WorldWideScience

Sample records for states medical licensing

  1. Medical review practices for driver licensing volume 3: guidelines and processes in the United States.

    Science.gov (United States)

    2017-04-01

    This is the third of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically or : functionally at-risk drivers. ...

  2. Factors associated with high-severity disciplinary action by a state medical board: a Texas study of medical license revocation.

    Science.gov (United States)

    Cardarelli, Roberto; Licciardone, John C

    2006-03-01

    There has been an increase in research evaluating factors associated with disciplinary action of physicians by state medical boards. However, factors related to the severity of disciplinary action are lacking. By investigating these factors while controlling for the type of violation, the authors sought to determine whether physician characteristics influenced the process of disciplinary action by state medical boards. Physicians disciplined by the Texas Medical Board between January 1, 1989, and December 31, 1998, were included in this case-controlled study (N=1129). Multivariate logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with license revocation, the most severe disciplinary action, compared with all other forms of disciplinary action combined. Anesthesiologists (OR, 2.45; 95% CI, 1.05-5.74), general practitioners (OR, 1.80; 95% CI, 1.01-3.19), and psychiatrists (OR, 2.68; 95% CI, 1.41-5.13), as well as those with multiple disciplinary actions (OR, 1.91; 95% CI, 1.29-2.83) were most susceptible to license revocation. The more years a disciplined physician was in practice, the greater risk he or she had of license revocation (OR, 1.05; 95% CI, 1.04-1.07). Factors associated with a greater likelihood of license revocation for physicians are: primary medical specialty, number of years in practice, and a history of multiple disciplinary actions.

  3. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination performance.

    Science.gov (United States)

    Perez, Jose A; Greer, Sharon

    2009-12-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical Licensing Examination (USMLE) to make decisions in recruitment of potential applicants. This study was done to determine a correlation of USMLE Steps 1, 2 and 3 results with ITE scores in each level of Internal Medicine training. A retrospective review of all residents graduating from an Internal Medicine program from 1999 to 2006 was done. Subjects included had data for all USMLE Steps and ITE during all years of training. Thirty-one subjects were included in the study. Correlations of USMLE Steps 1, 2 and 3 were done with ITE scores (percent correct) in each year of training. Pearson's correlation coefficient (r) was determined for each pairing and a t test to determine statistical significance of the correlation was done. Statistical significance was defined as P value ITE percent correct in PGY I, II and III were 0.46, 0.55 and 0.51 respectively. Corresponding r values for USMLE Step 2 and ITE percent correct were 0.79, 0.70 and 0.72; for USMLE Step 3 these values were 0.51, 0.37 and 0.51 respectively for each training year. USMLE scores are correlated with ITE scores. This correlation was strongest for USMLE Step 2.

  4. State Licenses & Permits

    Data.gov (United States)

    Small Business Administration — Starting a business? Confused about whether you need a business license or permit? Virtually every business needs some form of license or permit to operate legally....

  5. Medical review practices for driver licensing : Volume 1 : a case study of guidelines and processes in seven U.S. States.

    Science.gov (United States)

    2016-10-01

    This report is the first of three examining driver medical review practices in the United States and how they fulfilled the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk drivers. The aim was not to ...

  6. A survey of collection development for United States Medical Licensing Examination (USMLE) and National Board Dental Examination (NBDE) preparation material.

    Science.gov (United States)

    Hendrix, Dean; Hasman, Linda

    2008-07-01

    The research sought to ascertain medical and dental libraries' collection development policies, evaluation methods, purchase decisions, and issues that relate to print and electronic United States Medical Licensing Examination (USMLE) and National Board Dental Examination (NBDE) preparation materials. The investigators surveyed librarians supporting American Association of Medical Colleges (AAMC)-accredited medical schools (n = 58/125) on the USMLE and librarians supporting American Dental Association (ADA)-accredited dental schools (n = 23/56) on the NBDE. The investigators analyzed the data by cross-tabulating and filtering the results using EFM Continuum web survey software. Investigators also surveyed print and electronic USMLE and NBDE preparation materials from 2004-2007 to determine the number of publications and existence of reviews. A majority of responding AAMC libraries (62%, n = 58) provide at least 1 electronic or online USMLE preparation resource and buy an average of 11.6 print USMLE titles annually. Due to a paucity of NBDE print and electronic resources, ADA libraries bought significantly fewer print resources, and only 1 subscribed to an electronic resource. The most often reported evaluation methods for both populations were feedback from medical or dental students, feedback from medical or dental faculty, and online trials. Some AAMC (10%, n = 58) and ADA libraries (39%, n = 23) libraries reported that no evaluation of these materials occured at their libraries. From 2004-2007, publishers produced 45 USMLE preparation resources (total n = 546) to every 1 NBDE preparation resource (total n = 12). Users' needs, institutional missions and goals, financial status, and official collection policies most often underlie decisions to collect or not collect examination preparation materials. Evaluating the quality of examination preparation materials can be problematic due to lack of published reviews, lack of usability testing by libraries, and

  7. Why Not Wait? Eight Institutions Share Their Experiences Moving United States Medical Licensing Examination Step 1 After Core Clinical Clerkships.

    Science.gov (United States)

    Daniel, Michelle; Fleming, Amy; Grochowski, Colleen O'Conner; Harnik, Vicky; Klimstra, Sibel; Morrison, Gail; Pock, Arnyce; Schwartz, Michael L; Santen, Sally

    2017-11-01

    The majority of medical students complete the United States Medical Licensing Examination Step 1 after their foundational sciences; however, there are compelling reasons to examine this practice. This article provides the perspectives of eight MD-granting medical schools that have moved Step 1 after the core clerkships, describing their rationale, logistics of the change, outcomes, and lessons learned. The primary reasons these institutions cite for moving Step 1 after clerkships are to foster more enduring and integrated basic science learning connected to clinical care and to better prepare students for the increasingly clinical focus of Step 1. Each school provides key features of the preclerkship and clinical curricula and details concerning taking Steps 1 and 2, to allow other schools contemplating change to understand the landscape. Most schools report an increase in aggregate Step 1 scores after the change. Despite early positive outcomes, there may be unintended consequences to later scheduling of Step 1, including relatively late student reevaluations of their career choice if Step 1 scores are not competitive in the specialty area of their choice. The score increases should be interpreted with caution: These schools may not be representative with regard to mean Step 1 scores and failure rates. Other aspects of curricular transformation and rising national Step 1 scores confound the data. Although the optimal timing of Step 1 has yet to be determined, this article summarizes the perspectives of eight schools that changed Step 1 timing, filling a gap in the literature on this important topic.

  8. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

    Science.gov (United States)

    Perez, Jose A., Jr.; Greer, Sharon

    2009-01-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

  9. Associations between United States Medical Licensing Examination (USMLE) and Internal Medicine In-Training Examination (IM-ITE) scores.

    Science.gov (United States)

    McDonald, Furman S; Zeger, Scott L; Kolars, Joseph C

    2008-07-01

    Little is known about the associations of previous standardized examination scores with scores on subsequent standardized examinations used to assess medical knowledge in internal medicine residencies. To examine associations of previous standardized test scores on subsequent standardized test scores. Retrospective cohort study. One hundred ninety-five internal medicine residents. Bivariate associations of United States Medical Licensing Examination (USMLE) Steps and Internal Medicine In-Training Examination (IM-ITE) scores were determined. Random effects analysis adjusting for repeated administrations of the IM-ITE and other variables known or hypothesized to affect IM-ITE score allowed for discrimination of associations of individual USMLE Step scores on IM-ITE scores. In bivariate associations, USMLE scores explained 17% to 27% of the variance in IME-ITE scores, and previous IM-ITE scores explained 66% of the variance in subsequent IM-ITE scores. Regression coefficients (95% CI) for adjusted associations of each USMLE Step with IM-ITE scores were USMLE-1 0.19 (0.12, 0.27), USMLE-2 0.23 (0.17, 0.30), and USMLE-3 0.19 (0.09, 0.29). No single USMLE Step is more strongly associated with IM-ITE scores than the others. Because previous IM-ITE scores are strongly associated with subsequent IM-ITE scores, appropriate modeling, such as random effects methods, should be used to account for previous IM-ITE administrations in studies for which IM-ITE score is an outcome.

  10. 22 CFR 96.30 - State licensing.

    Science.gov (United States)

    2010-04-01

    ... Licensing and Corporate Governance § 96.30 State licensing. (a) The agency or person is properly licensed or... person follows applicable State licensing and regulatory requirements in all jurisdictions in which it provides adoption services. (c) If it provides adoption services in a State in which it is not itself...

  11. Teacher License Reciprocity. 50-State Review

    Science.gov (United States)

    Aragon, Stephanie

    2017-01-01

    This policy report defines and provides a 50-state review of teacher license reciprocity, explores how state-specific licensing requirements impact the teacher labor market, and includes examples of national and state efforts to facilitate reciprocity.

  12. 21 CFR 515.10 - Medicated feed mill license applications.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Medicated feed mill license applications. 515.10... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Applications § 515.10 Medicated feed mill license applications. (a) Medicated feed mill license applications (Forms FDA 3448) may...

  13. Medical licensing board characteristics and physician discipline: an empirical analysis.

    Science.gov (United States)

    Law, Marc T; Hansen, Zeynep K

    2010-02-01

    This article investigates the relationship between the characteristics of medical licensing boards and the frequency with which boards discipline physicians. Specifically, we take advantage of variation in the structure of medical licensing boards between 1993 and 2003 to determine the effect of organizational and budgetary independence, public oversight, and resource constraints on rates of physician discipline. We find that larger licensing boards, boards with more staff, and boards that are organizationally independent from state government discipline doctors more frequently. Public oversight and political control over board budgets do not appear to influence the extent to which medical licensing boards discipline doctors. These findings are broadly consistent with theories of regulatory behavior that emphasize the importance of bureaucratic autonomy for effective regulatory enforcement.

  14. Medical review practices for driver licensing volume 2: case studies of medical referrals and licensing outcomes in Maine, Ohio, Oregon, Texas, Washington, and Wisconsin.

    Science.gov (United States)

    2017-03-01

    This is the second of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk : drivers. This volume pre...

  15. Are study strategies related to medical licensing exam performance?

    Science.gov (United States)

    West, Courtney; Kurz, Terri; Smith, Sherry; Graham, Lori

    2014-11-02

    To examine the relationship between study strategies and performance on a high stakes medical licensing exam entitled the United States Medical Licensing Examination Step 1. The action research project included seventy nine student participants at the Texas A & M Health Science Center College of Medicine during their pre-clinical education. Data collection included pre-matriculation and matriculation academic performance data, standardized exam data, and the Learning and Study Strategies Instrument. Multiple regression analyses were conducted. For both models, the dependent variable was the Step 1 score, and the independent variables included Medical College Admission Test, Undergraduate Grade Point Average, Year 1 Average, Year 2 Average, Customized National Board of Medical Examiners Average, Comprehensive Basic Science Exam score, and Learning and Study Strategy Instrument sub-scores. Model 2 added Comprehensive Basic Science Self-Assessment average. Concentration (Model 1 - β = .264; Model 2 - β = .254) was the only study strategy correlated with Step 1 performance. The other statistically significant predictors were Customized National Board of Medical Examiners Average (β = .315) and Year 2 Average (β = .280) in Model 1 and Comprehensive Basic Science Self-Assessment Average (β = .338) in Model 2. There does appear to be a relationship between the study strategy concentration and Step 1 licensing exam performance. Teaching students to practice and utilize certain techniques to improve concentration skills when preparing for and taking exams may help improve licensing exam scores.

  16. License renewal in the United States

    International Nuclear Information System (INIS)

    Brons, Jack

    2002-01-01

    Full text: Nuclear plants in the United States are licensed for 40 years, a length specified in the Atomic Energy Act of 1954, which laid out much of the regulatory basis for the commercial nuclear industry. The Act, however, made provision for license renewal. The original 40-year license period was chosen arbitrarily by the U.S. Congress because it was the typical period over which utilities recovered their investment in electricity generating plants. Nuclear plants, however, are subject to a rigorous program of Nuclear Regulatory Commission oversight, maintenance and equipment replacement. In effect, they must be in the same operating condition on the last day of their licenses as they were on the first. As the industry matured, it became apparent that there was no physical limitation on the continued operation of nuclear plants past 40 years. The industry turned its attention toward license renewal. When the issue was first raised, the NRC considered stringent process equivalent to seeking a new operating license for each plant. The complexity, length and cost of the process made it unlikely that many nuclear plants would seek license renewal. The nuclear industry worked successfully with NRC on the application of generic principles to license renewal, however, and in 1995, the NRC issued an efficient, tightly-focused rule that made license renewal a safe, viable option. To extend the operating license for a reactor, a company must demonstrate to the NRC that aging effects will be adequately managed during the renewal terms, thus ensuring equipment functionality. The rule allows licensees to apply for extensions of up to 20 years. The first license renewal application was filed in 1998 by the owner of the two-unit Calvert Cliffs plant. Shortly thereafter, an application was filed for the three-unit Oconee Nuclear Station. The NRC renewed the licenses for all five units in 2000, and since then, five more licenses have been renewed. The NRC has received 37

  17. Role of State Medical Boards in Continuing Medical Education

    Science.gov (United States)

    Johnson, David A.; Austin, Dale L.; Thompson, James N.

    2005-01-01

    The evaluation of physician competency prior to issuing an initial medical license has been a fundamental responsibility of medical boards. Growing public expectation holds that medical boards will ensure competency throughout a physician's career. The Federation of State Medical Boards (FSMB) strongly supports the right of state medical boards to…

  18. Licensing of HTGRs in the United States

    International Nuclear Information System (INIS)

    Fisher, C.R.; Orvis, D.D.

    1981-01-01

    The licensing history of the high-temperature gas-cooled reactor (HTGR) in the United States is given historical perspective. The experience began with the licensing of the Peach Bottom Atomic Power Station and extends to the continuing experience at the Fort St. Vrain Nuclear Generating Station. Additional experience was obtained from the licensing reviews in the mid-1970s of the large HTGR plants that were to be built by Philadelphia Electric Company and Delmarva Power and Light. Also, information was provided by the licensing review of the General Atomic standard plant by the U.S. Nuclear Regulatory Commission (NRC) at about the same time. These experiences are summarized in terms of the principal design criteria that were required by the regulatory authority for each project. These criteria include specification of the design basis accidents that were postulated for the plant safety analysis. Several technical issues raised by the NRC during their review of the large HTGR are presented. (author)

  19. Licensing of HTGRs in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, C. R.; Orvis, D. D. [General Atomic Co., San Diego, CA (USA)

    1981-01-15

    The licensing history of the high-temperature gas-cooled reactor (HTGR) in the United States is given historical perspective. The experience began with the licensing of the Peach Bottom Atomic Power Station and extends to the continuing experience at the Fort St. Vrain Nuclear Generating Station. Additional experience was obtained from the licensing reviews in the mid-1970s of the large HTGR plants that were to be built by Philadelphia Electric Company and Delmarva Power and Light. Also, information was provided by the licensing review of the General Atomic standard plant by the U.S. Nuclear Regulatory Commission (NRC) at about the same time. These experiences are summarized in terms of the principal design criteria that were required by the regulatory authority for each project. These criteria include specification of the design basis accidents that were postulated for the plant safety analysis. Several technical issues raised by the NRC during their review of the large HTGR are presented.

  20. Adherence to Medical Cannabis Among Licensed Patients in Israel

    OpenAIRE

    Zolotov, Yuval; Baruch, Yehuda; Reuveni, Haim; Magnezi, Racheli

    2016-01-01

    Abstract Objectives: To evaluate adherence among Israeli patients who are licensed to use medical cannabis and to identify factors associated with adherence to medical cannabis. Methods: Ninety-five novice licensed patients were interviewed for this cross-sectional study. The questionnaire measured demographics, the perceived patient?physician relationship, and the level of patients' active involvement in their healthcare. In addition, patients were queried about adverse effect(s) and about t...

  1. Do US Medical Licensing Applications Treat Mental and Physical Illness Equivalently?

    Science.gov (United States)

    Gold, Katherine J; Shih, Elizabeth R; Goldman, Edward B; Schwenk, Thomas L

    2017-06-01

    State medical licensing boards are responsible for evaluating physician impairment. Given the stigma generated by mental health issues among physicians and in the medical training culture, we were interested in whether states asked about mental and physical health conditions differently and whether questions focused on current impairment. Two authors reviewed physician medical licensing applications for US physicians seeking first-time licensing in 2013 in the 50 states and the District of Columbia. Questions about physical and mental health, as well as substance abuse, were identified and coded as to whether or not they asked about diagnosis and/or treatment or limited the questions to conditions causing physician impairment. Forty-three (84%) states asked questions about mental health conditions, 43 (84%) about physical health conditions, and 47 (92%) about substance use. States were more likely to ask for history of treatment and prior hospitalization for mental health and substance use, compared with physical health disorders. Among states asking about mental health, just 23 (53%) limited all questions to disorders causing functional impairment and just 6 (14%) limited to current problems. While most state medical licensing boards ask about mental health conditions or treatment, only half limited queries to disorders causing impairment. Differences in how state licensing boards assess mental health raise important ethical and legal questions about assessing physician ability to practice and may discourage treatment for physicians who might otherwise benefit from appropriate care.

  2. United States Medical Licensing Examination and American Board of Pediatrics Certification Examination Results: Does the Residency Program Contribute to Trainee Achievement.

    Science.gov (United States)

    Welch, Thomas R; Olson, Brad G; Nelsen, Elizabeth; Beck Dallaghan, Gary L; Kennedy, Gloria A; Botash, Ann

    2017-09-01

    To determine whether training site or prior examinee performance on the US Medical Licensing Examination (USMLE) step 1 and step 2 might predict pass rates on the American Board of Pediatrics (ABP) certifying examination. Data from graduates of pediatric residency programs completing the ABP certifying examination between 2009 and 2013 were obtained. For each, results of the initial ABP certifying examination were obtained, as well as results on National Board of Medical Examiners (NBME) step 1 and step 2 examinations. Hierarchical linear modeling was used to nest first-time ABP results within training programs to isolate program contribution to ABP results while controlling for USMLE step 1 and step 2 scores. Stepwise linear regression was then used to determine which of these examinations was a better predictor of ABP results. A total of 1110 graduates of 15 programs had complete testing results and were subject to analysis. Mean ABP scores for these programs ranged from 186.13 to 214.32. The hierarchical linear model suggested that the interaction of step 1 and 2 scores predicted ABP performance (F[1,1007.70] = 6.44, P = .011). By conducting a multilevel model by training program, both USMLE step examinations predicted first-time ABP results (b = .002, t = 2.54, P = .011). Linear regression analyses indicated that step 2 results were a better predictor of ABP performance than step 1 or a combination of the two USMLE scores. Performance on the USMLE examinations, especially step 2, predicts performance on the ABP certifying examination. The contribution of training site to ABP performance was statistically significant, though contributed modestly to the effect compared with prior USMLE scores. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. 21 CFR 515.20 - Approval of medicated feed mill license applications.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Approval of medicated feed mill license... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.20 Approval of medicated feed mill license applications. Within 90 days after an...

  4. 21 CFR 515.21 - Refusal to approve a medicated feed mill license application.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Refusal to approve a medicated feed mill license... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.21 Refusal to approve a medicated feed mill license application. (a) The...

  5. 21 CFR 515.23 - Voluntary revocation of medicated feed mill license.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Voluntary revocation of medicated feed mill... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.23 Voluntary revocation of medicated feed mill license. A license issued under...

  6. 21 CFR 515.24 - Notice of revocation of a medicated feed mill license.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Notice of revocation of a medicated feed mill... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.24 Notice of revocation of a medicated feed mill license. When a license...

  7. Adherence to Medical Cannabis Among Licensed Patients in Israel.

    Science.gov (United States)

    Zolotov, Yuval; Baruch, Yehuda; Reuveni, Haim; Magnezi, Racheli

    2016-01-01

    Objectives: To evaluate adherence among Israeli patients who are licensed to use medical cannabis and to identify factors associated with adherence to medical cannabis. Methods: Ninety-five novice licensed patients were interviewed for this cross-sectional study. The questionnaire measured demographics, the perceived patient-physician relationship, and the level of patients' active involvement in their healthcare. In addition, patients were queried about adverse effect(s) and about their overall satisfaction from this medical treatment. Results: Eighty percent ( n =76) has been identified as adherent to medical cannabis use. Variables found associated with adherence were "country of origin" (immigrant status), "type of illness" (cancer vs. non-cancer), and "experiencing adverse effect(s)." Three predictors of adherence were found significant in a logistic regression model: "type of illness" (odds ratio [OR] 0.101), patient-physician relationship (OR 1.406), and level of patient activation (OR 1.132). 71.5% rated themselves being "completely satisfied" or "satisfied" from medical cannabis use. Conclusions: Our findings show a relatively high adherence rate for medical cannabis, as well as relative safety and high satisfaction among licensed patients. Additionally indicated is the need to develop and implement standardized education about this evolving field-to both patients and physicians.

  8. 21 CFR 558.4 - Requirement of a medicated feed mill license.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Requirement of a medicated feed mill license. 558... Provisions § 558.4 Requirement of a medicated feed mill license. (a) A feed manufacturing facility must possess a medicated feed mill license in order to manufacture a Type B or Type C medicated feed from a...

  9. 21 CFR 515.11 - Supplemental medicated feed mill license applications.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Supplemental medicated feed mill license... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Applications § 515.11 Supplemental medicated feed mill license applications. (a) After approval of a medicated feed...

  10. To License or Not to License: An Examination of State Statutes Regarding Private Investigators and Digital Examiners

    Directory of Open Access Journals (Sweden)

    Thomas Lonardo

    2008-09-01

    Full Text Available In this paper the authors examine statutes that regulate, license, and enforce investigative functions in each US state. After identification and review of Private Investigator licensing requirements, the authors find that very few state statutes explicitly differentiate between Private Investigators and Digital Examiners. After contacting all state agencies the authors present a distinct grouping organizing state approaches to professional Digital Examiner licensing. The authors conclude that states must differentiate between Private Investigator and Digital Examiner licensing requirements and oversight.

  11. Crossing boundaries: a comprehensive survey of medical licensing laws and guidelines regulating the interstate practice of pathology.

    Science.gov (United States)

    Hiemenz, Matthew C; Leung, Stanley T; Park, Jason Y

    2014-03-01

    In the United States, recent judicial interpretation of interstate licensure laws has found pathologists guilty of malpractice and, more importantly, the criminal practice of medicine without a license. These judgments against pathologists highlight the need for a timely and comprehensive survey of licensure requirements and laws regulating the interstate practice of pathology. For all 50 states, each state medical practice act and state medical board website was reviewed. In addition, each medical board was directly contacted by electronic mail, telephone, or US registered mail for information regarding specific legislation or guidelines related to the interstate practice of pathology. On the basis of this information, states were grouped according to similarities in legislation and medical board regulations. This comprehensive survey has determined that states define the practice of pathology on the basis of the geographic location of the patient at the time of surgery or phlebotomy. The majority of states (n=32) and the District of Columbia allow for a physician with an out-of-state license to perform limited consultation to a physician with the specific state license. Several states (n=5) prohibit physicians from consultation without a license for the specific state. Overall, these results reveal the heterogeneity of licensure requirements between states. Pathologists who either practice in multiple states, send cases to out-of-state consultants, or serve as consultants themselves should familiarize themselves with the medical licensure laws of the states from which they receive or send cases.

  12. The United States nuclear regulatory commission license renewal process

    International Nuclear Information System (INIS)

    Holian, B.E.

    2009-01-01

    The United States (U.S.) Nuclear Regulatory Commission (NRC) license renewal process establishes the technical and administrative requirements for the renewal of operating power plant licenses. Reactor ope-rating licenses were originally issued for 40 years and are allowed to be renewed. The review process for license renewal applications (L.R.A.) provides continued assurance that the level of safety provided by an applicant's current licensing basis is maintained for the period of extended operation. The license renewal review focuses on passive, long-lived structures and components of the plant that are subject to the effects of aging. The applicant must demonstrate that programs are in place to manage those aging effects. The review also verifies that analyses based on the current operating term have been evaluated and shown to be valid for the period of extended operation. The NRC has renewed the licenses for 52 reactors at 30 plant sites. Each applicant requested, and was granted, an extension of 20 years. Applications to renew the licenses of 20 additional reactors at 13 plant sites are under review. As license renewal is voluntary, the decision to seek license renewal and the timing of the application is made by the licensee. However, the NRC expects that, over time, essentially all U.S. operating reactors will request license renewal. In 2009, the U.S. has 4 plants that enter their 41. year of ope-ration. The U.S. Nuclear Industry has expressed interest in 'life beyond 60', that is, requesting approval of a second renewal period. U.S. regulations allow for subsequent license renewals. The NRC is working with the U.S. Department of Energy (DOE) on research related to light water reactor sustainability. (author)

  13. 2012 Economic Survey of Gulf State Shrimp License Holders

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This mail survey collected economic data on inshore commercial shrimp fishermen who held licenses to commercially harvest shrimp in state waters of the U.S. Gulf of...

  14. 21 CFR 515.25 - Revocation of order refusing to approve a medicated feed mill license application or suspending...

    Science.gov (United States)

    2010-04-01

    ... medicated feed mill license application or suspending or revoking a license. 515.25 Section 515.25 Food and..., FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.25 Revocation of order refusing to approve a medicated feed mill license application or suspending or revoking a...

  15. 21 CFR 515.22 - Suspension and/or revocation of approval of a medicated feed mill license.

    Science.gov (United States)

    2010-04-01

    ... medicated feed mill license. 515.22 Section 515.22 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... MILL LICENSE Administrative Actions on Licenses § 515.22 Suspension and/or revocation of approval of a medicated feed mill license. (a) The Secretary of Health and Human Services may suspend a medicated feed...

  16. 10 CFR 150.20 - Recognition of Agreement State licenses.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Recognition of Agreement State licenses. 150.20 Section 150.20 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) EXEMPTIONS AND CONTINUED REGULATORY AUTHORITY... the activities authorized, for an unlimited period of time. (5) Shall comply with all terms and...

  17. Nuclear power reactor licensing and regulation in the United States

    International Nuclear Information System (INIS)

    Shapar, H.K.

    1979-01-01

    The report is devoted to four subjects: an explanation of the origins, statutory basis and development of the present regulatory system in the United States; a description of the various actions which must be taken by a license applicant and by the Nuclear Regulatory Commission before a nuclear power plant can be constructed and placed on-line, an account of the current regulatory practices followed by the US NRC in licensing nuclear power reactors; an identification of some of the 'lessons learned' from the Three Mile Island accident and some proposed regulatory and legislative solutions. (NEA) [fr

  18. To License or Not to License Revisited: An Examination of State Statutes Regarding Private Investigators and Digital Examiners

    OpenAIRE

    Thomas Lonardo; Doug White; Alan Rea

    2009-01-01

    In this update to the previous year's study, the authors examine statutes that regulate, license, and enforce investigative functions in each US state. After identification and review of Private Investigator licensing requirements, the authors find that very few state statutes explicitly differentiate between Private Investigators and Digital Examiners. After contacting all state agencies the authors present a distinct grouping organizing state approaches to professional Digital Examiner lice...

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

    Directory of Open Access Journals (Sweden)

    Kyung-Lock Lee

    2015-05-01

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

  20. Inspection of licensed nuclear power plants in the United States

    International Nuclear Information System (INIS)

    Thornburg, H. D.

    1977-01-01

    Inspection of licensed nuclear power plants in the United States is performed by the Office of Inspection and Enforcement (IE), United States Nuclear Regulatory Commission. IE has several key functions : a) Inspection of licensees and investigation of incidents, occurrences and allegations. b) Detection and correction of safety and security problems. c) Enforcement of rules, regulations, and Commission orders. d) Feedback to the industry and others regarding safety experience. e) Informing the public and others. Major enforcement actions and events involving operating power reactors for the past several years will be summarized. (author)

  1. Performance during internal medicine residency training and subsequent disciplinary action by state licensing boards.

    Science.gov (United States)

    Papadakis, Maxine A; Arnold, Gerald K; Blank, Linda L; Holmboe, Eric S; Lipner, Rebecca S

    2008-06-03

    Physicians who are disciplined by state licensing boards are more likely to have demonstrated unprofessional behavior in medical school. Information is limited on whether similar performance measures taken during residency can predict performance as practicing physicians. To determine whether performance measures during residency predict the likelihood of future disciplinary actions against practicing internists. Retrospective cohort study. State licensing board disciplinary actions against physicians from 1990 to 2006. 66,171 physicians who entered internal medicine residency training in the United States from 1990 to 2000 and became diplomates. Predictor variables included components of the Residents' Annual Evaluation Summary ratings and American Board of Internal Medicine (ABIM) certification examination scores. 2 performance measures independently predicted disciplinary action. A low professionalism rating on the Residents' Annual Evaluation Summary predicted increased risk for disciplinary action (hazard ratio, 1.7 [95% CI, 1.3 to 2.2]), and high performance on the ABIM certification examination predicted decreased risk for disciplinary action (hazard ratio, 0.7 [CI, 0.60 to 0.70] for American or Canadian medical school graduates and 0.9 [CI, 0.80 to 1.0] for international medical school graduates). Progressively better professionalism ratings and ABIM certification examination scores were associated with less risk for subsequent disciplinary actions; the risk ranged from 4.0% for the lowest professionalism rating to 0.5% for the highest and from 2.5% for the lowest examination scores to 0.0% for the highest. The study was retrospective. Some diplomates may have practiced outside of the United States. Nondiplomates were excluded. Poor performance on behavioral and cognitive measures during residency are associated with greater risk for state licensing board actions against practicing physicians at every point on a performance continuum. These findings support

  2. 21 CFR 510.305 - Maintenance of copies of approved medicated feed mill licenses to manufacture animal feed bearing...

    Science.gov (United States)

    2010-04-01

    ... mill licenses to manufacture animal feed bearing or containing new animal drugs. 510.305 Section 510... copies of approved medicated feed mill licenses to manufacture animal feed bearing or containing new... medicated feed mill license (Form FDA 3448) on the premises of the manufacturing establishment; and (b...

  3. A COMPARATIVE STUDY OF STATE LICENSING BOARDS FOR SCHOOL ADMINISTRATION AND OTHER SELECTED PROFESSIONS.

    Science.gov (United States)

    MOLINARI, RALPH G.; AND OTHERS

    COMPARISON OF THE COMPOSITION, CHARACTERISTICS, AND CURRENT LICENSING PRACTICES OF STATE LICENSING BOARDS FOR EDUCATIONAL ADMINISTRATION WITH LICENSING PROGRAMS FOR SEVEN OTHER PROFESSIONS, (ACCOUNTANCY, ARCHITECTURE, DENTISTRY, ENGINEERING, LAW, MEDICINE, AND NURSING) WAS THE PURPOSE OF THIS NATIONWIDE STUDY. THE RESEARCH PROCEDURES WERE DIVIDED…

  4. School Social Workers Sanctioned by State Departments of Education and State Licensing Boards

    Science.gov (United States)

    Boland-Prom, Kim; Alvarez, Michelle E.

    2014-01-01

    This article presents the results of a study on the unprofessional conduct of school social workers who have been sanctioned by state regulatory boards (boards of education and licensing boards). The data represent information from 14 states and the District of Columbia. Results indicate that school social workers are rarely sanctioned at the…

  5. Location, location, location: Assessing the spatial patterning between marijuana licenses, alcohol outlets and neighborhood characteristics within Washington state.

    Science.gov (United States)

    Tabb, Loni Philip; Fillmore, Christina; Melly, Steven

    2018-04-01

    The availability of marijuana products is becoming increasingly prevalent across the United States (US), many states are allowing for the production, processing, and retailing of these products for medical and/or recreational use. The purpose of this study is to: (1) examine the spatial patterning of marijuana licenses, and (2) examine the impact of alcohol outlets in addition to other neighborhood characteristics on marijuana licenses within the state of Washington. This cross-sectional observational study examined 1458 census tracts in Washington state from 2017, using marijuana and alcohol data from the Washington State Liquor and Cannabis Board as well as neighborhood characteristics data from the American Community Survey 2011-2015 5-year estimates. We used exploratory and formal spatial regression methods, including integrated nested Laplace approximation within a Bayesian statistical framework, to address the study aims. Our results indicate there is significant spatial patterning of marijuana producers and processors across the state. We also found that all marijuana licenses are located in poorer census tracts, and marijuana retailers are co-located in census tracts with off-premises alcohol outlets. Our study provides empirical evidence of the relationship between marijuana licenses, alcohol outlets, and neighborhood characteristics, and has important implications for policymakers in other states currently considering legalizing marijuana-products for medical and/or recreational use. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Licensed pertussis vaccines in the United States. History and current state.

    Science.gov (United States)

    Klein, Nicola P

    2014-01-01

    The United States switched from whole cell to acellular pertussis vaccines in the 1990s following global concerns with the safety of the whole cell vaccines. Despite high levels of acellular pertussis vaccine coverage, the United States and other countries are experiencing large pertussis outbreaks. The aim of this article is to describe the historical context which led to acellular pertussis vaccine development, focusing on vaccines currently licensed in the US, and to review evidence that waning protection following licensed acellular pertussis vaccines have been significant factors in the widespread reappearance of pertussis.

  7. Relationship between licensing, registration, and other gun sales laws and the source state of crime guns.

    Science.gov (United States)

    Webster, D W; Vernick, J S; Hepburn, L M

    2001-09-01

    To determine the association between licensing and registration of firearm sales and an indicator of gun availability to criminals. Tracing data on all crime guns recovered in 25 cities in the United States were used to estimate the relationship between state gun law categories and the proportion of crime guns first sold by in-state gun dealers. In cities located in states with both mandatory registration and licensing systems (five cities), a mean of 33.7% of crime guns were first sold by in-state gun dealers, compared with 72.7% in cities that had either registration or licensing but not both (seven cities), and 84.2% in cities without registration or licensing (13 cites). Little of the difference between cities with both licensing and registration and cities with neither licensing nor registration was explained by potential confounders. The share of the population near a city that resides in a neighboring state without licensing or registration laws was negatively associated with the outcome. States with registration and licensing systems appear to do a better job than other states of keeping guns initially sold within the state from being recovered in crimes. Proximity to states without these laws, however, may limit their impact.

  8. Medical review licensing outcomes in drivers with visual field loss in Victoria, Australia

    Science.gov (United States)

    Muir, Carlyn; Charlton, Judith L; Odell, Morris; Keeffe, Jill; Wood, Joanne; Bohensky, Megan; Fildes, Brian; Oxley, Jennifer; Bentley, Sharon; Rizzo, Matthew

    2017-01-01

    Background Good vision is essential for safe driving and studies have associated visual impairment with an increased crash risk. Currently, there is little information about the medical review of drivers with visual field loss. This study examines the prevalence of visual field loss among drivers referred for medical review in one Australian jurisdiction and investigates factors associated with licence outcome in this group. Methods A random sample of 10,000 (31.25 per cent) medical review cases was extracted for analysis from the Victorian licensing authority. Files were screened for the presence of six visual field-related medical conditions. Data were captured on a range of variables, including referral source, age, gender, health status, crash history and licence outcome. Prevalence analyses were univariate and descriptive. Logistic regression was used to assess factors associated with licence outcomes in the visual field loss group. Results Approximately 1.9 per cent of the 10,000 medical review cases screened had a visual field loss condition identified (n=194). Among the visual field loss group, 57.2 per cent were permitted to continue driving (conditional/unconditional licence). Primary referral sources were the police, self-referrals and general medical practitioners. Key factors associated with licence test outcomes were visual field condition, age group, crash involvement and referral to the Driver Licensing Authority’s Medical Advisors. Those who were younger had a crash involvement triggering referral and those who were referred to the Medical Advisors were more likely to have a positive licensing outcome. Conclusion The evidence base for making licensing decisions is complicated by the variable causes, patterns, progressions and measuring technologies for visual field loss. This study highlighted that the involvement of an expert medical advisory service in Victoria resulted in an increased likelihood that drivers with visual field loss will be

  9. AP1000R licensing and deployment in the United States

    International Nuclear Information System (INIS)

    Jordan, R. P.; Russ, P. A.; Filiak, P. P.; Castiglione, L. L.

    2012-01-01

    In recent years, both domestic and foreign utilities have turned to the standardized Westinghouse AP1000 plant design in satisfying their near - and long-term - sustainable energy needs. As direct support to these actions, licensing the AP1000 design has played a significant role by providing one of the fundamental bases in clearing regulatory hurdles leading to the start of new plant construction. Within the U.S. alone, Westinghouse AP1000 licensing activities have reached unprecedented milestones with the approvals of both AP1000 Design Certification and Southern Company's combined construction permit and operating license (COL) application directly supporting the construction of two new nuclear plants in Georgia. Further COL application approvals are immediately pending for an additional two AP1000 plants in South Carolina. And, across the U.S. nuclear industry spectrum, there are 10 other COL applications under regulatory review representing some 16 new plants at 10 sites. In total, these actions represent the first wave of new plant licensing under the regulatory approval process since 1978. Fundamental to the Nuclear Regulatory Commission's AP1000 Design Certification is the formal recognition of the AP1000 passive safety design through regulatory acceptance rulemaking. Through recognition and deployment of the AP1000 Design Certification, the utility licensee / operator of this reactor design are now offered an opportunity to use a simplified 'one-step' combined license process, thereby managing substantial back-end construction schedule risk from regulatory and intervention delays. Application of this regulatory philosophy represents both acceptance and encouragement of standardized reactor designs like the AP1000. With the recent AP1000 Design Certification and utility COL acceptances, the fundamental licensing processes of this philosophy have successfully proven the attainment of significant milestones with the next stage licensing actions directed

  10. Licensed pertussis vaccines in the United States: History and current state

    OpenAIRE

    Klein, Nicola P

    2014-01-01

    The United States switched from whole cell to acellular pertussis vaccines in the 1990s following global concerns with the safety of the whole cell vaccines. Despite high levels of acellular pertussis vaccine coverage, the United States and other countries are experiencing large pertussis outbreaks. The aim of this article is to describe the historical context which led to acellular pertussis vaccine development, focusing on vaccines currently licensed in the US, and to review evidence that w...

  11. Results from a National Study of Social Workers Sanctioned by State Licensing Boards

    Science.gov (United States)

    Boland-Prom, Kim W.

    2009-01-01

    This article presents the results of a descriptive study, synthesizing the reports of 27 state regulatory boards about their actions against certified and licensed social workers (N = 874) during the period of 1999 to 2004. The purpose of this study was to examine the unprofessional behavior of certified and licensed social workers, the results of…

  12. Alcohol price elasticities in control and license states in the United States, 1982-99.

    Science.gov (United States)

    Trolldal, Björn; Ponicki, William

    2005-08-01

    The demand for alcohol has been demonstrated repeatedly to be sensitive to price changes. However, estimated price elasticities vary by study region and over time. One explanation for these variations might be that different countries or parts of countries have had different alcohol control systems. The hypothesis addressed in this study was that a regulated market leads to higher transaction costs associated with purchasing alcohol, which in turn increases the full price of the beverages (the nominal cash price plus transaction costs). As a result, the cash price of alcohol represents a smaller part of the full price in a highly regulated market. Assuming that customers respond primarily to changes in full price, the demand for alcohol should be less sensitive to changes in cash price where regulation is stricter. This study examined whether variations in price elasticities were a function of the different regulatory systems in control and license states in the United States during the period 1982-99. Time-series cross-sectional analyses (in 50 states over 18 years) were conducted. Elasticities were estimated using a multiplicative model based upon first-differences of time-series within states. Disposable income and other socio-demographic variables were used as control variables. All data were obtained from archival sources. The demand for spirits and beer were significantly more sensitive to price changes in license states than in control states. The estimated price elasticity for wine sales was also somewhat larger in license states, but not significantly so. The lower price elasticities for spirits and beer in the control states support the hypothesis that customers respond primarily to changes in the full price of alcohol.

  13. Changes in the 'medical research' licensing procedure under the German Radiation Protection Ordinance

    International Nuclear Information System (INIS)

    Habeck, M.; Minkov, V.; Griebel, J.; Brix, G.; Epsch, R.; Langer, M.

    2012-01-01

    This publication outlines the 'medical research' licensing procedure as specified in the amendment of the German Radiation Protection Ordinance of November 1, 2011. The general licensing requirements for the use of radiation have not been changed by the amendment. Three so-called use restrictions (i.e., dose limits of 10 mSv and 20 mSv, age limit of 50 years) have been modified. They will only apply to healthy volunteers in the future. In addition, there are considerable simplifications with respect to applications and licensing procedures of the Federal Office for Radiation Protection (Bundesamt fuer Strahlenschutz, BfS) regarding the use of radiation in the newly introduced 'accompanying diagnostics' ('Begleitdiagnostik') case group. The newly established, independent panel of experts at the German Radiological Society (Deutsche Roentgengesellschaft, DRG) may provide essential support to principal investigators, qualified physicians and sponsors for differentiating between 'medical research' and 'health care', the latter not being subject to licensing. An expert statement will be issued by the DRG within four weeks of an inquiry. This consulting service is subject to confidentiality, and is free of charge for inquirers and without any commitment. (orig.)

  14. State Child Care Licensing Laws in the Fifty States: A New Look in the Face of Child Abuse.

    Science.gov (United States)

    Bulkley, Josephine; Jackson, Jolie

    1989-01-01

    The article reviews state child care licensing legislation in light of reported child abuse and neglect in some such facilities. Recommended are licensing of all facilities of any size or religious affiliation, criminal record screening, at least annual inspections, unannounced inspections, and required notice to parents when abuse has been…

  15. Reactor licensing in the United States and Federal Republic of Germany

    International Nuclear Information System (INIS)

    Salvatore, J.E.L.

    1980-02-01

    The licensing procedure for nuclear power plants in the United States and in the Federal Republic of Germany is analysed. The security policy, the inspections and the supervision during their construction and operation are discussed. (A.L.) [pt

  16. The comparison of license management procedure for nuclear power plant in China and United States

    International Nuclear Information System (INIS)

    Yu Zusheng

    2006-01-01

    'Tow steps' license management procedure for nuclear power plant has been performed bas- ted on the requirement of 10CFR Part50-DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES in United States since last century fifties. In order to ulterior reduce the risk of investment and technical for new construction nuclear power plants, new regulations 'One step' license management procedure-10CFR Part52-EARLY SITE PERMITS; STANDARD DESIGN CERTIFICATIONS; AND COMBINED LICENSES FOR NUCLEAR POWER PLANTS issued in 1989. The new regulations has been adopted by new design of nuclear power plant, for example AP1000. ‘The similar tow steps’ license management procedure for nuclear power plant has been performed basted on the requirement of HAFO01/01 Rules for the Implementation of Regulations on the Safety Regulation for Civilian Nuclear Installations of the People's Re- public of China Part One: Application and Issuance of Safety License for Nuclear Power Plant (December 1993) in China since last century nineties. This article introduces and compares the requirements and characteristics of above license management procedure for nuclear power plant in China and United States. (author)

  17. Standardization of the licensing process in the United States

    International Nuclear Information System (INIS)

    Villa, R.

    1986-01-01

    The paper discusses a major problem with the design review process for light water reactors. Major confusion exists over the design-basis requirements for a future nuclear power plant in the US. It is not at all clear how the conclusions of a severe accident review are to be integrated into the design approval process. The separation between a design-basis review and a severe accident review makes absolutely no sense if the severe accident review is to have an influence on the design. If an acceptable design is defined during the deterministic review, it is destructive to allow new design-basis requirements to appear during the probabilistic review. Clearly, the review process has too many undefined steps. It is believed that once all of the requirements are defined for a future design, and once the licensing process is exactly defined, the industry can begin a productive and successful standardization program

  18. Step-2 Thai Medical Licensing Examination result: a follow-up study.

    Science.gov (United States)

    Wanvarie, Samkaew; Prakunhungsit, Supavadee

    2008-12-01

    The Thai medical students sat for the Medical Licensing Examination of Thailand (MLET) Step 2 for the first time in 2008. This paper analysed the first batch of Ramathibodi students taking the MLET Steps 1 and 2 in 2006 and 2008 respectively. The scores from the MLET Steps1 and 2, and fifth-year cumulative grade point averages (GPAX) of 108 students were analysed. Only 6 (5.6%) students failed the MLET Step 2 examination. Students who failed the MLET Step1 were more likely to fail their MLET Step 2 (relative risk, 5.8; 95% confidence interval, 1.3-26.0). Students with low GPAX or scoring in the lowest quintile or tertile on the MLET Step1 were also at increased risk of failing the LET Step 2. The data suggest that performance on the MLET Step 1 and GPAX are important predictors of a student's chances of passing the MLET Step 2. Students with poor academic achievement or failing the MLET Step1 should be given intensive tutorials to pass the medical licensing examination.

  19. Logistic regression analysis to predict Medical Licensing Examination of Thailand (MLET) Step1 success or failure.

    Science.gov (United States)

    Wanvarie, Samkaew; Sathapatayavongs, Boonmee

    2007-09-01

    The aim of this paper was to assess factors that predict students' performance in the Medical Licensing Examination of Thailand (MLET) Step1 examination. The hypothesis was that demographic factors and academic records would predict the students' performance in the Step1 Licensing Examination. A logistic regression analysis of demographic factors (age, sex and residence) and academic records [high school grade point average (GPA), National University Entrance Examination Score and GPAs of the pre-clinical years] with the MLET Step1 outcome was accomplished using the data of 117 third-year Ramathibodi medical students. Twenty-three (19.7%) students failed the MLET Step1 examination. Stepwise logistic regression analysis showed that the significant predictors of MLET Step1 success/failure were residence background and GPAs of the second and third preclinical years. For students whose sophomore and third-year GPAs increased by an average of 1 point, the odds of passing the MLET Step1 examination increased by a factor of 16.3 and 12.8 respectively. The minimum GPAs for students from urban and rural backgrounds to pass the examination were estimated from the equation (2.35 vs 2.65 from 4.00 scale). Students from rural backgrounds and/or low-grade point averages in their second and third preclinical years of medical school are at risk of failing the MLET Step1 examination. They should be given intensive tutorials during the second and third pre-clinical years.

  20. Gas reactor international cooperative program interim report: United States/Federal Republic of Germany nuclear licensing comparison

    International Nuclear Information System (INIS)

    1978-09-01

    In order to compare US and FRG Nuclear Licensing, a summary description of United States Nuclear Licensing is provided as a basis. This is followed by detailed information on the participants in the Nuclear Licensing process in the Federal Republic of Germany (FRG). FRG licensing procedures are described and the rules and regulations imposed are summarized. The status of gas reactor licensing in both the U.S. and the FRG is outlined and overall conclusions are drawn as to the major licensing differences. An appendix describes the most important technical differences between US and FRG criteria

  1. Licensing procedures and registration of medical doctors in the European Union.

    Science.gov (United States)

    Kovacs, Eszter; Schmidt, Andrea E; Szocska, Gabor; Busse, Reinhard; McKee, Martin; Legido-Quigley, Helena

    2014-06-01

    The current proposals to update the European Union (EU) directive on professional qualifications will have potentially important implications for health professions. Yet those discussing it will struggle to find basic information on key issues such as licensing and registration of physicians in different countries. A survey was conducted among national experts in 14 EU member states, supplemented by literature and independent expert review. The questionnaire covered five components of licensing and registration: (1) definitions, (2) regulatory basis, (3) governance, (4) the process of registration and (5) flow and quantity of applications. We identify seven areas of concern: (1) the meaning of terminology, which is inconsistent; (2) the role of language assessments and the responsibility for them; (3) whether approval to practise should be lifelong or time limited, subject to periodic assessment; (4) the need for improved systems to identify those deemed no longer fit to practise in one member state; (5) the complexity of processes for graduates from non-EU/European Economic Area (EAA) countries; (6) public access to registers; and (7) transparency of systems of governance. The systems of licensing and registration of doctors in Europe have developed within specific national contexts and vary widely. This creates inevitable problems in the context of free movement of professionals and increasing mobility. © 2014 Royal College of Physicians.

  2. 12 CFR 564.3 - Appraisals required; transactions requiring a State certified or licensed appraiser.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Appraisals required; transactions requiring a State certified or licensed appraiser. 564.3 Section 564.3 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.3 Appraisals required; transactions requiring a State...

  3. Occupational radiation Exposure at Agreement State-Licensed Materials Facilities, 1997-2010

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Nuclear Regulatory Commission, Office of Nuclear Regulatory Research

    2012-07-07

    The purpose of this report is to examine occupational radiation exposures received under Agreement State licensees. As such, this report reflects the occupational radiation exposure data contained in the Radiation Exposure Information and Reporting System (REIRS) database, for 1997 through 2010, from Agreement State-licensed materials facilities.

  4. Safety philosophy and licensing practice in different member states of IAEA: Spain

    International Nuclear Information System (INIS)

    Alonso, A.

    1981-01-01

    With the aim of presenting the licensing experience in Spain, the countries with nuclear activities are divided into three main groups: exporters, qualified importers and importers, being Spain in the second group. The licensing problems, and therefore the licensing experience, are different in the different groups of countries. Moreover, the experience in Spain is enriched by the following facts: an early start, a substantial program and a diversity of types, pressurized and boiling water reactors, and suppliers, American and German plants. Reference is made to the basic legal documents governing licensing in Spain, together with the difficulties in adopting and applying detailed regulations. Within this framework, the licensing experience in Spain is described with reference to the reference plant concept, later enlarged to include the reference-site reference plant concept, ending in the most practical approach of the reference problem concept. Finally specific licensing problems are introduced with reference to the Spanish operating nuclear power plants, the ones under commissioning and in an advanced state of construction and the ones just staring construction. (orig./RW)

  5. Driving licences and medical screening in old age: Review of literature and European licensing policies

    DEFF Research Database (Denmark)

    Siren, Anu Kristiina; Haustein, Sonja

    2015-01-01

    Chronological age, per se, seems to be, in the case of mature drivers, only a weak predictor of safe driving performance. However, screening policies based on chronological age are widely used. Nevertheless, lately, more evidence-based policies have been called for. In this paper we first......, investigate the evidence for and against having an age-based driver screening policy in place; second, we map and compare the current driving licensing policies in European Union (EU) member states in order to examine the variation; and third, we draw conclusions based on the literature and the policy mapping...... are likely to limit the mobility and potentially worsen the safety of older persons....

  6. 77 FR 60956 - State Graduated Driver Licensing Incentive Grant

    Science.gov (United States)

    2012-10-05

    ... and proficiency to move through each level of the system before graduating to the next. States have.... How do I prepare and submit comments? Your comments must be written and in English. To ensure that.... Regulatory Analyses and Notices A. Executive Order (E.O.) 12866 (Regulatory Planning and Review), E.O. 13563...

  7. 76 FR 13973 - United States Warehouse Act; Processed Agricultural Products Licensing Agreement

    Science.gov (United States)

    2011-03-15

    ... security of goods in the care and custody of the licensee. The personnel conducting the examinations will..., Warehouse Operations Program Manager, FSA, United States Department of Agriculture, Mail Stop 0553, 1400... continuing compliance with the standards of approval and operation. FSA will conduct examinations of licensed...

  8. [Radiation protection in medical research : Licensing requirement for the use of radiation and advice for the application procedure].

    Science.gov (United States)

    Minkov, V; Klammer, H; Brix, G

    2017-07-01

    In Germany, persons who are to be exposed to radiation for medical research purposes are protected by a licensing requirement. However, there are considerable uncertainties on the part of the applicants as to whether licensing by the competent Federal Office for Radiation Protection is necessary, and regarding the choice of application procedure. The article provides explanatory notes and practical assistance for applicants and an outlook on the forthcoming new regulations concerning the law on radiation protection of persons in the field of medical research. Questions and typical mistakes in the application process were identified and evaluated. The qualified physicians involved in a study are responsible for deciding whether a license is required for the intended application of radiation. The decision can be guided by answering the key question whether the study participants would undergo the same exposures regarding type and extent if they had not taken part in the study. When physicians are still unsure about their decision, they can seek the advisory service provided by the professional medical societies. Certain groups of people are particularly protected through the prohibition or restriction of radiation exposure. A simplified licensing procedure is used for a proportion of diagnostic procedures involving radiation when all related requirements are met; otherwise, the regular licensing procedure should be used. The new radiation protection law, which will enter into force on the 31st of december 2018, provides a notification procedure in addition to deadlines for both the notification and the licensing procedures. In the article, the authors consider how eligible studies involving applications of radiation that are legally not admissible at present may be feasible in the future, while still ensuring a high protection level for study participants.

  9. Licensed Healthcare Facilities

    Data.gov (United States)

    California Natural Resource Agency — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  10. Comparative analysis of LMFBR licensing in the United States and other countries - notably France. Executive summary

    International Nuclear Information System (INIS)

    Golay, M.W.; Castillo, M.

    1981-01-01

    The safety-related design aspects and licensing experiences of LMFBR projects in other democratic countries have been studied and contrasted to those in the United States in order to understand the importance of different approaches to safety, and also to understand better the system of the United States. The regulatory systems and LMFBR programs of France and the United States are contrasted in detail, and that of West Germany is also studied. The programs of Japan and the United Kingdom receive considerably less attention, and that of the Soviet Union is ignored

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

    Science.gov (United States)

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

    2012-05-01

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

  12. Driver licensing and reasons for delaying licensure among young adults ages 18-20, United States, 2012

    OpenAIRE

    Tefft, Brian C; Williams, Allan F; Grabowski, Jurek G

    2014-01-01

    Background Motor vehicle crashes are the leading cause of death for teens and young adults in the United States. Graduated driver licensing (GDL) systems were designed to protect young novice drivers by limiting their exposure to specific risks while they gain experience driving. In the United States, most states? GDL systems only apply to new drivers younger than 18. Some experts suggest that GDL might encourage young people to wait until age 18 to obtain a license, to avoid GDL requirements...

  13. Licensing Status of New and Expanding In-Situ Recovery Uranium Projects in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Catchpole, G.; Thomas, M., E-mail: gccatchpole@uranerz.com [Uranerz Energy Corporation (URZ), Casper, WY (United States)

    2014-05-15

    The authors investigated the licensing status of new in-situ recovery (“ISR”) uranium projects, as well as the expansion of existing projects, within the United States (“US”). Specific emphasis and analysis is placed on those projects within the states of Texas and Wyoming. Of note, information used to prepare this paper was obtained from public sources that included company web sites, the US Securities and Exchange Commission, the US Nuclear Regulatory Commission (“NRC”), the US Energy Information Agency (“EIA”), and the relevant state regulatory agencies. The renewed interest in the production of natural uranium has been motivated, in part, by the increased sale price of yellowcake beginning around 2003 resulting in numerous new and existing natural resources companies acquiring mineral rights in the United States. Because of the economic favorability in terms of both operating and capital costs of ISR mines versus conventional mines in the US (with its relatively low grade of uranium ore), the model for most companies was to acquire mineral properties that had the potential for being mined using the ISR method. There were, however, exceptions to this model. The Uravan mineral district in southwest Colorado and southeast Utah, where relatively high-grade, shallow uranium deposits have the potential to be mined using underground methods, is one such exception. However, the focus of this paper will be on ISR projects. In Wyoming, which has been the top producer of natural uranium among the 50 states for the past seven years, there is one producing ISR mine (Bill Smith — Highland), one ISR mine on standby (Christensen Ranch), and two ISR uranium projects licensed but not yet built (Gas Hills and North Butte). Cameco Resources is planning to develop two ISR projects in Wyoming that have been licensed but not yet constructed. Additionally, three new uranium companies (Ur-Energy, Uranerz and Uranium One) have filed applications with the federal and

  14. Report of survey results for newly licensed registered nurses in Washington state.

    Science.gov (United States)

    Hirsch, Anne M

    2011-10-01

    Current projections for the need for nurses in Washington state are based on an increase in the need for health care, the aging of the population, and the inability of the nursing educational institutions to supply adequate numbers of graduates. Yet many new graduates are providing anecdotal evidence that they cannot find a job in nursing. This study gathered information regarding the employment of newly licensed registered nurses in Washington between May 2009 and August 2010. Questionnaires were administered to a randomly selected sample of 2,200 newly licensed nurses; 532 responses were returned. Nearly 81% reported current employment as a registered nurse and 69.5% reported that they were very or somewhat satisfied with their employment situation. The job search strategies, type of job sought, and factors contributing to their success are reported. Factors contributing to the success of their job search and to job dissatisfaction are explored. Copyright 2011, SLACK Incorporated.

  15. Characterization of design ground motion for the central and eastern United States: licensing implications

    International Nuclear Information System (INIS)

    Litehiser, J.; Carrato, P.

    2005-01-01

    For the first time in decades several US utilities are exploring the possibility of building new Nuclear Power Plant (NPP) generating capacity in the Central and Eastern United States (CEUS). Among the many topics that must be considered to license a nuclear plant (NPP) is appropriate design to mitigate the potential effects of vibratory ground motion from earthquakes. Agreement on seismic design ground motion was not always easy during licensing of the last generation of NPPs. Therefore, over the last few decades both industry and the United States Nuclear Regulatory Commission (USNRC) have worked to find ground motion criteria that recognize and overcome earlier licensing difficulties. Such criteria should be stable and easily implemented. Important and complementary programs under the direction of the Lawrence Livermore National Laboratory (LLNL) and the Electric Power Research Institute (EPRI) were part of this effort, and these studies resulted in probabilistic seismic hazard assessments (PSHAs) for a number of CEUS NPP sites. These results and the concepts underlying them are now incorporated into both USNRC regulation and regulatory guidance. Nevertheless, as the utilities and the NRC begin a renewed licensing dialog, issues of regulatory interpretation of earthquake ground motion design criteria have emerged. These issues are as fundamental as the shape and amplitude of ground motion design response spectra and as significant as the impact of these spectra on structural design. Successful and timely resolution of these issues will significantly impact the future of nuclear power in the US. The purpose of this paper is to briefly describe some of these issues and the approaches that have been proposed for their resolution. (authors)

  16. Improving regulatory effectiveness in federal/state siting actions: water supplies and the nuclear licensing process

    International Nuclear Information System (INIS)

    Davenport, F.S.

    1977-07-01

    The Interstate Conference on Water Problems (ICWP) is a national association of State, intrastate, and interstate officials concerned with water resources administration and related matters. The Conference was established in 1959 as an outgrowth of regional conferences on water problems as recognized in the same year by action of the General Assembly of the States. This report was produced by the Interstate Conference on Water Problems in an effort to provide a compilation and summary of the views of selected States regarding relationships of water supplies to the nuclear power plant licensing process. This publication does not represent the official position of the U.S Water Resources Council, or the U.S. Nuclear Regulatory Commission, nor does it represent the position of any single state or the ICWP

  17. Medical licensing examination (uigwa and the world of the physician officers (uigwan in Korea’s Joseon Dynasty

    Directory of Open Access Journals (Sweden)

    Nam Hee Lee

    2015-05-01

    Full Text Available Physicians for ordinary people in Korea’s Joseon Dynasty (1392-1910 did not need to pass the national medical licensing examination. They were able to work after a sufficient apprenticeship period. Only physician officers were licensed as technical civil servants. These physician officers were middle class, located socially between the nobility and the commoner. They had to pass a national licensing examination to be considered for high-ranking physician officer positions, that is, those at the rank equal to or above the 6th level out of a total of 9 ranks, where the first rank was highest. Royal physicians also had to pass this examination before accepting responsibility for the King’s healthcare. This article aims to describe the world of physician officers during the Joseon Dynasty. Physician officers enjoyed considerable social status because they dealt with matters of life and death. Owing to the professional nature of their fields and a strong sense of group identity, they came to compose a distinct social class. The physician officers’ world was marked by strong group allegiances based on shared professional knowledge; the use of marriage to gain and maintain social status; and the establishment of hereditary technical posts within the medical profession that were handed down from one generation to the next. The medical licensing examination persisted until 1894 when the civil service examination agency, of which it was part, was abolished. Until that time, the testing agency, the number of candidates who were accepted, two-step test procedures, and the method of test item selection were maintained and enforced.

  18. 77 FR 20353 - United States Warehouse Act; Export Food Aid Commodities Licensing Agreement

    Science.gov (United States)

    2012-04-04

    ... licensing agreement include, but are not limited to, corn soy blend, vegetable oil, and pulses such as peas, beans, and lentils. USWA licensing is a voluntary program. Warehouse operators that apply for USWA...

  19. Improving regulatory effectiveness in Federal/State siting actions: Federal/State regulatory permitting actions in selected nuclear power station licensing cases

    International Nuclear Information System (INIS)

    Baroff, J.

    1977-06-01

    The Federal/State regulatory permitting actions in 12 case histories of nuclear power station licensing in nine different states are documented. General observations regarding Federal/State siting roles in the siting process are included. Eleven of the case histories are illustrated with a logic network that gives the actions of the utilities in addition to the Federal/State permits

  20. Driver licensing and reasons for delaying licensure among young adults ages 18-20, United States, 2012.

    Science.gov (United States)

    Tefft, Brian C; Williams, Allan F; Grabowski, Jurek G

    2014-12-01

    Motor vehicle crashes are the leading cause of death for teens and young adults in the United States. Graduated driver licensing (GDL) systems were designed to protect young novice drivers by limiting their exposure to specific risks while they gain experience driving. In the United States, most states' GDL systems only apply to new drivers younger than 18. Some experts suggest that GDL might encourage young people to wait until age 18 to obtain a license, to avoid GDL requirements, resulting in older teenagers having less driving experience and higher crash risk than they might have had without GDL. This study examined the prevalence and timing of licensure among young adults, and explored factors associated with delaying licensure among those not licensed before age 18. An online questionnaire was completed by 1,039 persons aged 18-20 years, recruited from a representative panel of United States households. Main outcome measures were acquisition of driver's license (a) within 12 months of the state minimum age for licensure, (b) before age 18. Associations of timing of licensure with demographic characteristics were assessed using multivariable logistic regression. Respondents not licensed before age 18 were asked to rate the importance of various possible reasons for delaying licensure. 54% of respondents were licensed before age 18. Blacks (37%; adjusted Prevalence Ratio 0.67, 95% Confidence Interval 0.48-0.93) and Hispanics (29%; adjusted Prevalence Ratio 0.60, 95% Confidence Interval 0.45-0.81) were less likely than non-Hispanic whites (67%) to be licensed before age 18. Lower household income was independently associated with delayed licensure (P self-reported reasons for not becoming licensed sooner were not having a car, being able to get around without driving, and costs associated with driving. There was little evidence that GDL is a major contributor to delayed licensure; however, a substantial minority of young people do not obtain a driver

  1. Identification of Vape Shops in Two North Carolina Counties: An Approach for States without Retailer Licensing

    Directory of Open Access Journals (Sweden)

    Joseph G. L. Lee

    2016-10-01

    Full Text Available Stores that sell electronic nicotine delivery systems (ENDS as their primary product are a new phenomenon and often termed “vape shops”. While vape shops are now regulated by state and federal agencies, not all states maintain lists of vape shops in operation. Standard ways of identifying tobacco retailers through off-premise alcohol permits and business listing services may not identify vape shops. We used four online business listing services (i.e., Google Maps, ReferenceUSA, YellowPages.com, Yelp to identify vape shops in two counties in North Carolina (NC. In one county, we also assessed four vaping web sites. We drove primary and secondary roads to physically validate the identified stores and attempt to identify stores not listed online. To assess the accuracy of the online searches, we calculated sensitivity and positive predictive values (PPVs. This research was conducted in spring and summer 2016 and identified 28 vape shops online. We confirmed 16 vape shops (seven in Pitt County, NC, USA, and nine in Durham County, NC, USA. Online searches ranged in sensitivity, 62.5%–81.3%, and PPVs ranged from 73.3% to 92.3%. Because of the range of sensitivity found among the business listing services, state policymakers should consider uniform licensing requirements for vape and tobacco retailers to more easily track retailers and ensure compliance with regulations.

  2. Identification of Vape Shops in Two North Carolina Counties: An Approach for States without Retailer Licensing

    Science.gov (United States)

    Lee, Joseph G. L.; D’Angelo, Heather; Kuteh, Jaleel D.; Martin, Ryan J.

    2016-01-01

    Stores that sell electronic nicotine delivery systems (ENDS) as their primary product are a new phenomenon and often termed “vape shops”. While vape shops are now regulated by state and federal agencies, not all states maintain lists of vape shops in operation. Standard ways of identifying tobacco retailers through off-premise alcohol permits and business listing services may not identify vape shops. We used four online business listing services (i.e., Google Maps, ReferenceUSA, YellowPages.com, Yelp) to identify vape shops in two counties in North Carolina (NC). In one county, we also assessed four vaping web sites. We drove primary and secondary roads to physically validate the identified stores and attempt to identify stores not listed online. To assess the accuracy of the online searches, we calculated sensitivity and positive predictive values (PPVs). This research was conducted in spring and summer 2016 and identified 28 vape shops online. We confirmed 16 vape shops (seven in Pitt County, NC, USA, and nine in Durham County, NC, USA). Online searches ranged in sensitivity, 62.5%–81.3%, and PPVs ranged from 73.3% to 92.3%. Because of the range of sensitivity found among the business listing services, state policymakers should consider uniform licensing requirements for vape and tobacco retailers to more easily track retailers and ensure compliance with regulations. PMID:27801793

  3. Identification of Vape Shops in Two North Carolina Counties: An Approach for States without Retailer Licensing.

    Science.gov (United States)

    Lee, Joseph G L; D'Angelo, Heather; Kuteh, Jaleel D; Martin, Ryan J

    2016-10-27

    Stores that sell electronic nicotine delivery systems (ENDS) as their primary product are a new phenomenon and often termed "vape shops". While vape shops are now regulated by state and federal agencies, not all states maintain lists of vape shops in operation. Standard ways of identifying tobacco retailers through off-premise alcohol permits and business listing services may not identify vape shops. We used four online business listing services (i.e., Google Maps, ReferenceUSA, YellowPages.com, Yelp) to identify vape shops in two counties in North Carolina (NC). In one county, we also assessed four vaping web sites. We drove primary and secondary roads to physically validate the identified stores and attempt to identify stores not listed online. To assess the accuracy of the online searches, we calculated sensitivity and positive predictive values (PPVs). This research was conducted in spring and summer 2016 and identified 28 vape shops online. We confirmed 16 vape shops (seven in Pitt County, NC, USA, and nine in Durham County, NC, USA). Online searches ranged in sensitivity, 62.5%-81.3%, and PPVs ranged from 73.3% to 92.3%. Because of the range of sensitivity found among the business listing services, state policymakers should consider uniform licensing requirements for vape and tobacco retailers to more easily track retailers and ensure compliance with regulations.

  4. [The Medical Examination - Between Desire and Reality - Analysis of Consensus Between the Second Part of the Medical Licensing Exam (IMPP) and the National Catalogue of Expertise-based Learning Goals in Surgery (NKLC)].

    Science.gov (United States)

    Sterz, Jasmina; Rüsseler, Miriam; Britz, Vanessa; Stefanescu, Christina; Hoefer, Sebastian H; Adili, Farzin; Schreckenbach, Teresa; Schleicher, Iris; Weber, Roxane; Hofmann, Hans-Stefan; Voß, Friedericke; König, Sarah; Heinemann, Markus K; Kadmon, Martina

    2017-12-01

    examined surgical topic was "disorders of the rheumatic spectrum". Conclusion The number of surgical examination questions in the German second medical licensing examination seems to be sufficient. However, the questions seem to be unevenly distributed between different surgical areas of undergraduate education. In order to achieve a more homogenous representation of relevant surgical topics, improved alignment is needed between the state examination with existing catalogues of learning goals by the IMPP. Georg Thieme Verlag KG Stuttgart · New York.

  5. 45 CFR 61.7 - Reporting licensure actions taken by Federal or State licensing and certification agencies.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting licensure actions taken by Federal or State licensing and certification agencies. 61.7 Section 61.7 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...

  6. 76 FR 79228 - Combined Licenses at William States Lee III Nuclear Station Site, Units 1 and 2; Duke Energy...

    Science.gov (United States)

    2011-12-21

    ... NUCLEAR REGULATORY COMMISSION [Docket Nos. 52-018 and 52-019; NRC-2008-0170] Combined Licenses at William States Lee III Nuclear Station Site, Units 1 and 2; Duke Energy Carolinas, LLC AGENCY: Nuclear.... SUMMARY: Notice is hereby given that the U.S. Nuclear Regulatory Commission (NRC) and the U.S. Army Corps...

  7. Correlations between the scores of computerized adaptive testing, paper and pencil tests, and the Korean Medical Licensing Examination

    Directory of Open Access Journals (Sweden)

    Mee Young Kim

    2005-06-01

    Full Text Available To evaluate the usefulness of computerized adaptive testing (CAT in medical school, the General Examination for senior medical students was administered as a paper and pencil test (P&P and using CAT. The General Examination is a graduate examination, which is also a preliminary examination for the Korean Medical Licensing Examination (KMLE. The correlations between the results of the CAT and P&P and KMLE were analyzed. The correlation between the CAT and P&P was 0.8013 (p=0.000; that between the CAT and P&P was 0.7861 (p=0.000; and that between the CAT and KMLE was 0.6436 (p=0.000. Six out of 12 students with an ability estimate below 0.52 failed the KMLE. The results showed that CAT could replace P&P in medical school. The ability of CAT to predict whether students would pass the KMLE was 0.5 when the criterion of the theta value was set at -0.52 that was chosen arbitrarily for the prediction of pass or failure.

  8. Post-hoc simulation study to adopt a computerized adaptive testing (CAT) for a Korean Medical License Examination.

    Science.gov (United States)

    Seo, Dong Gi; Choi, Jeongwook

    2018-05-17

    Computerized adaptive testing (CAT) has been adopted in license examinations due to a test efficiency and accuracy. Many research about CAT have been published to prove the efficiency and accuracy of measurement. This simulation study investigated scoring method and item selection methods to implement CAT in Korean medical license examination (KMLE). This study used post-hoc (real data) simulation design. The item bank used in this study was designed with all items in a 2017 KMLE. All CAT algorithms for this study were implemented by a 'catR' package in R program. In terms of accuracy, Rasch and 2parametric logistic (PL) model performed better than 3PL model. Modal a Posteriori (MAP) or Expected a Posterior (EAP) provided more accurate estimates than MLE and WLE. Furthermore Maximum posterior weighted information (MPWI) or Minimum expected posterior variance (MEPV) performed better than other item selection methods. In terms of efficiency, Rasch model was recommended to reduce test length. Simulation study should be performed under varied test conditions before adopting a live CAT. Based on a simulation study, specific scoring and item selection methods should be predetermined before implementing a live CAT.

  9. AP1000{sup R} licensing and deployment in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, R. P.; Russ, P. A.; Filiak, P. P.; Castiglione, L. L. [Westinghouse Electric Company LLC, 1000 Westinghouse Drive, Cranberry Township, PA 16066 (United States)

    2012-07-01

    In recent years, both domestic and foreign utilities have turned to the standardized Westinghouse AP1000 plant design in satisfying their near - and long-term - sustainable energy needs. As direct support to these actions, licensing the AP1000 design has played a significant role by providing one of the fundamental bases in clearing regulatory hurdles leading to the start of new plant construction. Within the U.S. alone, Westinghouse AP1000 licensing activities have reached unprecedented milestones with the approvals of both AP1000 Design Certification and Southern Company's combined construction permit and operating license (COL) application directly supporting the construction of two new nuclear plants in Georgia. Further COL application approvals are immediately pending for an additional two AP1000 plants in South Carolina. And, across the U.S. nuclear industry spectrum, there are 10 other COL applications under regulatory review representing some 16 new plants at 10 sites. In total, these actions represent the first wave of new plant licensing under the regulatory approval process since 1978. Fundamental to the Nuclear Regulatory Commission's AP1000 Design Certification is the formal recognition of the AP1000 passive safety design through regulatory acceptance rulemaking. Through recognition and deployment of the AP1000 Design Certification, the utility licensee / operator of this reactor design are now offered an opportunity to use a simplified 'one-step' combined license process, thereby managing substantial back-end construction schedule risk from regulatory and intervention delays. Application of this regulatory philosophy represents both acceptance and encouragement of standardized reactor designs like the AP1000. With the recent AP1000 Design Certification and utility COL acceptances, the fundamental licensing processes of this philosophy have successfully proven the attainment of significant milestones with the next stage licensing

  10. Sales of Forestry-Related Specialty License Plates in the Southern United States: A County Level Empirical Analysis

    Directory of Open Access Journals (Sweden)

    Shaun M. Tanger

    2016-07-01

    Full Text Available In recent years, specialty license plates have become an increasingly popular way to raise awareness and show support for a myriad of issues with which the plate is linked. Several states and various organizations that provide forestry education have developed forestry license plates. Vehicle owners can purchase the plates to show their support towards forestry by buying the forestry license plates, which generates revenue for the provider organization. Using county-level data from five states in the Southeastern United States, a statistical model was developed to examine explanatory factors of forestry-based specialty license plate sales in 2014. Using linear count regression modeling, we observed that the significant predictor variables of plate sales were income per capita, population density, the percentage of acres that are forested in the county, acres of forest in the county that are privately owned, percentage of people who are 65 or older, and presence of the forest industry in the county. Plate sales were positively correlated with the presence of the forest industry in the county.

  11. Technical issues and approach to license dry storage of LWR fuel in the United States

    International Nuclear Information System (INIS)

    Johnson, A.B.; Beeman, G.H.; Creer, J.M.; Gilbert, E.R.

    1984-01-01

    Dry storage is emerging as an important alternative to wet storage for US utilities, even though wet storage will remain the principal storage method, at least until the federal government begins to accept fuel in 1998. Dry storage has been licensed in several countries. In the USA, dry storage issues are related to storage system performance and behavior of spent fuel during storage. There is a coordinated US effort among electric utilities, the Electric Power Research Institute (EPRI), the Department of Energy (DOE) and the Nuclear Regulatory Commission (NRC) to license two dry storage concepts: metal casks, and horizontal storage modules. The following activities are underway to resolve the licensing issues associated with dry storage and to establish the licensing basis: a) summarize and assimilate domestic and foreigh dry storage experience; b) conduct tests which resolve specific licensing issues; c) conduct cooperative demonstrations of the leading dry storage concepts; d) establish criteria and justifications for generic licensing. The paper summarizes the licensing issues and the approach to their resolution

  12. 76 FR 13972 - United States Warehouse Act; Export Food Aid Commodities Licensing Agreement

    Science.gov (United States)

    2011-03-15

    ..., nuts, cottonseed, and dry beans. Warehouse operators that apply voluntarily agree to be licensed... program for port and transload facility operators storing EFAC. This proposal is in response to the...

  13. Technology licensing in China

    DEFF Research Database (Denmark)

    Wang, Yuandi; Li-Ying, Jason; Chen, Jin

    2015-01-01

    We explore the landscape of technology licensing among Chinese entities in the period 2000–12, using a unique database on technological licensing from the State Intellectual Property Office of China. We find that: first, among Chinese licensee organizations, firms have dominated in terms...... of the number of licensed technologies; second, the geographical distribution of licensed technologies among the provinces has gradually reached a new quantitative balance; third, utility models are the most popular technologies to be licensed and the majority of technology licensing in China has been between...... Chinese entities, and most transactions have been local within provinces; and finally, Chinese firms have gradually in-licensed newer and newer technologies, but the technologies in-licensed from foreign sources are by no means state-of-the-art. We make several suggestions for innovation policy...

  14. Nuclear power stations licensing

    International Nuclear Information System (INIS)

    Solito, J.

    1978-04-01

    The judicial aspects of nuclear stations licensing are presented. The licensing systems of the United States, Spain, France and Federal Republic of Germany are focused. The decree n 0 60.824 from July 7 sup(th), 1967 and the following legislation which define the systematic and area of competence in nuclear stations licensing are analysed [pt

  15. United States Army Medical Materiel Development Activity

    Science.gov (United States)

    1989-03-10

    and BPL were provided by the contractor to USAMMDA personnel as required. 3 ,I SAutomatic Data Processing Support: During 1988, USAMI.DA procured...PABO, and WRAIR cooperated to immunize 40,000 volunteers in a double blind study of 0. neningitidis Vaccine. Controls received a licensed Group C

  16. Federal/State cooperation in the licensing of a nuclear power project. A joint licensing process between the US Nuclear Regulatory Commission and the Washington State Energy Facility Site Evaluation Council

    International Nuclear Information System (INIS)

    1984-05-01

    This report summarizes and documents a joint environmental review and licensing process established between the US Nuclear Regulatory Commission (NRC) and the Washington State Energy Facility Site Evaluation Council (EFSEC) in 1980-1983 for the Skagit/Hanford Nuclear Project (S/HNP). It documents the agreements made between the agencies to prepare a joint environmental impact statement responsive to the requirements of the National Environmental Policy Act of 1969 (NEPA) and the Washington State Environmental Policy Act. These agreements also established protocol to conduct joint public evidentiary hearings on matters of mutual jurisdiction, thereby reducing the duplication of effort and increasing the efficiency of the use of resources of federal and state governments and other entities involved in the process. This report may provide guidance and rationale to licensing bodies that may wish to adopt some of the procedures discussed in the report in the event that they become involved in the licensing of a nuclear power plant project. The history of the S/HNP and of the agreement processes are discussed. Discussions are provided on implementing the joint review process. A separate section is included which presents independent evaluations of the process by the applicant, NRC, and EFSEC

  17. Order of 15 October 1992 amending the Order of 26 March 1974 on the competence of persons licensed to use radioelements in unsealed sources for medical uses

    International Nuclear Information System (INIS)

    1992-01-01

    This Order amends the 1974 Order which provides that a license to use artificial radioelements in unsealed sources may only be granted to medical doctors and to holders of a diploma, a certificate attesting studies or other certificate specified in the Order. The 1992 Order adds some requirements regarding specialized diplomas. (NEA)

  18. Safety philosophy and licensing practice in different member states of IAEA: Germany, F.R

    International Nuclear Information System (INIS)

    Lahner, K.

    1981-01-01

    The safety philosophy, as the basis of the design of a NPP, will be shown under the aspects of general design rules, requirements by law, reactor safety commission and nuclear or conventional technical standards. Then a discussion of the licensing practise in the Federal Republic of Germany and in the USA will follow for the different stages of conceptual design, construction and operation with special consideration of the example of the NPP Muelheim-Kaerlich. The interrelation between designer and licensing authority, reactor safety commission and technical consultants will be taken into account. (orig./RW)

  19. Nuclear reactor operator licensing

    International Nuclear Information System (INIS)

    Bursey, R.J.

    1978-01-01

    The Atomic Energy Act of 1954, which was amended in 1974 by the Energy Reorganization Act, established the requirement that individuals who had the responsibility of operating the reactors in nuclear power plants must be licensed. Section 107 of the act states ''the Commission shall (1) prescribe uniform conditions for licensing individuals; (2) determine the qualifications of such individuals; and (3) issue licenses to such individuals in such form as the Commission may prescribe.'' The article discusses the types of licenses, the selection and training of individuals, and the administration of the Nuclear Regulatory Commission licensing examinations

  20. Safety Evaluation Report related to the renewal of the operating license for the research reactor at Pennsylvania State University

    International Nuclear Information System (INIS)

    1986-01-01

    This Safety Evaluation Report for the application filed by the Pennsylvania State University for a renewal of Operating License R-2 to continue to operate the Pennsylvania State University Breazeale Reactor (PSBR) has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located on the campus in University Park, Pennsylvania. On the basis of its technical review, the staff concludes that the reactor facility can continue to be operated by the university without endangering the health and safety of the public or the environment

  1. A real-time material control concept for safeguarding special nuclear material in United States licensed processing facilities

    International Nuclear Information System (INIS)

    Shea, T.E.

    1976-01-01

    This paper describes general safeguards research being undertaken by the United States Nuclear Regulatory Commission. Efforts to improve the ability of United States licensed plants to contend with the perceived threat of covert material theft are emphasized. The framework for this improvement is to break down the internal control and accounting system into subsystems to achieve material isolation, inventory control, inventory characterization, and inventory containment analysis. A general programme is outlined to develop and evaluate appropriate mechanisms, integrate selected mechanisms into subsystems, and evaluate the subsystems in the context of policy requirements. (author)

  2. Safety philosophy and licensing practice in different member states of IAEA: Canada

    International Nuclear Information System (INIS)

    Boyd, F.C.

    1981-01-01

    The lecture will provide an outline of the Canadian nuclear organization and basic characteristics of the CANDU reactor as a background for a brief description of the nuclear power plant licensing process and the safety philosophy followed. The regulatory agency (Atomic Energy Control Board) follows a three step licensing procedure, Site Acceptance, Construction Approval, Operating Licence. Defense in depth is followed as a general safety concept, but is applied in a special way. Completely separate and independant safety systems are required and basic criteria established through reference dose limits for any assumed failure (or initiating event) in any process (operating) system and for any such failure combined with complete failure at any safety system. The application of the Canadian approach in other countries will be mentioned. (orig./RW)

  3. Pharmacist prescriptive authority for smoking cessation medications in the United States.

    Science.gov (United States)

    Adams, Alex J; Hudmon, Karen Suchanek

    2018-02-06

    To characterize the status of state laws regarding the expansion of pharmacists' prescriptive authority for smoking cessation medications and to summarize frequently asked questions and answers that arose during the associated legislative debates. Legislative language was reviewed and summarized for all states with expanded authority, and literature supporting the pharmacist's capacity for an expanded role in smoking cessation is described. The core elements of autonomous tobacco cessation prescribing models for pharmacists vary across states. Of 7 states that currently have fully or partially delineated protocols, 4 states (Colorado, Idaho, Indiana, New Mexico) include all medications approved by the U.S. Food and Drug Administration for smoking cessation, and 3 (Arizona, California, Maine) include nicotine replacement therapy products only. The state protocol in Oregon is under development. Most states specify minimum cessation education requirements and define specific elements (e.g., patient screening, cessation intervention components, and documentation requirements) for the autonomous prescribing models. Through expanded authority and national efforts to advance the tobacco cessation knowledge and skills of pharmacy students and licensed pharmacists, the profession's role in tobacco cessation has evolved substantially in recent years. Eight states have created, or are in the process of creating, pathways for autonomous pharmacist prescriptive authority. States aiming to advance tobacco control strategies to help patients quit smoking might consider approaches like those undertaken in 8 states. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  4. [Driving license of patients with epilepsy, management of their oral drugs and suppositories by non-medical professionals, and the role of pediatric neurologists].

    Science.gov (United States)

    Ito, Masatoshi; Miyake, Shouta

    2004-05-01

    In June 2002, the following new driving regulations were enforced in Japan: 1. A person with epilepsy may be granted a driving license after a seizure-free period of two years. 2. A person with simple partial seizures that would not impair driving safety may be granted a driving license if no other seizures that may impair driving safety have occurred over a period of at least one year. 3. A person with seizures occurring only in sleep may be granted a driving license if no seizures have occurred in waking over a period of at least two years. 4. In case that the above requirements are going to be met within 6 months, driving should be prohibited for 6 months. 5. A person with epilepsy is recommended to apply for a license to drive heavy and/or public vehicles only after a seizure-free period of 5 years without medication. The committee for legal problems of the Japan Epilepsy Society proposed a guideline for non-medical teaching or caring professionals to give children with epilepsy antiepileptic medication or to insert suppositories, if needed, at schools or care institutions. The guideline indicated the following preconditions as important: 1. There must be a wish and consent of the patient or his/her family. 2. Drugs or suppositories are usually taken or used at home and regarded as a safe procedure. 3. Attending doctor should provide clear information about the use and risk of the medication or suppository. 4. Privacy of the patient should be protected. Pediatric neurologists are expected to play an important role on these issues.

  5. Meeting United States re-licensing requirements related to environmental protection using innovative technologies

    International Nuclear Information System (INIS)

    Taft, E.P.; Winchell, F.C.; Cook, T.C.

    1998-01-01

    Procedure for meeting re-licensing requirements related to environmental protection and an overview of several new and emerging technologies regarding the development of ways to prevent fish passage through hydraulic turbines at hydroelectric power dams is described. Fish mortality and injury has long been a concern in the hydroelectric industry and research and development efforts have been ongoing since the 1970s to prevent fish passage through turbines. Several new and emerging technologies are examined that have the potential for wide-spread cost-effective applications

  6. Final report of the NRC-Agreement State Working Group to evaluate control and accountability of licensed devices

    International Nuclear Information System (INIS)

    1996-10-01

    US NRC staff acknowledged that licensees were having problems maintaining control over and accountability for devices containing radioactive material. In June 1995, NRC approved the staff's suggestion to form a joint NRC-Agreement State Working Group to evaluate the problem and propose solutions. The staff indicated that the Working Group was necessary to address the concerns from a national perspective, allow for a broad level of Agreement State input, and to reflect their experience. Agreement State participation in the process was essential since some Agreement States have implemented effective programs for oversight of device users. This report includes the 5 recommendations proposed by the Working Group to increase regulatory oversight, increase control and accountability of devices, ensure proper disposal, and ensure disposal of orphaned devices. Specifically, the Working Group recommends that: (1) NRC and Agreement States increase regulatory oversight for users of certain devices; (2) NRC and Agreement State impose penalties on persons losing devices; (3) NRC and Agreement States ensure proper disposal of orphaned devices; (4) NRC encourage States to implement similar oversight programs for users of Naturally-Occurring or Accelerator- Produced Material; and (5) NRC encourage non-licensed stakeholders to take appropriate actions, such as instituting programs for material identification

  7. Final report of the NRC-Agreement State Working Group to evaluate control and accountability of licensed devices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    US NRC staff acknowledged that licensees were having problems maintaining control over and accountability for devices containing radioactive material. In June 1995, NRC approved the staff`s suggestion to form a joint NRC-Agreement State Working Group to evaluate the problem and propose solutions. The staff indicated that the Working Group was necessary to address the concerns from a national perspective, allow for a broad level of Agreement State input, and to reflect their experience. Agreement State participation in the process was essential since some Agreement States have implemented effective programs for oversight of device users. This report includes the 5 recommendations proposed by the Working Group to increase regulatory oversight, increase control and accountability of devices, ensure proper disposal, and ensure disposal of orphaned devices. Specifically, the Working Group recommends that: (1) NRC and Agreement States increase regulatory oversight for users of certain devices; (2) NRC and Agreement State impose penalties on persons losing devices; (3) NRC and Agreement States ensure proper disposal of orphaned devices; (4) NRC encourage States to implement similar oversight programs for users of Naturally-Occurring or Accelerator- Produced Material; and (5) NRC encourage non-licensed stakeholders to take appropriate actions, such as instituting programs for material identification.

  8. Medical marijuana: the state of the research.

    Science.gov (United States)

    Mirken, B

    1996-10-18

    Recent raids on buyers' clubs in San Francisco have focused attention on medicinal uses of marijuana. The Clinton administration's policy is that there is no scientific evidence that smoked marijuana is useful in treating pain and nausea in AIDS and cancer patients. However, mainstream medical literature has supported the use of cannabis in managing symptoms of diseases such as glaucoma and multiple sclerosis. Well designed, controlled studies of marijuana are needed to determine the effective medical uses of the drug and break the political stalemate on this issue.

  9. ITER licensing

    International Nuclear Information System (INIS)

    Gordon, C.W.

    2005-01-01

    ITER was fortunate to have four countries interested in ITER siting to the point where licensing discussions were initiated. This experience uncovered the challenges of licensing a first of a kind, fusion machine under different licensing regimes and helped prepare the way for the site specific licensing process. These initial steps in licensing ITER have allowed for refining the safety case and provide confidence that the design and safety approach will be licensable. With site-specific licensing underway, the necessary regulatory submissions have been defined and are well on the way to being completed. Of course, there is still work to be done and details to be sorted out. However, the informal international discussions to bring both the proponent and regulatory authority up to a common level of understanding have laid the foundation for a licensing process that should proceed smoothly. This paper provides observations from the perspective of the International Team. (author)

  10. Non-medical use of methylphenidate among medical students of the University of the Free State

    OpenAIRE

    Jain, Roshini; Chang, Chiech; Koto, Mpho; Geldenhuys, Alden; Nichol, Richard; Joubert, Gina

    2017-01-01

    Background: Faced with demanding training programmes, medical students may be more prone to use methylphenidate for non-medical purposes in order to improve concentration, alertness and academic performance. Aim: The study aimed to investigate the prevalence of the non-medical use of methylphenidate and knowledge of this drug among undergraduate medical students of the University of the Free State. Methods: This was a cross-sectional study. A self-administered, anonymous questionnaire...

  11. Performance assessment and licensing issues for United States commercial near-surface low-level radioactive waste disposal facilities

    International Nuclear Information System (INIS)

    Birk, S. M.

    1997-01-01

    This paper covers the performance assessment and licensing issues, the performance the objectives, the performance assessment phases, the scenario selection, the mathematical modeling and computer programs, the final results of performance assessments submitted for license applications, the institutional control period, and the licensing issues. 38 refs

  12. 76 FR 62868 - Washington State University; Notice of Issuance of Renewed Facility Operating License No. R-76

    Science.gov (United States)

    2011-10-11

    ...; Notice of Issuance of Renewed Facility Operating License No. R-76 AGENCY: Nuclear Regulatory Commission. ACTION: Notice of issuance of renewed facility operating license No. R- 76. ADDRESSES: You can access.... Nuclear Regulatory Commission (NRC, the Commission) has issued renewed Facility Operating License No. R-76...

  13. Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board.

    Science.gov (United States)

    Papadakis, Maxine A; Hodgson, Carol S; Teherani, Arianne; Kohatsu, Neal D

    2004-03-01

    To determine if medical students who demonstrate unprofessional behavior in medical school are more likely to have subsequent state board disciplinary action. A case-control study was conducted of all University of California, San Francisco, School of Medicine graduates disciplined by the Medical Board of California from 1990-2000 (68). Control graduates (196) were matched by medical school graduation year and specialty choice. Predictor variables were male gender, undergraduate grade point average, Medical College Admission Test scores, medical school grades, National Board of Medical Examiner Part 1 scores, and negative excerpts describing unprofessional behavior from course evaluation forms, dean's letter of recommendation for residencies, and administrative correspondence. Negative excerpts were scored for severity (Good/Trace versus Concern/Problem/Extreme). The outcome variable was state board disciplinary action. The alumni graduated between 1943 and 1989. Ninety-five percent of the disciplinary actions were for deficiencies in professionalism. The prevalence of Concern/Problem/Extreme excerpts in the cases was 38% and 19% in controls. Logistic regression analysis showed that disciplined physicians were more likely to have Concern/Problem/Extreme excerpts in their medical school file (odds ratio, 2.15; 95% confidence interval, 1.15-4.02; p =.02). The remaining variables were not associated with disciplinary action. Problematic behavior in medical school is associated with subsequent disciplinary action by a state medical board. Professionalism is an essential competency that must be demonstrated for a student to graduate from medical school.

  14. Training programs in medical physics in the United States

    International Nuclear Information System (INIS)

    Lanzl, L.H.

    1977-01-01

    The history of the field of medical physics in the United States is reviewed; the importance of the development of the nuclear reactor and particle accelerators to medical physics is pointed out. Conclusions and recommendations of an IAEA/WHO seminar on the training of medical physicists (in 1972) are given and compared with existing programs in the US. It is concluded that the recommendations of the IAEA are, for the most part, followed. 1 table

  15. Prevalence of Medical Disorders in Pregnancy in Ebonyi State ...

    African Journals Online (AJOL)

    Background: Pregnancy is a physiological state, but when associated with an underlying medical disorder, it has a large ..... bacteriuria in pregnant women versus inpatient treatment ... implication of routine screen for asymptomatic bacteria.

  16. Variations by state in physician disciplinary actions by US medical licensure boards.

    Science.gov (United States)

    Harris, John Alexander; Byhoff, Elena

    2017-03-01

    To investigate the variation in the rate of state medical board physician disciplinary actions between US states. Longitudinal study of state medical board physician disciplinary action rates using the US National Practitioner Data Bank and American Medical Association estimates of physician demographics across all 50 states and the District of Columbia from 2010 to 2014. Results were reliability adjusted using a multilevel logistic model controlling for year of disciplinary action, physicians per capita in each state and the rate of malpractice claims per physician in each state. From 2010 to 2014, there were a total of 5046 506 physician licensure years present. Medical boards reported a total of 21 647 disciplinary actions, of which 5137 (23.7%) were major disciplinary actions involving revocation, suspension or surrender of licence. The mean, reliability-adjusted rate of all disciplinary actions was 3.76 (95% CI 3.21 to 4.42) with a significant variation between states. State rates ranged from 2.13 (95% CI 1.86 to 2.45) to 7.93 (95% CI 6.33 to 9.93) actions per 1000 physicians. The mean rate of major disciplinary actions was 2.71 (95% CI 1.93 to 3.82), ranging from 0.64 (95% CI 0.53 to 0.76) to 2.71 (95% CI 1.93 to 3.82) actions per 1000 physicians. The correlation between the rate of major disciplinary action and minor disciplinary actions was 0.34. There is a significant, fourfold variation in the annual rate of medical board physician disciplinary action by state in the USA. When indicated, state medical boards should consider policies aimed at improving standardisation and coordination to provide consistent supervision to physicians and ensure public safety. 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/.

  17. Medical Student Education in State Psychiatric Hospitals: A Survey of US State Hospitals.

    Science.gov (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Kennedy, Cheryl; Walker, Mary O; Mayerhoff, David

    2016-04-01

    State hospitals may be underutilized in medical education. US state psychiatric hospitals were surveyed on current and potential psychiatry medical student education. A 10-item questionnaire, with multiple response formats, was sent to identified hospitals in late 2012. Ninety-seven of 221 hospitals contacted responded. Fifty-three (55%) reported current medical student education programs, including 27 clinical clerkship rotations. Education and training in other disciplines was prevalent in hospitals both with and without medical students. The large majority of responders expressed enthusiasm about medical education. The most frequent reported barrier to new programs was geographic distance from the school. Limited resources were limiting factors for hospitals with and without current programs. Only a minority of US state hospitals may be involved in medical student education. While barriers such as geographic distance may be difficult to overcome, responses suggest opportunities for expanding medical education in the state psychiatric hospitals.

  18. Nutrition Education Needs Assessment for Licensed Group Day Care Centers in the State of Utah

    OpenAIRE

    Barksdale, Almina

    1980-01-01

    In November 1977 Congress established the Nutrition Education and Training Program (NETP) with the passage of Public Law 95-166. Section 227.37 of the NETP Regulations (1978) mandates that each state establish a plan of action for the use of any federally appropriated funds earmarked for "nutrition education" , and further, the plan should contain a proposal to instruct all students in the state about the nutritional value of foods as well as the relationship between food , nutrition, and hea...

  19. License renewal

    International Nuclear Information System (INIS)

    Newberry, S.

    1993-01-01

    This article gives an overview of the process of license renewal for nuclear power plants. It explains what is meant by license renewal, the significance of license renewal, and goes over key elements involved in the process of license renewal. Those key elements are NRC requirements embodied in 10 CFR Part 54 (Reactor Safety) and 10 CFR Part 51 (Environmental Issues). In addition Industry Reports must be developed and reviewed. License renewal is essentially the process of applying for a 20 year extension to the original 40 year operating license granted for the plant. This is a very long term process, which involves a lot of preparation, and compliance with regulatory rules and guidelines. In general it is a process which is expected to begin when plants reach an operating lifetime of 20 years. It has provisions for allowing the public to become involved in the review process

  20. [When state authorisation was introduced for medical doctors in Norway].

    Science.gov (United States)

    Haave, Per

    2007-12-13

    In 1927, a law was implemented in Norway that for the first time required medical students to be state authorised before they could practice medicine and use the title medical doctor. The question of authorisation split the professional elite, both the Norwegian Medical Association and the Medical Faculty at the University of Oslo. Those very few members of the professional elite that advocated authorisation did, however, convince the government as well as the parliament that authorisation should be given and recalled by the state. State authorisation was first of all aimed at protecting the medical profession against "unfit" members; it was not a question of monopolising medical work or preventing other groups from working within the healthcare services. To put this into context, one should know that there had been a transition from a bureaucratic to a free labour market and most doctors were no longer engaged by the State, but had to practise in a private market. One feared that this would undermine the doctors' authority and status. In this situation, authorisation by the state was considered necessary to safeguard the public's confidence in doctors and their work.

  1. Management of the licensing of users of radioactive materials should be improved

    International Nuclear Information System (INIS)

    1976-01-01

    Radioactive material licenses are required for manufacturing nuclear fuel for reactors and for industrial, commercial, medical, and educational uses of radioactive materials. This type of license is not for constructing or operating nuclear power reactors and facilities for processing used nuclear fuels. This report discusses the need for better management improvements in the NRC's program for licensing the users. As of December 31, 1974, there were 8,253 active NRC-issued material licenses held by 6,310 licensees. The study reviewed NRC's policies, procedures, and practices, and examined recent evaluations of state programs to identify problems encountered by the states

  2. United States Army Medical Department Journal, January-March 2010

    Science.gov (United States)

    2010-03-01

    uti - lization of government-owned inventions by licensing inventions to the private sector. Licensing of federally owned inventions and other...physical therapists, podiatrists, optometrists, clinical dieticians, social workers, clinical pharmacists , clinical psychologists, occupational

  3. 78 FR 25349 - Policy Clarification Concerning Designation of Adjacent Coastal States for Deepwater Port License...

    Science.gov (United States)

    2013-04-30

    ... United States. The United Nations Convention on the Law of the Sea (``UNCLOS'') further clarifies the...\\ United Nations Convention on the Law of the Sea, Art. 2-3, Art. 33, Dec. 10, 1982, 1833 U.N.T.S. 397. \\13... three geographical miles into the Atlantic Ocean or the Pacific Ocean, or more than three marine leagues...

  4. 34 CFR 395.17 - Suspension of designation as State licensing agency.

    Science.gov (United States)

    2010-07-01

    ... protection of Federal property on which vending machines subject to the requirements of § 395.32 are located in the State. Upon the suspension of such designation, vending machine income from vending machines... maintenance, operation and protection of the Federal property on which such vending machines are located...

  5. 15 CFR Notes Applicable to State... - Notes applicable to State of Understanding related to Medical Equipment:

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Notes applicable to State of Understanding related to Medical Equipment: applicable Notes applicable to State of Understanding related to Medical Equipment: Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY,...

  6. Contestable Licensing

    OpenAIRE

    Zvika Neeman; Gerhard O. Orosel

    2000-01-01

    We analyze a model of repeated franchise bidding for natural monopoly with contestable licensing - a franchisee halds an (exclusive) license to operate a franchise until another rm offers to pay more for it. In a world where quality is observable but not veri able, the simple regulatory scheme we describe combines market-like incentives with regulatory oversight to generate efficient outcomes.

  7. Radiopharmaceutical licensing

    International Nuclear Information System (INIS)

    Mather, S.J.

    1992-01-01

    Recent health service legislation, and especially the loss of crown immunity has once again focussed attention on the arrangements for licensing of radiopharmaceuticals. The aim of the article is to describe in general terms the UK licensing system and in particular to provide guidance to those responsible for the supply of radiopharmaceuticals in hospitals. (author)

  8. Reactor licensing

    International Nuclear Information System (INIS)

    Harvie, J.D.

    2002-01-01

    This presentation discusses reactor licensing and includes the legislative basis for licensing, other relevant legislation , the purpose of the Nuclear Safety and Control Act, important regulations, regulatory document, policies, and standards. It also discusses the role of the CNSC, its mandate and safety philosophy

  9. Curb your premium! evaluating state intervention in medical malpractice insurance

    OpenAIRE

    Sofia, AmaralGarcia; Veronica, Grembi

    2011-01-01

    Using data of Italian public healthcare providers over years 2001 through 2008, we evaluate the impact of two policies adopted by Italian Regions (i.e., States) to cope with increasing medical malpractice costs using a Difference-in-Difference specification. We assess the impact of the policies on premiums paid and legal expenditures. The first policy consisted in collecting information and monitoring both compensation requests and any legal action related to a medical malpractice claim again...

  10. Status of development and licensing support for advanced liquid metal reactors in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, D R [Argonne National Laboratory, Argonne, IL (United States); Gyorey, G [General Electric, San Jose, CA (United States)

    1991-07-01

    The cornerstones of the United States Advanced Liquid Metal Cooled Reactor (ALMR) program sponsored by the Department of Energy are: the ALMR plant design program at General Electric based on the PRISM (Power Reactor Innovative Small Module) concept, and the Integral Fast Reactor program (IFR) at Argonne National Laboratory (ANL). The goal of the U.S. program is to produce a standard, commercial ALMR, including the associated fuel cycle. The paper addresses the status of the IFR program, the ALMR program and the interaction of the ALMR program with the regulatory environment. (author)

  11. Status of development and licensing support for advanced liquid metal reactors in the United States

    International Nuclear Information System (INIS)

    Pedersen, D.R.; Gyorey, G.

    1991-01-01

    The cornerstones of the United States Advanced Liquid Metal Cooled Reactor (ALMR) program sponsored by the Department of Energy are: the ALMR plant design program at General Electric based on the PRISM (Power Reactor Innovative Small Module) concept, and the Integral Fast Reactor program (IFR) at Argonne National Laboratory (ANL). The goal of the US program is to produce a standard, commercial ALMR, including the associated fuel cycle. The paper addresses the status of the IFR program, the ALMR program and the interaction of the ALMR program with the regulatory environment

  12. Status of development and licensing support for advanced liquid metal reactors in the United States

    International Nuclear Information System (INIS)

    Pedersen, D.R.; Gyorey, G.

    1991-01-01

    The cornerstones of the United States Advanced Liquid Metal Cooled Reactor (ALMR) program sponsored by the Department of Energy are: the ALMR plant design program at General Electric based on the PRISM (Power Reactor Innovative Small Module) concept, and the Integral Fast Reactor program (IFR) at Argonne National Laboratory (ANL). The goal of the U.S. program is to produce a standard, commercial ALMR, including the associated fuel cycle. The paper addresses the status of the IFR program, the ALMR program and the interaction of the ALMR program with the regulatory environment. (author)

  13. Medical tourism services available to residents of the United States.

    Science.gov (United States)

    Alleman, Brandon W; Luger, Tana; Reisinger, Heather Schacht; Martin, Rene; Horowitz, Michael D; Cram, Peter

    2011-05-01

    There are growing reports of United States (US) residents traveling overseas for medical care, but empirical data about medical tourism are limited. To characterize the businesses and business practices of entities promoting medical tourism and the types and costs of procedures being offered. DESIGN, PARTICIPANTS, AND OUTCOMES: Between June and August 2008, we conducted a telephone survey of all businesses engaged in facilitating overseas medical travel for US residents. We collected information from each company including: the number of employees; number of patients referred overseas; medical records security processes; destinations to which patients were referred; treatments offered; treatment costs; and whether patient outcomes were collected. We identified 63 medical tourism companies and 45 completed our survey (71%). Companies had a mean of 9.8 employees and had referred an average of 285 patients overseas (a total of approximately 13,500 patients). 35 (79%) companies reported requiring accreditation of foreign providers, 22 (50%) collected patient outcome data, but only 17 (39%) described formal medical records security policies. The most common destinations were India (23 companies, 55%), Costa Rica (14, 33%), and Thailand (12, 29%). The most common types of care included orthopedics (32 companies, 73%), cardiac care (23, 52%), and cosmetic surgery (29, 66%). 20 companies (44%) offered treatments not approved for use in the US--most commonly stem cell therapy. Average costs for common procedures, CABG ($18,600) and knee arthroplasty ($10,800), were similar to previous reports. The number of Americans traveling overseas for medical care with assistance from medical tourism companies is relatively small. Attention to medical records security and patient outcomes is variable and cost-savings are dependent on US prices. That said, overseas medical care can be a reasonable alternative for price sensitive patients in need of relatively common, elective medical

  14. Comparative survey of public participation in the nuclear licensing procedure in other European states

    International Nuclear Information System (INIS)

    Pelzer, N.; Bischof, W.

    1977-01-01

    The majority of states know either no participitation of the public at all (Italy, Austria), or only a very minor one (Great Britain, Spain, Belgium). This applies even to states like Sweden and Switzerland which are often held up as an example with regard to handling democracy. On the other hand, there is a comprehensive participation of the public in France and in the Netherlands. In France, a planned project is open for inspection within a radius of 5 km. After that, there are 4 weeks in which to lodge objections in written form. Everybody, who has an interest in the decision, has the right to file a suit against decisions by the authorities, in the context of which also a moral interest suffices according to law. In the Netherlands, the files are open for inspection within a radius of 10 km. Objections can be made orally or in a written form. They are discussed in a special hearing. Those immediately concerned have the right to file a suit. (HP) [de

  15. Variability in United States Allopathic Medical School Tuition.

    Science.gov (United States)

    Gil, Joseph A; Park, Sarah H; Daniels, Alan H

    2015-11-01

    Over the course of the last generation, the cost of medical school attendance and medical student debt has increased drastically. Medical student debt has been reported as high as $350,000, and the Association of American Medical Colleges (AAMC) reports that medical school tuition continues to increase annually. The increasing cost of medical education and associated financial burden is now beginning to deter potential applicants from pursuing a career in medicine. In this study we aimed to assess medical school tuition across the US. We hypothesized that the cost of medical school attendance is variable across all regions of the US, and as a result, the financial burden on medical students is inconsistent. All 123 allopathic medical schools accredited by the AAMC were assessed in this investigation. In-state and out-of-state tuitions for the year 2016 were obtained from U.S. News and World Report. Additionally, medical school size was collected. Regions were defined according to the US Census Bureau definition, with the US being divided into 4 regions: Northeast, Midwest, South, and West. There was no difference in average medical school size among the 4 regions (P > .05). Average in-state tuition was $38,291.56 ± $9801.38 (95% confidence interval [CI], $34,658.07-$41,513.46) in the Midwest, $45,923.04 ± $9178.87 (95% CI, $42,566.28-$49,216.78) in the Northeast, $32,287.78 ± $12,277.53 (95% CI, $28,581.90-$35,378.68) in the South, and $37,745.40 ± $11,414.37 (95% CI, $30,063.28-$40,458.99) in the West. In-state tuition in the South was significantly lower than in the Northeast, West, and Midwest (P tuition in the Northeast was significantly higher than in the South, West, and Midwest (P tuition is $54,104.04 ± $8227.65 (95% CI, $51,207.6-$57,000.39) in the Midwest, $53,180.10 ± $3963.71 (95% CI, $51,761.71-$54,598.50) in the Northeast, $48,191.86 ± $12,578.13 (95% CI, $44,595.84-$51,787.89) in the South, and $52,920.47 ± $7400.83 (95% CI, $49

  16. Safety evaluation report related to the renewal of the operating license for the research reactor at North Carolina State University

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    This safety evaluation report (SER) summarizes the findings of a safety review conducted by the staff of the U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Reactor Regulation (NRR). The staff conducted this review in response to a timely application filed by North Carolina State University (the licensee or NCSU) for a 20-year renewal of Facility Operating License R-120 to continue to operate the NCSU PULSTAR research reactor. The facility is located in the Burlington Engineering Laboratory complex on the NCSU campus in Raleigh, North Carolina. In its safety review, the staff considered information submitted by the licensee (including past operating history recorded in the licensee`s annual reports to the NRC), as well as inspection reports prepared by NRC Region H personnel and first-hand observations. On the basis of this review, the staff concludes that NCSU can continue to operate the PULSTAR research reactor, in accordance with its application, without endangering the health and safety of the public. 16 refs., 31 figs., 7 tabs.

  17. Safety evaluation report related to the renewal of the operating license for the research reactor at North Carolina State University

    International Nuclear Information System (INIS)

    1997-04-01

    This safety evaluation report (SER) summarizes the findings of a safety review conducted by the staff of the U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Reactor Regulation (NRR). The staff conducted this review in response to a timely application filed by North Carolina State University (the licensee or NCSU) for a 20-year renewal of Facility Operating License R-120 to continue to operate the NCSU PULSTAR research reactor. The facility is located in the Burlington Engineering Laboratory complex on the NCSU campus in Raleigh, North Carolina. In its safety review, the staff considered information submitted by the licensee (including past operating history recorded in the licensee's annual reports to the NRC), as well as inspection reports prepared by NRC Region H personnel and first-hand observations. On the basis of this review, the staff concludes that NCSU can continue to operate the PULSTAR research reactor, in accordance with its application, without endangering the health and safety of the public. 16 refs., 31 figs., 7 tabs

  18. International medical cooperation project for State of Libya using international medical tourism system in Thailand

    OpenAIRE

    奥寺, 敬; 坂本, 美重

    2013-01-01

    International medical cooperation project for State of Libya is reported. The concept of this project is to treat Libyan injured people using international medical tourism system in Thailand. Management of patient, including evaluation, domestic and international transportation arrangement of hospital, is supported by Normeca International Co., Ltd, (Pattaya, Thailand). Treatment of Libyan patient in two international hospitals (Bangpakok 9 Hospital and Navamin 9 Hopsital) in Bangkok was succ...

  19. Medical tourism today: what is the state of existing knowledge?

    Science.gov (United States)

    Hopkins, Laura; Labonté, Ronald; Runnels, Vivien; Packer, Corinne

    2010-07-01

    One manifestation of globalization is medical tourism. As its implications remain largely unknown, we reviewed claimed benefits and risks. Driven by high health-care costs, long waiting periods, or lack of access to new therapies in developed countries, most medical tourists (largely from the United States, Canada, and Western Europe) seek care in Asia and Latin America. Although individual patient risks may be offset by credentialing and sophistication in (some) destination country facilities, lack of benefits to poorer citizens in developing countries offering medical tourism remains a generic equity issue. Data collection, measures, and studies of medical tourism all need to be greatly improved if countries are to assess better both the magnitude and potential health implications of this trade.

  20. Varying levels of difficulty index of skills-test items randomly selected by examinees on the Korean emergency medical technician licensing examination

    Directory of Open Access Journals (Sweden)

    Bongyeun Koh

    2016-01-01

    Full Text Available Purpose: The goal of this study was to characterize the difficulty index of the items in the skills test components of the class I and II Korean emergency medical technician licensing examination (KEMTLE, which requires examinees to select items randomly. Methods: The results of 1,309 class I KEMTLE examinations and 1,801 class II KEMTLE examinations in 2013 were subjected to analysis. Items from the basic and advanced skills test sections of the KEMTLE were compared to determine whether some were significantly more difficult than others. Results: In the class I KEMTLE, all 4 of the items on the basic skills test showed significant variation in difficulty index (P<0.01, as well as 4 of the 5 items on the advanced skills test (P<0.05. In the class II KEMTLE, 4 of the 5 items on the basic skills test showed significantly different difficulty index (P<0.01, as well as all 3 of the advanced skills test items (P<0.01. Conclusion: In the skills test components of the class I and II KEMTLE, the procedure in which examinees randomly select questions should be revised to require examinees to respond to a set of fixed items in order to improve the reliability of the national licensing examination.

  1. Varying levels of difficulty index of skills-test items randomly selected by examinees on the Korean emergency medical technician licensing examination.

    Science.gov (United States)

    Koh, Bongyeun; Hong, Sunggi; Kim, Soon-Sim; Hyun, Jin-Sook; Baek, Milye; Moon, Jundong; Kwon, Hayran; Kim, Gyoungyong; Min, Seonggi; Kang, Gu-Hyun

    2016-01-01

    The goal of this study was to characterize the difficulty index of the items in the skills test components of the class I and II Korean emergency medical technician licensing examination (KEMTLE), which requires examinees to select items randomly. The results of 1,309 class I KEMTLE examinations and 1,801 class II KEMTLE examinations in 2013 were subjected to analysis. Items from the basic and advanced skills test sections of the KEMTLE were compared to determine whether some were significantly more difficult than others. In the class I KEMTLE, all 4 of the items on the basic skills test showed significant variation in difficulty index (P<0.01), as well as 4 of the 5 items on the advanced skills test (P<0.05). In the class II KEMTLE, 4 of the 5 items on the basic skills test showed significantly different difficulty index (P<0.01), as well as all 3 of the advanced skills test items (P<0.01). In the skills test components of the class I and II KEMTLE, the procedure in which examinees randomly select questions should be revised to require examinees to respond to a set of fixed items in order to improve the reliability of the national licensing examination.

  2. Pattern of Medical Admissions at Enugu State University of Science ...

    African Journals Online (AJOL)

    Technology Teaching Hospital, Parklane, Enugu, 2Department of Community Medicine, University of Nigeria Teaching. Hospital, Ituku/Ozalla ... A review of medical admissions into the Enugu State University of Science and Technology. Teaching .... Cord lesions, rabies, Guilliane Barré syndrome, motor neuron disease and ...

  3. Pattern of medical admissions at Enugu state university of science ...

    African Journals Online (AJOL)

    Pattern of medical admissions at Enugu state university of science and technology teaching hospital: a 5 year review. ... The diseases encountered most were diabetes mellitus‑735/3,865 (19.1%), hypertension/congestive cardiac failure‑703/3,865 (18.2%), strokes‑614/3,865 (15.9%) and human immunodeficiency virus ...

  4. An introduction to medical malpractice in the United States.

    Science.gov (United States)

    Bal, B Sonny

    2009-02-01

    Medical malpractice law in the United States is derived from English common law, and was developed by rulings in various state courts. Medical malpractice lawsuits are a relatively common occurrence in the United States. The legal system is designed to encourage extensive discovery and negotiations between adversarial parties with the goal of resolving the dispute without going to jury trial. The injured patient must show that the physician acted negligently in rendering care, and that such negligence resulted in injury. To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages. Money damages, if awarded, typically take into account both actual economic loss and noneconomic loss, such as pain and suffering.

  5. Non-medical use of methylphenidate among medical students of the University of the Free State

    Directory of Open Access Journals (Sweden)

    Roshini Jain

    2017-01-01

    Full Text Available Background: Faced with demanding training programmes, medical students may be more prone to use methylphenidate for non-medical purposes in order to improve concentration, alertness and academic performance. Aim: The study aimed to investigate the prevalence of the non-medical use of methylphenidate and knowledge of this drug among undergraduate medical students of the University of the Free State. Methods: This was a cross-sectional study. A self-administered, anonymous questionnaire was distributed during lectures to all students in the five year groups of the undergraduate medical programme. Results: Of the 643 undergraduate medical students, 541 completed the questionnaire (response rate: 84.1%. Approximately 11.0% of surveyed students were using methylphenidate at the time of the study, of which the majority (67.9% used it for academic purposes and 70.6% received it from a medical health professional. Less than a third of users had been diagnosed with Attention-Deficit/Hyperactivity Disorder. Methylphenidate users’ median knowledge was greater than non-users, and methylphenidate knowledge increased from first-year and second-year students to third-year to fifth-year students. Median knowledge scores per year group ranged from 52.0% to 60.0%. Conclusion: Methylphenidate is mainly used for non-medical purposes by medical students. Students generally have a low level of knowledge on methylphenidate. Specific information on methylphenidate should be included in lectures on stress management and study methods during the course of the medical curriculum.

  6. Development of diode-pumped medical solid-state lasers

    International Nuclear Information System (INIS)

    Kim, Cheol Jung; Kim, Min Suk

    2000-09-01

    Two thirds of human body consists of water and the absorption of laser by water is an important factor in medical laser treatment. Er medical lasers have been used in the dermatology, ophthalmology and dental treatments due to its highest absorption by water. However, 2.9 um Er laser can not be transmitted through an optical fiber. On the other hand, Tm laser can be transmitted through an fiber and also has very high absorption by water. Therefore, Tm lasers are used in ophthalmology and heart treatment wherein the fiber delivery is very important for the treatment. Until now, mainly lamp-pumped solid-state lasers have been used in medical treatments, but the lamp-pumped solid-state lasers are being replaced with the diode-pumped solid-state lasers because the diode-pumped solid-state lasers are more compact and much easier to maintain. Following this trend, end-pumped Er and side-pumped Tm lasers have been developed and the output power of 1 W was obtained for Er and Tm respectively

  7. Development of diode-pumped medical solid-state lasers

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Cheol Jung; Kim, Min Suk

    2000-09-01

    Two thirds of human body consists of water and the absorption of laser by water is an important factor in medical laser treatment. Er medical lasers have been used in the dermatology, ophthalmology and dental treatments due to its highest absorption by water. However, 2.9 um Er laser can not be transmitted through an optical fiber. On the other hand, Tm laser can be transmitted through an fiber and also has very high absorption by water. Therefore, Tm lasers are used in ophthalmology and heart treatment wherein the fiber delivery is very important for the treatment. Until now, mainly lamp-pumped solid-state lasers have been used in medical treatments, but the lamp-pumped solid-state lasers are being replaced with the diode-pumped solid-state lasers because the diode-pumped solid-state lasers are more compact and much easier to maintain. Following this trend, end-pumped Er and side-pumped Tm lasers have been developed and the output power of 1 W was obtained for Er and Tm respectively.

  8. Motor vehicle injury, mortality, and hospital charges by strength of graduated driver licensing laws in 36 States.

    Science.gov (United States)

    Pressley, Joyce C; Benedicto, Camilla B; Trieu, Lisa; Kendig, Tiffany; Barlow, Barbara

    2009-07-01

    To assess the relation between strength of graduated driver licensing (GDL) laws and motor vehicle (MV) injury burden, this study examined injury mortality, hospitalizations and related charges for 15 year to 17 year olds in 36 states by strength of GDL legislation. Data sources include the CDC's Web-Based Injury Statistics Query and Reporting System (WISQARS) and the 2003 Healthcare Cost and Utilization Kids' Inpatient database (KID). Hospital admissions for injuries in 15 year to 17 year olds (n = 49,520) are unweighted. Injury severity was assessed using ICDMAP-90 and International Classification of Injury Severity Scores. The Insurance Institute for Highway Safety rating system was used to categorize legislative strength: good, fair, marginal/poor, and none. Logistic regression was used to assess independent predictors of MV injury. MV injury accounted for 14.6% of all-cause injury-related hospital admissions with 47.7% classified as drivers. Total MV occupant mortality was 14.6% lower after enactment of GDL with greater improvement observed in the good law category (26.0%). In multivariate models for hospitalized injury, all GDL law categories were protective for MV driver injury in 16 year olds. Compared with whites, black and Hispanic teens were more frequently injured as passengers than drivers. The contribution of MV occupant to all-cause injury-related hospital charges was 16.0% lower in good versus no-GDL categories and 39.5% lower for MV drivers. These findings suggest that the presence of any GDL legislation is associated with a lower burden of MV-related injury and expenditures with the largest differences observed for 16-year-old drivers.

  9. Safety Evaluation Report related to the renewal of the operating license for the research reactor at Michigan State University (Docket No. 50-294)

    International Nuclear Information System (INIS)

    1984-08-01

    This Safety Evaluation Report for the application filed by the Michigan State University (MSU) for a renewal of operating license number R-114 to continue to operate the TRIGA Mark I research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the Michigan State University and is located on the campus of Michigan State University in East Lansing, Ingham County, Michigan. The staff concludes that the TRIGA reactor facility can continue to be operated by MSU without endangering the health and safety of the public

  10. Flexible licensing

    Directory of Open Access Journals (Sweden)

    Martyn Jansen

    2012-07-01

    Full Text Available The case is presented for a more flexible approach to licensing online library resources. Today's distributed education environment creates pressure for UK higher and further education institutions (HEI/FEIs to form partnerships and to develop educational products and roll them out across the globe. Online library resources are a key component of distributed education and yet existing licensing agreements struggle to keep pace with the increasing range of users and purposes for which they are required. This article describes the process of developing a flexible approach to licensing and proposes a new model licence for online library resources which has the adaptability needed in this new global educational landscape. These ideas have been presented and discussed at various workshops across Eduserv's and JISC Collections' higher education and publisher communities, and further consultation is ongoing.

  11. Predicting risk for disciplinary action by a state medical board.

    Science.gov (United States)

    Cardarelli, Roberto; Licciardone, John C; Ramirez, Gilbert

    2004-01-01

    Disciplinary actions taken against physicians in the United States have been increasing over the last decade, yet the factors that place physicians at risk have not been well identified. The objective of this study is to identify predictors of physician disciplinary action. This case-control study used data from the Texas State Board of Medical Examiners from January 1989 through December 1998. Characteristics of disciplined physicians and predictors of disciplinary action for all violations and by type of violation were the main outcome descriptors. Years in practice, black physicians, and osteopathic graduates were positive predictors for disciplinary action. In contrast, female physicians, international medical graduates, and Hispanic and Asian physicians were less likely to receive disciplinary action compared with male, US allopathic, and white physicians, respectively. Most specialists, except psychiatrists and obstetrician-gynecologists, were less likely to be disciplined than were family practitioners, whereas general practitioners were more likely to be disciplined. More studies are needed to corroborate these findings.

  12. Tracking progress in teenage driver crash risk in the United States since the advent of graduated driver licensing programs.

    Science.gov (United States)

    McCartt, Anne T; Teoh, Eric R

    2015-06-01

    This study examined U.S. teenagers' crash rates since 1996, when the first graduated driver licensing (GDL) program in the United State was implemented. Passenger vehicle driver crash involvement rates for 16-19 and 30-59 (middle-aged) year-olds were examined, using data from the Fatality Analysis Reporting System, National Automotive Sampling System General Estimates System, Census Bureau, and National Household Travel Surveys. Per capita fatal and police-reported crash rates in 2012 were lower for 16year-olds than for middle-aged drivers but older teenagers' rates were higher. Mileage-based fatal and police-reported crash rates in 2008 were higher for teenagers than for middle-aged drivers and higher for 16-17year-olds than for older teenagers. In 1996-2012, teenagers' per capita fatal and police-reported crash rates declined sharply, especially for 16-17year-olds, and more so than for middle-aged drivers. Substantial declines also occurred in teenagers' mileage-based fatal and police-reported crash rates from 1995-96 to 2008, generally more so than for middle-aged drivers. Regarding factors in fatal crashes in 1996 and 2012, proportions of young teenagers' crashes occurring at night and with multiple teenage passengers declined, more so than among older teenagers and middle-aged drivers. The proportion of fatally injured drivers who had been drinking declined for teenagers but changed little for middle-aged drivers. Improvements were not apparent in rates of driver errors or speeding among teenage drivers in fatal crashes. Teenage drivers' crash risk dropped during the period of implementation of GDL laws, especially fatal crash types targeted by GDL. However, teenagers' crash risk remains high, and important crash factors remain unaddressed by GDL. Although this study was not designed to examine the role of GDL, the results are consistent with the increased presence of such laws. More gains are achievable if states strengthen their laws. Copyright © 2015

  13. The current state of basic medical education in Israel: implications for a new medical school.

    Science.gov (United States)

    Reis, Shmuel; Borkan, Jeffrey M; Weingarten, Michael

    2009-11-01

    The recent government decision to establish a new medical school, the fifth in Israel, is an opportune moment to reflect on the state of Basic Medical Education (BME) in the country and globally. It provides a rare opportunity for planning an educational agenda tailored to local needs. This article moves from a description of the context of Israeli health care and the medical education system to a short overview of two existing Israeli medical schools where reforms have recently taken place. This is followed by an assessment of Israeli BME and an effort to use the insights from this assessment to inform the fifth medical school blueprint. The fifth medical school presents an opportunity for further curricular reforms and educational innovations. Reforms and innovations include: fostering self-directed professional development methods; emphasis on teaching in the community; use of appropriate educational technology; an emphasis on patient safety and simulation training; promoting the humanities in medicine; and finally the accountability to the community that the graduates will serve.

  14. State-level medical and absenteeism cost of asthma in the United States.

    Science.gov (United States)

    Nurmagambetov, Tursynbek; Khavjou, Olga; Murphy, Louise; Orenstein, Diane

    2017-05-01

    For medically treated asthma, we estimated prevalence, medical and absenteeism costs, and projected medical costs from 2015 to 2020 for the entire population and separately for children in the 50 US states and District of Columbia (DC) using the most recently available data. We used multiple data sources, including the Medical Expenditure Panel Survey, U.S. Census Bureau, Kaiser Family Foundation, Medical Statistical Information System, and Current Population Survey. We used a two-part regression model to estimate annual medical costs of asthma and a negative binomial model to estimate annual school and work days missed due to asthma. Per capita medical costs of asthma ranged from $1,860 (Mississippi) to $2,514 (Michigan). Total medical costs of asthma ranged from $60.7 million (Wyoming) to $3.4 billion (California). Medicaid costs ranged from $4.1 million (Wyoming) to $566.8 million (California), Medicare from $5.9 million (DC) to $446.6 million (California), and costs paid by private insurers ranged from $27.2 million (DC) to $1.4 billion (California). Total annual school and work days lost due to asthma ranged from 22.4 thousand (Wyoming) to 1.5 million days (California) and absenteeism costs ranged from $4.4 million (Wyoming) to $345 million (California). Projected increase in medical costs from 2015 to 2020 ranged from 9% (DC) to 34% (Arizona). Medical and absenteeism costs of asthma represent a significant economic burden for states and these costs are expected to rise. Our study results emphasize the urgency for strategies to strengthen state level efforts to prevent and control asthma attacks.

  15. NRC analysis of the environmental impacts and licensing policies for expanded spent fuel storage in the United States

    International Nuclear Information System (INIS)

    Smith, C.V. Jr.

    1978-01-01

    This paper reviews the findings of the U.S. environmental impact studies on spent fuel storage to the year 2000, addresses design criteria for independent spent fuel storage installations and expresses the position of the NRC for licensing expanded spent fuel storage capabilities until such time as final solutions are established

  16. NRC Analysis of the environmental impacts and licensing policies for expanded spent fuel storage in the United States

    International Nuclear Information System (INIS)

    Clifford, V.S.

    1978-01-01

    The findings of the U.S. environmental impact studies on spent fuel storage to the year 2000 are reviewed, the design criteria for independent spent fuel storage installations are addressed and the position of the NRC for licensing expanded spent fuel storage capabilities, until such time as final solutions are established, is expressed. (author)

  17. 75 FR 23820 - Notice of Docketing of Amendment Request for Materials License No. SNM-2506; Northern States...

    Science.gov (United States)

    2010-05-04

    ... INFORMATION CONTACT: Pamela Longmire, Ph.D., Project Manager, Licensing Branch, Division of Spent Fuel Storage... Generating Plant (PINGP), Unit Nos. 1 and 2, site in Goodhue County, Minnesota. The TN-40 cask is currently..., higher burnup spent fuel used in the PINGP reactor as well as associated changes to the ISFSI's technical...

  18. List of Nuclear Materials Licensing Actions Received

    Data.gov (United States)

    Nuclear Regulatory Commission — A catalog of all Materials Licensing Actions received for review. The catalog lists the name of the entity submitting the license application, their city and state,...

  19. Trends in Cigarette Advertising, Price-Reducing Promotions, and Policy Compliance in New York State Licensed Tobacco Retailers, 2004 to 2015.

    Science.gov (United States)

    Watson, Kimberly A; Gammon, Doris G; Loomis, Brett R; Juster, Harlan R; Anker, Elizabeth

    2018-01-01

    To describe the presence of licensed tobacco retailers (LTRs), cigarette advertisements, price-reducing promotions, and compliance with tobacco control policies in New York State from 2004 to 2015 and to discuss implications and lessons learned from 11 years of experience conducting LTR surveys. Annual surveys of tobacco advertising from cross-sectional, stratified random samples of LTRs in New York State from 2004 to 2015 were conducted by professional data collectors. Data for 2013 were unavailable as the survey was not fielded in that year. New York State. Licensed tobacco retailers, which are stores licensed to sell tobacco in the state of New York. Between 3.6% (n = 800) and 19.7% (n = 3945) of all LTRs were sampled annually. The presence and number of cigarette advertisements and the presence of price-reducing promotions, required age-of-sale signage, and self-service tobacco displays were documented. We tested for significant differences between 2014 and 2015 and significant trends overall and by outlet type. We used logistic regression for binary outcomes and Poisson regression for count variables. The number of LTRs in New York State decreased 22.9% from 2004 (n = 25 740) to 2015 (n = 19 855). The prevalence and number of cigarette advertisements and the prevalence of cigarette price-reducing promotions decreased significantly over time. Compliance with posting required age-of-sale signs increased significantly from 2004 to 2015 and from 2014 to 2015. Compliance with the ban on self-service tobacco displays was consistently near 100%. The tobacco retail environment in New York State improved substantially from 2004 to 2015. The implications of these findings for youth and adult smoking and the associated social costs are unknown; however, decreases in pro-tobacco marketing, decreases in the number of LTRs, and improvements in compliance are likely to have positive impacts on youth and adult smoking outcomes, such as reduced initiation and increased

  20. Safety evaluation report related to the renewal of the operating license for the Washington State University TRIGA reactor. Docket No. 50-27

    International Nuclear Information System (INIS)

    1982-05-01

    This Safety Evaluation Report for the application filed by the Washington State University (WSU) for a renewal of operating license number R-76 to continue to operate a research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the Washington State University and is located on the WSU campus in Pullman, Whitman County, Washington. The staff concludes that the TRIGA reactor facility can continue to be operated by WSU without endangering the health and safety of the public

  1. Licensing issues

    International Nuclear Information System (INIS)

    Roberts, J.P.; Desell, L.J.; Birch, M.L.; Berkowitz, L.; Bader, J.F.

    1992-01-01

    To provide guidance for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program, the Nuclear Regulatory Commission (NRC) has issued a draft regulatory guide on the Format and Content for the License Application for the High-Level Waste Repository (FCRG). To facilitate the development of the FCRG, NRC suggested that DOE use the draft guide as the basis for preparing an annotated outline for a license application. DOE is doing so using an iterative process called the Annotated Outline Initiative. DOE;s use of the Initiative will assist in achieving the desired incorporation of actual experience in the FCRG, contribute to the development of shared interpretation and understanding of NRC regulations, and provide other important programmatic benefits described in this paper

  2. Assisted Living Facilities, This file contains the name, address, contact and some licensing information for the Assisted Living Facilites for the State of Maryland., Published in 2010, Smaller than 1:100000 scale, Maryland Department of Health and Mental Hygiene.

    Data.gov (United States)

    NSGIC State | GIS Inventory — Assisted Living Facilities dataset current as of 2010. This file contains the name, address, contact and some licensing information for the Assisted Living Facilites...

  3. Performance assessment and licensing issues for United States commercial near-surface low-level radioactive waste disposal facilities

    International Nuclear Information System (INIS)

    Birk, S.M.

    1997-10-01

    The final objective of performance assessment for a near-surface LLW disposal facility is to demonstrate that potential radiological impacts for each of the human exposure pathways will not violate applicable standards. This involves determining potential pathways and specific receptor locations for human exposure to radionuclides; developing appropriate scenarios for each of the institutional phases of a disposal facility; and maintaining quality assurance and control of all data, computer codes, and documentation. The results of a performance assessment should be used to demonstrate that the expected impacts are expected to be less than the applicable standards. The results should not be used to try to predict the actual impact. This is an important distinction that results from the uncertainties inherent in performance assessment calculations. The paper discusses performance objectives; performance assessment phases; scenario selection; mathematical modeling and computer programs; final results of performance assessments submitted for license application; institutional control period; licensing issues; and related research and development activities

  4. A state-level analysis of the economic impacts of medical tourism in Malaysia

    OpenAIRE

    Klijs, J.; Ormond, M.E.; Mainil, T.; Peerlings, J.H.M.; Heijman, W.J.M.

    2016-01-01

    In Malaysia, a country that ranks among the world's most recognised medical tourism destinations, medical tourism is identified as a potential economic growth engine for both medical and non-medical sectors. A state-level analysis of economic impacts is important, given differences between states in economic profiles and numbers, origins, and expenditure of medical tourists. We applied input–output (I–O) analysis, based on state-specific I–O data and disaggregated foreign patient data. The an...

  5. Pediatric marijuana exposures in a medical marijuana state.

    Science.gov (United States)

    Wang, George Sam; Roosevelt, Genie; Heard, Kennon

    2013-07-01

    An increasing number of states are decriminalizing the use of medical marijuana, and the effect on the pediatric population has not been evaluated. To compare the proportion of marijuana ingestions by young children who sought care at a children's hospital in Colorado before and after modification of drug enforcement laws in October 2009 regarding medical marijuana possession. Retrospective cohort study from January 1, 2005, through December 31, 2011. Tertiary-care children's hospital emergency department in Colorado. A total of 1378 patients younger than 12 years evaluated for unintentional ingestions: 790 patients before September 30, 2009, and 588 patients after October 1, 2009. Marijuana ingestion. Marijuana exposure visits, marijuana source, symptoms, and patient disposition. The proportion of ingestion visits in patients younger than 12 years (age range, 8 months to 12 years)that were related to marijuana exposure increased after September 30, 2009, from 0 of 790 (0%; 95% CI, 0%-0.6%) to 14 of 588 (2.4%; 95% CI, 1.4%-4.0%) (P patients had lethargy, 1 had ataxia, and 1 had respiratory insufficiency. Eight patients were admitted, 2 to the intensive care unit. Eight of the 14 cases involved medical marijuana, and 7 of these exposures were from food products. We found a new appearance of unintentional marijuana ingestions by young children after modification of drug enforcement laws for marijuana possession in Colorado. The consequences of unintentional marijuana exposure in children should be part of the ongoing debate on legalizing marijuana.

  6. A state-level analysis of the economic impacts of medical tourism in Malaysia

    NARCIS (Netherlands)

    Klijs, J.; Ormond, M.E.; Mainil, T.; Peerlings, J.H.M.; Heijman, W.J.M.

    2016-01-01

    In Malaysia, a country that ranks among the world's most recognised medical tourism destinations, medical tourism is identified as a potential economic growth engine for both medical and non-medical sectors. A state-level analysis of economic impacts is important, given differences between states in

  7. A Review of State Licensing Regulations to Determine Alignment with Best Practices to Prevent Human Norovirus Infections in Child-Care Centers.

    Science.gov (United States)

    Leone, Cortney M; Jaykus, Lee-Ann; Cates, Sheryl M; Fraser, Angela M

    2016-01-01

    Close, frequent contact between children and care providers in child-care centers presents many opportunities to spread human noroviruses. We compared state licensing regulations for child-care centers with national guidelines written to prevent human noroviruses. We reviewed child-care licensing regulations for all 50 U.S. states and the District of Columbia in effect in June 2015 to determine if these regulations fully, partially, or did not address 14 prevention practices in four topic areas: (1) hand hygiene, (2) exclusion of ill people, (3) environmental sanitation, and (4) diapering. Approximately two-thirds (8.9) of the 14 practices across all state regulations were partially or fully addressed, with few (2.6) fully addressed. Practices related to exclusion of ill people and diapering were fully addressed most often, while practices related to hand hygiene and environmental sanitation were fully addressed least often. Regulations based on guidelines for best practices are one way to prevent the spread of human noroviruses in child-care facilities, if the regulations are enforced. Our findings show that, in mid-2015, many state child-care regulations did not fully address these guidelines, suggesting the need to review these regulations to be sure they are based on best practices.

  8. Observations of the role of science in the United States medical cannabis state policies: Lessons learnt.

    Science.gov (United States)

    Grbic, Jelica; Goddard, Perilou; Ryder, David

    2017-04-01

    Clinical trials have shown cannabis to be effective in the treatment of some medical conditions and there is mounting public and political pressure to enact laws enabling the use of cannabis for medicinal purposes. To date, 28 United States (U.S.) states and the District of Columbia have enacted medical cannabis laws. This study sought to identify the main issues pertaining to the development of medical cannabis laws in the U.S, including the role of scientific evidence. Data were collected from three groups of participants: government officials, lobbyists and medical professionals involved in the medical cannabis debate in five selected states in the U.S.; researchers from the same five states conducting funded research in the alcohol and other drugs field; and members of the International Society for the Study of Drug Policy. The data were analysed using thematic analysis. Six major themes emerged in relation to the factors influencing policy: scientific evidence plays a limited role in the development of policy; the available research is limited and mixed; there is a need for clearer communication and active dissemination of evidence to policy makers; researchers need to consider what research is likely to impact on policy; scientific evidence is not a major factor in policy development; and there is a need to consider evidence within a political context. Researchers need to be aware of the political context in which medical cannabis laws are or are not enacted and consider ways in which research findings can achieve a higher profile within this context. Copyright © 2016. Published by Elsevier B.V.

  9. The State of Emergency Medical Services (EMS) Systems in Africa.

    Science.gov (United States)

    Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A

    2017-06-01

    Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet. The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each). Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (<9.0%) of Africans have coverage by an EMS system. Most systems were predominantly BLS, government operated, and fee-for-service. Mould-Millman NK , Dixon JM , Sefa N , Yancey A , Hollong BG , Hagahmed M , Ginde AA , Wallis LA . The state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

  10. A progressive three-phase innovation to medical education in the United States.

    Science.gov (United States)

    Pfeifer, Cory M

    2018-12-01

    The practice of medicine has changed greatly over the past 100 years, yet the structure of undergraduate medical education has evolved very little. Many schools have modified their curricula to incorporate problem-based learning and organ systems-based curricula, but few schools have adequately addressed rising tuition costs. Undergraduate medical education has become cost-prohibitive for students interested in primary care. In the meanwhile, the concept of a separate dedicated intern year is outdated and mired in waste despite remaining a requirement for several hospital-based and surgical specialties. Described here is an innovative approach to medical education which reduces tuition costs and maximizes efficiency, based on principals already employed by several schools. This integrated curriculum, first suggested by the author in 2010, keeps the current USMLE system in place, exposes medical students to patient care earlier, expands and incorporates the 'intern' year into a four-year medical training program, provides more time for students to decide on a specialty, and allows residency programs to acquire fully-licensed practitioners with greater clinical experience than the status quo. MCAT: Medical college admission test; USMLE: US medical licensing examination.

  11. Changes in the 'medical research' licensing procedure under the German Radiation Protection Ordinance; Neuerungen im Genehmigungsverfahren 'Medizinische Forschung' gemaess Roentgen- und Strahlenschutzverordnung

    Energy Technology Data Exchange (ETDEWEB)

    Habeck, M.; Minkov, V.; Griebel, J.; Brix, G. [Bundesamt fuer Strahlenschutz (BfS), Oberschleissheim-Neuherberg (Germany). Fachbereich Strahlenschutz und Gesundheit; Epsch, R.; Langer, M. [Deutsche Roentgengesellschaft e.V. (DRG), Berlin (Germany). Klinische Studienkoordination

    2012-06-15

    This publication outlines the 'medical research' licensing procedure as specified in the amendment of the German Radiation Protection Ordinance of November 1, 2011. The general licensing requirements for the use of radiation have not been changed by the amendment. Three so-called use restrictions (i.e., dose limits of 10 mSv and 20 mSv, age limit of 50 years) have been modified. They will only apply to healthy volunteers in the future. In addition, there are considerable simplifications with respect to applications and licensing procedures of the Federal Office for Radiation Protection (Bundesamt fuer Strahlenschutz, BfS) regarding the use of radiation in the newly introduced 'accompanying diagnostics' ('Begleitdiagnostik') case group. The newly established, independent panel of experts at the German Radiological Society (Deutsche Roentgengesellschaft, DRG) may provide essential support to principal investigators, qualified physicians and sponsors for differentiating between 'medical research' and 'health care', the latter not being subject to licensing. An expert statement will be issued by the DRG within four weeks of an inquiry. This consulting service is subject to confidentiality, and is free of charge for inquirers and without any commitment. (orig.)

  12. 22 CFR 120.20 - License.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false License. 120.20 Section 120.20 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS PURPOSE AND DEFINITIONS § 120.20 License. License means a document bearing the word “license” issued by the Directorate of Defense Trade...

  13. 10 CFR 781.51 - Nonexclusive licenses.

    Science.gov (United States)

    2010-01-01

    ... corporate structure of which licensee is a part, if any. However, the license shall not be assignable or... license upon the policies of the United States Government; (3) The effect of the license upon domestic and... extent of U.S. Government contribution to the development of the invention; (iv) The degree of...

  14. Self-medication of mood and anxiety disorders with marijuana: Higher in states with medical marijuana laws.

    Science.gov (United States)

    Sarvet, Aaron L; Wall, Melanie M; Keyes, Katherine M; Olfson, Mark; Cerdá, Magdalena; Hasin, Deborah S

    2018-05-01

    Self-medication with drugs or alcohol is commonly reported among adults with mood or anxiety disorders, and increases the risk of developing substance use disorders. Medical marijuana laws (MML) may be associated with greater acceptance of the therapeutic value of marijuana, leading individuals to self-medicate. The study utilized data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005). Participants were sampled from households in the general population and included adults with a mood or anxiety disorder in the past 12 months (n = 7418), and the subset of those who used marijuana and no other drug (n = 314). Weighted logistic regression models predicted the prevalence of self-medication with drugs in U.S. states with and without MML, adjusting for individual and state-level covariates. As a negative control, analyses were repeated for self-medication with alcohol. Overall, self-medication with drugs was 3.73 percentage points higher (95% confidence interval [CI]: 0.93-6.53) among those living in MML states (p = 0.01). For the subpopulation that only used marijuana, self-medication with drugs was 21.22 percentage points higher (95% CI: 3.91-38.53) among those living in MML states (p = 0.02). In contrast, self-medication with alcohol had nearly identical prevalence in MML and non-MML states, overall and for drinkers. Among adults with mood or anxiety disorders, living in a medical marijuana law state is associated with self-medication with marijuana. While additional research is needed to determine the reasons for this association, clinical screening for self-medication with marijuana may be particularly important in states with medical marijuana laws. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Concomitant use of an oral live pentavalent human-bovine reassortant rotavirus vaccine with licensed parenteral pediatric vaccines in the United States.

    Science.gov (United States)

    Rodriguez, Zoe M; Goveia, Michelle G; Stek, Jon E; Dallas, Michael J; Boslego, John W; DiNubile, Mark J; Heaton, Penny M

    2007-03-01

    A live pentavalent rotavirus vaccine (PRV) containing 5 human-bovine (WC3) reassortants expressing human serotypes G1, G2, G3, G4 and P1A[8] was evaluated in a blinded, placebo-controlled study. Possible interactions between PRV and concomitantly administered licensed pediatric vaccines were investigated in a United States-based nested substudy (Concomitant Use Study) of the Rotavirus Efficacy and Safety Trial. From 2002 to 2003, healthy infants approximately 6 to 12 weeks of age at entry were randomized to receive either 3 oral doses of PRV or placebo at 4- to 10-week intervals. Subjects were also to receive combined Haemophilus influenzae type b and hepatitis B vaccine (2 doses), diphtheria and tetanus toxoids and acellular pertussis vaccine (3 doses), inactivated poliovirus vaccine (2 doses) and pneumococcal conjugate vaccine (3 doses) on the same day; oral poliovirus vaccine was not administered. Immunogenicity was assessed by measuring antibody responses to PRV and antigens contained in the licensed vaccines. Cases of rotavirus gastroenteritis were defined by forceful vomiting and/or -3 watery or looser-than-normal stools within a 24-hour period, and detection of rotavirus antigen in the stool. Safety was assessed by reporting of adverse events using diary cards. The Concomitant Use Study enrolled 662 subjects in the PRV group and 696 subjects in the placebo group. For the 17 antigens in the concomitantly administered vaccines, antibody responses were similar in PRV and placebo recipients, except for moderately diminished antibody responses to the pertactin component of pertussis vaccine. Efficacy of PRV against rotavirus gastroenteritis of any severity was 89.5% (95% CI = 26.5-99.8%). PRV was generally well tolerated when given concomitantly with the prespecified vaccines. In this study, antibody responses to the concomitantly administered vaccines were generally similar in PRV and placebo recipients. PRV was efficacious and well tolerated when given

  16. Contending medical ideologies and state formation: the nineteenth-century origins of medical pluralism in contemporary Colombia.

    Science.gov (United States)

    Sowell, David

    2003-01-01

    This article addresses the encounter between contending medical ideologies in nineteenth-century Colombia. The first era of medical pluralism, in colonial Latin America, developed from the imposition of Hispanic medicine on existing indigenous medical systems through an imperial structure. This produced a "colonial medical spectrum" incorporating various medical ideologies that came under attack by practitioners of scientific medicine in the 1800s. As scientific physicians gained privileged access to state resources, they undertook partially successful campaigns to deny Hispanic, homeopathic, and other medical systems the right to be practiced. As the state authorized scientific medicine, other practices became "popularized," thereby laying the foundation for the medical pluralism of contemporary Colombia that juxtaposes "academic" and "traditional" medicines.

  17. MEDICAL ETHICS EDUCATION IN TURKEY; STATE OF PLAY AND CHALLENGES.

    Science.gov (United States)

    Ekmekçi, Perihan Elif

    Medical ethics can be traced back to Hippocratic Oath in antiquity. Last decade witnessed improvements in science and technology which attracted attention to the ethical impacts of the innovations in medicine. The need to combine medical innovations with a preservation of human values and to cultivate ethical competencies required by professionalism conceived medical ethics education in various levels in medical schools. Despite the diversities regarding teaching hours, methodology and content of the courses, medical ethics became a fundamental part of medical education around the world. In Turkey medical ethics education is given both in undergraduate and postgraduate levels. The high increase in the number of medical schools and shortfall of instructors who have medical ethics as their primary academic focus creates a big challenge in medical ethics education in both levels. Currently there are 89 medical schools in Turkey and only six medical schools are giving postgraduate medical ethics education. In 2010 only 33 of all medical schools could establish a separate department dedicated to medical ethics. There are no medical ethics courses embedded in residency programs. The quality and standardization of undergraduate medical ethics education has started but there are no initiatives to do so in postgraduate level.

  18. The Monticello license renewal project

    International Nuclear Information System (INIS)

    Clauss, J.M.; Harrison, D.L.; Pickens, T.A.

    1993-01-01

    Today, 111 nuclear power plants provide over 20 percent of the electrical energy generated in the United States. The operating license of the oldest operating plant will expire in 2003, one-third of the existing operating licenses will expire by 2010 and the newest plant's operating license will expire in 2033. The National Energy Strategy (NES) prepared by the Department of Energy (DOE) assumes that 70 percent of the current operating plants will continue to operate beyond their current license expiration. Power from current operating plants can assist in ensuring an adequate, diverse, and environmentally acceptable energy supply for economic growth and improved U.S. competitiveness. In order to preserve this energy resource, three major tasks must be successfully completed: (1) establishment of regulations, technical standards, and procedures for the preparation and review of License Renewal Applications (LRAs); (2) development of technical criteria and bases for monitoring, refurbishing or replacing plant equipment; and (3) demonstration of the regulatory process by a plant obtaining a renewed license. Since 1986, the DOE has been working with the nuclear industry and the Nuclear Regulatory Commission (NRC) to establish and demonstrate the option to extend the life of a nuclear power plant by renewing the operating license. The Monticello Lead Plant demonstration project was initiated in September 1988, following the Pilot Plant studies. This paper is primarily focused on the status and insights gained from the Northern States Power Company (NSP) Monticello Lead Plant demonstration project. The following information is included: (1) Current Status - Monticello License Renewal Application; (2) Economic Analysis; (3) License Renewal Regulatory Uncertainty Issues; (4) Key Decisions; (5) Management Structure; (6) Technical and Licensing Perspective; (7) NRC Interactions; (8) Summary

  19. Safety-evaluation report related to the renewal of the operating license for the research reactor at the Iowa State University (Docket No. 50-116)

    International Nuclear Information System (INIS)

    1983-09-01

    This Safety Evaluation Report for the application filed by the Iowa State University (ISU) for a renewal of the Class 104 Operating License R-59 to continue to operate its Argonaut-type research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the Iowa State University, and is located on the ISU campus in Ames, Story County, Iowa. The staff concludes that the reactor facility can continue to be operated by ISU without endangering the health and safety of the public. The principal matters reviewed are: design, testing, and performance of the reactor components and systems; the expected consequences of credible accidents; the licensee's management organization; the method used for the control of radiological effluents; the licensee's technical specifications; financial data and information; the physical protection program; procedures for training reactor operators; and emergency plans. 11 references, 15 figures, 13 tables

  20. 42 CFR 440.50 - Physicians' services and medical and surgical services of a dentist.

    Science.gov (United States)

    2010-10-01

    ... or osteopathy as defined by State law; and (2) By or under the personal supervision of an individual licensed under State law to practice medicine or osteopathy. (b) “Medical and surgical services of a...

  1. South African medical schools: Current state of selection criteria and ...

    African Journals Online (AJOL)

    Selection of medical students at South African (SA) medical schools must promote ... groups, while ensuring optimal student throughput and success, and training future ... In keeping = with international practices, a variety of academic and ...

  2. Qualification, training, licensing/authorization and retraining of operating personnel in nuclear power plants. Some requirements and practices commonly shared in the European Community Member States

    International Nuclear Information System (INIS)

    Pele, J.P.

    1987-01-01

    At the end of the fifties a treaty was signed instituting between six countries of the European Community for Atomic Energy, or in brief, Euratom. This treaty, in addition to the Common Market Treaty and the Coal and Steel one, constitutes the legal frame of the European Community which, at present, comprises 12 Member States. A commission, the so-called Commission of the European Communities (or in brief CEC) has to implement the provisions laid down in the treaties. Qualification, training, licensing and re-training of operating personnel have been the subjects of an in-depth exchange of views and information in the frame of the work conducted by the Commission. The evaluation of the regulations and practices in countries of the EC and some other countries having a large nuclear energy program, has led to the identification of some generally valid concepts. This synthesis, made with the assistance of a consultant, is now published under the form of an EUR report (EUR 10981). The main topics addressed within this report are the following: shift staffing and staffing of the control room, personnel selection, qualifications necessary for recruitment, training and retraining, and licensing/authorization

  3. Medical aspects of quality assurance in the United States

    International Nuclear Information System (INIS)

    Hanks, G.E.

    1997-01-01

    Three powerful national programs have been developed, and their acceptance and utilization in the United States have been accelerated by the recent development of managed competition. The first program was a model quality assurance program for day to day use in an individual radiation oncology facility. In addition to maintaining the physical aspects of the department, the medical side includes indicator items in patient evaluation and treatment and other measures that are periodically monitored. The entire process is comprehensive and is accepted by the Joint Commission on Hospital Accreditation as being satisfactory evidence of ongoing quality assurance and quality improvement. The second program was the development of a set of standards for radiation oncology in the United States. These standards were developed in the past and have recently been expanded into a more comprehensive document that describes the appropriate performance by this specialty. The third program was a Practice Accreditation program. The Practice Accreditation program is an on-site review of structure and processes of patient care by a radiation oncologist and data manager. This intense on-site review generated data that is then compared to similar facilities and to national averages to judge the adequacy of patient management in the facility. We have observed recently that various managed care programs require this practice accreditation before their patients can be treated in contracting facilities. Lastly, the Council of the American College of Radiology has made some extremely positive statements in support of improving radiation oncology practice, and the positive effects of these council resolutions can be clearly shown on the practice

  4. Prevalência de disfonia em professores do ensino público estadual afastados de sala de aula Prevalence of vocal dysfunction in teachers from the state education, licensed from classroom

    Directory of Open Access Journals (Sweden)

    Lucia Cristina Fernandes Antunes Provenzano

    2010-02-01

    Full Text Available OBJETIVO: identificar a prevalência da disfonia, gerando afastamento de sala de aula, em docentes do Ensino Médio da Rede Estadual de Educação. MÉTODOS: foi realizado um levantamento exploratório de prontuários médicos de professores afastados de sala de aula, durante os anos de 2005 e 2006, registrados na Superintendência Central de Perícias Médicas e Saúde Ocupacional do Estado do Rio de Janeiro. De uma amostra total de 554 professores lecionando durante o período analisado, foram pesquisados 130 prontuários de docentes licenciados por diversos diagnósticos, procurando-se identificar os afastamentos com diagnóstico médico de disfonia. RESULTADOS: evidenciou-se que, apesar das elevadas taxas de prevalência de sinais e sintomas vocais negativos entre os professores relatados em outras pesquisas, apenas 6,9% afastaram-se de sala de aula por disfonia. Os resultados possibilitam, ainda, reflexões acerca da relação existente entre voz, corpo, respiração e emoção, no contexto da docência. CONCLUSÃO: conclui-se que mesmo a disfonia sendo um problema frequente no trabalho docente, pouco se conhece sobre os dados oficiais de professores afastados de sala de aula por esse comprometimento. Torna-se necessário maior número de pesquisas para que os responsáveis por decisões políticas, sejam alertados e sensibilizados quanto à importância do assunto, em termos sociais e econômicos para o País. Ressalta-se a necessidade de que o trabalho fonoaudiológico desenvolvido com os professores tenha cunho transdisciplinar, e que, de forma intersetorial e harmônica, programas e políticas de prevenção e promoção da saúde vocal possam ser oferecidos à classe docente.PURPOSE: to identify the prevalence of the vocal dysfunction which caused medical leave among high school teachers from the "State Education System". METHODS: a survey was conducted analyzing school teachers' medical reports who were licensed for medical leave in

  5. 2015 Business Licenses

    Data.gov (United States)

    City of Jackson, Mississippi — This data displays all business license information for the year of 2015. This information details license classifications and status. This information will updated...

  6. Profesional medical library education in the United States in relation to the qualifications of medical library manpower in Ohio.

    Science.gov (United States)

    Rees, A M; Rothenberg, L; Denison, B

    1968-10-01

    THE PRESENT SYSTEM OF EDUCATION FOR MEDICAL LIBRARY PRACTICE IN THE UNITED STATES CONSISTS OF FOUR MAJOR COMPONENTS: graduate degree programs in library science with specialization in medical librarianship; graduate degree programs in library science with no such specialization; postgraduate internships in medical libraries; continuing education programs. Data are presented illustrating the flow of graduates along these several educational pathways into medical library practice.The relevance of these educational components to the current medical library work force is discussed with reference to manpower data compiled for Ohio. The total number of medical library personnel in Ohio in 1968 is 316. Of this total, only forty-two (approximately 14 percent) have received any formal library training. Seventy persons have only a high school education. From these figures, it is concluded that there is no standard or essential qualification which is universally accepted as educational preparation for work in medical libraries; that the comparative sophistication of the educational programs in medical librarianship has yet to be reflected widely in general medical library practice; that an increasingly large number of non-professional or ancillary personnel are being, and will continue to be, utilized in medical libraries; that large numbers of untrained persons have sole responsibility for medical libraries; and that appropriate educational programs will have to be designed specifically for this type of personnel.

  7. The United States Army Medical Department Journal, April - June 2008

    Science.gov (United States)

    2008-06-01

    Amazon community at Iquitos, Stancil42 (Naval Medical Research Center Detachment, Peru ) received a grant to optimize strategies for preventing the breeding...Detachment, Lima, Peru ; Naval Medical Research Unit-2, Jakarta, Indonesia; and the Naval Medical Research Unit 3, Cairo, Egypt. These resources...the soil beneath tents and camps. In an effort to prevent sand flies breeding in rodent burrows, the Genesis Company (Wellington, Colorado) won an

  8. Means for improving state participation in the siting, licensing, and development of Federal nuclear waste facilities. A report to Congress

    International Nuclear Information System (INIS)

    1979-03-01

    This report is based on the premise that State involvement in any national nuclear waste management program is important in making the program work. The following issues are discussed: national planning process, technical review capability, state participation in the Federal processes, grant programs, transportation, and consultation and concurrence. Recommendations are given

  9. Association Between State Medical Malpractice Environment and Postoperative Outcomes in the United States.

    Science.gov (United States)

    Minami, Christina A; Sheils, Catherine R; Pavey, Emily; Chung, Jeanette W; Stulberg, Jonah J; Odell, David D; Yang, Anthony D; Bentrem, David J; Bilimoria, Karl Y

    2017-03-01

    The US medical malpractice system assumes that the threat of liability should deter negligence, but it is unclear whether malpractice environment affects health care quality. We sought to explore the association between state malpractice environment and postoperative complication rates. This observational study included Medicare fee-for-service beneficiaries undergoing one of the following operations in 2010: colorectal, lung, esophageal, or pancreatic resection, total knee arthroplasty, craniotomy, gastric bypass, abdominal aortic aneurysm repair, coronary artery bypass grafting, or cystectomy. The state-specific malpractice environment was measured by 2010 medical malpractice insurance premiums, state average award size, paid malpractice claims/100 physicians, and a composite malpractice measure. Outcomes of interest included 30-day readmission, mortality, and postoperative complications (eg sepsis, myocardial infarction [MI], pneumonia). Using Medicare administrative claims data, associations between malpractice environment and postoperative outcomes were estimated using hierarchical logistic regression models with hospital random-intercepts. Measures of malpractice environment did not have significant, consistent associations with postoperative outcomes. No individual tort reform law was consistently associated with improved postoperative outcomes. Higher-risk state malpractice environment, based on the composite measure, was associated with higher likelihood of sepsis (odds ratio [OR] 1.22; 95% CI 1.07 to 1.39), MI (OR 1.14; 95% CI 1.06 to 1.23), pneumonia (OR 1.09; 95% CI 1.03 to 1.16), acute renal failure (OR 1.15; 95% CI 1.08 to 1.22), deep vein thrombosis/pulmonary embolism (OR 1.22; 95% CI 1.13 to 1.32), and gastrointestinal bleed (OR 1.18; 95% CI 1.08 to 1.30). Higher risk malpractice environments were not consistently associated with a lower likelihood of surgical postoperative complications, bringing into question the ability of malpractice lawsuits to

  10. Self-medication in three Orange Free State communities

    African Journals Online (AJOL)

    lates of non-compliance were explored, but self- medication was not found to be a substitute for formal medical care. S Air Med J 1993; 83: 345·346. Medicines. None. 1-3 types ... availability and accessibility of professional health care;. (iv) the perceived health .... tent manner in which cultural differences, education, health ...

  11. The Current Status of Medical Marijuana in the United States

    OpenAIRE

    McKenna, Gerald J

    2014-01-01

    Medical marijuana is currently a controversial issue in medicine. There are strong pro and con opinions but relatively little scientific data on which to base medical decisions. The unfortunate scheduling of marijuana in class I has limited research and only serves to fuel the controversy.

  12. The nuclear licensing procedure

    International Nuclear Information System (INIS)

    Wagner, H.

    1976-01-01

    To begin with, the present nuclear licensing procedure is illustrated by a diagram. The relationship between the state and the Laender, the various experts (GRS - IRS + LRA -, TUEV, DWD, university institutes, firms of consulting engineers, etc), participation of the public, e.g. publication of the relevant documents, questions, objections (made by individuals or by groups such as citizens' initiatives), public discussion, official notice, appeals against the decision, the right of immediate execution of the decision are shortly dealt with. Finally, ways to improve the licensing procedure are discussed, from the evaluation of the documents to be submitted, published, and examined by the authorities (and their experts) up to an improvement of the administrative procedure. An improved licensing procedure should satisfy the well-founded claims of the public for more transparency as well as the equally justifiable claims of industry and utilities in order to ensure that the citizens' legal right to have safe and adequate electric power is guaranteed. The updated energy programme established by the Federal Government is mentioned along with the effectiveness of dealing with nuclear problems on the various levels of a Land government. (orig.) [de

  13. 75 FR 54116 - Notice of Intent To Grant Partially Exclusive License of the United States Patent Application No...

    Science.gov (United States)

    2010-09-03

    ... coatings, side dressing, lawn application and starter ground cover) and applications in the fields of soil... announcement. ADDRESSES: United States Army Engineer Research and Development Center, Attn: CEERD-OT (Ms. Bea...

  14. The state and profile of open source software projects in health and medical informatics.

    Science.gov (United States)

    Janamanchi, Balaji; Katsamakas, Evangelos; Raghupathi, Wullianallur; Gao, Wei

    2009-07-01

    Little has been published about the application profiles and development patterns of open source software (OSS) in health and medical informatics. This study explores these issues with an analysis of health and medical informatics related OSS projects on SourceForge, a large repository of open source projects. A search was conducted on the SourceForge website during the period from May 1 to 15, 2007, to identify health and medical informatics OSS projects. This search resulted in a sample of 174 projects. A Java-based parser was written to extract data for several of the key variables of each project. Several visually descriptive statistics were generated to analyze the profiles of the OSS projects. Many of the projects have sponsors, implying a growing interest in OSS among organizations. Sponsorship, we discovered, has a significant impact on project success metrics. Nearly two-thirds of the projects have a restrictive license type. Restrictive licensing may indicate tighter control over the development process. Our sample includes a wide range of projects that are at various stages of development (status). Projects targeted towards the advanced end user are primarily focused on bio-informatics, data formats, database and medical science applications. We conclude that there exists an active and thriving OSS development community that is focusing on health and medical informatics. A wide range of OSS applications are in development, from bio-informatics to hospital information systems. A profile of OSS in health and medical informatics emerges that is distinct and unique to the health care field. Future research can focus on OSS acceptance and diffusion and impact on cost, efficiency and quality of health care.

  15. Streamlining the license renewal review process

    International Nuclear Information System (INIS)

    Dozier, J.; Lee, S.; Kuo, P.T.

    2001-01-01

    The staff of the NRC has been developing three regulatory guidance documents for license renewal: the Generic Aging Lessons Learned (GALL) report, Standard Review Plan for License Renewal (SRP-LR), and Regulatory Guide (RG) for Standard Format and Content for Applications to Renew Nuclear Power Plant Operating Licenses. These documents are designed to streamline the license renewal review process by providing clear guidance for license renewal applicants and the NRC staff in preparing and reviewing license renewal applications. The GALL report systematically catalogs aging effects on structures and components; identifies the relevant existing plant programs; and evaluates the existing programs against the attributes considered necessary for an aging management program to be acceptable for license renewal. The GALL report also provides guidance for the augmentation of existing plant programs for license renewal. The revised SRP-LR allows an applicant to reference the GALL report to preclude further NRC staff evaluation if the plant's existing programs meet the criteria described in the GALL report. During the review process, the NRC staff will focus primarily on existing programs that should be augmented or new programs developed specifically for license renewal. The Regulatory Guide is expected to endorse the Nuclear Energy Institute (NEI) guideline, NEI 95-10, Revision 2, entitled 'Industry Guideline for Implementing the Requirements of 10 CFR Part 54 - The License Renewal Rule', which provides guidance for preparing a license renewal application. This paper will provide an introduction to the GALL report, SRP-LR, Regulatory Guide, and NEI 95-10 to show how these documents are interrelated and how they will be used to streamline the license renewal review process. This topic will be of interest to domestic power utilities considering license renewal and international ICONE participants seeking state-of-the-art information about license renewal in the United States

  16. Maternal Mortality at Federal Medical Centre Yola, Adamawa State ...

    African Journals Online (AJOL)

    the management of the Federal Medical centre Yola before the .... response to emergencies may help reduce deaths from obstetric ... HIV, anesthetic deaths and Diabetic ketoacidosis (DKA) were the indirect causes of maternal mortality.

  17. 76 FR 35425 - Notice of Intent to Grant Partially Exclusive License of the United States Patent Application No...

    Science.gov (United States)

    2011-06-17

    ... by the fluid in which the sample is incorporated determines the gap without need of a spacer. To... States Army Engineer Research and Development Center, Attn: CEERD-OT (Ms. Bea Shahin), 2902 Newmark Drive... each of two silicon wafers abutting to contain the sample in a small uniform gap formed between the...

  18. The USNCR license renewal process

    International Nuclear Information System (INIS)

    Kuo, Pao-Tsin

    2002-01-01

    The US Congress promulgated a law in 1954, entitled 'Atomic Energy Act'. This Act states that operating licenses for commercial nuclear power plants are limited to a fixed term of 40 years, but they may be renewed for a period not to exceed 20 years. The terms were established mainly for economic considerations, not based on technical limitations. The U.S. Nuclear Regulatory Commission (USNRC) published the license renewal rule, Title 10 of the Code of Federal Regulations, Part 54 (10 CFR Part 54), in December, 1991. The rule has since been amended in May, 1995. The underlying principle of the rule is that the regulatory process is adequate for ensuring safety of operating plants. The regulatory process includes NRC's issuance of Orders, Bulletins, Generic Letters, and Information Notices, as well as a number of special inspections in addition to the continuous oversight and routine inspection activities performed by on-site inspectors. Because of this comprehensive regulatory process, compilation of the current license basis or re-verification of the current licensing basis is not considered necessary for a license renewal review. The USNRC also determined on the basis of the findings of its research programs that active structures and components are well maintained by the existing programs. Therefore, the focus of the license renewal review is on passive, long-lived structures and components and on time-limited ageing analyses. The time-limited ageing analyses are for those structures and components which were originally designed to a 40 year service life

  19. The Effect of Medical Marijuana Laws on Crime: Evidence from State Panel Data, 1990-2006

    OpenAIRE

    Morris, Robert G.; TenEyck, Michael; Barnes, J. C.; Kovandzic, Tomislav V.

    2014-01-01

    Background Debate has surrounded the legalization of marijuana for medical purposes for decades. Some have argued medical marijuana legalization (MML) poses a threat to public health and safety, perhaps also affecting crime rates. In recent years, some U.S. states have legalized marijuana for medical purposes, reigniting political and public interest in the impact of marijuana legalization on a range of outcomes. Methods Relying on U.S. state panel data, we analyzed the association between st...

  20. Residency training in the United States: What foreign medical ...

    African Journals Online (AJOL)

    FMGs) planning to pursue post-graduate residency training in the United States of America (USA). While the number of residency training positions is shrinking, and the number of United States graduates has steadily declined over the past ...

  1. South African medical schools: Current state of selection criteria and medical students' demographic profile.

    Science.gov (United States)

    van der Merwe, L J; van Zyl, G J; St Clair Gibson, A; Viljoen, M; Iputo, J E; Mammen, M; Chitha, W; Perez, A M; Hartman, N; Fonn, S; Green-Thompson, L; Ayo-Ysuf, O A; Botha, G C; Manning, D; Botha, S J; Hift, R; Retief, P; van Heerden, B B; Volmink, J

    2015-12-16

    Selection of medical students at South African (SA) medical schools must promote equitable and fair access to students from all population groups, while ensuring optimal student throughput and success, and training future healthcare practitioners who will fulfil the needs of the local society. In keeping with international practices, a variety of academic and non-academic measures are used to select applicants for medical training programmes in SA medical schools. To provide an overview of the selection procedures used by all eight medical schools in SA, and the student demographics (race and gender) at these medical schools, and to determine to what extent collective practices are achieving the goals of student diversity and inclusivity. A retrospective, quantitative, descriptive study design was used. All eight medical schools in SA provided information regarding selection criteria, selection procedures, and student demographics (race and gender). Descriptive analysis of data was done by calculating frequencies and percentages of the variables measured. Medical schools in SA make use of academic and non-academic criteria in their selection processes. The latter include indices of socioeconomic disadvantage. Most undergraduate medical students in SA are black (38.7%), followed by white (33.0%), coloured (13.4%) and Indian/Asian (13.6%). The majority of students are female (62.2%). The number of black students is still proportionately lower than in the general population, while other groups are overrepresented. Selection policies for undergraduate medical programmes aimed at redress should be continued and further refined, along with the provision of support to ensure student success.

  2. United States Nuclear Regulatory Commission Staff Practice and Procedure Digest: Commission, Appeal Board and Licensing Board decisions, July 1972--March 1992

    International Nuclear Information System (INIS)

    1993-02-01

    This 5th revision of the sixth edition of the NRC Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period of July 1, 1972 to March 31, 1992, interpreting the NRC's Rules of Practice in 10 CFR Part 2

  3. United States Nuclear Regulatory Commission staff practice and procedure digest: Commission, Appeal Board and Licensing Board decisions, July 1972--December 1991

    International Nuclear Information System (INIS)

    1992-11-01

    This 4th revision of the sixth edition of the NRC Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period of July 1, 1972 to December 31, 1991, interpreting the NRC's Rules of Practice in 10 CFR Part 2

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

    Science.gov (United States)

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

    2016-09-01

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

  5. A systematic review of the safety information contained within the Summaries of Product Characteristics of medications licensed in the United Kingdom for Attention Deficit Hyperactivity Disorder. how does the safety prescribing advice compare with national guidance?

    Directory of Open Access Journals (Sweden)

    Savill Nicola

    2012-01-01

    Full Text Available Abstract Background The safety of paediatric medications is paramount and contraindications provide clear pragmatic advice. Further advice may be accessed through Summaries of Product Characteristics (SPCs and relevant national guidelines. The SPC can be considered the ultimate independent guideline and is regularly updated. In 2008, the authors undertook a systematic review of the SPC contraindications of medications licensed in the United Kingdom (UK for the treatment of Attention Deficit Hyperactivity Disorder (ADHD. At that time, there were fewer contraindications reported in the SPC for atomoxetine than methylphenidate and the specific contraindications varied considerably amongst methylphenidate formulations. In 2009, the European Medicines Agency (EMA mandated harmonisation of methylphenidate SPCs. Between September and November 2011, there were three changes to the atomoxetine SPC that resulted in revised prescribing information. In addition, Clinical Guidance has also been produced by the National Institute for Health and Clinical Excellence (NICE (2008, the Scottish Intercollegiate Guidelines Network (SIGN (2009 and the British National Formulary for Children (BNFC. Methods An updated systematic review of the Contraindications sections of the SPCs of all medications currently licensed for treatment of ADHD in the UK was undertaken and independent statements regarding contraindications and relevant warnings and precautions were then compared with UK national guidance with the aim of assessing any disparity and potential areas of confusion for prescribers. Results As of November 2011, there were seven medications available in the UK for the treatment of ADHD. There are 15 contraindications for most formulations of methylphenidate, 14 for dexamfetamine and 5 for atomoxetine. Significant differences exist between the SPCs and national guidance part due to the ongoing reactive process of amending the former as new information becomes known

  6. Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence.

    Science.gov (United States)

    Cerdá, Magdalena; Wall, Melanie; Keyes, Katherine M; Galea, Sandro; Hasin, Deborah

    2012-01-01

    Marijuana is the most frequently used illicit substance in the United States. Little is known of the role that macro-level factors, including community norms and laws related to substance use, play in determining marijuana use, abuse and dependence. We tested the relationship between state-level legalization of medical marijuana and marijuana use, abuse, and dependence. We used the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national survey of adults aged 18+ (n=34,653). Selected analyses were replicated using the National Survey on Drug Use and Health (NSDUH), a yearly survey of ∼68,000 individuals aged 12+. We measured past-year cannabis use and DSM-IV abuse/dependence. In NESARC, residents of states with medical marijuana laws had higher odds of marijuana use (OR: 1.92; 95% CI: 1.49-2.47) and marijuana abuse/dependence (OR: 1.81; 95% CI: 1.22-2.67) than residents of states without such laws. Marijuana abuse/dependence was not more prevalent among marijuana users in these states (OR: 1.03; 95% CI: 0.67-1.60), suggesting that the higher risk for marijuana abuse/dependence in these states was accounted for by higher rates of use. In NSDUH, states that legalized medical marijuana also had higher rates of marijuana use. States that legalized medical marijuana had higher rates of marijuana use. Future research needs to examine whether the association is causal, or is due to an underlying common cause, such as community norms supportive of the legalization of medical marijuana and of marijuana use. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010

    Science.gov (United States)

    Bachhuber, Marcus A.; Saloner, Brendan; Cunningham, Chinazo O.; Barry, Colleen L.

    2015-01-01

    IMPORTANCE Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. OBJECTIVE To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. DESIGN, SETTING, AND PARTICIPANTS A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. EXPOSURES Presence of a law establishing a medical cannabis program in the state. MAIN OUTCOMES AND MEASURES Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. RESULTS Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, −37.5% to −9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (−19.9%; 95% CI, −30.6% to −7.7%; P = .002), year 2 (−25.2%; 95% CI, −40.6% to −5.9%; P = .01), year 3 (−23.6%; 95% CI, −41.1% to −1.0%; P = .04), year 4 (−20.2%; 95% CI, −33.6% to −4

  8. Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010.

    Science.gov (United States)

    Bachhuber, Marcus A; Saloner, Brendan; Cunningham, Chinazo O; Barry, Colleen L

    2014-10-01

    Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. Presence of a law establishing a medical cannabis program in the state. Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, -37.5% to -9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (-19.9%; 95% CI, -30.6% to -7.7%; P = .002), year 2 (-25.2%; 95% CI, -40.6% to -5.9%; P = .01), year 3 (-23.6%; 95% CI, -41.1% to -1.0%; P = .04), year 4 (-20.2%; 95% CI, -33.6% to -4.0%; P = .02), year 5 (-33.7%; 95% CI, -50.9% to -10.4%; P = .008), and year 6 (-33.3%; 95% CI, -44.7% to

  9. Radiation protection in medical research. Licensing requirement for the use of radiation and advice for the application procedure; Strahlenschutz in der medizinischen Forschung. Genehmigungsbeduerftigkeit von Strahlenanwendungen und Hinweise zum Antragsverfahren

    Energy Technology Data Exchange (ETDEWEB)

    Minkov, V.; Klammer, H.; Brix, G. [Bundesamt fuer Strahlenschutz, Abteilung fuer medizinischen und beruflichen Strahlenschutz, Neuherberg (Germany)

    2017-07-15

    In Germany, persons who are to be exposed to radiation for medical research purposes are protected by a licensing requirement. However, there are considerable uncertainties on the part of the applicants as to whether licensing by the competent Federal Office for Radiation Protection is necessary, and regarding the choice of application procedure. The article provides explanatory notes and practical assistance for applicants and an outlook on the forthcoming new regulations concerning the law on radiation protection of persons in the field of medical research. Questions and typical mistakes in the application process were identified and evaluated. The qualified physicians involved in a study are responsible for deciding whether a license is required for the intended application of radiation. The decision can be guided by answering the key question whether the study participants would undergo the same exposures regarding type and extent if they had not taken part in the study. When physicians are still unsure about their decision, they can seek the advisory service provided by the professional medical societies. Certain groups of people are particularly protected through the prohibition or restriction of radiation exposure. A simplified licensing procedure is used for a proportion of diagnostic procedures involving radiation when all related requirements are met; otherwise, the regular licensing procedure should be used. The new radiation protection law, which will enter into force on the 31st of december 2018, provides a notification procedure in addition to deadlines for both the notification and the licensing procedures. In the article, the authors consider how eligible studies involving applications of radiation that are legally not admissible at present may be feasible in the future, while still ensuring a high protection level for study participants. (orig.) [German] Personen, bei denen Strahlenanwendungen zum Zweck der medizinischen Forschung durchgefuehrt

  10. The State of Disability Awareness in American Medical Schools.

    Science.gov (United States)

    Seidel, Erica; Crowe, Scott

    2017-09-01

    This study was designed to: (1) determine how many American medical schools include disability awareness in their curriculum, (2) explore the format of disability awareness programs in existence, and (3) understand why some schools do not include disability awareness in their curriculum. An online survey was sent to deans of medical education (or equivalent positions) at accredited allopathic and osteopathic American medical schools (N = 167) in 2015. Seventy-five schools (45%) completed surveys. Fifty-two percent (39/75) reported having a disability awareness program. The most common format was people with disabilities or caregivers speaking in a large group setting. Programs were most likely to focus on adults with physical disabilities. Among schools without a program, the top barriers were no one advocating for inclusion in the curriculum and time constraints. Nearly half of schools without a program expressed interest in adopting an awareness curriculum if one was made available. Such results indicate that efforts should be made to increase the number of schools that provide disability awareness education through increased advocacy and providing additional resources to schools without a curriculum.

  11. Improvement of the training system of medical and pharmaceutical specialists at medical college of Saratov State Medical University

    Directory of Open Access Journals (Sweden)

    Popkov V.M.

    2015-06-01

    Full Text Available The development of high-technological medical care in Russia has improved the quality of rendering of medical aid to the population, but at the same time the lack of efficient, qualified specialists has been revealed. Today graduates of professional educational institution are characterized by the knowledge in theory and inefficient practical experience, while the employer is interested in the optimal combination of these qualities. All of these facts lead to the necessity of introducing into the educational process technologies of dual training as a tool of approximation theory to practice Saratov. Medical University may share the experience of introduction and organization of elements of the complex educational system in the process of realization of the programs of secondary professional education through the creation of educational-productive cluster on the bases of clinics.

  12. The effect of medical marijuana laws on crime: evidence from state panel data, 1990-2006.

    Directory of Open Access Journals (Sweden)

    Robert G Morris

    Full Text Available Debate has surrounded the legalization of marijuana for medical purposes for decades. Some have argued medical marijuana legalization (MML poses a threat to public health and safety, perhaps also affecting crime rates. In recent years, some U.S. states have legalized marijuana for medical purposes, reigniting political and public interest in the impact of marijuana legalization on a range of outcomes.Relying on U.S. state panel data, we analyzed the association between state MML and state crime rates for all Part I offenses collected by the FBI.Results did not indicate a crime exacerbating effect of MML on any of the Part I offenses. Alternatively, state MML may be correlated with a reduction in homicide and assault rates, net of other covariates.These findings run counter to arguments suggesting the legalization of marijuana for medical purposes poses a danger to public health in terms of exposure to violent crime and property crimes.

  13. Online driver's license renewal.

    Science.gov (United States)

    2015-09-01

    The Kentucky Department of Vehicle Regulation is exploring the possibility of developing and implementing online : drivers license renewal. The objective of this project was to: 1) evaluate online drivers license and REAL ID renewal : programs ...

  14. Psychotropic Medication Use among Adolescents: United States, 2005-2010

    Science.gov (United States)

    ... no. 12–3929. 2010. Pratt LA, Brody DJ. Depression in the United States household population, 2005–2006. NCHS data brief, no 7. Hyattsville, MD: National Center for Health Statistics. 2008. Akinbami LJ, Liu X, Pastor PN, Reuben ...

  15. Characterization and analysis of medical solid waste in Osun State ...

    African Journals Online (AJOL)

    use

    1Department of Civil Engineering, Osun State College of Technology, ... achieve waste segregation, packaging in colour-coded and labeled bags, safe ...... J. Air. Waste Manage. Assoc., 48: 516–526. Martin J, Nakayama T, Flores L (2002).

  16. Knowledge, Practices, and Barriers to HIV Pre-Exposure Prophylaxis (PrEP) Prescribing Among Washington State Medical Providers.

    Science.gov (United States)

    Wood, Brian R; McMahan, Vanessa M; Naismith, Kelly; Stockton, Jonathan B; Delaney, Lori A; Stekler, Joanne D

    2018-01-04

    We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. Of 735 eligible providers, 64.8% had heard of PrEP. Younger providers and providers with a Doctor of Medicine (MD) degree were more likely to be aware of PrEP compared to older providers (p=0.0001) and providers of other training backgrounds (Advanced Registered Nurse Practitioner [ARNP], Doctor of Osteopathic Medicine [DO], or Physician Assistant [PA]) (p=0.04). Among providers aware of PrEP, most frequent reported concerns about prescribing were adherence (46.0%) and costs (42.9%). Providers felt very (20.1%) or somewhat (33.8%) comfortable discussing PrEP overall, but very (26.8%) or somewhat (44.7%) uncomfortable discussing cost and insurance issues. The 124 PrEP prescribers reported a median of 2 (range 1-175, total 1,142) patients prescribed PrEP. Prior authorizations and insurance denials had prevented prescriptions for 28.7% and 12.1% of prescribers, respectively. Interventions to improve PrEP access should include education to inform medical providers about PrEP, with particular attention to provider types less likely to be aware. Continued efforts to eliminate cost and insurance barriers and educate providers regarding financial resources would help improve PrEP access.

  17. United State Nuclear Regulatory Commission staff practice and procedure digest: Commission, Appeal Board, and Licensing Board decisions, July 1972--June 1988

    International Nuclear Information System (INIS)

    1989-04-01

    This fifth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to June 30, 1988 interpreting the NRC's Rules of Practice in 10 CFR Part 2. This edition replaces in their entirety earlier editions and supplements and includes appropriate changes reflecting the amendments to the Rules of Practice effective through June 30, 1988

  18. United States Nuclear Regulatory Commission staff practice and procedure digest. Commission, Appearl Board and Licensing Board decisions, July 1972-June 1985. Digest No. 4

    International Nuclear Information System (INIS)

    1986-01-01

    This edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period July 1, 1972 to June 30, 1985 interpreting the NRC's Rules of Practice in 10 CFR Part 2. This edition replaces earlier editions and supplements and includes appropriate changes reflecting the amendment to the Rules of Practice effective June 30, 1985

  19. Slaves of the statemedical internship and community service in ...

    African Journals Online (AJOL)

    Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctors work up to 200 hours of overtime per month under the state's commuted overtime policy. Nurses moonlight in circumvention of the Basic Conditions of Employment Act. For trainee doctors, overtime ...

  20. Medical abortion practices : a survey of National Abortion Federation members in the United States

    NARCIS (Netherlands)

    Wiegerinck, Melanie M. J.; Jones, Heidi E.; O'Connell, Katharine; Lichtenberg, E. Steve; Paul, Maureen; Westhoff, Carolyn L.

    2008-01-01

    Background: Little is known about clinical implementation of medical abortion in the United States following approval of mifepristone as an abortifacient by the Food and Drug Administration (FDA) in 2000. We collected information regarding medical abortion practices of National Abortion Federation

  1. Medical abortion practices: a survey of National Abortion Federation members in the United States

    NARCIS (Netherlands)

    Wiegerinck, Melanie M. J.; Jones, Heidi E.; O'Connell, Katharine; Lichtenberg, E. Steve; Paul, Maureen; Westhoff, Carolyn L.

    2008-01-01

    Little is known about clinical implementation of medical abortion in the United States following approval of mifepristone as an abortifacient by the Food and Drug Administration (FDA) in 2000. We collected information regarding medical abortion practices of National Abortion Federation (NAF) members

  2. Type 2 diabetes in 'the young' | Iro | Abia State University Medical ...

    African Journals Online (AJOL)

    Abia State University Medical Students' Association Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 1 (2000) >. Log in or Register to get access to full text downloads.

  3. [Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University].

    Science.gov (United States)

    Karpishchenko, S A

    This article is designed to report the results of the analysis ofacademic, scientific, and clinical activities of the Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University.

  4. Characterization and analysis of medical solid waste in Osun State ...

    African Journals Online (AJOL)

    This paper reports the study of quantum and characterization of medica solid wastes generated by healthcare facilities in Osun State. The work involved administration of a questionnaire and detailed studies conducted on facilities selected on the basis of a combination of purposive and random sampling methods.

  5. Clinical neuro-oncology formal education opportunities for medical students in the United States and Canada.

    Science.gov (United States)

    Dixit, Karan S; Nicholas, Martin Kelly; Lukas, Rimas V

    2014-12-01

    To develop an understanding of the availability of the formal clinical neuro-oncology educational opportunities for medical students. The curriculum websites of all medical schools accredited by the Liaison Committee on Medical Education were reviewed for the presence of clinical neuro-oncology electives as well as other relevant data. Ten (6.8%) of medical schools accredited by the Liaison Committee on Medical Education offer formal neuro-oncology electives. Half are clustered in the Midwest. Forty percent are at institutions with neuro-oncology fellowships. All are at institutions with neurosurgery and neurology residency programs. Formal clinical neuro-oncology elective opportunities for medical students in the United States and Canada are limited. Additional such opportunities may be of value in the education of medical students. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    1987-05-01

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes

  7. Hands in medicine: understanding the impact of competency-based education on the formation of medical students' identities in the United States.

    Science.gov (United States)

    Gonsalves, Catherine; Zaidi, Zareen

    2016-01-01

    There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on 'doing the work of a physician' rather than identity formation and 'being a physician.' This study aims to understand how competency-based education impacts the development of a medical student's identity. Three ceramic models representing three core competencies 'medical knowledge,' 'patient care,' and 'professionalism' were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Students across all four years of medical school related to the 'professionalism' competency domain (50%). They reflected that 'being an empathetic physician' was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized 'professionalism' as a competency. Students perceive 'professionalism' as a competency that impacts their identity formation in the social role of 'being a doctor,' albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

  8. NUPLEX Licensing Subcommittee

    International Nuclear Information System (INIS)

    Edwards, D.W.; Allen, S.R.

    1988-01-01

    The NUPLEX Licensing Subcommittee was organized to seek a formal license renewal mechanism that institutionalizes the current licensing basis and consequent level of safety of a plant as the legitimate standard for acceptance and approval of an application for extended operation. Along with defining the most workable approach to and scope of review for license renewal, this paper explains the reasons why a regulatory framework is needed by the early 1990s. The initial results of development work on two key issues, licensing criteria and hearing process, are also presented. at this point six potential license renewal criteria have emerged: evaluation of existing monitoring/maintenance programs, revalidation of current licensing basis, conformance to special regulations, evaluation to a safety goal, plant performance history, and environmental assessment. The work on a hearing process has led to the development of two models for future consideration: hybrid legislative and hybrid adjudicatory

  9. Diversity of United States medical students by region compared to US census data

    Directory of Open Access Journals (Sweden)

    Smith MM

    2015-05-01

    Full Text Available Mark M Smith,1 Steven H Rose,1 Darrell R Schroeder,2 Timothy R Long1 1Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USA; 2Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN, USA Purpose: Increasing the diversity of the United States (US physician workforce to better represent the general population has received considerable attention. The purpose of this study was to compare medical student race data to that of the US general population. We hypothesized that race demographics of medical school matriculants would reflect that of the general population. Patients and methods: Published race data from the United States Census Bureau (USCB 2010 census and the 2011 Association of American Medical Colleges (AAMC allopathic medical school application and enrollment by race and ethnicity survey were analyzed and compared. Race data of enrolled medical students was compared to race data of the general population within geographic regions and subregions. Additionally, race data of medical school applicants and matriculants were compared to race data of the overall general population. Results: Race distribution within US medical schools was significantly different than race distribution for the overall, regional, and subregional populations of the US (P<0.001. Additionally, the overall race distribution of medical school applicants differed significantly to the race distribution of the general population (P<0.001. Conclusion: This study demonstrated that race demographics of US medical school applicants and matriculants are significantly different from that of the general population, and may be resultant of societal quandaries present early in formal education. Initiatives targeting underrepresented minorities at an early stage to enhance health care career interest and provide academic support and mentorship will be required to address the racial disparity that exists in US

  10. Licensed operating reactors

    International Nuclear Information System (INIS)

    1990-01-01

    The US Nuclear Regulatory Commission's monthly LICENSED OPERATING REACTORS Status Summary Report provides data on the operation of nuclear units as timely and accurately as possible. This information is collected by the Office of Information Resources Management, from the Headquarters Staff of NRC's Office of Inspection and Enforcement, from NRC's Regional Offices, and from utilities. This report is divided into three sections: the first contains monthly highlights and statistics for commercial operating units, and errata from previously reported data; the second is a compilation of detailed information on each unit, provided by NRC Regional Offices, IE Headquarters and the Utilities; and the third section is an appendix for miscellaneous information such as spent fuel storage capability, reactor years of experience and non-power reactors in the United States

  11. Licensed operating reactors

    International Nuclear Information System (INIS)

    Hartfield, R.A.

    1990-03-01

    The US Nuclear Regulatory Commission's monthly Licensed Operating Reactors Status Summary Report provides data on the operation of nuclear units as timely and accurately as possible. This information is collected by the Office of Information Resources Management, from the Headquarters Staff of NRC's Office of Inspection and Enforcement, from NRC's Regional Offices, and from utilities. This report is divided into three sections: the first contains monthly highlights and statistics for commercial operating units, and errata from previously reported data; the second is a compilation of detailed information on each unit, provided by NRC Regional Offices, IE Headquarters and the Utilities; and the third section is an appendix for miscellaneous information such as spent fuel storage capability, reactor years of experience and non-power reactors in the United States

  12. Licensed operating reactors

    International Nuclear Information System (INIS)

    1989-08-01

    The US Nuclear Regulatory Commission's monthly LICENSED OPERATING REACTORS Status Summary Report provides data on the operation of nuclear units as timely and accurately as possible. This information is collected by the Office of Information Resources Management, from the Headquarters Staff of NRC's Office of Inspection and Enforcement, from NRC's Regional Offices, and from utilities. This report is divided into three sections: the first contains monthly highlights and statistics for commercial operating units, and errata from previously reported data; the second is a compilation of detailed information on each unit, provided by NRC Regional Offices, IE Headquarters and the utilities; and the third section is an appendix for miscellaneous information such as spent fuel storage capability, reactor years of experience and non-power reactors in the United States

  13. Affective computing and medical informatics: state of the art in emotion-aware medical applications.

    Science.gov (United States)

    Luneski, Andrej; Bamidis, Panagiotis D; Hitoglou-Antoniadou, Madga

    2008-01-01

    The area of affective computing has received significant attention by the research community over the last few years. In this paper we review the underlying principles in the field, in an effort to draw threads for possible future development within medical informatics. The approach is lead by considering the three main affective channels, namely, visual, audio/speech, and physiological in relation to e-health, emotional intelligence and e-learning. A discussion on the importance of past and present applications together with a prediction on future literature output is also provided.

  14. Safety of currently licensed hepatitis B surface antigen vaccines in the United States, Vaccine Adverse Event Reporting System (VAERS), 2005-2015.

    Science.gov (United States)

    Haber, Penina; Moro, Pedro L; Ng, Carmen; Lewis, Paige W; Hibbs, Beth; Schillie, Sarah F; Nelson, Noele P; Li, Rongxia; Stewart, Brock; Cano, Maria V

    2018-01-25

    Currently four recombinant hepatitis B (HepB) vaccines are in use in the United States. HepB vaccines are recommended for infants, children and adults. We assessed adverse events (AEs) following HepB vaccines reported to the Vaccine Adverse Event Reporting System (VAERS), a national spontaneous reporting system. We searched VAERS for reports of AEs following single antigen HepB vaccine and HepB-containing vaccines (either given alone or with other vaccines), from January 2005 - December 2015. We conducted descriptive analyses and performed empirical Bayesian data mining to assess disproportionate reporting. We reviewed serious reports including reports of special interest. VAERS received 20,231 reports following HepB or HepB-containing vaccines: 10,291 (51%) in persons 18 years; for 1485 (7.3%) age was missing. Dizziness and nausea (8.4% each) were the most frequently reported AEs following a single antigen HepB vaccine: fever (23%) and injection site erythema (11%) were most frequent following Hep-containing vaccines. Of the 4444 (22%) reports after single antigen HepB vaccine, 303 (6.8%) were serious, including 45 deaths. Most commonly reported cause of death was Sudden Infant Death Syndrome (197). Most common non-death serious reports following single antigen HepB vaccines among infants aged children aged 1-23 months; infections and infestation (8) among persons age 2-18 years blood and lymphatic systemic disorders; and general disorders and administration site conditions among persons age >18 years. Most common vaccination error following single antigen HepB was incorrect product storage. Review current U.S.-licensed HepB vaccines administered alone or in combination with other vaccines did not reveal new or unexpected safety concerns. Vaccination errors were identified which indicate the need for training and education of providers on HepB vaccine indications and recommendations. Published by Elsevier Ltd.

  15. 47 CFR 97.5 - Station license required.

    Science.gov (United States)

    2010-10-01

    .... (3) A military recreation station license grant. A military recreation station license grant may be... States military recreational premises where the station is situated. The person must not be a... the balance of the license term and the suspension is still in effect, suspended for the balance of...

  16. 50 CFR 80.4 - Diversion of license fees.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Diversion of license fees. 80.4 Section 80... fees. Revenues from license fees paid by hunters and fishermen shall not be diverted to purposes other than administration of the State fish and wildlife agency. (a) Revenues from license fees paid by...

  17. Licensing process in Finland

    International Nuclear Information System (INIS)

    Tiippana, Petteri

    2011-01-01

    In accordance with the Nuclear Energy Act, the use of nuclear energy constitutes operations subject to license. The licensing process and conditions for granting a license is defined in the legislation. The licenses are applied from and granted by the Government. This paper discusses briefly the licensing process in Finland and also the roles and responsibilities of main stakeholders in licensing. Licensing of a nuclear power plant in Finland has three steps. The first step is the Decision in Principle (DiP). Goal of DiP is to decide whether using nuclear power is for the overall good for the Finnish society. The second step is Construction License (CL) and the goal of CL phase is to determine whether the design of the proposed plant is safe and that the participating organisations are capable of constructing the plant to meet safety goals. The third step is the Operating License (OL) and the goal of the OL phase is to determine whether the plant operates safely and licensee is capable to operate the plant safely. Main stakeholders in the licensing process in Finland are the utility (licensee) interested in using nuclear power in Finland, Ministry of Employment and the Economy (MEE), Government, Parliament, STUK, the municipality siting the plant and the general public. Government grants all licenses, and Parliament has to ratify Government's Decision in Principle. STUK has to assess the safety of the license applications in each step and give statement to the Ministry. Municipality has to agree to site the plant. Both STUK and the municipality have a veto right in the licensing process

  18. State and Federal Regulatory measurement responsibilities around medical facilities

    International Nuclear Information System (INIS)

    Lanzl, L.H.

    1976-01-01

    Radiation exposure to man is due chiefly to diagnostic x-ray procedures, in which radiation is intentionally directed toward a patient. Radiation therapy presents a lesser problem because a smaller percentage of the population is subjected to such treatment. Recently, some innovative steps were taken in the State of Illinois to reduce patient exposure in four diagnostic procedures without reducing the benefits derived therefrom. However, if these procedures are to be carried out properly, it is necessary to increase the precision and accuracy of radiation exposure measurements to the order of +-2 percent. The usual accuracy and precision of radiation protection measurements are of the order of +- 20 percent. Thus, should the Illinois radiation protection rules become widely adopted, the national dosimetry network will need to upgrade exposure measurement techniques

  19. United States Department of Health and Human Services Biodosimetry and radiological/nuclear medical countermeasure programs

    International Nuclear Information System (INIS)

    Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.

    2016-01-01

    The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)

  20. United States Nuclear Regulatory Commission staff practice and procedure digest: Commission, Appeal Board and Licensing Board decisions, July 1972--December 1987

    International Nuclear Information System (INIS)

    1988-11-01

    This Revision 10 of the fourth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and licensing Board decisions issued during the period from July 1, 1972 to December 31, 1987 interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 10 replaces in part earlier editions and supplements and includes appropriate changes reflecting the amendments to the Rules of Practice effective through December 31, 1987. The Digest is roughly structured in accordance with the chronological sequence of the nuclear facility licensing process as set forth in Appendix A to 10 CFR Part 2. Those decisions which did not fit into that structure are dealt with in a section on ''general matters.'' Where appropriate, particular decisions are indexed under more than one heading. Some topical headings contain no decision citations or discussion

  1. Mapping medical marijuana: state laws regulating patients, product safety, supply chains and dispensaries, 2017.

    Science.gov (United States)

    Klieger, Sarah B; Gutman, Abraham; Allen, Leslie; Pacula, Rosalie Liccardo; Ibrahim, Jennifer K; Burris, Scott

    2017-12-01

    (1) To describe open source legal data sets, created for research use, that capture the key provisions of US state medical marijuana laws. The data document how state lawmakers have regulated a medicine that remains, under federal law, a Schedule I illegal drug with no legitimate medical use. (2) To demonstrate the variability that exists across states in rules governing patient access, product safety and dispensary practice. Two legal researchers collected and coded state laws governing marijuana patients, product safety and dispensaries in effect on 1 February 2017, creating three empirical legal data sets. We used summary tables to identify the variation in specific statutory provisions specified in each state's medical marijuana law as it existed on 1 February 2017. We compared aspects of these laws to the traditional Federal approach to regulating medicine. Full data sets, codebooks and protocols are available through the Prescription Drug Abuse Policy System (http://www.pdaps.org/; Archived at http://www.webcitation.org/6qv5CZNaZ on 2 June 2017). Twenty-eight states (including the District of Columbia) have authorized medical marijuana. Twenty-seven specify qualifying diseases, which differ across states. All states protect patient privacy; only 14 protect patients against discrimination. Eighteen states have mandatory product safety testing before any sale. While the majority have package/label regulations, states have a wide range of specific requirements. Most regulate dispensaries (25 states), with considerable variation in specific provisions such as permitted product supply sources number of dispensaries per state and restricting proximity to various types of location. The federal ban in the United States on marijuana has resulted in a patchwork of regulatory strategies that are not uniformly consistent with the approach usually taken by the Federal government and whose effectiveness remains unknown. © 2017 Society for the Study of Addiction.

  2. NRC's license renewal regulations

    International Nuclear Information System (INIS)

    Akstulewicz, Francis

    1991-01-01

    In order to provide for the continuity of the current generation of nuclear power plant operating licenses and at the same time ensure the health and safety of the public, and the quality of the environment, the US Nuclear Regulatory Commission (NRC) established a goal of developing and issuing regulations and regulatory guidance for license renewal in the early 1990s. This paper will discuss some of those activities underway to achieve this goal. More specifically, this paper will discuss the Commission's regulatory philosophy for license renewal and the two major license renewal rule makings currently underway. The first is the development of a new Part 54 to address procedural and technical requirements for license renewal; the second is a revision to existing Part 51 to exclude environmental issues and impacts from consideration during the license renewal process. (author)

  3. 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)

  4. United States Nuclear Regulatory Commission Staff Practice and Procedure Digest. Commission, Appeal Board and Licensing Board decisions, July 1972-December 1985. Digest No. 4, Revision No. 2

    International Nuclear Information System (INIS)

    1986-08-01

    This Revision 2 of the fourth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period July 1, 1972 to December 31, 1985, interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 2 replaces in part earlier editions and supplements and includes appropriate changes reflecting the amendment to the Rules of Practice effective December 31, 1985. Topics covered include prehearing and posthearing matters, herings, appeals, and general matters

  5. United States Nuclear Regulatory Commission Staff Practice and Procedure Digest: Commission, Appeal Board and Licensing Board decisions, July 1972-December 1986

    International Nuclear Information System (INIS)

    1987-11-01

    This Revision 6 of the fourth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to December 31, 1986, interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 6 replaces in part earlier editions and supplements and includes appropriate changes reflecting the amendments to the Rules of Practice effective through December 31, 1986

  6. United States Nuclear Regulatory Commission staff practice and procedure digest: Commission, Appeal Board, and Licensing Board decisions issued from July 1, 1972 through March 31, 1986

    International Nuclear Information System (INIS)

    1986-10-01

    A digest is given of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to March 31, 1986, interpreting the NRC's Rules of Practice. Parts of earlier editions and supplements are replaced, and amendments to the Rules of Practice effective through March 31, 1986 are reflected. The material included deals with applications, prehearing matters, hearings, post-hearing matters, appeals, and decisions related to general matters. Decisions are indexed by facility, citation, CFR, statutes, case law, and other legal citations

  7. United States Nuclear Regulatory Commission staff practice and procedure digest: Commission, Appeal Board and Licensing Board decisions, July 1972--December 1989

    International Nuclear Information System (INIS)

    1990-06-01

    This Revision 6 of the fifth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to December 31, 1989 interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 6 replaces in part earlier editions and revisions and includes appropriate changes reflecting the amendments to the Rules of Practice effective through December 31, 1989

  8. United States Nuclear Regulatory Commission Staff practice and procedure digest: Commission, Appeal Board and Licensing Board Decisions, July 1972-March 1987

    International Nuclear Information System (INIS)

    1987-12-01

    This Revision 7 of the fourth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to March 31, 1987 interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 7 replaces in part earlier editions and supplements and includes appropriate changes reflecting the amendments to the Rules of Practice effective through March 31, 1987

  9. United States Nuclear Regulatory Commission staff practice and procedure digest: Commission, Appeal Board and Licensing Board decisions, July 1972--September 1988

    International Nuclear Information System (INIS)

    1989-04-01

    This Revision 1 of the fifth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to September 30, 1988 interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 1 replaces in part earlier editions and supplements and includes appropriate changes reflecting the amendments to the Rules of Practice effective through September 30, 1988

  10. United States Nuclear Regulatory Commission staff practice and procedure digest. Commission, Appeal Board and Licensing Board decisions, July 1972-September 1985. Digest No. 4, Revision No. 1

    International Nuclear Information System (INIS)

    1986-04-01

    This Revision 1 of the fourth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to September 30, 1985 interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 1 replaces earlier editions and supplements and includes appropriate changes reflecting the admendments to the Rules of Practice effective through September 20, 1985

  11. Trends in nuclear licensing

    International Nuclear Information System (INIS)

    Dalton, N.W.

    1990-01-01

    The development of nuclear safety and licensing is briefly reviewed in four stages namely: The Formative Period (1946-1959), The Expansive Period (1960-1969), The Mature Period (1970-1979) and the Apprehensive Period (1980-1989). Particular safety issues in the respective periods are highlighted to indicate the changing emphasis of nuclear licensing over the past thirty years or so. Against this background, nuclear licensing. (author)

  12. Trends in nuclear licensing

    Energy Technology Data Exchange (ETDEWEB)

    Dalton, N W [Council for Nuclear Safety, Hennopsmeer, Pretoria (South Africa)

    1990-06-01

    The development of nuclear safety and licensing is briefly reviewed in four stages namely: The Formative Period (1946-1959), The Expansive Period (1960-1969), The Mature Period (1970-1979) and the Apprehensive Period (1980-1989). Particular safety issues in the respective periods are highlighted to indicate the changing emphasis of nuclear licensing over the past thirty years or so. Against this background, nuclear licensing. (author)

  13. The state of radiologic teaching practice in preclinical medical education: survey of American medical, osteopathic, and podiatric schools.

    Science.gov (United States)

    Rubin, Zachary; Blackham, Kristine

    2015-04-01

    This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Online nutrition and T2DM continuing medical education course launched on state-level medical association.

    Science.gov (United States)

    Hicks, Kristen K; Murano, Peter S

    2017-01-01

    The purpose of this research study was to determine whether a 1-hour online continuing medical education (CME) course focused on nutrition for type 2 diabetes would result in a gain in nutrition knowledge by practicing physicians. A practicing physician and dietitian collaborated to develop an online CME course (both webinar and self-study versions) on type 2 diabetes. This 1-hour accredited course was launched through the state-level medical association's education library, available to all physicians. Physicians (n=43) registered for the course, and of those, 31 completed the course in its entirety. A gain in knowledge was found when comparing pre- versus post-test scores related to the online nutrition CME ( P Online CME courses launched via state-level medical associations offer convenient continuing education to assist practicing physicians in addressing patient nutrition and lifestyle concerns related to chronic disease. The present diabetes CME one-credit course allowed physicians to develop basic nutrition care concepts on this topic to assist patients in a better way.

  15. IRIS Licensing Status

    International Nuclear Information System (INIS)

    Kling, Charles L.; Carelli, Mario D.

    2006-01-01

    The International Reactor Innovative and Secure (IRIS) nuclear power plant is well into the pre-application review process with the US NRC and has accomplished its first near term goal of obtaining US NRC feedback on the long term testing program. To date, the IRIS team has submitted to the US NRC a number of documents patterned after the Evaluation Model Development and Assessment Process (EMDAP) outlined in Regulatory Guide 1,203. They have covered a detailed description of IRIS, initial safety analysis results, PIRT development for limiting transients, scaling analysis and a description of the test program. The IRIS Safety-by-Desing TM intrinsically eliminates and/or significantly reduces the consequences of traditional LWR accidents. In addition, the fewer passive safety systems are similar in principle to those of the US NRC approved AP1000 design. For these reasons, the IRIS testing program only needs to include those features unique to the IRIS design. NRC feedback was that the planned test program appeared to be complete and could generate sufficient information to support a Design Certification (DC) submittal. The US NRC has also stated that a DC application must include complete information regarding the test program. On this basis the IRIS team has initiated an aggressive program to conduct IRIS testing to support a DC submittal by the end of 2008. Subsequent US NRC review should be expeditious because of the AP1000 precedent, allowing IRIS to obtain its Final Design Approval (FDA) in 2012; thereby, maintaining its goal of deployment in the 2015-2017 time frame. The next steps in the pre-application review process will be to provide the US NRC with a road map of the anticipated IRIS licensing process, a review of current licensing requirements showing that IRIS meets or exceeds all current criteria and information to support the long term goal of redefining the Emergency Planning Zone (EPZ)

  16. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    1993-01-01

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes

  17. Libraries and licensing

    Directory of Open Access Journals (Sweden)

    Maja Žumer

    2001-01-01

    Full Text Available In the mid 90s, the abundance of various electronic publications exposed libraries to the problems of licensing electronic content. Various licensing principles have been prepared recently to help libraries in the process; it can be said that in general, the knowledge of licensing issues has improved in libraries of all types. Libraries form consortia in order to gain stronger negotiating positions and obtain better conditions.In the article, new licensing principles are presented in more detail, as well as some domestic and foreign experiences with consortia forming.

  18. The risk of disciplinary action by state medical boards against physicians prescribing opioids.

    Science.gov (United States)

    Richard, Jack; Reidenberg, Marcus M

    2005-02-01

    Concern of physicians about being disciplined for prescribing opioids for patients in pain is one cause for undertreatment of pain. This study was done to assess the actual risk of being disciplined by state medical boards. A review of records of actions by the New York State Board for Professional Medical Misconduct for 3 years and of all medical boards in the United States for 9 months was done to determine this risk. New York State, with 7.8% of U.S. physicians, had 10 physicians disciplined annually related to overprescribing opioids, while the total for the entire U.S. was 120 physicians annually. Most physicians disciplined had multiple violations in addition to overprescribing controlled substances. In the national sample, 43% were prescribing for themselves or for nonpatients, 12% prescribed for addicts without addressing the patients' problems of addiction, 42% had inadequate records, 19% prescribed without indication for opioids, 13% were incompetent in additional ways, and 8% were having sexual activity with patients. Not a single physician, for whom information was available, was disciplined solely for overprescribing opioids. The actual risk of an American physician being disciplined by a state medical board for treating a real patient with opioids for a painful medical condition is virtually nonexistent.

  19. Licensing aspects regarding the RBMN project

    International Nuclear Information System (INIS)

    Cuccia, Valeria; Sacramento, Arivaldo M.; Aleixo, Bruna L.; Ferreira, Vinicius V.M.

    2013-01-01

    The licensing process of a waste disposal facility is a complex and demanding undertaking. It proceeds in phases, starting with the site selection and ending many decades later, when the radionuclides decayed and no longer offer possible hazard. That is one of the reasons why the licensing process for the Brazilian repository for low and intermediate level radioactive waste (RBMN Project) is a challenge for all the technicians involved. Besides that, the only national experience associated to this subject arose after a radiological accident in the State of Goias, in 1987. Two different institutions are involved in this licensing process: IBAMA, for environmental licensing, and CNEN, for nuclear licensing. Both of them will evaluate the possible impacts caused by the waste disposal, so it is essential to avoid conflicts and duplications of activities. The RBMN project has different teams for each main activity, and one of them is the Licensing group. This team has been planning the licensing activities for the repository, studying the legal framework and estimating costs and execution time for each step. This paper presents the status of the licensing activities regarding to the RBMN project done by the CNEN staff. (author)

  20. Licensing of ''grandfather's'' facilities: Ukrainian experience

    International Nuclear Information System (INIS)

    Mikolaitchouk, H.; Bogdan, L.; Steinberg, N.

    1995-01-01

    In the former USSR, unlike most countries, radioactive waste management activities including waste disposal needed no license. But after the USSR breakdown the Ukrainian Parliament -- Verkhovna Rada -- invoked the revised Law on Business activities. According to Article 4 of the Law, in order to treat or to dispose radioactive waste every enterprise has to get a special permission or license. In compliance with the Law, the Cabinet of Ministers by its Ordinance of January 13, 1993, authorized the Ukrainian State Committee for Nuclear and Radiation Safety (UkrSCNRS) to issue special permissions or licenses for waste treatment and disposal. And that requirement was valid not only for future activities but also for existing facilities in operation. Taking into account the undergoing legislative process, SCNRS began to develop its licensing process without waiting for the special nuclear laws to be passed. On the basis of the legislation already in effect, first of all the Law on Enterprises (full responsibility of enterprises for their activities) and Law on Business activities (requirement to have a license for special types of activities), the newly formed national regulatory body had to identify all the enterprises that needed to be licensed, to establish relevant procedures, to develop related regulatory documents, to implement these procedures and documents at operating enterprises, and for each case to make a decision concerning feasibility of issuing a license, period of validity and license conditions

  1. Periodic medical check-up among residents of three Nigerian South-western States

    Directory of Open Access Journals (Sweden)

    Saheed Opeyemi Usman

    2016-09-01

    Full Text Available Objectives: General medical examination is a common form of preventive medicine. Periodic medical check-up generally involves thorough history, physical examination and screening of asymptomatic persons by physicians on a regular basis as part of a routine health care process. Periodic medical check-up is considered effective in preventing illness and promoting health and reducing morbidity and mortality. This study is therefore designed to determine the knowledge, attitude and practice of periodic medical check-up among residents of Osun, Ondo and Ekiti States of Nigeria. It is also to determine the influence of educational status on its practice and compare the outcomes in the three states. Materials and Methods: The cross-sectional survey study utilizing both qualitative and quantitative method of data collection was conducted at various locations across the three states. The locations included those of public servants, private sector workers, artisans, traders, business men/women, farmers, among others. Results: 1200 consenting residents participated in the study in each of the three states. 518 (43.2% of the respondents in Ondo State are males while 682 (57.8% are females. 465 (38.8% of the respondents in Ekiti State are males while 735 (61.2% are females. 494 (41.2% of the respondents in Osun State are males while 706 (59.8% are females. The mean age in Ondo, Ekiti and Osun were 43.8 +/- 10.7 years, 44.6 +/- 11.5 years and 41.7 +/- 10.1 years respectively. 89.2%, 88.3% and 87.4% of the respondents are aware of periodic medical check-up in Ondo, Ekiti and Osun states respectively. Conclusion: There is high level of awareness of periodic medical check-up in all three states but the level of practice of routine medical check-up is low. The majority of the respondents probably don't practice it because their health insurance plan does not cover the medical check-up or due to individual/organizational financial constraints. [J Contemp Med 2016

  2. A Comparative Analysis of Patient Access Modes at Wilford Hall United States Air Force Medical Center and Selected Civilian Medical Centers

    Science.gov (United States)

    1983-12-01

    In A COMPARATIVE ANALYSIS OF PATIENT ACCESS MODES AT WILFORD HALL UNITED STATES AIR FORCE MEDICAL CENTER N AND SELECTED CIVILIAN MEDICAL CENTERS0 N...current patient access modes at WHMC and several civilian medical centers of comparable size. This project has pursued the subject of patient access in...selected civilian medical centers which are comparable to WHMC in size, specialty mix, workload, and mission, providing responsive and efficient patient

  3. Slaves of the state - medical internship and community service in South Africa.

    Science.gov (United States)

    Erasmus, Nicolette

    2012-06-05

    Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctors work up to 200 hours of overtime per month under the state's commuted overtime policy. Nurses moonlight in circumvention of the Basic Conditions of Employment Act. For trainee doctors, overtime over 80 hours is unpaid, and rendered involuntarily under threat of not qualifying to practise medicine in South Africa. As forced labour, and sleep deprivation amounting to cruel and degrading treatment, it is outlawed in international law. No other professional group in the country is subjected to such levels of exploitation and discrimination by the state. These abuses should be challenged under the Constitution. Solutions include the installation of electronic time-recording in state hospitals, cessation of unpaid overtime, limits on medical intern shifts to a maximum of 16 hours, and an investigation by the Human Rights Commission of South Africa.

  4. Gifts and influence: Conflict of interest policies and prescribing of psychotropic medications in the United States.

    Science.gov (United States)

    King, Marissa; Bearman, Peter S

    2017-01-01

    The pharmaceutical industry spends roughly 15 billion dollars annually on detailing - providing gifts, information, samples, trips, honoraria and other inducements - to physicians in order to encourage them to prescribe their drugs. In response, several states in the United States adopted policies that restrict detailing. Some states banned gifts from pharmaceutical companies to doctors, other states simply required physicians to disclose the gifts they receive, while most states allowed unrestricted detailing. We exploit this geographic variation to examine the relationship between gift regulation and the diffusion of four newly marketed medications. Using a dataset that captures 189 million psychotropic prescriptions written between 2005 and 2009, we find that uptake of new costly medications was significantly lower in states with marketing regulation than in areas that allowed unrestricted pharmaceutical marketing. In states with gift bans, we observed reductions in market shares ranging from 39% to 83%. Policies banning or restricting gifts were associated with the largest reductions in uptake. Disclosure policies were associated with a significantly smaller reduction in prescribing than gift bans and gift restrictions. In states that ban gift-giving, peer influence substituted for pharmaceutical detailing when a relatively beneficial drug came to market and provided a less biased channel for physicians to learn about new medications. Our work suggests that policies banning or limiting gifts from pharmaceutical representatives to doctors are likely to be more effective than disclosure policies alone. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. An ontology based trust verification of software license agreement

    Science.gov (United States)

    Lu, Wenhuan; Li, Xiaoqing; Gan, Zengqin; Wei, Jianguo

    2017-08-01

    When we install software or download software, there will show up so big mass document to state the rights and obligations, for which lots of person are not patient to read it or understand it. That would may make users feel distrust for the software. In this paper, we propose an ontology based verification for Software License Agreement. First of all, this work proposed an ontology model for domain of Software License Agreement. The domain ontology is constructed by proposed methodology according to copyright laws and 30 software license agreements. The License Ontology can act as a part of generalized copyright law knowledge model, and also can work as visualization of software licenses. Based on this proposed ontology, a software license oriented text summarization approach is proposed which performances showing that it can improve the accuracy of software licenses summarizing. Based on the summarization, the underline purpose of the software license can be explicitly explored for trust verification.

  6. Medical devices and the Middle East: market, regulation, and reimbursement in Gulf Cooperation Council states

    Directory of Open Access Journals (Sweden)

    Howard JJ

    2014-11-01

    Full Text Available Jason J Howard Division of Paediatric Orthopaedics, Department of Surgery, Sidra Medical and Research Center, Doha, Qatar Abstract: With some of the richest economies in the world, the Gulf Cooperation Council (GCC is undergoing rapid growth not only in its population but also in health care expenditure. Despite the GCC's abundance of hydrocarbon-based wealth, the drivers of the medical device industry in the GCC are still in flux, with gains yet to be made in areas of infrastructure, regulation, and reimbursement. However, the regional disease burden, expanding health insurance penetration, increasing privatization, and a desire to attract skilled expatriate health care providers have led to favorable conditions for the medical device market in the GCC. The purpose of this article is to investigate the current state of the GCC medical device industry, with respect to market, regulation, and reimbursement, paying special attention to the three largest medical device markets: Saudi Arabia, the United Arab Emirates, and Qatar. The GCC would seem to represent fertile ground for the development of medical technologies, especially those in line with the regional health priorities of the respective member states. Keywords: medical devices, regulation, reimbursement, Middle East 

  7. Safety evaluation report related to the renewal of the operating license for the Research Reactor at the State University of New York at Buffalo, Docket No. 50-57

    International Nuclear Information System (INIS)

    1983-05-01

    This Safety Evaluation Report for the application filed by the State University of New York at Buffalo for a renewal of Operating License R-77 to continue to operate a research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned by the State University of New York and is located on the campus in Buffalo, New York. Based on its technical review, the staff concludes that the reactor facility can continue to be operated by the University without endangering the health and safety of the public or endangering the environment

  8. License renewal process

    International Nuclear Information System (INIS)

    Fable, D.; Prah, M.; Vrankic, K.; Lebegner, J.

    2004-01-01

    The purpose of this paper is to provide information about license renewal process, as defined by Nuclear Regulatory Commission (NRC). The Atomic Energy Act and NRC regulations limit commercial power reactor licenses to an initial 40 years but also permit such licenses to be renewed. This original 40-year term for reactor licenses was based on economic and antitrust considerations not on limitations of nuclear technology. Due to this selected time period; however, some structures and components may have been engineered on the basis of an expected 40-year service life. The NRC has established a timely license renewal process and clear requirements codified in 10 CFR Part 51 and 10 CFR Part 54, that are needed to assure safe plant operation for extended plant life. The timely renewal of licenses for an additional 20 years, where appropriate to renew them, may be important to ensuring an adequate energy supply during the first half of the 21st Century. License renewal rests on the determination that currently operating plants continue to maintain adequate levels of safety, and over the plant's life, this level has been enhanced through maintenance of the licensing bases, with appropriate adjustments to address new information from industry operating experience. Additionally, NRC activities have provided ongoing assurance that the licensing bases will continue to provide an acceptable level of safety. This paper provides additional discussion of license renewal costs, as one of key elements in evaluation of license renewal justifiability. Including structure of costs, approximately value and two different approaches, conservative and typical. Current status and position of Nuclear Power Plant Krsko, related to license renewal process, will be briefly presented in this paper. NPP Krsko is designed based on NRC Regulations, so requirements from 10 CFR 51, and 10 CFR 54, are applicable to NPP Krsko, as well. Finally, this paper will give an overview of current status of

  9. State Variation in Medical Imaging: Despite Great Variation, the Medicare Spending Decline Continues.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Hughes, Danny R; Duszak, Richard

    2015-10-01

    The purpose of this study was to assess state-level trends in per beneficiary Medicare spending on medical imaging. Medicare part B 5% research identifiable files from 2004 through 2012 were used to compute national and state-by-state annual average per beneficiary spending on imaging. State-to-state geographic variation and temporal trends were analyzed. National average per beneficiary Medicare part B spending on imaging increased 7.8% annually between 2004 ($350.54) and its peak in 2006 ($405.41) then decreased 4.4% annually between 2006 and 2012 ($298.63). In 2012, annual per beneficiary spending was highest in Florida ($367.25) and New York ($355.67) and lowest in Ohio ($67.08) and Vermont ($72.78). Maximum state-to-state geographic variation increased over time, with the ratio of highest-spending state to lowest-spending state increasing from 4.0 in 2004 to 5.5 in 2012. Spending in nearly all states decreased since peaks in 2005 (six states) or 2006 (43 states). The average annual decrease among states was 5.1% ± 1.8% (range, 1.2-12.2%) The largest decrease was in Ohio. In only two states did per beneficiary spending increase (Maryland, 12.5% average annual increase since 2005; Oregon, 4.8% average annual increase since 2008). Medicare part B average per beneficiary spending on medical imaging declined in nearly every state since 2005 and 2006 peaks, abruptly reversing previously reported trends. Spending continued to increase, however, in Maryland and Oregon. Identification of state-level variation may facilitate future investigation of the potential effect of specific and regional changes in spending on patient access and outcomes.

  10. Nuclear plant license renewal

    International Nuclear Information System (INIS)

    Gazda, P.A.; Bhatt, P.C.

    1991-01-01

    During the next 10 years, nuclear plant license renewal is expected to become a significant issue. Recent Electric Power Research Institute (EPRI) studies have shown license renewal to be technically and economically feasible. Filing an application for license renewal with the Nuclear Regulatory Commission (NRC) entails verifying that the systems, structures, and components essential for safety will continue to perform their safety functions throughout the license renewal period. This paper discusses the current proposed requirements for this verification and the current industry knowledge regarding age-related degradation of structures. Elements of a license renewal program incorporating NRC requirements and industry knowledge including a schedule are presented. Degradation mechanisms for structural components, their significance to nuclear plant structures, and industry-suggested age-related degradation management options are also reviewed

  11. The SLOWPOKE licensing model

    Energy Technology Data Exchange (ETDEWEB)

    Snell, V. G.; Takats, F.; Szivos, K.

    1989-08-15

    The SLOWPOKE Energy System (SES-10) is a 10 MW heating reactor that has been developed in Canada. It will be capable of running without a licensed operator in continuous attendance, and will be sited in urban areas. It has forgiving safety characteristics, including transient time-scales of the order of hours. A process called `up-front` licensing has been evolved in Canada to identify, and resolve, regulatory concerns early in the process. Because of the potential market in Hungary for nuclear district heating, a licensing plan has been developed that incorporates Canadian licensing experience, identifies specific Hungarian requirements, and reduces the risk of licensing delays by seeking agreement of all parties at an early stage in the program.

  12. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    1983-10-01

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, these standards will be revised periodically to accommodate comments and reflect new information or experience

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

    Science.gov (United States)

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

    2014-01-01

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

  14. Otolaryngology in the medical school curriculum: Current trends in the United States.

    Science.gov (United States)

    Boscoe, Elizabeth F; Cabrera-Muffly, Cristina

    2017-02-01

    To identify trends in medical school otolaryngology curriculum requirements. Survey of United States allopathic medical schools. A survey was sent to deans of curriculum at allopathic medical schools. We identified opportunities for medical students to learn basic concepts in otolaryngology during their undergraduate medical training. The opportunities were classified into preclinical and clinical as well as elective and mandatory rotations. Of the schools surveyed, 60% responded. Mean class size was 149 students. Sixty-eight percent of surveyed schools noted that 75% to 100% of their students participated in preclinical otolaryngology experiences, with 59% reporting a mandatory preclinical otolaryngology module for all students. Eighty-nine percent of schools offered otolaryngology as a clinical elective rotation, with a mean of 12 students participating yearly. Only 7% of schools required a mandatory otolaryngology clinical rotation. Our data suggest that medical students do not receive sufficient exposure to otolaryngology during medical school. Increased requirements for otolaryngology curriculum may be beneficial to all medical students, regardless of their specialty choice. NA. Laryngoscope, 00:000-000, 2016 127:346-348, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Medical and Nonmedical Use of Prescription Opioids among High School Seniors in the United States

    Science.gov (United States)

    McCabe, Sean Esteban; West, Brady T.; Teter, Christian J.; Boyd, Carol J.

    2012-01-01

    Objective To determine the prevalence of medical and nonmedical use of prescription opioids among high school seniors in the United States, and to assess substance use behaviors based on medical and nonmedical use of prescription opioids. Design Nationally representative samples of high school seniors (modal age 18) were surveyed during the spring of their senior year via self-administered questionnaires. Setting Data were collected in public and private high schools. Participants The sample consisted of 7,374 students from three independent cohorts (2007-09). Main Outcome Measures Self-reports of medical and nonmedical use of prescription opioids and other substance use. Results An estimated 17.6% of high school seniors reported lifetime medical use of prescription opioids, while 12.9% reported nonmedical use of prescription opioids. Gender differences in the medical and nonmedical use were minimal, while racial/ethnic differences were extensive. Over 37% of nonmedical users reported intranasal administration of prescription opioids. An estimated 80% of nonmedical users with an earlier history of medical use had obtained prescription opioids from a prescription they had previously. The odds of substance use behaviors were greater among individuals who reported any history of nonmedical use of prescription opioids relative to those who reported medical use only. Conclusions Nearly one in every four high school seniors in the United States has ever had some exposure to prescription opioids either medically or nonmedically. The quantity of prescription opioids and number of refills prescribed to adolescents should be carefully considered and closely monitored to reduce subsequent nonmedical use of leftover medication. PMID:22566521

  16. Distinguishing medication-free subjects with unipolar disorder from subjects with bipolar disorder: state matters.

    Science.gov (United States)

    Rive, Maria M; Redlich, Ronny; Schmaal, Lianne; Marquand, André F; Dannlowski, Udo; Grotegerd, Dominik; Veltman, Dick J; Schene, Aart H; Ruhé, Henricus G

    2016-11-01

    Recent studies have indicated that pattern recognition techniques of functional magnetic resonance imaging (fMRI) data for individual classification may be valuable for distinguishing between major depressive disorder (MDD) and bipolar disorder (BD). Importantly, medication may have affected previous classification results as subjects with MDD and BD use different classes of medication. Furthermore, almost all studies have investigated only depressed subjects. Therefore, we focused on medication-free subjects. We additionally investigated whether classification would be mood state independent by including depressed and remitted subjects alike. We applied Gaussian process classifiers to investigate the discriminatory power of structural MRI (gray matter volumes of emotion regulation areas) and resting-state fMRI (resting-state networks implicated in mood disorders: default mode network [DMN], salience network [SN], and lateralized frontoparietal networks [FPNs]) in depressed (n=42) and remitted (n=49) medication-free subjects with MDD and BD. Depressed subjects with MDD and BD could be classified based on the gray matter volumes of emotion regulation areas as well as DMN functional connectivity with 69.1% prediction accuracy. Prediction accuracy using the FPNs and SN did not exceed chance level. It was not possible to discriminate between remitted subjects with MDD and BD. For the first time, we showed that medication-free subjects with MDD and BD can be differentiated based on structural MRI as well as resting-state functional connectivity. Importantly, the results indicated that research concerning diagnostic neuroimaging tools distinguishing between MDD and BD should consider mood state as only depressed subjects with MDD and BD could be correctly classified. Future studies, in larger samples are needed to investigate whether the results can be generalized to medication-naïve or first-episode subjects. © 2016 John Wiley & Sons A/S. Published by John Wiley

  17. Exchange sex among people receiving medical care for HIV in the United States - medical monitoring project 2009-2013.

    Science.gov (United States)

    Olaiya, Oluwatosin; Nerlander, Lina; Mattson, Christine L; Beer, Linda

    2018-04-20

    Many studies of persons who exchange sex for money or drugs have focused on their HIV acquisition risk, and are often limited to select populations and/or geographical locations. National estimates of exchange sex among people living with HIV (PLWH) who are in medical care, and its correlates, are lacking. To address these gaps, we analyzed data from the Medical Monitoring Project, a surveillance system that produces nationally representative estimates of behavioral and clinical characteristics of PLWH receiving medical care in the United States, to estimate the weighted prevalence of exchange sex overall, and by selected socio-demographic, behavioral and clinical characteristics. We found 3.6% of sexually active adults reported exchange sex in the past 12 months. We found a higher prevalence of exchange sex among transgender persons, those who experienced homelessness, and those with unmet needs for social and medical services. Persons who exchanged sex were more likely to report depression and substance use than those who did not exchange sex. We found a higher prevalence of sexual behaviors that increase the risk of HIV transmission and lower viral suppression among persons who exchanged sex. PLWH who exchanged sex had a higher prevalence of not being prescribed ART, and not being ART adherent than those who did not exchange sex. We identify several areas for intervention, including: provision of or referral to services for unmet needs (such as housing or shelter), enhanced delivery of mental health and substance abuse screening and treatment, risk-reduction counseling, and ART prescription and adherence support services.

  18. Nuclear licensing and supervision in Germany

    International Nuclear Information System (INIS)

    1996-06-01

    The legal instrument for implementing the licensing and supervisory procedure is specified by statutory ordinances, guidelines and provisions. The licensing requirements for nuclear power plants on the final storage of radioactive wastes in the federal republic of germany are described. The nuclear facilities are subject to continuous state supervision after they have been granted. The appendix gives a brief account of the most important ordinances relating to the AtG and extracts from the Nuclear Safety Convention. (HP)

  19. Visitor, State of Alaska

    Science.gov (United States)

    /Fishing License Get a Birth Certificate, Marriage License, etc. Alaska Permanent Fund Dividend Statewide Library Alaska Historical Society Alaska State Museum Sheldon Jackson Museum Industry Facts Agriculture

  20. United States Nuclear Regulatory Commission staff practice and procedure digest: Commission, Appeal Board and Licensing Board decisions, July 1972--September 1987

    International Nuclear Information System (INIS)

    1988-07-01

    This Revision 9 of the fourth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to September 30, 1987 interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 9 replaces in part earlier editions and supplements and includes appropriate changes reflecting the amendments to the Rules of Practice effective through September 30, 1987. The Digest is roughly structured in accordance with the chronological sequence of the nuclear facility licensing process as set forth in Appendix A to 10 CFR Part 2. Those decisions which did not fit into that structure are dealt with in a section on ''general matters.'' Where appropriate, particular decisions are indexed under more than one heading. Some topical headings contain no decisions citations or discussion. It is anticipated that future updates to the Digest will utilize these headings

  1. Using standardized patients to assess the communication skills of graduating physicians for the comprehensive osteopathic medical licensing examination (COMLEX) level 2-performance evaluation (level 2-PE).

    Science.gov (United States)

    Weidner, Angela C; Gimpel, John R; Boulet, John R; Solomon, Mia

    2010-01-01

    Standardized patients can be trained to assess the communication and interpersonal skills of medical students and graduates. The purpose of this study is to present data to support the psychometric adequacy of the communication ratings provided by standardized patients. Using the data from testing of 3, 450 examinees over a 1-year period, a number of psychometric analyses were undertaken. These included a variance component analysis, the calculation of various validity coefficients, the comparison of communication ratings for select examinee cohorts and case characteristics, and the investigation of some potential sources of score invalidity. Communication skills scores are moderately correlated to other competencies (knowledge, skills) and may be influenced by candidate characteristics such as gender and English language proficiency. They are not dependant on the age of the examinees, the clinical case content, or the gender of the standardized patients. For a multistation assessment, a reasonably precise and valid estimate of a candidate's communication ability can be obtained from trained standardized patients.

  2. Environmental licensing for the implementation of small hydroelectric power plants: analysis and optimization proposals for Minas Gerais state, Brazil; Licenciamento ambiental para implantacao de pequenas centrais hidreletricas: analise e propostas de otimizacao para Minas Gerais

    Energy Technology Data Exchange (ETDEWEB)

    Pedreira, Adriana Coli [Universidade Federal de Itajuba (UNIFEI), MG (Brazil). Programa de Pos-graduacao em Engenharia da Energia], e-mail: adriana@unifei.edu.br; Dupas, Francisco Antonio [Universidade Federal de Itajuba (UNIFEI), MG (Brazil). Inst. de Recursos Naturais], e-mail: dupas@unifei.edu.brT

    2004-07-01

    This document presents the legal and institutional aspects of the environmental licensing for the implementation of small hydroelectric power plants (SHPP). Laws and doctrine related to the topic were researched and concluded for Minas Gerais State with the help of a survey with the enterprises and institutions involved in the process to find out the difficulties that influence the delay of the analysis of the SHPP. It also highlights the importance of environmental zoning as a tool of environmental management for the procedure to obtain these licenses. The results show that 80% of the cases, the institutions do not respect the deadlines, 40% of the studies presented by the enterprises are insufficient, 60% there is lack of human resource and technical capacities of the environment institutions, and 80% non-fulfilment of the laws and non-integration of the institutions. Finally, the study concludes that the difficulties to obtain these licenses are based on the facts mentioned which are, the non-integration of the institutions and also, being recent, on the inexperience of the actors involved. Therefore, it is suggested that deadlines should be imposed for the institutions and the enterprises. There should be training, fund raising for the hiring of technicians, fulfillment of the law and above all, transparency in order to supply the electrical energy demand and guarantee the sustainable development. (author)

  3. 76 FR 38463 - SAFE Mortgage Licensing Act: Minimum Licensing Standards and Oversight Responsibilities

    Science.gov (United States)

    2011-06-30

    ... housing laws that address the dramatic rise in mortgage delinquencies and foreclosures in the residential... regarding the status and employment history of all state-licensed and federally loan originators, as well as...

  4. Air ambulance medical transport advertising and marketing.

    Science.gov (United States)

    2011-01-01

    The National Association of EMS Physicians (NAEMSP), the American College of Emergency Physicians (ACEP), the Air Medical Physician Association (AMPA), the Association of Air Medical Services (AAMS), and the National Association of State EMS Officials (NASEMSO) believe that patient care and outcomes are optimized by using air medical transport services that are licensed air ambulance providers with robust physician medical director oversight and ongoing quality assessment and review. Only air ambulance medical transport services with these credentials should advertise/market themselves as air ambulance services.

  5. Psychotropic Medication Use Among Adults With Schizophrenia and Schizoaffective Disorder in the United States.

    Science.gov (United States)

    Stroup, T Scott; Gerhard, Tobias; Crystal, Stephen; Huang, Cecilia; Tan, Zhiqiang; Wall, Melanie M; Mathai, Chacku M; Olfson, Mark

    2018-05-01

    The authors examined the use of different classes of psychotropic medication in outpatient treatment of schizophrenia and schizoaffective disorder. Data from the United States Medicaid program were used to examine psychotropic medication use in a cohort of patients who had a diagnosis of schizophrenia or schizoaffective disorder in the calendar year 2010. The cohort of Medicaid recipients who filled one or more prescriptions for a psychotropic medication in 2010 included 116,249 patients classified as having schizophrenia and 84,537 classified as having schizoaffective disorder. During 2010, 86.1% of patients with schizoaffective disorder and 70.1% with schizophrenia were treated with two or more different classes of psychotropic. Psychotropic medications other than antipsychotics were commonly prescribed for individuals with a diagnosis of schizophrenia or schizoaffective disorder. Their widespread use and uncertainty about their net benefits signal a need for research on their efficacy, safety, and appropriate use in these conditions.

  6. 42 CFR 456.6 - Review by State medical agency of appropriateness and quality of services.

    Science.gov (United States)

    2010-10-01

    ... and quality of services. 456.6 Section 456.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Provisions § 456.6 Review by State medical agency of appropriateness and quality of services. (a) The... professional health personnel of the appropriateness and quality of Medicaid services. (b) The purpose of this...

  7. [State policy at the end of life. The transformation of medical deontology].

    Science.gov (United States)

    Serrano Ruiz-Calderón, José Miguel

    2012-01-01

    The contemporary state invades privacy in ways that affect even the end of life process. It develops public policies that can affect medical ethics. This limitation of power leaves the doctor's attention to the profession and may become a convenient code.

  8. An Update on the Status of Anatomical Sciences Education in United States Medical Schools

    Science.gov (United States)

    Drake, Richard L.; McBride, Jennifer M.; Pawlina, Wojciech

    2014-01-01

    Curricular changes continue at United States medical schools and directors of gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses continue to adjust and modify their offerings. Developing and supplying data related to current trends in anatomical sciences education is important if informed decisions are going to…

  9. Advances in solid state laser technology for space and medical applications

    Science.gov (United States)

    Byvik, C. E.; Buoncristiani, A. M.

    1988-01-01

    Recent developments in laser technology and their potential for medical applications are discussed. Gas discharge lasers, dye lasers, excimer lasers, Nd:YAG lasers, HF and DF lasers, and other commonly used lasers are briefly addressed. Emerging laser technology is examined, including diode-pumped lasers and other solid state lasers.

  10. Licensed operating reactors

    International Nuclear Information System (INIS)

    1990-01-01

    The US Nuclear Regulatory Commission's monthly LICENSED OPERATING REACTORS Status Summary Report provides data on the operation of nuclear units as timely and accurately as possible. This information is collected by the Office of Information Resources Management, from the Headquarters Staff of NRC's Office of Inspection and Enforcement, from NRC's Regional Offices, and from utilities. Since all of the data concerning operation of the units is provided by the utility operators less than two weeks after the end of the month, necessary corrections to published information are shown on the ERRATA page. This report is divided into three sections: the first contains monthly highlights and statistics for commercial operating units, and errata from previously reported data; the second is a compilation of detailed information on each unit, provided by NRC Regional Offices, IE Headquarters and the Utilities; and the third section is an appendix for miscellaneous information such as spent fuel storage capability, reactor years of experience and non-power reactors in the United States

  11. Licensed operating reactors

    International Nuclear Information System (INIS)

    1989-06-01

    The US Nuclear Regulatory Commission's monthly LICENSED OPERATING REACTORS Status Summary Report provides data on the operation of nuclear units as timely and accurately as possible. This information is collected by the Office of Information Resources Management, from the Headquarters Staff of NRC's Office of Inspection and Enforcement, from NRC's Regional Offices, and from utilities. Since all of the data concerning operation of the units are provided by the utility operators less than two weeks after the end of the month, necessary corrections to published information are shown on the ERRATA page. This report is divided into three sections: the first contains monthly highlights and statistics for commercial operating units, and errata from previously reported data; the second is a compilation of detailed information on each unit, provided by NRC Regional Offices, IE Headquarters and the Utilities; and the third section is an appendix for miscellaneous information such as spent fuel storage capability, reactor years of experience and non-power reactors in the United States

  12. Product Licenses Database Application

    CERN Document Server

    Tonkovikj, Petar

    2016-01-01

    The goal of this project is to organize and centralize the data about software tools available to CERN employees, as well as provide a system that would simplify the license management process by providing information about the available licenses and their expiry dates. The project development process is consisted of two steps: modeling the products (software tools), product licenses, legal agreements and other data related to these entities in a relational database and developing the front-end user interface so that the user can interact with the database. The result is an ASP.NET MVC web application with interactive views for displaying and managing the data in the underlying database.

  13. Understanding Licensing Behavior

    DEFF Research Database (Denmark)

    Cabaleiro, Goretti; Moreira, Solon; Reichstein, Toke

    The potential for rent dissipation has been argued to be the main cause of firms? licensing out behavior being stifled.However, this aspect has been scarcely studied empirically. We draw on rent dissipation arguments, and hypothesize that firms suffering from the not-invented-here (NIH) syndrome......, firms in competitive product markets, and firms that have incurred substantial sunk cost are associated with lower rates of technology out-licensing. We also posit that sunk costs negatively moderate the relationship between competition in the licensor?s product market, and licensing rate. We test our...

  14. Perceptions of the state policy environment and adoption of medications in the treatment of substance use disorders.

    Science.gov (United States)

    Knudsen, Hannah K; Abraham, Amanda J

    2012-01-01

    Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state's Medicaid formulary and that state-contract funding permitted the purchase of medications. States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment.

  15. Licensing an assured isolation facility for low-level radioactive waste. Volume 1: Licensing strategy and issues

    International Nuclear Information System (INIS)

    Silverman, D.J.; Bauser, M.A.; Baird, R.D.

    1998-07-01

    This report provides a detailed set of proposed criteria and guidance for the preparation of a license application for an assured isolation facility (AIF). The report is intended to provide a detailed planning basis upon which a prospective applicant may begin pre-licensing discussions with the Nuclear Regulatory Commission and initiate development of a license application. The report may also be useful to the NRC or to state regulatory agencies that may be asked to review such an application. Volume 1 of this report provides background information, and describes the licensing approach and methodology. Volume 2 identifies specific information that is recommended for inclusion in a license application

  16. Educational gradients in psychotropic medication use among older adults in Costa Rica and the United States.

    Science.gov (United States)

    Domino, Marisa Elena; Dow, William H; Coto-Yglesias, Fernando

    2014-10-01

    The relationship of education, psychiatric diagnoses, and use of psychotropic medication has been explored in the United States, but little is known about this relationship in poorer countries, despite the high burden of mental illness in these countries. This study estimated educational gradients in diagnosis and psychotropic drug use in the United States and Costa Rica, a middle-income country with universal health insurance. Analyses were conducted by using data of older adults (≥60) from the 2005 U.S. Medical Expenditure Panel Survey (N=4,788) and the 2005 Costa Rican Longevity and Healthy Aging Study (N=2,827). Logistic regressions examined the effect of education level (low, medium, or high) and urban residence on the rates of self-reported mental health diagnoses, screening diagnosis, and psychotropic medication use with and without an associated psychiatric diagnosis. Rates of self-reported diagnoses were lower in the United States (12%) than in Costa Rica (20%), possibly reflecting differences in survey wording. In both countries, the odds of having depression were significantly lower among persons with high education. In Costa Rica, use of psychotropic medication among persons with self-reported diagnoses increased by education level. The educational gradients in medication use were different in the United States and Costa Rica, and stigma and access to care in these countries may play an important role in these differences, although type of insurance did not affect educational gradients in the United States. These analyses increase the evidence of the role of education in use of the health care system.

  17. Allegheny County Dog Licenses

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — A list of dog license dates, dog breeds, and dog name by zip code. Currently this dataset does not include City of Pittsburgh dogs.

  18. Credentialing, Licensing, and Education

    Science.gov (United States)

    ... V W X Y Z Credentialing, Licensing, and Education Share: On This Page The Bottom Line Credentials, ... and practices that chiropractors are allowed to perform. Education and Training Professional organizations in some complementary health ...

  19. Site Specific Vendor's License

    Data.gov (United States)

    Montgomery County of Maryland — This dataset contains information of a site-specific vendor's license which is required if an individual sells or offers to sell goods or services from a stationary...

  20. License to build

    International Nuclear Information System (INIS)

    Huntelaar, Mark; Vos, Renate de; Roobol, Lars

    2007-01-01

    Full text: A new license under the nuclear power act is applied for at the Dutch Government for the building of a High Active Repackaging Unit (HAVA-VU in Dutch) at NRG in Petten, The Netherlands. This new building is necessary to comply with our nuclear license to dispose of high active nuclear waste at Petten to the intermediate storage facility (COVRA). In the first part of this paper attention is given to the formal procedure followed by the Government, what type of documents are to be submitted, what time frames are followed, how citizen participation is organized, and as final result a new license. In the second part more detailed information is given about the present license renewal needed for the High Active Repackaging Unit

  1. Hands in medicine: understanding the impact of competency-based education on the formation of medical students’ identities in the United States

    Science.gov (United States)

    2016-01-01

    Purpose There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results Students across all four years of medical school related to the ‘professionalism’ competency domain (50%). They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception. PMID:27572244

  2. Hands in medicine: understanding the impact of competency-based education on the formation of medical students’ identities in the United States

    Directory of Open Access Journals (Sweden)

    Catherine Gonsalves

    2016-08-01

    Full Text Available Purpose There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results Students across all four years of medical school related to the ‘professionalism’ competency domain (50%. They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

  3. Nuclear facilities licensing

    International Nuclear Information System (INIS)

    Carvalho, A.J.M. de.

    1978-01-01

    The need for the adoption of a legal and normative system, defining objectives, pescriptions and the process of nuclear licensing and building of nuclear power plants in Brazil is enphasized. General rules for the development of this system are presented. The Brazilian rules on the matter are discussed. A general view of the German legal system for nuclear power plant licensing and the IAEA recommendations on the subject are finally presented. (A.L.S.L.) [pt

  4. Who killed Rambhor?: The state of emergency medical services in India

    Directory of Open Access Journals (Sweden)

    Rajesh H Garg

    2012-01-01

    Full Text Available In India, the healthcare delivery system starts up from the sub-center at the village level and reaches up to super specialty medical centers providing state of the art emergency medical services (EMS. These highest centers, located in big cities, are considered the last referral points for the patients from nearby cities and states. As the incidents of rail and road accidents have increased in recent years, the role of EMS becomes critical in saving precious lives. But when the facilities and management of these emergency centers succumbs before the patient, then the question arises regarding the adequate availability and quality of EMS. The death of an unknown common man, Rambhor, for want of EMS in three big hospitals in the national capital of India put a big question on the "health" of the emergency health services in India. The emergency services infrastructure seems inadequate and quality and timely provision of EMS to critical patients appears unsatisfactory. There is lack of emergency medicine (EM specialists in India and also the postgraduation courses in EM have not gained foot in our medical education system. Creation of a Centralized Medical Emergency Body, implementation of management techniques, modification of medical curriculum, and fixing accountability are some of the few steps which are required to improve the EMS in India.

  5. Medical devices and the Middle East: market, regulation, and reimbursement in Gulf Cooperation Council states.

    Science.gov (United States)

    Howard, Jason J

    2014-01-01

    With some of the richest economies in the world, the Gulf Cooperation Council (GCC) is undergoing rapid growth not only in its population but also in health care expenditure. Despite the GCC's abundance of hydrocarbon-based wealth, the drivers of the medical device industry in the GCC are still in flux, with gains yet to be made in areas of infrastructure, regulation, and reimbursement. However, the regional disease burden, expanding health insurance penetration, increasing privatization, and a desire to attract skilled expatriate health care providers have led to favorable conditions for the medical device market in the GCC. The purpose of this article is to investigate the current state of the GCC medical device industry, with respect to market, regulation, and reimbursement, paying special attention to the three largest medical device markets: Saudi Arabia, the United Arab Emirates, and Qatar. The GCC would seem to represent fertile ground for the development of medical technologies, especially those in line with the regional health priorities of the respective member states.

  6. United States academic medical centers: priorities and challenges amid market transformation.

    Science.gov (United States)

    Thompson, Irene M; Anason, Barbara

    2012-01-01

    United States academic medical centers (AMCs) have upheld their long-standing reputation for excellence by teaching and training the next generation of physicians, supporting medical research, providing world-class medical care, and offering breakthrough treatments for highly complex medical cases. In recent years, the pace and direction of change reshaping the American health care industry has created a set of new and profound challenges that AMC leaders must address in order to sustain their institutions. University HealthSystem Consortium (UHC) is an alliance of 116 leading nonprofit academic medical centers and 276 of their affiliated hospitals, all of which are focused on delivering world-class patient care. Formed in 1984, UHC fosters collaboration with and among its members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. Each year, UHC surveys the executives of its member institutions to understand the issues they view as most critical to sustaining the viability and success of their organizations. The results of UHC's most recent 2011 member survey, coupled with a 2012 Strategic Health Perspectives Harris Interactive presentation, based in parton surveys of major health care industry stakeholders reveal the most important and relevant issues and opportunities that hospital leaders face today, as the United States health care delivery system undergoes a period of unprecedented transformation.

  7. Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009-2014.

    Science.gov (United States)

    Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R Luke

    2018-01-01

    To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.

  8. Library instruction in medical education: a survey of current practices in the United States and Canada.

    Science.gov (United States)

    Nevius, Amanda M; Ettien, A'Llyn; Link, Alissa P; Sobel, Laura Y

    2018-01-01

    The most recent survey on instruction practices in libraries affiliated with accredited medical institutions in the United States was conducted in 1996. The present study sought to update these data, while expanding to include Canadian libraries. Additional analysis was undertaken to test for statistically significant differences between library instruction in the United States and Canada and between libraries affiliated with highly ranked and unranked institutions. A twenty-eight-question survey was distributed to libraries affiliated with accredited US and Canadian medical schools to assess what and how often librarians teach, as well as how librarians are involved in the curriculum committee and if they are satisfied with their contact with students and faculty. Quantitative data were analyzed with SAS, R, and MedCalc. Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall. In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians' provision of instruction in multiple formats on multiple topics is increasingly common.

  9. Current disparities in the prices of medical materials between Japan and the United States: further investigation of cardiovascular medical devices.

    Science.gov (United States)

    Yasunaga, Hideo; Ide, Hiroo; Imamura, Tomoaki

    2007-02-01

    Prices of medical devices in Japan were previously reported to be 2 to 4 times higher than those in the United States in 1996 and 1997. However, such data are out of date. We previously compared the market prices in early 2005 between Japan and the US for 16 items in 10 categories of medical materials, and showed that price differences still existed for all these items. However, the number of items investigated was small for each category, and generalization of the results might have been limited. The present study conducted a further investigation into price information for multiple items for each category, focusing on 5 cardiovascular devices. The US market price information was obtained from interviews of a healthcare provider network and 2 different group-purchasing organizations. We could obtain price information on 19 items in 5 categories. We substituted the Japanese reimbursement prices for the Japanese market prices. The price ratio (Japanese reimbursement price / US market price)was 2.0-3.5 for coronary stents, 5.9-6.8 for percutaneous transluminal coronary angioplasty catheters, 2.2-3.5 for pacemakers, 1.6-2.5 for mechanical valves, and 3.4-4.7 for oxygenators. The price disparities for cardiovascular devices between Japan and the US were reconfirmed. Japan's healthcare system should establish group-purchasing organizations, promote centers of clinical excellence, and abolish regulation of parallel imports and protectionism under the Japanese Pharmaceutical Affairs Law.

  10. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    1994-06-01

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes. Revision 7 was published in January 1993 and became effective in August 1993. Supplement 1 is being issued primarily to implement administrative changes to the requalification examination program resulting from the amendment to 10 CFR 55 that eliminated the requirement for every licensed operator to pass an NRC-conducted requalification examination as a condition for license renewal. The supplement does not substantially alter either the initial or requalification examination processes and will become effective 30 days after its publication is noticed in the Federal Register. The corporate notification letters issued after the effective date will provide facility licensees with at least 90 days notice that the examinations will be administered in accordance with the revised procedures

  11. Culture and medical decision making: Healthcare consumer perspectives in Japan and the United States.

    Science.gov (United States)

    Alden, Dana L; Friend, John M; Lee, Angela Y; de Vries, Marieke; Osawa, Ryosuke; Chen, Qimei

    2015-12-01

    Two studies identified core value influences on medical decision-making processes across and within cultures. In Study 1, Japanese and American adults reported desired levels of medical decision-making influence across conditions that varied in seriousness. Cultural antecedents (interdependence, independence, and power distance) were also measured. In Study 2, American adults reviewed a colorectal cancer screening decision aid. Decision preparedness was measured along with interdependence, independence, and desire for medical information. In Study 1, higher interdependence predicted stronger desire for decision-making information in both countries, but was significantly stronger in Japan. The path from information desire to decision-making influence desire was significant only in Japan. The independence path to desire for decision-making influence was significant only in the United States. Power distance effects negatively predicted desire for decision-making influence only in the United States. For Study 2, high (low) interdependents and women (men) in the United States felt that a colorectal cancer screening decision aid helped prepare them more (less) for a medical consultation. Low interdependent men were at significantly higher risk for low decision preparedness. Study 1 suggests that Japanese participants may tend to view medical decision-making influence as an interdependent, information sharing exchange, whereas American respondents may be more interested in power sharing that emphasizes greater independence. Study 2 demonstrates the need to assess value influences on medical decision-making processes within and across cultures and suggests that individually tailored versions of decision aids may optimize decision preparedness. (c) 2015 APA, all rights reserved).

  12. [Medical doctors as the state presidents and prime ministers--a biographical analysis].

    Science.gov (United States)

    Lass, Piotr; Szarszewski, Adam; Gaworska-Krzemińska, Aleksandra; Sławek, Jarosław

    2012-01-01

    The authors overviewed the biographies of 29 medical doctors who became the heads of the state or the prime ministers of their countries. Most of them ruled in a countries of fresh or unstable democracies, most often in Asia, Africa and Latin America, three of them were bloody dictators. With the exemptions of Georges Clemenceau and Sun-Yat-Sen they were not famous as historical figures, although some were good administrators like the prime minister of Norway, Gro Harlem Brundtland, Malayan prime minister Mahatir bin Mohamad, Brasilian and Chilean presidents, Juscelino Kubitschek and Veronica Bachelet. Regarding specialisation was mostly general medics or they specialised in public health.

  13. Licensing of the Ignalina NPP

    International Nuclear Information System (INIS)

    Kutas, S.

    1999-01-01

    Since 1991 State Nuclear Power Safety Inspectorate (VATESI) has regulated Ignalina NPP operation by issuing annual operating permits. Those have been issued following submission of specified documents by the Ignalina NPP that have been reviewed by VATESI. However, according to to the procedures that are now established in the Law on Nuclear Energy and subordinate regulations the use of nuclear energy in the Republic of Lithuania is subject to strict licensing. Therefore a decision about the licence for continued operation of unit 1 should be taken. Licence would be granted by VATESI in cooperation with the Ministry of Health, Ministry of Environment and the institutions of local authorities. Ignalina NPP presented to the VATESI safety analysis report (SAR) with other documents. SAR was made mainly by foreign experts and financed by European Bank for Reconstruction and Development (EBRD). VATESI in this process is supported by western regulators. A special project LAP - Licensing Assistance Project was launched to help VATESI perform licensing according western practices

  14. 45 CFR 1321.75 - Licenses and safety.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Licenses and safety. 1321.75 Section 1321.75... AND COMMUNITY PROGRAMS ON AGING Service Requirements § 1321.75 Licenses and safety. The State shall... that the facility complies with all applicable State and local health, fire, safety, building, zoning...

  15. The workplace satisfaction of Romania’s medical personnel in state and public institutions

    Directory of Open Access Journals (Sweden)

    Ghenu Cristina

    2017-07-01

    Full Text Available Nowadays the Romanian medical system is facing changes in terms of qualified personnel. Each year a great number of doctors decide to leave Romania in order to conduct practice in other countries with better working conditions. In this situation where doctors are no longer pleased to work in Romanian institutions, can we question the quality of their working environment? This study aims to determine the workplace satisfaction of Romania’s medical personnel currently working in private as well as state healthcare institutions. In this process, the study also discloses the inside image of Romanian medical units concerning the quality of the working environment, the quality of communications between subordinates belonging to the same section as well as their relations with their „direct superior”, „hierarchic superior” and „senior management”. To construct the current research, Romanian medical personnel completed a survey in order to determine their knowledge and judgment regarding their working environment. The research implied two phases: the first phase lasted one month and a half during which 100 medical personnel from a public hospital were selected to answer a survey; the second phase followed and it targeted the application of the same questions on 100 medical personnel working in a private institution. The survey comprised situations of everyday life in which any employee can be found. The results reveal the present situation of Romanian medical personnel, how often, despite of their unpleasant working conditions, they are forced to give their best in order to provide the quality medical treatment that any patient is entitled to. Therefore, the findings (1 reveal the inside image of Romanian hospital’s system and (2 offer an empirical foundation for subsequent research and improvement of working environments in Romanian hospitals.

  16. Exposure and Knowledge of Sharps Injuries among Medical Students in Seven States of Mexico

    Directory of Open Access Journals (Sweden)

    Adrián Camacho-Ortiz

    2015-03-01

    Full Text Available Background: Medical students are vulnerable to accidental exposure to blood-borne pathogens when performing clinical activities. Knowle­dge of both the prevalence of exposure and necessary reporting procedures is important to minimize the risk of harm to medical students. Methods: A cross-sectional online survey of medical students from 19 universities from seven states in Mexico was utilized to determine the prevalence of needle stick injuries amongst medical students and the associated reporting procedures. Results: We included 312 res­pondents; of these, 52.24% were men and 47.76% were women, with a mean age of 23.19 years (SD ± 2.11 years. Nearly all of them (94.23% were medical students doing clerkships in public hospitals. Mean knowledge score of blood-borne pathogens was 3.6 (SD ± 1.16 on a scale of 0-10 designed specifically for this study. Thirty-five per cent of the respondents had sustained a needle stick injury at some point during their medical school training, and 33.97% reported some type of mucocutaneous exposure. Overall, the non-reporting rate of needle stick injury was 48.34%. Approximately 25% of the respondents were not familiar with reporting procedures in the event of a needle stick injury or mucocutaneous exposure; 61.50% had received information from their hospital about the standard protocol to follow after a blood or body fluid exposure. Conclusion: In this Mexican population of medical students, there is a high risk of suffering needle stick injuries during medical training. Furthermore, knowledge regarding prevention, evaluation, and reporting of needle stick injuries is suboptimal.

  17. Predicting Falls in Parkinson Disease: What Is the Value of Instrumented Testing in OFF Medication State?

    Directory of Open Access Journals (Sweden)

    Martina Hoskovcová

    Full Text Available Falls are a common complication of advancing Parkinson's disease (PD. Although numerous risk factors are known, reliable predictors of future falls are still lacking. The objective of this prospective study was to investigate clinical and instrumented tests of balance and gait in both OFF and ON medication states and to verify their utility in the prediction of future falls in PD patients.Forty-five patients with idiopathic PD were examined in defined OFF and ON medication states within one examination day including PD-specific clinical tests, instrumented Timed Up and Go test (iTUG and computerized dynamic posturography. The same gait and balance tests were performed in 22 control subjects of comparable age and sex. Participants were then followed-up for 6 months using monthly fall diaries and phone calls.During the follow-up period, 27/45 PD patients and 4/22 control subjects fell one or more times. Previous falls, fear of falling, more severe motor impairment in the OFF state, higher PD stage, more pronounced depressive symptoms, higher daily levodopa dose and stride time variability in the OFF state were significant risk factors for future falls in PD patients. Increased stride time variability in the OFF state in combination with faster walking cadence appears to be the most significant predictor of future falls, superior to clinical predictors.Incorporating instrumented gait measures into the baseline assessment battery as well as accounting for both OFF and ON medication states might improve future fall prediction in PD patients. However, instrumented testing in the OFF state is not routinely performed in clinical practice and has not been used in the development of fall prevention programs in PD. New assessment methods for daylong monitoring of gait, balance and falls are thus required to more effectively address the risk of falling in PD patients.

  18. United States Nuclear Regulatory Commission Staff practice and procedure digest: Commission, Appeal Board and Licensing Board Decisions, July 1972--December 1988

    International Nuclear Information System (INIS)

    1989-10-01

    This Revision 2 of the fifth edition of the NRC Staff Practice and Procedure Digest contains a digest of a number of Commission, Atomic Safety and Licensing Appeal Board, and Atomic Safety and Licensing Board decisions issued during the period from July 1, 1972 to December 31, 1988, interpreting the NRC's Rules of Practice in 10 CFR Part 2. This Revision 2 replaces in part earlier editions and revisions and includes appropriate changes reflecting the amendments to the Rules of Practice Effective through December 31, 1988. The Practice and Procedure Digest was originally prepared by attorneys in the NRC's Office of the Executive Legal Director (now, Office of the General Counsel) as an internal research tool. Because of its proven usefulness to those attorneys, it was decided that it might also prove useful to members of the public. Accordingly, the decision was made to publish the Digest and subsequent editions thereof. This edition of the Digest was prepared by attorneys from Aspen Systems Corporation pursuant to Contract number 18-89-346

  19. Retrospective on the construction and practice of a state-level emergency medical rescue team.

    Science.gov (United States)

    Lei, Zhang; Haitao, Guo; Xin, Wang; Yundou, Wang

    2014-10-01

    For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.

  20. Cross-cultural medical education in the United States: key principles and experiences.

    Science.gov (United States)

    Betancourt, Joseph R; Cervantes, Marina C

    2009-09-01

    The field of cross-cultural care focuses on the ability to communicate effectively and provide quality health care to patients from diverse sociocultural backgrounds. In recent years, medical schools in the United States have increasingly recognized the growing importance of incorporating cross-cultural curricula into medical education. Cross-cultural medical education in the United States has emerged for four reasons: (1) the need for providers to have the skills to care for a diverse patient population; (2) the link between effective communication and health outcomes; (3) the presence of racial/ethnic disparities that are, in part, due to poor communication across cultures; and (4) medical school accreditation requirements. There are three major approaches to cross-cultural education: (1) the cultural sensitivity/awareness approach that focuses on attitudes; (2) the multicultural/categorical approach that focuses on knowledge; and (3) the cross-cultural approach that focuses on skills. The patient-based approach to cross-cultural care combines these three concepts into a framework that can be used to care for any patient, anytime, anywhere. Ultimately, if cross-cultural medical education is to evolve, students must believe it is important and understand that the categorical approach can lead to stereotyping; it should be taught using patient cases and highlighting clinical applications; it should be embedded in a longitudinal, developmentally appropriate fashion; and it should be integrated into the larger curriculum whenever possible. At the Harvard Medical School, we have tried to apply all of these lessons to our work, and we have started to develop a strategic integration process where we try to raise awareness, impart knowledge, and teach cross-cultural skills over the 4 years of schooling.

  1. Do medical French students know how to properly score a mini mental state examination?

    Science.gov (United States)

    Hernandorena, Intza; Chauvelier, Sophie; Vidal, Jean-Sébastien; Piccoli, Matthieu; Coulon, Joséphine; Hugonot-Diener, Laurence; Rigaud, Anne-Sophie; Hanon, Olivier; Duron, Emmanuelle

    2017-06-01

    The mini mental state examination (MMSE) is a validated tool to assess global cognitive function. Training is required before scoring. Inaccurate scoring can lead to inappropriate medical decisions. In France, MMSE is usually scored by medical students. To assess if medical French students know how to properly score a mini mental state examination. Two « physician-patient » role playings performed by 2 specialized physicians, were performed in front of University Paris V medical students. Role playing A: Scoring of a MMSE according to a script containing five tricks; Role playing B: Find the 5 errors committed in a pre-filled MMSE form, according to the second script. One hundred and five students (64.4% of women, 49.5% in fifth medical school year) anonymously participated. Eighty percent of students had already scored a MMSE and 40% had been previously trained to MMSE scoring. Forty five percent of students previously scored an MMSE, without previously being trained. In test A, 16% of students did not commit any errors, 45.7% one error and 38.1% two errors. In test B, the proportion of students who provided 0, 1, 2, 3, 4 and 5 good answers was 3.3%, 29.7%, 29.7%, 25.3%, 7.7% and 4.4% respectively. No association between medical school year, previous training to MMSE scoring and performances at both tests were found. French students do not properly score MMSE. MMSE scoring is not enough or accurately taught (by specialists). The university will provide on line the tests and a short filmed teaching course performed by neuropsychological specialists.

  2. The Impact of State Medical Malpractice Reform on Individual-Level Health Care Expenditures.

    Science.gov (United States)

    Yu, Hao; Greenberg, Michael; Haviland, Amelia

    2017-12-01

    Past studies of the impact of state-level medical malpractice reforms on health spending produced mixed findings. Particularly salient is the evidence gap concerning the effect of different types of malpractice reform. This study aims to fill the gap. It extends the literature by examining the general population, not a subgroup or a specific health condition, and controlling for individual-level sociodemographic and health status. We merged the Database of State Tort Law Reforms with the Medical Expenditure Panel Survey between 1996 and 2012. We took a difference-in-differences approach to specify a two-part model for analyzing individual-level health spending. We applied the recycled prediction method and the bootstrapping technique to examining the difference in health spending growth between states with and without a reform. All expenditures were converted to 2010 U.S. dollars. Only two of the 10 major state-level malpractice reforms had significant impacts on the growth of individual-level health expenditures. The average annual expenditures in states with caps on attorney contingency fees increased less than that in states without the reform (p negligence rule, the average annual expenditures increased more in both states with a pure comparative fault reform (p < .05) and states with a comparative fault reform that barred recovery if the plaintiff's fault was equal to or greater than the defendant's (p < .05). A few state-level malpractice reforms had significantly affected the growth of individual-level health spending, and the direction and magnitude of the effects differed by type of reform. © Health Research and Educational Trust.

  3. Cohesion assessment of student groups from the faculty of dentistry at Burdenko Voronezh State Medical University

    Directory of Open Access Journals (Sweden)

    Pashkov A. N.

    2017-10-01

    Full Text Available the article presents data on the study of the cohesion of 115 students from the faculty of dentistry at Burdenko Voronezh State Medical University. The study revealed that students have high and medium favorable psychological climate. 99 of them have the average level of group cohesion, and 16 revealed a low level of this indicator. To improve the educational process and interpersonal relations, these results must be taken into account when forming groups.

  4. Return of TRIGA fuel from the Medical University of Hanover (MHH) to the United States

    International Nuclear Information System (INIS)

    Hampel, Gabriele; Klaus, Uwe; Schmidt, Thomas

    1999-01-01

    The Medical University of Hanover (MHH) returned its TRIGA fuel to the United States in the summer of 1999. This paper deals with the procedure for handling the fuel elements within and outside the reactor facility. It describes the dry loading technology, taking into account the special conditions relevant to the MHH. It also includes the time scale for both the various steps of the procedure and the entire process, as well as the main results of the radiological surveys. (author)

  5. 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.

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

    Science.gov (United States)

    Smith, Lawrence

    2009-01-01

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

  7. Impact of Medical Tourism on Cosmetic Surgery in the United States

    Science.gov (United States)

    Franzblau, Lauren E.

    2013-01-01

    Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States. PMID:25289258

  8. Impact of Medical Tourism on Cosmetic Surgery in the United States

    Directory of Open Access Journals (Sweden)

    Lauren E. Franzblau, BS

    2013-10-01

    Full Text Available Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

  9. Impact of medical tourism on cosmetic surgery in the United States.

    Science.gov (United States)

    Franzblau, Lauren E; Chung, Kevin C

    2013-10-01

    Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

  10. Medical police and the nanny state: public health versus private autonomy.

    Science.gov (United States)

    Baron, Jeremy Hugh

    2006-07-01

    Rome tried to increase both the numbers of its people and their well-being, and hence their wealth, but it was not until the 16th century that European rulers were urged to achieve these aims by the power of the state to enforce public health. By the 17th century, absolutist states such as France, Austria and especially Germany had created an administrative profession of enlightened despotism, with medical police to encourage healthy and thus wealth-producing citizens. Johann Peter Frank (1745-1821) was the profession's exemplar with his 6,262 page System einer vollstländigen medischiner Polizey, leading to comprehensive public health legislation in German-speaking states, followed by more libertarian countries such as Britain and the United States. However, controversy continues on the role of government in trying to save its citizens, and especially their children, from harming themselves and/or others by their actions and omissions.

  11. Nuclear licensing in Slovenia

    International Nuclear Information System (INIS)

    Prah, M.; Spiler, J.; Vojnovic, D.; Pristavec, M.

    1998-01-01

    The article presents the approach to nuclear licensing in Slovenia. The paper describes, the initialization, internal authorization and review process in the Krsko NPP. The overall process includes preparation, internal independent evaluation, the Krsko Operating Committee and the Krsko Safety Committee review and internal approval. In addition, the continuation of the licensing process is discussed which includes independent evaluation by an authorized institution and a regulatory body approval process. This regulatory body approval process includes official hearing of the licensee, communication with the licensee, and final issuance of a license amendment. The internal evaluation, which follows the methodology of US NRC (defined in 10 CFR 50.59 and NUMARC 125) is described. This concept is partially implemented in domestic legislation.(author)

  12. Software licenses: Stay honest!

    CERN Multimedia

    Computer Security Team

    2012-01-01

    Do you recall our article about copyright violation in the last issue of the CERN Bulletin, “Music, videos and the risk for CERN”? Now let’s be more precise. “Violating copyright” not only means the illegal download of music and videos, it also applies to software packages and applications.   Users must respect proprietary rights in compliance with the CERN Computing Rules (OC5). Not having legitimately obtained a program or the required licenses to run that software is not a minor offense. It violates CERN rules and puts the Organization at risk! Vendors deserve credit and compensation. Therefore, make sure that you have the right to use their software. In other words, you have bought the software via legitimate channels and use a valid and honestly obtained license. This also applies to “Shareware” and software under open licenses, which might also come with a cost. Usually, only “Freeware” is complete...

  13. Experiences and meanings of integration of TCAM (Traditional, Complementary and Alternative Medical) providers in three Indian states: results from a cross-sectional, qualitative implementation research study.

    Science.gov (United States)

    Nambiar, D; Narayan, V V; Josyula, L K; Porter, J D H; Sathyanarayana, T N; Sheikh, K

    2014-11-25

    Efforts to engage Traditional, Complementary and Alternative Medical (TCAM) practitioners in the public health workforce have growing relevance for India's path to universal health coverage. We used an action-centred framework to understand how policy prescriptions related to integration were being implemented in three distinct Indian states. Health departments and district-level primary care facilities in the states of Kerala, Meghalaya and Delhi. In each state, two or three districts were chosen that represented a variation in accessibility and distribution across TCAM providers (eg, small or large proportions of local health practitioners, Homoeopaths, Ayurvedic and/or Unani practitioners). Per district, two blocks or geographical units were selected. TCAM and allopathic practitioners, administrators and representatives of the community at the district and state levels were chosen based on publicly available records from state and municipal authorities. A total of 196 interviews were carried out: 74 in Kerala, and 61 each in Delhi and Meghalaya. We sought to understand experiences and meanings associated with integration across stakeholders, as well as barriers and facilitators to implementing policies related to integration of Traditional, Complementary and Alternative (TCA) providers at the systems level. We found that individual and interpersonal attributes tended to facilitate integration, while system features and processes tended to hinder it. Collegiality, recognition of stature, as well as exercise of individual personal initiative among TCA practitioners and of personal experience of TCAM among allopaths enabled integration. The system, on the other hand, was characterised by the fragmentation of jurisdiction and facilities, intersystem isolation, lack of trust in and awareness of TCA systems, and inadequate infrastructure and resources for TCA service delivery. State-tailored strategies that routinise interaction, reward individual and system

  14. Licensing safety critical software

    International Nuclear Information System (INIS)

    Archinoff, G.H.; Brown, R.A.

    1990-01-01

    Licensing difficulties with the shutdown system software at the Darlington Nuclear Generating Station contributed to delays in starting up the station. Even though the station has now been given approval by the Atomic Energy Control Board (AECB) to operate, the software issue has not disappeared - Ontario Hydro has been instructed by the AECB to redesign the software. This article attempts to explain why software based shutdown systems were chosen for Darlington, why there was so much difficulty licensing them, and what the implications are for other safety related software based applications

  15. Evaluation of the environmental licensing process for small hydroelectric power plants in Minas Gerais state, Brazil; Avaliacao do processo de licenciamento ambiental para pequenas centrais hidreletricas no estado de Minas Gerais

    Energy Technology Data Exchange (ETDEWEB)

    Pedreira, Adriana Coli

    2004-07-01

    The present situation of the environmental licensing process have been slow and complicated, in relation to the current conception of the sustainable environmental development in the country. The enterprises and impacting activities are being discussed and analysed through a great number of environmental laws and specific laws to each enterprise. These laws along with the inexperience of the enterprises and of the many institutions involved in the process are an obstacle to the development. This document presents the legal and institutional aspects of the environmental licensing for the implementation of small hydroelectric power plants. Laws and doctrine related to the topic were researched and concluded for Minas Gerais State with the help of a survey with the enterprises and institutions involved in the process to find out the difficulties that influence the delay of the analysis of the SHPP. The results show that the main barriers are the non-application of the CONAMA resolution 279/2001 to the SHPP, undetermined inspection criteria, excess of environmental programs, technical incapacity, lack of financial resources, non-integration of the institutional organs, the building of SHPP in permanent preservation area, project interfering in the fish fauna, studies an environmental impact with then reports and public audiences. Finally, concludes that the difficulties are based on the non-integration of the institutions and also, being recent, on the inexperience of the actors involved. Therefore, the study suggests on increase of the technical body in the institutions and training of their analysts; hiring of specialized consultancy, implantation of an environmental integrated system, social communication program in the planning phase, fulfillment of the CONAMA resolution 279/2001; integration of public ministry representatives in the licensing organs; application of planning and zoning, deadlines and legal imposition of these deadlines in order to supply the

  16. Licensing in an international triopoly

    Science.gov (United States)

    Ferreira, Fernanda A.; Ferreira, Flávio

    2011-12-01

    We study the effects of entry of two foreign firms on domestic welfare in the presence of licensing, when the incumbent is technologically superior to the entrants. We consider two different situations: (i) the cost-reducing innovation is licensed to both entrants; (ii) the cost-reducing innovation is licensed to just one of the entrants. We analyse three kind of license: (lump-sum) fixed-fee; (per-unit) royalty; and two-part tariff, that is a combination of a fixed-fee and a royalty. We prove that a two part tariff is never an optimal licensing scheme for the incumbent. Moreover, (i) when the technology is licensed to the two entrants, the optimal contract consists of a licensing with only output royalty; and (ii) when the technology is licensed to just one of the entrants, the optimal contract consists of a licensing with only a fixed-fee.

  17. Pre-Medical Preparation in Microbiology among Applicants and Matriculants in Osteopathic Medical School in the United States.

    Science.gov (United States)

    Ramos, Raddy L; Guercio, Erik; Martinez, Luis R

    2017-01-01

    It is recognized that medical school curricula contain significant microbiology-related content as part of the training of future physicians who will be responsible stewards of antimicrobials. Surprisingly, osteopathic and allopathic medical schools do not require pre-medical microbiology coursework, and the extent to which medical students have completed microbiology coursework remains poorly understood. In this report, we show that fewer than 3% of applicants and matriculants to osteopathic medical school (OMS) have completed an undergraduate major or minor in microbiology, and fewer than 17% of applicants and matriculants to OMS have completed one or more microbiology-related courses. These data demonstrate limited pre-medical microbiology-related knowledge among osteopathic medical students, which may be associated with an increase in perceived stress when learning this content or during clinical rotations as well as a potential lack of interest in pursuing a career in infectious diseases.

  18. Accommodating the medical use of marijuana: surveying the differing legal approaches in Australia, the United States and Canada.

    Science.gov (United States)

    Bogdanoski, Tony

    2010-02-01

    While the scientific and medical communities continue to be divided on the therapeutic benefits and risks of cannabis use, anecdotal evidence from medical users themselves suggests that using cannabis is indeed improving their quality of life by alleviating their pain and discomfort. Notwithstanding the benefits anecdotally claimed by these medical users and the existence of some scientific studies confirming their claims, criminal drug laws in all Australian and most United States jurisdictions continue to prohibit the possession, cultivation and supply of cannabis even for medical purposes. However, in contrast to Australia and most parts of the United States, the medical use of cannabis has been legal in Canada for about a decade. This article reviews these differing legal and regulatory approaches to accommodating the medical use of cannabis (namely, marijuana) as well as some of the challenges involved in legalising it for medical purposes.

  19. Medical research in emergency research in the European Union member states: tensions between theory and practice.

    Science.gov (United States)

    Kompanje, Erwin J O; Maas, Andrew I R; Menon, David K; Kesecioglu, Jozef

    2014-04-01

    In almost all of the European Union member states, prior consent by a legal representative is used as a substitute for informed patient consent for non-urgent medical research. Deferred (patient and/or proxy) consent is accepted as a substitute in acute emergency research in approximately half of the member states. In 12 European Union member states emergency research is not mentioned in national law. Medical research in the European Union is covered by the Clinical Trial Directive 2001/20/EC. A proposal for a regulation by the European Commission is currently being examined by the European Parliament and the Council and will replace Directive 2001/20/EC. Deferred patient and/or proxy consent is allowed in the proposed regulation, but does not fit completely in the practice of emergency research. For example, deferred consent is only possible when legal representatives are not available. This criterion will delay inclusion of patients in acute life-threatening conditions in short time frames. As the regulation shall be binding in its entirety in all member states, emergency research in acute situations is still not possible as it should be.

  20. Medical Device Regulation: A Comparison of the United States and the European Union.

    Science.gov (United States)

    Maak, Travis G; Wylie, James D

    2016-08-01

    Medical device regulation is a controversial topic in both the United States and the European Union. Many physicians and innovators in the United States cite a restrictive US FDA regulatory process as the reason for earlier and more rapid clinical advances in Europe. The FDA approval process mandates that a device be proved efficacious compared with a control or be substantially equivalent to a predicate device, whereas the European Union approval process mandates that the device perform its intended function. Stringent, peer-reviewed safety data have not been reported. However, after recent high-profile device failures, political pressure in both the United States and the European Union has favored more restrictive approval processes. Substantial reforms of the European Union process within the next 5 to 10 years will result in a more stringent approach to device regulation, similar to that of the FDA. Changes in the FDA regulatory process have been suggested but are not imminent.

  1. Spanish adaptation of The Penn State College of Medicine Scale to assess professionalism in medical students.

    Science.gov (United States)

    Bustamante, Eliseo; Sanabria, Álvaro

    2014-01-01

    Professionalism is a subject of interest in medical schools around the world. The use of a questionnaire could be useful to assess professionalism in Colombia. To adapt The Penn State University College of Medicine Professionalism Questionnaire as a culturally valid instrument in the Spanish language. We followed recommendations from the IQOLA project and used forward and back translation with four independent translations, as well as a pilot evaluation and an evaluation of psychometric features with 250 students. We evaluated item-scale correlations and internal consistency with Chronbach's alpha test and conducted a principal components factor analysis. Global Cronbach's alpha was 0.86, the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.83, and Bartlett's test of sphericity had a p >0.00001. We found six factors that explained 93% of the total variance and four new factors emerged in the factor analysis, while eight items had high uniqueness. The Penn State University College of Medicine Scale measures professionalism attitudes in medical students with good reliability. However, the structure of the scale demonstrated differences when used in the Latin American medical student population.

  2. Medicalization and morality in a weak state: health, hygiene and water in Dar Es Salaam, Tanzania.

    Science.gov (United States)

    Obrist, Brigit

    2004-04-01

    Inspired by Foucault, many studies have examined the medicalization of everyday life in Western societies. This paper reconsiders potentials and limitations of this concept in an African city. Grounded in ethnographic research in Dar es Salaam, Tanzania, it concentrates on cleanliness, health and water in a lower middle-class neighbourhood. The findings show that women are familiar with professional health development discourses emphasizing cleanliness as a high value linked to bodily and domestic health. These discourses have been diffused in schools, clinics and other institutions during the colonial and socialist period. Women not only refer to these discourses, they try to reproduce them in daily practice and even demand them. This coercive yet voluntary nature of institutionalized discourses points to 'paradoxes of medicalization' also found in Western societies. It acquires, however, different meanings in a weak state like contemporary Tanzania which hardly manages to institutionalize medicalization through professional practice. Under such conditions, women who choose to follow health development discourses suffer a heavier practical, intellectual and emotional burden than those who are less committed. This may at least partly explain why many women assume a pragmatic stance towards the medicalization of everyday life.

  3. Licensing the Sun

    Science.gov (United States)

    Demski, Jennifer

    2013-01-01

    The University of San Diego (USD) and Point Loma Nazarene University (PLNU) are licensing the sun. Both California schools are generating solar power on campus without having to sink large amounts of capital into equipment and installation. By negotiating power purchasing agreements (PPAs) with Amsolar and Perpetual Energy Systems, respectively,…

  4. Trends in CANDU licensing

    International Nuclear Information System (INIS)

    Snell, V.G.; Grant, S.D.

    1997-01-01

    Modern utilities view nuclear power more and more as a commodity - it must compete 'today' with current alternatives to attract their investment. With its long construction times and large capital investment, nuclear plants are vulnerable to delays once they have been committed. There are two related issues. Where the purchaser and the regulator are experienced in CANDU, the thrust is a very practical one: to identify and resolve major licensing risks at a very early stage in the project. Thus for a Canadian project, the designer (AECL) and the prospective purchaser would deal directly with the AECB. However CANDU has also been successfully licensed in other countries, including Korea, Romania, Argentina, India and Pakistan. Each of these countries has its own regulatory agency responsible for licensing the plant. In addition, however, the foreign customer and regulator may seek input from the AECB, up to and including a statement of licensability in Canada; this is not normally needed for a ''repeat'' plant and/or if the customer is experienced in CANDU, but can be requested if the plant configuration has been modified significantly from an already-operating CANDU. It is thus the responsibility of the designer to initiate early discussions with the AECB so the foreign CANDU meets the expectations of its customers

  5. Future of nuclear licensing

    International Nuclear Information System (INIS)

    Denton, H.R.

    1984-01-01

    The following topics are outlined: Comparison of US and best foreign experience in nuclear power plant construction and operation; Status of licensing and construction; Observed attributes; Reduced construction time; Fewer reactor trips; Higher capacity factor; Diesel generator reliability; Steam generator tube leakage; and US regulatory initiatives: NRC efforts and industry efforts

  6. Pain clinic definitions in the medical literature and U.S. state laws: an integrative systematic review and comparison.

    Science.gov (United States)

    Andraka-Christou, Barbara; Rager, Joshua B; Brown-Podgorski, Brittany; Silverman, Ross D; Watson, Dennis P

    2018-05-22

    In response to widespread opioid misuse, ten U.S. states have implemented regulations for facilities that primarily manage and treat chronic pain, called "pain clinics." Whether a clinic falls into a state's pain clinic definition determines the extent to which it is subject to oversight. It is unclear whether state pain clinic definitions model those found in the medical literature, and potential differences lead to discrepancies between scientific and professionally guided advice found in the medical literature and actual pain clinic practice. Identifying discrepancies could assist states to design laws that are more compatible with best practices suggested in the medical literature. We conducted an integrative systematic review to create a taxonomy of pain clinic definitions using academic medical literature. We then identified existing U.S. state pain clinic statutes and regulations and compared the developed taxonomy using a content analysis approach to understand the extent to which medical literature definitions are reflected in state policy. In the medical literature, we identified eight categories of pain clinic definitions: 1) patient case mix; 2) single-modality treatment; 3) multidisciplinary treatment; 4) interdisciplinary treatment; 5) provider supervision; 6) provider composition; 7) marketing; and 8) outcome. We identified ten states with pain clinic laws. State laws primarily include the following definitional categories: patient case mix; single-modality treatment, and marketing. Some definitional categories commonly found in the medical literature, such as multidisciplinary treatment and interdisciplinary treatment, rarely appear in state law definitions. This is the first study to our knowledge to develop a taxonomy of pain clinic definitions and to identify differences between pain clinic definitions in U.S. state law and medical literature. Future work should explore the impact of different legal pain clinic definitions on provider decision

  7. A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States

    Directory of Open Access Journals (Sweden)

    Zullig LL

    2016-07-01

    Full Text Available Leah L Zullig,1,2 Bradi B Granger,3 Hayden B Bosworth,1–4 On behalf of the Medication Adherence Alliance 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 2Division of General Internal Medicine, Department of Medicine, Duke University, 3Duke Heart Center Nursing Research Program, School of Nursing, Duke University, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA The problem: Nonadherence to prescription medications is a common and costly problem with multiple contributing factors, spanning the dimensions of individual behavior change, psychology, medicine, and health policy, among others. Addressing the problem of medication nonadherence requires strategic input from key experts in a number of fields.Meeting of experts: The Medication Adherence Alliance is a group of key experts, predominately from the US, in the field of medication nonadherence. Members include representatives from consumer advocacy groups, community health providers, nonprofit groups, the academic community, decision-making government officials, and industry. In 2015, the Medication Adherence Alliance convened to review the current landscape of medication adherence. The group then established three working groups that will develop recommendations for shifting toward solutions-oriented science.Commentary of expert opinion: From the perspective of the Medication Adherence Alliance, the objective of this commentary is to describe changes in the US landscape of medication adherence, framing the evolving field in the context of a recent think tank meeting of experts in the field of medication adherence. Keywords: medication adherence, health planning recommendations, chronic disease

  8. Environmental license process complexity in natural protected areas: case of OSBAT pipeline operated by TRANSPETRO in the state of Sao Paulo; Complexidade do licenciamento ambiental em areas naturais protegidas: caso do duto OSBAT operado pela TRANSPETRO no estado de Sao Paulo

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Anibal Jose Constantino; Raul, Vanderlei Lourenco; Martini, Andrea Dietrich; Campos, Cleber Lucio dos Santos; Ozorio, Tarcisio Faria; Melo Neto, Joao Evangelista de; Lima, Silvia Ferreira de [PETROBRAS Transporte S. A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil)

    2008-07-01

    It presents the environmental license process enforced to obtain the Implementation License (LI) of the OSBAT pipeway part substitution, in the Sao Sebastiao city, State of Sao Paulo, with the analyses centered on the several public power instances and on the many special legal protection aspects around the natural area scenarios of the project interference. The license process had the duration of seventeen months, since the LI protocol and its emission. The process had the involvement of several organisms, the main part from the Sistema Nacional de Meio Ambiente - SISNAMA, and represented an interesting experience that can contribute to the agility of other license process of infrastructure works on protected natural areas, which has the incidence of an extensive legislation and activities restriction. (author)

  9. A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States.

    Science.gov (United States)

    Zullig, Leah L; Granger, Bradi B; Bosworth, Hayden B

    2016-01-01

    Nonadherence to prescription medications is a common and costly problem with multiple contributing factors, spanning the dimensions of individual behavior change, psychology, medicine, and health policy, among others. Addressing the problem of medication nonadherence requires strategic input from key experts in a number of fields. The Medication Adherence Alliance is a group of key experts, predominately from the US, in the field of medication nonadherence. Members include representatives from consumer advocacy groups, community health providers, nonprofit groups, the academic community, decision-making government officials, and industry. In 2015, the Medication Adherence Alliance convened to review the current landscape of medication adherence. The group then established three working groups that will develop recommendations for shifting toward solutions-oriented science. From the perspective of the Medication Adherence Alliance, the objective of this commentary is to describe changes in the US landscape of medication adherence, framing the evolving field in the context of a recent think tank meeting of experts in the field of medication adherence.

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

    CERN Document Server

    Xie, Shane

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-12-20

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

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

    International Nuclear Information System (INIS)

    Darambara, Dimitra G.

    2006-01-01

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

  13. First trimester medication abortion practice in the United States and Canada.

    Directory of Open Access Journals (Sweden)

    Heidi E Jones

    Full Text Available We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703 and Canada (n = 94 to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5% US and 78 (83.0% Canadian facilities participated. In the US, 95.3% offered first trimester medication abortion compared to 25.6% in Canada. While 100% of providers were physicians in Canada, just under half (49.4% were advanced practice clinicians in the US, which was more common in Eastern and Western states. All Canadian providers used misoprostol; 85.3% with methotrexate. 91.4% of US providers used 200 mg of mifepristone and 800 mcg of misoprostol, with 96.7% reporting home misoprostol administration. More than three-quarters of providers in both countries required an in-person follow-up visit, generally with ultrasound. 87.7% of US providers routinely prescribed antibiotics compared to 26.2% in Canada. Nonsteroidal anti-inflammatory drugs were the most commonly reported analgesic, with regional variation in opioid narcotic prescription. In conclusion, medication abortion practice follows evidence-based guidelines in the US and Canada. Efforts to update practice based on the latest evidence for reducing in-person visits and increasing provision by advanced practice clinicians could strengthen these services and reduce barriers to access. Research is needed on optimal antibiotic and analgesic use.

  14. 10 CFR 55.21 - Medical examination.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Medical examination. 55.21 Section 55.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.21 Medical examination. An applicant for a license shall have a medical examination by a physician. A licensee shall have a medical...

  15. A meta-analytic review of moral licensing.

    Science.gov (United States)

    Blanken, Irene; van de Ven, Niels; Zeelenberg, Marcel

    2015-04-01

    Moral licensing refers to the effect that when people initially behave in a moral way, they are later more likely to display behaviors that are immoral, unethical, or otherwise problematic. We provide a state-of-the-art overview of moral licensing by conducting a meta-analysis of 91 studies (7,397 participants) that compare a licensing condition with a control condition. Based on this analysis, the magnitude of the moral licensing effect is estimated to be a Cohen's d of 0.31. We tested potential moderators and found that published studies tend to have larger moral licensing effects than unpublished studies. We found no empirical evidence for other moderators that were theorized to be of importance. The effect size estimate implies that studies require many more participants to draw solid conclusions about moral licensing and its possible moderators. © 2015 by the Society for Personality and Social Psychology, Inc.

  16. ACR: Licensing and design readiness

    International Nuclear Information System (INIS)

    Alizadeh, A.

    2009-01-01

    Full text The Canadian nuclear technology has a long history dating back to the 1940s. In this regard, Canada is in a unique situation, shared only by a very few countries, where original nuclear power technology has been invented and further developed. Canadian Nuclear Safety Commission (CNSC), then called AECB, was established in 1946. CNSC focuses on nuclear security, nuclear safety, establishing health and safety regulations, and has also played an instrumental role in the formation of the IAEA. CNSC has provided assistance to the establishment of regulatory authorities in AECL's client countries such as Korea, Argentina, China and Romania. AECL has developed the Gen III+ ACR 1000 as evolutionary advancement of the current CANDU 6 reactor. ACR-1000 has evolved from AECL's in depth experience with CANDU systems, components, and materials, as well as the feedback received from owners and operators of CANDU plants. The ACR-1000 design retains the proven strengths and features of CANDU reactors, while incorporating innovations and state-of-the-art technology. It also features major improvements in economics, inherent safety characteristics, and performance. ACR-1000 has completed its Basic Engineering, has advanced in the licensing process in Canada, and is ready for deployment in Canadian and world markets. EC6 is an evolution of CANDU 6 and is a Gen III natural uranium fuelled reactor. Its medium size and potential for fuel localization and advanced fuel cycles is an optimal strategic solution in many markets.AECL's reactor products are shown to be compliant with a variety of licensing and regulatory requirements. These include the new CNSC DRD-337, IAEA NS-R1, and EUR. This allows the countries interested in CANDU reactor products to be confident of its licensing in their own regulatory regimes.

  17. Licensing and Operations of the Clive, Utah Low-Level Containerized Radioactive Waste Disposal Facility- A Continuation of Excellence

    International Nuclear Information System (INIS)

    Ledoux, M. R.; Cade, M. S.

    2002-01-01

    Envirocare's Containerized Waste Facility (CWF) is the first commercial low-level radioactive waste disposal facility to be licensed in the 21st century and the first new site to be opened and operated since the late 1970's. The licensing of this facility has been the culmination of over a decade's effort by Envirocare of Utah at their Clive, Utah site. With the authorization to receive and dispose of higher activity containerized Class A low-level radioactive waste (LLRW), this facility has provided critical access to disposal for the nuclear power industry, as well as the related research and medical communities. This paper chronicles the licensing history and operational efforts designed to address the disposal of containerized LLRW in accordance with state and federal regulations

  18. Licensing and Operations of the Clive, Utah Low-Level Containerized Radioactive Waste Disposal Facility- A Continuation of Excellence

    Energy Technology Data Exchange (ETDEWEB)

    Ledoux, M. R.; Cade, M. S.

    2002-02-25

    Envirocare's Containerized Waste Facility (CWF) is the first commercial low-level radioactive waste disposal facility to be licensed in the 21st century and the first new site to be opened and operated since the late 1970's. The licensing of this facility has been the culmination of over a decade's effort by Envirocare of Utah at their Clive, Utah site. With the authorization to receive and dispose of higher activity containerized Class A low-level radioactive waste (LLRW), this facility has provided critical access to disposal for the nuclear power industry, as well as the related research and medical communities. This paper chronicles the licensing history and operational efforts designed to address the disposal of containerized LLRW in accordance with state and federal regulations.

  19. Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan.

    Science.gov (United States)

    Christensen, Dale B; Roth, Mary; Trygstad, Troy; Byrd, John

    2007-01-01

    To assess the feasibility of a pharmacist-based medication therapy management (MTM) service for North Carolina State Health Plan enrollees. Before/after design with two control groups. Community pharmacies and an ambulatory care clinic in North Carolina serving patients from October 2004 to March 2005. 67 patients who used a large number of prescription drugs, 10 community/ambulatory care pharmacists, and more than 600 participants from two control groups. Pharmacist-conducted MTM reviews for volunteering patients. Process measures (type and frequency of drug therapy problems detected and services performed), economic measures (number and cost of medications dispensed), and humanistic measures (patient satisfaction with services). Pharmacists identified an average of 3.6 potential drug therapy problems (PDTPs) per patient at the first visit. The most common PDTP categories were "potential underuse" and "more cost-effective drug available." Pharmacist actions were divided nearly equally between activities that would result in increased and decreased drug use. Pharmacists recommended a drug therapy change in about 50% of patients and contacted the prescriber more than 85% of the time. About 50% of patients with PDTPs had a change in drug therapy. Prescription use during the postintervention period decreased in both the study and control groups but was statistically significant only among the control groups. No significant differences were observed in patient co-payment or insurer prescription costs. Pharmacists provided the following educational services: medication use (90%), disease management (88%), adherence, and self-care (60%). Survey results indicated that patients highly valued the service. A voluntary MTM program targeted at ambulatory patients using a large number of medications reduced the number of PDTPs but did not necessarily result in reductions in prescription drug use or cost. Nearly all patients received some form of medication adherence or disease

  20. Motorcycle Training for California Driver Licensing Personnel. Final Report.

    Science.gov (United States)

    California State Dept. of Motor Vehicles, Sacramento.

    The development of a 6-hour motorcycle course of instruction for personnel responsible for motorcycle licensing is described in this project report. The primary goals are stated and include (1) training driver licensing personnel in motorcycle safety and principles of operation, and (2) purchasing and installing appropriate motorcycle skill…

  1. Effective Continuing Education for Licensed Real Estate Professionals

    Science.gov (United States)

    Tilton, Wendy A.

    2004-01-01

    Mandatory real estate education has been intensely debated for many years. New Jersey is the only state in the nation that does not require licensed real estate agents to attend an ongoing educational event after securing a license to practice. A bill was proposed to the legislature to mandate real estate education in June of 2001. (It was…

  2. A Meta-Analytic Review of Moral Licensing

    NARCIS (Netherlands)

    Blanken, Irene; van de Ven, Niels; Zeelenberg, Marcel

    2015-01-01

    Moral licensing refers to the effect that when people initially behave in a moral way, they are later more likely to display behaviors that are immoral, unethical, or otherwise problematic. We provide a state-of-the-art overview of moral licensing by conducting a meta-analysis of 91 studies (7,397

  3. A meta-analytic review of moral licensing

    NARCIS (Netherlands)

    Blanken, I.; van de Ven, N.; Zeelenberg, M.

    2015-01-01

    Moral licensing refers to the effect that when people initially behave in a moral way, they are later more likely to display behaviors that are immoral, unethical, or otherwise problematic. We provide a state-of-the-art overview of moral licensing by conducting a meta-analysis of 91 studies (7,397

  4. 78 FR 47009 - Notice of Intent to grant exclusive license

    Science.gov (United States)

    2013-08-02

    ... gives notice of its intent to grant an exclusive license in the United States to practice the invention... of Chief Counsel, NASA Langley Research Center, MS 30, Hampton, VA 23681, (757) 864-7686 (phone...-9190. Information about other NASA inventions available for licensing can be found online at http...

  5. Librarian Certification and Licensing: A Brief Accounting.

    Science.gov (United States)

    Kaatrude, Peter B.

    1992-01-01

    Examines certification and licensing of librarians in the United States and Canada from the perspective of differences between the two concepts and through historical analysis of applications of each. A contextual framework for studying applications of these concepts to other professions is provided. (nine references) (MES)

  6. 31 CFR 596.309 - Specific license.

    Science.gov (United States)

    2010-07-01

    ... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.309 Specific license. The term specific license means any license or...

  7. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1981-08-01

    The Operating Reactors Licensing Actions Summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors

  8. Integration of Educational and Research Activities of Medical Students (Experience of the Medical Faculty of Saint Petersburg State University).

    Science.gov (United States)

    Balakhonov, Aleksei V; Churilov, Leonid P; Erman, Mikhail V; Shishkin, Aleksandr N; Slepykh, Lyudmila A; Stroev, Yuri I; Utekhin, Vladimir J; Basantsova, Natalia Y

    2017-12-01

    The article is devoted to the role of research activity of the medical students in higher education of physicians. The teaching of physicians in classical universities and specialized medical schools is compared. The history of physicians' training in Russia in imperial, Soviet and post-Soviet periods is reviewed and compared to development of higher medical education in other countries. Article gives the the description of all failed attempts to establish a Medical Faculty within oldest classical university of Russia, crowned by history of last and successful attempt of its establishment. Authors' experience of adjoining education and research in curriculum and extra-curricular life of this Medical Faculty is discussed. The problems of specialization and fundamentalization of medical education are subjected to analysis. Clinical reasoning and reasoning of scholar-experimentalist are compared. The article reviews the role of term and course papers and significance of self-studies and graduation thesis in education of a physician. The paper gives original definition of interactive learning, and discusses the methods and pathways of intermingling the fundamental science and clinical medicine in medical teaching for achievement of admixed competencies of medical doctor and biomedical researcher.

  9. Radiation control through licensing and intensive training

    International Nuclear Information System (INIS)

    Cheng, C.-H.; Yang, Y.-C.; Wu, T.-Y.; Weng, P.-S.

    1982-01-01

    Various types of intensive training courses to suit radiation workers in different fields were sponsored by both the Atomic Energy Council of Executive Yuan and the National Health Administration of Executive Yuan, Republic of China during the past seven years. During the years 1974-79, the number of radiation workers attending each training course, their age, sex and educational background are presented in detail. The typical course contents for both medical and non-medical radiation workers are given. A summary of the percentage of passes and failures of the final examination given at the end of each training course is also given. The present status of licensing for radiation facilities and workers is described, and its results are indicated. The successful control of ionizing radiation through this kind of intensive training and licensing is evidenced in the film badge records given by a centralized service laboratory located at the National Tsing Hua University. (author)

  10. Orthopedic board certification and physician performance: an analysis of medical malpractice, hospital disciplinary action, and state medical board disciplinary action rates.

    Science.gov (United States)

    Kocher, Mininder S; Dichtel, Laura; Kasser, James R; Gebhardt, Mark C; Katz, Jeffery N

    2008-02-01

    Specialty board certification status has become the de facto standard of competency by which the profession and the public recognize physician specialists. However, the relationship between orthopedic board certification and physician performance has not been established. Rates of medical malpractice claims, hospital disciplinary actions, and state medical board disciplinary actions were compared between 1309 board-certified (BC) and 154 non-board-certified (NBC) orthopedic surgeons in 3 states. There was no significant difference between BC and NBC surgeons in medical malpractice claim proportions (BC, 19.1% NBC, 16.9% P = .586) or in hospital disciplinary action proportions (BC, 0.9% NBC, 0.8% P = 1.000). There was a significantly higher proportion of state medical board disciplinary action for NBC surgeons (BC, 7.6% NBC, 13.0% P = .028). An association between board certification status and physician performance is necessary to validate its status as the de facto standard of competency. In this study, BC surgeons had lower rates of state medical board disciplinary action.

  11. Teaching psychosomatic (biopsychosocial) medicine in United States medical schools: survey findings.

    Science.gov (United States)

    Waldstein, S R; Neumann, S A; Drossman, D A; Novack, D H

    2001-01-01

    A survey of US medical schools regarding the incorporation of psychosomatic (biopsychosocial) medicine topics into medical school curriculum was conducted. The perceived importance and success of this curriculum, barriers to teaching psychosomatic medicine, and curricular needs were also assessed. From August 1997 to August 1999, representatives of US medical schools were contacted to complete a survey instrument either by telephone interview or by written questionnaire. Survey responses were received from 54 of the 118 US medical schools contacted (46%). Responses were obtained from representatives of both public (57%) and private (43%) institutions. Only 20% of respondents indicated that their schools used the term "psychosomatic medicine"; the terms "behavioral medicine" (63%) and "biopsychosocial medicine" (41%) were used more frequently. Coverage of various health habits (eg, substance use and exercise) ranged from 52% to 96%. The conceptualization and/or measurement of psychosocial factors (eg, stress and social support) was taught by 80% to 93% of schools. Teaching about the role of psychosocial factors in specific disease states or syndromes ranged from 33% (renal disease) to 83% (cardiovascular disease). Coverage of treatment-related issues ranged from 44% (relaxation/biofeedback) to 98% (doctor-patient communication). Topics in psychosomatic medicine were estimated to comprise approximately 10% (median response) of the medical school curriculum. On a scale of 1 (lowest) to 10 (highest), ratings of the relative importance of this curriculum averaged 7 (SD = 2.5; range = 2-10). Student response to the curriculum varied from positive to mixed to negative. Perceived barriers to teaching psychosomatic medicine included limited resources (eg, time, money, and faculty), student and faculty resistance, and a lack of continuity among courses. Sixty-three percent of respondents expressed an interest in receiving information about further incorporation of topics in

  12. Stability in licensing requirements: a technical perspective

    International Nuclear Information System (INIS)

    Szalay, R.A.

    1978-01-01

    The serious difficulties encountered in the licensing procedure for nuclear power plants in the United States have resulted in the elaboration of a Bill on the siting and licensing of nuclear installations for the purpose of reforming the present system. The author fears, however, that this Bill will not reduce the complexity of present regulations and will be unable to reach the object sought which is to reduce the length of the procedure; he analyses the technical and political reasons underlying this situation, and in particular the role of the staff of the Nuclear Regulatory Commission. (NEA) [fr

  13. Devolution's policy impact on non-emergency medical transportation in State Children's Health Insurance Programs.

    Science.gov (United States)

    Borders, Stephen; Blakely, Craig; Ponder, Linda; Raphael, David

    2011-01-01

    Proponents of devolution often maintain that the transfer of power and authority of programs enables local officials to craft policy solutions that better align with the needs of their constituents. This article provides one of the first empirical evaluations of this assumption as it relates to non-emergency medical transportation (NEMT) in the State Children's Health Insurance Program (SCHIP). NEMT programs meet a critical need in the areas in which they serve, directly targeting this single key access barrier to care. Yet states have great latitude in making such services available. The authors utilize data from 32 states to provide a preliminary assessment of devolution's consequences and policy impact on transportation-related access to care. Their findings provide mixed evidence on devolution's impact on policy outcomes. Proponents of devolution can find solace in the fact that several states have gone beyond federally mandated minimum requirements to offer innovative programs to remove transportation barriers to care. Detractors of devolution will find continued pause on several key issues, as a number of states do not offer NEMT to their SCHIP populations while cutting services and leaving over $7 billion in federal matching funding unspent.

  14. Licensing in an International Market

    Science.gov (United States)

    Ferreira, Fernanda A.

    2008-09-01

    We study the effects of entry of a foreign firm on domestic welfare in the presence of licensing, when the entrant is technologically superior to the incumbent. We show that foreign entry increases domestic welfare for sufficiently large technological differences between the firms under both fixed-fee licensing and royalty licensing.

  15. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1982-04-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis

  16. ER-E4 regulation. Transitional arrangement to implement the rules for evaluating and state control of medical equipment

    International Nuclear Information System (INIS)

    2015-01-01

    Establish a regulatory document where the validity and status of the documents contained in the Regulatory Legal Base Technical Program of medical equipment is exposed, given the scope thereof to comply with the provisions of the Regulation. This regulation is aimed at all subjects (manufacturers or producers, suppliers or distributors, importers, users, medical equipment, as well as health institutions SNS) involved in activities related to the evaluation and control of the State Medical equipment and make use of complementary technical legal documents.

  17. National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.

    Science.gov (United States)

    Kinsman, Jeremiah M; Robinson, Kathy

    2018-02-27

    Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR). State law and scopes of practice were systematically reviewed using a multi-tiered approach to determine each state's legally-defined EMS licensure levels and their authority to administer an opioid antagonist. State law, state EMS websites, and state EMS scope of practice documents were identified and searched using Google Advanced Search with Boolean Search Strings. Initial results of the review were sent to each state office of EMS for review and comment. As of September 1, 2017, 49 states and DC authorize EMTs to administer an opioid antagonist. Among the 40 US jurisdictions (39 states and DC) that define the EMR or a comparable first responder licensure level in state law, 37 states and DC authorize their EMRs to administer an opioid antagonist. Paramedics are authorized to administer opioid antagonists in all 50 states, DC, and PR. All 49 of the US jurisdictions (48 states and DC) that define the advanced emergency medical technician (AEMT) or a comparable intermediate EMS licensure level in state law authorize their AEMTs to administer an opioid antagonist. 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited

  18. License application approach for the California LLRW disposal facility

    International Nuclear Information System (INIS)

    Gaynor, R.K.; Romano, S.A.; Hanrahan, T.P.

    1990-01-01

    US Ecology, Inc. is the State of California's license designee to site, develop and operate a low-level radioactive waste (LLRW) disposal facility to serve member states of the Southwestern Compact. US Ecology identified a proposed site in the Ward Valley of southeastern California in March 1988. Following proposed site selection, US Ecology undertook studies required to prepare a license application. US Ecology's license application for this desert site was deemed complete for detailed regulatory review by the California Department of Health Services (DHS) in December 1989. By mutual agreement, disposal of mixed waste is not proposed pending the State of California's decision on appropriate management of this small LLRW subset

  19. A comparison of medical education in Germany and the United States: from applying to medical school to the beginnings of residency.

    Science.gov (United States)

    Zavlin, Dmitry; Jubbal, Kevin T; Noé, Jonas G; Gansbacher, Bernd

    2017-01-01

    Both Germany and the United States of America have a long tradition of science and medical excellence reaching back as far as the nineteenth century. The same tribute must be paid to the medical educational system in both countries. Despite significant initial similarities and cross-inspiration, the paths from enrolling in a medical university to graduating as a medical doctor in Germany and the US seem to have become much different. To fill a void in literature, the authors' objective therefore is to delineate both structures of medical education in an up-to-date review and examine their current differences and similarities. Recent medical publications, legal guidelines of governmental or official organizations, articles in media, as well as the authors' personal experiences are used as sources of this report. Tuition loans of over $200,000 are not uncommon for students in the US after graduating from medical schools, which are often private institutions. In Germany, however, the vast majority of medical universities are tax-funded and, for this reason, free of tuition. Significant differences and surprisingly multiple similarities exist between these two systems, despite one depending on government and the other on private organizations. Germany currently employs an integrated medical curriculum that typically begins right after high school and consists of a 2-year long pre-clinical segment teaching basic sciences and a 4-year clinical segment leading medical students to the practical aspects of medicine. On the other hand, the US education is a two-stage process. After successful completion of a Bachelor's degree in college, an American student goes through a 4-year medical program encompassing 2 years of basic science and 2 years of clinical training. In this review, we will address some of these similarities and major differences.

  20. Radiation monitoring and dose distribution of medical workers in A.P. state 1999-2000

    International Nuclear Information System (INIS)

    Singh, D.R.; Reddy, K.S.; Kamble, M.K.; Roy, Madhumita

    2001-01-01

    Individual monitoring for external ionizing radiation is being conducted for all radiation workers in Andhra Pradesh State by TLD Unit located in Nuclear Fuel Complex, Hyderabad.The Unit comes under Personnel Monitoring Section of Bhabha Atomic Research Center, Mumbai. The aim of monitoring is to confirm that the radiation safety standards are strictly adhered in the institutions and also to investigate excessive exposures, if any. Personnel monitoring also provides data for epidemiological studies. In view of ICRP/AERB recommendations of 100 mSv dose limit for the five years block of 1994-98, the dose distribution among radiation workers in Andhra Pradesh State is analyzed for the period 1994-98. In continuation of above work, we have analyzed the data for the year 1999-2000 for various medical diagnostic procedures and these are presented

  1. Cask development, testing, and licensing

    International Nuclear Information System (INIS)

    Quinn, G.J.; Haelsig, R.T.; Warrant, M.M.

    1986-01-01

    The NuPac 125-B Rail Cask was developed to provide a safe means of transporting the damaged core of Three Mile Island Unit 2 from the TMI site at Middletown, PA, to the Idaho National Engineering laboratory (INEL) at Idaho Falls, ID. The development of the NuPac 125-B Rail Cask posed two engineering and technical management challenges; Licensing Strategy - The NuPac 125-B Rail Cask represented the first irradiated fuel rail cask developed within the United States in the past decade, a decade characterized by changing nuclear regulations, and Accelerated Schedule - The TMI-2 defueling schedule demanded a cask development schedule one-third as long as normally required. These challenges governed the overall development and licensing process for the cask. First, a high degree of conservation was incorporated into the design to allow quick, simplified demonstrations of adequacy to regulatory staff. Second, redundant design techniques were employed in all areas of uncertainty. The testing program eliminated performance uncertainties and validated predictions and predictive models. Drop tests of a quarter-scale model of the cask were conducted, and results were correlated with analytic predictions to verify structural and mechanical performance of the cask. Full-scale tests of the canisters were conducted to verify structural behavior of canister internals which provide criticality control. This paper describes the testing program for the NuPac 125-B Rail Cask, presents results therefrom, and correlates findings with Regulation 10 CFR 71 of the U.S. Nuclear Regulatory Commission

  2. University of the Witwatersrand physiotherapy undergraduate curriculum alignment to medical conditions of patients within Gauteng state health facilities

    Directory of Open Access Journals (Sweden)

    Mokgobadibe V. Ntsiea

    2017-06-01

    Conclusion: The Wits physiotherapy curriculum covers all medical conditions treated by physiotherapists within the Gauteng state health facilities, and overall, the curriculum prepares the students to practise in a variety of situations.

  3. A BWR licensing experience in the USA

    International Nuclear Information System (INIS)

    Powers, J.; Ogura, C.; Arai, K.; Thomas, S.; Mookhoek, B.

    2015-09-01

    The US-Advanced Boiling Water Reactor (A BWR), certified by the United States Nuclear Regulatory Commission (US NRC), is a third generation, evolutionary boiling water reactor design which is the reference for the South Texas Project Units 3 and 4 (STP3-4) Combined License Application (Cola). Nuclear Innovation North America (Nina) is the License Applicant for this new build project, and Toshiba is the selected primary technology contractor. The STP3-4 project has finished the US NRC technical review of the Cola through the final meeting of the Advisory Committee on Reactor Safeguards (ACRS), and the Final Safety Evaluation Report (FSER) is scheduled to be issued by the US NRC in the middle of 2015. The next steps are to support the Mandatory Hearing process, and voting by the NRC commissioners on the motion to grant the Combined License, which is scheduled beginning of 2016 according to US NRC schedule as of March 30, 2015. This paper summarizes the history and progress of the US-A BWR licensing, including the experiences of the Licensee, Nina, and Toshiba as the Epc team worked through the Code of Federal Regulations Title 10 (10-Cfr) Part 52 process, and provides some perspectives on how the related licensing material would also be of value within a 10-Cfr Part 50, two-step process to minimize schedule and financial risks which could arise from ongoing technical developments and regulatory reviews. (Author)

  4. A BWR licensing experience in the USA

    Energy Technology Data Exchange (ETDEWEB)

    Powers, J.; Ogura, C. [Toshiba America Nuclear Energy, Charlotte, North Carolina (United States); Arai, K. [Toshiba Corporation, Yokohama, Kanagawa (Japan); Thomas, S.; Mookhoek, B., E-mail: jim.powers@toshiba.com [Nuclear Innovation North America, Lake Jackson, Texas (United States)

    2015-09-15

    The US-Advanced Boiling Water Reactor (A BWR), certified by the United States Nuclear Regulatory Commission (US NRC), is a third generation, evolutionary boiling water reactor design which is the reference for the South Texas Project Units 3 and 4 (STP3-4) Combined License Application (Cola). Nuclear Innovation North America (Nina) is the License Applicant for this new build project, and Toshiba is the selected primary technology contractor. The STP3-4 project has finished the US NRC technical review of the Cola through the final meeting of the Advisory Committee on Reactor Safeguards (ACRS), and the Final Safety Evaluation Report (FSER) is scheduled to be issued by the US NRC in the middle of 2015. The next steps are to support the Mandatory Hearing process, and voting by the NRC commissioners on the motion to grant the Combined License, which is scheduled beginning of 2016 according to US NRC schedule as of March 30, 2015. This paper summarizes the history and progress of the US-A BWR licensing, including the experiences of the Licensee, Nina, and Toshiba as the Epc team worked through the Code of Federal Regulations Title 10 (10-Cfr) Part 52 process, and provides some perspectives on how the related licensing material would also be of value within a 10-Cfr Part 50, two-step process to minimize schedule and financial risks which could arise from ongoing technical developments and regulatory reviews. (Author)

  5. Alfred Russel Wallace's medical libertarianism: state medicine, human progress, and evolutionary purpose.

    Science.gov (United States)

    Flannery, Michael A

    2015-01-01

    Alfred Russel Wallace (1823-1913), naturalist and explorer of South America and the Malay Archipelago, secured his place in history by independently discovering the theory of natural selection. His letter outlining the theory was sent from Ternate in eastern Indonesia and received at Down House, according to Charles Darwin (1809-82), on June 18, 1858, prompting the now-famed evolutionist to rush his languishing manuscript to press. Wallace's contributions to evolutionary biology, biogeography, and anthropology are well known, but his medical views have received far less attention. Within the context of a strident populist antivaccination movement and an ominous elitist eugenics campaign, Wallace took his stand, which revealed itself in a libertarianism that defended traditional socialist constituencies (the working poor, the lumpenproletariat, and feminist reformers) against state-mandated medical interventions. Rather than viewing Wallace as a heterodox contrarian, this article argues that his positions were logical outgrowths of his medical libertarianism and evolutionary and social theories. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. The evaluation of psycho-emotional state in junior students of medical university

    Directory of Open Access Journals (Sweden)

    Tetiana Pavliuk

    2017-06-01

    Full Text Available Currently, psychosocial factors, stress and mental exhaustion are considered by WHO experts and the International Labour Organization as an important new factor affecting the health, working capacity, training and career. Young generation, especially students, who are an industrial and intellectual potential of the country can be attributed to the risk group because of the extremely high burden of adaptation. The intensity and tension of modern life at a psychological level preceding the occurrence of negative emotional experiences and stress reactions that, accumulating, cause the formation of depressions. The aim of the study was to examine the level of psycho-emotional stress in the junior students of medical university. The observations of the medical students of the second year of study were performed. To determine the psycho-emotional stress we have used adaptive varint of H.Ayzenko method that include an anxiety, frustration, aggressiveness and rigidity, through questionnaires. According to a survey results of the state of psycho-emotional state low levels of stress resistance were found in students in learning activities, indicating that students are exposed to the negative impact of the environment. It should also be noted that the level of emotional condition of students depends on the personal experience of stressful situations that arise in students’ lives.

  7. Transforming the Primary Care Training Clinic: New York State's Hospital Medical Home Demonstration Pilot.

    Science.gov (United States)

    Angelotti, Marietta; Bliss, Kathryn; Schiffman, Dana; Weaver, Erin; Graham, Laura; Lemme, Thomas; Pryor, Veronica; Gesten, Foster C

    2015-06-01

    Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. The 2013-2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P≤.001, and 11%, P=.011, respectively). A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

  8. Predicting United States Medical Licensure Examination Step 2 clinical knowledge scores from previous academic indicators

    Directory of Open Access Journals (Sweden)

    Monteiro KA

    2017-06-01

    Full Text Available Kristina A Monteiro, Paul George, Richard Dollase, Luba Dumenco Office of Medical Education, The Warren Alpert Medical School of Brown University, Providence, RI, USA Abstract: The use of multiple academic indicators to identify students at risk of experiencing difficulty completing licensure requirements provides an opportunity to increase support services prior to high-stakes licensure examinations, including the United States Medical Licensure Examination (USMLE Step 2 clinical knowledge (CK. Step 2 CK is becoming increasingly important in decision-making by residency directors because of increasing undergraduate medical enrollment and limited available residency vacancies. We created and validated a regression equation to predict students’ Step 2 CK scores from previous academic indicators to identify students at risk, with sufficient time to intervene with additional support services as necessary. Data from three cohorts of students (N=218 with preclinical mean course exam score, National Board of Medical Examination subject examinations, and USMLE Step 1 and Step 2 CK between 2011 and 2013 were used in analyses. The authors created models capable of predicting Step 2 CK scores from academic indicators to identify at-risk students. In model 1, preclinical mean course exam score and Step 1 score accounted for 56% of the variance in Step 2 CK score. The second series of models included mean preclinical course exam score, Step 1 score, and scores on three NBME subject exams, and accounted for 67%–69% of the variance in Step 2 CK score. The authors validated the findings on the most recent cohort of graduating students (N=89 and predicted Step 2 CK score within a mean of four points (SD=8. The authors suggest using the first model as a needs assessment to gauge the level of future support required after completion of preclinical course requirements, and rescreening after three of six clerkships to identify students who might benefit from

  9. Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

    Science.gov (United States)

    Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

    2018-03-22

    To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  10. Effects of disease severity and medication state on postural control asymmetry during challenging postural tasks in individuals with Parkinson's disease.

    Science.gov (United States)

    Barbieri, Fabio A; Polastri, Paula F; Baptista, André M; Lirani-Silva, Ellen; Simieli, Lucas; Orcioli-Silva, Diego; Beretta, Victor S; Gobbi, Lilian T B

    2016-04-01

    The aim of this study was to investigate the effects of disease severity and medication state on postural control asymmetry during challenging tasks in individuals with Parkinson's disease (PD). Nineteen people with PD and 11 neurologically healthy individuals performed three standing task conditions: bipedal standing, tandem and unipedal adapted standing; the individuals with PD performed the tasks in ON and OFF medication state. The participants with PD were distributed into 2 groups according to disease severity: unilateral group (n=8) and bilateral group (n=11). The two PD groups performed the evaluations both under and without the medication. Two force plates were used to analyze the posture. The symmetric index was calculated for various of center of pressure. ANOVA one-way (groups) and two-way (PD groups×medication), with repeated measures for medication, were calculated. For main effects of group, the bilateral group was more asymmetric than CG. For main effects of medication, only unipedal adapted standing presented effects of PD medication. There was PD groups×medication interaction. Under the effects of medication, the unilateral group presented lower asymmetry of RMS in anterior-posterior direction and area than the bilateral group in unipedal adapted standing. In addition, the unilateral group presented lower asymmetry of mean velocity, RMS in anterior-posterior direction and area in unipedal standing and area in tandem adapted standing after a medication dose. Postural control asymmetry during challenging postural tasks was dependent on disease severity and medication state in people with PD. The bilateral group presented higher postural control asymmetry than the control and unilateral groups in challenging postural tasks. Finally, the medication dose was able to reduce postural control asymmetry in the unilateral group during challenging postural tasks. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Licensing Surrogate Decision-Makers.

    Science.gov (United States)

    Rosoff, Philip M

    2017-06-01

    As medical technology continues to improve, more people will live longer lives with multiple chronic illnesses with increasing cumulative debilitation, including cognitive dysfunction. Combined with the aging of society in most developed countries, an ever-growing number of patients will require surrogate decision-makers. While advance care planning by patients still capable of expressing their preferences about medical interventions and end-of-life care can improve the quality and accuracy of surrogate decisions, this is often not the case, not infrequently leading to demands for ineffective, inappropriate and prolonged interventions. In 1980 LaFollette called for the licensing of prospective parents, basing his argument on the harm they can do to vulnerable people (children). In this paper, I apply his arguments to surrogate decision-makers for cognitively incapacitated patients, rhetorically suggesting that we require potential surrogates to qualify for this position by demonstrating their ability to make reasonable and rational decisions for others. I employ this theoretical approach to argue that the loose criteria by which we authorize surrogates' generally unchallenged power should be reconsidered.

  12. Mobile medical and health apps: state of the art, concerns, regulatory control and certification

    Science.gov (United States)

    Boulos, Maged N. Kamel; Brewer, Ann C.; Karimkhani, Chante; Buller, David B.; Dellavalle, Robert P.

    2014-01-01

    This paper examines the state of the art in mobile clinical and health-related apps. A 2012 estimate puts the number of health-related apps at no fewer than 40,000, as healthcare professionals and consumers continue to express concerns about the quality of many apps, calling for some form of app regulatory control or certification to be put in place. We describe the range of apps on offer as of 2013, and then present a brief survey of evaluation studies of medical and health-related apps that have been conducted to date, covering a range of clinical disciplines and topics. Our survey includes studies that highlighted risks, negative issues and worrying deficiencies in existing apps. We discuss the concept of ‘apps as a medical device’ and the relevant regulatory controls that apply in USA and Europe, offering examples of apps that have been formally approved using these mechanisms. We describe the online Health Apps Library run by the National Health Service in England and the calls for a vetted medical and health app store. We discuss the ingredients for successful apps beyond the rather narrow definition of ‘apps as a medical device’. These ingredients cover app content quality, usability, the need to match apps to consumers’ general and health literacy levels, device connectivity standards (for apps that connect to glucometers, blood pressure monitors, etc.), as well as app security and user privacy. ‘Happtique Health App Certification Program’ (HACP), a voluntary app certification scheme, successfully captures most of these desiderata, but is solely focused on apps targeting the US market. HACP, while very welcome, is in ways reminiscent of the early days of the Web, when many “similar” quality benchmarking tools and codes of conduct for information publishers were proposed to appraise and rate online medical and health information. It is probably impossible to rate and police every app on offer today, much like in those early days of the Web

  13. 50 CFR 660.336 - Pacific whiting vessel licenses.

    Science.gov (United States)

    2010-10-01

    ... groundfish fishing capacity reduction program. NMFS will also make license applications available online at... by that vessel's United States Coast Guard documentation number. (b) [Reserved] [74 FR 10193, Mar. 10, 2009; 74 FR 11881, Mar. 20, 2009] ...

  14. Regulatory view on licensing and commissioning of Temelin NPP

    International Nuclear Information System (INIS)

    Drabova, D.; Boehm, K.; Brandejs, P.; Tipek, Z.

    2004-01-01

    The competencies delegated to the Czech State Office for Nuclear Safety by Czech legislation are highlighted and the history of construction and commissioning of the Temelin nuclear power plant in relation to the licensing process is described. (P.A.)

  15. 37 CFR 404.4 - Authority to grant licenses.

    Science.gov (United States)

    2010-07-01

    ... past infringement. Any license shall not confer on any person immunity from the antitrust laws or from... immunized from the operation of state or federal law by reason of the source of the grant. [71 FR 11512, Mar...

  16. 76 FR 56759 - Ocean Transportation Intermediary License; Applicants

    Science.gov (United States)

    2011-09-14

    ...), Ariel S. Villamayor, Limited Partner, Application Type: New OFF License. UTi, United States, Inc. dba UTi (NVO & OFF), 1660 Walt Whitman Road, Melville, NY 11747. Officers: Charles N. Deller, Vice...

  17. 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.

  18. 76 FR 60941 - Policy Regarding Submittal of Amendments for Processing of Equivalent Feed at Licensed Uranium...

    Science.gov (United States)

    2011-09-30

    ... Processing of Equivalent Feed at Licensed Uranium Recovery Facilities AGENCY: Nuclear Regulatory Commission... State-licensed uranium recovery site, either conventional, heap leach, or in situ recovery. DATES... Regarding Submittal of Amendments for Processing of Equivalent Feed at Licensed Uranium Recovery Facilities...

  19. 76 FR 63330 - Policy Regarding Submittal of Amendments for Processing of Equivalent Feed at Licensed Uranium...

    Science.gov (United States)

    2011-10-12

    ... Processing of Equivalent Feed at Licensed Uranium Recovery Facilities AGENCY: Nuclear Regulatory Commission... NRC and Agreement State-licensed uranium recovery site. This action is necessary to correct several... read ``(see Page A2 of SECY-99-011, ``Draft Rulemaking Plan: Domestic Licensing of Uranium and Thorium...

  20. Variation in cash price of the generic medications most prescribed by dermatologists in pharmacies across the United States.

    Science.gov (United States)

    Alghanem, Noor; Abokwidir, Manal; Fleischer, Alan B; Feldman, Steven R; Alghanem, Ward

    2017-03-01

    The United States has the highest drug costs in the world. Consumers complain about large price differences at pharmacies on generic drugs. To evaluate variation in cash prices of generic medications most prescribed in dermatology across different drugstores and states in United States. The 11 generic drugs most prescribed by dermatologists according to National Ambulatory Medical Care Survey were assessed. By using Google, the most common used pharmacies in United States were listed, which are located at a random selection of six states. By calling the first available number of each pharmacy in the six states and asking about the generic cash price of the smallest stock size and the most prescribed type, the data were collected. Drug prices varied; the median cumulative price of the 11 medications was highest at Rite Aid ($1226) and lowest at Walmart ($795.34) with 35% difference. The prices at CVS differed by 20% across different states; however, the prices at Walmart, Rite Aid and Walgreens were consistent. New York has the highest and Iowa the lowest prices, especially at CVS, ($1160.79) versus ($931.32). There are varieties in the prices for the generic medications in different pharmacies and States.

  1. Licensed operating reactors

    International Nuclear Information System (INIS)

    1989-11-01

    The US Nuclear Regulatory Commission's monthly Licensed Operating Reactors Status Summary Report provides data on the operation of nuclear units as timely and accurately as possible. This information is collected by the Office of Information Resources Management, from the Headquarters Staff of NRC's Office of Inspection and Enforcement, from NRC's Regional Offices, and from utilities. Since all of the data concerning operation of the units is provided by the utility operators less than two weeks after the end of the month, necessary corrections to published information are shown on the errata page

  2. License to Learn

    DEFF Research Database (Denmark)

    Leone, Maria Isabella; Boccardelli, Paolo; Reichstein, Toke

    2016-01-01

    the technology. Drawing on a sample of 133 licensees and an equal number of matched nonlicensees, we present empirical evidence that thick contracts propel the licensees' likelihood of introducing new inventions. It is also found that thick contracts act as a substitute for licensees' absorptive capacity....... Licensees that are more familiar with the licensed technology are in less need of assistance from the licensors to assimilate and integrate the knowledge. However, this substitution effect is neutralized once the hurdle of invention has been overcome, meaning that the licensees have succeeded to ignite...... the invention process, suggesting the exploitation of the learning curve, triggered by their mutual understanding....

  3. Licensed operating reactors

    International Nuclear Information System (INIS)

    1990-04-01

    The Operating Units Status Report --- Licensed Operating Reactors provides data on the operation of nuclear units as timely and accurately as possible. This information is collected by the Office of Information Resources Management from the Headquarters staff on NRC's Office of Enforcement (OE), from NRC's Regional Offices, and from utilities. The three sections of the report are: monthly highlights and statistics for commercial operating units, and errata from previously reported data; a compilation of detailed information on each unit, provided by NRC's Regional Offices, OE Headquarters and the utilities; and an appendix for miscellaneous information such as spent fuel storage capability, reactor-years of experience and non- power reactors in the US

  4. Validation, acceptance and licensing

    International Nuclear Information System (INIS)

    Wene, C.O.

    1992-01-01

    The licensing process requires communication of complex scientific and technical information. In this paper transfer of such information is discussed using concepts and ideas from systems analysis, cybernetics and argumentation theory. A simple model for the decision process is developed. The analysis stresses the need for careful design of the communication channels between the three systems involved: the political system, the judicial-regulatory system and the scientific-technical community. The Dialogue - Scenario project initiated by the Swedish nuclear Inspectorate is briefly presented

  5. License agreement, employee work

    OpenAIRE

    Poncová, Veronika

    2012-01-01

    The rigorous thesis is focused on license agreement and employee work. The aim of the thesis is not only an analysis of the use of a copyrighted work by a person different from the author of the work, but also an analysis of the performance of copyright by a person different from the author of the work. The thesis consists of five chapters. The opening chapter provides a summary of the notion of copyright, its sources at the national and international levels, but also the European Union legis...

  6. [The state's physics examinations for medical students and the construction of a natural science basis for academic medical training between 1865-1880].

    Science.gov (United States)

    Van Lieburg, M J

    1995-01-01

    Betweem 1865, when the new Dutch Health Acts introduced the legal monopoly of the academic medical profession, and 1879, when a new law for higher education provided the basis for the integration of the non-academic teaching of medicine within the universities, non-academic students could pass state medical examinations in order to become a physician. In this article I studied in detail the first phase of this examination route, when students were questioned about their knowledge of mathematics, physics, chemistry and the life sciences. The state commissions responsible for taking these examinations have certainly played an important role in the process of the introduction of scientific medicine into the universities as well as the introduction of the sciences into secondary schools, preparing scholars for academic medical training. Moreover, because scientists, physicians and secondary school teachers participated together in these commissions, the science examination boards linked the several educational echelons and divisions in science and medicine concerned with this process of transformation of the medical professions and medical science in the 1860s and 1870s.

  7. The Cost of Sustaining a Patient-Centered Medical Home: Experience From 2 States

    Science.gov (United States)

    Magill, Michael K.; Ehrenberger, David; Scammon, Debra L.; Day, Julie; Allen, Tatiana; Reall, Andreu J.; Sides, Rhonda W.; Kim, Jaewhan

    2015-01-01

    PURPOSE As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these “advanced primary care” functions. A key required input is personnel effort. This study’s objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. METHODS We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. RESULTS Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. CONCLUSIONS Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. PMID:26371263

  8. Medical rehabilitation of leprosy patients discharged home in abia and ebonyi States of Nigeria.

    Science.gov (United States)

    Enwereji, Ezinne Ezinna; Ahuizi, Eke Reginald; Iheanocho, Okereke Chukwunenye; Enwereji, Kelechi Okechukwu

    2011-11-01

    To examine the extent to which medical coverage is available to discharged leprosy patients in communities. Evidence has shown that after care services, follow-up visits and national disease prevention programs are important components of medical rehabilitation to leprosy patients discharged home after treatment. Denying them accessibility to these services could expose them to multiple disabilities as well as several disease conditions including HIV/AIDS. These adverse health conditions could be averted if health workers extend healthcare services to discharged leprosy patients. This study was conducted to examine the extent to which discharged leprosy patients have access to healthcare services in the communities. All 33 leprosy patients who were fully treated with multi-drug therapy (MDT) and discharged home in the two leprosy settlements in Abia and Ebonyi States of Nigeria were included in this study. The list of discharged leprosy patients studied and their addresses were provided by the leprosy settlements where they were treated. Also, snowball-sampling method was used to identify some of the leprosy patients whose addresses were difficult to locate in the communities. Instruments for data collection were questionnaire, interview guide and checklist. These were administered because respondents were essentially those with no formal education. Analysis of data was done quantitatively and qualitatively. Findings showed that 20 (60.6%) of discharged patients did not receive health programs like HIV/AIDS prevention or family planning. Also, follow-up visits and after-care services were poor. About 14 (42.4%) of the patients live in dirty and overcrowded houses. On the whole, discharged patients were poorly medically rehabilitated (mean score: 4.7±1.1 out of total score of 7). Denying discharged leprosy patients opportunity of accessing health care services could increase prevalence of infectious diseases including HIV/AIDS among them. There is need to extend

  9. Globalization of health care delivery in the United States through medical tourism.

    Science.gov (United States)

    Kumar, Sameer; Breuing, Richard; Chahal, Rajneet

    2012-01-01

    This study highlights some of the inefficiencies in the U.S. health care system and determines what effect medical tourism has had on the U.S. and global health care supply chains. This study also calls attention to insufficient health communication efforts to inform uninsured or underinsured medical tourists about the benefits and risks and determines the managerial and cost implications of various surgical procedures on the global health care system into the future. This study evaluated 3 years (2005, 2007, and 2011) of actual and projected surgical cost data. The authors selected 3 countries for analysis: the United States, India, and Thailand. The surgeries chosen for evaluation were total knee replacement (knee arthroplasty), hip replacement (hip arthroplasty), and heart bypass (coronary artery bypass graft). Comparisons of costs were made using Monte Carlo simulation with variability encapsulated by triangular distributions. The results are staggering. In 2005, the amount of money lost to India and Thailand on just these 3 surgeries because of cost inefficiencies in the U.S. health care system was between 1.3 to 2 billion dollars. In 2011, because many more Americans are expected to travel overseas for health care, this amount is anticipated to rise to between 20 and 30.2 billion dollars. Therefore, more attention should be paid to health communication efforts that truly illustrate the benefits/risks of medical travel. The challenge of finding reliable data for surgeries performed and associated surgical cost estimates was mitigated by the use of a Monte Carlo simulation of triangular distributions. The implications from this study are clear: If the U.S. health care industry is unable to eliminate waste and inefficiency and thus curb rising costs, it will continue to lose surgical revenue to foreign health providers. Copyright © Taylor & Francis Group, LLC

  10. The cost of sustaining a patient-centered medical home: experience from 2 states.

    Science.gov (United States)

    Magill, Michael K; Ehrenberger, David; Scammon, Debra L; Day, Julie; Allen, Tatiana; Reall, Andreu J; Sides, Rhonda W; Kim, Jaewhan

    2015-09-01

    As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these "advanced primary care" functions. A key required input is personnel effort. This study's objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. © 2015 Annals of Family Medicine, Inc.

  11. Proceedings [of the] Second National Conference of State Medical Association Representatives on Continuing Medical Education, October 13-15, 1970.

    Science.gov (United States)

    American Medical Association, Chicago, IL.

    The responsibility of organized medicine in the area of continuing education was the focus of this conference. Papers presented at the conference and summaries of workshop discussion groups comprise this document. The papers are: The Purpose of the Conference; Maintenance of Physician Competence; Motivation for Continuing Medical Education; Peer…

  12. A flexible super-capacitive solid-state power supply for miniature implantable medical devices.

    Science.gov (United States)

    Meng, Chuizhou; Gall, Oren Z; Irazoqui, Pedro P

    2013-12-01

    We present a high-energy local power supply based on a flexible and solid-state supercapacitor for miniature wireless implantable medical devices. Wireless radio-frequency (RF) powering recharges the supercapacitor through an antenna with an RF rectifier. A power management circuit for the super-capacitive system includes a boost converter to increase the breakdown voltage required for powering device circuits, and a parallel conventional capacitor as an intermediate power source to deliver current spikes during high current transients (e.g., wireless data transmission). The supercapacitor has an extremely high area capacitance of ~1.3 mF/mm(2), and is in the novel form of a 100 μm-thick thin film with the merit of mechanical flexibility and a tailorable size down to 1 mm(2) to meet various clinical dimension requirements. We experimentally demonstrate that after fully recharging the capacitor with an external RF powering source, the supercapacitor-based local power supply runs a full system for electromyogram (EMG) recording that consumes ~670 μW with wireless-data-transmission functionality for a period of ~1 s in the absence of additional RF powering. Since the quality of wireless powering for implantable devices is sensitive to the position of those devices within the RF electromagnetic field, this high-energy local power supply plays a crucial role in providing continuous and reliable power for medical device operations.

  13. Judicial demand of medications through the Federal Justice of the State of Paraná

    Science.gov (United States)

    Nisihara, Renato Mitsunori; Possebom, Ana Carolina; Borges, Luiza de Martino Cruvinel; Shwetz, Ana Claudia Athanasio; Bettes, Fernanda Francis Benevides

    2017-01-01

    ABSTRACT Objective To describe the profile of lawsuits related to drug requests filled at the Federal Justice of the State of Paraná. Methods A cross-sectional study, and the data were obtained through consulting the lawsuits at the online system of the Federal Justice of Paraná. Results Out of 347 lawsuits included in the study, 55% of plaintiffs were women, with a median age of 56 years. Oncology was the field with more requests (23.6%), and the highest mean costs. A wide variety of diseases and broad variety of requested drugs were found in the lawsuits. Approximately two-thirds of them were requested by the brand name, and the most often requested drugs were palivizumab and tiotropium bromide. Only 14.5% of the requested medicines were registered in the National Medication Register. The Public Defender’s Office filled actions in 89.6% of cases and all lawsuits had an interim relief. The mean time for approval was 35 days and 70% of requests were granted. Conclusion Oncology was the field with the highest demand for medicines at the Federal Justice of Paraná in 2014. A great variety of medications was requested. The Public Defender´s Office represented most lawsuits. All demands had an interim relief, and the majority of requests were granted, within an average of 35 days. PMID:28444095

  14. Solid-state pulse modulator using Marx generator for a medical linac electron-gun

    Science.gov (United States)

    Lim, Heuijin; Hyeok Jeong, Dong; Lee, Manwoo; Lee, Mujin; Yi, Jungyu; Yang, Kwangmo; Ro, Sung Chae

    2016-04-01

    A medical linac is used for the cancer treatment and consists of an accelerating column, waveguide components, a magnetron, an electron-gun, a pulse modulator, and an irradiation system. The pulse modulator based on hydrogen thyratron-switched pulse-forming network is commonly used in linac. As the improvement of the high power semiconductors in switching speed, voltage rating, and current rating, an insulated gate bipolar transistor has become the more popular device used for pulsed power systems. We propose a solid-state pulse modulator to generator high voltage by multi-stacked storage-switch stages based on the Marx generator. The advantage of our modulator comes from the use of two semiconductors to control charging and discharging of the storage capacitor at each stage and it allows to generate the pulse with various amplitudes, widths, and shapes. In addition, a gate driver for two semiconductors is designed to reduce the control channels and to protect the circuits. It is developed for providing the pulsed power to a medical linac electron-gun that requires 25 kV and 1 A as the first application. In order to improve the power efficiency and achieve the compactness modulator, a capacitor charging power supply, a Marx pulse generator, and an electron-gun heater isolated transformer are constructed and integrated. This technology is also being developed to extend the high power pulsed system with > 1 MW and also other applications such as a plasma immersed ion implantation and a micro pulse electrostatic precipitator which especially require variable pulse shape and high repetition rate > 1 kHz. The paper describes the design features and the construction of this solid-state pulse modulator. Also shown are the performance results into the linac electron-gun.

  15. Characteristics of Transgender Women Living with HIV Receiving Medical Care in the United States.

    Science.gov (United States)

    Mizuno, Yuko; Frazier, Emma L; Huang, Ping; Skarbinski, Jacek

    2015-09-01

    Little has been reported from population-based surveys on the characteristics of transgender persons living with HIV. Using Medical Monitoring Project (MMP) data, we describe the characteristics of HIV-infected transgender women and examine their care and treatment needs. We used combined data from the 2009 to 2011 cycles of MMP, an HIV surveillance system designed to produce nationally representative estimates of the characteristics of HIV-infected adults receiving medical care in the United States, to compare demographic, behavioral, and clinical characteristics, and met and unmet needs for supportive services of transgender women with those of non-transgender persons using Rao-Scott chi-square tests. An estimated 1.3% of HIV-infected persons receiving care in the United States self-identified as transgender women. Transgender women were socioeconomically more marginalized than non-transgender men and women. We found no differences between transgender women and non-transgender men and women in the percentages prescribed antiretroviral therapy (ART). However, a significantly lower percentage of transgender women compared to non-transgender men had 100% ART dose adherence (78.4% vs. 87.4%) and durable viral suppression (50.8% vs. 61.4%). Higher percentages of transgender women needed supportive services. No differences were observed in receipt of most of supportive services, but transgender women had higher unmet needs than non-transgender men for basic services such as food and housing. We found little difference between transgender women and non-transgender persons in regards to receipt of care, treatment, and most of supportive services. However, the noted disparities in durable viral suppression and unmet needs for basic services should be explored further.

  16. Solid-state pulse modulator using Marx generator for a medical linac electron-gun

    International Nuclear Information System (INIS)

    Lim, Heuijin; Jeong, Dong Hyeok; Lee, Manwoo; Lee, Mujin; Yi, Jungyu; Yang, Kwangmo; Ro, Sung Chae

    2016-01-01

    A medical linac is used for the cancer treatment and consists of an accelerating column, waveguide components, a magnetron, an electron-gun, a pulse modulator, and an irradiation system. The pulse modulator based on hydrogen thyratron-switched pulse-forming network is commonly used in linac. As the improvement of the high power semiconductors in switching speed, voltage rating, and current rating, an insulated gate bipolar transistor has become the more popular device used for pulsed power systems. We propose a solid-state pulse modulator to generator high voltage by multi-stacked storage-switch stages based on the Marx generator. The advantage of our modulator comes from the use of two semiconductors to control charging and discharging of the storage capacitor at each stage and it allows to generate the pulse with various amplitudes, widths, and shapes. In addition, a gate driver for two semiconductors is designed to reduce the control channels and to protect the circuits. It is developed for providing the pulsed power to a medical linac electron-gun that requires 25 kV and 1 A as the first application. In order to improve the power efficiency and achieve the compactness modulator, a capacitor charging power supply, a Marx pulse generator, and an electron-gun heater isolated transformer are constructed and integrated. This technology is also being developed to extend the high power pulsed system with > 1 MW and also other applications such as a plasma immersed ion implantation and a micro pulse electrostatic precipitator which especially require variable pulse shape and high repetition rate > 1 kHz. The paper describes the design features and the construction of this solid-state pulse modulator. Also shown are the performance results into the linac electron-gun

  17. National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

    Science.gov (United States)

    Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

    2018-01-01

    Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

  18. Westinghouse AP1000 licensing maturity

    International Nuclear Information System (INIS)

    Schulz, T.; Vijuk, R.P.

    2005-01-01

    The Westinghouse AP1000 Program is aimed at making available a nuclear power plant that is economical in the U.S deregulated electrical power industry in the near-term. The AP1000 is two-loop 1000 MWe pressurizer water reactor (PWR). It is an up rated version of the AP600. The AP1000 uses passive safety systems to provide significant and measurable improvements in plant simplification, safety, reliability, investment protection and plant costs. The AP1000 uses proven technology, which builds on over 35 years of operating PWR experience. The AP1000 received Final Design Approval by the United States Nuclear Regulatory Commission (U.S. NRC) in September 2004. The AP1000 meets the US utility requirements. The AP1000 and its sister plant the AP600 have gone through a very through and complete licensing review. This paper describes the U.S. NRC review efforts of both the AP600 and the AP1000. The detail of the review and the independent calculations, evaluations and testing is discussed. The AP600 licensing documentation was submitted in 1992. The U.S. NRC granted Final Design Approval in 1999. During the intervening 7 years, the U.S. NRC asked thousands of questions, performed independent safety analysis, audited Westinghouse calculations and analysis, and performed independent testing. The more significant areas of discussion will be described. For the AP1000 Westinghouse first engaged the U.S. NRC in pre-certification discussions to define the extent of the review required, since the design is so similar to the AP600. The AP1000 licensing documentation was submitted in March 2002. The U.S. NRC granted Final Design Approval in September 2004. During the intervening 2 1/2 years, the U.S. NRC asked hundreds of questions, performed independent safety analysis, audited Westinghouse calculations and analysis, and performed independent testing. The more significant areas of discussion will be described. The implications of this review and approval on AP1000 applications in

  19. Exporting the Canadian licensing program

    International Nuclear Information System (INIS)

    Whelan, D.J.

    1981-06-01

    This paper deals with the problems of an overseas regulatory agency in licensing a Canadian-supplied nuclear plant which is referenced to a plant in Canada. Firstly, the general problems associated with the use of a reference plant are discussed. This is followed by a discussion of specific problems which arise from the licensing practices in Canada. The paper concludes with recommendations to simplify the task of demonstrating the licensability of an overseas CANDU plant

  20. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1983-01-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

  1. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1982-05-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

  2. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1983-03-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

  3. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1982-07-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

  4. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1982-11-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

  5. Technology Licensing and Firm Innovation

    DEFF Research Database (Denmark)

    Moreira, Solon

    acquisition. The findings indicate that technology licensing is positively related to the number of inventions produced by the licensee in the years subsequent to the licensing deal. Subsequently, I investigate the moderating effect that organizational slack and myopia have on this main relationship....... The findings also suggest that high levels of Organizational Slack (available financial resources) strengthen the positive effect of licensing on innovation. However, higher levels of Organizational Myopia (the extent to which a firm draws on its own knowledge) can decrease the main effect of licensing....

  6. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1982-10-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

  7. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1982-08-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

  8. Operating reactors licensing actions summary

    International Nuclear Information System (INIS)

    1982-09-01

    The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

  9. Patterns of medical management of overactive bladder (OAB) and benign prostatic hyperplasia (BPH) in the United States.

    Science.gov (United States)

    Anger, Jennifer T; Goldman, Howard B; Luo, Xuemei; Carlsson, Martin O; Chapman, Douglass; Zou, Kelly H; Russell, David; Ntanios, Fady; Esinduy, Canan B; Clemens, J Quentin

    2018-01-01

    Overactive bladder (OAB) and benign prostatic hyperplasia (BPH) are highly prevalent conditions that place a large burden on the United States (US) health care system. We sought to analyze patterns of prescription medication usage for incident OAB in men and women, and for incident BPH in men using US health insurance claims data. This study used Truven Health MarketScan® Commercial and Medicare Supplemental Research databases. The data were pooled from diverse points of care. BPH subjects included men age 18+ with the first and last two diagnoses of BPH ≥30 days apart and no BPH diagnosis for 1 year prior. OAB subjects included men and women age 18+, who were diagnosed similarly with incident OAB. The type of medication, medication continuation (persistence), and switching to a different medication were analyzed through September 30, 2013. Medication persistence was much higher overall for BPH than OAB (56% vs 34%, respectively, P BPH age 65+ (62%). Patients age 18-64 were less likely to continue medication than older adults (age 65+) for both BPH and OAB. A 9.4% of patients in the OAB cohort and 6.9% of men with BPH switched from one medication to another. Persistence was higher with BPH than OAB medications overall, whereas switching rates were higher in the OAB group. The lower persistence of OAB medication may be due to less efficacy or tolerability. The possibility of under treatment of OAB also warrants future investigations. © 2017 Wiley Periodicals, Inc.

  10. Teenagers' licensing decisions and their views of licensing policies: a national survey.

    Science.gov (United States)

    Williams, Allan F

    2011-08-01

    One objective was to determine teenage licensing rates on a national basis, interest in early licensure, and reasons for delay. A second objective was to learn teenagers' opinions about licensing policies, important in states considering ways to upgrade their current licensing systems. One thousand three hundred eighty-three 15- to 18-year-olds completed an online survey in November 2010. They were drawn from a nationally representative panel of US households recruited using probability-based sampling. The panel included cell phone-only households, and Internet access was provided to those without it. Weighting procedures were applied so that the study population represented the national US population of 15- to 18-year-olds. Most teens said that they were interested in getting a license as soon as legally possible, but many had not started the process. At 16, teens were about equally divided among those who had not started, those in the learner stage, and those with a restricted or full license. At 18, 62 percent had full licenses; 22 percent had not started. For those old enough to start, lack of a car, costs, parent availability, ability to get around without a car, and being busy with other activities were leading reasons for delay. The majority of teens were not in favor of higher licensing ages. Forty-six percent thought the minimum learner age should be 16; 30 percent thought the full license age should be 18 or older. The majority approved of night (78%) and passenger (57%) restrictions, and 85 and 93 percent endorsed cell phone and texting bans, respectively. When these policies were packaged together in a single law that included an age 16 start, night, passenger, cell phone and texting bans, and a full license at age 18, 74 percent of teens were in favor. Teenagers are not as supportive of strong licensing policies as parents of teens, but there is evidence that they will support comprehensive policies likely to lead to further reductions in teen crash

  11. ITER Safety and Licensing

    International Nuclear Information System (INIS)

    Girard, J-.P; Taylor, N.; Garin, P.; Uzan-Elbez, J.; GULDEN, W.; Rodriguez-Rodrigo, L.

    2006-01-01

    The site for the construction of ITER has been chosen in June 2005. The facility will be implemented in Europe, south of France close to Marseille. The generic safety scheme is now under revision to adapt the design to the host country regulation. Even though ITER will be an international organization, it will have to comply with the French requirements in the fields of public and occupational health and safety, nuclear safety, radiation protection, licensing, nuclear substances and environmental protection. The organization of the central team together with its partners organized in domestic agencies for the in-kind procurement of components is a key issue for the success of the experimentation. ITER is the first facility that will achieve sustained nuclear fusion. It is both important for the experimental one-of-a-kind device, ITER itself, and for the future of fusion power plants to well understand the key safety issues of this potential new source of energy production. The main safety concern is confinement of the tritium, activated dust in the vacuum vessel and activated corrosion products in the coolant of the plasma-facing components. This is achieved in the design through multiple confinement barriers to implement the defence in depth approach. It will be demonstrated in documents submitted to the French regulator that these barriers maintain their function in all postulated incident and accident conditions. The licensing process started by examination of the safety options. This step has been performed by Europe during the candidature phase in 2002. In parallel to the final design, and taking into account the local regulations, the Preliminary Safety Report (RPrS) will be drafted with support of the European partner and others in the framework of ITER Task Agreements. Together with the license application, the RPrS will be forwarded to the regulatory bodies, which will launch public hearings and a safety review. Both processes must succeed in order to

  12. Image simulation for automatic license plate recognition

    Science.gov (United States)

    Bala, Raja; Zhao, Yonghui; Burry, Aaron; Kozitsky, Vladimir; Fillion, Claude; Saunders, Craig; Rodríguez-Serrano, José

    2012-01-01

    Automatic license plate recognition (ALPR) is an important capability for traffic surveillance applications, including toll monitoring and detection of different types of traffic violations. ALPR is a multi-stage process comprising plate localization, character segmentation, optical character recognition (OCR), and identification of originating jurisdiction (i.e. state or province). Training of an ALPR system for a new jurisdiction typically involves gathering vast amounts of license plate images and associated ground truth data, followed by iterative tuning and optimization of the ALPR algorithms. The substantial time and effort required to train and optimize the ALPR system can result in excessive operational cost and overhead. In this paper we propose a framework to create an artificial set of license plate images for accelerated training and optimization of ALPR algorithms. The framework comprises two steps: the synthesis of license plate images according to the design and layout for a jurisdiction of interest; and the modeling of imaging transformations and distortions typically encountered in the image capture process. Distortion parameters are estimated by measurements of real plate images. The simulation methodology is successfully demonstrated for training of OCR.

  13. Overview and current management of computerized adaptive testing in licensing/certification examinations

    Directory of Open Access Journals (Sweden)

    Dong Gi Seo

    2017-07-01

    Full Text Available Computerized adaptive testing (CAT has been implemented in high-stakes examinations such as the National Council Licensure Examination-Registered Nurses in the United States since 1994. Subsequently, the National Registry of Emergency Medical Technicians in the United States adopted CAT for certifying emergency medical technicians in 2007. This was done with the goal of introducing the implementation of CAT for medical health licensing examinations. Most implementations of CAT are based on item response theory, which hypothesizes that both the examinee and items have their own characteristics that do not change. There are 5 steps for implementing CAT: first, determining whether the CAT approach is feasible for a given testing program; second, establishing an item bank; third, pretesting, calibrating, and linking item parameters via statistical analysis; fourth, determining the specification for the final CAT related to the 5 components of the CAT algorithm; and finally, deploying the final CAT after specifying all the necessary components. The 5 components of the CAT algorithm are as follows: item bank, starting item, item selection rule, scoring procedure, and termination criterion. CAT management includes content balancing, item analysis, item scoring, standard setting, practice analysis, and item bank updates. Remaining issues include the cost of constructing CAT platforms and deploying the computer technology required to build an item bank. In conclusion, in order to ensure more accurate estimations of examinees’ ability, CAT may be a good option for national licensing examinations. Measurement theory can support its implementation for high-stakes examinations.

  14. Licensed operating reactors

    International Nuclear Information System (INIS)

    1991-08-01

    The Nuclear Regulatory Commission's annual summary of licensed nuclear power reactor data is based primarily on the report of operating data submitted by licensees for each unit for the month of December because that report contains data for the month of December, the year to date (in this case calendar 1990) and cumulative data, usually from the date of commercial operation. The data is not independently verified, but various computer checks are made. The report is divided into two sections. The first contains summary highlights and the second contains data on each individual unit in commercial operation. Section 1 capacity and availability factors are simple arithmetic averages. Section 2 items in the cumulative column are generally as reported by the licensee and notes as to the use of weighted averages and starting dates other than commercial operation are provided

  15. Licensed operating reactors

    International Nuclear Information System (INIS)

    Hartfield, R.A.

    1994-03-01

    The Nuclear Regulatory Commissions annual summary of licensed nuclear power reactor data is based primarily on the report of operating data submitted by licensees for each unit for the month of December, the year to date (in this case calendar year 1993) and cumulative data, usually for the date of commercial operation. The data is not independently verified, but various computer checks are made. The report is divided into two sections. The first contains summary highlights and the second contains data on each individual unit in commercial operation. Section 1 capacity and availability factors are simple arithmetic averages. Section 2 items in the cumulative column are generally as reported by the licensee and notes as to the use of weighted averages and starting dates other than commercial operation are provided

  16. Licensed operating reactors

    International Nuclear Information System (INIS)

    1989-08-01

    THE OPERATING UNITS STATUS REPORT - LICENSED OPERATING REACTORS provides data on the operation of nuclear units as timely and accurately as possible. This information is collected by the Office of Information Resources Management from the Headquarters staff of NRC's Office of Enforcement (OE), from NRC's Regional Offices, and from utilities. The three sections of the report are: monthly highlights and statistics for commercial operating units, and errata from previously reported data; a compilation of detailed information on each unit, provided by NRC's Regional Offices, OE Headquarters and the utilities; and an appendix for miscellaneous information such as spent fuel storage capability, reactor-years of experience and non-power reactors in the US

  17. Licensing, supervision, retrofitting

    International Nuclear Information System (INIS)

    Steinkemper, H.

    1991-01-01

    The following proposals for the amendment to the Atomic Energy Act are made: the term of provisions against damage and the content and scope of the principle of commensurability should be defined by law. Their concretization should be left to the level of the statutory instruments and technical codes. In usage the scope of application of the subsequent obligation should be approximated to the category of element relevant to licensing. Lability to indemnification for subsequent obligations should be abolished. The need for a backfitting licence in the case of 'substantial' alterations requires a closer definition. A legal obligation should be placed on operators of nuclear reactors to carry out periodical safety checks. (orig./HSCH) [de

  18. Decommissioning licensing procedure

    International Nuclear Information System (INIS)

    Perello, M.

    1979-01-01

    Decommissioning or closure of a nuclear power plant, defined as the fact that takes place from the moment that the plant stops producing for the purpose it was built, is causing preocupation. So this specialist meeting on Regulatory Review seems to be the right place for presenting and discusing the need of considering the decommissioning in the safety analysis report. The main goal of this paper related to the licensing procedure is to suggest the need of a new chapter in the Preliminary Safety Analysis Report (P.S.A.R.) dealing with the decommissioning of the nuclear power plant. Therefore, after a brief introduction the problem is exposed from the point of view of nuclear safety and finally a format of the new chapter is proposed. (author)

  19. From 32 ounces to zero: a medical geographic study of dispensing a cultivated batch of "plum" cannabis flowers to medical marijuana patients in Washington State.

    Science.gov (United States)

    Aggarwal, Sunil K; Carter, Gregory T; Zumbrunnen, Craig; Morrill, Richard; Sullivan, Mark; Mayer, Jonathan D

    2013-01-01

    The medicinal use of cannabis is a growing phenomenon in the U.S. predicated on the success of overcoming specific spatial challenges and establishing particular human-environment relationships. This article takes a medical geographic "snapshot" of an urban site in Washington State where qualifying chronically ill and debilitated patients are delivered locally produced botanical cannabis for medical use. Using interview, survey, and observation, this medical geographic research project collected information on the social space of the particular delivery site and tracked the production cost, reach, and health value of a 32-ounce batch of strain-specific medical cannabis named "Plum" dispensed over a four-day period. A convenience sample of 37 qualifying patients delivered this batch of cannabis botanical medicine was recruited and prospectively studied with survey instruments. Results provide insight into patients' self-rated health, human-plant relationships, and travel-to-clinic distances. An overall systematic geographic understanding of the medical cannabis delivery system gives a grounded understanding of the lengths that patients and care providers go, despite multiple hurdles, to receive and deliver treatment with botanical cannabis that relieves diverse symptoms and improves health-related quality-of-life.

  20. Challenges of SMR licensing practices

    Energy Technology Data Exchange (ETDEWEB)

    Soderholm, K., E-mail: kristiina.soderholm@fortum.com [Fortum Power, Espoo (Finland)

    2012-12-15

    This paper aims to increase the understanding of high level Nuclear Power Plant (NPP) licensing processes in Finland, France, the UK, Canada and the USA. These countries have been selected for this study because of their different licensing processes and recent actions in new NPP construction. After discussing their similarities and differences, suitable features for Small Modular Reactor licensing can be emphasized and suggested. Some of the studied licensing processes have elements that are already quite well suited for application to SMRs, but all of these different national processes can benefit from studying and implementing lessons learned from SMR specific licensing needs. The main SMR features to take into account in licensing are standardization of the design, modularity, mass production and serial construction. Modularity can be divided into two different categories: the first category is simply a single unit facility constructed of independently engineered modules (e.g., construction process for Westinghouse AP-1000 NPP) and the second is a facility structure composed of many reactor modules where modules are manufactured in factories and installed into the facility as needed (e.g., NuScale Power SMR design). Short construction schedules will not be fully benefited from if the long licensing process prolongs the commissioning and approach to full-power operation. The focus area of this study is to better understand the possibility of SMR deployment in small nuclear countries, such as Finland, which currently has four operating NPPs. The licensing process needs to be simple and clear to make SMR deployment feasible from an economical point of view. This paper uses public information and interviews with experts to establish the overview of the different licensing processes and their main steps. A high-level comparison of the licensing steps has been carried out. Certain aspects of the aviation industry licensing process have also been studied and certain

  1. Waste management and licensing

    International Nuclear Information System (INIS)

    Dauk, W.

    1980-01-01

    It is the Court's consideration of the repercussions the regulation on waste management of Sect. 9a of the Atomic Energy Law will have, relating to the licensing of a plant according to Sect. 7 (2) of the Atomic Energy Law which is noteworthy. Overruling its former legal conception, the Administrative Court Schleswig now assumes, together with the public opinion, that the problem of waste management being brought to a point only with the initial operation of a nuclear power station is accordingly to be taken into account in line with the discretion of licensing according to Sect. 7 (2) of the Atomic Energy Law. In addition, the Administrative Court expressed its opinion on the extent to the right of a neighbour to a nuclear power station to file suit. According to the Sections 114 and 42 (2) of the rules of Administrative Courts it is true that a plaintiff cannot take action to set aside the licence because public interests have not been taken into account sufficiently, but he may do so because his own interests have not been included in the discretionary decision. The Administrative Court is reserved when qualifying the regulation on waste management with regard to the intensity of legal control. The Court is not supposed to replace controversial issues of technology and natural sciences on the part of the executive and its experts by its own assessment. According to the proceedings, the judicial review refers to the finding as to whether decisions made by authorities are suited - according to the way in which they were made - to guarantee the safety standard prescribed in Subdivision 3 of Sect. 7 (2) of the Atomic Energy Law. (HSCH) [de

  2. The effect of race on postsurgical ambulatory medical follow-up among United States Veterans.

    Science.gov (United States)

    Schonberger, Robert B; Dai, Feng; Brandt, Cynthia; Burg, Matthew M

    2017-08-01

    To investigate the association between self-identified black or African American race and the presence of ambulatory internal medicine follow-up in the year after surgery. Our hypothesis was that among US Veterans who presented for surgery, black or African American race would be associated with a decreased likelihood to receive ambulatory internal medicine follow-up in the year after surgery. Retrospective observational. All US Veterans Affairs hospitals. A total of 236,200 Veterans undergoing surgery between 2006 and 2011 who were discharged within 10 days of surgery and survived the full 1-year exposure period. None. Attendance at an internal medicine follow-up appointment within 1 year after surgery. After controlling for year of surgery, age, age ≥65 years, sex, Hispanic ethnicity, and number of inpatient days, black or African American patients were 11% more likely to lack internal medicine follow-up after surgery (adjusted odds ratio, 1.11; 95% confidence interval, 1.06-1.16). When accounting for geographic region, this difference remained significant at the Bonferoni-corrected P < .007 level only in the Midwest United States where black or African American patients were 28% more likely to lack medical follow-up in the year after surgery (odds ratio, 1.28; 95% confidence interval, 1.16-1.42; P < .0001). The disparity in ambulatory medical follow-up following surgery among black or African American vs nonblack or non-African American Veterans in the Midwest region deserves further study and may lead to important quality improvement initiatives aimed specifically at this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. 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...

  4. MEDICATION SYSTEM ANALYSIS OF AN UNIVERSITY HOSPITAL IN THE STATE OF GOIÁS

    Directory of Open Access Journals (Sweden)

    Ana Elisa Bauer de Camargo Silva

    2004-04-01

    Full Text Available The medication errors can bring serious consequences to patients, professionals andhealthcare institutions, they have multiple causes, amongst them failures related to theprofessionals and related to the medication system. This study’s objective was to identify and toanalyse the medication system process, its failures in order to propose improvement actions to thehospital. This exploratory descriptive study took place in the medical clinical unit and in thepharmacy of a general and university hospital of the state of Goiás, after approval of theCommittee of the Ethics of the correspondent hospital. The sample included: (first phase apharmacist, (third phase 40 professionals divided into 12 resident physicians (30%, 20 nursingprofessionals (50%, 8 pharmacy team members (20%; 294 patient charts were also used. Thedata was collected in 2002 and consisted of an interview with the professional in charge of themedication system, and non-participant observation of the environment and actions of theprofessionals and the academic people, interviews with the professionals and patient chartanalysis. The professionals were asked to sign on the “Free Will Participation Agreement”. It waspossible based on the data collected to describe the following processes: handwriting medicationprescription using carbon paper, individually dose dispensing and that the nursing professional whoadministrates the drug is not the same that prepares it in the clinical unit. The results based on the21 days of observation of the drug prescription, dispensing and administration processes were: theenvironment is the main problem in the prescription (75% and dispensing (30,6% processes, it isa noisy place and interruptions frequently occur; safety failures during the technique and inadvancedrug preparation appeared in the top (46,8% in the preparation process. The datacollection also allowed to build a chart of the 60 steps from drug prescription to monitoring. Theresults from

  5. Trends in medical malpractice claims in patients with cleft or craniofacial abnormalities in the United States.

    Science.gov (United States)

    Rawal, Rounak B; Kilpatrick, Lauren A; Wood, Jeyhan S; Drake, Amelia F

    2016-11-01

    To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities. A modified Delphi approach was used to gather search terms. Search settings included "all jury verdicts and settlements", with jurisdiction of "all states" and "all federal courts" (by court and circuit). A retrospective review of WestLawNext legal database was conducted. Cases were excluded if they did not have a direct association from the patient's craniofacial anomaly or if they were not related to malpractice. Forty-two cases met inclusion criteria. Cases closed between 1981 and 2014 were included. The mean payment among claims with an indemnity payment was $3.9 million. Of cases brought to trial, 62% were in favor of the plaintiff. Amongst physicians named as co-defendants, pediatricians were most commonly named (24%), followed by plastic surgeons (16%), obstetricians (7.8%), and radiologists (7.8%). "Missed diagnosis" was the most common type of negligent claim (45%), followed by "surgical error" (21%), and "medication error" (17%). "Anoxic brain injury" resulted in the highest median indemnity payment for complication of patient management ($3.5 million), followed by "wrongful birth" ($1.03 million), and "minor physical injury" ($520,000). No specific type of negligent claim (p = 0.764) nor complication of patient management (p = 0.61) was associated with a greater indemnity payment. Mean indemnity payment was $920,000 prior to 2001 and $4.4 million after 2001 (p = 0.058). Mean indemnity payments were fourteen-fold greater in patients as compared to those in the overall population ($3.9 million versus $274,887) and seven-fold greater than those in the average pediatric population ($3.9 million versus $520,923). All healthcare providers should be aware of the associated medical malpractice claims that may be incurred when treating patients at risk for these conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Essays on the economics of licensing nuclear power plants

    International Nuclear Information System (INIS)

    Cohen, L.R.

    1979-01-01

    Regulation and licensing of nuclear power plants by the United States Atomic Energy Commission and the United States Nuclear Regulatory Commission are discussed. Chapter 1 overviews the licensing process and issues raised in licensing cases. Based on a sample of plants licensed between 1967 and 1978, a statistical study of the impact of public participation in licensing is performed. The study concludes that public participation has had a major impact on licensing and power-plant costs. The impact is due to a fundamental weakness of the Commissions: their inability to resolve certain issues related to acceptable social risk. The study has important policy implications for reforming the Federal licensing process. Chapter 2 contains an analysis of the Price-Anderson Act, a Federal program for compensating victims of large nuclear accidents. The Price-Anderson Act is placed within the context of generalized federal disaster relief. A model is developed that allows an evaluation programs on the basis of moral hazard and equity principles. Chapter 3 analyzes the Nuclear Regulatory Commission's treatment of its mandatory antitrust review of applicants for nuclear power plants. The main conclusion of the chapter is that the reviews have not addressed the central economic issues of antitrust that are relevant to nuclear power. Instead, the reviews contribute to further cartelization of the electric utility industry. While politically expedient, the reviews are counter-productive to the development of an optimal industry structure

  7. 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

  8. An adaptive and generalizable closed-loop system for control of medically induced coma and other states of anesthesia

    Science.gov (United States)

    Yang, Yuxiao; Shanechi, Maryam M.

    2016-12-01

    Objective. Design of closed-loop anesthetic delivery (CLAD) systems is an important topic, particularly for medically induced coma, which needs to be maintained for long periods. Current CLADs for medically induced coma require a separate offline experiment for model parameter estimation, which causes interruption in treatment and is difficult to perform. Also, CLADs may exhibit bias due to inherent time-variation and non-stationarity, and may have large infusion rate variations at steady state. Finally, current CLADs lack theoretical performance guarantees. We develop the first adaptive CLAD for medically induced coma, which addresses these limitations. Further, we extend our adaptive system to be generalizable to other states of anesthesia. Approach. We designed general parametric pharmacodynamic, pharmacokinetic and neural observation models with associated guidelines, and derived a novel adaptive controller. We further penalized large steady-state drug infusion rate variations in the controller. We derived theoretical guarantees that the adaptive system has zero steady-state bias. Using simulations that resembled real time-varying and noisy environments, we tested the closed-loop system for control of two different anesthetic states, burst suppression in medically induced coma and unconsciousness in general anesthesia. Main results. In 1200 simulations, the adaptive system achieved precise control of both anesthetic states despite non-stationarity, time-variation, noise, and no initial parameter knowledge. In both cases, the adaptive system performed close to a baseline system that knew the parameters exactly. In contrast, a non-adaptive system resulted in large steady-state bias and error. The adaptive system also resulted in significantly smaller steady-state infusion rate variations compared to prior systems. Significance. These results have significant implications for clinically viable CLAD design for a wide range of anesthetic states, with potential cost

  9. Domains of unprofessional behavior during medical school associated with future disciplinary action by a state medical board.

    Science.gov (United States)

    Teherani, Arianne; Hodgson, Carol S; Banach, Mary; Papadakis, Maxine A

    2005-10-01

    In a previous study, we showed that unprofessional behavior in medical school was associated with subsequent disciplinary action. This study expands on that work by identifying the domains of unprofessional behavior that are most problematic. In this retrospective case-control study, negative comments were extracted from student files for 68 case (disciplined) and 196 matched control (nondisciplined) physicians. Comments were analyzed qualitatively and subsequently quantified. The relationship between domains of behavior and disciplinary action was established through chi-square tests and multivariate analysis of variance. Three domains of unprofessional behavior emerged that were related significantly to later disciplinary outcome: (1) poor reliability and responsibility, (2) lack of self-improvement and adaptability, and (3) poor initiative and motivation. Three critical domains of professionalism associated with future disciplinary action have been defined. These findings could lead to focused remediation strategies and policy decisions.

  10. [Management of chemical burns and inhalation poisonings in acute medical care procedures of the State Fire Service].

    Science.gov (United States)

    Chomoncik, Mariusz; Nitecki, Jacek; Ogonowska, Dorota; Cisoń-Apanasewicz, Urszula; Potok, Halina

    2013-01-01

    Emergency Medical Services (EMS) were founded by the government to perform tasks aimed at providing people with help in life-threatening conditions. The system comprises two constituent parts. The first one is public administrative bodies which are to organise, plan, coordinate and supervise the completion of the tasks. The other constituent is EMS units which keep people, resources and units in readiness. Supportive services, which include: the State Fire Service (SFS) and the National Firefighting and Rescue System (NFRS), are of great importance for EMS because they are eligible for providing acute medical care (professional first aid). Acute medical care covers actions performed by rescue workers to help people in life-threatening conditions. Rescue workers provide acute medical care in situations when EMS are not present on the spot and the injured party can be accessed only with the use of professional equipment by trained workers of NFRS. Whenever necessary, workers of supportive services can assist paramedics' actions. Cooperation of all units of EMS and NFRS is very important for rescue operations in the integrated rescue system. Time is a key aspect in delivering first aid to a person in life-threatening conditions. Fast and efficient first aid given by the accident's witness, as well as acute medical care performed by a rescue worker can prevent death and minimise negative effects of an injury or intoxication. It is essential that people delivering first aid and acute medical care should act according to acknowledged and standardised procedures because only in this way can the process of decision making be sped up and consequently, the number of possible complications following accidents decreased. The present paper presents an analysis of legal regulations concerning the management of chemical burn and inhalant intoxication in acute medical care procedures of the State Fire Service. It was observed that the procedures for rescue workers entitled to

  11. Review of survey articles regarding medication therapy management (MTM) services/programs in the United States.

    Science.gov (United States)

    Oladapo, Abiola O; Rascati, Karen L

    2012-08-01

    To provide a summary of published survey articles regarding the provision of medication therapy management (MTM) services in the United States. A literature search was conducted to identify original articles on MTM-related surveys conducted in the United States, involving community and outpatient pharmacists, physicians, patients, or pharmacy students and published by the primary researchers who conducted the study. Search engines used included PubMed, Medline, and International Pharmaceutical Abstracts (IPA). If MTM was in the keyword list, mesh heading, title, or abstract, the article was reviewed. References from these articles were searched to determine whether other relevant articles were available. A total of 405 articles were initially reviewed; however, only 32 articles met the study requirements. Of the 32 articles, 17 surveyed community/outpatient pharmacists, 3 surveyed pharmacy students, 4 surveyed physicians, and 8 surveyed patients. The survey periods varied across the different studies, with the earliest survey conducted in 2004 and the most recent survey conducted in 2009. The surveys were conducted via the telephone, US mail, interoffice mail, e-mails, Internet/Web sites, hand-delivered questionnaires, and focus groups. Despite the identified barriers to the provision of MTM services, pharmacists reportedly found it professionally rewarding to provide these services. Pharmacists claimed to have adequate clinical knowledge, experience, and access to information required to provide MTM services. Pharmacy students were of the opinion that the provision of MTM services was important to the advancement of the pharmacy profession and in providing patients with a higher level of care. Physicians supported having pharmacists adjust patients’ drug therapy and educate patients on general drug information but not in selecting patients’ drug therapy. Finally, patients suggested that alternative ways need to be explored in describing and marketing MTM

  12. Cerebral angioplasty practice at major medical centers in the United States

    International Nuclear Information System (INIS)

    Chaturvedi, S.; St Pierre, M.E.; Bertasio, B.

    2000-01-01

    Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42 %) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e. g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates. (orig.)

  13. Resting State Brain Network Disturbances Related to Hypomania and Depression in Medication-Free Bipolar Disorder.

    Science.gov (United States)

    Spielberg, Jeffrey M; Beall, Erik B; Hulvershorn, Leslie A; Altinay, Murat; Karne, Harish; Anand, Amit

    2016-12-01

    Research on resting functional brain networks in bipolar disorder (BP) has been unable to differentiate between disturbances related to mania or depression, which is necessary to understand the mechanisms leading to each state. Past research has also been unable to elucidate the impact of BP-related network disturbances on the organizational properties of the brain (eg, communication efficiency). Thus, the present work sought to isolate network disturbances related to BP, fractionate these into components associated with manic and depressive symptoms, and characterize the impact of disturbances on network function. Graph theory was used to analyze resting functional magnetic resonance imaging data from 60 medication-free patients meeting the criteria for BP and either a current hypomanic (n=30) or depressed (n=30) episode and 30 closely age/sex-matched healthy controls. Correction for multiple comparisons was carried out. Compared with controls, BP patients evidenced hyperconnectivity in a network involving right amygdala. Fractionation revealed that (hypo)manic symptoms were associated with hyperconnectivity in an overlapping network and disruptions in the brain's 'small-world' network organization. Depressive symptoms predicted hyperconnectivity in a network involving orbitofrontal cortex along with a less resilient global network organization. Findings provide deeper insight into the differential pathophysiological processes associated with hypomania and depression, along with the particular impact these differential processes have on network function.

  14. Prevalence and cost of hospital medical errors in the general and elderly United States populations.

    Science.gov (United States)

    Mallow, Peter J; Pandya, Bhavik; Horblyuk, Ruslan; Kaplan, Harold S

    2013-12-01

    The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years. Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits. There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population. This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database. This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.

  15. The medical examination in United States immigration applications: the potential use of genetic testing leads to heightened privacy concerns.

    Science.gov (United States)

    Burroughs, A Maxwell

    2005-01-01

    The medical examination has been an integral part of the immigration application process since the passing of the Immigration Act of 1891. Failing the medical examination can result in denial of the application. Over the years the medical examination has been expanded to include questioning about diseases that are scientifically shown to be rooted in an individual's genetic makeup. Recent advances in the fields of genomics and bioinformatics are making accurate and precise screening for these conditions a reality. Government policymakers will soon be faced with decisions regarding whether or not to sanction the use of these newly-developed genetic tests in the immigration application procedure. The terror threat currently facing the United States may ultimately bolster the argument in favor of genetic testing and/or DNA collection of applicants. However, the possibility of a government mandate requiring genetic testing raises a host of ethical issues; including the threat of eugenics and privacy concerns. Genetic testing has the ability to uncover a wealth of sensitive medical information about an individual and currently there are no medical information privacy protections afforded to immigration applicants. This article examines the potential for genetic testing in the immigration application process and the ethical issues surrounding this testing. In particular, this article explores the existing framework of privacy protections afforded to individuals living in the United States and how this and newly-erected standards like those released by the Health and Human Services (HHS) might apply to individuals seeking to immigrate to the United States.

  16. Role of fission gas release in reactor licensing

    International Nuclear Information System (INIS)

    1975-11-01

    The release of fission gases from oxide pellets to the fuel rod internal voidage (gap) is reviewed with regard to the required safety analysis in reactor licensing. Significant analyzed effects are described, prominent gas release models are reviewed, and various methods used in the licensing process are summarized. The report thus serves as a guide to a large body of literature including company reports and government documents. A discussion of the state of the art of gas release analysis is presented

  17. Immigration, Statecraft and Public Health: The 1920 Aliens Order, Medical Examinations and the Limitations of the State in England

    Science.gov (United States)

    Taylor, Becky

    2016-01-01

    This article considers the medical measures of the 1920 Aliens Order barring aliens from Britain. Building on existing local and port public health inspection, the requirement for aliens to be medically inspected before landing significantly expanded the duties of these state agencies and necessitated the creation of a new level of physical infrastructure and administrative machinery. This article closely examines the workings and limitations of alien medical inspection in two of England’s major ports—Liverpool and London—and sheds light on the everyday working of the Act. In doing so it reflects on the ambitions, actions and limitations of the state and so extends research by historians of the nineteenth and early twentieth century on the disputed histories of public health and the complexities of statecraft. Overall it suggests the importance of developing nuanced understandings of the gaps and failures arising from the translation of legislation into practice. PMID:27482146

  18. 31 CFR 596.306 - License.

    Science.gov (United States)

    2010-07-01

    ... ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.306 License. Except as otherwise specified, the term license means any license or...

  19. 31 CFR 596.305 - General license.

    Science.gov (United States)

    2010-07-01

    ... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.305 General license. The term general license means any license or authorization...

  20. More medical comorbidities in patients with bipolar disorder from the United States than from the Netherlands and Germany

    NARCIS (Netherlands)

    Post, R.M.; Altshuler, L.L.; Leverich, G.S.; Frye, M.A.; Suppes, T.; McElroy, S.L.; Keck, P.E.; Nolen, W.A.; Kupka, R.W.; Grunze, H.; Rowe, M.

    2014-01-01

    Medical comorbidities are common in patients with bipolar (BP) disorder but have not been previously examined for differences between United States and Europe. More than 900 outpatients with BP I and BP II disorder (mean age, 41 years) filled out a questionnaire including the occurrence of 30 listed

  1. More Medical Comorbidities in Patients With Bipolar Disorder From the United States Than From the Netherlands and Germany

    NARCIS (Netherlands)

    Post, Robert M.; Altshuler, Lori L.; Leverich, Gabriele S.; Frye, Mark A.; Suppes, Trish; McElroy, Susan L.; Keck, Paul E.; Nolen, Willem A.; Kupka, Ralph W.; Grunze, Heinz; Rowe, Mike

    Medical comorbidities are common in patients with bipolar (BP) disorder but have not been previously examined for differences between United States and Europe. More than 900 outpatients with BP I and BP II disorder (mean age, 41 years) filled out a questionnaire including the occurrence of 30 listed

  2. VEHICLES LICENSED IN SWITZERLAND

    CERN Multimedia

    Service des Relations avec les Pays-Hôtes

    2000-01-01

    1.\tVehicle licensinga)\tTime limitsVehicles must have a Swiss registration document and Swiss number plates: -\tif the owner has been residing in Switzerland for more than one year without a break of more than three consecutive months and has been using it for more than one month on Swiss territory, or -\tif the vehicle itself has been on Swiss territory for more than one year without a break of more than three consecutive months. b)\tTechnical details Vehicles belonging to non-Swiss members of the personnel who hold a carte de légitimation issued by the Swiss Federal Department of Foreign Affairs (hereinafter referred to as 'DFAE') and who were not permanently resident in Switzerland before taking up their appointment may be licensed in Switzerland with virtually no restrictions provided that their owner produces: -\tthe vehicle registration document and number plates of the country in which the car was previously registered, or -\ta manufacturer's certi...

  3. Impact on future licensing

    International Nuclear Information System (INIS)

    Pasedag, W.F.; Postma, A.K.

    1986-01-01

    The TMI-2 accident has had a dramatic impact on the assessment of severe accidents, particularly on accident source term assumptions. TMI not only demonstrated that regulatory interest in severe accidents is appropriate, but also illustrated our limited understanding of fission product behaviour under degraded core conditions. The resulting reassessment of accident source terms has resulted in a concerted, world-wide research effort, which has produced a new source term estimation methodology. In order to assess the potential impact of the application of this methodology on regulatory requirements, a comparison with the approach used in licensing analyses is necessary. Such a comparison performed for the TMI-2 accident sequence, shows that differences in assumptions concerning accident progression far outweigh the differences in the methodology per se. In particular, the degree of conservatism incorporated into assumptions concerning operator action and containment response has over-riding influence on source term estimates. A major contribution to the impact of the new source term methodology on regulatory requirements, therefore, is its capability to provide the improved level of understanding necessary for reassessment of regulatory assumptions in this area

  4. The causes of medical malpractice suits against radiologists in the United States.

    Science.gov (United States)

    Whang, Jeremy S; Baker, Stephen R; Patel, Ronak; Luk, Lyndon; Castro, Alejandro

    2013-02-01

    To determine the most frequent causes of malpractice suits as derived from credentialing data of 8401 radiologists. This study was approved by the Institutional Review Board of New Jersey Medical School. A total of 8401 radiologists in 47 states participating in the network of One-Call Medical, a broker for computed tomographic/magnetic resonance studies in workers' compensation cases, were required to provide their malpractice history as part of their credentialing application. Of these, 2624 (31%) radiologists had at least one claim in their career. In each enrollee's credentialing file, if there was a claim against the enrollee there was a narrative regarding each malpractice case from which, in most instances, a primary allegation could be discerned. Among the 4793 cases, an alleged cause could be derived from the narrative in 4043 (84%). Statistical analysis was performed with Stata 12 (2011; Stata, College Station, Tex) software. The most common general cause was error in diagnosis (14.83 claims per 1000 person-years [95% confidence interval {CI}: 14.19, 15.51]). In this category, breast cancer was the most frequently missed diagnosis (3.57 claims per 1000 person-years [95% CI: 3.26, 3.91]), followed by nonspinal fractures (2.49 claims per 1000 person-years [95% CI: 2.28, 2.72]), spinal fractures (1.32 claims per 1000 person-years [95% CI: 1.16, 1.49]), lung cancer (1.26 claims per 1000 person-years [95% CI: 1.11, 1.42]), and vascular disease (1.08 claims per 1000 person-years [95% CI: 0.93, 1.24]). The category next in frequency was procedural complications (1.76 claims per 1000 person-years [95% CI: 1.58, 1.96]), followed by inadequate communication with either patient (0.40 claim per 1000 person-years [95% CI: 0.32, 0.50]) or referrer (0.71 claim per 1000 person-years [95% CI: 0.60, 0.84]). Radiologists had only a peripheral role in 0.92 claim per 1000 person-years (95% CI: 0.77, 1.10). Failure to recommend additional testing was a rare cause (0.41 claim

  5. Department of Energy licensing strategy

    International Nuclear Information System (INIS)

    Frei, M.W.

    1984-01-01

    The Department of Energy (DOE) is authorized by the Nuclear Waste Policy Act of 1982 (Act) to site, design, construct, and operate mined geologic repositories for high-level radioactive wastes and is required to obtain licenses from the Nuclear Regulatory Commission (NRC) to achieve that mandate. To this end the DOE has developed a licensing approach which defines program strategies and which will facilitate and ease the licensing process. This paper will discuss the regulatory framework within which the repository program is conducted, the DOE licensing strategy, and the interactions between DOE and NRC in implementing the strategy. A licensing strategy is made necessary by the unique technical nature of the repository. Such a facility has never before been licensed; furthermore, the duration of isolation of waste demanded by the proposed EPA standard will require a degree of reliance on probabilistic performance assessment as proof of compliance that is a first of a kind for any industry. The licensing strategy is also made necessary by the complex interrelationships among the many involved governmental agencies and even within DOE itself, and because these relationships will change with time. Program activities which recognize these relationships are essential for implementing the Act. The guiding principle in this strategy is an overriding commitment to safeguarding public health and safety and to protecting the environment

  6. Managing Licensing in a Market for Technology

    DEFF Research Database (Denmark)

    Arora, Ashish; Rønde, Thomas; Fosfuri, Andrea

    the technology makes licensing decisions—to centralized licensing. The business unit has superior information about licensing opportunities but may not have the appropriate incentives because its rewards depend upon product market performance. If licensing is decentralized, the business unit forgoes valuable...... licensing opportunities since the rewards for licensing are (optimally) weaker than those for product market profits. This distortion is stronger when production-based incentives are more powerful, making centralization more attractive. Growth of technology markets favors centralization and drives higher...

  7. FOSS License Selection and Code Management

    OpenAIRE

    Vescuso, Peter

    2011-01-01

    With nearly 2,000 free and open source software (FLOSS) licenses, software license proliferation¿ can be a major headache for software development organizations trying to speed development through software component reuse, as well as companies redistributing software packages as components of their products. Scope is one problem: from the Free Beer license to the GPL family of licenses to platform-specific licenses such as Apache and Eclipse, the number and variety of licenses make it difficu...

  8. AACE/ACE Disease State Clinical Review: Medical Management of Cushing Disease.

    Science.gov (United States)

    Hamrahian, Amir H; Yuen, Kevin C J; Hoffman, Andrew R

    2014-07-01

    To review available medical therapies for patients with Cushing disease and to provide a roadmap for their use in clinical practice. PubMed searches were performed to identify all of the available published data on medical management of Cushing disease. Medical therapy is usually not the first-line treatment for patients with Cushing disease but may be used to improve clinical manifestations of Cushing disease in patients who are not suitable candidates for surgery, following unsuccessful surgery or recurrence, or as a "bridge therapy" in those who have undergone radiotherapy. Medical therapy may also be used in preoperative preparation of patients with severe disease. Current available medical options for patients with Cushing disease include centrally acting agents, steroidogenesis inhibitors, and a glucocorticoid receptor antagonists. At present, there are no head-to-head studies comparing the efficacy, tolerability, and safety of different U.S. Food and Drug Administration (FDA)- and non-FDA-approved drugs in patients with Cushing disease. With the initiation of new studies and the completion of ongoing clinical trials, the number of FDA-approved drugs for medical treatment of Cushing disease is expected to increase. Medical therapy has an important adjunctive role in the management of patients with Cushing disease. The decision to initiate medical treatment depends on many factors, including patient characteristics and preference. Long-term studies are needed to better define the clinical efficacy, safety, and tolerability of medical treatment of Cushing disease, including the role of combination therapies.

  9. Regulatory guidance for license renewal

    International Nuclear Information System (INIS)

    Thoma, John A.

    1991-01-01

    The proposed 10 CFR Part 54 rule proceduralizes the process for license renewal by identifying both the administrative and technical requirements for a renewal application. To amplify and support this regulation, written guidance has been provided in the form of a draft Regulatory Guide (DG 1009) and a draft Standard Review Plan for License Renewal (NUREG 1299). This guidance is scheduled to be finalized in 1992. Similar guidance will be provided for the proposed revisions to 10 CFR Part 51 concerning the environmental aspects of license renewal. (author)

  10. Variations in teenage activities with and without a driver's license.

    Science.gov (United States)

    Preusser, D F; Leaf, W A; Ferguson, S A; Williams, A F

    2000-01-01

    High school students were surveyed every 6 months from their freshman through senior years concerning licensing, driving, and transportation to and from their various activities. Students in Delaware (learner's permit can be issued at age 15 years, 10 months; driver's license at age 16) were compared with students in Connecticut and New York (permit at age 16; license at age 16) and in New Jersey (license at age 17). During the junior year, most Delaware students, some New York and Connecticut students, and few New Jersey students were licensed. However, even during the junior year, students in the respective states did not differ significantly with respect to time spent at activities such as a paying job, homework, watching television, dating, parties, being with friends, talking on the phone, or participating in sports or school activities. Graduated licensing systems can delay full-privilege teenage licensure and reduce teenage crash rates. These systems also can increase the number of times parents and others must drive. However, the present study's results indicate that licensing delays of as much as 1 year have minimal effects on the nondriving activities of high school students.

  11. Gender disparities in medical expenditures attributable to hypertension in the United States.

    Science.gov (United States)

    Basu, Rituparna; Franzini, Luisa; Krueger, Patrick M; Lairson, David R

    2010-01-01

    We sought to examine and attempt to explain gender disparities in hypertension-attributable expenditure among noninstitutionalized individuals in the United States. Using the 2001-2004 Medical Expenditure Panel Survey and the Aday and Andersen health care use model, we estimated hypertension-attributable health care expenditures for inpatient stay, outpatient visits, prescription drugs, office visits, and emergency room (ER) visits among men and women by applying the method of recycled prediction. Hypertensive individuals were identified using International Classification of Diseases, 9th edition, codes or self-report of a diagnosis of hypertension. The adjusted mean hypertension-attributable expenditure per individual was significantly higher for women than for men for prescription drugs, inpatient stays, office visits, outpatient visits and ER visits expenditures. However, as age increased, the gender difference in adjusted mean expenditures became smaller and eventually reversed. This reversal occurred at different ages for different expenditures. For prescription drugs, office visits and outpatient expenditures, the reversal in expenditures occurred around age 50 to 59. The maximum difference was observed in outpatient expenditures, where women's average expenditure was $102 more than men's below age 45 but $103 less than men's above age 75. These differences remained significant even after controlling for predisposing, enabling, and need predictors of health care use. Our findings imply that there are gender disparities in hypertension-related expenditures, but that this disparity depends on age. These findings support recent findings on gender disparities in heart diseases and raise the question of physicians' bias in their diagnostic or prognostic approaches to hypertension in men and women. Copyright 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  12. Guide to preemption of state-law claims against Class III PMA medical devices.

    Science.gov (United States)

    Whitney, Daniel W

    2010-01-01

    There is a perception that the express preemption holding of the Supreme Court in Riegel v. Medtronic, 552 U.S. 312(2008), immunizes medical device manufacturers from common law personal injury actions involving Class III devices that received FDA clearance under a premarket approval application (PMA). In the aftermath of Riegel, many lawsuits involving Class III PMA devices have been dismissed by district courts applying the new heightened pleading standard of Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (2007). Other lawsuits involving Class III PMA devices premised on fraud-on-FDA have been dismissed based on the implied preemption holding of the Supreme Court in Buckman v. Plaintiffs' Legal Comm., 531 U.S. 341 (2001). When these decisions are carefully analyzed together with Medtronic, Inc. v. Lohr, 518 U.S. 470 (1996), which found no preemption regarding a Class III device receiving FDA clearance through the 510(k) mechanism, it is apparent that the preemption defense does not apply universally to Class III PMA devices. The overall methodology for framing a non-preempted claim is to first identify conduct which violated the PMA or other specific requirements related to safety or efficacy. If such conduct can also be stated in terms of a breach of a parallel common law duty (e.g, failure to warn under strict liability or negligence, manufacturing defect or breach of warranty), then it would appear the claim is not preempted. Alternatively, regardless of a specific violation, common law remedies are not preempted by general CGMP requirements.

  13. Analysis of licensed South African diagnostic imaging equipment ...

    African Journals Online (AJOL)

    Analysis of licensed South African diagnostic imaging equipment. ... Pan African Medical Journal ... Introduction: Objective: To conduct an analysis of all registered South Africa (SA) diagnostic radiology equipment, assess the number of equipment units per capita by imaging modality, and compare SA figures with published ...

  14. Emergency Medical Services Public Health Implications and Interim Guidance for the Ebola Virus in the United States

    Directory of Open Access Journals (Sweden)

    Christopher E. McCoy

    2014-11-01

    Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.

  15. Survey of pharmacy involvement in hospital medication reconciliation programs across the United States

    Directory of Open Access Journals (Sweden)

    Gregory R Stein

    2015-11-01

    Full Text Available Objective: The objective of this study is to conduct a review of pertinent literature, assess pharmacy involvement in medication reconciliation, and offer insight into best practices for hospitals to implement and enhance their medication reconciliation programs. Method: Pharmacists in hospitals nationwide were asked to complete an anonymous survey via the American College of Clinical Pharmacy online database. The multiple choice survey analyzed the roles that healthcare professionals play in medication reconciliation programs at hospitals. Results: Of the survey responses received, 32/91 (35% came from pharmacists at hospitals with a pharmacy-led medication reconciliation program. Of these pharmacy-led programs, 17/32 (53% have a dedicated pharmacist or pharmacy staff to perform medication reconciliation. Conclusion: A comprehensive review of literature suggests that pharmacy involvement has the potential to reduce medication reconciliation errors and may improve patient satisfaction. Focused, full-time medication reconciliation pharmacists can help hospitals save time and money, improve outcomes, and meet higher standards issued by the Joint Commission. Data obtained in this study show the extent to which pharmacists contribute to achieving these goals in healthcare systems nationwide. This baseline study provides a strong case for hospitals to implement a pharmacy-led medication reconciliation program.

  16. Influence of Clerkship on Attitudes of Medical Students toward Psychiatry across Cultures: United States and Qatar

    Science.gov (United States)

    Burgut, F. Tuna; Polan, H. Jonathan

    2013-01-01

    Objective: To assure adequate treatment for patients with mental illness worldwide, medical schools must impart positive attitudes toward psychiatry. The authors examined the effect of culture on changes in attitudes toward psychiatry among medical students receiving the same psychiatry clerkship curriculum in two different countries. Methods: A…

  17. University of the Free State medical students' view of at-risk drinking ...

    African Journals Online (AJOL)

    Marijuana was the most common non-alcoholic substance used by medical students (14.6%) in the preceding 3 years. Alcohol and other substances were most frequently used during social activities with friends. Conclusions. Both medical students' knowledge of levels of alcohol intake associated with increased risks and ...

  18. Race, ethnicity, and medical student well-being in the United States.

    Science.gov (United States)

    Dyrbye, Liselotte N; Thomas, Matthew R; Eacker, Anne; Harper, William; Massie, F Stanford; Power, David V; Huschka, Mashele; Novotny, Paul J; Sloan, Jeff A; Shanafelt, Tait D

    2007-10-22

    Little is known about the training experience of minority medical students. We explore differences in the prevalence of burnout, depressive symptoms, and quality of life (QOL) among minority and nonminority medical students as well as the role race/ethnicity plays in students' experiences. Medical students (N = 3080) at 5 medical schools were surveyed in 2006 using validated instruments to assess burnout, depression, and QOL. Students were also asked about the impact of race/ethnicity on their training experience. The response rate was 55%. Nearly half of students reported burnout (47%) and depressive symptoms (49%). Mental QOL scores were lower among students than among the age-matched general population (43.1 vs 47.2; P race/ethnicity had adversely affected their medical school experience (11% vs 2%; P race does contribute to the distress minority students do experience. Additional studies are needed to define the causes of these perceptions and to improve the learning climate for all students.

  19. A pilot study exploring awareness among general public toward issues related to medication safety in the state of Penang, Malaysia

    Directory of Open Access Journals (Sweden)

    Mohamed Azmi Hassali

    2012-01-01

    Full Text Available Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistical analysis: Data were analyzed by using SPSS version 12.0 and descriptive statistics were reported where appropriate. Results: Majority of the respondents (n=292, 61.3% stated that they were well aware of the possible side effects of their current medications. A total of 196 respondents (41.17% believed that all medicines registered in Malaysia are safe to use as these medicines have no side effects. About 40.33% (n=192 of the respondents claimed that they share their unused medicines with family and friends who are having similar illness. Majority of respondents 57.7% (n=275 were satisfied with the drug information provided by the healthcare professionals. This study also found that more than 80% of the respondents (n=409 did report that they read the labels of their medication before using. Conclusions: In this study, it was revealed that there is a moderate level of public knowledge regarding medication safety. It is evident that public underestimates the risk of their medications. There is a general lack of awareness and understanding among the public especially toward side effects.

  20. License plate recognition (phase B).

    Science.gov (United States)

    2010-06-01

    License Plate Recognition (LPR) technology has been used for off-line automobile enforcement purposes. The technology has seen mixed success with correct reading rate as high as 60 to 80% depending on the specific application and environment. This li...

  1. Licensing and advanced fuel designs

    International Nuclear Information System (INIS)

    Davidson, S.L.; Novendstern, E.H.

    1991-01-01

    For the past 15 years, Westinghouse has been actively involved in the development and licensing of fuel designs that contain major advanced features. These designs include the optimized fuel assembly, The VANTAGE 5 fuel assembly, the VANTAGE 5H, and most recently the VANTAGE+ fuel assembly. Each of these designs was supported by extensive experimental data, safety evaluations, and design efforts and required intensive interaction with the US Nuclear Regulatory Commission (NRC) during the review and approval process. This paper presents a description of the licensing approach and how it was utilized by the utilities to facilitate the licensing applications of the advanced fuel designs for their plants. The licensing approach described in this paper has been successfully applied to four major advanced fuel design changes ∼40 plant-specific applications, and >350 cycle-specific reloads in the past 15 years

  2. [General awareness and use of generic medication among citizens of Tubarão, state of Santa Catarina, Brazil].

    Science.gov (United States)

    Blatt, Carine Raquel; Trauthman, Silvana Cristina; Schmidt, Edegar Henrique; Marchesan, Samuel; da Silva, Luana May; Martins, João Luiz

    2012-01-01

    Although generic medication has been introduced in the country to offer an accessible alternative to brand-name medication, it represents only 14% of sales in number of units within the pharmaceutical market. The aim of this work was to research the level of awareness and the use of generic products among residents of the municipality of Tubarão, State of Santa Catarina, Brazil. A transversal study was carried out with a sample of 234 interviewees, distributed among municipal areas. With regard to use, the majority of those interviewed had used generic medication, and half of them had at least one such product in their home. To verify awareness of different types of medication, pictures with the generic, brand name and similar packaging for paracetamol and atenolol were shown and 91% were able to identify all products correctly. To be of higher economic standing, already having used generic products, believing that the generic medication has the same effect as the brand name medication, finding generic products in drugstores easily and being accustomed to buy generic products, were factors that were positively associated with the correct identification.

  3. Accreditation of undergraduate medical training programs: practices in nine developing countries as compared with the United States.

    Science.gov (United States)

    Cueto, Jose; Burch, Vanessa C; Adnan, Nor Azila Mohd; Afolabi, Bosede B; Ismail, Zalina; Jafri, Wasim; Olapade-Olaopa, E Oluwabunmi; Otieno-Nyunya, Boaz; Supe, Avinash; Togoo, Altantsetseg; Vargas, Ana Lia; Wasserman, Elizabeth; Morahan, Page S; Burdick, William; Gary, Nancy

    2006-07-01

    Undergraduate medical training program accreditation is practiced in many countries, but information from developing countries is sparse. We compared medical training program accreditation systems in nine developing countries, and compared these with accreditation practices in the United States of America (USA). Medical program accreditation practices in nine developing countries were systematically analyzed using all available published documents. Findings were compared to USA accreditation practices. Accreditation systems with explicitly defined criteria, standards and procedures exist in all nine countries studied: Argentina, India, Kenya, Malaysia, Mongolia, Nigeria, Pakistan, Philippines and South Africa. Introduction of accreditation processes is relatively recent, starting in 1957 in India to 2001 in Malaysia. Accrediting agencies were set up in these countries predominantly by their respective governments as a result of legislation and acts of Parliament, involving Ministries of Education and Health. As in the USA, accreditation: (1) serves as a quality assurance mechanism promoting professional and public confidence in the quality of medical education, (2) assists medical schools in attaining desired standards, and (3) ensures that graduates' performance complies with national norms. All nine countries follow similar accreditation procedures. Where mandatory accreditation is practiced, non-compliant institutions may be placed on probation, student enrollment suspended or accreditation withdrawn. Accreditation systems in several developing countries are similar to those in the developed world. Data suggest the trend towards instituting quality assurance mechanisms in medical education is spreading to some developing countries, although generalization to other areas of the world is difficult to ascertain.

  4. What Are Medical Students in the United States Learning About Radiation Oncology? Results of a Multi-Institutional Survey

    International Nuclear Information System (INIS)

    Zaorsky, Nicholas G.; Shaikh, Talha; Handorf, Elizabeth; Eastwick, Gary; Hesney, Adam; Scher, Eli D.; Jones, Ryan T.; Showalter, Timothy N.; Avkshtol, Vladimir; Rice, Stephanie R.; Horwitz, Eric M.; Meyer, Joshua E.

    2016-01-01

    Purpose: The purposes of this study were to assess the exposure that medical students (MSs) have to radiation oncology (RO) during the course of their medical school career, as evidenced by 2 time points in current medical training (ie, first vs fourth year; MS1s and MS4s, respectively) and to assess the knowledge of MS1s, MS4s, and primary care physicians (PCPs) about the appropriateness of RT in cancer management in comparison with RO attendings. Methods: We developed and beta tested an electronic survey divided into 3 parts: RO job descriptions, appropriateness of RT, and toxicities of RT. The surveys were distributed to 7 medical schools in the United States. A concordance of >90% (either yes or no) among RO attendings in an answer was necessary to determine the correct answer and to compare with other subgroups using a χ"2 test (P 1 of 5 respondents. Multiple nontoxicities of RT (eg, emitting low-level radiation from the treatment site) were incorrectly identified as toxicities by >1 of 5 respondents. MS4s/PCPs with an RO rotation in medical school had improved scores in all prompts. Conclusions: Although MS knowledge of general RT principles improves from the first to the fourth year, a large knowledge gap still exists between MSs, current PCPs, and ROs. Some basic misconceptions of RT persist among a minority of MSs and PCPs. We recommend implementing formal education in RO fundamentals during the core curriculum of medical school.

  5. Licensing of nuclear reactor operators

    International Nuclear Information System (INIS)

    1979-09-01

    Recommendations are presented for the licensing of nuclear reactor operators in units licensed according to the legislation in effect. They apply to all physical persons designated by the Operating Organization of the nuclear reactor or reactors to execute any of the following functional activities: a) to manipulate the controls of a definite reactor b) to direct the authorized activities of the reactor operators licesed according to the present recommendations. (F.E.) [pt

  6. DOE Patents Available for Licensing

    International Nuclear Information System (INIS)

    Stuber, C.

    1981-01-01

    DOE Patents Available for Licensing (DOE PAL) provides abstracting and indexing coverage of the DOE patent literature, including patent applications, that concerns any apsect of energy production, conservation, and utilization. The citations are arranged by subject category. DOE is prepared to grant exclusive or nonexclusive, revocable licenses under DOE-owned US patents and patent applications in accordance with the provisions of 10CFR781

  7. The American Board of Internal Medicine Maintenance of Certification Examination and State Medical Board Disciplinary Actions: a Population Cohort Study.

    Science.gov (United States)

    McDonald, Furman S; Duhigg, Lauren M; Arnold, Gerald K; Hafer, Ruth M; Lipner, Rebecca S

    2018-03-07

    Some have questioned whether successful performance in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program is meaningful. The association of the ABIM Internal Medicine (IM) MOC examination with state medical board disciplinary actions is unknown. To assess risk of disciplinary actions among general internists who did and did not pass the MOC examination within 10 years of initial certification. Historical population cohort study. The population of internists certified in internal medicine, but not a subspecialty, from 1990 through 2003 (n = 47,971). ABIM IM MOC examination. General internal medicine in the USA. The primary outcome measure was time to disciplinary action assessed in association with whether the physician passed the ABIM IM MOC examination within 10 years of initial certification, adjusted for training, certification, demographic, and regulatory variables including state medical board Continuing Medical Education (CME) requirements. The risk for discipline among physicians who did not pass the IM MOC examination within the 10 year requirement window was more than double than that of those who did pass the examination (adjusted HR 2.09; 95% CI, 1.83 to 2.39). Disciplinary actions did not vary by state CME requirements (adjusted HR 1.02; 95% CI, 0.94 to 1.16), but declined with increasing MOC examination scores (Kendall's tau-b coefficient = - 0.98 for trend, p actions were less severe among those passing the IM MOC examination within the 10-year requirement window than among those who did not pass the examination. Passing a periodic assessment of medical knowledge is associated with decreased state medical board disciplinary actions, an important quality outcome of relevance to patients and the profession.

  8. Dry spent fuel storage licensing

    International Nuclear Information System (INIS)

    Sturz, F.C.

    1995-01-01

    In the US, at-reactor-site dry spent fuel storage in independent spent fuel storage installations (ISFSI) has become the principal option for utilities needing storage capacity outside of the reactor spent fuel pools. Delays in the geologic repository operational date at or beyond 2010, and the increasing uncertainty of the US Department of Energy's (DOE) being able to site and license a Monitored Retrievable Storage (MRS) facility by 1998 make at-reactor-site dry storage of spent nuclear fuel increasingly desirable to utilities and DOE to meet the need for additional spent fuel storage capacity until disposal, in a repository, is available. The past year has been another busy year for dry spent fuel storage licensing. The licensing staff has been reviewing 7 applications and 12 amendment requests, as well as participating in inspection-related activities. The authors have licensed, on a site-specific basis, a variety of dry technologies (cask, module, and vault). By using certified designs, site-specific licensing is no longer required. Another new cask has been certified. They have received one new application for cask certification and two amendments to a certified cask design. As they stand on the brink of receiving multiple applications from DOE for the MPC, they are preparing to meet the needs of this national program. With the range of technical and licensing options available to utilities, the authors believe that utilities can meet their need for additional spent fuel storage capacity for essentially all reactor sites through the next decade

  9. Federalism, intergovernmental relations, and the challenge of the medically uninsurable: a retrospective on high risk pools in the states.

    Science.gov (United States)

    Plein, L Christopher

    2010-01-01

    While relatively overlooked in health policy research and analysis, state high risk insurance pools play a notable role in contemporary health policy arrangements. Also know as State Comprehensive Health Insurance Plans, high-risk pools emerged in the late 1970s as states began to grapple with the challenges of the medically uninsured. Today, thirty-five states operate these programs. To further our understanding of health and human services administration, it is important to examine these plans, especially in context of intergovernmental health policy in the United States. This analysis provides an overview of high risk pool evolution and gives attention to forces that have shaped their development, such as model legislation, funding arrangements, and increasing federal-level interest in their use as platforms to advance national policy initiatives.

  10. Treatment of Young People With Antipsychotic Medications in the United States.

    Science.gov (United States)

    Olfson, Mark; King, Marissa; Schoenbaum, Michael

    2015-09-01

    Despite concerns about rising treatment of young people with antipsychotic medications, little is known about trends and patterns of their use in the United States. To describe antipsychotic prescription patterns among young people in the United States, focusing on age and sex. A retrospective descriptive analysis of antipsychotic prescriptions among patients aged 1 to 24 years was performed with data from calendar years 2006 (n = 765,829), 2008 (n = 858,216), and 2010 (n = 851,874), including a subset from calendar year 2009 with service claims data (n = 53,896). Data were retrieved from the IMS LifeLink LRx Longitudinal Prescription database, which includes approximately 60% of all retail pharmacies in the United States. Denominators were adjusted to generalize estimates to the US population. The percentage of young people filling 1 or more antipsychotic prescriptions during the study year by sex and age group (younger children, 1-6 years; older children, 7-12 years; adolescents, 13-18 years; and young adults, 19-24 years) was calculated. Among young people with antipsychotic use, percentages with specific clinical psychiatric diagnoses and 1 or more antipsychotic prescriptions from a psychiatrist and from a child and adolescent psychiatrist were also determined. The percentages of young people using antipsychotics in 2006 and 2010, respectively, were 0.14% and 0.11% for younger children, 0.85% and 0.80% for older children, 1.10% and 1.19% for adolescents, and 0.69% and 0.84% for young adults. In 2010, males were more likely than females to use antipsychotics, especially during childhood and adolescence: 0.16% vs 0.06% for younger children, 1.20% vs 0.44% for older children, 1.42% vs 0.95% for adolescents, and 0.88% vs 0.81% for young adults. Among young people treated with antipsychotics in 2010, receiving a prescription from a psychiatrist was less common among younger children (57.9%) than among other age groups (range, 70.4%-77.9%). Approximately 29.3% of

  11. Licensing the California low-level radioactive waste disposal facility

    International Nuclear Information System (INIS)

    Dressen, A.L.; Serie, P.J.; Junkert, R.

    1992-01-01

    California has made significant progress toward the issuance of a license to construct and operate the Southwestern Compact's low-level radioactive waste disposal facility. However, obstacles to completing construction and preparing to receive waste still exist. This paper will describe the technical licensing issues, EIR/S process, political events, and public interactions that have impacted on California regulators' ability to complete the license application review and reach a decision on issuing a license. Issues associated with safely and liability evaluations, finalization of the environmental impact report, and land transfer processes involving multiple state, federal, and local agencies will be identified. Major issues upon which public and political opposition is focusing will also be described. (author)

  12. Discharge against medical advice in a pediatric emergency center in the State of Qatar

    Directory of Open Access Journals (Sweden)

    Hala Abdulateef

    2012-05-01

    Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

  13. Prevalence of alcohol-interactive prescription medication use among current drinkers: United States, 1999 to 2010.

    Science.gov (United States)

    Breslow, Rosalind A; Dong, Chuanhui; White, Aaron

    2015-02-01

    The majority of Americans consume alcoholic beverages. Alcohol interacts negatively with numerous commonly prescribed medications. Yet, on a population level, little is known about use of alcohol-interactive (AI) prescription medications among drinkers. The purpose of our study was to determine the prevalence of AI prescription medication use among current drinkers in the U.S. population. Data were from the National Health and Nutrition Examination Survey (NHANES 1999 to 2010); 26,657 adults aged ≥20 years had data on past year alcohol consumption and past month prescription medication use. Analyses were adjusted for covariates: age, race/ethnicity, education, marital status, and smoking. Statistical procedures accounted for survey stratification, clustering, and nonresponse. Analyses were weighted to be nationally representative. The unadjusted total prevalence of AI medication use was 42.8% (95% confidence interval [CI] 41.5 to 44.0). Among current drinkers, adjusted prevalence was 41.5% (CI 40.3 to 42.7). Among participants aged ≥65 total prevalence of AI medication use was 78.6% (CI 77.3 to 79.9) and adjusted prevalence among current drinkers was 77.8% (CI 75.7 to 79.7). The AI medications most commonly used by current drinkers were cardiovascular agents, central nervous system agents, and metabolic agents. Our results suggest that there could be substantial simultaneous exposure to alcohol and AI prescription medications in the U.S. population. Given the adverse health risks of combining alcohol with AI prescription medications, future efforts are needed to collect data to determine actual simultaneous prevalence. Copyright © 2015 by the Research Society on Alcoholism.

  14. State of the art assessment and engineering evaluation of medical waste thermal treatment

    International Nuclear Information System (INIS)

    Barton, R.G.; Hassel, G.R.; Lanier, W.S.; Seeker, W.R.

    1989-01-01

    Incineration is a method of disposing of medical waste (such as radioactive materials, toxic metals, etc.) that is increasingly utilized to reduce the wastes volume and hazard. Recent field tests indicate that medical waste incinerators may be prone to emitting high concentrations of acid gases, toxic organic compounds and other hazardous substances. This paper examines current practices in the design and operation of medical waste incinerators to identify the parameters which govern toxic emissions. A variety of design and operating parameters including chamber temperatures, gas phase mixing and waste feed rate were found to have an important impact on emissions

  15. Judicial demand of medications through the Federal Justice of the State of Paraná.

    Science.gov (United States)

    Nisihara, Renato Mitsunori; Possebom, Ana Carolina; Borges, Luiza de Martino Cruvinel; Shwetz, Ana Claudia Athanasio; Bettes, Fernanda Francis Benevides

    2017-01-01

    To describe the profile of lawsuits related to drug requests filled at the Federal Justice of the State of Paraná. A cross-sectional study, and the data were obtained through consulting the lawsuits at the online system of the Federal Justice of Paraná. Out of 347 lawsuits included in the study, 55% of plaintiffs were women, with a median age of 56 years. Oncology was the field with more requests (23.6%), and the highest mean costs. A wide variety of diseases and broad variety of requested drugs were found in the lawsuits. Approximately two-thirds of them were requested by the brand name, and the most often requested drugs were palivizumab and tiotropium bromide. Only 14.5% of the requested medicines were registered in the National Medication Register. The Public Defender's Office filled actions in 89.6% of cases and all lawsuits had an interim relief. The mean time for approval was 35 days and 70% of requests were granted. Oncology was the field with the highest demand for medicines at the Federal Justice of Paraná in 2014. A great variety of medications was requested. The Public Defender´s Office represented most lawsuits. All demands had an interim relief, and the majority of requests were granted, within an average of 35 days. Descrever o perfil das ações que solicitam medicamentos ajuizadas na Justiça Federal do Paraná. Estudo transversal descritivo, cujos dados foram obtidos por meio de consulta aos processos no sistema on-line da Justiça Federal do Paraná. Dentre os 347 processos incluídos no estudo, 55% dos autores eram mulheres, com mediana da idade de 56 anos, sendo a área mais procurada a oncologia (23,6%). A área oncológica também foi a que apresentou maiores custos médios. Foi ampla a variedade de doenças geradoras das ações e também foi consequentemente grande a variedade de medicamentos solicitados. Cerca de dois terços dos fármacos foram solicitados pelo nome comercial, e os mais requeridos foram o palivizumabe e brometo de

  16. 77 FR 32167 - Revocation of License of Small Business Investment Company

    Science.gov (United States)

    2012-05-31

    ... States Small Business Administration hereby revokes the license of Women's Growth Capital Fund I, LLLP, a... SMALL BUSINESS ADMINISTRATION Revocation of License of Small Business Investment Company Pursuant to the authority granted to the United States Small Business Administration by the Wind-Up Order of...

  17. University of the Free State medical students' view of at-risk drinking ...

    African Journals Online (AJOL)

    2009-03-01

    Mar 1, 2009 ... Medical students' view of what constitutes at-risk drinking behaviour is ... several forms of cancer.5 Individual susceptibility to alcohol-related complications .... marijuana, tranquillisers and miscellaneous substances. In each.

  18. State of the art in medical applications using non-thermal atmospheric pressure plasma

    Science.gov (United States)

    Tanaka, Hiromasa; Ishikawa, Kenji; Mizuno, Masaaki; Toyokuni, Shinya; Kajiyama, Hiroaki; Kikkawa, Fumitaka; Metelmann, Hans-Robert; Hori, Masaru

    2017-12-01

    Plasma medical science is a novel interdisciplinary field that combines studies on plasma science and medical science, with the anticipation that understanding the scientific principles governing plasma medical science will lead to innovations in the field. Non-thermal atmospheric pressure plasma has been used for medical treatments, such as for cancer, blood coagulation, and wound healing. The interactions that occur between plasma and cells/tissues have been analyzed extensively. Direct and indirect treatment of cells with plasma has broadened the applications of non-thermal atmospheric pressure plasma in medicine. Examples of indirect treatment include plasma-assisted immune-therapy and plasma-activated medium. Controlling intracellular redox balance may be key in plasma cancer treatment. Animal studies are required to test the effectiveness and safety of these treatments for future clinical applications.

  19. Library instruction in medical education: a survey of current practices in the United States and Canada

    Directory of Open Access Journals (Sweden)

    Amanda M. Nevius

    2018-01-01

    Results: Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall. Conclusions: In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians’ provision of instruction in multiple formats on multiple topics is increasingly common.  This article has been approved for the Medical Library Association’s Independent Reading Program.

  20. Medical Diplomacy in the United States Army: A Concept Whose Time Has Come

    National Research Council Canada - National Science Library

    Krueger, Mary V

    2008-01-01

    ... to the terrorists who wish to defeat US troops, as well as the Western way of life. Medical diplomacy is a nonlethal tool used in combination with economic and diplomatic efforts to achieve this end...