation within clinical communities. HCA experience also seems to benefit in the 'hard to reach' dimensions of medical training: empathy; humanisation of patient care; professional socialisation; and providing a sense of belonging within health care environments. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  9. A reference center for evaluation and assistance of radiation victims

    International Nuclear Information System (INIS)

    Valverde, Nelson J.L.; Oliveira, A. Alexandre; Peregrino, Augusto A.; Almeida, Carlos E.V. de

    1995-01-01

    The medical assistance of of accidentally exposed individuals to ionizing radiation demands a highly qualified support, considering human, organizational and materials resources. Such a need has been highlighted since the Goiania Radiation Accident in 1987. The Reference Center for Evaluation and Assistance of Radiation Victims - CRAAR was designed within the framework of the Laboratory of Radiological Sciences - LCR of the University of the State of Rio de Janeiro - UFRJ. Its main purposes are no coordinate the medical tertiary response in a radiation accident and to serve as a training site for all personnel that may respond to such a condition. This paper describes the three-level scheme of assistance adopted by CRAAR and its insertion in the National Radiological Emergency Assistance System under development by the Health Ministry. (author). 15 refs

  10. A reference center for evaluation and assistance of radiation victims

    International Nuclear Information System (INIS)

    Lima Valverde, Nelson Jose de; Peregrino, Antonio Augusto; Almeida, Carlos Eduardo V. de

    1995-01-01

    The medical assistance of accidentally exposed individuals to ionizing radiation demands a highly qualified support, considering human, organizational and material resources. Such a needed has been highlighted since the Goiania Radiation Accident in 1987. The Reference Center for Evaluation and Assistance of Radiation Victims - CRAAR was designed within the framework of the Laboratory of Radiological Sciences - LCR of the University of the State of Rio de Janeiro - UERJ. Its main purposes are to coordinate the medical tertiary response in a radiation accident and to serve as a training site for all personnel that may respond to such a condition. This paper describes the three-level scheme of assistance adopted by CRAAR and its insertion in the National Radiological Emergency Assistance System under development by the Health Ministry. (author). 15 refs

  11. Framework for dementia Quality of Life assessment with Assistive Technology

    DEFF Research Database (Denmark)

    Peterson, Carrie Beth; Prasad, Neeli R.; Prasad, Ramjee

    2010-01-01

    This paper proposes a theoretical framework for a Quality of Life (QOL) evaluation tool that is sensitive, flexible, computerized, and specific to assistive technology (AT) for dementia care. Using the appropriate evaluation tool serves to improve methodologies that are used for AT assessment...... to assessing QOL is that results are subjective and difficult to analyze in an objective, empirical manner. This paper accentuates that this is not a hindrance to measuring OQL, but could be emphasized and adapted to create a precise measurement tool; the consumer voice must be sought and empowered...

  12. Medical-Information-Management System

    Science.gov (United States)

    Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.

    1989-01-01

    Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.

  13. AAPM Medical Physics Practice Guideline 8.a.: Linear accelerator performance tests.

    Science.gov (United States)

    Smith, Koren; Balter, Peter; Duhon, John; White, Gerald A; Vassy, David L; Miller, Robin A; Serago, Christopher F; Fairobent, Lynne A

    2017-07-01

    The purpose of this guideline is to provide a list of critical performance tests in order to assist the Qualified Medical Physicist (QMP) in establishing and maintaining a safe and effective quality assurance (QA) program. The performance tests on a linear accelerator (linac) should be selected to fit the clinical patterns of use of the accelerator and care should be given to perform tests which are relevant to detecting errors related to the specific use of the accelerator. A risk assessment was performed on tests from current task group reports on linac QA to highlight those tests that are most effective at maintaining safety and quality for the patient. Recommendations are made on the acquisition of reference or baseline data, the establishment of machine isocenter on a routine basis, basing performance tests on clinical use of the linac, working with vendors to establish QA tests and performing tests after maintenance. The recommended tests proposed in this guideline were chosen based on the results from the risk analysis and the consensus of the guideline's committee. The tests are grouped together by class of test (e.g., dosimetry, mechanical, etc.) and clinical parameter tested. Implementation notes are included for each test so that the QMP can understand the overall goal of each test. This guideline will assist the QMP in developing a comprehensive QA program for linacs in the external beam radiation therapy setting. The committee sought to prioritize tests by their implication on quality and patient safety. The QMP is ultimately responsible for implementing appropriate tests. In the spirit of the report from American Association of Physicists in Medicine Task Group 100, individual institutions are encouraged to analyze the risks involved in their own clinical practice and determine which performance tests are relevant in their own radiotherapy clinics. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on

  14. The ethics of assisted reproduction.

    Science.gov (United States)

    Chatzinikolaou, Nikolaos

    2010-05-01

    Issues concerning the beginning of life and medical intervention in the onset of human existence are very delicate in their nature; they involve multi-dimensional knowledge, they are difficult to comprehend and sensitive to handle. When pure scientific elements are combined with profound emotions, when the genius of technological discoveries touches upon human dignity and sanctity, when passion for the technological achievement intervenes in basic human rights, then the sense of inadequacy and ignorance becomes intense and critical. Silence seems more sought-after than words, and willingness to learn more prudent than the desire to speak. Fear of the inconceivable consequences and even more so the inability to assess them, experiments with the unknown, the likelihood that basic historical, ethical and social values may change forever, but mainly the replacement of God in His wondrous work of creation--the onset of human life--places the ethics of reproductive technologies on the frontline of contemporary bioethics. This opinion paper does not deal with dangers, insults, fears, threats, "speed limits" or ethical controversies, but rather with the very mystery of life. Although there are no generally accepted replies to the various questions being posed, some thoughts and reservations, which can shed some light upon complicated dilemmas are presented. Firstly, the content of reproductive technologies, the problem of infertility today, the methods of fertility treatment, and of prenatal and pre-implantation testing are described, and then the social impact of IVF, complicated cases, deontological dilemmas and some ethical concerns are discussed. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  15. [Euthanasia/assisted suicide. Ethical and socio-religious aspects].

    Science.gov (United States)

    Chiriţă, V; Chiriţă, Roxana; Duică, Lavinia; Talau, Gh

    2009-01-01

    Euthanasia/Assisted Suicide are viewed differently by moral and religious references. In a religious way, cardinal confessions (Christianity, Judaism, Islamism, Buddhism) condemn euthanasia/assisted suicide and, in the same time have a more relaxed attitude regarding passive euthanasia. Other aspects of euthanasia regard financial/economic and ethical-medical considerations. All these contradictory standpoints are expressed in some legal acts that make specifications on the concept of "euthanasia"--Oregon's Death with Dignity Act (1994) and Netherlands's Euthanasia Law (2001).

  16. Medical student involvement in website development.

    Science.gov (United States)

    Rosenbaum, Benjamin P; Gorrindo, Tristan L; Patel, Sanjay G; McTigue, Michael P; Rodgers, Scott M; Miller, Bonnie M

    2009-07-01

    The digital management of educational resources and information is becoming an important part of medical education. At Vanderbilt University School of Medicine, two medical students sought to create a website for all medical students to act as each student's individual homepage. Using widely available software and database technology, a highly customized Web portal, known as the VMS Portal, was created for medical students. Access to course material, evaluations, academic information, and community assets were customized for individual users. Modular features were added over the course of a year in response to student requests, monitoring of usage habits, and solicitation of direct student feedback. During the first 742 days of the VMS Portal's release, there were 209,460 student login sessions (282 average daily). Of 348 medical students surveyed (71% response rate), 84% agreed or strongly agreed that 'consolidated student resources made their lives easier' and 82% agreed or strongly agreed that their needs were represented by having medical students design and create the VMS Portal. In the VMS Portal project, medical students were uniquely positioned to help consolidate, integrate, and develop Web resources for peers. As other medical schools create and expand digital resources, the valuable input and perspective of medical students should be solicited.

  17. The implementation of medical monitoring programs following potentially hazardous exposures: a medico-legal perspective.

    Science.gov (United States)

    Vearrier, David; Greenberg, Michael I

    2017-11-01

    approach is inconsistent with the targeted approach advocated by the Agency for Toxic Substances and Disease Registry and the United States Preventive Services Task Force and the bulk of the peer-reviewed medical literature. Medical monitoring in legal contexts: Numerous medical monitoring actions have been litigated. Legal rationales for allowing medical monitoring claims often incorporate some of the scientific criteria for the appropriateness of monitoring programs. In the majority of cases in which plaintiffs were awarded medical monitoring relief, plaintiffs were required to demonstrate both that the condition for which medical monitoring was sought could be detected early, and that early detection and treatment will improve morbidity and mortality. However, the treatment of medical monitoring claims varies significantly depending upon jurisdiction. Examples of large-scale, comprehensive medical monitoring programs: Large-scale, comprehensive medical monitoring programs have been implemented, such as the Fernald Medical Monitoring Program and the World Trade Center Health Program, both of which exceeded the scope of medical monitoring typically recommended in the peer-reviewed medical literature and the courts. The Fernald program sought to prevent death and disability due to non-exposure-related conditions in a manner similar to general preventive medicine. The World Trade Center Health Program provides comprehensive medical care for World Trade Center responders and may be viewed as a large-scale, federally--funded research effort, which distinguishes it from medical monitoring in a medico-legal context. Synthesis of public health approaches to medical monitoring: Medical monitoring may be indicated following a hazardous exposure in limited circumstances. General causation for a specific adverse health effect must be either established by scientific consensus through a formal causal analysis using a framework such as the Bradford-Hill criteria. The exposure must be

  18. TATTOOS: What Do People Really Know About the Medical Risks of Body Ink?

    Science.gov (United States)

    Rahimi, Iliana A; Eberhard, Igor; Kasten, Erich

    2018-03-01

    Background: Tattoos have become increasing popular; however, medical complications and health risks can occur when getting a tattoo. Aim: The objective of this study is to determine whether people are properly informed about the medical risks and complications associated with tattoos and how the level of knowledge differs between those who have gotten tattooed and those who have not. Method: A cross-sectional online survey was performed. One-hundred participants had tattoos (32% male, 67% female) and 111 had no tattoos (53% male, 47% female); the average age was 26.9 years; level of education of both groups was comparable. There was a considerable (but not significant) difference between the two randomly selected samples with respect to sex and age, but both variables had no significant influence on the knowledge about medical risks, so no adjustment of the groups was carried out. The following variables were examined: demographics, characteristics of the tattoo, the intensity of the decision-making process that participants underwent before getting a tattoo, and the knowledge of medical risks and complications of tattoos. Results: More than 50 percent of the answers from both groups were incorrect (i.e., 55% of the answers from tattooed subjects were incorrect, and 58% of the non-tattooed group were incorrect). Neither sex (t-test, p =0.81) nor age (t-test, p =0.11) had any significant influence on the presence of knowledge. No significant correlations between sociodemographic variables and knowledge of medical risks of tattoos were found. No differences were found between characteristics of the tattoo and knowledge of medical risks apart from the size of the tattooed area (i.e., the larger the tattoo, the more information was sought by the person being tattooed). Differences were also found between educational levels and the knowledge of medical risks and complications of tattoos. Conclusions: Educating the public on the medical risks of tattoos might assist

  19. Developing Soft Power Using Afloat Medical Capability

    Science.gov (United States)

    2009-03-02

    engagement with the nations in the Asia -Pacific region contributed to considerable progress across a broad range of security issues. Southeast Asia remains...Forces and the U.S. military has been positive and valuable in the War on Terror and humanitarian assistance.20 The poor economies, overpopulation , weak...Public Health Services combined to conduct a medical and dental civil-assistance program (MEDCAP/DENCAP) visit throughout Southeast Asia and Oceania.42

  20. Mentoring assistant practitioners - The radiographer's perspective

    International Nuclear Information System (INIS)

    Colthart, Iain; McBride, Margot; Murray, Maria

    2010-01-01

    Purpose: The aim of this study was to evaluate the experiences of diagnostic and therapeutic radiographers as they mentored trainee assistant practitioners undertaking an educational programme. The evaluation study describes the challenges and benefits the radiographers experienced as mentors as well as giving their insights into the introduction of assistant practitioners in their departments. Method: The mentors' opinions were sought by a questionnaire which formed part of the evaluation of the respective diagnostic imaging and therapeutic educational programmes run by two colleges. Results: The response rate was 54% (22/41). Mentors described personal and professional benefits for themselves from undertaking this role. Although mentoring had provided a number of challenges including an increase in workload, the experience had also enhanced their teaching and mentoring skills and contributed to their Continuing Professional Development (CPD). Whilst the role was more time consuming than initially expected this had not impacted generally on their ability to undertake CPD or deliver patient care. In relation to the wider impact of the programmes some negative impact was reported on the speed of service delivery but not on the quality of practice. Mentors felt that the programmes had a positive effect on teamworking and had been beneficial for patient care. Some difficulties were noted in balancing the mentoring of trainee assistant practitioners and radiography undergraduates. Conclusion: The mentors strongly endorsed the educational programmes and their roles and responsibilities in their delivery. Protected time to carry out mentoring duties and establishing good communication with the colleges providing the theoretical teaching were identified as means of further improving the mentoring process.

  1. Use of asthma medication during pregnancy and risk of specific congenital anomalies

    DEFF Research Database (Denmark)

    Garne, Ester; Hansen, Anne Vinkel; Morris, Joan

    2015-01-01

    BACKGROUND: Pregnant women with asthma need to take medication during pregnancy. OBJECTIVE: We sought to identify whether there is an increased risk of specific congenital anomalies after exposure to antiasthma medication in the first trimester of pregnancy. METHODS: We performed a population-bas...

  2. ASSIST user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1995-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all the states and transitions in a complex system model can be devastatingly tedious and error prone. The Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST) computer program allows the user to describe the semi-Markov model in a high-level language. Instead of listing the individual model states, the user specifies the rules governing the behavior of the system, and these are used to generate the model automatically. A few statements in the abstract language can describe a very large, complex model. Because no assumptions are made about the system being modeled, ASSIST can be used to generate models describing the behavior of any system. The ASSIST program and its input language are described and illustrated by examples.

  3. Medical tourism

    Directory of Open Access Journals (Sweden)

    Abbas Ghanbari

    2014-08-01

    Full Text Available Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism potentials. In this survey, the researcher investigated the existing potentials of Zanjan province based on descriptive - analytical tourism in offering and providing medical services and accommodation. The survey reports that offered services in tourism were not acceptable and satisfactory.

  4. Assisted Dying in Canada.

    Science.gov (United States)

    Schuklenk, Udo

    This paper makes an affirmative ethical case in favour of the decriminalization of assisted dying in Canada. It then proceeds to defending the affirmative case against various slippery-slope arguments that are typically deployed by opponents of assisted dying. Finally, a recent case of questionable professional conduct by anti-euthanasia campaigners cum academics is flagged as a warning to all of us not to permit the quality of the professional debate to deteriorate unacceptably, despite the personal emotional investments involved on all sides of the debate.

  5. 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.

  6. 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

  7. Medical emplotment

    DEFF Research Database (Denmark)

    Mønsted, Troels Sune

    ’. Theoretically the project departs from Computer Supported Cooperative Work and Participatory Design and is informed by Medical Informatics, Design Research and Science and Technology Studies. Methodically the project is founded on collaborative prototyping, ethnographic studies, and design interventions...... philosophy and building on theory on narrative reasoning, the dissertation offers the notions of emplotment and re-emplotment to describe how physicians marshal information from various sources, including the medical record, the patient and coSummary to form a narrative, when making sense of patients...

  8. Access to surgical assistance: challenges and perspectives

    Directory of Open Access Journals (Sweden)

    Maria Fernanda do Prado Tostes

    2016-01-01

    Full Text Available Objective to characterize the access to surgical assistance in Brazil. Method documentary study, with a quantitative approach, developed from information of the Caixa Preta da Saúde [Health Black Box] database, of the Brazilian Medical Association. Results in the one-year period 3773 cases related to health care in Brazil were recorded. There were 458 (12.3% records on surgical assistance. Of these, most, 339 (74.1%, involved the lack of access in all regions of Brazil. The main access constraint was the prolonged waiting time for surgery. Other constraints were the excessive waiting for medical appointment with experts, doing examinations and cancellation of surgeries. Conclusion the access to surgical assistance, by users of the Brazilian health system, is not widely guaranteed, reinforcing the need for integrated governmental actions, organization of the health care network, management of health care and human resources to overcome the challenges imposed to achieve the Universal Access to Health and Universal Health Coverage.

  9. Language (Medical Terminology) Assistance to Multinational Partners in Coalition Operations

    Science.gov (United States)

    2012-02-01

    also without us being conscious that we are learning” [19], i.e. facilitate life-long learning as a part of other activities related to business or...research a proof of concept experiment, qualitative study, statistical evaluation Due to the varieties of the MALL studies as described above and quick...learning research agenda for active, experiential learning: Four case studies. Australasian Journal of Educational Technology, http

  10. Medical Image Computing and Computer-Assisted Intervention - MICCAI 2006

    DEFF Research Database (Denmark)

    Nielsen, Mads; Sporring, Jon

    and 193 revised poster papers from 578 submissions for presentation in two volumes, based on a rigorous peer reviews. The first volume includes 114 contributions related to bone shape analysis, robotics and tracking, segmentation, analysis of diffusion tensor MRI, shape analysis and morphometry...

  11. Computer assisted analysis of medical x-ray images

    Science.gov (United States)

    Bengtsson, Ewert

    1996-01-01

    X-rays were originally used to expose film. The early computers did not have enough capacity to handle images with useful resolution. The rapid development of computer technology over the last few decades has, however, led to the introduction of computers into radiology. In this overview paper, the various possible roles of computers in radiology are examined. The state of the art is briefly presented, and some predictions about the future are made.

  12. Telemonitoring for assisted living residences: the medical specialists' view.

    NARCIS (Netherlands)

    Alizadeh, S.; Bakkes, S.C.J.; Kanis, M.; Rijken, M.; Kröse, B.J.A.; Jordanova, M.; Lievens, F.

    2011-01-01

    Telemonitoring is regarded as a means to maintain a relatively high quality of life for independently living elderly. This paper discusses a requirements study of a system to, foremost, telemonitor activities of daily living (ADL) of the elderly. The study utilizes literature and in-depth interviews

  13. Male psychological adaptation to unsuccessful medically assisted reproduction treatments

    DEFF Research Database (Denmark)

    Martins, Mariana Veloso; Basto-Pereira, Miguel; Pedro, Juliana

    2016-01-01

    BACKGROUND: Similarly to women, men suffer from engaging in fertility treatments, both physically and psychologically. Although there is a vast body of evidence on the emotional adjustment of women to infertility, there are no systematic reviews focusing on men's psychological adaptation...... for psychological maladaptation?' SEARCH METHODS: A literature search was conducted from inception to September 2015 on five databases using combinations of MeSH terms and keywords. Eligible studies had to present quantitative prospective designs and samples including men who did not achieve pregnancy or parenthood...... at follow-up. A narrative synthesis approach was used to conduct the review. OUTCOMES: Twelve studies from three continents were eligible from 2534 records identified in the search. The results revealed that psychological symptoms of maladjustment significantly increased in men 1 year after the first...

  14. Physician assistant education: five countries.

    Science.gov (United States)

    Hooker, Roderick S; Kuilman, Luppo

    2011-01-01

    Physician assistant (PA) education has undergone substantial change since the late 1960s. After four decades of development, other countries have taken a page from the American experience and launched their own instructional initiatives. The diversity in how different countries approach education and produce a PA for their nation's needs provides an opportunity to make comparisons. The intent of this study was to document and describe PA programs in Australia, Canada, the United Kingdom, The Netherlands, and the United States. We reviewed the literature and contacted a network of academics in various institutions to obtain primary information. Each contact was asked a set of basic questions about the country, the PA program, and the deployment of graduates. Information on US PA programs was obtained from the Physician Assistant Education Association. At year's end 2010, the following was known about PA development: Australia, one program; Canada, four programs; United Kingdom, four programs; The Netherlands, five programs; the United States, 154 programs. Trends in program per capita growth remain the largest in the United States, followed by The Netherlands and Canada. The shortest program length was 24 months and the longest, 36 months. Outside the United States, almost all programs are situated in an academic health center ([AHC] defined as a medical university, a teaching hospital, and a nursing or allied health school), whereas only one-third of US PA programs are in AHCs. All non-US programs receive public/government funding whereas American programs are predominately private and depend on tuition to fund their programs. The PA movement is a global phenomenon. How PAs are being educated, trained, and deployed is known only on the basic level. We identify common characteristics, unique aspects, and trends in PA education across five nations, and set the stage for collaboration and analysis of optimal educational strategies. Additional information is needed on

  15. A Comprehensive Pregnancy and Family Medical Care Leave Program for the 21st Century

    National Research Council Canada - National Science Library

    Sayre, Batte

    1999-01-01

    .... It also provides an option for extended family care for all medical needs with a family medical care leave of up to one year to assist unit readiness, improve quality of life, and increase soldier...

  16. Otolaryngology residency selection process. Medical student perspective.

    Science.gov (United States)

    Stringer, S P; Cassisi, N J; Slattery, W H

    1992-04-01

    In an effort to improve the otolaryngology matching process at the University of Florida, Gainesville, we sought to obtain the medical student's perspective of the current system. All students who interviewed here over a 3-year period were surveyed regarding the application, interview, and ranking process. In addition, suggestions for improving the system were sought from the students. The application and interviewing patterns of the students surveyed were found to be similar to those of the entire otolaryngology residency applicant pool. We were unable to identify any factors that influence a student's rank list that could be prospectively used to help select applicants for interview. A variety of suggestions for improvements in the match were received, several of which could easily be instituted. A uniform interview invitation date as requested by the students could be rapidly implemented and would provide benefits for both the students and the residency programs.

  17. Medical negligence

    African Journals Online (AJOL)

    Enrique

    19. SA JOURNAL OF RADIOLOGY • August 2004. Abstract. The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malprac- tice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the.

  18. Medical Devices

    NARCIS (Netherlands)

    Verkerke, Gijsbertus Jacob; Mahieu, H.F.; Geertsema, A.A.; Hermann, I.F.; van Horn, J.R.; Hummel, J. Marjan; van Loon, J.P.; Mihaylov, D.; van der Plaats, A.; Schraffordt Koops, H.; Schutte, H.K.; Veth, R.P.H.; de Vries, M.P.; Rakhorst, G.; Shi, Donglu

    2004-01-01

    The development of new medical devices is a very time-consuming and costly process. Besides the time between the initial idea and the time that manufacturing and testing of prototypes takes place, the time needed for the development of production facilities, production of test series, marketing,

  19. Medical Malpractice

    DEFF Research Database (Denmark)

    Grembi, Veronica

    2014-01-01

    MM first came to the attention of policy makers primarily in the USA where, from the 1970s, healthcare providers denounced problems in getting insurance for medical liability, pointing out to a crisis in the MM insurance market (Sage WM (2003) Understanding the first malpractice crisis of the 21th...

  20. Medical marijuana

    Science.gov (United States)

    ... different amounts of cannabinoids. This sometimes makes the effects of medical marijuana hard to predict or control. The effects also ... wasting syndrome) Severe muscle spasms Multiple sclerosis Side Effects ... physical symptoms from using marijuana include: A fast or irregular heartbeat Dizziness Slow ...

  1. [Medical geography].

    Science.gov (United States)

    Hauri, D

    2007-10-17

    Hippocrates already noted that geographical factors such as climate, relief, geology but also settlement patterns had influenced the distribution of diseases. The task of medical geography is to investigate the associations between geographical factors and diseases. Thereby, geographic techniques and concepts are applied on health problems. Of particular importance is the mapping of diseases whose causes are environmental-related. In addition, epidemiological, ecological but also social scientific studies play an important part in the investigation of the associations between geographical factors and diseases. In order to understand the associations between the spatial distribution of diseases and environmental exposures, geographic information systems as well as statistical analyses have recently become more important. Some authors regard medical geography merely as supporting discipline of medicine. Nevertheless, as men and environment future and as they play an important part in the diffusion of diseases being regarded as defeated, medical geography will play an important part concerning medical questions. Especially travel medicine will rely on geographic knowledge, if a patient has to be consulted who plans to travel to an unknown country of which knowledge on the geographical distribution and ecology of diseases will be necessary.

  2. Legal knowledge, needs, and assistance seeking among HIV positive and negative women in Umlazi, South Africa.

    Science.gov (United States)

    Hill, Lauren M; Maman, Suzanne; Holness, David; Moodley, Dhayendre

    2016-01-22

    The rights of women and people living with HIV (PLHIV) are protected under South African law, yet there is a gap in the application of these laws. While there are numerous systemic and social barriers to women's and PLHIV's exercise of their legal rights and rights to access social services, there has been little effort to document these barriers as well as legal needs and knowledge in this context. 1480 HIV-positive and HIV-negative women recruited from an antenatal clinic in Umlazi Township completed a questionnaire on legal knowledge, experience of legal issues, assistance seeking for legal issues, and barriers to seeking assistance. We compared the legal knowledge and experience of legal issues of HIV-positive and HIV-negative women, and described assistance seeking and barriers to assistance seeking among all women. Both HIV-positive and HIV-negative women had high levels of knowledge of their legal rights. There were few important differences in legal knowledge and experience of legal issues by HIV status. The most common legal issues women experienced were difficulty obtaining employment (11 %) and identification documents (7 %). A minority of women who had ever experienced a legal issue had sought assistance for this issue (38 %), and half (50 %) of assistance sought was from informal sources such as family and friends. Women cited lack of time and government bureaucracy as the major barriers to seeking assistance. These results indicate few differences in legal knowledge and needs between HIV-positive and HIV-negative women in this context, but rather legal needs common among women of reproductive age. Legal knowledge may be a less important barrier to seeking assistance for legal issues than time, convenience, and cost. Expanding the power of customary courts to address routine legal issues, encouragement of pro bono legal assistance, and introduction of legal navigators could help to address these barriers.

  3. Assistance Focus: Africa

    Energy Technology Data Exchange (ETDEWEB)

    2017-05-18

    The Clean Energy Solutions Center, an initiative of the Clean Energy Ministerial, helps countries throughout the world create policies and programs that advance the deployment of clean energy technologies. Through the Solutions Center's no-cost Ask an Expert service, a team of international experts has delivered assistance to countries in all regions of the world, including Africa.

  4. Intelligent Speed Assistance (ISA).

    NARCIS (Netherlands)

    2015-01-01

    Intelligent Speed Assistance (ISA) has been a promising type of advanced driver support system for some decades. From a technical point of view, large scale ISA implementation is possible in the short term. The different types of ISA are expected to have different effects on behaviour and traffic

  5. Computer-assisted instruction

    NARCIS (Netherlands)

    Voogt, J.; Fisser, P.; Wright, J.D.

    2015-01-01

    Since the early days of computer technology in education in the 1960s, it was claimed that computers can assist instructional practice and hence improve student learning. Since then computer technology has developed, and its potential for education has increased. In this article, we first discuss

  6. Managing Employee Assistance Programmes.

    Science.gov (United States)

    Schmidenberg, Olive C.; Cordery, John L.

    1990-01-01

    Interviews with 20 branch managers and 20 accountants in an Australian bank determined factors influencing the success of an employee assistance program (EAP). It was found that policies requiring supervisors to act against normal managerial practice doom EAPs to failure. Organizational analysis to integrate the EAP within existing organizational…

  7. Employee Assistance Programs.

    Science.gov (United States)

    Levine, Hermine Zagat

    1985-01-01

    The author reports company responses to a questionnaire concerning employee assistance programs (EAP). Answers concern EAP structure, staff training, use of outside consultant, services provided by EAPs, program administration, employee confidence in EAPs, advertising the program, program philosophy, problems encountered by EAP users, coverage and…

  8. Robotic assisted andrological surgery

    Science.gov (United States)

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  9. [The medical French-speaking world].

    Science.gov (United States)

    Gouazé, André

    2002-01-01

    Medicine has always been and remains the most solid base of the French-speaking world which was born in Africa and Indochina with the admirable action of "colonial" military physicians, the implantation of the Pasteur Institutes and the emergence of resulting overseas medical schools. Obviously, we are referring to the French-speaking medical world. Since the first International Conference of the Deans of French-Speaking Medical Schools in Abidjan in 1981, today medical schools from 40 French-speaking countries participate. The conference undertakes co-operative medical school initiatives in a multi-lateral spirit, comprised by concrete, practical actions to assist universities in developing countries strive for excellence. These actions, which are conducted with the help of both institutional (AUF, MAE, WHO, UNESCO) and private partners mainly concentrate on promoting medical education of medicine, the evaluation of medical schools, the development of scientific and technical information and training teachers in the methodology of scientific clinical research and in public health. For the future, the Conference has three important objectives, to assist in training researchers and consequently in the development of research centres in emerging countries, to promote continuing medical education in rural areas far from medical schools by taking advantage of modern computer technology, and finally to open horizons toward other communities which speak other languages, and first of all, towards non French-speaking countries who live in a French-speaking environment.

  10. The Doubling Undone? Double Effect in Recent Medical Ethics ...

    African Journals Online (AJOL)

    , and Frances Kamm against familiar ways of applying DER to certain controversies within medical ethics, especially, that over physician-assisted suicide. After detailing, interpreting, and attempting to rebut the challenges from these ...

  11. [Neurological assistance as a product. Evaluation of the process in neurology].

    Science.gov (United States)

    Morera-Guitart, J

    Appraisal of the process of assistance is a fundamental step in determination of the quality of medical assistance given. In this paper we review the concept of medical assistance as a product, establishing a parallel between medical assistance and a process of industrial production. We consider the similarities and differences between them. From the point of view of production management we may distinguish different elements: the setting, structure, process of production, result and evaluation. All these are also found in healthcare assistance. We review the concept of the process of assistance both from the limited point of view of the management of disease and its complications, and from a broader perspective which includes the activities of patients in seeking and obtaining assistance. Different aspects and methods of appraisal of the process of assistance are considered: medical audit and monitoring. Finally, we approach the problem of appraisal of the process in outpatient assistance, the importance of this and the methods used in evaluation. We comment on experience of this aspect obtained in the Neurology Unit of the Hospital Marina Alta in Denia.

  12. Physician Assistant profession (PA)

    Science.gov (United States)

    ... training program was founded in 1965 at Duke University by Dr. Eugene Stead. Most programs require applicants ... year 2020. The first PA students were mostly military medics. They were able to expand on the ...

  13. 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 ...

  14. 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

  15. Medication Errors - A Review

    OpenAIRE

    Vinay BC; Nikhitha MK; Patel Sunil B

    2015-01-01

    In this present review article, regarding medication errors its definition, medication error problem, types of medication errors, common causes of medication errors, monitoring medication errors, consequences of medication errors, prevention of medication error and managing medication errors have been explained neatly and legibly with proper tables which is easy to understand.

  16. Leadership, Medication Administration, and Knowledge Retention: A Quality Improvement Project

    Science.gov (United States)

    Treister, Pamela

    2017-01-01

    A leadership and quality improvement project was undertaken in order to assist undergraduate baccalaureate nursing students in knowledge retention for medication administration during their senior semester in nursing school. Specific changes in curriculum were implemented to assist these undergraduate baccalaureate nursing students at a suburban…

  17. Medication-handling challenges among visually impaired population

    Directory of Open Access Journals (Sweden)

    Ling Zhi-Han

    2017-01-01

    Full Text Available Objective: Visually impaired individuals are particularly at higher risk for experiencing a medication error. The aim of this study is to identify the problems encountered by the visually impaired population when handling their medication. Methods: A cross-sectional survey was conducted using an interviewer-guided questionnaire with 100 visually impaired individuals. The questionnaire comprised a series of questions in medication management. Results: All of the respondents perceived that self-administration of medication was a challenging task. A total of 89% of respondents were unable to read the prescription labels, 75% of respondents did not know the expiry date of their own medication, and 58% of respondents did not know the name of the medication. With regard to storage of medication, 72% of respondents did not practice appropriate methods to store their medication, and 80% of respondents kept the unused medication. All of the respondents disposed leftover medication through household rubbish. A total of 64% of respondents never practice medication review. Most (96% of them did not tell health-care providers when they faced difficulties in handling their medication. Conclusion: Most of the visually impaired individuals did not receive appropriate assistance regarding medicine use and having low awareness in medication management. This can lead to increased risk of medication errors or mismanagement among visually impaired population. Hence, effective strategies, especially in pharmaceutical care services, should be structured to assist this special population in medication handling.

  18. Radiation protection in medical applications

    International Nuclear Information System (INIS)

    Maldonado M, H.

    2008-12-01

    The justification of the practices is the fundamental principle on which rests the peaceful use of ionizing radiations. They actually contain as aspirations to improve the quality of people's lives, contributing to sustainable development through environmental protection, so that the sources security and the individuals protection will be conditions which are not and should can not be operated. For medical applications is a highly illustrative example of this, since both for the diagnosis and therapy, the goal is to achieve what is sought for the white tissue, secured the least possible damage to the neighboring tissues so that in turn reduce the negative effects for the patient. As a basis for achieving the above, it is essential to have qualified personnel in all areas incidents, for example users, workers, officials and staff members. There are a variety of specialists in the field of medical applications as, nuclear chemistry, nuclear engineering, radiation protection, medical physics, radiation physics and others. Among the human resource in the country must make up the majority are medical radiologists, highlighting gaps in the number of radiotherapy and nuclear medicine but specially in the medical physics, who is in some way from a special viewpoint of the formal school, new to the country. This is true for the number of facilities which are in the country. The radiation protection responsibilities in medical applications focus primarily on two figures: the radiology safety manager, who is primarily dedicated to the protection of occupationally exposed personnel and the public, and the medical physicist whose functions are geared towards the radiological protection of the patient. The principal legislation in the medical applications area has been enacted and is monitored by the Health Secretary and National Commission on Nuclear Safety and Safeguards, entities that have reached agreements to avoid overlap and over-regulation. Medical applications in the

  19. Progress Testing for Medical Students at the University of Auckland: Results from the First Year of Assessments

    Directory of Open Access Journals (Sweden)

    Steven Lillis

    2014-01-01

    Full Text Available Background Progress testing is a method of assessing longitudinal progress of students using a single best answer format pitched at the standard of a newly graduated doctor. Aim To evaluate the results of the first year of summative progress testing at the University of Auckland for Years 2 and 4 in 2013. SUBJECTS: Two cohorts of medical students from Years 2 and 4 of the Medical Program. Methods A survey was administered to all involved students. Open text feedback was also sought. Psychometric data were collected on test performance, and indices of reliability and validity were calculated. Results The three tests showed increased mean scores over time. Reliability of the assessments was uniformly high. There was good concurrent validity. Students believe that progress testing assists in integrating science with clinical knowledge and improve learning. Year 4 students reported improved knowledge retention and deeper understanding. Conclusion Progress testing has been successfully introduced into the Faculty for two separate year cohorts and results have met expectations. Other year cohorts will be added incrementally. Recommendation Key success factors for introducing progress testing are partnership with an experienced university, multiple and iterative briefings with staff and students as well as demonstrating the usefulness of progress testing by providing students with detailed feedback on performance.

  20. [Statement of fair retribution in medical oaths].

    Science.gov (United States)

    Pérez, Marta L; Rancich, Ana M; Gelpi, Ricardo J

    2004-01-01

    to determine if Medical Oaths from different times include the statement of the physician to request from patients a fair retribution for his/her medical services. Fifty Medical Oaths found in articles and publications were analyzed. In accordance with their corresponding dates, the Oaths were grouped as ancient /medieval (12), and modern/contemporary (38). Of the fifty, only three specifically included the statement of fair retribution. Two of the three were medieval and belonged to the School of Medicine of Montpellier. The other text was modern (Amato Lusitano's Oath). Four writings showed statements regarding medical assistance to the poor. Eleven pledges indirectly stated that no earnings from other activities and/or relations were obtained. Ancient oaths emphasize fair retribution, no discrimination in medical assistance based on payment possibilities, and gain of honest earnings. Modern oaths generally do not include these topics and very few mention that the medical profession should not be exercised merely for material purposes. Despite the above, physicians should respect the limits of their obligations and should be committed to assist without discriminating, particularly without taking into consideration their patient's financial possibilities. Therefore their fees should not be excessive for the services rendered.