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Sample records for teaching transfusion medicine

  1. Transfusion Medicine

    Directory of Open Access Journals (Sweden)

    Smit Sibinga CT

    2013-07-01

    Full Text Available Cees Th. Smit Sibinga ID Consulting, Zuidhorn, The NetherlandsTransfusion Medicine is a bridging science, spanning the evidence-based practice at the bedside with the social sciences in the community.     Transfusion Medicine starts at the bedside. Surprisingly, only recently that has become rediscovered with the development of ‘patient blood management’ and ‘patient centered’ approaches to allow the growth of an optimal and rational patient care through supportive hemotherapy – safe and effective, affordable and accessible.1    Where transfusion of blood found its origin in the need of a patient, it has drifted away for a long period of time from the bedside and has been dominated for almost a century by laboratory sciences. At least the first ten editions of the famous and well reputed textbook Mollison’s Blood Transfusion in Clinical Medicine contained only a fraction on the actual bedside practice of transfusion medicine and did not focus at all on patient blood management.2    This journal will focus on all aspects of the transfusion chain that immediately relate to the bedside practice and clinical use of blood and its components, and plasma derivatives as integral elements of a human transplant tissue. That includes legal and regulatory aspects, medical, ethical and cultural aspects, pure science and pathophysiology of disease and the impact of transfusion of blood, as well as aspects of the epidemiology of blood transfusion and clinical indications, and cost-effectiveness. Education through timely and continued transfer of up to date knowledge and the application of knowledge in clinical practice to develop and maintain clinical skills and competence, with the extension of current educational approaches through e-learning and accessible ‘apps’ will be given a prominent place.

  2. [Teaching transfusion medicine research in the francophone world].

    Science.gov (United States)

    Lefrère, J-J; Shiboski, C; Fontanet, A; Murphy, E L

    2009-01-01

    A two-week, French language, clinical research course in transfusion medicine has recently been created at the Pasteur Institute in Paris under the joint leadership of faculty members from the University of California San Francisco (UCSF), the Blood Systems Research Institute (BSRI) and the National Institute of Transfusion of Paris. The goal is to train transfusion professionals from the developing world to conduct clinical research that will contribute to improving the quality of care and safety in transfusion practices in their respective countries. The course provides training on clinical and epidemiological research methods and their potential applications in transfusion medicine. As part of the course, each student develops a study protocol that can be implemented in his/her blood center of hospital.

  3. Transfusion medicine

    International Nuclear Information System (INIS)

    Murawski, K.; Peetoom, F.

    1986-01-01

    These proceedings contain 24 selections, including papers presented at the conference of American Red Cross held in May 1985, on the Subject of transfusion medicine. Some of the titles are: Fluosol/sup R/-DA in Radiation Therapy; Expression of Cloned Human Factor VIII and the Molecular Basis of Gene Defects that Cause Hemophilia; DNA-Probing Assay in the Detection of Hepatitis B Virus Genome in Human Peripheral Blood Cells; and Monoclonal Antibodies: Convergence of Technology and Application

  4. An Observational Study of 3 Different Transfusion Medicine Teaching Methods for Medical Students.

    Science.gov (United States)

    Konia, Mojca Remskar; Richtsfeld, Martina; Johnson, Andrew D; Lougee, Michael; Cohn, Claudia; Morgan, Shanna

    2018-04-01

    Knowledge deficits of transfusion medicine are prevalent among learners and practicing physicians. In the past, the transfusion medicine community has thoughtfully defined the content of transfusion medicine curriculums through Transfusion Medicine Academic Award Group and The Academy of Clinical Laboratory Physicians and Scientists. The manner in which the curriculum should be delivered has been less carefully examined and defined. We completed an observational study in which we analyzed 3 different teaching techniques: in-person faculty-led simulation curriculum consisting of didactic session and simulation ("Simulation group"); hybrid education with a combination of online materials and short in-person simulation ("Hybrid group"); and online-only education module, which delivered the whole curricular content through a variety of online materials and videos ("Online-only group"). Knowledge acquisition was assessed with a 10-question multiple-choice questionnaire, and satisfaction was assessed by a 9-question online student satisfaction survey. A total of 276second-year medical students participated in the study. There was statistically significant difference between pre- and posttest results and in knowledge gain favoring the Simulation group as compared with the Online-only group (P=.03, P<.0001) and favoring the Simulation group as compared with the Hybrid group (P=.004, P<.0001). The Simulation group and Hybrid group medical students were also more satisfied with the education activity as compared with the Online-only group (P<.0001, P<.001). Our study demonstrated that a faculty-run transfusion medicine simulation curriculum consisting of an in-person didactic session and simulation session for the second-year medical students produced greater immediate knowledge acquisition compared with an online only or a hybrid curriculum. Furthermore, any curriculum that contained in-person teaching by faculty was preferred over the online only education. Copyright

  5. [Proteomics and transfusion medicine].

    Science.gov (United States)

    Lion, N; Prudent, M; Crettaz, D; Tissot, J-D

    2011-04-01

    The term "proteomics" covers tools and techniques that are used to analyze and characterize complex mixtures of proteins from various biological samples. In this short review, a typical proteomic approach, related to the study of particular and illustrative situation related to transfusion medicine is reported. This "case report" will allow the reader to be familiar with a practical proteomic approach of a real situation, and will permit to describe the tools that are usually used in proteomic labs, and, in a second part, to present various proteomic applications in transfusion medicine. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. Metabolomics in transfusion medicine.

    Science.gov (United States)

    Nemkov, Travis; Hansen, Kirk C; Dumont, Larry J; D'Alessandro, Angelo

    2016-04-01

    Biochemical investigations on the regulatory mechanisms of red blood cell (RBC) and platelet (PLT) metabolism have fostered a century of advances in the field of transfusion medicine. Owing to these advances, storage of RBCs and PLT concentrates has become a lifesaving practice in clinical and military settings. There, however, remains room for improvement, especially with regard to the introduction of novel storage and/or rejuvenation solutions, alternative cell processing strategies (e.g., pathogen inactivation technologies), and quality testing (e.g., evaluation of novel containers with alternative plasticizers). Recent advancements in mass spectrometry-based metabolomics and systems biology, the bioinformatics integration of omics data, promise to speed up the design and testing of innovative storage strategies developed to improve the quality, safety, and effectiveness of blood products. Here we review the currently available metabolomics technologies and briefly describe the routine workflow for transfusion medicine-relevant studies. The goal is to provide transfusion medicine experts with adequate tools to navigate through the otherwise overwhelming amount of metabolomics data burgeoning in the field during the past few years. Descriptive metabolomics data have represented the first step omics researchers have taken into the field of transfusion medicine. However, to up the ante, clinical and omics experts will need to merge their expertise to investigate correlative and mechanistic relationships among metabolic variables and transfusion-relevant variables, such as 24-hour in vivo recovery for transfused RBCs. Integration with systems biology models will potentially allow for in silico prediction of metabolic phenotypes, thus streamlining the design and testing of alternative storage strategies and/or solutions. © 2015 AABB.

  7. [Ethical issues in transfusion medicine].

    Science.gov (United States)

    Tissot, J-D; Danic, B; Cabaud, J-J; Garraud, O

    2016-09-01

    Ethics is on the cross road of off values that are present along the ways of transfusion medicine. This is an important tool to afford opinions as well as debates that always emerge when discussing transfusion medicine. The wording is particularly important; this was one among several others that characterized the soul of Jean-Jacques Lefrère when he opened the doors of the ethical issues of transfusion medicine. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland.

    Science.gov (United States)

    von Babo, Michelle; Chmiel, Corinne; Müggler, Simon Andreas; Rakusa, Julia; Schuppli, Caroline; Meier, Philipp; Fischler, Manuel; Urner, Martin

    2018-01-01

    Transfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC) greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland. In this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed. 560 physicians of 71 hospitals (64%) responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care.

  9. Transfusion medicine on American television.

    Science.gov (United States)

    Karp, J K

    2014-02-01

    Television is a beloved American pastime and a frequent American export. As such, American television shapes how the global public views the world. This study examines how the portrayal of blood transfusion and blood donation on American television may influence how domestic and international audiences perceive the field of transfusion medicine. American television programming of the last quarter-century was reviewed to identify programmes featuring topics related to blood banking/transfusion medicine. The included television episodes were identified through various sources. Twenty-seven television episodes airing between 1991 and 2013 were identified as featuring blood bank/transfusion medicine topics. Although some accurate representations of the field were identified, most television programmes portrayed blood banking/transfusion medicine inaccurately. The way in which blood banking/transfusion medicine is portrayed on American television may assist clinicians in understanding their patient's concerns about blood safety and guide blood collection organisations in improving donor recruitment. © 2013 The Author. Transfusion Medicine © 2013 British Blood Transfusion Society.

  10. Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland.

    Directory of Open Access Journals (Sweden)

    Michelle von Babo

    Full Text Available Transfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland.In this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed.560 physicians of 71 hospitals (64% responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin <130 g/L for men and by 57% at <120 g/L in non-pregnant women. 62% and 43% respectively, did not define anemia in men and in women according to the World Health Organization. Fifty percent reported not to transfuse RBC according to international guidelines. Following factors were indicated to influence the decision to transfuse: educational background of the physicians, geographical region of employment, severity of anemia, and presence of known coronary artery disease. 60% indicated that their knowledge on Transfusion-related Acute Lung Injury (TRALI did not influence transfusion practice. 50% of physicians stated that no local transfusion guidelines exist and 84% supported the development of national recommendations on transfusion in non-acutely bleeding, anemic patients.This study highlights the lack of adherence to current transfusion guidelines in Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care.

  11. Benchmarking: applications to transfusion medicine.

    Science.gov (United States)

    Apelseth, Torunn Oveland; Molnar, Laura; Arnold, Emmy; Heddle, Nancy M

    2012-10-01

    Benchmarking is as a structured continuous collaborative process in which comparisons for selected indicators are used to identify factors that, when implemented, will improve transfusion practices. This study aimed to identify transfusion medicine studies reporting on benchmarking, summarize the benchmarking approaches used, and identify important considerations to move the concept of benchmarking forward in the field of transfusion medicine. A systematic review of published literature was performed to identify transfusion medicine-related studies that compared at least 2 separate institutions or regions with the intention of benchmarking focusing on 4 areas: blood utilization, safety, operational aspects, and blood donation. Forty-five studies were included: blood utilization (n = 35), safety (n = 5), operational aspects of transfusion medicine (n = 5), and blood donation (n = 0). Based on predefined criteria, 7 publications were classified as benchmarking, 2 as trending, and 36 as single-event studies. Three models of benchmarking are described: (1) a regional benchmarking program that collects and links relevant data from existing electronic sources, (2) a sentinel site model where data from a limited number of sites are collected, and (3) an institutional-initiated model where a site identifies indicators of interest and approaches other institutions. Benchmarking approaches are needed in the field of transfusion medicine. Major challenges include defining best practices and developing cost-effective methods of data collection. For those interested in initiating a benchmarking program, the sentinel site model may be most effective and sustainable as a starting point, although the regional model would be the ideal goal. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. [Guidelines for blood transfusion teaching to medical laboratory technology students].

    Science.gov (United States)

    Moncharmont, P; Tourlourat, M; Fourcade, C; Julien, E; Peyrard, T; Cabaud, J-J

    2012-02-01

    The new French law about clinical laboratory medicine, the requirements of the ISO/CEI 15189 standard, the numerous abilities expected from the medical laboratory technologists and their involvement in blood bank management has led the working group "Recherche et démarche qualité" of the French Society of Blood Transfusion to initiate an inventory of blood transfusion teaching syllabus for medical laboratory technology students and to propose transfusion medicine teaching guidelines. Seven worksheets have been established for that purpose including red blood cell antigen typing and antibody screening, blood sampling in immunohaematology, automation, clinical practices, blood products, blood delivery and haemovigilance. These guidelines aim at contributing to the harmonization of transfusion medicine teaching and at providing objective elements to the medical laboratory managers regarding the practical and theoretical skills of theirs collaborators. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  13. Evidence Based Studies in Clinical Transfusion Medicine

    NARCIS (Netherlands)

    A.J.G. Jansen (Gerard)

    2007-01-01

    textabstractAfter the introduction of blood component therapy in the 1960s, more and more attention is given to clinical transfusion medicine. Although blood transfusion is an important treatment in different clinical settings, there are still lack of much randomized clinical trials. Nowadays

  14. [French training program for medical students in transfusion medicine. Transfusion Medicine Teachers' College].

    Science.gov (United States)

    Wautier, J-L; Cabaud, J-J; Cazenave, J-P; Fialon, P; Fruchart, M-F; Joussemet, M; Leblond, V; Muller, J-Y; Rouger, P; Vignon, D; Waller, C; Lefrère, J-J; Worms, B; Vileyn, F

    2005-02-01

    In France, transfusion medicine training program has been updated. A national committee of professors in transfusion medicine propose a series of 13 items which represent the minimum knowledge that general practitioners should possess. This overview of transfusion medicine is far below the level that specialists should reach and they will need an additional specialized training. Several French universities have set up their own training program which is quite similar to the work of the committee of professors. The following recommendations are not strict guidelines but is a common basis which will be improved in 2005 according to new evidence based transfusion medicine.

  15. Patient inclusion in transfusion medicine: current perspectives

    Directory of Open Access Journals (Sweden)

    Friedman MT

    2015-01-01

    Full Text Available Mark T Friedman,1 Peyman Bizargity,1 Sandra Gilmore,2 Arnold Friedman3 1Blood Bank and Transfusion Medicine Service, Department of Pathology, Mount Sinai St Luke's–Roosevelt Hospital Center, 2Patient Blood Management Program, Center for Blood Management and Bloodless Medicine and Surgery, Mount Sinai Beth Israel Medical Center, 3Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA Abstract: Patients may have differing perceptions about blood transfusions based on their backgrounds, values, education levels, or cultural or religious beliefs, which may or may not be accurate. Unfortunately, despite the fact that transfusions are associated with a number of infectious and noninfectious risks, and in spite of the fact that there are ethical, accreditation, and regulatory requirements to provide information regarding transfusion risks, benefits, and alternatives to patients, transfusion consent remains inconsistently obtained. This can partly be attributed to the fact that clinicians may take on a paternalistic approach to transfusion decisions as well as to the fact that many clinicians have knowledge gaps in transfusion medicine that prevent them from obtaining transfusion consent adequately. As a result, unlike the case with other medical and surgical therapies, most patients are not included in the making of informed decisions regarding the need for transfusion versus alternative therapies, leading to many situations in which the transfusions provide little benefit to them. Recently however, a number of organizations, such as the American Association of Blood Banks and The Joint Commission in the US, have promoted multidisciplinary, evidence-based treatment strategies that aim to minimize the need for blood transfusion, the so-called patient blood management (PBM protocols. PBM strategies are expected to improve blood utilization through optimization of patients who may need

  16. Design of a Mobile Application for Transfusion Medicine.

    Science.gov (United States)

    Albornoz, M A; Márquez, S; Rubin, L; Luna, D

    2017-01-01

    One of the most frequent error in transfusion medicine is the failure in verifying the patient's identity prior to transfusion. This paper describes the design and development of a Mobile Application (MA) for transfusion medicine. The app uses barcode and QR reading technology for the verification of the patient's identity and the administration of blood components when making a blood transfusion. Physicians, developers, technicians of transfusion medicine and a User Centered Design team participated in the design. The inclusion of end users was fundamental to get full representativeness of their workflow. The project was based on agile methodologies of project management and software development.

  17. Simulation-based education for transfusion medicine.

    Science.gov (United States)

    Morgan, Shanna; Rioux-Masse, Benjamin; Oancea, Cristina; Cohn, Claudia; Harmon, James; Konia, Mojca

    2015-04-01

    The administration of blood products is frequently determined by physicians without subspecialty training in transfusion medicine (TM). Education in TM is necessary for appropriate utilization of resources and maintaining patient safety. Our institution developed an efficient simulation-based TM course with the goal of identifying key topics that could be individualized to learners of all levels in various environments while also allowing for practice in an environment where the patient is not placed at risk. A 2.5-hour simulation-based educational activity was designed and taught to undergraduate medical students rotating through anesthesiology and TM elective rotations and to all Clinical Anesthesia Year 1 (CA-1) residents. Content and process evaluation of the activity consisted of multiple-choice tests and course evaluations. Seventy medical students and seven CA-1 residents were enrolled in the course. There was no significant difference on pretest results between medical students and CA-1 residents. The posttest results for both medical students and CA-1 residents were significantly higher than pretest results. The results of the posttest between medical students and CA-1 residents were not significantly different. The TM knowledge gap is not a trivial problem as transfusion of blood products is associated with significant risks. Innovative educational techniques are needed to address the ongoing challenges with knowledge acquisition and retention in already full curricula. Our institution developed a feasible and effective way to integrate TM into the curriculum. Educational activities, such as this, might be a way to improve the safety of transfusions. © 2014 AABB.

  18. Contemporary issues in transfusion medicine informatics

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2011-01-01

    Full Text Available The Transfusion Medicine Service (TMS covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.

  19. Contemporary issues in transfusion medicine informatics.

    Science.gov (United States)

    Sharma, Gaurav; Parwani, Anil V; Raval, Jay S; Triulzi, Darrell J; Benjamin, Richard J; Pantanowitz, Liron

    2011-01-07

    The Transfusion Medicine Service (TMS) covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.

  20. Collection and Transfusion of Blood in Jos University Teaching ...

    African Journals Online (AJOL)

    Objective: This study was embarked on to investigate the pattern of blood collection and transfusion in Jos University Teaching Hospital (JUTH), Jos between 2000 and 2005 in the face of the present human immunodeficiency virus (HIV) pandemic. Methodology: Blood bank records of blood donors and transfusions were ...

  1. Blood banking and transfusion medicine for the nephrologist.

    Science.gov (United States)

    Wehrli, Gay

    2012-01-01

    Therapeutic Apheresis Medicine Services work closely with Blood Banking and Transfusion Medicine Services (BBTMS). The BBTMS performs patient testing and provides blood components for patients undergoing therapeutic apheresis procedures. This article will provide an overview of blood component descriptions, patient testing, and blood component options and preparations for therapeutic apheresis procedures. © 2012 Wiley Periodicals, Inc.

  2. The use of big data in transfusion medicine.

    Science.gov (United States)

    Pendry, K

    2015-06-01

    'Big data' refers to the huge quantities of digital information now available that describe much of human activity. The science of data management and analysis is rapidly developing to enable organisations to convert data into useful information and knowledge. Electronic health records and new developments in Pathology Informatics now support the collection of 'big laboratory and clinical data', and these digital innovations are now being applied to transfusion medicine. To use big data effectively, we must address concerns about confidentiality and the need for a change in culture and practice, remove barriers to adopting common operating systems and data standards and ensure the safe and secure storage of sensitive personal information. In the UK, the aim is to formulate a single set of data and standards for communicating test results and so enable pathology data to contribute to national datasets. In transfusion, big data has been used for benchmarking, detection of transfusion-related complications, determining patterns of blood use and definition of blood order schedules for surgery. More generally, rapidly available information can monitor compliance with key performance indicators for patient blood management and inventory management leading to better patient care and reduced use of blood. The challenges of enabling reliable systems and analysis of big data and securing funding in the restrictive financial climate are formidable, but not insurmountable. The promise is that digital information will soon improve the implementation of best practice in transfusion medicine and patient blood management globally. © 2015 British Blood Transfusion Society.

  3. Blood transfusion in jehovah's witnesses, a dilemma in medicine?

    Directory of Open Access Journals (Sweden)

    Rafael Gutierrez-Vega

    2014-10-01

    Full Text Available The provision of health services should be carried attached to the scientific and ethical principles of medicine. The negative to accept blood transfusion by Jehovah's Witnesses, when indicated, determines a conflict and a challenge for physicians. We discuss concepts related to this complex situation, including: Freedom of religion and belief, patients’ rights, regulatory framework that applies to providers of health services and medical rights. Which should be taken into account in these situations to make an informed decision from the legal and ethical point of view.

  4. BEST-TEST2: assessment of hematology trainee knowledge of transfusion medicine.

    Science.gov (United States)

    Lin, Yulia; Tinmouth, Alan; Mallick, Ranjeeta; Haspel, Richard L

    2016-02-01

    As transfusion is a common therapy and key component in every hematologist's practice, hematology training programs should dedicate significant time and effort to delivering high-quality transfusion medicine education to their trainees. The current state of hematology trainee knowledge of transfusion medicine is not known. A validated assessment tool developed by the Biomedical Excellence for Safer Transfusion (BEST) Collaborative was used to assess prior transfusion medicine education, attitudes, perceived ability, and transfusion medicine knowledge of hematology trainees. A total of 149 hematology trainees at 17 international sites were assessed. The overall mean exam score was 61.6% (standard deviation, 13.4%; range, 30%-100%) with no correlation in exam scores with postgraduate year or previous transfusion medicine education in medical school or internal medicine residency. However, better scores correlated with 3 or more hours of transfusion medicine education (p = 0.0003) and perceived higher-quality education during hematology training (p = 0.03). Hematology trainees at US sites, where hematology is often combined with oncology training, had statistically lower scores than trainees at non-US sites (56.2% vs. 67.4%; p hematology training programs to reevaluate the quality and quantity of transfusion medicine training and can assist in the development of targeted curricula. © 2015 AABB.

  5. Blood transfusion at the time of the First World War--practice and promise at the birth of transfusion medicine.

    Science.gov (United States)

    Boulton, F; Roberts, D J

    2014-12-01

    The centenary of the start of the First World War has stirred considerable interest in the political, social, military and human factors of the time and how they interacted to produce and sustain the material and human destruction in the 4 years of the war and beyond. Medical practice may appear distant and static and perhaps seems to have been somewhat ineffectual in the face of so much trauma and in the light of the enormous advances in medicine and surgery over the last century. However, this is an illusion of time and of course medical, surgical and psychiatric knowledge and procedures were developing rapidly at the time and the war years accelerated implementation of many important advances. Transfusion practice lay at the heart of resuscitation, and although direct transfusion from donor to recipient was still used, Geoffrey Keynes from Britain, Oswald Robertson from America and his namesake Lawrence Bruce Robertson from Canada, developed methods for indirect transfusion from donor to recipient by storing blood in bottles and also blood-banking that laid the foundation of modern transfusion medicine. This review explores the historical setting behind the development of blood transfusion up to the start of the First World War and on how they progressed during the war and afterwards. A fresh look may renew interest in how a novel medical speciality responded to the needs of war and of post-war society. © 2015 British Blood Transfusion Society.

  6. CAR-T Cell Therapies From the Transfusion Medicine Perspective.

    Science.gov (United States)

    Fesnak, Andrew; Lin, ChieYu; Siegel, Don L; Maus, Marcela V

    2016-07-01

    The use of chimeric antigen receptor (CAR)-T cell therapy for the treatment of hematologic malignancies has generated significant excitement over the last several years. From a transfusion medicine perspective, the implementation of CAR-T therapy as a potential mainstay treatment for not only hematologic but also solid-organ malignancies represents a significant opportunity for growth and expansion. In this review, we will describe the rationale for the development of genetically redirected T cells as a cancer therapeutic, the different elements that are required to engineer these cells, as well as an overview of the process by which patient cells are harvested and processed to create and subsequently validate CAR-T cells. Finally, we will briefly describe some of the toxicities and clinical efficacy of CAR-T cells in the setting of patients with advanced malignancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Toward the Relevance of Platelet Subpopulations for Transfusion Medicine

    Directory of Open Access Journals (Sweden)

    Stefan Handtke

    2018-02-01

    Full Text Available Circulating platelets consist of subpopulations with different age, maturation state and size. In this review, we address the association between platelet size and platelet function and summarize the current knowledge on platelet subpopulations including reticulated platelets, procoagulant platelets and platelets exposing signals to mediate their clearance. Thereby, we emphasize the impact of platelet turnover as an important condition for platelet production in vivo. Understanding of the features that characterize platelet subpopulations is very relevant for the methods of platelet concentrate production, which may enrich or deplete particular platelet subpopulations. Moreover, the concept of platelet size being associated with platelet function may be attractive for transfusion medicine as it holds the perspective to separate platelet subpopulations with specific functional capabilities.

  8. Preserving human cells for regenerative, reproductive, and transfusion medicine.

    Science.gov (United States)

    Asghar, Waseem; El Assal, Rami; Shafiee, Hadi; Anchan, Raymond M; Demirci, Utkan

    2014-07-01

    Cell cryopreservation maintains cellular life at sub-zero temperatures by slowing down biochemical processes. Various cell types are routinely cryopreserved in modern reproductive, regenerative, and transfusion medicine. Current cell cryopreservation methods involve freezing (slow/rapid) or vitrifying cells in the presence of a cryoprotective agent (CPA). Although these methods are clinically utilized, cryo-injury due to ice crystals, osmotic shock, and CPA toxicity cause loss of cell viability and function. Recent approaches using minimum volume vitrification provide alternatives to the conventional cryopreservation methods. Minimum volume vitrification provides ultra-high cooling and rewarming rates that enable preserving cells without ice crystal formation. Herein, we review recent advances in cell cryopreservation technology and provide examples of techniques that are utilized in oocyte, stem cell, and red blood cell cryopreservation. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. [The European network of transfusion medicine societies (EuroNet-TMS): The White Book 2005].

    Science.gov (United States)

    Rouger, P

    2005-06-01

    Europe is building up. It develops in a quite complex environment, in which health care represents an important field of activities. As for blood transfusion, it plays a major role especially in the development of medical activities as well as for the patients treatments. Today, blood components are still of human origin and there are no substitutes for them. As a medical discipline, Blood Transfusion represents a broad field in medicine which requests the involvement of numerous actors. It is up to professional medical/scientific societies to promote the discipline. This is why it has been considered necessary and relevant to build up a federation of transfusion medicine societies throughout the European Union (EU) ; it is called EuroNet-TMS, the European Network of Transfusion Medicine Societies. This network groups more than 7500 professionals of involved in blood transfusion activities. It has six major objectives: 1) To find coherent responses to issues at stake in transfusion; 2) To promote medical and scientific developments of blood transfusion in Europe; 3) To ensure the highest and most up-to-date scientific level to meet safety and quality standards; 4) To offer similar services to all EU citizens in the field of blood transfusion; 5) To share knowledge and date within Europe; 6) To develop interfaces with decision-makers among the diverse European countries. The first step is the writing of the "White Book 2005" which reports the state of the art of blood transfusion in Europe; a prospective plan is proposed to be discussed.

  10. Transfusion Medicine and Coagulation Management in Organ Transplantation.

    Science.gov (United States)

    Madisetty, Jaswanth; Wang, Cynthia

    2017-09-01

    Organ transplantation recipients present unusual challenges with regard to blood transfusion. Although this patient population requires a larger proportion of blood product resources, liberal transfusion of allogeneic blood products can lead to a plethora of complications. Recent trends suggest that efforts to minimize bleeding, conserve products, and target transfusion to specific deficits and needs are increasingly becoming the standard practice; these must all occur with optimization of graft function and preservation in mind. With newer monitoring modalities and factor concentrates, the approach toward transfusion and bleeding in organ transplantation has rapidly improved in recent years. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Prevention of Post Transfusion Hepatitis Employing Sensitive Assay for Hepatitis B Surface Antigen Screening(Topics in Transfusion Medicine 1990 : Autologous Transfusion and Post-Transfusion Hepatitis)

    OpenAIRE

    小島, 秀男; 大竹, 幸子; 富樫, 和枝; 石口, 重子; 山田, 恵子; 品田, 章二; Kojima, Hideo; Ohtake, Sachiko; Togashi, Kazue; Ishiguchi, Shigeko; Yamada, Keiko; Shinada, Shoji

    1990-01-01

    Post transfusion Hepatitis (PTH) is one of serious side effects and some times lead to fulminant hepatic failure in case transfused blood contain very low level (under the sensitivity of usual screening method) of hepatitis B virus (HBV). Redcross blood center and blood transfusion devision of our hospital have been employed reverse passive hemmaglutination method (RPHA) for HBsAg screening. Authors employed EIA for sensitive HBsAg test system and compared with RPHA method. Of 2,255 sera from...

  12. One size will never fit all: the future of research in pediatric transfusion medicine.

    Science.gov (United States)

    Josephson, Cassandra D; Mondoro, Traci Heath; Ambruso, Daniel R; Sanchez, Rosa; Sloan, Steven R; Luban, Naomi L C; Widness, John A

    2014-11-01

    There is concern at the National Heart, Lung, and Blood Institute (NHLBI) and among transfusion medicine specialists regarding the small number of investigators and studies in the field of pediatric transfusion medicine (PTM). Accordingly, the objective of this article is to provide a snapshot of the clinical and translational PTM research considered to be of high priority by pediatricians, neonatologists, and transfusion medicine specialists. Included is a targeted review of three research areas of importance: (i) transfusion strategies, (ii) short- and long-term clinical consequences, and (iii) transfusion-transmitted infectious diseases. The recommendations by PTM and transfusion medicine specialists represent opportunities and innovative strategies to execute translational research, observational studies, and clinical trials of high relevance to PTM. With the explosion of new biomedical knowledge and increasingly sophisticated methodologies over the past decade, this is an exciting time to consider transfusion medicine as a paradigm for addressing questions related to fields such as cell biology, immunology, neurodevelopment, outcomes research, and many others. Increased awareness of PTM as an important, fertile field and the promotion of accompanying opportunities will help establish PTM as a viable career option and advance basic and clinical investigation to improve the health and wellbeing of children.

  13. The teaching of nuclear medicine

    International Nuclear Information System (INIS)

    Bok, B.; Ducassou, D.

    1984-01-01

    Having first recalled the need of a specialized teaching in the field of nuclear medicine, the authors describe the training programmes now available in this sector for doctors, chemists and hospital-attendants [fr

  14. A survey of resident physicians′ knowledge concerning transfusion medicine in Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    Leila Kasraian

    2014-01-01

    Full Text Available Objective: The knowledge of physicians concerning blood transfusion has a significant impact on the optimal use of blood and blood products. The aim was to survey their knowledge regarding this area and identify whether additional training is required. Material and Methods: This cross-sectional study was conducted on all 1 st year resident physicians at Shiraz University of Medical Sciences, Iran in 2011. The questionnaire solicited information on demographic variables, knowledge regarding transfusion medicine, education and experience regarding blood transfusion. Results: The mean total knowledge score regarding transfusion medicine was 15.44 ± 3.3 (7-25 out of 29. Only about one-fourth (27.4% replied correctly to over 60% of questions. The mean score of knowledge was higher among residents who stated that they received special training regarding blood transfusion in their medical courses (P < 0.01. Seventy-five percent of residents believed that they had received insufficient education and 97.8% believed that they need additional training. Conclusion: The results reflect the uncertainties among resident physicians regarding blood transfusion. It has been suggested that a special transfusion medicine educational program should be added to the medical education curriculum.

  15. An acute hemolytic transfusion reaction due to the "anti-c" rhesus antibody: A case report emphasizing the role of transfusion medicine

    Directory of Open Access Journals (Sweden)

    Deepti Sachan

    2015-01-01

    Full Text Available Rhesus (Rh mediated hemolytic transfusion reactions (HTR are usually immunoglobulin G mediated and delayed onset. Rh antibodies being the cause of acute HTR (AHTR and intravascular hemolysis are still under debate. We report here a case of a 53-year-old male who developed AHTR due to "anti-c" antibodies within 3 h of blood transfusion, precipitating fatal acute liver failure in a patient with hepatitis C related chronic liver disease. This case emphasizes the need of inclusion of antibody screening in routine pretransfusion testing as well as a critical role of transfusion medicine specialists for early diagnosis and minimizing transfusion-related morbidity and mortality.

  16. [Evaluation of the professional practices of physicians in transfusion technology and medicine].

    Science.gov (United States)

    Hergon, Eric; Py, Jean-Yves; Jullien, Stéphanie; Quaranta, Jean-François; Folléa, Gilles; Andreu, Georges; Cabaud, Jean-Jacques; Staccini, Pascal; Rouger, Philippe

    2007-08-01

    The evaluation of the professional practices (EPP) is obligatory for all the physicians since July 1, 2005 for a first five-year period. It represents one of the components of the continuous medical training (CMT). The French Society of Blood Transfusion and National Institute of Blood Transfusion are the promoters of the EPP in transfusion technology and medicine. Initially, the programs of EPP will be conceived and controlled by experts and will relate to their basic activities. During a five years cycle, the physician taking part in a program must validate a specific action and take part in a rolling programme. At the end of the programme, the physician will receive a certificate issued by National Institute of Blood Transfusion and will have to submit it to a committee placed under the responsibility of the regional physicians' committee.

  17. Alternative Blood Products and Clinical Needs in Transfusion Medicine

    OpenAIRE

    Whitsett, Carolyn; Vaglio, Stefania; Grazzini, Giuliano

    2012-01-01

    The primary focus of national blood programs is the provision of a safe and adequate blood supply. This goal is dependent on regular voluntary donations and a regulatory infrastructure that establishes and enforces standards for blood safety. Progress in ex vivo expansion of blood cells from cell sources including peripheral blood, cord blood, induced pluripotent stem cells, and human embryonic stem cell lines will likely make alternative transfusion products available for clinical use in the...

  18. Teaching of nuclear medicine at medical faculties

    International Nuclear Information System (INIS)

    Dienstbier, Z.

    1987-01-01

    The teaching of nuclear medicine at medical faculties in the CSSR is analyzed. It is shown that the teaching conditions are different at the individual faculties of medicine and the respective conditions are exemplified. (author). 4 tabs

  19. Teaching evidence based medicine in family medicine

    Directory of Open Access Journals (Sweden)

    Davorka Vrdoljak

    2012-05-01

    Full Text Available The concept of evidence based medicine (EBM as the integrationof clinical expertise, patient values and the best evidence was introduced by David Sackett in the 1980’s. Scientific literature in medicine is often marked by expansion, acummulation and quick expiration. Reading all important articles to keep in touch with relevant information is impossible. Finding the best evidence that answers a clinical question in general practice (GP in a short time is not easy. Five useful steps are described –represented by the acronym “5A+E”: assess, ask, acquire, appraise, apply and evaluate.The habit of conducting an evidence search “on the spot’’ is proposed. Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses, their experience of evidence-searching and critical appraisal of the evidence, in real time with real patient is inadequate. Teaching the final-year students the practical use of EBM in a GP’s office is different and can have an important role in their professional development. It can positively impact on quality of their future work in family practice (or some other medical specialty by acquiring this habit of constant evidence-checking to ensure that best practice becomes a mechanism for life-long learning. Conclusion. EBM is a foundation stone of every branch of medicine and important part of Family Medicine as scientific and professional discipline. To have an EB answer resulting from GP’s everyday work is becoming a part of everyday practice.

  20. Utilization and quality of cryopreserved red blood cells in transfusion medicine

    NARCIS (Netherlands)

    Henkelman, S.; Noorman, F.; Badloe, J. F.; Lagerberg, J. W. M.

    Cryopreserved (frozen) red blood cells have been used in transfusion medicine since the Vietnam war. The main method to freeze the red blood cells is by usage of glycerol. Although the usage of cryopreserved red blood cells was promising due to the prolonged storage time and the limited cellular

  1. Applying radio-frequency identification (RFID) technology in transfusion medicine.

    Science.gov (United States)

    Hohberger, Clive; Davis, Rodeina; Briggs, Lynne; Gutierrez, Alfonso; Veeramani, Dhamaraj

    2012-05-01

    ISO/IEC 18000-3 mode 1 standard 13.56 MHz RFID tags have been accepted by the International Society for Blood Transfusion (ISBT) and the United States Food and Drug Administration (FDA) as data carriers to integrate with and augment ISBT 128 barcode data carried on blood products. The use of 13.56 MHz RFID carrying ISBT 128 data structures allows the global deployment and use of RFID, supporting both international transfer of blood and international disaster relief. The deployment in process at the BloodCenter of Wisconsin and testing at the University of Iowa Health Center is the first FDA-permitted implementation of RFID throughout in all phases of blood banking, donation through transfusion. RFID technology and equipment selection will be discussed along with FDA-required RF safety testing; integration with the blood enterprise computing system and required RFID tag performance. Tag design and survivability is an issue due to blood bag centrifugation and irradiation. Deployment issues will be discussed. Use of RFID results in significant return on investment over the use of barcodes in the blood center operations through labor savings and error reduction. Copyright © 2011 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

  2. Parvovirus B19: What Is the Relevance in Transfusion Medicine?

    Science.gov (United States)

    Juhl, David; Hennig, Holger

    2018-01-01

    Parvovirus B19 (B19V) has been discovered in 1975. The association with a disease was unclear in the first time after the discovery of B19V, but meanwhile, the usually droplet transmitted B19V is known as the infectious agent of the “fifth disease,” a rather harmless children’s illness. But B19V infects erythrocyte progenitor cells and thus, acute B19V infection in patients with a high erythrocyte turnover may lead to a life-threatening aplastic crisis, and acutely infected pregnant women can transmit B19V to their unborn child, resulting in a hydrops fetalis and fetal death. However, in many adults, B19V infection goes unnoticed and thus many blood donors donate blood despite the infection. The B19V infection does not impair the blood cell counts in healthy blood donors, but after the acute infection with extremely high DNA concentrations exceeding 1010 IU B19V DNA/ml plasma is resolved, B19V DNA persists in the plasma of blood donors at low levels for several years. That way, many consecutive donations that contain B19V DNA can be taken from a single donor, but the majority of blood products from donors with detectable B19V DNA seem not to be infectious for the recipients from several reasons: first, many recipients had undergone a B19V infection in the past and have formed protective antibodies. Second, B19V DNA concentration in the blood product is often too low to infect the recipient. Third, after the acute infection, the presence of B19V DNA in the donor is accompanied by presumably neutralizing antibodies which are protective also for the recipient of his blood products. Thus, transfusion-transmitted (TT-) B19V infections are very rarely reported. Moreover, in most blood donors, B19V DNA concentration is below 1,000 IU/ml plasma, and no TT-B19V infections have been found by such low-viremic donations. Cutoff for an assay for B19V DNA blood donor screening should, therefore, be approximately 1,000 IU/ml plasma, if a general screening of blood

  3. Molecular Diagnostics in Transfusion Medicine: In Capillary, on a Chip, in Silico, or in Flight?

    Science.gov (United States)

    Garritsen, Henk S.P.; Xiu-Cheng Fan, Alex; Lenz, Daniela; Hannig, Horst; Yan Zhong, Xiao; Geffers, Robert; Lindenmaier, Werner; Dittmar, Kurt E.J.; Wörmann, Bernhard

    2009-01-01

    Summary Serology, defined as antibody-based diagnostics, has been regarded as the diagnostic gold standard in transfusion medicine. Nowadays however the impact of molecular diagnostics in transfusion medicine is rapidly growing. Molecular diagnostics can improve tissue typing (HLA typing), increase safety of blood products (NAT testing of infectious diseases), and enable blood group typing in difficult situations (after transfusion of blood products or prenatal non-invasive RhD typing). Most of the molecular testing involves the determination of the presence of single nucleotide polymorphisms (SNPs). Antigens (e.g. blood group antigens) mostly result from single nucleotide differences in critical positions. However, most blood group systems cannot be determined by looking at a single SNP. To identify members of a blood group system a number of critical SNPs have to be taken into account. The platforms which are currently used to perform molecular diagnostics are mostly gel-based, requiring time-consuming multiple manual steps. To implement molecular methods in transfusion medicine in the future the development of higher-throughput SNP genotyping non-gel-based platforms which allow a rapid, cost-effective screening are essential. Because of its potential for automation, high throughput and cost effectiveness the special focus of this paper is a relative new technique: SNP genotyping by MALDI-TOF MS analysis. PMID:21113259

  4. Hemoglobin levels and blood transfusion in patients with sepsis in Internal Medicine Departments.

    Science.gov (United States)

    Muady, Gassan Fuad; Bitterman, Haim; Laor, Arie; Vardi, Moshe; Urin, Vitally; Ghanem-Zoubi, Nesrin

    2016-10-13

    Acute reduction in hemoglobin levels is frequently seen during sepsis. Previous studies have focused on the management of anemia in patients with septic shock admitted to intensive care units (ICU's), including aggressive blood transfusion aiming to enhance tissue oxygenation. To study the changes in hemoglobin concentrations during the first week of sepsis in the setting of Internal Medicine (IM) units, and their correlation to survival. Observational prospective study. We recorded hemoglobin values upon admission and throughout the first week of hospital stay in a consecutive cohort of septic patients admitted to IM units at a community hospital, the patients were enrolled into a prospective registry. Data on blood transfusions was also collected, we examined the correlation between hemoglobin concentrations during the first week of sepsis and survival, the effect of blood transfusion was also assessed. Eight hundred and fifteen patients (815) with sepsis were enrolled between February 2008 to January 2009. More than 20 % of them had hemoglobin levels less than 10g/dL on admission, a rate that was doubled during the first week of sepsis. Overall, 68 (8.3 %) received blood transfusions, 14 of them (20.6 %) due to bleeding. Typically, blood transfusion was given to older patients with a higher rate of malignancy and lower hemoglobin levels. While hemoglobin concentration on admission had strong correlation with in-hospital mortality (O.R-0.83 [95 % C.I. 0.74-0.92], blood transfusion was not found to be an independent predicting factor for mortality. Anemia is very common in sepsis. While hemoglobin level on admission exhibit independent correlation with survival, blood transfusion do not.

  5. Improving patient safety in transfusion medicine: contemporary challenges and the roles for bedside and laboratory biovigilance in addressing them

    Directory of Open Access Journals (Sweden)

    Andrzejewski Jr C

    2014-07-01

    Full Text Available Chester Andrzejewski Jr,1 Darlene Cloutier,1 David Unold,2 Richard C Friedberg1 1Transfusion Medicine Services, Department of Pathology, Baystate Medical Center, Baystate Health, Springfield, MA, 2Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA Abstract: Throughout the history of hemotherapy (HT, various challenges and concerns have been encountered in its practical application. When viewed using a prismatic lens of history, recurrent themes regarding adverse HT sequelae separate and become apparent. These can be broadly classified into three categories: infectious, noninfectious, and administrative/logistical. Using the HT care map as a frame of reference along with its associated rites, we examine the contemporary spectrum of HT adverse events and concerns, and some approaches as to how these may be addressed from bedside and laboratory medicine biovigilance perspectives enhancing patient care and blood transfusion safety. Although our vantage point is from an academic community hospital venue, the issues and concerns identified are germane to many if not all transfusion-medicine practice environments. Included among the subjects we explore are patient/specimen identification issues, blood-management initiatives, unrecognized and/or unreported suspected transfusion reactions, transfusion-associated adverse pulmonary sequelae (including transfusion-related acute lung injury and transfusion-associated circulatory overload, expanded applications of electronic health records and issues regarding their “meaningful use” and interinstitutional “digital compatibilities”, biovigilance integration of electronic data networks within and between health care entities, and anticipated workforce contractions secondary to projected declines in the availability of qualified laboratory professionals. Cooperative initiatives between accreditation and regulatory entities, blood collectors and suppliers, hospital

  6. Transfusion medicine and solid organ transplant – Update and review of some current issues

    OpenAIRE

    Sarkar, R.S.; Philip, J.; Yadav, Pramod

    2013-01-01

    Transfusion medicine holds a place of prime importance in organ transplant surgeries. There is a huge demand of organs worldwide with long waiting periods before the organ is available for transplant. Currently the dependency on ABO and HLA matching has decreased considerably with the use of modern immunosuppressant drugs and transplant techniques. The greatest advance in clinical implementation of ABO-incompatible transplants came about through desensitization and isoagglutinin elimination t...

  7. Changing educational paradigms in transfusion medicine and cellular therapies: development of a profession.

    Science.gov (United States)

    Hathaway, Elaine Osier

    2005-10-01

    The transfusion medicine profession can be easily compared and contrasted with an early 1900 ironclad ship operating in the rough seas of the 21st century. Without modifying the old ship to today's standards, even the captain and crew will begin to expect the ship to meet its demise. The unfortunate passengers, on the other hand, do not expect that they are on an old obsolete ship and, instead, are innocent victims stuck on a doomed course. The old ironclad ship must change into a sleek cruiser and utilize the latest available technology so that its well-educated and competent captain and crew can safely navigate even the most challenging waters. The transfusion medicine profession must transform itself into a state-of-the-art ship so that it, like the refurbished ironclad ship, can be set on cruise control through the open seas. The question facing our industry is do we have the courage to utilize modern technology and to commit the funds necessary to develop, implement, and maintain our existence? It is difficult to plot a steady course into the future because of existing challenges that stand ready to sink our profession, including economic wrangling over regulation, technologic changes, generation conflict, and political differences that threaten our excellence. The primary purpose of this article is to focus on the educational needs that affect all personnel involved in transfusion medicine. In addition, this article will address potential adverse outcomes and investigate possible resolutions to avoid the "sinking ship." Within the next 5 to 7 years, without a corrective course of action, our profession will be at the bottom of the clinical ladder, remembered more for its demise and tragic ending than for its accomplishments. It is hoped, successful implementation of changes in educational paradigms in transfusion medicine may lead to a renaissance within our workforce-generations working together, each sharing and learning from one another.

  8. Transfusion medicine and solid organ transplant - Update and review of some current issues.

    Science.gov (United States)

    Sarkar, R S; Philip, J; Yadav, Pramod

    2013-04-01

    Transfusion medicine holds a place of prime importance in organ transplant surgeries. There is a huge demand of organs worldwide with long waiting periods before the organ is available for transplant. Currently the dependency on ABO and HLA matching has decreased considerably with the use of modern immunosuppressant drugs and transplant techniques. The greatest advance in clinical implementation of ABO-incompatible transplants came about through desensitization and isoagglutinin elimination techniques with immunoadsorption and anti-CD20 antibodies becoming the norm, and spleenectomy fading out. The implications and practices of transfusion medicine in organ transplant are also undergoing drastic changes. The practice of infusion of one unit of donor's blood preoperatively for immunomodulation is no longer practiced. Use of leuco-reduced products has shown decreasing trends of alloimmunization and graft rejection in cases of multiple surgeries related to organ transplants. Worldwide donor and recipient registry programmes are being setup and existing ones are being upgraded. Such a registry system has been opened in India for kidney transplant cases very recently. Due to such registry programmes the dependency on siblings and directed donations have decreased considerably. This review deals with some of the current issues contributing to the successful outcome of mismatched transplants and the changing concepts of transfusion medicine related to it.

  9. [North-South cooperation on transfusion and hematology teaching: A Benin experience].

    Science.gov (United States)

    Lafia, E; Anani, L; Glitho, S; Bankole, C; Fachinan, H; Py, J-Y; Domenech, J; Martenot, B; Colombat, P; Chobli, M; Zohoun, I

    2015-06-01

    Hematologic diseases are a significant part of health disorders in Benin. As an example, anemia is the second cause of hospitalization, measuring up to 7.9% all over the country (National Plan of Sanitary Development, 2009-2018). By contrast, there is only one active hematologist in the country. Thanks to two partnerships, on one hand between the health sciences faculty in Cotonou (Benin) and the medicine one in Tours (France), and on the other hand between the Beninese Blood Transfusion National Agency and the French Blood Establishment, a first blood transfusion and hematology formation was held in Cotonou on December 2014. Among other benefits, was created an hematology-transfusion network in order to facilitate relations between Beninese hospital doctors, with the support of the two French partner institutions. The article describes this progress. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. El Programa de Medicina Transfusional de Cuba The Transfusion Medicine Program in Cuba

    Directory of Open Access Journals (Sweden)

    José M. Ballester Santovenia

    2003-03-01

    Full Text Available Cuba's Transfusion Medicine Program (TMP is a subsystem of the country's National Health System. The TMP's objective is to ensure hemotherapy with blood that is safe and sufficient for all the individuals who need it. The TMP subsystem is made up of the National Commission on Transfusion Medicine, the Institute of Hematology and Immunology, 37 clinical services, 44 blood banks, 120 collection centers, 19 mobile units, and 37 blood certification laboratories. Additional facilities include a laboratory for plasma separation, a laboratory that produces leukocyte interferon and transfer factor, and two laboratories that produce reagents for blood classification and blood diagnosis systems. In Cuba, blood donation is voluntary. Since 1997 approximately 5% of the population per year has donated blood, thus meeting the goal recommended by the Pan American Health Organization of one voluntary blood donation annually for every 20 persons. During 2002, 563 204 blood donations were received, and there were 445 898 transfusions of blood or blood components. All donations are individually screened for HIV 1 and 2, hepatitis B, hepatitis C, and syphilis, thus meeting the country's current regulations. In 2002 these screening measures led to discarding, respectively, 0.12%, 0.60%, 0.71%, and 1.8% of the blood donations. Although the prevalence of human T-cell lymphotropic virus I and II in Cuba is very low, this test will soon be added to the screening process.

  11. [The transfusion practice in the hepatogastroenterology department of the Campus Teaching Hospital of Lomé (Togo)].

    Science.gov (United States)

    Lawson-Ananissoh, L M; Bouglouga, O; El Hadji Yakoubou, R; Bagny, A; Kaaga, L; Redah, D

    2015-03-01

    To evaluate transfusion practice in the hepatogastroenterology department of the Campus Teaching Hospital of Lomé. This is a respective, descriptive and analytical study conducted from January 1 to December 31, 2013 on cases of in-patients' observation in the department. The cases of in-patients of more than 15 years old, having benefited from a blood transfusion were included. During the study period, 849 patients were admitted; 136 were transfused, or blood transfusion rate of 16.02%. The average age of patients was of 48.25 years with extremes of 15 and 90 years. The most transfused rhesus blood group was O positive (36.76%). Red blood cell was the most frequently used blood product (94.12%). The transfusion was performed in 58.82% of cases as a matter of emergency. Gastrointestinal bleeding were the main indications (55.88%). The average pre-transfusion hemoglobinemia was 6.51 g/dL±1.67. The average post-transfusion hemoglobinemia was 8.95 g/dL±1.75. Liver disease (cirrhosis and hepatocellular carcinoma) were the main diagnosis associated with blood transfusion (44.85%). The quantity of blood to be transfused was not calculated in 100% of cases. In 11.03% of cases, the compatibility test has not been done in the laboratory. Incidents during blood transfusion were noted in 5 cases. Blood transfusion is frequent in the department. There is a good observance of blood transfusion safety regulations. However, its practice remains to be improved. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Teaching Prevention in Internal Medicine Clerkships.

    Science.gov (United States)

    Kinsinger, Linda

    2000-01-01

    Reviews the rationale for including prevention in the clinical medicine clerkship. Summarizes current guidelines, presents examples of curricula in several medical schools, and proposes a future direction that stresses integrating teaching preventive medicine into internal medicine clerkships and across the entire four-year medical curriculum. (DB)

  13. Cost-effectiveness analysis: what it really means for transfusion medicine decision making.

    Science.gov (United States)

    Custer, Brian; Hoch, Jeffrey S

    2009-01-01

    Some have suggested that "blood is different," and the role for cost-effectiveness is thus circumscribed. In this article, the authors start by reviewing key concepts in health economics and economic analysis methods. Examples are drawn from published blood safety studies. After explaining the underlying reasoning behind cost-effectiveness analysis, the authors point out how economic thinking is evident in some aspects of transfusion medicine. Some cost-effectiveness study results for blood safety are discussed to provide context, followed by consideration of prominent decisions that have been made in transfusion medicine field. In the last section, the authors conjecture as to why in some cases cost-effectiveness analysis appears to have greater impact than in others, noting the terrible price that is paid in mortality and morbidity when cost-effectiveness analysis is ignored. In this context, the implications of opportunity cost are discussed, and it is noted that opportunity cost should not be viewed as benefits forgone by concentrating on one aspect of blood safety and instead should be viewed as our societal willingness to misallocate resources to achieve less health for the same cost.

  14. Transfusion Related Emergencies

    OpenAIRE

    Osborn, Megan Boysen; Tran, Min-Ha

    2016-01-01

    Audience: This exercise is appropriate for all emergency medicine learners (residents and medical students) and learners from other specialties (internal medicine, family medicine, anesthesia). Introduction: About 85 million red blood cell units are transfused worldwide each year. Transfusion reactions can complicate up to 8% of blood transfusions and can range from benign to life threatening. An emergency physician must be able to discuss the risks and benefits of blood transfusion...

  15. 2015 proceedings of the National Heart, Lung, and Blood Institute's State of the Science in Transfusion Medicine symposium

    NARCIS (Netherlands)

    Spitalnik, Steven L.; Triulzi, Darrell; Devine, Dana V.; Dzik, Walter H.; Eder, Anne F.; Gernsheimer, Terry; Josephson, Cassandra D.; Kor, Daryl J.; Luban, Naomi L. C.; Roubinian, Nareg H.; Mondoro, Traci; Welniak, Lisbeth A.; Zou, Shimian; Glynn, Simone; Hendrickson, Jeanne; Zimring, James C.; Yazdanbakhsh, Karina; Delaney, Megan; Ware, Russell E.; Tinmouth, Alan; Doctor, Allan; Migliaccio, Anna Rita; Fergusson, Dean A.; Widness, John A.; Carson, Jeffrey L.; Hess, John; Roback, John D.; Waters, Jonathan H.; Cancelas, Jose A.; Gladwin, Mark T.; Rogers, Mary A. M.; Ness, Paul M.; Rao, Sunil; Watkins, Timothy R.; Spinella, Philip C.; Kaufman, Richard M.; Slichter, Sherrill J.; McCullough, Jeffrey; Blumberg, Neil; Webert, Kathryn E.; Fitzpatrick, Michael; Shander, Aryeh; Corash, Laurence M.; Murphy, Michael; Silberstein, Leslie E.; Dumont, Larry J.; Mitchell, W. Beau; Juffermans, Nicole P.; Vlaar, Alexander P. J.; de Kort, Wim

    2015-01-01

    On March 25 and 26, 2015, the National Heart, Lung, and Blood Institute sponsored a meeting on the State of the Science in Transfusion Medicine on the National Institutes of Health (NIH) campus in Bethesda, Maryland, which was attended by a diverse group of 330 registrants. The meeting's goal was to

  16. [Teaching family medicine in Lausanne].

    Science.gov (United States)

    Bischoff, Thomas; Junod, Michel; Cornuz, Jacques; Herzig, Lilli; Bonvin, Raphael

    2010-12-01

    The Faculty of Biology and Medicine of Lausanne has integrated education of family medicine all along its new undergraduate medical curriculum. The Institute of general medicine is in charge to implement those offers among which two are presented hereafter. In the new module "Generalism" several courses cover the specificities of the discipline as for example medical decision in the practice. A mandatory one-month internship in the medical practice offers an experiential immersion into family medicine for all students. In a meeting at the end of their internship, students discuss in group with their peers their individual experiences and are asked to identify, based on their personal experience, the general concepts of the specialty of family medicine and general practice.

  17. The revision of the European blood directives: A major challenge for transfusion medicine.

    Science.gov (United States)

    Folléa, G; Aranko, K

    2015-08-01

    account and given appropriate regulatory formulation) should help to optimize patient safety and donor care, progress the compliance with the ethical principles for donors and improve the efficiency of the healthcare systems dedicated to transfusion medicine. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Bedside practice of blood transfusion in a large teaching hospital in Uganda : an observational study

    NARCIS (Netherlands)

    de Graaf, J D; Kajja, I; Bimenya, G S; Postma, Maarten; Smit Sibinga, C.Th.

    BACKGROUND: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. MATERIALS AND

  19. Scotblood 2007: Tackling local and global issues in transfusion medicine - donor recruitment, effective use of blood, stem cell plasticity, and vCJD.

    Science.gov (United States)

    Bessos, Hagop; Fraser, Robin; Seghatchian, Jerard

    2008-02-01

    This commentary briefly highlights some of the local and the global contemporary issues affecting transfusion medicine worldwide. The main areas of focus addressed this year were: donor recruitment, stem cell plasticity, the effective use of blood, and vCJD.

  20. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    Directory of Open Access Journals (Sweden)

    Rebecca Levy

    2010-01-01

    Full Text Available Background: Electronic medical records (EMRs provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution′s initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting strategy within the EMR. Methods: A focus group of our hospital′s transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater real-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encountered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also

  1. Bedside practice of blood transfusion in a large teaching hospital in Uganda: An observational study

    Directory of Open Access Journals (Sweden)

    de Graaf J

    2009-01-01

    Full Text Available Background: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. Materials and Methods: An observational study on three wards of Mulago Hospital. Physicians, paramedics, nurses, medical students and nurse students were observed using two questionnaires. For comparison, a limited observational study was performed in the University Medical Centre Groningen (UMCG in Groningen, The Netherlands. Results: In Mulago Hospital guidelines for blood transfusion practice were not easily available. Medical staff members work on individual professional levels. Students perform poorly due to inconsistency in their supervision. Documentation of blood transfusion in patient files is scarce. There is no immediate bedside observation, so transfusion reactions and obstructions in the blood transfusion flow are not observed. Conclusion: The poor blood transfusion practice is likely to play a role in the morbidity and mortality of patients who receive a blood transfusion. There is a need for a blood transfusion policy and current practical guidelines.

  2. Developing an administrative plan for transfusion medicine--a global perspective.

    Science.gov (United States)

    Sullivan, Patrick

    2005-10-01

    Throughout the world blood services aim to provide a life-saving service by ensuring an adequate supply of safe blood. However, across the world blood services are at very different levels of development. Consequently, the actions taken in one country or region would not be appropriate in another. This paper aims to identify how suitable solutions can be developed to match the different prevailing circumstances of an individual country or region. In trying to do this it is important to look at the whole of the supply chain within a blood service and identify the part where a change could make the biggest impact. Four key areas are identified that are integral to this. These are the donor, testing of blood, hemovigilance, and overall management arrangements. Whilst the first two have largely been addressed in highly developed countries, there is still much work that could be done in these areas in developing countries. In particular, a move to voluntary nonremunerated donors worldwide would significantly improve overall safety. Hemovigilance systems are identified as a powerful tool to influence policy development, yet these are largely under developed throughout the world. In order to make high impact and sustainable changes it is important that those in the blood industry across the world work together to improve education and training, to share experience of best practice, and to move to develop agreed standards in transfusion medicine. It is imperative that developed countries recognize the importance of working with developing countries if the safety of the global blood supply is to be maintained and improved.

  3. Red Cell Antigens and the Practice of Transfusion Medicine in Nigeria

    African Journals Online (AJOL)

    OBJECTIVE: To generate data and information that would assist in the implementation of the recently enacted National blood transfusion policy. METHOD: In the Worlledge series which was carried on amongst 31050 blood donors in Ibadan and other cities in the mid 1960s and 1970s, the following blood group systems ...

  4. Medicine, law, ethics: teaching versus learning.

    Science.gov (United States)

    Kapp, Marshall; Turner, Gregory; Baker, Dennis

    2012-10-01

    Doctors' anxieties about the legal environment begin during medical school. The signals faculty members send to medical students contribute to this anxiety. A pilot study was conducted to examine signals sent by faculty members to students regarding the relationship of legal risk management and ethical patient care at one medical school. It was also intended to determine the agreement between the messages faculty staff believe they are transmitting and those that students think they are hearing from faculty mentors. A survey with six multiple-choice questions was sent electronically to clinical faculty staff of one medical school to elicit the signals faculty members send students regarding the relationship of legal risk management and ethical patient care. A complementary survey instrument was sent to all 240 third- and fourth-year students to elicit their perceptions of what they were being taught by their mentors about the legal environment. Responses were tabulated, analysed, and interpreted. Faculty staff and student responses to six questions regarding teaching and learning about the relationship of legal risk management and ethical patient care revealed, for four of the six questions, statistically significantly different perspectives between what faculty members thought they were teaching and what students thought they were learning. Medical schools should be teaching patient-centered medicine, reconciling an awareness of the legal environment with the provision of ethically and clinically sound patient care. To improve performance, we must address the messages faculty members send students and reduce the disparity between perceived faculty teaching and claimed student learning in this context. © Blackwell Publishing Ltd 2012.

  5. Transfusion medicine in the Formosa Fun Coast water park explosion: The role of combined tissue and blood banking.

    Science.gov (United States)

    Chang, Chih-Chun; Yeh, Chin-Chuan; Chu, Fang-Yeh

    2016-10-01

    The Formosa Fun Coast explosion, occurring in a recreational water park located in the Northern Taiwan on 27 June 2015, made 499 people burn-injured. For those who had severe burn trauma, surgical intervention and fluid resuscitation were necessary, and potential blood transfusion therapy could be initiated, especially during and after broad escharotomy. Here, we reviewed the literature regarding transfusion medicine and skin grafting as well as described the practicing experience of combined tissue and blood bank in the burn disaster in Taiwan. It was reported that patients who were severely burn-injured could receive multiple blood transfusions during hospitalization. Since the use of skin graft became a mainstay alternative for wound coverage after the early debridement of burn wounds at the beginning of the 20th century, the development of tissue banking program was initiated. In Taiwan, the tissue banking program was started in 2006. And the first combined tissue and blood bank was established in Far Eastern Memorial Hospital in 2010, equipped with the non-sterile, clean and sterile zones distinctly segregated with a unidirectional movement in the sterile area. The sterile zone was a class 10000 clean room equipped with high efficiency particulate air filter (HEPAF) and positive air pressure ventilation. The combined tissue and blood bank has been able to provide the assigned blood products and tissue graft timely and accurately, with the concepts of centralized management. In the future, the training of tissue and blood bank technicians would be continued and fortified, particularly on the regulation and quality control for further bio- and hemovigilance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Teaching evidence-based medicine more effectively.

    Science.gov (United States)

    Hatmi, Zinat Nadia; Tahvildari, Sousan; Dabiran, Soheila; Soheili, Suraya; Sabouri Kashani, Ahmad; Raznahan, Maedeh

    2010-01-01

    Evidence-based Medicine (EBM) is becoming an integral component of graduate medical education competency and a requirement for grad medical education practice-based learning core competency. This study tries to compare the efficacy of conferences utilizing small-group discussions with the traditional conference method in enhancing EBM competency. The participants in this randomized controlled trial (RCT) were 170 members of the medical faculty who were divided into two groups of 86 (intervention) and 84 (control). Following the intervention, EBM competency was assessed by a written examination. statistical analysis made use of chi-square test, independent sample t-test and relative risks for univariate analysis. Mantel-Hanszel was used for bivariate analysis. Cox proportional hazard models were used to evaluate multivariate-adjusted associations between EBM educational intervention and EBM knowledge, attitude and skills. A new indicator of number needed to intervention (NNI) was defined and computed. The results proved conference along with small-group discussion to be a more effective teaching method with P=0.001 on knowledge, P<0.001 for attitude and skills P<0.001 in an EBM exam when compared with medical faculty members who did not participate in EBM educational intervention (n=84). Moreover, they had also increased confidence with critical appraisal skills, and searching EBM resources. Conferences followed by small-group discussions significantly enhance EBM knowledge, attitude, critical appraisal skills and literature review skills.

  7. Teaching Evidence-Based Medicine More Effectively

    Directory of Open Access Journals (Sweden)

    Zinat Nadia Hatmi

    2010-09-01

    Full Text Available "nEvidence-based Medicine (EBM is becoming an integral component of graduate medical education competency and a requirement for grad medical education practice-based learning core competency. This study tries to compare the efficacy of conferences utilizing small-group discussions with the traditional conference method in enhancing EBM competency. The participants in this randomized controlled trial (RCT were 170 members of the medical faculty who were divided into two groups of 86 (intervention and 84 (control. Following the intervention, EBM competency was assessed by a written examination. statistical analysis made use of chi-square test, independent sample t-test and relative risks for univariate analysis. Mantel-Hanszel was used for bivariate analysis. Cox proportional hazard models were used to evaluate multivariate-adjusted associations between EBM educational intervention and EBM knowledge, attitude and skills. A new indicator of number needed to intervention (NNI was defined and computed. Results: The results proved conference along with small-group discussion to be a more effective teaching method with P=0.001 on knowledge, P<0.001 for attitude and skills P<0.001 in an EBM exam when compared with medical faculty members who did not participate in EBM educational intervention (n=84. Moreover, they had also increased confidence with critical appraisal skills, and searching EBM resources. Conclusions: Conferences followed by small-group discussions significantly enhance EBM knowledge, attitude, critical appraisal skills and literature review skills.

  8. Teaching Evidence-Based Medicine More Effectively

    Directory of Open Access Journals (Sweden)

    Zinat Nadia Hatmi

    2010-10-01

    Full Text Available Evidence-based Medicine (EBM is becoming an integral component of graduate medical education competency and a requirement for grad medical education practice-based learning core competency. This study tries to compare the efficacy of conferences utilizing small-group discussions with the traditional conference method in enhancing EBM competency. The participants in this randomized controlled trial (RCT were 170 members of the medical faculty who were divided into two groups of 86 (intervention and 84 (control. Following the intervention, EBM competency was assessed by a written examination. statistical analysis made use of chi-square test, independent sample t-test and relative risks for univariate analysis. Mantel-Hanszel was used for bivariate analysis. Cox proportional hazard models were used to evaluate multivariate-adjusted associations between EBM educational intervention and EBM knowledge, attitude and skills. A new indicator of number needed to intervention (NNI was defined and computed. Results: The results proved conference along with small-group discussion to be a more effective teaching method with P=0.001 on knowledge, P

  9. Prescribing Patterns and Medicine Use at the University Teaching ...

    African Journals Online (AJOL)

    University Teaching Hospital (UTH) using World Health. Organization (WHO) ... The global scale and impact of irrational use of medicines .... cotrimoxazole (18), erythromycin (13) and amoxicillin- .... and 45% respectively pre-intervention.

  10. How Can Eastern/Southern Mediterranean Countries Resolve Quality and Safety Issues in Transfusion Medicine?

    Directory of Open Access Journals (Sweden)

    Antoine Haddad

    2018-02-01

    Full Text Available Unlike their Western counterparts, some of the Eastern/Southern Mediterranean countries lack centralized coordinated blood transfusion services leading to an unequal blood safety level. This was recently highlighted by a recent World Health Organization (WHO regional committee report in which WHO urges these countries to establish and implement a national blood system with well-coordinated blood transfusion activities and to make attempts to reach 100% voluntary non-remunerated blood donation. The objective is thus to meet the same levels or standards as Western countries in term of self-sufficiency and blood safety. This raises the question whether these countries can either comply with Western countries’ guidelines and experiences or develop their own safety scheme based on proper sociopolitical and economic features. Another option is to identify efficient and cost-effective strategies setup successfully in neighbor countries sharing cultural and economic features. To address this issue—and make an attempt to achieve this goal—we designed a number of surveys specifically addressed to Mediterranean countries, which were sent out to the national authorities; so far, five surveys aim at covering all aspects in blood collection, processing, testing, inventory and distribution, as well as patient immune-hematological testing and follow-up (including surveillance and vigilances. It is anticipated that such practice can help identifying and then sharing the more successful and cost-effective experiences, and be really focused on Mediterranean areas while not necessarily copying and pasting experiences designed for Western/Northern areas with significantly distinct situations.

  11. How Can Eastern/Southern Mediterranean Countries Resolve Quality and Safety Issues in Transfusion Medicine?

    Science.gov (United States)

    Haddad, Antoine; Bou Assi, Tarek; Garraud, Olivier

    2018-01-01

    Unlike their Western counterparts, some of the Eastern/Southern Mediterranean countries lack centralized coordinated blood transfusion services leading to an unequal blood safety level. This was recently highlighted by a recent World Health Organization (WHO) regional committee report in which WHO urges these countries to establish and implement a national blood system with well-coordinated blood transfusion activities and to make attempts to reach 100% voluntary non-remunerated blood donation. The objective is thus to meet the same levels or standards as Western countries in term of self-sufficiency and blood safety. This raises the question whether these countries can either comply with Western countries’ guidelines and experiences or develop their own safety scheme based on proper sociopolitical and economic features. Another option is to identify efficient and cost-effective strategies setup successfully in neighbor countries sharing cultural and economic features. To address this issue—and make an attempt to achieve this goal—we designed a number of surveys specifically addressed to Mediterranean countries, which were sent out to the national authorities; so far, five surveys aim at covering all aspects in blood collection, processing, testing, inventory and distribution, as well as patient immune-hematological testing and follow-up (including surveillance and vigilances). It is anticipated that such practice can help identifying and then sharing the more successful and cost-effective experiences, and be really focused on Mediterranean areas while not necessarily copying and pasting experiences designed for Western/Northern areas with significantly distinct situations. PMID:29536009

  12. Online Teaching Resources about Medicinal Plants and Ethnobotany

    Science.gov (United States)

    Straus, Kristina M.; Chudler, Eric H.

    2016-01-01

    Classroom exploration of plant-based medicines and ethnobotany is a timely and valuable way to engage students in science. This Feature highlights Internet-based resources to help teachers in primary and secondary classrooms incorporate lessons and activities to teach about plant medicines. These Internet resources include curricula, videos, sites…

  13. An internet-based teaching file on clinical nuclear medicine

    International Nuclear Information System (INIS)

    Jiang Zhong; Wu Jinchang

    2001-01-01

    Objective: The goal of this project was to develop an internet-based interactive digital teaching file on nuclide imaging in clinical nuclear medicine, with the capability of access to internet. Methods: On the basis of academic teaching contents in nuclear medicine textbook for undergraduates who major in nuclear medicine, Frontpage 2000, HTML language, and JavaScript language in some parts of the contents, were utilized in the internet-based teaching file developed in this study. Results: A practical and comprehensive teaching file was accomplished and may get access with acceptable speed to internet. Besides basic teaching contents of nuclide imagings, a large number of typical and rare clinical cases, questionnaire with answers and update data in the field of nuclear medicine were included in the file. Conclusion: This teaching file meets its goal of providing an easy-to-use and internet-based digital teaching file, characteristically with the contents instant and enriched, and with the modes diversified and colorful

  14. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

    Directory of Open Access Journals (Sweden)

    Sricharoen P

    2015-02-01

    Full Text Available Pungkava Sricharoen,1 Chaiyaporn Yuksen,1 Yuwares Sittichanbuncha,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, Khon Kaen University, Khon Kaen, Thailand Background: There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods: Fifth year medical students (academic year of 2010 at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results: During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74% were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001. The top three highest average satisfaction scores in the new EM curriculum group were trauma

  15. Outcomes in transfusion.

    Science.gov (United States)

    Sherman, L A

    1999-07-01

    Outcomes data in medicine can be limited by subjective methodologic issues such as poor selection of end points and use of nonvalidated systems for quality adjustment. Blood transfusion analyses are further complicated by the fact that transfusion seldom is primary therapy but is usually supportive or adjunctive. Thus, much of the outcome data in transfusion medicine are either unavailable or in one of two areas. The first area is prevention of bad sequelae of various cytopenias or factor deficiencies. The second is decreasing adverse effects of transfusion itself. A different useful area for outcome and root cause approaches in individual institutions is examining preanalytical and postanalytical processes of their own. Examples are sample labeling accuracy, quality and timeliness of blood suppliers, internal delivery processes and times, and product wastage. Use review can be changed to real time from retrospective time. By reducing complaints about service to objective data, realistic change can be made in internal and external processes.

  16. A multidisciplinary "think tank": the top 10 clinical trial opportunities in transfusion medicine from the National Heart, Lung, and Blood Institute-sponsored 2009 state-of-the-science symposium.

    Science.gov (United States)

    Josephson, Cassandra D; Glynn, Simone A; Kleinman, Steve H; Blajchman, Morris A

    2011-04-01

    In September 2009, the National Heart, Lung, and Blood Institute convened the State-of-the-Science Symposium in Transfusion Medicine to identify Phase II and/or III clinical trials that would provide important information to advance transfusion medicine. Seven multidisciplinary subcommittees developed proposals in the following areas: 1) platelet (PLT) product use, 2) neonatal and/or pediatric transfusion practice, 3) surgical transfusion practice, 4) intensive care unit and/or in trauma transfusion practice, 5) plasma and/or cryoprecipitate product use and therapeutic apheresis practice, 6) red blood cell (RBC) product use and/or blood conservation management, and 7) medical transfusion practice or blood donor studies. The committees consisted of transfusion medicine specialists, hematologists, cardiovascular surgeons, anesthesiologists, neonatologists, critical care physicians, and clinical trial methodologists. Proposals were presented and an external panel evaluated and prioritized each concept for scientific merit, clinical importance, and feasibility. Twenty-four concepts were presented by the subcommittees. Ten concepts addressed four areas deemed most important: 1) PLT transfusion strategies to prevent and/or mitigate bleeding in neonates and patients with hematologic malignancies, 2) RBC transfusion trigger strategies to improve overall outcomes in different patient populations, 3) evaluation of optimal plasma:PLT:RBC ratios in trauma resuscitation, and 4) pathogen inactivation of PLTs to improve PLT transfusion safety. The proposal themes not only represent inquiries about the indications for transfusion, but also epitomize the lack of consensus when clinical practice lacks a strong evidence base. Ultimately, the purpose of this publication is to provide a "blueprint" of ideas for further development rather than endorse any one specific clinical trial design. © 2010 American Association of Blood Banks.

  17. Undergraduate teaching of occupational medicine in European schools of medicine

    NARCIS (Netherlands)

    Gehanno, J. F.; Bulat, P.; Martinez-Jarreta, B.; Pauncu, E. A.; Popescu, F.; Smits, P. B. A.; van Dijk, F. J. H.; Braeckman, L.

    2014-01-01

    General practitioners play or should play a role in occupational medicine (OM), either in diagnosing occupational diseases or in counseling on return to work. Nevertheless, their training has been reported to be insufficient in most single country studies. The objectives of this study were to

  18. Awareness among Parents of β-Thalassemia Major Patients Regarding Prenatal Diagnosis and Premarital Screening in Day Care Centre of Transfusion Medicine Department.

    Science.gov (United States)

    Rudra, S; Chakrabarty, P; Hossain, M A; Ripon, M J; Rudra, M; Mirza, T T

    2016-01-01

    Thalassemia is one of the most common genetic diseases in the world. It is a major health problem, brings much morbidity, early mortality and a great deal of misery for a family both financially and emotionally. The patients suffering from beta thalassemia major do not survive for more than 5 years without blood transfusion. Blood transfusion is usually administered every two to five weeks to maintain the pre-transfusion hemoglobin level of 9-10 gm/dL. This study carried out in the department of Transfusion Medicine of Mymensingh Medical College Hospital from January 2014 to June 2014. A total of 200 parents were interviewed. There was a slight preponderance of females which accounted for 57.5% of the parents. Ninety seven (45.5%) had an income less than Rs. 5000 per month. Nearly 50% were illiterate with only 24.5% with a higher education. Consanguinity was positive in 72.5% of the parents with extended family history of thalassemia positive in 40.8%. Only 29.5% were immunized against Hepatitis B. Around 27.5% did not know whether they should be immunized. Fifty five percent of parents knew children should receive Dysferol. Twelve percent were aware of consanguinity to be a risk factor for thalassaemia with only 5% having undergone antenatal diagnosis. Parental knowledge about thalassemia and its preventive measures is inadequate; this requires intervention in the form of public health education programs concentrating on high risk/targeted population.

  19. Blood transfusions

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000431.htm Blood transfusions To use the sharing features on this page, ... There are many reasons you may need a blood transfusion: After knee or hip replacement surgery, or other ...

  20. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education.

    Science.gov (United States)

    Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak

    2015-01-01

    There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.

  1. Application of case analysis teaching method in nursing teaching in Department of Internal Medicine

    Directory of Open Access Journals (Sweden)

    Zhang-xiu SHENG

    2014-04-01

    Full Text Available Objective:In order to adapt to the modern occupation education teaching idea, to stimulate students’ interest in learning, training students' comprehensive quality, improve the students' active participation, understanding, analysis and problem solving skills. Methods: I In the course of different stages using teaching methods of case analysis: case introduction before class teaching method, case analysis during and after class teaching method, and case analysis of the whole chapter after class teaching method.  Results and Conclusion: Through the course of different stages of using case analysis teaching method, we can launch the students’ active learning, stimulate the students' interest in learning, activate classroom atmosphere, train students' independent thinking, strengthen the problems solving ability, improve the self-learning ability of students, activate their participation and awareness, analysis, judgment, introduction, and strengthen students' exam ability, improve the test scores of students and the teaching effect of nursing in Department of internal medicine.

  2. THE TEACHING OF COMPREHENSIVE MEDICINE 1938· 1969*

    African Journals Online (AJOL)

    In the teaching and training field my personal thinking had been very ... Professor of Physic at the University of Cambridge in. 1936-1937. ... This thinking was later crystallized in his .... Department of Medicine as a full-time academic phy ician.

  3. Benefits and Barriers of Implementation and Utilization of Radio-Frequency Identification (RFID) Systems in Transfusion Medicine.

    Science.gov (United States)

    Coustasse, Alberto; Cunningham, Brian; Deslich, Stacie; Willson, Eric; Meadows, Pamela

    2015-01-01

    Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-time reduction and error reduction. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security, and privacy appear to be the principal barriers to adoption.

  4. Teaching geriatric medicine at the Queen's University of Belfast.

    Science.gov (United States)

    Stout, R W

    1983-01-01

    Undergraduate teaching at the Queen's University, Belfast, takes place in the fourth year of a five year curriculum. It lasts three weeks and this is divided into two parts. First, held within the university department, is topic-based teaching including seminars, discussions, case histories and visits. The second phase of two weeks consists of attachment of two to four students to geriatric medical units both in and outside Belfast. The whole of this module is situated within a combined course involving community medicine, general practice, geriatric medicine and mental health lasting 12 weeks and involving one-third of the year of 150 students each time. In addition to the three weeks teaching in geriatrics, joint discussion groups are held.

  5. THE FUTURE OF NEXT-GENERATION SEQUENCING FOR BLOOD GROUP GENOTYPING AND ITS IMPLICATIONS IN TRANSFUSION MEDICINE

    OpenAIRE

    Halawani, Amr Jamal J

    2016-01-01

    Alloimmunisation becomes a problem when serological discrepancies occur in matching antigens between donors and patients for blood transfusion. The rate of alloimmunisation has been increased especially in multiply transfused patients. Blood group genotyping (BGG) is a DNA-based assay that aids in reducing this situation. Currently, many platforms of BGG have become available, in which every technique has its own advantages and disadvantages. All these platforms lack the ability to identify n...

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

    Science.gov (United States)

    von Engelhardt, D

    1999-03-01

    The current interest in philosophical questions and ethical aspects of medicine turns attention towards the past and obtains suggestions and perspectives from previous descriptions and interpretations of sickness, therapy, and the relation between the patient and physician. Culture as therapy and therapy as culture are fundamental challenges for the present; physician, patient, and society, i.e., humans and humane medicine, need this dialogue, which should also be constitutive for teaching history of medicine. Through the separation of the natural sciences and the humanities, modern progress of medicine has produced many benefits but has, at the same time, raised many problems. Negative consequences of this development exist not only for the patient, but also for his personal environment and for the physician. In the course of modern history, there have been several reactions aimed at overcoming these one-sided tendencies: in the Renaissance, in the epoch of Romanticism and Idealism, and at the beginning and the end of the 19th century. This article outlines, with historical examples and contemporary reflections, the concept of teaching history of medicine in the perspective of "medical humanities".

  7. Developing an eLearning tool formalizing in YAWL the guidelines used in a transfusion medicine service.

    Science.gov (United States)

    Russo, Paola; Piazza, Miriam; Leonardi, Giorgio; Roncoroni, Layla; Russo, Carlo; Spadaro, Salvatore; Quaglini, Silvana

    2012-01-01

    The blood transfusion is a complex activity subject to a high risk of eventually fatal errors. The development and application of computer-based systems could help reducing the error rate, playing a fundamental role in the improvement of the quality of care. This poster presents an under development eLearning tool formalizing the guidelines of the transfusion process. This system, implemented in YAWL (Yet Another Workflow Language), will be used to train the personnel in order to improve the efficiency of care and to reduce errors.

  8. Health economics of blood transfusion safety

    NARCIS (Netherlands)

    Hulst, Marinus van

    2008-01-01

    The HIV/AIDS disaster in transfusion medicine shaped the future agendas for blood transfusion safety. More than ever before, the implementation of interventions which could improve blood transfusion safety was driven merely by availability of technology. The introduction of new expensive

  9. Defining clinically important perioperative blood loss and transfusion for the Standardised Endpoints for Perioperative Medicine (StEP) collaborative: a protocol for a scoping review.

    Science.gov (United States)

    Bartoszko, Justyna; Vorobeichik, Leon; Jayarajah, Mohandas; Karkouti, Keyvan; Klein, Andrew A; Lamy, Andre; Mazer, C David; Murphy, Mike; Richards, Toby; Englesakis, Marina; Myles, Paul S; Wijeysundera, Duminda N

    2017-06-30

    'Standardised Endpoints for Perioperative Medicine' (StEP) is an international collaboration undertaking development of consensus-based consistent definitions for endpoints in perioperative clinical trials. Inconsistency in endpoint definitions can make interpretation of trial results more difficult, especially if conflicting evidence is present. Furthermore, this inconsistency impedes evidence synthesis and meta-analyses. The goals of StEP are to harmonise definitions for clinically meaningful endpoints and specify standards for endpoint reporting in clinical trials. To help inform this endeavour, we aim to conduct a scoping review to systematically characterise the definitions of clinically important endpoints in the existing published literature on perioperative blood loss and transfusion. The scoping review will be conducted using the widely adopted framework developed by Arksey and O'Malley, with modifications from Levac. We refined our methods with guidance from research librarians as well as researchers and clinicians with content expertise. The electronic literature search will involve several databases including Medline, PubMed-not-Medline and Embase. Our review has three objectives, namely to (1) identify definitions of significant blood loss and transfusion used in previously published large perioperative randomised trials; (2) identify previously developed consensus-based definitions for significant blood loss and transfusion in perioperative medicine and related fields; and (3) describe the association between different magnitudes of blood loss and transfusion with postoperative outcomes. The multistage review process for each question will involve two reviewers screening abstracts, reading full-text articles and performing data extraction. The abstracted data will be organised and subsequently analysed in an iterative process. This scoping review of the previously published literature does not require research ethics approval. The results will be used

  10. The great East Japan earthquake of March 11, 2011, from the vantage point of blood banking and transfusion medicine.

    Science.gov (United States)

    Nollet, Kenneth E; Ohto, Hitoshi; Yasuda, Hiroyasu; Hasegawa, Arifumi

    2013-01-01

    The Great East Japan Earthquake of March 11, 2011, and subsequent tsunami took nearly 20 000 lives in Tohoku, the northeastern part of Japan's main island. Most victims were either carried away by the tsunami or drowned. The ability to collect blood was disrupted on the Pacific coast of Tohoku. Inland areas were less affected, but allogeneic blood collected in Tohoku is tested at the Miyagi Red Cross Blood Center (Miyagi Center) in the coastal city of Sendai. Miyagi Center was damaged and could not test for 2 months. The aims of this study are as follows: (1) to assess transfusion practice at 8 disaster response hospitals in Tohoku's Fukushima Prefecture, for equal intervals before and after March 11, 2011; (2) to report activities related to blood collection and distribution in response to the disaster; and (3) to describe the Great East Japan Earthquake in the context of other disasters. Data were collected through a survey of transfusion services at 8 major disaster response hospitals, communication at transfusion conferences, and literature review. Transfused patients and units transfused were about 70% and 60% of normal in the surveyed hospitals because this was a disaster of mass casualty rather than mass injury, and patients requiring chronic care were evacuated out. A nationally coordinated effort allowed excess blood collected outside Tohoku to be transported in, despite infrastructure damage. Japan's national system of blood collection and distribution responded effectively to local needs after the Great East Japan Earthquake. Disasters such as Japan's 3.11 should guide discourse about emergency preparedness and centralization of services. Copyright © 2013. Published by Elsevier Inc.

  11. Importância dos carreadores de oxigênio livre de células Oxygen carriers free of cells in transfusion medicine

    Directory of Open Access Journals (Sweden)

    Marcia Cristina Z. Novaretti

    2007-12-01

    perfluorocarbons (PFCs. Even though not without adverse effects, extensive clinical trials are being conducted to test their safety and efficacy. The understanding of free oxygen carrying cell mechanisms has made testing of a new generation of these products for other applications possible thereby expanding transfusion medicine frontiers.

  12. Getting to the core of medicine: Developing undergraduate forensic medicine and pathology teaching.

    Science.gov (United States)

    Jones, Richard Martin

    2017-11-01

    Teaching and learning of forensic medicine and pathology in the undergraduate medical curriculum has been in decline for decades in the UK, and yet graduates are expected to be able to recognise, and protect, those who are most vulnerable in society - i.e. at risk of abuse or neglect - a matter highly relevant to the role of the forensic medical practitioner. When Cardiff University School of Medicine created a new 'learner-centred' undergraduate curriculum, championing case-based discussion in small groups, and earlier clinical contact, residual teaching on 'the pathology of trauma' disappeared. An opportunity to create a new course for the year 3 core curriculum, however, led to re-emergence of forensic medicine and pathology, with a focus on identification, and protection, of the 'vulnerable patient'. This paper describes the development process of the first two iterations of that course, and the influence of 'listening to the student voice'. Forensic medicine and pathology remain relevant in undergraduate medical education; effective, and ethical, safeguarding of the vulnerable is an essential 'core' skill of the modern medical graduate, and forensic medical practitioners can play an integral role in the preparation of medical students for their future clinical practice. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  13. [The Pharo School: a century of teaching in tropical medicine].

    Science.gov (United States)

    Buisson, Yves

    2007-01-01

    1907-2007: one hundred years separate this year's intake from the first students to enroll at the Pharo School. 1907: in February, the first class, called the "Marseillaise", entered the new School of Colonial Medicine (Ecole d'application du Service de santé des troupes coloniales), where they received theoretical and practical training in tropical medicine. 2007: the latest class, recruited through a national examination, will join the Tropical Medicine Institute of the Army health service in May, for the first autonomous training program in supervised ambulatory primary care. The past hundred years have seen many upheavals. After the colonial period and the two world wars, followed by decolonization and technical assistance for young independent nations, globalization has brought the continents together, shrunk distances, and led to an intermingling of populations. Pharo students are still posted overseas, but no longer on the same types of mission. The lengthy postings to the Sahara, sub-Saharan Africa, Madagascar, Southeast Asia and Oceania have been supplanted by shorter stays and overseas operations in a variety of theaters (not just the intertropical regions), to provide healthcare support for French military forces and medical assistance to local populations. The teaching of tropical medicine has had to adapt to these changes. The concept itself has evolved too: from exotic diseases to colonial medicine, from major endemics to public health, and from humanitarian medicine to international healthcare. The increase in migratory fluxes and cultural exchanges means that tropical medicine is now a global discipline. This teaching activity potentially caters for all physicians, as malaria, dengue or cholera could strike at any time in the very heart of our provinces, or invite themselves into the general practitioner's office. Although mainly confronted by imported diseases, physicians specializing in travel medicine and infectious diseases, along with

  14. Student's perception about innovative teaching learning practices in Forensic Medicine.

    Science.gov (United States)

    Gupta, Sanjay; Parekh, Utsav N; Ganjiwale, Jaishree D

    2017-11-01

    Since decades, Forensic Medicine is mainly taught by didactic methods but in last couple of years some other teachinglearning and assessment methods are also introduced at some places which also lacks uniformity. Feedback from learners is most fundamental aspect to assess effectiveness of applied methods, but is not implemented in practice at most medical schools in India. Unfortunately, medical students are deprived of this practical empowerment and thus may not be efficient enough to contribute potentially to the justice system during their professional life. In order to improve their efficiency in the field, we introduced few innovative teaching-learning methods and documented their perceptions. This pilot study was carried out with students who had completed their second professional year (5th semester) of medical curriculum. Students were exposed to few innovative teaching-learning and assessment approaches in addition to conventional methods during their Forensic Medicine term. These approaches were interactivity in large group lecturing, small group activities, student led objective tutorial, court visit in real scenario, practical records book, surprise tests, structured theory question papers, model answers, objective structured practical examinations and structured oral viva. Their perceptions were documented later through structured questionnaire. Students reported all methods as 'interesting' except 'surprise tests'. Court visits were rated highest for generating interest (98%). Clarity of concept was experienced through all methods (range of 71-95%). Interactive large group lectures reported highest (by 95%students) for clarifying concepts, although this is not a typical characteristic of large group teaching. Enhanced learning experience was reported in 75-92.5% for different methods. Student Led Objective Tutorials seemed to facilitate enhance learning most (92.5%). Innovations in teaching-learning are need of hour especially in subject like Forensic

  15. Community medicine teaching and evaluation: scope of betterment.

    Science.gov (United States)

    Gopalakrishnan, S; Kumar, P Ganesh

    2015-01-01

    There have been rapid and extensive changes in the way assessment is conducted in medical education. Assessment brings about standardization of the manner in which the syllabus is to be implemented and also gives guidelines regarding the teaching pattern, especially when the student is going to rotate through various departments in a medical college. Community Medicine is an important branch of medicine concerned with the health of populations. Existing forms of assessment of community medicine education mainly consists of internal [formative] assessment and final (summative) examination. Advantages of the present system is the similarity of the methods used for internal assessments and final examinations and is relatively easily done since only the knowledge application and recall ability of the student in theory and practical are assessed. Disadvantages in the current evaluation system are neglecting the assessment of psychomotor, affective and communication skills. Evaluation systems can be improved by implementing techniques to assess psychomotor skills, presentation and communication skills, organizational skills and the student's ability to work in a team. Regular feedback from students should be taken periodically for the betterment of Community Medicine education. This article is meant to sensitise the academic experts in medical education to plan better need based methods of assessment in the subject of Community Medicine, in relation to the new MCI 2012 Regulations, in order to make it a better learning experience for the students.

  16. Why teach literature and medicine? Answers from three decades.

    Science.gov (United States)

    Jones, Anne Hudson

    2013-12-01

    In this essay, I look back at some of the earliest attempts by the first generation of literature-and-medicine scholars to answer the question: Why teach literature and medicine? Reviewing the development of the field in its early years, I examine statements by practitioners to see whether their answers have held up over time and to consider how the rationales they articulated have expanded or changed in the following years and why. Greater emphasis on literary criticism, narrative ethics, narrative theory, and reflective writing has influenced current work in the field in ways that could not have been foreseen in the 1970s. The extraordinary growth of interest and work in the field nationally and, especially since 1996, internationally has included practitioners in many additional areas such as disability studies, film studies, therapeutic writing, and trauma studies. Along with the emergence of narrative medicine, this diverse community of scholars and practitioners-affiliated more through their use of narrative methodologies than the teaching of literature-makes the perennial challenge of evaluation and assessment even more complicated.

  17. Microbes and blood transfusion

    Directory of Open Access Journals (Sweden)

    Narayan S

    2001-01-01

    Full Text Available Transfusion medicine has been constantly evolving through the years with improved technologies that enhance the capability of identifying existing and newer emerging transfusion transmissible infections (TTI. In spite of the efforts made by blood banks the risk of TTI remains. This article deals with the various steps involved in ensuring blood safety, i.e. donor selection, role of screening donated blood for known and emerging infections, issues and assessment of threat posed by the risk, methodologies employed for testing and possible suggestions to improve transfusion services. While the threat of TTI remains, with a concerted effort of private and government organisations, and co-operation from the diagnostic companies, it is possible to raise the levels of blood safety. A surveillance system is also essential to identify any new agents that might pose a threat in a geographic area and to include them too in the screening process.

  18. Blood Transfusion

    Science.gov (United States)

    ... transfusions, you're at risk of developing iron overload, which, if not treated, can damage your heart ... of proteins in plasma that play a key role in preventing infection. Severely low levels of gamma ...

  19. Model of teaching competence in teachers of medicine at UNAM

    Directory of Open Access Journals (Sweden)

    Flores-Hernández, Fernando

    2011-09-01

    Full Text Available The study presents a model of teaching competence in teachers of medicine. It was generated from an existing conceptual model: a it was referred to the opinion of experts who selected the competencies of greater impact; b a reference profile was constructed; c an instrument was generated based on student opinion, and another for self-assessment; d the instruments were validated by 18 experts in evaluation; e they were applied to 2,281 students and 107 teachers, obtaining adequate psychometric characteristics, establishing a model according to current trends in teacher performance assessment.

  20. Movies as a vehicle to teach addiction medicine.

    Science.gov (United States)

    Cape, Gavin

    2009-06-01

    Dependence on a substance and the role of medical practitioners in this health problem can be perceived as an enigma. Movies, as a tool for teaching, can be a powerful means of engaging, clarifying and educating students within the addiction medicine arena. Popular mythologies and stereotypes of drug use (including alcohol) and users in cinema can be explored within a learning environment aiding the understanding of this complex topic, thereby improving the therapeutic commitment to addiction medicine. There is a responsibility of the teacher to use this tool with care so as not to perpetuate the mythologies of addiction as often portrayed within commercial cinema. Tried and tested use of this potent educational aid, with suggestions for further development, are outlined in this article.

  1. Undergraduate teaching of nuclear medicine: a comparison between Central and Eastern Europe and European Union countries

    International Nuclear Information System (INIS)

    Lass, P.; Scheffler, J.; Bandurski, T.

    2003-01-01

    This paper overviews the curricula of nuclear medicine (NM) undergraduate training in 34 Central and Eastern European (CEE) and 37 European Union (EU) medical faculties. The data show enormous variation in the number of hours devoted to nuclear medicine, varying between 1-2 to 40 hours and highly differentiated concepts/ideas of nuclear medicine training in particular countries. In most EU countries this teaching is integrated with that of radiology or clinical modules, also with training in clinical physiology. In many CEE countries teaching and testing of NM are independent, although integration with other teaching modules is frequent. The paper discusses the differences in particular approaches to nuclear medicine teaching. (author)

  2. Transfusion in critically ill children

    DEFF Research Database (Denmark)

    Secher, E L; Stensballe, J; Afshari, A

    2013-01-01

    Transfusion of blood products is a cornerstone in managing many critically ill children. Major improvements in blood product safety have not diminished the need for caution in transfusion practice. In this review, we aim to discuss the interplay between benefits and potential adverse effects...... of transfusion in critically ill children by including 65 papers, which were evaluated based on previously agreed selection criteria. Current practice on transfusing critically ill children is mainly founded on the basis of adult studies, common practices with cut-off values, and expert opinions, rather than...... evidence-based medicine. Paediatric patients have explicit physiological challenges and requirements to be addressed. Critically ill children often suffer from anaemia, have substantial iatrogenic blood loss with subsequent transfusions, and are at a higher risk of complications, often due to human errors...

  3. The Art and Science of Learning, Teaching, and Delivering Feedback in Psychosomatic Medicine.

    Science.gov (United States)

    Lokko, Hermioni N; Gatchel, Jennifer R; Becker, Madeleine A; Stern, Theodore A

    2016-01-01

    The teaching and learning of psychosomatic medicine has evolved with the better understanding of effective teaching methods and feedback delivery in medicine and psychiatry. We sought to review the variety of teaching methods used in psychosomatic medicine, to present principles of adult learning (and how these theories can be applied to students of psychosomatic medicine), and to discuss the role of effective feedback delivery in the process of teaching and learning psychosomatic medicine. In addition to drawing on the clinical and teaching experiences of the authors of the paper, we reviewed the literature on teaching methods, adult learning theories, and effective feedback delivery methods in medicine to draw parallels for psychosomatic medicine education. We provide a review of teaching methods that have been employed to teach psychosomatic medicine over the past few decades. We outline examples of educational methods using the affective, behavioral, and cognitive domains. We provide examples of learning styles together with the principles of adult learning theory and how they can be applied to psychosomatic medicine learners. We discuss barriers to feedback delivery and offer suggestions as to how to give feedback to trainees on a psychosomatic medicine service. The art of teaching psychosomatic medicine is dynamic and will continue to evolve with advances in the field. Psychosomatic medicine educators must familiarize themselves with learning domains, learning styles, and principles of adult learning in order to be impactful. Effective feedback delivery methods are critical to fostering a robust learning environment for psychosomatic medicine. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  4. Teaching adaptive leadership to family medicine residents: what? why? how?

    Science.gov (United States)

    Eubank, Daniel; Geffken, Dominic; Orzano, John; Ricci, Rocco

    2012-09-01

    Health care reform calls for patient-centered medical homes built around whole person care and healing relationships. Efforts to transform primary care practices and deliver these qualities have been challenging. This study describes one Family Medicine residency's efforts to develop an adaptive leadership curriculum and use coaching as a teaching method to address this challenge. We review literature that describes a parallel between the skills underlying such care and those required for adaptive leadership. We address two questions: What is leadership? Why focus on adaptive leadership? We then present a synthesis of leadership theories as a set of process skills that lead to organization learning through effective work relationships and adaptive leadership. Four models of the learning process needed to acquire such skills are explored. Coaching is proposed as a teaching method useful for going beyond information transfer to create the experiential learning necessary to acquire the process skills. Evaluations of our efforts to date are summarized. We discuss key challenges to implementing such a curriculum and propose that teaching adaptive leadership is feasible but difficult in the current medical education and practice contexts.

  5. [A structured ePortfolio to handle a programme of professional competences assessment in the area of transfusion medicine].

    Science.gov (United States)

    Staccini, P; Hergon, E; Bordonado, C; Jullien, S; Quaranta, J-F

    2007-08-01

    In order to organize a nationwide program for the evaluation of professional practices in the area of blood transfusion, the French National Blood Transfusion Institute and the Nice-Sophia Antipolis University designed and implemented a web based service aimed at following-up and guiding the physicians involved in such an assessment program. The core component is a structured electronic portfolio (ePortfolio), the implementation of which was based on an object-oriented environment combined with a content management system. The modelling of the global evaluation system makes it possible to describe this type of portfolio according to six axes: an axis "objectives" (competencies accreditation); an axis "target" (heath care professionals); an axis "content" (numerical documents); an axis "structure" (matrix of answer defined in space and time); an axis "source" (single source peer-reviewed); an axis "level of evidence" (validation of the proof after its deposit by an identified and authenticated peer user, whole tracking of the exchanges and interactions between users and device).

  6. Transfusion strategy

    DEFF Research Database (Denmark)

    Jakobsen, Carl-Johan

    2014-01-01

    Blood transfusion is associated with increased morbidity and mortality and numerous reports have emphasised the need for reduction. Following this there is increased attention to the concept of patient blood management. However, bleeding is relatively common following cardiac surgery and is furth....... In conclusion the evidence supports that each institution establishes its own patient blood management strategy to both conserve blood products and maximise outcome.......Blood transfusion is associated with increased morbidity and mortality and numerous reports have emphasised the need for reduction. Following this there is increased attention to the concept of patient blood management. However, bleeding is relatively common following cardiac surgery and is further...

  7. [Status of health psychology teaching in Chilean schools of medicine].

    Science.gov (United States)

    Santander, Jaime T; Pinedo, José P; Repetto, Paula L

    2012-07-01

    Physicians should be exposed, during their training to basic concepts in psychology. To describe the current status of the formal teaching of health psychology or medical psychology in Chilean medical schools. We reviewed the programs of the courses including topics of Medical Psychology, Health Psychology and Behavioral Medicine at 18 medical schools in Chile, using a focused coding method. The contents and the time spent on these courses were considered and analyzed. Eighty three percent of medical schools have a Medical Psychology or related program, 56.3% are carried out during the first year of medical School teaching and the weekly load has an average of 4 hours. The contents are mixed and predominantly concerning general and developmental psychology, but also address specific issues of Medical Psychology in most cases. There is little clarity about the training issues to be addressed in medical psychology for medical students in Chile. It is necessary to define the minimum content that all medical graduates should learn.

  8. Teaching trainers to incorporate evidence-based medicine (EBM) teaching in clinical practice : the EU-EBM project

    OpenAIRE

    Thangaratinam, S.; Barnfield, Gemma; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodoros N.; Horvath, Andrea R.; Zanrei, Gianni; Kunz, Regina; Suter, Katja; Walczak, Jacek; Kaleta, Anna; Rengerink, Katrien; Gee, Harry FRCOG‏; Mol, Ben W. J.; Khan, Khalid Saeed

    2009-01-01

    Background:\\ud Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However, clinical teachers lack confidence in teaching EBM in workplace and are often unsure of the existing opportunities for teaching EBM in the clinical setting. There is a need for continuing professional developme...

  9. Teaching trainers to incorporate evidence-based medicine (EBM) teaching in clinical practice: the EU-EBM project

    OpenAIRE

    Thangaratinam, Shakila; Barnfield, Gemma; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodoros N; Horvath, Andrea R; Zanrei, Gianni; Kunz, Regina; Suter, Katja; Walczak, Jacek; Kaleta, Anna; Rengerink, Katrien; Gee, Harry; Mol, Ben WJ; Khan, Khalid S

    2009-01-01

    Abstract Background Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However, clinical teachers lack confidence in teaching EBM in workplace and are often unsure of the existing opportunities for teaching EBM in the clinical setting. There is a need for continuing professional deve...

  10. The Hospitalist Huddle: a 1-year experience of teaching Hospital Medicine utilizing the concept of peer teaching in medical education.

    Science.gov (United States)

    Elhassan, Mohammed

    2017-01-01

    The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical education of postgraduate residents and medical students. Little is known about the effectiveness of peer-to-peer teaching in internal medicine residency training programs and how the medical residents perceive its educational value in learning Hospital Medicine. The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching. It requires medical residents to teach and educate their peers about the clinical topics related to Hospital Medicine. Faculty hospitalists serve as facilitators during the teaching sessions. A survey disseminated at the end of the first year of its implementation examined the residents' perception of the educational value of this new teaching activity. Most residents reported that they see the Huddle as a useful educational forum which may improve their skills in teaching, create a better educational and learning environment during their inpatient rotation, and improve their understanding of Hospital Medicine. Most residents also prefer that their peers, rather than faculty hospitalists, run the activity and do the teaching. The survey results support the notion that teaching and learning with flat hierarchies can be an appealing educational method to medical residents to help them understand Hospital Medicine during their medical wards rotation. Some areas need to be improved and others need to be continued and emphasized in order to make this novel educational activity grow and flourish in terms of its educational value and residents' satisfaction.

  11. Teaching medicine with the help of "Dr. House".

    Science.gov (United States)

    Jerrentrup, Andreas; Mueller, Tobias; Glowalla, Ulrich; Herder, Meike; Henrichs, Nadine; Neubauer, Andreas; Schaefer, Juergen R

    2018-01-01

    TV series such as "House MD", "Grey´s Anatomy" or "Emergency Room" are well perceived by medical students. Seminars featuring medical TV series such as "House MD" might serve as door-opener to attract medical students to learn more about rare diseases. The TV series "House MD" is troublesome for the main character Dr. House is an excellent diagnostician but at the same time a rather misanthropic person. Therefore, lecturing medicine with the help of "House MD" requires constant evaluation. From 2008 to 2016 we are using the well-known TV series "House MD" continuously to attract medical students and teach them about rare diseases as well as diagnostic strategies. We collected from 213 students a detailed questionnaire assessing their learning experience. 76.6% of our students (n = 157) reported to watching medical dramas on a regular basis. The Dr. House seminar was compared to traditional seminars and our students reported an improved learning effect (69.9%), better concentration (89.7%), higher motivation to participate (88.7%), and more fun (86.7%) (all pHouse's behavior quite critically. Likert assessment on a 5-point scale identified strong disagreement with Dr. House´s interpersonal skills in dealing with his colleagues (median = 1) and patients (median = 1). At the same time, the students strongly agreed with his outstanding diagnostic (median = 5) and therapeutic capabilities (median = 4). Medical students visiting a Dr. House teaching seminar are highly motivated to learn more about rare diseases. They were positively influenced by TV series such as Dr. House to improve their diagnostic and clinical skills. At the same time, they are critical enough not to see Dr. House as a role model for their own personality. Well performed medical TV shows such as Dr. House can successfully be used in an educational setting to motivate medical students to come into seminars to learn more about rare diseases.

  12. Transfusion-related acute lung injury: a change of perspective

    NARCIS (Netherlands)

    Vlaar, A. P.; Schultz, M. J.; Juffermans, N. P.

    2009-01-01

    Two decades ago, transfusion-related acute lung injury (TRALI) was considered a rare complication of transfusion medicine. Nowadays, TRALI has emerged as the leading cause of transfusion-related mortality, presumably as a consequence of reaching international agreement on defining TRALI with

  13. Blood Transfusion Delay and Outcome in County Hospitals in Kenya.

    Science.gov (United States)

    Thomas, Julius; Ayieko, Philip; Ogero, Morris; Gachau, Susan; Makone, Boniface; Nyachiro, Wycliffe; Mbevi, George; Chepkirui, Mercy; Malla, Lucas; Oliwa, Jacquie; Irimu, Grace; English, Mike

    2017-02-08

    Severe anemia is a leading indication for blood transfusion and a major cause of hospital admission and mortality in African children. Failure to initiate blood transfusion rapidly enough contributes to anemia deaths in sub-Saharan Africa. This article examines delays in accessing blood and outcomes in transfused children in Kenyan hospitals. Children admitted with nonsurgical conditions in 10 Kenyan county hospitals participating in the Clinical Information Network who had blood transfusion ordered from September 2013 to March 2016 were studied. The delay in blood transfusion was calculated from the date when blood transfusion was prescribed to date of actual transfusion. Five percent (2,875/53,174) of admissions had blood transfusion ordered. Approximately half (45%, 1,295/2,875) of children who had blood transfusion ordered at admission had a documented hemoglobin transfusions, 82% were administered and documented in clinical records, and three-quarters of these (75%, 1,760/2,352) were given on the same day as ordered but these proportions varied from 71% to 100% across the 10 hospitals. Children who had a transfusion ordered but did not receive the prescribed transfusion had a mortality of 20%, compared with 12% among those transfused. Malaria-associated anemia remains the leading indication for blood transfusion in acute childhood illness admissions. Delays in transfusion are common and associated with poor outcomes. Variance in delay across hospitals may be a useful indicator of health system performance. © The American Society of Tropical Medicine and Hygiene.

  14. Blood Transfusion and Donation

    Science.gov (United States)

    ... people in the United States receive life-saving blood transfusions. During a transfusion, you receive whole blood or ... have liver failure or a severe infection. Most blood transfusions go very smoothly. Some infectious agents, such as ...

  15. Evaluation of teaching and learning in family medicine by students: A Sri Lankan experience

    OpenAIRE

    R. P. J. C. Ramanayake; A. H. W. De Silva; D P Perera; R. D. N. Sumanasekara; R Gunasekara; P Chandrasiri

    2015-01-01

    Background: Family Medicine occupies a prominent place in the undergraduate curriculum of the Faculty of Medicine, University of Kelaniya, Sri Lanka. The one month clinical attachment during the fourth year utilizes a variety of teaching methods. This study evaluates teaching learning methods and learning environment of this attachment. Methodology: A descriptive cross sectional study was carried out among consenting students over a period of six months on completion of the clinical attachmen...

  16. What Is a Blood Transfusion?

    Science.gov (United States)

    ... Transfusions Researchers are trying to find ways to make blood. There's currently no man-made alternative to human blood. However, researchers have developed medicines that may help do the job of some blood parts. For ... that helps their bodies make more red blood cells. This means they may ...

  17. Undergraduate teaching in geriatric medicine using computer-aided learning improves student performance in examinations.

    Science.gov (United States)

    Daunt, Laura A; Umeonusulu, Patience I; Gladman, John R F; Blundell, Adrian G; Conroy, Simon P; Gordon, Adam L

    2013-07-01

    computer-aided learning (CAL) is increasingly used to deliver teaching, but few studies have evaluated its impact on learning within geriatric medicine. We developed and implemented CAL packages on falls and continence, and evaluated their effect on student performance in two medical schools. traditional ward based and didactic teaching was replaced by blended learning (CAL package combined with traditional teaching methods). Examination scores were compared for cohorts of medical students receiving traditional learning and those receiving blended learning. Control questions were included to provide data on cohort differences. in both medical schools, there was a trend towards improved scores following blended learning, with a smaller number of students achieving low scores (P learning was associated with improvement in student examination performance, regardless of the setting or the methods adopted, and without increasing teaching time. Our findings support the use of CAL in teaching geriatric medicine, and this method has been adopted for teaching other topics in the undergraduate curriculum.

  18. Using movies in family medicine teaching: A reference to EURACT Educational Agenda

    Directory of Open Access Journals (Sweden)

    Klemenc Ketiš Zalika

    2017-06-01

    Full Text Available Cinemeducation is a teaching method where popular movies or movie clips are used. We aimed to determine whether family physicians’ competencies as listed in the Educational Agenda produced by the European Academy of Teachers in General Practice/Family Medicine (EURACT can be found in movies, and to propose a template for teaching by these movies.

  19. Students' Preferred Teaching Techniques for Biochemistry in Biomedicine and Medicine Courses

    Science.gov (United States)

    Novelli, Ethel L.B.; Fernandes, Ana Angelica H.

    2007-01-01

    The aim of this study was to investigate the students' preferred teaching techniques, such as traditional blackboard, power-point, or slide-projection, for biochemistry discipline in biomedicine and medicine courses from Sao Paulo State University, UNESP, Botucatu, Sao Paulo, Brazil. Preferences for specific topic and teaching techniques were…

  20. The impact of multimedia on teaching tropical medicine

    Directory of Open Access Journals (Sweden)

    M. F. Sarmento e Souza

    2004-01-01

    Full Text Available This study evaluated the impact of multimedia in the information transfer of subjects specific to Tropical Diseases - Tetanus and Snake Envenoming. We evaluated the autonomous learning process of 76 fourth-year medical students at Botucatu School of Medicine of UNESP, using printed matter, video, and CD-ROM. The students were submitted to a specific test, which was repeated approximately one week later. They were divided into groups and received a kit containing a textbook, a video, and a CD-ROM. These materials were used for out-of-class study. Before the second test, the students gave a seminar,where they discussed and resolved their doubts with their professor. The results of the first test showed averagesbetween 4.27±1.41 and 6.41±1.61. The second test, given after the seminar, presented averages that increased to 8.41±0.76 and 9.52±0.42, significance a = 5%. At the end of the course, the students answered a questionnaire, which evaluated the material quality and acquired knowledge. The students concluded that multimedia was a more efficient and quick means for knowledge building than traditional teaching materials. They said that the active participation and interactivity with the CD-ROM were the major differences. The authors continue to study the associated use of printed matter, video, and CD-ROM as a faster alternative to the traditional method of information transfer, which may be of help in the knowledge building process in medical education.

  1. Knowledge and attitude of donating and using cord blood for transfusion among patients attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria

    OpenAIRE

    Chide E Okocha; Nkiru N Ezeama; John C Aneke; Chinyere U Onubogu; Charles I Okafor; Chijioke G Egbunike

    2017-01-01

    Background: Allogeneic blood for transfusion is in short supply in most parts of the developing world. Cord blood for transfusion can be a significant source of blood supply to our health institutions. Aims: This study aims to investigate the knowledge and attitude to the donation and use of umbilical cord blood (UCB) for transfusion among the patients receiving services in a tertiary health institution in South-East Nigeria. Materials and Methods: This was a cross-sectional study; an a...

  2. Post-Academic Masters in Management of Transfusion Medicine (MMTM); an Evaluation of the eLearning Part of the Course

    NARCIS (Netherlands)

    Smit Sibinga, Cornelis; Escudeiro, P

    2010-01-01

    Health care includes supportive services such as laboratory, radiology and blood transfusion. Blood safety and sustainability of the blood supply is increasingly organized on a WHO advocated nationally supported principle where regional blood procurement centres supply hospitals. To manage such

  3. Post-Academic Masters Course in Management of Transfusion Medicine : Why the Difference in Access to the eLearning Between Countries?

    NARCIS (Netherlands)

    Smit Sibinga, Cornelis; Greener, S; Rospigliosi, A

    2011-01-01

    Health care includes supportive services such as laboratory, radiology and blood transfusion. Blood safety and sustainability of the blood supply is increasingly organized on a WHO advocated nationally supported principle where regional blood procurement centres supply hospitals. To manage such

  4. Blood Transfusions (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Blood Transfusions KidsHealth / For Teens / Blood Transfusions What's in this ... in his or her body. What Is a Blood Transfusion? A transfusion is a simple medical procedure that ...

  5. Teaching trainers to incorporate evidence-based medicine (EBM) teaching in clinical practice: the EU-EBM project.

    Science.gov (United States)

    Thangaratinam, Shakila; Barnfield, Gemma; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodoros N; Horvath, Andrea R; Zanrei, Gianni; Kunz, Regina; Suter, Katja; Walczak, Jacek; Kaleta, Anna; Oude Rengerink, Katrien; Gee, Harry; Mol, Ben W J; Khan, Khalid S

    2009-09-10

    Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However, clinical teachers lack confidence in teaching EBM in workplace and are often unsure of the existing opportunities for teaching EBM in the clinical setting. There is a need for continuing professional development (CPD) courses that train clinical trainers to teach EBM through on-the-job training by demonstration of applied EBM real time in clinical practice. We developed such a course to encourage clinically relevant teaching of EBM in post-graduate education in various clinical environments. We devised an e-learning course targeting trainers with EBM knowledge to impart educational methods needed to teach application of EBM teaching in commonly used clinical settings. The curriculum development group comprised experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions in seven European countries. The e-learning sessions were designed to allow participants (teachers) to undertake the course in the workplace during short breaks within clinical activities. An independent European steering committee provided input into the process. The curriculum defined specific learning objectives for teaching EBM by exploiting educational opportunities in six different clinical settings. The e-modules incorporated video clips that demonstrate practical and effective methods of EBM teaching in everyday clinical practice. The course encouraged focussed teaching activities embedded within a trainer's personal learning plan and documentation in a CPD portfolio for reflection. This curriculum will help senior clinicians to identify and make the best use of available opportunities in everyday practice in clinical situations to teach various steps of EBM and demonstrate their

  6. Teaching trainers to incorporate evidence-based medicine (EBM) teaching in clinical practice: the EU-EBM project

    NARCIS (Netherlands)

    Thangaratinam, Shakila; Barnfield, Gemma; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodoros N.; Horvath, Andrea R.; Zanrei, Gianni; Kunz, Regina; Suter, Katja; Walczak, Jacek; Kaleta, Anna; Oude Rengerink, Katrien; Gee, Harry; Mol, Ben W. J.; Khan, Khalid S.

    2009-01-01

    ABSTRACT: BACKGROUND: Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However,

  7. Epidemiology of massive transfusion

    DEFF Research Database (Denmark)

    Halmin, M A; Chiesa, F; Vasan, S K

    2015-01-01

    and to describe characteristics and mortality of massively transfused patients. Methods: We performed a retrospective cohort study based on the Scandinavian Donations and Transfusions (SCANDAT2) database, linking data on blood donation, blood components and transfused patients with inpatient- and population.......4% among women transfused for obstetrical bleeding. Mortality increased gradually with age and among all patients massively transfused at age 80 years, only 26% were alive [TABLE PRESENTED] after 5 years. The relative mortality, early after transfusion, was high and decreased with time since transfusion...

  8. Promoting addiction medicine teaching through functional mentoring by co-training generalist chief residents with faculty mentors.

    Science.gov (United States)

    Alford, Daniel P; Carney, Brittany L; Jackson, Angela H; Brett, Belle; Bridden, Carly; Winter, Michael; Samet, Jeffrey H

    2018-02-16

    Generalist physicians should play a vital role in identifying and managing individuals with substance use but are inadequately trained to do so. This 5-year (2008-2012) controlled educational study assessed whether internal medicine and family medicine chief residents' (CRs) addiction medicine teaching increased by co-training with faculty mentors at a Chief Resident Immersion Training (CRIT) program in addiction medicine. All CRIT CR attendees identified a residency program faculty mentor to support addiction medicine teaching after CRIT through functional mentoring with a focus on developing and implementing an Addiction Medicine Teaching Project ("Teaching Project"). Approximately half of the CRs attended CRIT with their mentor (co-trained) and half without their mentor (solo-trained). Addiction medicine teaching outcomes were compared between groups using 6- and 11-month questionnaires and 4 bimonthly teaching logs. Of co-trained CRs, mentor characteristics that positively influenced addiction medicine teaching outcomes were identified. One hundred CRs from 74 residency programs attended CRIT from 2008 to 2012; 47 co-trained with their mentors and 53 solo-trained without their mentors. At 6-month follow-up, the co-trained CRs were more likely to meet at least monthly with their mentor (22.7% vs. 9.6%, P mentor as a facilitator for Teaching Project implementation (82.2% vs. 38.5%, P Mentors with more experience, including years of teaching, was associated with better CR Teaching Project outcomes. Co-training generalist chief residents with a faculty mentor appeared to facilitate functional mentoring-driven Teaching Project implementation but did not further increase already high levels of other addiction medicine teaching. Faculty mentors with more years of teaching experience were more effective in facilitating Teaching Project implementation.

  9. "Physician, Heal Thyself": How Teaching Holistic Medicine Differs from Teaching CAM.

    Science.gov (United States)

    Graham-Pole, John

    2001-01-01

    Describes the fundamental difference between complementary and alternative medicine (CAM) and holistic medicine, highlighting holistic medicine's emphasis on the promotion of healthy lifestyles for practitioners and patients alike. Asserts that offering physicians-to-be more course work in holistic medicine could lay the groundwork for future…

  10. Evidence based medicine: teaching, learning and practice: results of a cross-sectional study from Turkey.

    Science.gov (United States)

    Avsar, Ummu Zeynep; Avsar, Umit; Cansever, Zeliha; Acemoglu, Hamit; Cayir, Yasemin; Khan, Abdul Sattar

    2014-07-01

    To assess the level of understanding related to the significance of evidence-based medicine among physicians. The cross-sectional study was conducted between March and October 2012 using an online questionnaire that was sent out to physicians and academics working as faculty at training hospitals across Turkey. The questionnaire consisted of questions about the knowledge, attitude and behaviour towards evidence-based medicine. Seven of the questions pertained to the learning of evidence-based medicine, six were about teaching evidence-based medicine, and six were about its practice. SPSS 20 was used for statistical analyses. The questionnaire was returned duly filled by 79 physicians. Of them, 41 (51.9%) were males; and 57 (72.2%) were part of the faculty. Only 1(1.2%) participant had attended a course about evidence-based medicine during undergraduate education, while 19 (24.05)had attended one after graduation. Besides, 26 (32.9%) academics were teaching some concepts of evidence-based medicine, and 21 (26.6%) were giving some information about clinical guidelines. The study found that levels of learning and teaching of evidence-based medicine among physicians were inadequate. They should be emphasised at both pre- and post-graduate tiers.

  11. Preventive and Community Medicine in Primary Care. Teaching of Preventive Medicine Vol. 5.

    Science.gov (United States)

    Barker, William H., Ed.

    This monograph is the result of a conference on the role of preventive and community medicine in primary medical care and education. The following six papers were presented at the conference: (1) Roles of Departments of Preventive Medicine; (2) Competency-Based Objectives in Preventive Medicine for the Family Physician; (3) Preventive Medicine…

  12. [Blood transfusion: the challenges for tomorrow?].

    Science.gov (United States)

    Folléa, Gilles; Garraud, Olivier; Tiberghien, Pierre

    2015-02-01

    As any therapeutic means, blood transfusion requires regular evaluation, particularly for its indications, effectiveness and risks. The availability of randomized clinical trials, the evolution of the quality of blood components, and the economic constraints shared by all countries, all lead to rethink both transfusion therapy as a whole and the organization of the transfusion chain from donor to recipient. The main tools available to improve transfusion and the transfusion chain management are the following: programs of patient blood management (PBM) to optimize the use of blood products with a patient centred approach, blood supply management tools to improve the effectiveness and efficiency of the transfusion chain, donor management tools to adapt donor collections to the patients' needs in compliance with safety requirements for patients and donors, and coordination of these activities. A better understanding of these tools and their implementation will certainly be major challenges for transfusion medicine in the near future. Integrating these evolutions in regulations through the revision of the European Directives on blood and blood components (the review process is expected to be launched in 2015) should enroll them in the long term, for the benefit of patients, donors and all other stakeholders involved in the transfusion chain. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Validation of an empirically based instrument for the assessment of the quality of teaching in medicine

    OpenAIRE

    Prescher, Anja

    2016-01-01

    Measuring the quality of teaching is a necessary prerequisite for the evaluation and development of medical education and thus for high-quality patient care. Corresponding quality indicators can make the feedback for teachers comprehensible. A completely empirically based instrument for the assessment of the quality of teaching in medicine has not yet been described. Ten empirically based criteria from the field of general pedagogy were developed: clear structure, amount of true learning time...

  14. Adopting a blended learning approach to teaching evidence based medicine: a mixed methods study

    OpenAIRE

    Ilic, Dragan; Hart, William; Fiddes, Patrick; Misso, Marie; Villanueva, Elmer

    2013-01-01

    Background Evidence Based Medicine (EBM) is a core unit delivered across many medical schools. Few studies have investigated the most effective method of teaching a course in EBM to medical students. The objective of this study was to identify whether a blended-learning approach to teaching EBM is more effective a didactic-based approach at increasing medical student competency in EBM. Methods A mixed-methods study was conducted consisting of a controlled trial and focus groups with second ye...

  15. Student attitudes towards clinical teaching resources in complementary medicine: a focus group examination of Australian naturopathic medicine students.

    Science.gov (United States)

    Wardle, Jonathan Lee; Sarris, Jerome

    2014-06-01

    Complementary medicine is forming an increasingly large part of health care in developed countries and is increasingly being formally taught in tertiary academic settings. An exploratory study of naturopathic student perceptions of, use of and attitudes towards teaching resources in naturopathic clinical training and education. Focus groups were conducted with current and recent students of 4-year naturopathic degree programmes in Brisbane and Sydney to ascertain how they interact with clinical teaching materials, and their perceptions and attitudes towards teaching materials in naturopathic education. Naturopathic students have a complex and critical relationship with their learning materials. Although naturopathic practice is often defined by traditional evidence, students want information that both supports and is critical of traditional naturopathic practices, and focuses heavily on evidence-based medicine. Students remain largely ambivalent about new teaching technologies and would prefer that these develop organically as an evolution from printed materials, rather than depart from dramatically and radically from these previously established materials. Findings from this study will assist publishers, librarians and academics develop clinical information sources that appropriately meet student expectations and support their learning requirements. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Group.

  16. Teaching medical ethics | Mielke | Central African Journal of Medicine

    African Journals Online (AJOL)

    Journal Home > Vol 46, No 3 (2000) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Teaching medical ethics. J Mielke. Abstract. No Abstract. Full Text: EMAIL FULL ...

  17. Prescribing Patterns and Medicine Use at the University Teaching ...

    African Journals Online (AJOL)

    Background: There is paucity of data on rational drug use studies at tertiary hospitals in Zambia. The aim of this study was to assess the extent of rational drug use at the adults and paediatrics outpatient departments of the University Teaching Hospital (UTH) using World Health Organization (WHO) standardized drug-use ...

  18. Trials of large group teaching in Malaysian private universities: a cross sectional study of teaching medicine and other disciplines

    Science.gov (United States)

    2011-01-01

    Background This is a pilot cross sectional study using both quantitative and qualitative approach towards tutors teaching large classes in private universities in the Klang Valley (comprising Kuala Lumpur, its suburbs, adjoining towns in the State of Selangor) and the State of Negeri Sembilan, Malaysia. The general aim of this study is to determine the difficulties faced by tutors when teaching large group of students and to outline appropriate recommendations in overcoming them. Findings Thirty-two academics from six private universities from different faculties such as Medical Sciences, Business, Information Technology, and Engineering disciplines participated in this study. SPSS software was used to analyse the data. The results in general indicate that the conventional instructor-student approach has its shortcoming and requires changes. Interestingly, tutors from Medicine and IT less often faced difficulties and had positive experience in teaching large group of students. Conclusion However several suggestions were proposed to overcome these difficulties ranging from breaking into smaller classes, adopting innovative teaching, use of interactive learning methods incorporating interactive assessment and creative technology which enhanced students learning. Furthermore the study provides insights on the trials of large group teaching which are clearly identified to help tutors realise its impact on teaching. The suggestions to overcome these difficulties and to maximize student learning can serve as a guideline for tutors who face these challenges. PMID:21902839

  19. Transfusion reaction - hemolytic

    Science.gov (United States)

    ... Names Blood transfusion reaction Images Surface proteins causing rejection References Choate JD, Maitta RW, Tormey CA, Wu ... PA: Elsevier Saunders; 2016:chap 177. Hall JE. Blood types; transfusion; tissue and organ transplantation. In: Hall JE, ...

  20. [The teaching of clinical medicine and surgery at the end of the Colonial Period].

    Science.gov (United States)

    Ramírez-Ortega, Verónica

    2010-01-01

    There were three schools of medicine in Mexico at the beginning of the Independence time where the doctors and surgeons could learn. In the Faculty of Medicine of the University of Mexico, the most ancient and traditional, the humoral model balance based on medieval knowledge and scholastic method was the rule. At the end of the XVIII century, the Nueva España enrollment in the Illustration movement, this led to an opening period and development of the scientific world. Botany was incorporated to curriculum in medicine school and the students could through the courses of the Surgery College approached to new medical theories and other teaching model without restrictions.

  1. Medicinal chemistry teaching and training: a continuous adaptation

    NARCIS (Netherlands)

    Timmerman, H.; de Souza, N.J.

    2009-01-01

    Bridging the gap: The differences between medicinal chemistry at the industrial and academic levels raises the question: Is there a significant gap between the two spheres that requires attention, or should such differences be deemed natural, without the need to close the gap? Herein we provide

  2. Teaching trainers to incorporate evidence-based medicine (EBM teaching in clinical practice: the EU-EBM project

    Directory of Open Access Journals (Sweden)

    Kaleta Anna

    2009-09-01

    Full Text Available Abstract Background Evidence based medicine (EBM is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However, clinical teachers lack confidence in teaching EBM in workplace and are often unsure of the existing opportunities for teaching EBM in the clinical setting. There is a need for continuing professional development (CPD courses that train clinical trainers to teach EBM through on-the-job training by demonstration of applied EBM real time in clinical practice. We developed such a course to encourage clinically relevant teaching of EBM in post-graduate education in various clinical environments. Methods We devised an e-learning course targeting trainers with EBM knowledge to impart educational methods needed to teach application of EBM teaching in commonly used clinical settings. The curriculum development group comprised experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions in seven European countries. The e-learning sessions were designed to allow participants (teachers to undertake the course in the workplace during short breaks within clinical activities. An independent European steering committee provided input into the process. Results The curriculum defined specific learning objectives for teaching EBM by exploiting educational opportunities in six different clinical settings. The e-modules incorporated video clips that demonstrate practical and effective methods of EBM teaching in everyday clinical practice. The course encouraged focussed teaching activities embedded within a trainer's personal learning plan and documentation in a CPD portfolio for reflection. Conclusion This curriculum will help senior clinicians to identify and make the best use of available opportunities in everyday practice in clinical

  3. Medicine utilization review at a university teaching hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    M Aqil

    2012-01-01

    Full Text Available Objective: A prospective medicine usage evaluation based on prescription monitoring was conducted in the medicine OPD of our university teaching hospital to know prescribing trends of different categories of medicines. Materials and Methods: A total of 600 patients were included in the study comprising of 339 (56.5% males and 261 (43.5% females. The data were recorded within the OPD by a registered pharmacist on a medicine usage evaluation form, approved by The University Institutional Review Board (IRB. Results: A total of 2365 medicines were prescribed to 600 patients during the 3 months study period. The mean number of medicines per prescription were found to be 3.94. Medicines were most frequently prescribed as solid dosage forms (85.62%, especially tablets (70.82%, and liquid formulations (14.12%. Oral route (96.17% was the most preferred mode of administration, followed by topical (2.11% and parenteral (1.60% routes. Combination therapy (94.33% was more prevalent than monotherapy (5.66%. An overwhelming tendency for prescribing medicines by brand names (99% was observed by the physicians. The most frequently prescribed class of medicines were antimicrobials > analgesics > cardiovascular > gastrointestinal agents. The most prescribed individual medicines among various therapeutic classes included isoniazid (antimicrobial, amlodipine (cardiovascular, metformin (hypoglycemic, cetirizine (antiallergic, rabeprazole (GI medicine, atorvastatin (hypolipidemic, dextromethorphan (respiratory medicine, alprazolam (sedative-hypnotic, paracetamol (analgesic. Conclusions: There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be developed for the purpose. The number of medicines to be included per prescription should be judged rationally and polypharmacy ought to be curbed. Use of antimicrobial also needs to be rationalized as over

  4. Blood Transfusion (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Blood Transfusions KidsHealth / For Parents / Blood Transfusions What's in this ... and help put your child at ease. About Blood Transfusions Blood is like the body's transportation system. As ...

  5. Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

    Science.gov (United States)

    Silk, Hugh; Shields, Sara

    2012-01-01

    Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…

  6. Teaching methods in Hawler College of Medicine in Iraq: A qualitative assessment from teachers' perspectives

    Directory of Open Access Journals (Sweden)

    Saleh Abubakir M

    2012-07-01

    Full Text Available Abstract Background Medical education in Iraq is poorly assessed and there is a general lack of documented knowledge about the challenges facing this field and the needs for its development. This study aimed to assess the existing teaching methods in the Hawler College of Medicine, Iraq from teaching staff perspectives and assess the knowledge of the teaching staff about student-centred learning. Methods A qualitative study based on a self-administered questionnaire survey of a purposive sample of 83 teaching staff in Hawler Medical University was conducted. The questionnaire addressed the participants’ view on the positive aspects and problems of the current teaching methods and priorities to change it. The qualitative data analysis comprised thematic analysis. Results The study revealed significant problems facing the existing teaching methods including having large number of students in the lecture hall (45.0 %, having focus on teacher-centred teaching (45.0 % and lack of infrastructures and facilities suitable for proper teaching (26.7 %. The priorities for improving the quality of teaching methods included adoption of small group teaching strategy in all study years (34.6 %, improving the infrastructure and facilities for teaching in the college (34.6 % and provision of continuous academic development programs for the teaching staff (24.3 %. Conclusions The existing medical education system face significant problems and it needs important and comprehensive improvements in different areas. There is a need for further research in this field to explore the identified problems in a more in-depth manner in order to better understand of the problems and needs of this important area of education.

  7. Teaching methods in Hawler College of Medicine in Iraq: a qualitative assessment from teachers' perspectives.

    Science.gov (United States)

    Saleh, Abubakir M; Al-Tawil, Namir G; Al-Hadithi, Tariq S

    2012-07-27

    Medical education in Iraq is poorly assessed and there is a general lack of documented knowledge about the challenges facing this field and the needs for its development. This study aimed to assess the existing teaching methods in the Hawler College of Medicine, Iraq from teaching staff perspectives and assess the knowledge of the teaching staff about student-centred learning. A qualitative study based on a self-administered questionnaire survey of a purposive sample of 83 teaching staff in Hawler Medical University was conducted. The questionnaire addressed the participants' view on the positive aspects and problems of the current teaching methods and priorities to change it. The qualitative data analysis comprised thematic analysis. The study revealed significant problems facing the existing teaching methods including having large number of students in the lecture hall (45.0 %), having focus on teacher-centred teaching (45.0 %) and lack of infrastructures and facilities suitable for proper teaching (26.7 %). The priorities for improving the quality of teaching methods included adoption of small group teaching strategy in all study years (34.6 %), improving the infrastructure and facilities for teaching in the college (34.6 %) and provision of continuous academic development programs for the teaching staff (24.3 %). The existing medical education system face significant problems and it needs important and comprehensive improvements in different areas. There is a need for further research in this field to explore the identified problems in a more in-depth manner in order to better understand of the problems and needs of this important area of education.

  8. [The federal state educational standard and teaching of history of medicine].

    Science.gov (United States)

    Sorokina, T S

    2016-01-01

    The article considers actual issues of teaching of history of medicine in Russia in connection with transition of higher medical school of Russia to the new Federal state educational standard of high education if the third generation meaning placement of discipline in education process, programs of training, personnel support.

  9. NOTES FOR THE PRIMARY CARE TEACHERS: TEACHING DOCTOR-PATIENT COMMUNICATION IN FAMILY MEDICINE

    Directory of Open Access Journals (Sweden)

    AR Yong Rafidah

    2007-01-01

    Full Text Available Doctor-patient communication skills are important in family medicine and can be taught and learned. This paper summarisesthe salient contents and main methods of the teaching and learning of doctor-patient communication, especially thoseapplicable to the discipline.

  10. Teaching medicine of the person to medical students during the beginning of their clerkships.

    NARCIS (Netherlands)

    Verhoeven, Anita; Dekker, Hanke

    2014-01-01

    This article describes how medicine of the person is taught to 4th year medical students in Groningen, The Netherlands, as part of the teaching programme ‘Professional Development’. In that year, the students start with their clerkships. In this transitional phase from medical student to young

  11. Home Care Services as Teaching Sites for Geriatrics in Family Medicine Residencies.

    Science.gov (United States)

    Laguillo, Edgardo

    1988-01-01

    A national survey of family medicine programs and residency training in geriatrics found almost half using home care services as teaching sites. In the program design preferred by residents, the resident followed the patient long-term and discussed management with a multidisciplinary team. An alternative combined rotation is discussed. (Author/MSE)

  12. The Holistic Medicine Wheel: An Indigenous Model of Teaching and Learning.

    Science.gov (United States)

    Pewewardy, Cornel

    1999-01-01

    Based on the Medicine Wheel, a culturally relevant model for holistic teaching and curriculum development in indigenous education is centered on the self, then expands to four domains (mental, spiritual, physical, emotional) operationalized via eight multiple intelligences. Outer circles portray societal values and a global view of the world. A…

  13. Basque Museum of the History of Medicine: conservation of heritage, teaching and research.

    Science.gov (United States)

    Erkoreka, Anton

    2009-01-01

    The Basque Museum of the History of Medicine was founded in 1982 to preserve the historic memory of medicine in the Basque Country and conserve its scientific heritage. Its permanent exposition comprises approx. 6,000 medical objects of the 19th and 20th centuries arranged, thematically in 24 rooms devoted to different medical specialities: folk medicine, unconventional medicine, pharmacy, weights and measures, asepsis and antisepsis, microscopes, laboratory material, X-rays, obstetrics and gynaecology, surgery, anesthesia, endoscope, odontology, cardiology, ophthalmology, electrotherapy, pathological anatomy and natural sciences. Temporary exhibitions are also held. The Museum is located on the university campus (UPV/EHU) and is important in the training of students in the Faculty of Medicine and the students coming from other faculties. Teaching and research constitute two of the pillars of the Museum that are complemented with publications and the organization of conferences, lectures and other activities.

  14. The special study module: a novel approach to undergraduate teaching in occupational medicine.

    Science.gov (United States)

    Fletcher, G; Agius, R M

    1995-12-01

    Difficulties in teaching occupational medicine to undergraduates stem from the reduced availability of teaching time and the perception of the specialty. Recent changes in the General Medical Council curricular framework have permitted the development of a special study module (options course) in occupational medicine, in which a small number of motivated undergraduates elected to participate and which was adequately resourced. This course laid particular emphasis on changing students' attitudes towards the specialty, self-learning techniques, problem-solving and other skills such as workplace assessment. The objectives, content and teaching methods of the course are described, as is a preliminary evaluation. It is suggested that other medical schools should adopt and refine this approach in order to improve the quality of undergraduate training in at least a proportion of the output of medical schools.

  15. Techniques and Behaviors Associated with Exemplary Inpatient General Medicine Teaching: An Exploratory Qualitative Study.

    Science.gov (United States)

    Houchens, Nathan; Harrod, Molly; Moody, Stephanie; Fowler, Karen; Saint, Sanjay

    2017-07-01

    Clinician educators face numerous obstacles to their joint mission of facilitating high-quality learning while also delivering patient-centered care. Such challenges necessitate increased attention to the work of exemplary clinician educators, their respective teaching approaches, and the experiences of their learners. To describe techniques and behaviors utilized by clinician educators to facilitate excellent teaching during inpatient general medicine rounds. An exploratory qualitative study of inpatient teaching conducted from 2014 to 2015. Inpatient general medicine wards in 11 US hospitals, including university-affiliated hospitals and Veterans Affairs medical centers. Participants included 12 exemplary clinician educators, 57 of their current learners, and 26 of their former learners. In-depth, semi-structured interviews of exemplary clinician educators, focus group discussions with their current and former learners, and direct observations of clinical teaching during inpatient rounds. Interview data, focus group data, and observational field notes were coded and categorized into broad, overlapping themes. Each theme elucidated a series of actions, behaviors, and approaches that exemplary clinician educators consistently demonstrated during inpatient rounds: (1) they fostered positive relationships with all team members by building rapport, which in turn created a safe learning environment; (2) they facilitated patient-centered teaching points, modeled excellent clinical exam and communication techniques, and treated patients as partners in their care; and (3) they engaged in coaching and collaboration through facilitation of discussion, effective questioning strategies, and differentiation of learning among team members with varied experience levels. This study identified consistent techniques and behaviors of excellent teaching during inpatient general medicine rounds. © 2017 Society of Hospital Medicine

  16. Teaching forensic pathology to undergraduates at Zhongshan School of Medicine.

    Science.gov (United States)

    Zhou, Nan; Wu, Qiu-Ping; Su, Terry; Zhao, Qian-Hao; Yin, Kun; Zheng, Da; Zheng, Jing-Jing; Huang, Lei; Cheng, Jian-Ding

    2018-04-01

    Producing qualified forensic pathological practitioners is a common difficulty around the world. In China, forensic pathology is one of the required major subspecialties for undergraduates majoring in forensic medicine, in contrast to forensic education in Western countries where forensic pathology is often optional. The enduring predicament is that the professional qualities and abilities of forensic students from different institutions vary due to the lack of an efficient forensic pedagogical model. The purpose of this article is to describe the new pedagogical model of forensic pathology at Zhongshan School of Medicine, Sun Yat-sen University, which is characterised by: (a) imparting a broad view of forensic pathology and basic knowledge of duties and tasks in future careers to students; (b) educating students in primary skills on legal and medical issues, as well as advanced forensic pathological techniques; (c) providing students with resources to broaden their professional minds, and opportunities to improve their professional qualities and abilities; and (d) mentoring students on occupational preparation and further forensic education. In the past few years, this model has resulted in numerous notable forensic students accomplishing achievements in forensic practice and forensic scientific research. We therefore expect this pedagogical model to establish the foundation for forensic pathological education and other subspecialties of forensic medicine in China and abroad.

  17. Transfusion issues in surgery

    Directory of Open Access Journals (Sweden)

    Paramjit Kaur

    2013-01-01

    Full Text Available Transfusion, just as any other medical intervention has both benefits and risks, which should be balanced for each patient so that the benefits outweigh the risks. Blood and its products are considered drugs and hence careful consideration of therapy is essential to minimize the potential adverse reactions. Moreover, alternative modes of treatment should be considered and final decision to transfuse should be based on individual patient evaluation. Reviews of blood transfusion practices have found that most surgical procedures do not require blood transfusion. This review is focused on the transfusion needs of the surgical patients.

  18. Survival after blood transfusion

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Ahlgren, Martin; Rostgaard, Klaus

    2008-01-01

    of transfusion recipients in Denmark and Sweden followed for up to 20 years after their first blood transfusion. Main outcome measure was all-cause mortality. RESULTS: A total of 1,118,261 transfusion recipients were identified, of whom 62.0 percent were aged 65 years or older at the time of their first...... the SMR remained significantly 1.3-fold increased. CONCLUSION: The survival and relative mortality patterns among blood transfusion recipients were characterized with unprecedented detail and precision. Our results are relevant to assessments of the consequences of possible transfusion-transmitted disease...... as well as for cost-benefit estimation of new blood safety interventions....

  19. Knowledge and attitude of donating and using cord blood for transfusion among patients attending Nnamdi Azikiwe University Teaching Hospital, Nnewi, South East Nigeria.

    Science.gov (United States)

    Okocha, Chide E; Ezeama, Nkiru N; Aneke, John C; Onubogu, Chinyere U; Okafor, Charles I; Egbunike, Chijioke G

    2017-01-01

    Allogeneic blood for transfusion is in short supply in most parts of the developing world. Cord blood for transfusion can be a significant source of blood supply to our health institutions. This study aims to investigate the knowledge and attitude to the donation and use of umbilical cord blood (UCB) for transfusion among the patients receiving services in a tertiary health institution in South-East Nigeria. This was a cross-sectional study; an anonymous structured questionnaire was used. A total of 549 consenting patients randomly selected from the antenatal, postnatal, sickle cell clinics, and wards were the subjects. Statistical analysis of the data was done using SPSS version 20.0. The mean age of the participants was 31.9 ± 9.5 years. The majority were females (77.2%), married (86.4%). About 26.2% of the respondents were willing to accept UCB for transfusion to them or their child. Following counseling, the acceptance rate increased to 71.5%. Most of the respondents (80.0%) were willing to donate the UCB of their baby; or be tested for HIV (93.3%), if necessary. Educational level was significantly associated with knowledge of UCB. After logistic regression, occupation, and gender were significantly associated with acceptance of UCB for transfusion. Up to 52% belonged to low income family background, approximately 150 US dollars monthly family income (50,000 naira). The knowledge and acceptance of UCB for transfusion are low in our environment. However, proper counseling and public enlightenment could change this attitude.

  20. Teaching-skills training programs for family medicine residents: systematic review of formats, content, and effects of existing programs.

    Science.gov (United States)

    Lacasse, Miriam; Ratnapalan, Savithiri

    2009-09-01

    To review the literature on teaching-skills training programs for family medicine residents and to identify formats and content of these programs and their effects. Ovid MEDLINE (1950 to mid-July 2008) and the Education Resources Information Center database (pre-1966 to mid-July 2008) were searched using and combining the MeSH terms teaching, internship and residency, and family practice; and teaching, graduate medical education, and family practice. The initial MEDLINE and Education Resources Information Center database searches identified 362 and 33 references, respectively. Titles and abstracts were reviewed and studies were included if they described the format or content of a teaching-skills program or if they were primary studies of the effects of a teaching-skills program for family medicine residents or family medicine and other specialty trainees. The bibliographies of those articles were reviewed for unidentified studies. A total of 8 articles were identified for systematic review. Selection was limited to articles published in English. Teaching-skills training programs for family medicine residents vary from half-day curricula to a few months of training. Their content includes leadership skills, effective clinical teaching skills, technical teaching skills, as well as feedback and evaluation skills. Evaluations mainly assessed the programs' effects on teaching behaviour, which was generally found to improve following participation in the programs. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects. Family medicine residency training programs differ from all other residency training programs in their shorter duration, usually 2 years, and the broader scope of learning within those 2 years. Few studies on teaching-skills training, however, were designed specifically for family medicine residents. Further studies assessing the effects of teaching-skills training in family medicine residents are

  1. 'THE UNVEILED HEART' a teaching program in cardiovascular nuclear medicine

    International Nuclear Information System (INIS)

    Itti, Roland; Merabet, Yasmina; Roca, Ramona; Bontemps, Laurence; Itti, Emmanuel

    2004-01-01

    The functional investigation of cardiac diseases using nuclear techniques involves several variables, such as myocardial perfusion, cellular viability or mechanical contraction. The combined, topographical and quantitative assessment of these variables can characterize the functional state of the heart in terms of normal myocardium, ischemia, hibernation or necrosis. The teaching program, 'The Unveiled Heart', has been designed in order to help nuclear physicians or cardiologists approaching these concepts and their implications for diagnosis of coronary artery disease, optimization of therapeutic strategies and prognosis evaluation. Anatomical correlations with coronary angiographic results obtained during balloon occlusion at the time of coronary angioplasty demonstrate the complementary role of imaging techniques and highlight the patient to patient variability of risk areas. A sectorial model derived from a polar projection of the myocardium presents for each sector the probability of involvement of a given coronary artery

  2. Medical students' perspective about role-plays as a teaching strategy in community medicine.

    Science.gov (United States)

    Manzoor, Iram; Mukhtar, Fatima; Hashmi, Noreen Rahat

    2012-04-01

    To assess the students' perspective about role-plays conducted as a teaching methodology in community medicine. A quasi-experimental study. Department of Community Medicine at Fatima Memorial College of Medicine and Dentistry from July to November 2010. A probability technique of simple random sampling was used to collect 63 students from the third and fourth year MBBS who were randomly distributed in five sub-groups. They were variously ascribed the roles of obsceners, participants and helpers. A questionnaire was distributed to collect student's responses. The data was analyzed on SPSS version 17 to compare the responses. Chi-square test was applied and p-value was fixed at andragogy (p = 0.005) and 48 (76.2%) said that it provoked critical thinking about the subject (p = 0.038). Fifty-four students (85.7%) admitted that their attention span was better in role-plays as compared to lectures (p = 0.047). Role-plays were well accepted by the students as an effective teaching methodology and can be incorporated as a part of teaching strategies in Community Medicine.

  3. [Beginning Knowledge of Transfusion in Japan].

    Science.gov (United States)

    Mazda, Toshio; Shimizu, Masaru

    2015-01-01

    Blood components and plasma derivatives are two of the most useful tools in modern medicine. When the Portuguese opened the maritime routes to the Far East in the 16th century. Western medicine traveled to Japan on the trading vessels that carried physicians and barber-surgeons to care for the body and Christian missionaries to care for the soul. Skilled interpreters such as Kōgyū Yoshio translated and studied Dutch editions of early medical books, like Lorenz Heister's "Chirurgie" (Nürnberg, 1719), that illustrate the concept of transfusion. The oldest description of transfusion originating in Japan is a handwritten manuscript entitled "Bansui Sensi Chojutsu Shomoku" by Masamichi Nishijima, a student of Bansui Otsuki. It is a list of Otsuki's translated works. He described book names and chapter names in the manuscript, and when he finished translation of a chapter, he marked a circle on the chapter name. The transfusion chapter had a circle. That dates the earliest writing on transfusion in Japanese to 1804, shortly after the death of Kōgyū. Unfortunately, the manuscript translation no longer exists. In 1814, Shunzō Yoshio, grandson of Kōgyū, and in 1820, Tokki Koshimura, translated the figure legends of "Chirurgie." Soon afterwards, after the first report of transfusion from human-to-human by James Blundell in London in 1818, Western medical books published on the subject began to arrive. The works of Christoph Wilhelm Hufeland, Georg Friedrich Most and Carl Canstatt all mentioning transfusion, albeit without details, were translated by Kōan Ogata and Shinryō Tsuboi. During the Edo period, Japan was a closed country; only open to the Dutch through a tiny island in Nagasaki. But Japanese doctors in the Edo period learned about blood transfusion through Dutch-translated versions of Western medical Books. Transfusion began being practiced in Japan in 1919, almost exactly 100 years after the concept was introduced

  4. 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

  5. Using movies in family medicine teaching: A reference to EURACT Educational Agenda.

    Science.gov (United States)

    Klemenc Ketiš, Zalika; Švab, Igor

    2017-06-01

    Cinemeducation is a teaching method where popular movies or movie clips are used. We aimed to determine whether family physicians' competencies as listed in the Educational Agenda produced by the European Academy of Teachers in General Practice/Family Medicine (EURACT) can be found in movies, and to propose a template for teaching by these movies. A group of family medicine teachers provided a list of movies that they would use in cinemeducation. The movies were categorised according to the key family medicine competencies, thus creating a framework of competences, covered by different movies. These key competencies are Primary care management, Personcentred care, Specific problem-solving skills, Comprehensive approach, Community orientation, and Holistic approach. The list consisted of 17 movies. Nine covered primary care management. Person-centred care was covered in 13 movies. Eight movies covered specific problem-solving skills. Comprehensive approach was covered in five movies. Five movies covered community orientation. Holistic approach was covered in five movies. All key family medicine competencies listed in the Educational Agenda can be taught using movies. Our results can serve as a template for teachers on how to use any appropriate movies in family medicine education.

  6. Using movies in family medicine teaching: A reference to EURACT Educational Agenda

    Science.gov (United States)

    Švab, Igor

    2017-01-01

    Abstract Introduction Cinemeducation is a teaching method where popular movies or movie clips are used. We aimed to determine whether family physicians’ competencies as listed in the Educational Agenda produced by the European Academy of Teachers in General Practice/Family Medicine (EURACT) can be found in movies, and to propose a template for teaching by these movies. Methods A group of family medicine teachers provided a list of movies that they would use in cinemeducation. The movies were categorised according to the key family medicine competencies, thus creating a framework of competences, covered by different movies. These key competencies are Primary care management, Personcentred care, Specific problem-solving skills, Comprehensive approach, Community orientation, and Holistic approach. Results The list consisted of 17 movies. Nine covered primary care management. Person-centred care was covered in 13 movies. Eight movies covered specific problem-solving skills. Comprehensive approach was covered in five movies. Five movies covered community orientation. Holistic approach was covered in five movies. Conclusions All key family medicine competencies listed in the Educational Agenda can be taught using movies. Our results can serve as a template for teachers on how to use any appropriate movies in family medicine education. PMID:28289469

  7. EFFECTIVENESS OF ACTIVE TEACHING METHODS FOR THE RESIDENTS OF PHYSICAL MEDICINE AND REHABILITATION

    Directory of Open Access Journals (Sweden)

    Mohan Raj Manjalavil

    2017-03-01

    Full Text Available BACKGROUND Lecture is the most common teaching aid not only for medical undergraduates, but also specialty residents. There are many disadvantages for this type of teaching. Active teaching methods include didactic lectures followed by interactive sessions, problem-based teaching and hands on demonstration apart from the traditional didactic lecture. The aim of this project was to compare the effectiveness of active teaching method over the didactic lecture to the first year residents of Physical Medicine and Rehabilitation. MATERIALS AND METHODS Settings- Physical Medicine and Rehabilitation Department among first year residents. Study Design- Educational intervention. Didactic lecture followed by active teaching method. Statistical Analysis- Analysed using SPSS-16 package software. Initially, the first year students were subjected to a pretest, which consists of ten single responses multiple choice questions regarding - “The Carpel Tunnel Syndrome.” This is followed by didactic lecture about the above topic. After this lecture, a post test was conducted with identical questions as the pretest. Then, an interactive session and hands on demonstration of confirming the carpel tunnel syndrome by nerve conduction studies were given. Following this, the same post test was then repeated. RESULTS The arithmetic mean value of pretest score was 3.5, which improved to 8.33 after the lecture session. After the live demonstration of nerve conduction studies, the mean value further increased to 9.8333. The ‘p’ value of the paired t-test after the lecture session was 0.000113, which is significant. The ‘p’ value after the live demonstration session was 0.008612, which is also significant. CONCLUSION The active teaching learning method is found to be more effective than the didactic lecture. Immediate and short-term gains are seen with such programmes.

  8. The design of diagnostic imaging and nuclear medicine facilities in a major new teaching hospital

    International Nuclear Information System (INIS)

    Causer, D.A.

    2010-01-01

    Full text: The design of the layout and radiation shielding for diagnostic imaging and nuclear medicine facilities in a modern teaching hospital requires the collaboration of persons from a number of professions including architects, engineers, radiologists, nuclear medicine physi cians, medical imaging technologists and medical physicists. This paper discusses the design of such facilities, including PET/CT and T-131 ablation therapy suites for a major new tertiary hospital in Perth. The importance of involving physicists on the planning team from the earliest stages of the design process is stressed, design plans presented, and some of the problems which may present themselves and their solutions are illustrated.

  9. APPLICATION OF IT IN EVALUATION OF TEACHING AT THE FACULTY OF MEDICINE IN NIŠ

    Directory of Open Access Journals (Sweden)

    Suzana Krstić

    2010-06-01

    Full Text Available There are numerous heterogenic IT solutions representing the IT support for the improvement of the teaching process, scientific-research work and management of academic institutions both worldwide and in Europe. This paper presents the software for the assessment and control of higher education institution work quality implemented at the Facullty of Medicine in Niš. The adapted programme solution contains a series of modules required for every day functioning and related data exchange through the Internet adjusted to the needs of higher education institutions, that is to the needs of faculties of medicine, first of all in the Republic of Serbia.

  10. TEACHING VALUES IN MEDICINE VIA AWARENESS CREATED THROUGH ART.

    Science.gov (United States)

    Karam, George H

    2016-01-01

    The design of a new medical education building sought through art to create awareness of important values in physicians. An antique silk embroidery depicting Aesculapius crowning a man charged to protect the medical profession from quackery is placed at the beginning of the space leading into the simulation laboratories to highlight the importance of competency. A charcoal drawing by an important regional artist conveys the message that trust can arise from vulnerability, with optimal mentoring being the outcome. A round table with an authentic French Art Deco lantern and a commissioned table designed as an interpretation of the lantern create the sense of importance that fosters critical thinking and professionalism. An outdoor terrace was designed to challenge residents and medical students to become in touch with their capacity for humanism in medicine. Included among the various elements to nurture this core value are an outdoor classroom, conversation gardens, open spaces under plane trees (which are within the family of trees under which Hippocrates taught), and a reflection cove (reminiscent of those sought by poets who travelled to Ravello, Italy, in an attempt to find the meaning of life). The major focal point on the terrace is a commissioned Dale Chihuly sculpture of red reeds intended to encourage art as a form of healing and as a source of humanism.

  11. Recommendations for the safe use and regulation of radiation sources in industry, medicine, research and teaching

    International Nuclear Information System (INIS)

    1990-01-01

    The use of radiation sources of various types and activities is widespread in industry, medicine, research and teaching, and is increasing yearly. The safety record has been admirable, although incidents have occurred where loss of control of radiation sources has given rise to unplanned exposures to workers, medical patients and members of the public, sometimes with fatal results, while in other situations exposure may not have been as low as reasonably achievable. This publication is intended as a practical aid for all concerned with operational radiation protection connected with the use of radiation sources in industry, medicine, research and teaching, from the point of view of both the user of such sources and the regulatory bodies. Refs, figs

  12. [Formative evaluation: experience of the Catalonian family and community medicine teaching units].

    Science.gov (United States)

    Ezquerra Lezcano, Matilde; Bundo Vidiella, Magda; Descarrega Queralt, Ramón; Martín Zurro, Amando; Fores García, Dolores; Fornells Vallès, Josep Maria

    2010-04-01

    The purpose of this article is to report on the experience in formative evaluation that was carried out in the Catalonian family and community medicine teaching units during the years 2001-2007. This formative evaluation project included the use of several evaluation tools such as, self-listening, video-recording, structured observation of clinical practice, cases by computer and simulated patients. Different resident intakes have participated in the development of the project, as well as their teaching unit tutors and coordinators. This accumulated experience has allowed it to progress into the field of formative evaluation, and to adapt and integrate the activities that were being carried out in a resident portfolio, which in our opinion is the best tool for the formative evaluation of the family medicine resident. Copyright 2009 Elsevier España, S.L. All rights reserved.

  13. [Level of teaching competence at the Undergraduate Medical Internship of UNAM's Faculty of Medicine].

    Science.gov (United States)

    Martínez-González, Adrián; Lifshitz-Guinzberg, Alberto; González-Quintanilla, Eduardo; Monterrosas-Rojas, Ana María; Flores-Hernández, Fernando; Gatica-Lara, Florina; Martínez-Franco, Adrián Israel; Sánchez-Mendiola, Melchor

    2017-01-01

    There is no systematic evaluation of teaching performance in the clinical area at UNAM Faculty of Medicine. The study purpose is to assess the teaching competence level in the Undergraduate Medical Internship (UMI). The paper describes the process of psychometric validity for the instrument designed to evaluate teaching competence in the UMI. This instrument was constructed from two previously developed instruments. The final version with 54 items in a Likert scale was studied with exploratory factorial analysis. Four dimensions were obtained: Solution of clinical problems, Psychopedagogy, Mentoring, and Evaluation. The instrument had a reliability of 0.994, with an explained variance of 77.75%. To evaluate the teaching competence level, we administered 844 questionnaires to a sample of students with a response rate of 89%. We obtained an overall global score of 89.4 ± 9.6 (mean ± SD). The dimension Solution of clinical problems was the one with a greater value, in contrast with the dimension of Evaluation, which had a lower score. The teachers of the UMI are considered educators with high level of teaching competence, according to the perceptions of the undergraduate internal doctors. The evaluation of teaching competence level is very important for institutions that look for the continuous professional development of its faculty.

  14. Didactic content and teaching methodologies on required allopathic US family medicine clerkships.

    Science.gov (United States)

    Schwiebert, L P; Aspy, C B

    1999-02-01

    Despite the increased prominence of family medicine clerkships in required third- and fourth-year clinical rotations in US allopathic medical schools, the content of these clerkships varies markedly among institutions, and there is little in the literature concerning the current or desired content of family medicine clerkships. This study explores the didactic content of a national sample of required family medicine clerkships to assess what and how this important aspect of clerkship curriculum is taught. Using an original survey instrument, we surveyed US medical schools through mailings and follow-up phone contacts. We categorized free-form responses using a coding dictionary specific to this study and computed descriptive statistics. Of 127 medical schools contacted, 105 (83%) responded. Among respondents, 86 (82%) had a required family medicine clerkship, 80% of them in the third year. Mean clerkship length was 5.3 weeks (median = 4 weeks), and the mean number of didactic sessions was about 2 per week. Almost 80% of clerkships had sessions in the broad area of family medicine, and prevention was the most frequent individual topic, taught in 32 (37%) of clerkships. Seventy-one percent of sessions used methodologies other than lectures. The mean time devoted to teaching 24 of the top 26 topics identified in the survey was between 1.2 and 3.1 hours/rotation, although case presentations and common problems each averaged more than 7 hours on clerkships teaching these topics. This survey provided more detailed information than previously available about the didactic content of required US allopathic family medicine clerkships. The survey also documented the lack of agreement among these clerkships on didactic content. Most didactic sessions used interactive rather than lecture format. The information from this first detailed survey provides family medicine clerkship directors with national comparisons of didactic content and methodology as a foundation for further

  15. Use of an identification system based on biometric data for patients requiring transfusions guarantees transfusion safety and traceability.

    Science.gov (United States)

    Bennardello, Francesco; Fidone, Carmelo; Cabibbo, Sergio; Calabrese, Salvatore; Garozzo, Giovanni; Cassarino, Grazia; Antolino, Agostino; Tavolino, Giuseppe; Zisa, Nuccio; Falla, Cadigia; Drago, Giuseppe; Di Stefano, Giovanna; Bonomo, Pietro

    2009-07-01

    One of the most serious risks of blood transfusions is an error in ABO blood group compatibility, which can cause a haemolytic transfusion reaction and, in the most severe cases, the death of the patient. The frequency and type of errors observed suggest that these are inevitable, in that mistakes are inherent to human nature, unless significant changes, including the use of computerised instruments, are made to procedures. In order to identify patients who are candidates for the transfusion of blood components and to guarantee the traceability of the transfusion, the Securblood system (BBS srl) was introduced. This system records the various stages of the transfusion process, the health care workers involved and any immediate transfusion reactions. The patients and staff are identified by fingerprinting or a bar code. The system was implemented within Ragusa hospital in 16 operative units (ordinary wards, day hospital, operating theatres). In the period from August 2007 to July 2008, 7282 blood components were transfused within the hospital, of which 5606 (77%) using the Securblood system. Overall, 1777 patients were transfused. In this year of experience, no transfusion errors were recorded and each blood component was transfused to the right patient. We recorded 33 blocks of the terminals (involving 0.6% of the transfused blood components) which required the intervention of staff from the Service of Immunohaematology and Transfusion Medicine (SIMT). Most of the blocks were due to procedural errors. The Securblood system guarantees complete traceability of the transfusion process outside the SIMT and eliminates the possibility of mistaken identification of patients or blood components. The use of fingerprinting to identify health care staff (nurses and doctors) and patients obliges the staff to carry out the identification procedures directly in the presence of the patient and guarantees the presence of the doctor at the start of the transfusion.

  16. Transfusion-related acute lung injury: Current understanding and preventive strategies

    NARCIS (Netherlands)

    Vlaar, A. P. J.

    2012-01-01

    Transfusion-related acute lung injury (TRALI) is the most serious complication of transfusion medicine. TRALI is defined as the onset of acute hypoxia within 6 hours of a blood transfusion in the absence of hydrostatic pulmonary oedema. The past decades have resulted in a better understanding of the

  17. Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice?

    Science.gov (United States)

    Heng, Kenneth Wj

    2014-01-01

    Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of interruption has been causally linked with medical errors. Formal teaching and evaluation of multitasking is often lacking in EM residency programs. This article reviewed the literature on multitasking in EM to identify best practices for teaching and evaluating multitasking amongst EM residents. With the advancement in understanding of what multitasking is, deliberate attempts should be made to teach residents pitfalls and coping strategies. This can be taught through a formal curriculum, role modeling by faculty, and simulation training. The best way to evaluate multitasking ability in residents is by direct observation. The EM Milestone Project provides a framework by which multitasking can be evaluated. EM residents should be deployed in work environments commiserate with their multitasking ability and their progress should be graduated after identified deficiencies are remediated.

  18. Acceptability of the flipped classroom approach for in-house teaching in emergency medicine.

    Science.gov (United States)

    Tan, Eunicia; Brainard, Andrew; Larkin, Gregory L

    2015-10-01

    To evaluate the relative acceptability of the flipped classroom approach compared with traditional didactics for in-house teaching in emergency medicine. Our department changed its learning model from a 'standard' lecture-based model to a 'flipped classroom' model. The 'flipped classroom' included provided pre-session learning objectives and resources before each 2 h weekly session. In-session activities emphasised active learning strategies and knowledge application. Feedback was sought from all medical staff regarding the acceptability of the new approach using an online anonymous cross-sectional qualitative survey. Feedback was received from 49/57 (86%) medical staff. Ninety-eight per cent (48/49) of respondents preferred the flipped classroom over the traditional approach. Aspects of the flipped classroom learners liked most included case-based discussion, interaction with peers, application of knowledge, self-directed learning and small-group learning. Barriers to pre-session learning include work commitments, 'life', perceived lack of time, family commitments, exam preparation and high volume of learning materials. Reported motivational factors promoting pre-session learning include formal assessment, participation requirements, more time, less material, more clinical relevance and/or more interesting material. Case studies and 'hands-on' activities were perceived to be the most useful in-session activities. The flipped classroom shows promise as an acceptable approach to in-house emergency medicine teaching. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  19. Generational influences in academic emergency medicine: teaching and learning, mentoring, and technology (part I).

    Science.gov (United States)

    Mohr, Nicholas M; Moreno-Walton, Lisa; Mills, Angela M; Brunett, Patrick H; Promes, Susan B

    2011-02-01

    For the first time in history, four generations are working together-traditionalists, baby boomers, generation Xers (Gen Xers), and millennials. Members of each generation carry with them a unique perspective of the world and interact differently with those around them. Through a review of the literature and consensus by modified Delphi methodology of the Society for Academic Emergency Medicine Aging and Generational Issues Task Force, the authors have developed this two-part series to address generational issues present in academic emergency medicine (EM). Understanding generational characteristics and mitigating strategies can help address some common issues encountered in academic EM. Through recognition of the unique characteristics of each of the generations with respect to teaching and learning, mentoring, and technology, academicians have the opportunity to strategically optimize interactions with one another. © 2011 by the Society for Academic Emergency Medicine.

  20. Integrating motivational interviewing and narrative therapy to teach behavior change to family medicine resident physicians.

    Science.gov (United States)

    Oshman, Lauren D; Combs, Gene N

    2016-05-01

    Motivational interviewing is a useful skill to address the common problem of patient ambivalence regarding behavior change by uncovering and strengthening a person's own motivation and commitment to change. The Family Medicine Milestones underline the need for clear teaching and monitoring of skills in communication and behavior change in Family Medicine postgraduate training settings. This article reports the integration of a motivational interviewing curriculum into an existing longitudinal narrative therapy-based curriculum on patient-centered communication. Observed structured clinical examination for six participants indicate that intern physicians are able to demonstrate moderate motivational interviewing skill after a brief 2-h workshop. Participant self-evaluations for 16 participants suggest a brief 2-h curriculum was helpful at increasing importance of learning motivational interviewing by participants, and that participants desire further training opportunities. A brief motivational interviewing curriculum can be integrated into existing communication training in a Family Medicine residency training program. © The Author(s) 2016.

  1. Toward a patient-based paradigm for blood transfusion.

    Science.gov (United States)

    Farrugia, Albert; Vamvakas, Eleftherios

    2014-01-01

    The current "manufacturing paradigm" of transfusion practice has detached transfusion from the clinical environment. As an example, fresh whole blood in large-volume hemorrhage may be superior to whole blood reconstituted from multiple components. Multicomponent apheresis can overcome logistical difficulties in matching patient needs with fresh component availability and can deliver the benefits of fresh whole blood. Because of the different transfusion needs of patients in emerging economies and the vulnerability of these blood systems to emerging infections, fresh whole blood and multicomponent apheresis can better meet patient needs when compared with transplants of the "manufacturing paradigm". We propose that patient blood management, along with panels of repeat, paid, accredited apheresis and fresh whole-blood donors can be used in emerging economies to support decentralized blood services. This alternative transfusion-medicine paradigm could eventually also be adopted by established economies to focus transfusion medicine on local patient needs and to alleviate the problem of the aging volunteer donor base.

  2. Platelet alloimmunization after transfusion

    DEFF Research Database (Denmark)

    Taaning, E; Simonsen, A C; Hjelms, E

    1997-01-01

    BACKGROUND AND OBJECTIVES: The frequency of platelet-specific antibodies after one series of blood transfusions has not been reported, and in multiply transfused patients is controversial. MATERIALS AND METHODS: We studied the frequency of alloimmunization against platelet antigens in 117 patient...

  3. Toward a patient-based paradigm for blood transfusion

    OpenAIRE

    Farrugia, Albert; Vamvakas, Eleftherios

    2014-01-01

    Albert Farrugia,1,2 Eleftherios Vamvakas31College of Medicine, Biology and Environment, Australian National University, Acton, ACT, Australia; 2Centre for Orthopaedic Research, Department of Surgery, Faculty of Medicine and Surgery, University of Western Australia, Perth, WA, Australia; 3Cedars-Sinai Medical Center, Los Angeles, CA, USAAbstract: The current "manufacturing paradigm" of transfusion practice has detached transfusion from the clinical environment. As an example,...

  4. HAS THE TIME COME TO CHANGE THE WAY WE TEACH COMMUNITY MEDICINE TO UNDERGRADUATE STUDENTS?

    Directory of Open Access Journals (Sweden)

    Rahul Bansal

    2013-03-01

    Full Text Available Why the need to change ? Substantial increase in the content of subject : The content of the subject has grown by at least 30 % from the time when I was an undergraduate student and we used to read the 7th edition of Preventive and Social Medicine by Park. At that time this book had only 686 pages (size of pages was at least 30 % less than now had only 16 chapters .The 21st edition of the same book has 868 pages and 23 chapters. This goes on to show that the content of subject has increased substantially. 12 weeks of clinical posting added : Medical Council of India has added 12 weeks of clinical posting to the teaching of Community Medicine similar to the postings in major clinical subjects, where in the students are available to us in small groups for approximately 3 hours everyday. In spite of the increase in subject content and the opportunity for small group teaching during postings, I personally feel that we have not been able to inspire students to learn Community Medicine with enthusiasm. Why the subject has not become much popular among under graduate students? Before going into the further details let us look at the following observations made by the WHO -SEARO expert group on “Improving the teaching of Public Health at undergraduate level in medical schools – suggested guidelines.” – Today most of the teaching in public health is carried out using didactic lectures within the ivory tower of an institution with limited exposure to the community .Public health education has to be an active process ,student centered , inquiry driven , evidence based and problem solving as well addressing the needs of the community .The role of the teacher should be to facilitate the student to acquire the competencies through field based experiential learning of public health competencies involving dedicated time for practice , receiving feedback and reflecting on its application in their future role as primary care doctors1.

  5. Implementation of evidence-based medicine in a health promotion teaching block for Thai medical students.

    Science.gov (United States)

    Liabsuetrakul, Tippawan; Suntharasaj, Thitima; Sangsupawanich, Pasuree; Kongkamol, Chanon; Pornsawat, Panumad

    2017-12-01

    Evidence-based medicine (EBM) is well known in medical practice. Although health promotion (HP) is promoted worldwide, there is still some debate as to whether EBM is needed or useful in the teaching of health promotion. To assess the perceived usefulness of EBM in the teaching of HP among medical students and faculty members. A comparative study was conducted between two groups of fourth-year medical students in the academic year 2012 during the five-week Health Promotion Teaching Block at Prince of Songkla University, southern Thailand. A one-week EBM course was conducted with half the students in the first week of the block and the other half of the students in the last week of the block. All activities in the HP block were similar except for the different periods of the one-week of EBM teaching. The effect on knowledge, ability and perceived application of EBM in future practice was assessed by student self-evaluations before versus after taking the EBM course, and by faculty member evaluation of the students' end-of-block presentations. All evaluation items were rated from 1 (lowest) to 5 (highest). Data were analyzed using a t-test or Wilcoxon test, as appropriate. The students' self-evaluations of knowledge and ability on EBM between the two groups were similar. The perception that teaching EBM is beneficial in health promotion and future practice increased significantly ( phigher scores for the first group than the second group, although the rating differences were not at the level of significance. Ninety percent of the students believed that EBM was a useful addition to the teaching of HP. Medical students and faculty members perceived that EBM is useful in the HP context. Future studies to evaluate the effect of using evidence-based teaching for health promotion are needed.

  6. Interactive algorithms for teaching and learning acute medicine in the network of medical faculties MEFANET.

    Science.gov (United States)

    Schwarz, Daniel; Štourač, Petr; Komenda, Martin; Harazim, Hana; Kosinová, Martina; Gregor, Jakub; Hůlek, Richard; Smékalová, Olga; Křikava, Ivo; Štoudek, Roman; Dušek, Ladislav

    2013-07-08

    Medical Faculties Network (MEFANET) has established itself as the authority for setting standards for medical educators in the Czech Republic and Slovakia, 2 independent countries with similar languages that once comprised a federation and that still retain the same curricular structure for medical education. One of the basic goals of the network is to advance medical teaching and learning with the use of modern information and communication technologies. We present the education portal AKUTNE.CZ as an important part of the MEFANET's content. Our focus is primarily on simulation-based tools for teaching and learning acute medicine issues. Three fundamental elements of the MEFANET e-publishing system are described: (1) medical disciplines linker, (2) authentication/authorization framework, and (3) multidimensional quality assessment. A new set of tools for technology-enhanced learning have been introduced recently: Sandbox (works in progress), WikiLectures (collaborative content authoring), Moodle-MEFANET (central learning management system), and Serious Games (virtual casuistics and interactive algorithms). The latest development in MEFANET is designed for indexing metadata about simulation-based learning objects, also known as electronic virtual patients or virtual clinical cases. The simulations assume the form of interactive algorithms for teaching and learning acute medicine. An anonymous questionnaire of 10 items was used to explore students' attitudes and interests in using the interactive algorithms as part of their medical or health care studies. Data collection was conducted over 10 days in February 2013. In total, 25 interactive algorithms in the Czech and English languages have been developed and published on the AKUTNE.CZ education portal to allow the users to test and improve their knowledge and skills in the field of acute medicine. In the feedback survey, 62 participants completed the online questionnaire (13.5%) from the total 460 addressed

  7. Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education.

    Science.gov (United States)

    Ratelle, John T; Wittich, Christopher M; Yu, Roger C; Newman, James S; Jenkins, Sarah M; Beckman, Thomas J

    2015-09-01

    There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM. This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014. Participants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5-point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal-Wallis test. The threshold for statistical significance was set at P teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations. © 2015 Society of Hospital Medicine.

  8. Blood transfusion in burn patients: Triggers of transfusion in a referral burn center in Iran.

    Science.gov (United States)

    Tavousi, S H; Ahmadabadi, A; Sedaghat, A; Khadem-Rezaiyan, M; Yaghoubi Moghaddam, Z; Behrouzian, M J; Nemati, S; Saghafi, H

    2018-02-01

    Blood and its derivatives are one of the most lifesaving products in the modern medicine practice. However, it is not an absolutely safe prescription. Many adverse effects such as infection, transfusion-related acute lung injury, immunosuppression, multi-organ dysfunction, acute respiratory syndrome, transfusion errors, transmission of infectious agents such as HIV, HBV, HCV are attributable to blood transfusion. The aim of this study was to describe how and when blood products were transfused in a referral burn center. This cross-sectional study was performed on medical records of all admitted patients in the Department of Burns and Reconstructive Surgery of Imam Reza Hospital, Mashhad, Iran during September 2014 up to August 2015. Transfusion measures such as Hb, Hct and demographic data were extracted from patient records. SPSS version 11.5 was used for data analysis. During the study period, 701 acute burnt patients were admitted with the mean age of 25.5±20.5 years. Sixty-four percent were male and burnt percentage of total body surface area (TBSA) was 30.9±24.3%. About one third (240) of patients received at least one blood product. Mean of the transfused packed red blood cell was 274.1±674.6mL per patient and 8.85mL per 1% of burnt TBSA. Anemia was the most common transfusion trigger. Mortality in burnt patients who received blood products was two folds more than patients who did not receive any blood products. We prescribed less blood products compared with other reviewed burn centers. However, following a written blood transfusion protocol by all clinicians may reduce blood transfusion in unnecessary situations even more significantly. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. Teaching psychosomatic medicine using problem-based learning and role-playing.

    Science.gov (United States)

    Heru, Alison M

    2011-01-01

    Problem-based learning (PBL) has been implemented in medical education world-wide. Despite its popularity, it has not been generally considered useful for residency programs. The author presents a model for the implementation of PBL in residency programs. The author presents a description of a PBL curriculum for teaching psychosomatic medicine to PGY 2 members in a psychiatry training program. The goals of PBL are to encourage self-directed learning; enhance curiosity, using case-based, contextualized learning; promote collaborative practice; and support patient-centered care. The addition of role-playing exercises helps PGY 2 residents to develop their skills from simply developing a differential diagnosis to being able to construct biopsychosocial formulations, and it provides these residents an opportunity to practice presenting case formulations to the patient and family. Residents and faculty enjoyed the PBL role-playing sessions. Residents wanted the learning objectives given to them rather than generating their own learning objectives, to move through the cases faster, and to receive more information and more cases. Teaching psychosomatic medicine, using PBL and role-playing, allows many of the proposed Academy of Psychosomatic Medicine residency core competencies to be met. However, further refinement of the PBL method needs to take place in order to adapt its use to residency programs.

  10. Transfusion practices in trauma

    Directory of Open Access Journals (Sweden)

    V Trichur Ramakrishnan

    2014-01-01

    Full Text Available Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury.

  11. Practice and application of problem-based learning in evidence-based medicine teaching

    Directory of Open Access Journals (Sweden)

    Tian-Ao Li

    2014-10-01

    Full Text Available AIM:To investigate the effect of problem-based learning(PBLused in the teaching of medical students' evidence-based medicine(EBM.METHODS: Five classes(total 147 studentswere randomly selected as experimental(PBLgroup, at the same time, another 5 classes(total 149 studentswere also randomly selected as control group, using traditional teaching method(lecture-based learning, LBLin 2010 grade. The final examination scores of the experimental group were compared with control at the end of term. In addition, all students were interviewed using self-administered questionnaire to obtain their evaluation for PBL practice. SPSS13.0 software was used for statistical analysis.RESULTS: The homogeneity test in baseline survey showed that the basic characteristics between the two groups of students were no significant differences, and were comparable(P>0.05. Final exam results showed that in addition to the scores of the EBM basic knowledge indicated no significant difference between two groups of students(P>0.05, for the 5 steps of EBM procedure, namely, asking questions, finding the best evidence, evaluating the evidence, using and practicing the evidence, re-evaluating the evidence, and the total scores between the two groups, there were significant statistically differences(PP>0.05in aspects of better understanding classroom knowledge, improving language expression ability, and writing skill exercises. And other residual items had a significant difference(PPCONCLUSION:PBL teaching mode can effectively improve teaching effectiveness and the quality of EBM teaching, so the this teaching mode is worth further popularizing.

  12. A randomised controlled trial of a blended learning education intervention for teaching evidence-based medicine.

    Science.gov (United States)

    Ilic, Dragan; Nordin, Rusli Bin; Glasziou, Paul; Tilson, Julie K; Villanueva, Elmer

    2015-03-10

    Few studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM. A mixed methods study consisting of a randomised controlled trial (RCT) and qualitative case study was performed with medical students undertaking their first clinical year of training in EBM. Students were randomly assigned to receive EBM teaching via either a BL approach or the incumbent DL approach. Competency in EBM was assessed using the Berlin questionnaire and the 'Assessing Competency in EBM' (ACE) tool. Students' self-efficacy, attitudes and behaviour was also assessed. A series of focus groups was also performed to contextualise the quantitative results. A total of 147 students completed the RCT, and a further 29 students participated in six focus group discussions. Students who received the BL approach to teaching EBM had significantly higher scores in 5 out of 6 behaviour domains, 3 out of 4 attitude domains and 10 out of 14 self-efficacy domains. Competency in EBM did not differ significantly between students receiving the BL approach versus those receiving the DL approach [Mean Difference (MD)=-0.68, (95% CI-1.71, 0.34), p=0.19]. No significant difference was observed between sites (p=0.89) or by student type (p=0.58). Focus group discussions suggested a strong student preference for teaching using a BL approach, which integrates lectures, online learning and small group activities. BL is no more effective than DL at increasing medical students' knowledge and skills in EBM, but was significantly more effective at increasing student

  13. Epidemiology of Massive Transfusion

    DEFF Research Database (Denmark)

    Halmin, Märit; Chiesa, Flaminia; Vasan, Senthil K

    2016-01-01

    in Sweden from 1987 and in Denmark from 1996. A total of 92,057 patients were included. Patients were followed until the end of 2012. MEASUREMENTS AND MAIN RESULTS: Descriptive statistics were used to characterize the patients and indications. Post transfusion mortality was expressed as crude 30-day...... mortality and as long-term mortality using the Kaplan-Meier method and using standardized mortality ratios. The incidence of massive transfusion was higher in Denmark (4.5 per 10,000) than in Sweden (2.5 per 10,000). The most common indication for massive transfusion was major surgery (61.2%) followed...

  14. [Preliminary discussion of the we media used in the teaching of the history of medicine].

    Science.gov (United States)

    Xia, Y Y

    2016-09-28

    With the increase of new Internet platform, student access to knowledge is more and more diversified, ensuing in the challenge to the traditional classroom model. In order to be able to better attract the attention of students, and to guide the students' interest in learning, the author reform in the history of medicine electives, we push the micro letter public articles into the traditional classroom teaching. In order to enable students to actively participate in public reading and writing, a series of measures is adopted with better effect, full mobilization of the enthusiasm and interest of students, training of the abilities of the students, popularization and promotion of history of medical knowledge and mutual promotion of both teaching and learning.

  15. Evaluation of teaching and learning in family medicine by students: A Sri Lankan experience

    Directory of Open Access Journals (Sweden)

    R. P. J. C. Ramanayake

    2015-01-01

    Full Text Available Background: Family Medicine occupies a prominent place in the undergraduate curriculum of the Faculty of Medicine, University of Kelaniya, Sri Lanka. The one month clinical attachment during the fourth year utilizes a variety of teaching methods. This study evaluates teaching learning methods and learning environment of this attachment. Methodology: A descriptive cross sectional study was carried out among consenting students over a period of six months on completion of the clinical attachment using a pretested self administered questionnaire. Results: Completed questionnaires were returned by 114(99% students. 90.2% were satisfied with the teaching methods in general while direct observation and feed back from teachers was the most popular(95.1% followed by learning from patients(91.2%, debate(87.6%, seminar(87.5% and small group discussions(71.9%. They were highly satisfied with the opportunity they had to develop communication skills (95.5% and presentation skills (92.9%. Lesser learning opportunity was experienced for history taking (89.9%, problem solving (78.8% and clinical examination (59.8% skills. Student satisfaction regarding space within consultation rooms was 80% while space for history taking and examination (62% and availability of clinical equipment (53% were less. 90% thought the programme was well organized and adequate understanding on family medicine concepts and practice organization gained by 94% and 95% of the students respectively. Conclusions: Overall student satisfaction was high. Students prefer learning methods which actively involve them. It is important to provide adequate infra structure facilities for student activities to make it a positive learning experience for them.

  16. Evaluation of teaching and learning in family medicine by students: a sri lankan experience.

    Science.gov (United States)

    Ramanayake, R P J C; De Silva, A H W; Perera, D P; Sumanasekara, R D N; Gunasekara, R; Chandrasiri, P

    2015-01-01

    Family Medicine occupies a prominent place in the undergraduate curriculum of the Faculty of Medicine, University of Kelaniya, Sri Lanka. The one month clinical attachment during the fourth year utilizes a variety of teaching methods. This study evaluates teaching learning methods and learning environment of this attachment. A descriptive cross sectional study was carried out among consenting students over a period of six months on completion of the clinical attachment using a pretested self administered questionnaire. Completed questionnaires were returned by 114(99%) students. 90.2% were satisfied with the teaching methods in general while direct observation and feed back from teachers was the most popular(95.1%) followed by learning from patients(91.2%), debate(87.6%), seminar(87.5%) and small group discussions(71.9%). They were highly satisfied with the opportunity they had to develop communication skills (95.5%) and presentation skills (92.9%). Lesser learning opportunity was experienced for history taking (89.9%), problem solving (78.8%) and clinical examination (59.8%) skills. Student satisfaction regarding space within consultation rooms was 80% while space for history taking and examination (62%) and availability of clinical equipment (53%) were less. 90% thought the programme was well organized and adequate understanding on family medicine concepts and practice organization gained by 94% and 95% of the students respectively. Overall student satisfaction was high. Students prefer learning methods which actively involve them. It is important to provide adequate infra structure facilities for student activities to make it a positive learning experience for them.

  17. Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes.

    Science.gov (United States)

    Brand, Michael W; Ekambaram, Vijayabharathi; Tucker, Phebe; Aggarwal, Ruchi

    2013-09-01

    Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear

  18. Will there be room for the teaching of internal medicine in a university hospital?

    Science.gov (United States)

    Junod, Alain F

    2002-01-12

    To answer the question addressed, two working groups, one made of the staff of a University clinic, the other one composed of practising general internists, have discussed the assets and weaknesses of a University service of Internal Medicine for postgraduate training. The groups agreed on a number of points: patients' characteristics (complexity and co-morbidities), quality of teaching, method acquisition for clinical reasoning, as well as absence of exposure to ambulatory patients and of follow-up. The groups differed in their views related to the lack of training in psychiatry and psychosocial problems or to hospital dysfunctions. Opening of internal medicine to primary care appears to be necessary at the same time as individual qualities among the senior staff are to be developed, such as critical analysis and self-questioning.

  19. Generational Influences in Academic Emergency Medicine: Teaching and Learning, Mentoring, and Technology (Part I)

    Science.gov (United States)

    Mohr, Nicholas M.; Moreno-Walton, Lisa; Mills, Angela M.; Brunett, Patrick H.; Promes, Susan B.

    2010-01-01

    For the first time in history, four generations are working together – Traditionalists, Baby Boomers, Generation Xers, and Millennials. Members of each generation carry with them a unique perspective of the world and interact differently with those around them. Through a review of the literature and consensus by modified Delphi methodology of the Society for Academic Emergency Medicine (SAEM) Aging and Generational Issues Task Force, the authors have developed this two-part series to address generational issues present in academic emergency medicine (EM). Understanding generational characteristics and mitigating strategies can help address some common issues encountered in academic EM. Through recognition of the unique characteristics of each of the generations with respect to teaching and learning, mentoring, and technology, academicians have the opportunity to strategically optimize interactions with one another. PMID:21314779

  20. Where We Fall Down: Tensions in Teaching Social Medicine and Global Health.

    Science.gov (United States)

    Finnegan, Amy; Morse, Michelle; Nadas, Marisa; Westerhaus, Michael

    As global health interest has risen, so too has the relevance of education on the social determinants of health and health equity. Social medicine offers a particularly salient framework for educating on the social determinants of health, health disparities, and health equity. SocMed and EqualHealth, 2 unique but related organizations, offer annual global health courses in Uganda, Haiti, and the United States, which train students to understand and respond to the social determinants of health through praxis, self-reflection and self-awareness, and building collaborative partnerships across difference. The aim of this paper is to describe an innovative pedagogical approach to teaching social medicine and global health. We draw on the notion of praxis, which illuminates the value of iterative reflection and action, to critically examine our points of weakness as educators in order to derive lessons with broad applicability for those engaged in global health work. The data for this paper were collected through an autoethnography of teaching 10 global health social medicine courses in Uganda and Haiti since 2010. It draws on revealing descriptions from participant observation, student feedback collected in anonymous course evaluations, and ongoing relationships with alumni. Critical analysis reveals 3 significant and complicated tensions raised by our courses. The first point of weakness pertains to issues of course ownership by North American outsiders. The second tension emerges from explicit acknowledgment of social and economic inequities among our students and faculty. Finally, there are ongoing challenges of sustaining positive momentum toward social change after transformative course experiences. Although successful in generating transformative learning experiences, these courses expose significant fracture points worth interrogating as educators, activists, and global health practitioners. Ultimately, we have identified a need for building equitable

  1. Blood transfusion safety: a new philosophy.

    Science.gov (United States)

    Franklin, I M

    2012-12-01

    Blood transfusion safety has had a chequered history, and there are current and future challenges. Internationally, there is no clear consensus for many aspects of the provision of safe blood, although pan-national legislation does provide a baseline framework in the European Union. Costs are rising, and new safety measures can appear expensive, especially when tested against some other medical interventions, such as cancer treatment and vaccination programmes. In this article, it is proposed that a comprehensive approach is taken to the issue of blood transfusion safety that considers all aspects of the process rather than considering only new measures. The need for an agreed level of safety for specified and unknown risks is also suggested. The importance of providing care and support for those inadvertently injured as a result of transfusion problems is also made. Given that the current blood safety decision process often uses a utilitarian principle for decision making--through the calculation of Quality Adjusted Life Years--an alternative philosophy is proposed. A social contract for blood safety, based on the principles of 'justice as fairness' developed by John Rawls, is recommended as a means of providing an agreed level of safety, containing costs and providing support for any adverse outcomes. © 2012 The Author. Transfusion Medicine © 2012 British Blood Transfusion Society.

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

    Science.gov (United States)

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

    2012-01-01

    It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE)--or the lack thereof--has on the judgement of these subjects. From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative impact. Therefore the teaching of GTE

  3. ATTITUDE AND PERCEPTION OF FACULTIES TOWARDS TEACHING EVIDENCE BASED MEDICINE TO PRE - CLINICAL & PARA - CLINICAL MEDICAL STUDENTS

    Directory of Open Access Journals (Sweden)

    Bhavita Patel

    2015-02-01

    Full Text Available NTRODUCTION: Evidence - based medicine (EBM is defined as the „conscientious, explicit, and judicious use of current best evidence‟. It i s an important tool for lifelong learning in medicine, and medical students can develop the skills necessary to understand and use EBM. The teaching of EBM in Sumandeep Vidyapeeth is as part of Evidence Based Education System (EBES. The university has imp lemented the 16 hours of teaching with project work on Evidence Based Medicine in 1st MBBS and 2nd MBBS curriculum in addition to MBBS syllabus. AIMS & OBJECTIVES: This study was planned to take feedback from all the faculties those who are involved in Evi dence based Medicine teaching to evaluate their attitude and perception towards this innovative teaching method and to recommend improvements. MATERIAL & METHODS: A Descriptive, self - structured , pilot pretested questionnaire based cross sectional study was conducted in the year 2013 - 2014 among 40 faculties from 7 Departments like Anatomy, Physiology, Biochemistry, Microbiology, Pharmacology, Pathology and Forensic Medicine teaching Evidence Base d Medicine to students at S.B.K.S MI & RC, Sumandeep Vidyapeeth. Data was expressed as percentage. RESULTS: The response rate for the study was 75%. Almost 87% of faculties agreed that teaching EBM is a welcoming development during pre and para clinical ye ars. About 80% faculties agreed that it will help them in future clinical learning. 87% faculties agreed that literature and research searching improves their day to day teaching. About 77% of faculties have attended workshop and training held in Universit y and 83% of faculties agreed that they are interested in more learning and improving skills necessary to incorporate Evidence based medicine into their discipline. Barriers included shortage of time and need for training in teaching EBM. CONCLUSION: Facul ties of this University teaching Pre - clinical and Para - clinical medical students recognized

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

    Science.gov (United States)

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

    2012-01-01

    Objectives: It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE) - or the lack thereof - has on the judgement of these subjects. Methods: From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). Results: 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Conclusion: Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative

  5. Realising the potential for an Olympic legacy; teaching medical students about sport and exercise medicine and exercise prescribing.

    Science.gov (United States)

    Jones, Paul R; Brooks, John H M; Wylie, Ann

    2013-11-01

    Physicians are increasingly being called upon to promote physical activity (PA) among patients. However, a paucity of exercise medicine teaching in the UK undergraduate medical curricula prevents students from acquiring the necessary knowledge and skills to do so. To address this issue, King's College London School of Medicine introduced an exercise medicine strand of teaching. This study evaluated the acceptability of exercise promotion behaviour change lectures and explored the knowledge and attitudes of the students who received it. Students were invited to complete a 6-item online questionnaire prior to and after exercise medicine lectures. The questionnaire assessed beliefs regarding the importance of PA in disease prevention and management, in addition to their confidence in advising patients on PA recommendations. A focus group (n=7) explored students' attitudes towards and knowledge of PA promotion and exercise prescribing. In total, 121 (15%) first-year and second-year MBBS students completed the questionnaire. Students' beliefs regarding the importance of PA in managing disease and their confidence in PA promotion among patients increased after the teaching (pexercise medicine teaching, strongly supportive of its continued inclusion in the curriculum and advocated its importance for patients and themselves as future doctors. Behaviour change teaching successfully improved students' knowledge of and confidence regarding PA promotion. These improvements are a step forward and may increase the rates and success of physician PA counselling in the future.

  6. [Transmission of parasites by blood transfusions and organ transplantation].

    Science.gov (United States)

    Burchard, G D

    1994-08-01

    The purpose of the present study consists in an updated review concerning the transmission of protozoa and worms by blood transfusion and organ transplantation. Prophylactic regimens and possible modifications will be discussed. The literature devoted to tropical medicine in recent years was screened and a search on Medline was performed. Relevant review articles were selected. Transfusion induced malaria and--especially in Latin America--transfusion associated Chagas' disease are the most important of these diseases. Prophylaxis of transfusion malaria is different in different countries, it is based primarily on donor selection and immunodiagnostic examinations. It is recommended that the German guidelines for prevention of transfusion malaria should be modified and that a donor selection should also take place concerning Chagas' disease.

  7. Intraoperative transfusion practices in Europe

    DEFF Research Database (Denmark)

    Meier, J; Filipescu, D; Kozek-Langenecker, S

    2016-01-01

    BACKGROUND: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (p......RBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. METHODS: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month...... period in 2013. RESULTS: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone...

  8. Teaching Psychology in Medicine: The Context, Methodologies and Doctor's Professional Identity.

    Science.gov (United States)

    Ouakinin, Silvia

    2016-12-30

    Teaching Psychology in medical curriculum has been the subject of numerous dissertations that focus on the relevance of this knowledge for doctors, at a general level. A non-systematic review of the relevant literature, particularly from the last decade, as well as national and international recommendations addressing the need for integration of behavioural and social sciences in medical training, was performed. The literature supports the existence of preconceptions and negative attitudes towards the role of psychology in medical education, demonstrated by research in various european and american universities. The socio-cultural context, the different methodologies and barriers experienced by teachers in medical education are listed and provide the matrix for a more comprehensive discussion of the development of the doctor's identity. Revisiting the experience of many years of teaching Medical Psychology, it is considered that the process of integration of this curricular area should occur horizontally and vertically throughout the course, stressing the need for the pedagogical training of teachers. Concepts that arise from personal reflection, adjusted to the reality of our education and the basic principles that guide it, are elaborated in order to integrate the teaching of Psychology in Medicine, emphasizing its importance and utility in the competencies and abilities of future doctors.

  9. Blood transfusion and resuscitation using penile corpora: an experimental study.

    Science.gov (United States)

    Abolyosr, Ahmad; Sayed, M A; Elanany, Fathy; Smeika, M A; Shaker, S E

    2005-10-01

    To test the feasibility of using the penile corpora cavernosa for blood transfusion and resuscitation purposes. Three male donkeys were used for autologous blood transfusion into the corpus cavernosum during three sessions with a 1-week interval between each. Two blood units (450 mL each) were transfused per session to each donkey. Moreover, three dogs were bled up until a state of shock was produced. The mean arterial blood pressure decreased to 60 mm Hg. The withdrawn blood (mean volume 396.3 mL) was transfused back into their corpora cavernosa under 150 mm Hg pressure. Different transfusion parameters were assessed. The Assiut faculty of medicine ethical committee approved the study before its initiation. For the donkey model, the mean time of blood collection was 12 minutes. The mean time needed to establish corporal access was 22 seconds. The mean time of blood transfusion was 14.2 minutes. The mean rate of blood transfusion was 31.7 mL/min. Mild penile elongation with or without mild penile tumescence was observed on four occasions. All penile shafts returned spontaneously to their pretransfusion state at a maximum of 5 minutes after cessation of blood transfusion. No extravasation, hematoma formation, or color changes occurred. Regarding the dog model, the mean rate of transfusion was 35.2 mL/min. All dogs were resuscitated at the end of the transfusion. The corpus cavernosum is a feasible, simple, rapid, and effective alternative route for blood transfusion and venous access. It can be resorted to whenever necessary. It is a reliable means for volume replacement and resuscitation in males.

  10. Why was this transfusion given? Identifying clinical indications for blood transfusion in health care data

    Directory of Open Access Journals (Sweden)

    van Hoeven LR

    2018-03-01

    Full Text Available Loan R van Hoeven,1,2 Aukje L Kreuger,3,4 Kit CB Roes,1 Peter F Kemper,2,4 Hendrik Koffijberg,5 Floris J Kranenburg,3,4,6 Jan MM Rondeel,7 Mart P Janssen1,2 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; 2Transfusion Technology Assessment Department, Sanquin Research, Amsterdam, the Netherlands; 3Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; 4Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands; 5Department of Health Technology & Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands; 6Department of Intensive Care, Leiden University Medical Center, Leiden, the Netherlands; 7Department of Clinical Chemistry, Isala, Zwolle, the Netherlands Background: To enhance the utility of transfusion data for research, ideally every transfusion should be linked to a primary clinical indication. In electronic patient records, many diagnostic and procedural codes are registered, but unfortunately, it is usually not specified which one is the reason for transfusion. Therefore, a method is needed to determine the most likely indication for transfusion in an automated way.Study design and methods: An algorithm to identify the most likely transfusion indication was developed and evaluated against a gold standard based on the review of medical records for 234 cases by 2 experts. In a second step, information on misclassification was used to fine-tune the initial algorithm. The adapted algorithm predicts, out of all data available, the most likely indication for transfusion using information on medical specialism, surgical procedures, and diagnosis and procedure dates relative to the transfusion date.Results: The adapted algorithm was able to predict 74.4% of indications in the sample correctly (extrapolated to the full data set 75.5%. A kappa

  11. Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching.

    Science.gov (United States)

    Balwan, Sandy; Fornari, Alice; DiMarzio, Paola; Verbsky, Jennifer; Pekmezaris, Renee; Stein, Joanna; Chaudhry, Saima

    2015-12-01

    Team-based learning (TBL) is used in undergraduate medical education to facilitate higher-order content learning, promote learner engagement and collaboration, and foster positive learner attitudes. There is a paucity of data on the use of TBL in graduate medical education. Our aim was to assess resident engagement, learning, and faculty/resident satisfaction with TBL in internal medicine residency ambulatory education. Survey and nominal group technique methodologies were used to assess learner engagement and faculty/resident satisfaction. We assessed medical learning using individual (IRAT) and group (GRAT) readiness assurance tests. Residents (N = 111) involved in TBL sessions reported contributing to group discussions and actively discussing the subject material with other residents. Faculty echoed similar responses, and residents and faculty reported a preference for future teaching sessions to be offered using the TBL pedagogy. The average GRAT score was significantly higher than the average IRAT score by 22%. Feedback from our nominal group technique rank ordered the following TBL strengths by both residents and faculty: (1) interactive format, (2) content of sessions, and (3) competitive nature of sessions. We successfully implemented TBL pedagogy in the internal medicine ambulatory residency curriculum, with learning focused on the care of patients in the ambulatory setting. TBL resulted in active resident engagement, facilitated group learning, and increased satisfaction by residents and faculty. To our knowledge this is the first study that implemented a TBL program in an internal medicine residency curriculum.

  12. Teaching evidence-based medicine using a problem-oriented approach.

    Science.gov (United States)

    Hosny, Somaya; Ghaly, Mona S

    2014-04-01

    Faculty of Medicine, Suez Canal University is adopting an innovative curriculum. Evidence-based medicine (EBM) has been integrated into problem based learning (PBL) sessions as a responsive innovative paradigm for the practice and teaching of clinical medicine. To integrate EBM in the problem based sessions of the sixth-year students, and to assess students' and tutor satisfaction with this change. EBM training was conducted for sixth-year students (196) including four theoretical, and eight practical sessions. Sixteen EBM educational scenarios (problems) were formulated, according to sixth-year curriculum. Each problem was discussed in two sessions through steps of EBM, namely: formulating PICO questions, searching for and appraising evidence, applying the evidence to the clinical scenario and analysing the practice. Students and tutors satisfaction were evaluated using a 3-point ratings questionnaire. The majority of students and faculty expressed their satisfaction about integrating EBM with PBL and agreed that the problems were more stimulating. However, 33.6% of students indicated that available time was insufficient for searching literatures. Integrating EBM into PBL sessions tends to be more interesting and stimulating than traditional PBL sessions for final year students and helps them to practice and implement EBM in clinical context.

  13. Adopting a blended learning approach to teaching evidence based medicine: a mixed methods study

    Science.gov (United States)

    2013-01-01

    Background Evidence Based Medicine (EBM) is a core unit delivered across many medical schools. Few studies have investigated the most effective method of teaching a course in EBM to medical students. The objective of this study was to identify whether a blended-learning approach to teaching EBM is more effective a didactic-based approach at increasing medical student competency in EBM. Methods A mixed-methods study was conducted consisting of a controlled trial and focus groups with second year graduate medical students. Students received the EBM course delivered using either a didactic approach (DID) to learning EBM or a blended-learning approach (BL). Student competency in EBM was assessed using the Berlin tool and a criterion-based assessment task, with student perceptions on the interventions assessed qualitatively. Results A total of 61 students (85.9%) participated in the study. Competency in EBM did not differ between the groups when assessed using the Berlin tool (p = 0.29). Students using the BL approach performed significantly better in one of the criterion-based assessment tasks (p = 0.01) and reported significantly higher self-perceived competence in critical appraisal skills. Qualitative analysis identified that students had a preference for the EBM course to be delivered using the BL approach. Conclusions Implementing a blended-learning approach to EBM teaching promotes greater student appreciation of EBM principles within the clinical setting. Integrating a variety of teaching modalities and approaches can increase student self-confidence and assist in bridging the gap between the theory and practice of EBM. PMID:24341502

  14. Adopting a blended learning approach to teaching evidence based medicine: a mixed methods study.

    Science.gov (United States)

    Ilic, Dragan; Hart, William; Fiddes, Patrick; Misso, Marie; Villanueva, Elmer

    2013-12-17

    Evidence Based Medicine (EBM) is a core unit delivered across many medical schools. Few studies have investigated the most effective method of teaching a course in EBM to medical students. The objective of this study was to identify whether a blended-learning approach to teaching EBM is more effective a didactic-based approach at increasing medical student competency in EBM. A mixed-methods study was conducted consisting of a controlled trial and focus groups with second year graduate medical students. Students received the EBM course delivered using either a didactic approach (DID) to learning EBM or a blended-learning approach (BL). Student competency in EBM was assessed using the Berlin tool and a criterion-based assessment task, with student perceptions on the interventions assessed qualitatively. A total of 61 students (85.9%) participated in the study. Competency in EBM did not differ between the groups when assessed using the Berlin tool (p = 0.29). Students using the BL approach performed significantly better in one of the criterion-based assessment tasks (p = 0.01) and reported significantly higher self-perceived competence in critical appraisal skills. Qualitative analysis identified that students had a preference for the EBM course to be delivered using the BL approach. Implementing a blended-learning approach to EBM teaching promotes greater student appreciation of EBM principles within the clinical setting. Integrating a variety of teaching modalities and approaches can increase student self-confidence and assist in bridging the gap between the theory and practice of EBM.

  15. Medicines

    Science.gov (United States)

    Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to ...

  16. Best practices for transfusion for patients with sickle cell disease

    OpenAIRE

    Ted Wun; Kathryn Hassell

    2010-01-01

    The beta-globin gene mutation in sickle cell anemia results in anemia and repeated bouts of vascular occlusion. The cumulative effect of these vasocclusive events is progressive damage to many organs including the kidneys, lungs, and brain. The transfusion of red blood cells (RBC) can ameliorate many of these complications, but can be associated with both acute and chronic complications, including iron overload. The objective of the Best Practices in Transfusion Medicine for Patients with S...

  17. Transfusão de plaquetas: do empirismo ao embasamento científico Platelet transfusion: from empiricism to scientific evidence

    Directory of Open Access Journals (Sweden)

    Aline A. Ferreira

    2010-01-01

    Full Text Available Despite major advances in Brazilian blood transfusion therapy with a growing number of scientific publications, an increased number of repeat donors and a decline in serological ineligibility, a lack of conformity in the application of pre-transfusion tests that may compromise transfusion safety is still observed at transfusion agencies in the fringes of the blood transfusion therapy system. Additionally, although high rates of platelet transfusion refractoriness and significant rates of alloimmunization have been demonstrated in the international literature, few Brazilian centers have been concerned with the study of platelet alloimmunization and even fewer centers have evaluated the efficacy of platelet concentrate transfusion. As more than one million Brazilians, including many repeat blood donors, are listed in the National Bone Marrow Donor Registry (Redome, why not grant transfusion therapy services access to the HLA typing of these blood and marrow donors after obtaining their consent? And why not make use of the Redome data to evaluate the HLA compatibility of donors for alloimmunized patients who are candidates for bone marrow transfusion and who have already been typed? These measures, together with the identification of ABO and HPA antigens, will permit a complete assessment of platelet immunology, will guarantee the transfusion safety of this blood component, and will put Brazil at the same level as the so-called developed countries in terms of transfusion medicine.

  18. Precautions and Adverse Reactions during Blood Transfusion

    Science.gov (United States)

    ... the Professional Version Blood Transfusion Overview of Blood Transfusion Blood Donation Process Blood Products Special Blood Donation Procedures ... CORTEF, SOLU-CORTEF Blood Transfusion Overview of Blood Transfusion Blood Donation Process Blood Products Special Blood Donation Procedures ...

  19. Teaching the Rational Use of Medicines to medical students: a qualitative research

    Directory of Open Access Journals (Sweden)

    Patrício Karina

    2012-07-01

    Full Text Available Abstract Background Prescribing is a complex and challenging task that must be part of a logical deductive process based on accurate and objective information and not an automated action, without critical thinking or a response to commercial pressure. The objectives of this study were 1 develop and implement a discipline based on the WHO’s Guide to Good Prescribing; 2 evaluate the course acceptance by students; 3 assess the impact that the Rational Use of Medicines (RUM knowledge had on the students habits of prescribing medication in the University Hospital. Methods In 2003, the RUM principal, based in the WHO's Guide to Good Prescribing, was included in the official curriculum of the Botucatu School of Medicine, Brazil, to be taught over a total of 24 hours to students in the 4th year. We analyzed the students' feedback forms about content and teaching methodology filled out immediately after the end of the discipline from 2003 to 2010. In 2010, the use of RUM by past students in their medical practice was assessed through a qualitative approach by a questionnaire with closed-ended rank scaling questions distributed at random and a single semistructured interview for content analysis. Results The discipline teaches future prescribers to use a logical deductive process, based on accurate and objective information, to adopt strict criteria (efficacy, safety, convenience and cost on selecting drugs and to write a complete prescription. At the end of it, most students considered the discipline very good due to the opportunity to reflect on different actions involved in the prescribing process and liked the teaching methodology. However, former students report that although they are aware of the RUM concepts they cannot regularly use this knowledge in their daily practice because they are not stimulated or even allowed to do so by neither older residents nor senior medical staff. Conclusions This discipline is useful to teach RUM to medical

  20. Teaching the Rational Use of Medicines to medical students: a qualitative research.

    Science.gov (United States)

    Patrício, Karina Pavão; Alves, Nycholas Adriano Borges; Arenales, Nadja Guazzi; Queluz, Thais Thomaz

    2012-07-19

    Prescribing is a complex and challenging task that must be part of a logical deductive process based on accurate and objective information and not an automated action, without critical thinking or a response to commercial pressure. The objectives of this study were 1) develop and implement a discipline based on the WHO's Guide to Good Prescribing; 2) evaluate the course acceptance by students; 3) assess the impact that the Rational Use of Medicines (RUM) knowledge had on the students habits of prescribing medication in the University Hospital. In 2003, the RUM principal, based in the WHO's Guide to Good Prescribing, was included in the official curriculum of the Botucatu School of Medicine, Brazil, to be taught over a total of 24 hours to students in the 4th year. We analyzed the students' feedback forms about content and teaching methodology filled out immediately after the end of the discipline from 2003 to 2010. In 2010, the use of RUM by past students in their medical practice was assessed through a qualitative approach by a questionnaire with closed-ended rank scaling questions distributed at random and a single semistructured interview for content analysis. The discipline teaches future prescribers to use a logical deductive process, based on accurate and objective information, to adopt strict criteria (efficacy, safety, convenience and cost) on selecting drugs and to write a complete prescription. At the end of it, most students considered the discipline very good due to the opportunity to reflect on different actions involved in the prescribing process and liked the teaching methodology. However, former students report that although they are aware of the RUM concepts they cannot regularly use this knowledge in their daily practice because they are not stimulated or even allowed to do so by neither older residents nor senior medical staff. This discipline is useful to teach RUM to medical students who become aware of the importance of this subject, but the

  1. The teacher-disciple tradition and secret teaching in Chinese medicine.

    Science.gov (United States)

    Solos, Ioannis; Liang, Yuan; Yue, Guang-xin

    2014-01-01

    The ancient teacher-disciple tradition is regarded as one of the most celebrated practices within the Chinese medicine world. Such traditions of secrecy, private wisdom and honor are deeply rooted in the theories of Confucianism. This paper only explores the surface of this ancient culture, by investigating relevant popular ancient texts and common Chinese proverbs, as well as utilizing personal experiences, in order to reflect on how the ancient Chinese perceived such practices within their own society and how secret teaching was passed on from teacher to student, including the revelation of secret formulas and their importance and how that tradition differs from our modern-day perspectives. Various rare manuscripts from the author's personal library are employed in order to provide relative examples of the importance of secret knowledge, and how these secrets applied in the traditional healing.

  2. Teaching writing of scientific abstracts in English: CLIL methodology in an integrated English and Medicine course

    Directory of Open Access Journals (Sweden)

    Philippa Mungra

    2010-10-01

    Full Text Available In the I Faculty at the University of Rome “La Sapienza” Medical School, one of the several methodology courses aims at developing approaches by physicians to patient queries. One such course comprises several disciplines: Pathology, Immunology, Medical Statistics, Internal Medicine and English, with the specific aim of furnishing students, all Italian speakers, with skills for searching and evaluating the medical literature for answers to patient queries regarding risks and effectiveness of therapy. This paper describes the integration of English into a Methodology Course and delineates how the language component uses a Content and Language Integrated Learning (CLIL approach to train students to write the highly specific genre of journal abstracts for medical experimental research articles. A corpus of student writing is presented and discussed with the aim of furnishing one didactic model for language teaching within the Italian Medical Curriculum.

  3. Teaching legal competencies through an individualized elective in medicine and law.

    Science.gov (United States)

    Kapp, Marshall B

    2016-10-14

    Medical education, including education intended to prepare future physicians to care to older individuals, should include development and implementation of competencies relating to a physician's ability to understand and interact with the legal environment and legal actors who will affect the practice of medicine. The wisdom of integrating legal knowledge into the medical curriculum has been documented, and literature discusses the content and methods of teaching medical students and residents about law and the legal system. This article describes one unique but replicable, pedagogical approach to preparing future physicians to thrive in their inevitably interprofessional careers as they fulfill the fiduciary responsibilities that lie at the heart of their therapeutic and advocacy relationships with older patients.

  4. [European Union and blood transfusion].

    Science.gov (United States)

    Rouger, P

    2003-06-01

    Blood transfusion is progressing, Europe is growing, European blood transfusion organisations are developing rapidly. The first step was the publication of a new directive (2002/98/CE). The directive is the result of a compromise between technocracy, lobbying and blood transfusion professionals. European blood transfusion must be based on medical, scientific and social criteria. Two imperatives must be considered: the respect of ethics and; independence from the commercial system. The primary objective is to give satisfaction to patients while respecting blood donors.

  5. Brand Name Statin Prescribing in a Resident Ambulatory Practice: Implications for Teaching Cost-Conscious Medicine.

    Science.gov (United States)

    Ryskina, Kira L; Pesko, Michael F; Gossey, J Travis; Caesar, Erica Phillips; Bishop, Tara F

    2014-09-01

    Several national initiatives aim to teach high-value care to residents. While there is a growing body of literature on cost impact of physicians' therapeutic decisions, few studies have assessed factors that influence residents' prescribing practices. We studied factors associated with intensive health care utilization among internal medicine residents, using brand name statin prescribing as a proxy for higher-cost care. We conducted a retrospective, cross-sectional analysis of statin prescriptions by residents at an urban academic internal medicine program, using electronic health record data between July 1, 2010, and June 30, 2011. For 319 encounters by 90 residents, patients were given a brand name statin in 50% of cases. When categorized into quintiles, the bottom quintile of residents prescribed brand name statins in 2% of encounters, while the top quintile prescribed brand name statins in 98% of encounters. After adjusting for potential confounders, including patient characteristics and supervising attending, being in the primary care track was associated with lower odds (odds ratio [OR], 0.38; P  =  .02; 95% confidence interval [CI], 0.16-0.86), and graduating from a medical school with an above-average hospital care intensity index was associated with higher odds of prescribing brand name statins (OR, 1.70; P  =  .049; 95% CI, 1.003-2.88). We found considerable variation in brand name statin prescribing by residents. Medical school attended and residency program type were associated with resident prescribing behavior. Future interventions should raise awareness of these patterns in an effort to teach high-value, cost-conscious care to all residents.

  6. Everyday ethics in internal medicine resident clinic: an opportunity to teach.

    Science.gov (United States)

    Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Catherine Beach, Mary; Hughes, Mark T

    2011-07-01

    Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor-resident interactions. This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor-Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor-System Interaction (financial issues; doctor-system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their

  7. 1980 Survey of Faculty Teaching in Departments of Medicinal/Pharmaceutical Chemistry at American Colleges of Pharmacy.

    Science.gov (United States)

    Matuszak, Alice Jean; Sarnoff, Darwin

    1981-01-01

    An American Association of Colleges of Pharmacy survey of medicinal/pharmaceutical chemistry faculty is reported. Data, including academic and experience backgrounds of faculty and their teaching load, are presented. Differences in training are noted in comparing the average chemistry professor to the average assistant professor. (Author/MLW)

  8. Development and evaluation of a new occupational medicine teaching module to advance self-efficacy and knowledge among medical students

    NARCIS (Netherlands)

    Braeckman, Lutgart; de Clercq, Bart; Janssens, Heidi; Gehanno, Jean-François; Bulat, Petar; Pauncu, Elena-Ana; Smits, Paul; van Dijk, Frank; Vanderlinde, Ruben; Valcke, Martin

    2013-01-01

    Self-efficacy is defined as a person's beliefs in his or her abilities to successfully complete a task, and has been shown to influence student motivation and academic achievement. The purpose of this study was to evaluate the impact of a new European teaching module in occupational medicine on

  9. Teaching with research: a strategy for students of postgraduation in medicine.

    Science.gov (United States)

    Rodrigues, Maria das Graças Villela; Gonçalves, Manuel Domingos da Cruz

    2013-01-01

    Promoting a scientific activity of research to students of a graduation program as a reflexive tool of teacher and formative practice of necessary activities to construction of a research in medical education. Graduation students of surgery at UFRJ did a research, randomly interviewing a population of medical teachers who acts at Medicine Universities of Rio de Janeiro. The study was structured in three steps: definition of the investigative content; realization of 150 interviews before field research and discussion about the results. The majority of interviewees (85%) assert to know the recent trends of education, but when they express their thoughts they leave doubts about the real knowledge of the subject. The expositive classes were used by 90% of the interviewees; only 10% of them utilized strategies of teaching to transmit the contents. Just 52% of the doctors said that they had already heard about the Resolution CNE/CES N° 4/2001. The teaching with research challenged the students as investigators preparing them to the research and construction of the necessary scientific attitudes in the graduation and assisting them in solving the investigated problem. The results highlighted that the found peaces of information in the research were not accurate to feature a real dimension of the update, showing that it is recommended new studies.

  10. Massive transfusion protocols: current best practice

    Directory of Open Access Journals (Sweden)

    Hsu YM

    2016-03-01

    Full Text Available Yen-Michael S Hsu,1 Thorsten Haas,2 Melissa M Cushing1 1Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland Abstract: Massive transfusion protocols (MTPs are established to provide rapid blood replacement in a setting of severe hemorrhage. Early optimal blood transfusion is essential to sustain organ perfusion and oxygenation. There are many variables to consider when establishing an MTP, and studies have prospectively evaluated different scenarios and patient populations to establish the best practices to attain improved patient outcomes. The establishment and utilization of an optimal MTP is challenging given the ever-changing patient status during resuscitation efforts. Much of the MTP literature comes from the trauma population, due to the fact that massive hemorrhage is the leading cause of preventable trauma-related death. As we come to further understand the positive and negative clinical impacts of transfusion-related factors, massive transfusion practice can be further refined. This article will first discuss specific MTPs targeting different patient populations and current relevant international guidelines. Then, we will examine a wide selection of therapeutic products to support MTPs, including newly available products and the most suitable of the traditional products. Lastly, we will discuss the best design for an MTP, including ratio-based MTPs and MTPs based on the use of point-of-care coagulation diagnostic tools. Keywords: hemorrhage, MTP, antifibrinolytics, coagulopathy, trauma, ratio, logistics, guidelines, hemostatic

  11. Update on massive transfusion.

    Science.gov (United States)

    Pham, H P; Shaz, B H

    2013-12-01

    Massive haemorrhage requires massive transfusion (MT) to maintain adequate circulation and haemostasis. For optimal management of massively bleeding patients, regardless of aetiology (trauma, obstetrical, surgical), effective preparation and communication between transfusion and other laboratory services and clinical teams are essential. A well-defined MT protocol is a valuable tool to delineate how blood products are ordered, prepared, and delivered; determine laboratory algorithms to use as transfusion guidelines; and outline duties and facilitate communication between involved personnel. In MT patients, it is crucial to practice damage control resuscitation and to administer blood products early in the resuscitation. Trauma patients are often admitted with early trauma-induced coagulopathy (ETIC), which is associated with mortality; the aetiology of ETIC is likely multifactorial. Current data support that trauma patients treated with higher ratios of plasma and platelet to red blood cell transfusions have improved outcomes, but further clinical investigation is needed. Additionally, tranexamic acid has been shown to decrease the mortality in trauma patients requiring MT. Greater use of cryoprecipitate or fibrinogen concentrate might be beneficial in MT patients from obstetrical causes. The risks and benefits for other therapies (prothrombin complex concentrate, recombinant activated factor VII, or whole blood) are not clearly defined in MT patients. Throughout the resuscitation, the patient should be closely monitored and both metabolic and coagulation abnormalities corrected. Further studies are needed to clarify the optimal ratios of blood products, treatment based on underlying clinical disorder, use of alternative therapies, and integration of laboratory testing results in the management of massively bleeding patients.

  12. in blood transfusion

    African Journals Online (AJOL)

    gestion de la transfusion des patients se traduit par une diminution spectaculaire de .... lABoRAToRy pERFoRMANCE ChECKs ... CoNTRôlEs DE pERFoRMANCE DE ...... mesure de fournir des packs ayant un faible volume de sang et une.

  13. Neonatal transfusion practices

    NARCIS (Netherlands)

    Lindern, Jeannette Susanne von

    2011-01-01

    Red blood cells (RBCs) are probably the most frequently used drug given to very preterm infants; more than 90% of infants with a birth weight <1000 grams receive one or more RBC transfusions. Except for reduction of the amount of blood drawn for laboratory tests and use of a single donor program, no

  14. Preventing blood transfusion failures: FMEA, an effective assessment method.

    Science.gov (United States)

    Najafpour, Zhila; Hasoumi, Mojtaba; Behzadi, Faranak; Mohamadi, Efat; Jafary, Mohamadreza; Saeedi, Morteza

    2017-06-30

    Failure Mode and Effect Analysis (FMEA) is a method used to assess the risk of failures and harms to patients during the medical process and to identify the associated clinical issues. The aim of this study was to conduct an assessment of blood transfusion process in a teaching general hospital, using FMEA as the method. A structured FMEA was recruited in our study performed in 2014, and corrective actions were implemented and re-evaluated after 6 months. Sixteen 2-h sessions were held to perform FMEA in the blood transfusion process, including five steps: establishing the context, selecting team members, analysis of the processes, hazard analysis, and developing a risk reduction protocol for blood transfusion. Failure modes with the highest risk priority numbers (RPNs) were identified. The overall RPN scores ranged from 5 to 100 among which, four failure modes were associated with RPNs over 75. The data analysis indicated that failures with the highest RPNs were: labelling (RPN: 100), transfusion of blood or the component (RPN: 100), patient identification (RPN: 80) and sampling (RPN: 75). The results demonstrated that mis-transfusion of blood or blood component is the most important error, which can lead to serious morbidity or mortality. Provision of training to the personnel on blood transfusion, knowledge raising on hazards and appropriate preventative measures, as well as developing standard safety guidelines are essential, and must be implemented during all steps of blood and blood component transfusion.

  15. Restrictive versus liberal transfusion strategy for red blood cell transfusion

    DEFF Research Database (Denmark)

    Holst, Lars B; Petersen, Marie W; Haase, Nicolai

    2015-01-01

    OBJECTIVE: To compare the benefit and harm of restrictive versus liberal transfusion strategies to guide red blood cell transfusions. DESIGN: Systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. DATA SOURCES: Cochrane central register of controlled...... differences with 95% confidence intervals. RESULTS: 31 trials totalling 9813 randomised patients were included. The proportion of patients receiving red blood cells (relative risk 0.54, 95% confidence interval 0.47 to 0.63, 8923 patients, 24 trials) and the number of red blood cell units transfused (mean...... were associated with a reduction in the number of red blood cell units transfused and number of patients being transfused, but mortality, overall morbidity, and myocardial infarction seemed to be unaltered. Restrictive transfusion strategies are safe in most clinical settings. Liberal transfusion...

  16. Using television shows to teach communication skills in internal medicine residency.

    Science.gov (United States)

    Wong, Roger Y; Saber, Sadra S; Ma, Irene; Roberts, J Mark

    2009-02-03

    To address evidence-based effective communication skills in the formal academic half day curriculum of our core internal medicine residency program, we designed and delivered an interactive session using excerpts taken from medically-themed television shows. We selected two excerpts from the television show House, and one from Gray's Anatomy and featured them in conjunction with a brief didactic presentation of the Kalamazoo consensus statement on doctor-patient communication. To assess the efficacy of this approach a set of standardized questions were given to our residents once at the beginning and once at the completion of the session. Our residents indicated that their understanding of an evidence-based model of effective communication such as the Kalamazoo model, and their comfort levels in applying such model in clinical practice increased significantly. Furthermore, residents' understanding levels of the seven essential competencies listed in the Kalamazoo model also improved significantly. Finally, the residents reported that their comfort levels in three challenging clinical scenarios presented to them improved significantly. We used popular television shows to teach residents in our core internal medicine residency program about effective communication skills with a focus on the Kalamazoo's model. The results of the subjective assessment of this approach indicated that it was successful in accomplishing our objectives.

  17. Using television shows to teach communication skills in internal medicine residency

    Directory of Open Access Journals (Sweden)

    Ma Irene

    2009-02-01

    Full Text Available Abstract Background To address evidence-based effective communication skills in the formal academic half day curriculum of our core internal medicine residency program, we designed and delivered an interactive session using excerpts taken from medically-themed television shows. Methods We selected two excerpts from the television show House, and one from Gray's Anatomy and featured them in conjunction with a brief didactic presentation of the Kalamazoo consensus statement on doctor-patient communication. To assess the efficacy of this approach a set of standardized questions were given to our residents once at the beginning and once at the completion of the session. Results Our residents indicated that their understanding of an evidence-based model of effective communication such as the Kalamazoo model, and their comfort levels in applying such model in clinical practice increased significantly. Furthermore, residents' understanding levels of the seven essential competencies listed in the Kalamazoo model also improved significantly. Finally, the residents reported that their comfort levels in three challenging clinical scenarios presented to them improved significantly. Conclusion We used popular television shows to teach residents in our core internal medicine residency program about effective communication skills with a focus on the Kalamazoo's model. The results of the subjective assessment of this approach indicated that it was successful in accomplishing our objectives.

  18. RELM: developing a serious game to teach evidence-based medicine in an academic health sciences setting.

    Science.gov (United States)

    Gleason, Ann Whitney

    2015-01-01

    Gaming as a means of delivering online education continues to gain in popularity. Online games provide an engaging and enjoyable way of learning. Gaming is especially appropriate for case-based teaching, and provides a conducive environment for adult independent learning. With funding from the National Network of Libraries of Medicine, Pacific Northwest Region (NN/LM PNR), the University of Washington (UW) Health Sciences Library, and the UW School of Medicine are collaborating to create an interactive, self-paced online game that teaches players to employ the steps in practicing evidence-based medicine. The game encourages life-long learning and literacy skills and could be used for providing continuing medical education.

  19. Incidence of transfusion reactions: a multi-center study utilizing systematic active surveillance and expert adjudication

    Science.gov (United States)

    Hendrickson, Jeanne E.; Roubinian, Nareg H.; Chowdhury, Dhuly; Brambilla, Don; Murphy, Edward L.; Wu, Yanyun; Ness, Paul M.; Gehrie, Eric A.; Snyder, Edward L.; Hauser, R. George; Gottschall, Jerome L.; Kleinman, Steve; Kakaiya, Ram; Strauss, Ronald G.

    2017-01-01

    Background Prevalence estimates of serious hazards of transfusion vary widely. We hypothesized that the current reporting infrastructure in the United States fails to capture many transfusion reactions, and undertook a multi-center study utilizing active surveillance, data review, and adjudication to test this hypothesis. Study Design and Methods A retrospective record review was completed for a random sample of 17% of all inpatient transfusion episodes over 6 months at 4 academic tertiary care hospitals, with an episode defined as all blood products released to a patient in 6 hours. Data were recorded by trained clinical research nurses, and serious reactions were adjudicated by a panel of transfusion medicine experts. Results Of 4857 transfusion episodes investigated, 1.1% were associated with a serious reaction. Transfusion associated circulatory overload (TACO) was the most frequent serious reaction noted, being identified in 1% of transfusion episodes. Despite clinical notes describing a potential transfusion association in 59% of these cases, only 5.1% were reported to the transfusion service. Suspected transfusion related acute lung injury (TRALI/possible TRALI), anaphylactic, and hypotensive reactions were noted in 0.08%, 0.02%, and 0.02% of transfusion episodes. Minor reactions, including febrile non-hemolytic and allergic, were noted in 0.62% and 0.29% of transfusion episodes, with 30–50% reported to the transfusion service. Conclusion Underreporting of cardiopulmonary transfusion reactions is striking among academic, tertiary care hospitals. Complete and accurate reporting is essential to identify, define, establish pathogenesis, and mitigate/treat transfusion reactions. A better understanding of the failure to report may improve the accuracy of passive reporting systems. PMID:27460200

  20. Blood transfusion practice in Belgium. As assessed by a national survey.

    Science.gov (United States)

    Beguin, C; Lambermont, M; Dupont, E; Vandermeersch, E; France, F H; Waterloos, H; Baele, P

    1998-01-01

    In April 1995 the Ministry of Public Health invited all Belgian hospitals to participate to a survey on the use of blood transfusion. The questionnaire presented two parts, the first one devoted to products transfused and the second one to the transfusion organisation in the hospital. 71 hospitals answered: 7 university and 64 general hospitals. All hospitals reported the use of red cells, 31 of them still used whole blood. Surgical departments transfused the greatest absolute amount of units, but the highest intensity (units/bed/year) was observed in intensive care units. 52 hospitals mentioned the use of autologous predeposit. The highest consumption of platelets occurred in medicine but intensive care showed the highest intensity of platelet transfusion. In 41 hospitals platelets were obtained by cytapheresis. The number of plasma units transfused was highly correlated with the quantities of packed red cells and whole blood transfused. Ten hospitals didn't report the use of any blood conservation technique. Returning unused units to the blood bank was allowed in 80% of the hospitals, their return to the transfusion center was permitted in 65% of the hospitals. A transfusion committee existed in only 11 hospitals. Transfusion should be improved by a better education of all physicians and nurses involved with transfusion and by improving standardisation, by better documentation, better reporting and information of all health care workers involved.

  1. Best practices for transfusion for patients with sickle cell disease

    Science.gov (United States)

    Wun, Ted; Hassell, Kathryn

    2010-01-01

    The β-globin gene mutation in sickle cell anemia results in anemia and repeated bouts of vascular occlusion. The cumulative effect of these vasocclusive events is progressive damage to many organs including the kidneys, lungs, and brain. The transfusion of red blood cells (RBC) can ameliorate many of these complications, but can be associated with both acute and chronic complications, including iron overload. The objective of the Best Practices in Transfusion Medicine for Patients with Sickle Cell Disease (SCD) Conference was to review the available published evidence and clinical experience surrounding the use of RBC transfusions for sickle cell disease by a panel of experts. The expert panel developed explicit clinical guidelines for the use of RBC in SCD patients. The panel also made recommendations for further research. A set of guidelines were produced for dissemination to pertinent stakeholders. If implemented, these clinical pathways have the potential to optimize the use of red blood cell transfusions in SCD.

  2. Are Self-study Procedural Teaching Methods Effective? A Pilot Study of a Family Medicine Residency Program.

    Science.gov (United States)

    Deffenbacher, Brandy; Langner, Shannon; Khodaee, Morteza

    2017-11-01

    A family medicine residency is a unique training environment where residents are exposed to care in multiple settings, across all ages. Procedures are an integral part of family medicine practice. Family medicine residency (FMR) programs are tasked with the job of teaching these skills at a level of intensity and frequency that allows a resident to achieve competency of such skills. In an environment that is limited by work hour restrictions, self-study teaching methods are one way to ensure all residents receive the fundamental knowledge of how to perform procedures. We developed and evaluated the efficacy of a self-study procedure teaching method and procedure evaluation checklist. A self-study procedure teaching intervention was created, consisting of instructional articles and videos on three procedures. To assess the efficacy of the intervention, and the competency of the residents, pre- and postintervention procedure performance sessions were completed. These sessions were reviewed and scored using a standardized procedure performance checklist. All 24 residents participated in the study. Overall, the resident procedure knowledge increased on two of the three procedures studied, and ability to perform procedure according to expert-validated checklist improved significantly on all procedures. A self-study intervention is a simple but effective way to increase and improve procedure training in a way that fits the complex scheduling needs of a residency training program. In addition, this study demonstrates that the procedure performance checklists are a simple and reliable way to increase assessment of resident procedure performance skills in a residency setting.

  3. Experiences with the implementation of a national teaching qualification in university medical centres and veterinary medicine in the Netherlands.

    Science.gov (United States)

    Molenaar, Willemina M Ineke; Zanting, Anneke

    2015-02-01

    In 2008, a compulsory national basic teaching qualification was introduced for all university teachers in the Netherlands. At that time all eight University Medical Centres (UMCs) and the only Faculty of Veterinary Medicine had adopted or were setting up teacher development programmes. This study explores how these programmes relate to each other and to the basic teaching qualification. To gather information on teacher development programmes in the UMCs and the Veterinary Medicine Faculty an online survey was filled out by teacher development representatives from each of them. The programmes had main features in common (e.g. competency based and portfolio assessment), but differed somewhat in contents according to the local situation. Importantly, they had all been formally accepted as equivalent to the basic teaching qualification. We consider the freedom to tailor the qualifications to the medical context as well as to the local situation of the UMCs and the Veterinary Medicine Faculty one of the major success factors and the well-established collaboration between teacher development representatives of the UMCs and the Faculty of Veterinary Medicine as another. Challenges for the future include embedding the teacher development programmes in the institutional organizations and maintaining and further developing the programmes and the competencies of the qualified teachers, e.g. in a senior qualification.

  4. [Prospects in blood transfusion].

    Science.gov (United States)

    Rouger, P

    2003-04-01

    What will be the evolution of blood transfusion in the next 10 years? What are the scientific and medical arguments to help the decision makers to propose the developments? Many scientific and clinical studies show that blood substitutes are not ready for use in man. So, for a long time, blood collection in man will still be a necessity to prepare cell concentrates (red blood cells and platelets) and fresh frozen plasma. During this period, blood safety will be based on development of testing technics and preparation processes of blood products. Another major point will be a better clinical use of blood derivates. Cellular therapy will be probably only a way of diversification in blood transfusion centers in partnership with hospitals.

  5. The Cinema in the Teaching of Medicine: Palliative Care and Bioethics

    Directory of Open Access Journals (Sweden)

    Wilson Astudillo Mendinueta

    2008-10-01

    Full Text Available   The cinema, as a window on human life and its ups and downs, is a very valuable tool for studying those situations that are most transcendental for the human being: pain, disease and death. Its idiosyncrasy and characteristics (ludic nature, sensorial and emotional impact, etc. endow it with “formative skills” in many insurmountable situations, provided that it is backed up by a rigorous definition of objectives and a logical, coherent and structured educational design.             In this sense, the range of films that are useful in medical education is very wide, so wide that it is difficult not only to make a compilation of titles and plots but also fundamentally to make a selection of those that tackle disease from perspectives that are interesting for teaching. In this article emphasis is given to two fundamental aspects in current Medicine, with multiple areas of contact and intersections: terminal diseases –and patients- and bioethics. In the first case an analysis is made of films full of human and scientific elements that make them highly attractive teaching instruments for the broad and deep study of different terminal diseases as well as for the analysis of their individual and collective impact: The Doctor, Wit, Ikiru, Begin the Beguine/ Volver a empezar, The Barbarian Invasions/ Les invasions Barbares, Marvin’s Room, Patch Adams or The 4th Floor/ Planta 4 a.             The second theme tackled, bioethics, is essential in medical practice and possibly has greater specific weight in the field of palliative care. As an element facilitating decision-making, it is underlying in such burning issues as euthanasia, aided suicide, doctor’s responsibility, etc., magnificently reflected in films such as Miss Evers’ Boys, Philadelphia, The Fugitive, The Constant Gardener, Million Dollar Baby or The Sea Within/ Mar Adentro.

  6. EFFECTIVENESS OF ACTIVE TEACHING METHODS FOR THE RESIDENTS OF PHYSICAL MEDICINE AND REHABILITATION

    OpenAIRE

    Mohan Raj Manjalavil; Reeba Mary Mani; Shehadad Kammili; Sreejith Kalathummarthu; Hemalta Viswan; Sooraj Rajagopal; Shervin Sheriff; Sreedevi Menon Parappil

    2017-01-01

    BACKGROUND Lecture is the most common teaching aid not only for medical undergraduates, but also specialty residents. There are many disadvantages for this type of teaching. Active teaching methods include didactic lectures followed by interactive sessions, problem-based teaching and hands on demonstration apart from the traditional didactic lecture. The aim of this project was to compare the effectiveness of active teaching method over the didactic lecture to the first year re...

  7. [The business game as a form of organization of competent approach in teaching of history of medicine].

    Science.gov (United States)

    Konopleva, E L; Ostapenko, V M

    2015-01-01

    The article considers issue of implementation of competent approach in teaching of course of history of medicine in medical universities. The such methods of active training as imitation role business games are proposed as a mean of developing common cultural and professional competences offuture medical personnel. The business games promote development of motivation basis or education and require activities related to practical implementation of acquired knowledge and skills (analysis of historical event, work with map, reading of historical documents, participation in scientific discussion, etc.). As a result, students acquire sufficiently large notion concerning world of medicine, relationship of historical epochs and occurrences and unity of medical systems.

  8. [Alternatives to allogenous blood transfusion].

    Science.gov (United States)

    Cernea, Daniela; Vlădoianu, Alice; Stoica, Maria; Novac, M; Berteanu, Cristina

    2009-01-01

    Blood transfusion is usually meant to lower morbidity and mortality rates. Allogenous blood transfusion implies certain risks that can be avoided by autologous blood transfusions techniques including: preoperatory autologous blood donation, acute normovolemic hemodilution, intraoperatory and postoperatory blood salvage. Preoperatory blood donation and acute normovolemic hemodilution are used for planned interventions with an estimated blood loss higher than 20% of blood volume. These methods imply Erythropoietin and iron treatment. Intraoperatory and postoperatory blood salvage is performed by personnel trained in blood donation, handling and storage. Autologous blood transfusions are used for certain surgical procedures that commonly require transfusions: orthopedic surgery, radical prostatectomy, cardiovascular surgery, organ transplantation. An alternative to allogenous blood transfusion is the use of artificial oxygen transporters: human or animal hemoglobin solutions or pefluorocarbonate solutions. These solutions do not require cross reactions, do not carry diseases and are generally well tolerated and easily stored in the operating room, ambulance and other transport means. They have however a slight degree of toxicity.

  9. Commentary: Teaching creativity and innovative thinking in medicine and the health sciences.

    Science.gov (United States)

    Ness, Roberta B

    2011-10-01

    The National Academies of Science recently criticized the state of scientific innovation and competitiveness in the United States. Evaluations of already-established creativity training programs--examining a broad array of students, from school age to adult and with a wide range of abilities--have shown that such courses improve thinking skills, attitudes, and performance. Although academic medicine provides informal training in creativity and innovation, it has yet to incorporate formal instruction on these topics into medical education. A number of existing, thoughtfully constructed and evaluated creativity programs in other fields provide a pedagogical basis for developing creativity training programs for the health sciences. The content of creativity training programs typically includes instruction and application in (1) divergent thinking, (2) problem solving, and (3) creative production. Instructional formats that have been shown to elicit the best outcomes are an admixture of lectures, discussion, and guided practice. A pilot program to teach innovative thinking to health science students at the University of Texas includes instruction in recognizing and finding alternatives to frames or habitual cognitive patterns, in addition to the constructs already mentioned. As innovation is the engine of scientific progress, the author, founder of Innovative Thinking, the creativity training pilot program at the University of Texas, argues in this commentary that academic health centers should implement and evaluate new methods for enhancing science students' innovative thinking to keep the United States as a worldwide leader in scientific discovery.

  10. Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq

    Directory of Open Access Journals (Sweden)

    Al-Taee Waleed G

    2005-08-01

    Full Text Available Abstract Background The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. Methods An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students was exposed to the experimental model and the control group (56 students received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999–2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. Results The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. Conclusion A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established.

  11. Information technology - a tool for development of the teaching process at the faculty of medicine, university of sarajevo.

    Science.gov (United States)

    Masic, Izet; Begic, Edin

    2015-04-01

    Information Technologies, taking slow steps, have found its application in the teaching process of Faculty of Medicine, University of Sarajevo. Online availability of the teaching content is mainly intended for users of the Bologna process. The aim was to present the level of use of information technologies at the Faculty of Medicine, University of Sarajevo, comparing two systems, old system and the Bologna process, and to present new ways of improving the teaching process, using information technology. The study included the period from 2012 to 2014, and included 365 students from the old system and the Bologna Process. Study had prospective character. Students of the old system are older than students of the Bologna process. In both systems higher number of female students is significantly present. All students have their own computers, usually using the Office software package and web browsers. Visits of social networks were the most common reason for which they used computers. On question if they know to work with databases, 14.6% of students of the old system responded positively and 26.2% of students of the Bologna process answered the same. Students feel that working with databases is necessary to work in primary health care. On the question of the degree of computerization at the university, there were significant differences between the two systems (p process were more interested in the introduction of information technology, than students of old system. 68.7% of students of the Bologna process of generation 2013-2014, and 71.3% of generation 2014-2015, believed that the subject of Medical Informatics, the same or similar name, should be included in the new reform teaching process of the Faculty of Medicine, University of Sarajevo. Information technologies can help the development of the teaching process, and represent attractive and accessible tool in the process of modernization and progress.

  12. Reducing risks of Transfusion-transmitted infections in a resource-limited hospital-based blood bank: the case of the Yaoundé University Teaching Hospital, Cameroon

    Science.gov (United States)

    Tagny, C. T.; Ndoumba, A.; Laperche, S.; Murphy, E.; Mbanya, D.

    2016-01-01

    Background and Objectives Although interest in assessing risk of TTIs, very few trends in blood safety epidemiological data from resource-limited blood services are reported in the literature. This analysis aims at reporting trends in seroprevalences of TTIs in blood donations in the Yaoundé University Teaching Hospital (UTH) from 2011 to 2015 and to describe reasons for these changes. Materials and Methods All donations of 2015 were tested for HIV 1&2 antibodies and the P24 antigen, HBsAg, HCV antibody and the Treponema pallidum antibody. Screening for HIV uses a national algorithm based on the systematic use of two assays of different principles: a rapid determination testing assay and an EIA HIV 1 & 2 Ab-Ag. The tests used for HBsAg and HCVAb screening were all based on EIA techniques. Treponema pallidum antibody screening was based on Treponema Pallidum hemagglutination assay (TPHA) and rapid immunochromatographic test (RIT). Screening techniques and results from 2015 were compared to retrospective data from 2011, 2012, 2013 and 2014. Results In 2015, 13·4% (n = 214) of 1,596 blood donations were seropositive for at least one screened TTIs. The most frequent serological marker was HBsAg with 123 (7·7%) blood units contaminated. Nineteen (1·2%) and 18 (1·1%) blood units was positive for HIV and syphilis, respectively. There was a significant decrease in the total number of blood donations (P < 10−4) and HIV, HBsAg and syphilis seroprevalences and an increase in the proportion of voluntary non-remunerated blood donor (P < 0·05). HCVAb seroprevalence was 3·8% in 2015 and has not decreased significantly over the years (P = 0·09). Conclusion Significant progress is noted in reduction in seroprevalences of HIV, HBV, HCV and syphilis since the beginning of a regular registration of data in 1990. PMID:28484511

  13. Carbohydrate clearance receptors in transfusion medicine

    DEFF Research Database (Denmark)

    Sørensen, Anne Louise Tølbøll; Clausen, Henrik; Wandall, Hans H

    2012-01-01

    Complex carbohydrates play important functions for circulation of proteins and cells. They provide protective shields and refraction from non-specific interactions with negative charges from sialic acids to enhance circulatory half-life. For recombinant protein therapeutics carbohydrates are espe...

  14. Evaluation of a visual risk communication tool: effects on knowledge and perception of blood transfusion risk.

    Science.gov (United States)

    Lee, D H; Mehta, M D

    2003-06-01

    Effective risk communication in transfusion medicine is important for health-care consumers, but understanding the numerical magnitude of risks can be difficult. The objective of this study was to determine the effect of a visual risk communication tool on the knowledge and perception of transfusion risk. Laypeople were randomly assigned to receive transfusion risk information with either a written or a visual presentation format for communicating and comparing the probabilities of transfusion risks relative to other hazards. Knowledge of transfusion risk was ascertained with a multiple-choice quiz and risk perception was ascertained by psychometric scaling and principal components analysis. Two-hundred subjects were recruited and randomly assigned. Risk communication with both written and visual presentation formats increased knowledge of transfusion risk and decreased the perceived dread and severity of transfusion risk. Neither format changed the perceived knowledge and control of transfusion risk, nor the perceived benefit of transfusion. No differences in knowledge or risk perception outcomes were detected between the groups randomly assigned to written or visual presentation formats. Risk communication that incorporates risk comparisons in either written or visual presentation formats can improve knowledge and reduce the perception of transfusion risk in laypeople.

  15. [Positive Distribution Rate of Coombs Test in Patients with Clinical Anemia and Blood Transfusion and Its Effect on Clinical Blood Transfusion].

    Science.gov (United States)

    Wu, Gang; Duan, Yu-Han

    2018-02-01

    To study the positive distribution rate of Coombs test in patients with clinical anemia and blood transfusion, and its effect on clinical blood transfusion. Seventy patients with hemoglobin level in the normal range were enrolled into control group, while 130 patients with anemia or blood transfusion who' s hemoglobin level was lower comfirmed by micro-column gel antihuman globin detection card and 70 surgical patients with anemia or blood transfusion who' s hemoglobin level was lower comfirmed by micro-column gel anti-human globin card were enrolled into anemia or blood transfusion (A or BT) group. And coomb' s test performed for all the patients, in which the positive patients in Department of Internal Medicine need to be re-typed. Among 70 surgical patients with anemia or blood transfusion, 14 cases were directly detected to be anti-human globine positive with detection rate 20%; among 130 internal medicine patients with anemia or blood transfusion, 54 cases were directly detected to be anti-human globine positive with detection rate 41.4%. Among 270 cases, the highest positive rate (66.7%) was observed in patients with 50-59 g/L of hemoglobin. According to type test, the samples of 54 patients with anemia in Department of Internal Medicine, who were directly selected to be anti-human globin positive, could be divided into anti-C3d(7 cases, accounting for 13.0%), anti-IgG(12 cases accounting for, 22.2%) and anti-C3d+anti-IgG(35 cases, accounting for 64.8%), while according to diseases, the anti-human globin positive ratio was high in tumor cancer, hephropathy and gastroenteropathy patients, and patients in intensive care unit, moreover the blood transfusion frequency of these patients was higher than that of patients with anti-human globin negative(Pblood transfusion, so as to ensure the effectiveness of blood transfusion.

  16. Emerging risks and outcomes of blood transfusion in surgery.

    Science.gov (United States)

    Shander, Aryeh

    2004-01-01

    Prior to 1900, blood transfusions were fraught with danger and often caused more complications than the underlying disease. Discovery of the ABO compatibility system in the early twentieth century opened the modern era of blood transfusion, yet ABO incompatibility-as a result of clerical error-remains a significant threat to the recipient today. The risk of disease transmission now includes new and emerging agents, such as Trepanosoma cruzii and West Nile Virus (WNV), as well as other existing pathogens. Transfusion-related immunomodulation (TRIM) presents a further risk to recipient patients. Confounding these problems are shortages of safe blood and the accelerated rise in the cost of blood due to increased testing. Outcome data on transfusion therapy have not always been favorable, particularly in the areas of postoperative infection, systemic inflammatory response syndrome (SIRS), multiple organ failure (MOF), and mortality. Such data have generated extensive efforts to determine association versus underlying cause of post-transfusion complications. In addition, unprecedented global initiatives to minimize the use of allogeneic blood are on the way. Options may include, but are not limited to, the use of "blood substitutes," although validation of such products is still required. In the meantime, blood product conservation techniques should become part of routine transfusion medicine.

  17. Toward a patient-based paradigm for blood transfusion

    Directory of Open Access Journals (Sweden)

    Farrugia A

    2014-01-01

    Full Text Available Albert Farrugia,1,2 Eleftherios Vamvakas31College of Medicine, Biology and Environment, Australian National University, Acton, ACT, Australia; 2Centre for Orthopaedic Research, Department of Surgery, Faculty of Medicine and Surgery, University of Western Australia, Perth, WA, Australia; 3Cedars-Sinai Medical Center, Los Angeles, CA, USAAbstract: The current "manufacturing paradigm" of transfusion practice has detached transfusion from the clinical environment. As an example, fresh whole blood in large-volume hemorrhage may be superior to whole blood reconstituted from multiple components. Multicomponent apheresis can overcome logistical difficulties in matching patient needs with fresh component availability and can deliver the benefits of fresh whole blood. Because of the different transfusion needs of patients in emerging economies and the vulnerability of these blood systems to emerging infections, fresh whole blood and multicomponent apheresis can better meet patient needs when compared with transplants of the "manufacturing paradigm". We propose that patient blood management, along with panels of repeat, paid, accredited apheresis and fresh whole-blood donors can be used in emerging economies to support decentralized blood services. This alternative transfusion–medicine paradigm could eventually also be adopted by established economies to focus transfusion medicine on local patient needs and to alleviate the problem of the aging volunteer donor base.Keywords: indications, emerging countries, patient blood management

  18. Blood transfusion exposure in Denmark and Sweden

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Edgren, Gustaf; Rostgaard, Klaus

    2009-01-01

    Although essential for the evaluation of blood transfusion safety, the prevalence of blood transfusion in the general population is not presently known. This study estimated the exposure to blood transfusion in the general Scandinavian population.......Although essential for the evaluation of blood transfusion safety, the prevalence of blood transfusion in the general population is not presently known. This study estimated the exposure to blood transfusion in the general Scandinavian population....

  19. The Effects of Blood Transfusion on Delirium Incidence.

    Science.gov (United States)

    van der Zanden, Vera; Beishuizen, Sara J; Scholtens, Rikie M; de Jonghe, Annemarieke; de Rooij, Sophia E; van Munster, Barbara C

    2016-08-01

    Both anemia and blood transfusion could be precipitating factors for delirium; hence in postoperative patients with anemia at high risk for delirium, it is controversial whether transfusion is the best option. The aim of this study is to investigate the association of anemia and delirium and the role of blood transfusion within the multicomponent prevention strategy of delirium. We conducted a substudy of a multicenter randomized controlled trial. Four hundred fifteen patients aged 65 to 102 years old admitted for hip fracture surgery were enrolled. Delirium was assessed daily using criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Data on hemoglobin values and transfusion were collected from the electronic medical records. One hundred fifteen (32.5%) patients experienced delirium during hospitalization, 238 (57.5%) had a hemoglobin level ≤ 6.0 mmol/L (9.7 g/dL) at any time during hospitalization, and 140 (33.7%) received a blood transfusion. Anemia (a hemoglobin level ≤ 6.0 mmol/L [9.7 g/dL]) was associated with delirium (odds ratio, 1.81; 95% confidence interval, 1.15-2.86). Blood transfusion was a protective factor for delirium in patients with the lowest measured hemoglobin level ≤ 6.0 mmol/L (9.7 g/dL) (odds ratio, 0.26; 95% confidence interval, 0.10-0.70). Low hemoglobin level is associated with delirium, and receiving a blood transfusion is associated with a lower delirium incidence. It would be interesting to investigate the effect of blood transfusion as part of the multicomponent treatment of delirium in patients with anemia. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  20. Working towards implementation of a nuclear medicine accreditation program in a South African teaching hospital

    International Nuclear Information System (INIS)

    Eiselen, T.; Ellmann, A.

    2004-01-01

    Full text: Introduction: Quality assurance in Nuclear Medicine is of utmost importance in order to ensure optimal scintigraphic results and correct patient management and care. The implementation of a good quality assurance program should address all factors that playa role in the optimal functioning of a department. It should be developed by scientific findings as well as national and international guidelines. Aim: To develop a tailor made program that can be managed according to the individual needs and requirements of a Nuclear Medicine department in a teaching hospital. This program is aimed at international accreditation of the department. Materials and methods: Auditing of the following aspects was conducted: organizational, clinical and technical, personnel satisfaction, patient experience and satisfaction, referring physicians experience and satisfaction. Information was collected by means of questionnaires to groups and individuals for opinion polls; one-to-one interviews with personnel and patients; technical evaluation of equipment according to manufacturer's specifications and international standards; laboratory equipment evaluation according to precompiled guidelines and investigation of laboratory procedures for standardization and radiation safety. Existing procedure protocols were measured against international guidelines and evaluated for possible shortcomings of technical as well as cosmetic details, and data storage facilities were evaluated in terms of user friendliness, viability and cost effectiveness. A number of international accreditation experts were also visited to establish the validity of our results. Results: Patient questionnaires indicated overall satisfaction with personal service providing, but provision of written and understandable information, long waiting periods and equipment must receive attention. Staff questionnaires indicated a general lack of communication between different professional groups and the need for

  1. Teaching cardiac auscultation to trainees in internal medicine and family practice: Does it work?

    Science.gov (United States)

    Favrat, B; Pécoud, A; Jaussi, A

    2004-01-01

    Background The general proficiency in physical diagnostic skills seems to be declining in relation to the development of new technologies. The few studies that have examined this question have invariably used recordings of cardiac events obtained from patients. However, this type of evaluation may not correlate particularly well with bedside skills. Our objectives were 1) To compare the cardiac auscultatory skills of physicians in training with those of experienced cardiologists by using real patients to test bedside diagnostic skills. 2) To evaluate the impact of a five-month bedside cardiac auscultation training program. Methods 1) In an academic primary care center, 20 physicians (trainees in internal medicine and family practice) and two skilled academic cardiologists listened to 33 cardiac events in 13 patients directly at bedside and identified the cardiac events by completing an open questionnaire. Heart sounds, murmurs and diagnosis were determined beforehand by an independent skilled cardiologist and were validated by echocardiography. Thirteen primary cardiologic diagnoses were possible. 2) Ten of the physicians agreed to participate in a course of 45-minute sessions once a week for 5 months. After the course they listened again to the same patients (pre/post-interventional study). Results 1) The experts were the most skillful, achieving 69% recognition of heart sounds and murmurs and correct diagnoses in 62% of cases. They also heard all of the diastolic murmurs. The residents heard only 40% of the extra heart sounds and made a correct diagnosis in 24% of cases. 2) After the weekly training sessions, their mean percentage for correct diagnosis was 35% [an increase of 66% (p < 0.05)]. Conclusions The level of bedside diagnostic skills in this relatively small group of physicians in training is indeed low, but can be improved by a course focusing on realistic bedside teaching. PMID:15056393

  2. Evidence Based Medicine Teaching in Undergraduate Medical Education: A Literature Review

    Directory of Open Access Journals (Sweden)

    Misa Mi

    2012-09-01

    Full Text Available Objectives – To determine the year when evidence based medicine (EBM wasintroduced and the extent to which medical students were exposed to EBM inundergraduate medical education and to investigate how EBM interventions weredesigned, developed, implemented, and evaluated in the medical curriculum.Methods – A qualitative review of the literature on EBM interventions was conductedto synthesize results of studies published from January 1997 to December 2011. Acomprehensive search was performed on PubMed, CINAHL, Web of Science,Cochrane Library, ProQuest Dissertations & Theses, PsycINFO, and ERIC. Articleswere selected if the studies involved some form of quantitative and qualitativeresearch design. Articles were excluded if they studied EBM interventions in medicalschools outside the United States or if they examined EBM interventions for alliedhealth profession education or at the levels of graduate medical education andcontinuing medical education. Thirteen studies which met the selection criteria wereidentified and reviewed. Information was abstracted including study design, year andsetting of EBM intervention, instructional method, instruction delivery format,outcome measured, and evaluation method.Results – EBM was introduced to preclinical years in three studies, integrated intoclinical clerkship rotations in primary care settings in eight studies, and spannedpreclinical and clinical curricula in two studies. The duration of EBM interventionsdiffered, ranging from a workshop of three student contact hours to a curriculum of 30 student contact hours. Five studies incorporated interactive and clinically integrated teaching and learning activities to support student learning. Diverse research designs, EBM interventions, and evaluation methods resulted in heterogeneity in results across the 13 studies.Conclusions – The review reveals wide variations in duration of EBM interventions, instructional methods, delivery formats for EBM

  3. Appraisal by Year Six French medical students of the teaching of forensic medicine and health law.

    Science.gov (United States)

    Franchitto, Nicolas; Rougé, Daniel

    2010-10-01

    Legal medicine is a cross-sectional specialty in which medico-legal situations very frequently combine with routine medical practice. A total of 132 students in the last year of the second cycle of medical studies (Year 6) replied anonymously and voluntarily to a questionnaire corresponding to the topics in the curriculum for the national ranking examination: law relating to death and the dying, examination of assault victims, medical malpractice liability rules, writing death certificates, respect of medical confidentiality and the principles of medical deontology. The most frequently cited activities of the forensic physician were autopsy (87.9%), writing certificates (75.8%) and consultations with victims of violence (60.6%). Students did not often come into contact with a medico-legal situation during Years 2-6 of medical studies. Assiduity in attending lectures was low. Students preferred the standard textbooks available in specialized bookshops. They were severe in their appraisal of their own competence at the end of the second cycle, and did not feel ready to examine a corpse (95.5%) or to examine victims of assault (92.4%). Knowledge of the law and of the risks of medical practice was felt to be inadequate by 60.5% of students, and of the writing of a medical certificate by 56.8%. Training medical students in this field is a major challenge in view of the limited number of teaching hours and the need to acquire increasingly specialized knowledge. Complementary initiatives appear to be necessary, such as partnership with other clinical specialties which are frequently confronted with medico-legal situations.

  4. Hepatitis C Virus(Topics in Transfusion Medicine 1990 : Autologous Transfusion and Post-Transfusion Hepatitis)

    OpenAIRE

    渡辺, 勇四郎; 宮村, 達男; Watanabe, Yushiro; Miyamura, Tatsuo

    1990-01-01

    The agent that causes blood-borne non-A, non-B hepatitis has been identified by M.Houghton and his colleagues. A cDNA of this virus has been cloned and assay system of HCV-antibody has been established. By using this assay system, we have been accumulating new epidemiological and clinical findings. We also isolated HCVcDNA clones from the serum of a Japanese healthy HCV carrier. Nucleotide sequences of these cDNA clones showed high homology with the Houghton's clones. Amino acid homology in t...

  5. Patient involvement in blood transfusion safety: patients' and healthcare professionals' perspective.

    Science.gov (United States)

    Davis, R; Murphy, M F; Sud, A; Noel, S; Moss, R; Asgheddi, M; Abdur-Rahman, I; Vincent, C

    2012-08-01

    Blood transfusion is one of the major areas where serious clinical consequences, even death, related to patient misidentification can occur. In the UK, healthcare professional compliance with pre-transfusion checking procedures which help to prevent misidentification errors is poor. Involving patients at a number of stages in the transfusion pathway could help prevent the occurrence of these incidents. To investigate patients' willingness to be involved and healthcare professionals' willingness to support patient involvement in pre-transfusion checking behaviours. A cross-sectional design was employed assessing willingness to participate in pre-transfusion checking behaviours (patient survey) and willingness to support patient involvement (healthcare professional survey) on a scale of 1-7. One hundred and ten patients who had received a transfusion aged between 18 and 93 (60 male) and 123 healthcare professionals (doctors, nurses and midwives) involved in giving blood transfusions to patients. Mean scores for patients' willingness to participate in safety-relevant transfusion behaviours and healthcare professionals' willingness to support patient involvement ranged from 4.96-6.27 to 4.53-6.66, respectively. Both groups perceived it most acceptable for patients to help prevent errors or omissions relating to their hospital identification wristband. Neither prior experience of receiving a blood transfusion nor professional role of healthcare staff had an effect on attitudes towards patient participation. Overall, both patients and healthcare professionals view patient involvement in transfusion-related behaviours quite favourably and appear in agreement regarding the behaviours patients should adopt an active role in. Further work is needed to determine the effectiveness of this approach to improve transfusion safety. © 2012 The Authors. Transfusion Medicine © 2012 British Blood Transfusion Society.

  6. As They Grow: Teaching Your Children How to Use Medicines Safely

    Science.gov (United States)

    ... Drugs Resources for You Information for Consumers (Drugs) Buying & Using Medicine Safely Understanding Over-the-Counter Medicines ... years old. They may try to copy your behavior. 8-year-olds Know how much you weigh. ...

  7. [The teaching and application of alternative medicine in medical education programs].

    Science.gov (United States)

    Chiang, Han-Sun

    2014-12-01

    The history of alternative medicine is perhaps as long as the history of human medicine. The development of evidence-based medicine has not annihilated alternative medicine. On the contrary, more people turn to alternative medicine because this approach to treatment serves as an effective remedial or supportive treatment when used in conjunction with evidence-based medicine. In contemporary healthcare, alternative medicine is now an essential part of integrated medicine. In Taiwan, most professional medical practitioners have not received proper education about alternative medicine and therefore generally lack comprehensive knowledge on this subject. While alternative medicine may be effective when used with some patients, it may also impart a placebo effect, which helps restore the body and soul of the patients. Medical staff with advanced knowledge of alternative medicine may not only help patients but also improve the doctor-patient relationship. There is great diversity in alternative medicine, with some alternative therapies supported by evidence and covered by insurance. However, there also remain fraudulent medical practices that may be harmful to health. Medical staff must be properly educated so that they can provide patients and their family a proper understanding and attitude toward alternative medicine. Therefore, alternative medicine should be included in the standard medical education curriculum. Offering classes on alternative medicine in university for more than 10 years, the author shares his experiences regarding potential content, lecture subjects, group experience exercises, and in-class activities. This article is intended to provide a reference to professors in university medical education and offer a possible model for alternative medicine education in Taiwan.

  8. [The Arab medicine and the way of teaching it in the Golden Age. al-Râzî, one of the best representatives!].

    Science.gov (United States)

    Zouaoui Boudjeltia, K

    2008-01-01

    In the collective psyche, the Arabs only passed the inheritance of the Greek medicine on to the Western countries. In fact, they were great developers and great discoverers. The Arab contribution in medicine was not just technical but also conceptual. The aim of this work is to describe a part of that contribution regarding the organization and the teaching of medicine and to introduce one of its best representatives, al-Râzî.

  9. An observational pre-post study of re-structuring Medicine inpatient teaching service: Improved continuity of care within constraint of 2011 duty hours.

    Science.gov (United States)

    Cheung, Joseph Y; Mueller, Daniel; Blum, Marissa; Ravreby, Hannah; Williams, Paul; Moyer, Darilyn; Caroline, Malka; Zack, Chad; Fisher, Susan G; Feldman, Arthur M

    2015-09-01

    Implementation of more stringent regulations on duty hours and supervision by the Accreditation Council for Graduate Medical Education in July 2011 makes it challenging to design inpatient Medicine teaching service that complies with the duty hour restrictions while optimizing continuity of patient care. To prospectively compare two inpatient Medicine teaching service structures with respect to residents' impression of continuity of patient care (primary outcome), time available for teaching, resident satisfaction and length-of-stay (secondary endpoints). Observational pre-post study. Surveys were conducted both before and after Conventional Medicine teaching service was changed to a novel model (MegaTeam). Academic General Medicine inpatient teaching service. Surveys before and after MegaTeam implementation were completed by 68.5% and 72.2% of internal medicine residents, respectively. Comparing conventional with MegaTeam, the % of residents who agreed or strongly agreed that the (i) ability to care for majority of patients from admission to discharge increased from 29.7% to 86.6% (pcare, decreases number of handoffs, provides adequate supervision and teaching of interns and medical students, increases resident overall satisfaction and decreases length-of-stay. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Transfusions of blood and blood products and viral infections

    Directory of Open Access Journals (Sweden)

    Marta Wróblewska

    2002-06-01

    Full Text Available Transfusions of blood and blood products are commonly used in medicine, but being biological materials they carry a risk of transmitting infections--viral, bacterial, parasitic, as well as prions. Laboratory tests used for screening of donated blood for viral infections at present cannot detect all infectious units. Criteria for selection of blood donors therefore must be very strict, while methods of inactivation of viruses and laboratory assays for detection of their presence must be improved. Indications for blood transfusion should be restricted.

  11. [Ethics and blood transfusion].

    Science.gov (United States)

    Tissot, J-D; Garraud, O; Danic, B; Cabaud, J-J; Lefrère, J-J

    2013-09-01

    Blood donation is an act of solidarity. Most often, this act is done on a volunteer basis and, depending on countries and circumstances, is not remunerated. The increase in need, the always-greater number of deferral criteria, the safety issues and the changes in the structures of our societies are among the many subjects for ethical debates. Taking these into account, the actors of the transfusion must analyze certain parameters: the value of a donation, the meaning of volunteering, the appropriateness of remunerating the act of giving a part of one's self, no longer as a donation or an expression of altruism and solidarity, but as a commercial act regimented by economic laws. Copyright © 2013. Published by Elsevier SAS.

  12. Computer-based teaching is as good as face to face lecture-based teaching of evidence based medicine: a randomised controlled trial

    Science.gov (United States)

    2007-01-01

    Background At postgraduate level evidence based medicine (EBM) is currently taught through tutor based lectures. Computer based sessions fit around doctors' workloads, and standardise the quality of educational provision. There have been no randomized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine. Methods This was a randomised controlled trial involving six postgraduate education centres in the West Midlands, U.K. Fifty five newly qualified foundation year one doctors (U.S internship equivalent) were randomised to either computer based sessions or an equivalent lecture in EBM and systematic reviews. The change from pre to post-intervention score was measured using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). Results Both groups were similar at baseline. Participants' improvement in knowledge in the computer based group was equivalent to the lecture based group (gain in score: 2.1 [S.D = 2.0] versus 1.9 [S.D = 2.4]; ANCOVA p = 0.078). Attitudinal gains were similar in both groups. Conclusion On the basis of our findings we feel computer based teaching and learning is as effective as typical lecture based teaching sessions for educating postgraduates in EBM and systematic reviews. PMID:17659076

  13. Alternatives to allogeneic platelet transfusion.

    Science.gov (United States)

    Desborough, Michael J R; Smethurst, Peter A; Estcourt, Lise J; Stanworth, Simon J

    2016-11-01

    Allogeneic platelet transfusions are widely used for the prevention and treatment of bleeding in thrombocytopenia. Recent evidence suggests platelet transfusions have limited efficacy and are associated with uncertain immunomodulatory risks and concerns about viral or bacterial transmission. Alternatives to transfusion are a well-recognised tenet of Patient Blood Management, but there has been less focus on different strategies to reduce bleeding risk by comparison to platelet transfusion. Direct alternatives to platelet transfusion include agents to stimulate endogenous platelet production (thrombopoietin mimetics), optimising platelet adhesion to endothelium by treating anaemia or increasing von Willebrand factor levels (desmopressin), increasing formation of cross-linked fibrinogen (activated recombinant factor VII, fibrinogen concentrate or recombinant factor XIII), decreasing fibrinolysis (tranexamic acid or epsilon aminocaproic acid) or using artificial or modified platelets (cryopreserved platelets, lyophilised platelets, haemostatic particles, liposomes, engineered nanoparticles or infusible platelet membranes). The evidence base to support the use of these alternatives is variable, but an area of active research. Much of the current randomised controlled trial focus is on evaluation of the use of thrombopoietin mimetics and anti-fibrinolytics. It is also recognised that one alternative strategy to platelet transfusion is choosing not to transfuse at all. © 2016 John Wiley & Sons Ltd.

  14. Critical Review of Data Evaluation in Teaching Clinics of Traditional Chinese Medicine Outside China: Implications for Education.

    Science.gov (United States)

    Jiang, Jian; Peng, Wenbo; Gu, Tieguang; King, Catherine; Yin, J Kevin

    2016-01-01

    The increasing acceptance of traditional Chinese medicine (TCM) worldwide has highlighted the importance of ensuring the provision of high-quality TCM clinical education. This clinical training should be partly guided by a robust assessment of patient data outcomes in TCM teaching clinics. We undertook a comprehensive literature review to examine the data evaluation in TCM teaching clinics outside China and its implications for TCM education. Literature was retrieved via MEDLINE (from 1946 to January 2015), EMBASE (from 1980 to February 2015), and Google Scholar for studies conducted outside China. The search was restricted to English articles reporting empirical findings related to the assessments of patient data in TCM teaching clinics, with implications for TCM education in countries other than China. Only seven articles from six studies met the inclusion criteria. The characteristics and main symptoms of patients who received any TCM treatment in the context of teaching clinics among all included studies were similar. Symptom relief as well as a high level of patient satisfaction with TCM treatment were found in TCM teaching clinics. Conventional healthcare providers and other complementary practitioners were not the main source of referral to TCM practitioners but rather patients׳ friends/relatives. Patients received acupuncture treatment more frequently than treatments utilizing Chinese herbal medicine in teaching clinics. A standardized and consistent framework for patient records within TCM teaching clinics is currently lacking. There was no robust study which "translated" TCM clinic data evaluation findings into implications for TCM education and clinical training. Recognizing that TCM evolves over time and its practice varies in different settings, there is an urgent need to conduct large-scale, rigorous evaluations of TCM clinic data to address the findings of our review, with the purpose of better informing TCM education and clinical training in

  15. The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors.

    Science.gov (United States)

    Boykan, Rachel; Jacobson, Robert M

    2017-10-01

    The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.

  16. Recent advances in transfusions in neonates/infants [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Ruchika Goel

    2018-05-01

    Full Text Available Transfusions of red blood cells (RBCs, platelets, and plasma are critical therapies for infants and neonates (particularly preterm neonates in the neonatal intensive care unit, who are the most frequently transfused subpopulation across all ages. Although traditionally a significant gap has existed between the blood utilization and the evidence base essential to adequately guide transfusion practices in infants and neonates, pediatric transfusion medicine is evolving from infancy and gradually coming of age. It is entering an exciting era with recognition as an independent discipline, a new and evolving high-quality evidence base for transfusion practices, novel technologies and therapeutics, and national/international collaborative research, educational, and clinical efforts. Triggers and thresholds for red cell transfusion are accumulating evidence with current phase III clinical trials. Ongoing trials and studies of platelet and plasma transfusions in neonates are anticipated to provide high-quality evidence in years to come. This article aims to summarize the most current evidence-based practices regarding blood component therapy in neonates. Data on the use of specific components (RBCs, plasma, and platelets are provided. We attempt to define thresholds for anemia, thrombocytopenia, and abnormal coagulation profile in neonates to highlight the difficulties in having a specific cutoff value in neonates and preterm infants. Indications for transfusion of specific products, transfusion thresholds, and current practices and guidelines are provided, and possible adverse outcomes and complications are discussed. Finally, the critical research knowledge gaps in these practices as well as ongoing and future research areas are discussed. In an era of personalized medicine, neonatal transfusion decisions guided by a strong evidence base must be the overarching goal, and this underlies all of the strategic initiatives in pediatric and neonatal

  17. Brazilian situation of blood component irradiation practice for the prevention of transfusion associated Graft-versus-Host disease

    International Nuclear Information System (INIS)

    Goes, E.G.; Borges, J.C.; Covas, D.T.; Motta, I.

    1998-01-01

    Transfusion-associated graft-versus-host disease (TA-GVHD) is a usually complication of transfusion of blood component containing T lymphocytes what recently has also involved immunocompetent patient. Gamma irradiation of cellular blood components has been the mainstay against TA-GVHD, nevertheless there is little information in the literature about current transfusion medicine practices regarding gamma irradiation of blood products. This work presents an overview of the Brazilian reality and suggests policies to optimize TA-GVHD prevention. (Author)

  18. Brazilian situation of blood component irradiation practice for the prevention of transfusion associated Graft-versus-Host disease

    Energy Technology Data Exchange (ETDEWEB)

    Goes, E.G.; Borges, J.C. [EE/COPPE-UFRJ (Brazil); Covas, D.T. [Faculdade deMedicina-USP-RP (Brazil); Motta, I. [Instituto Nacional do Cancer- Rio deJaneiro (Brazil)

    1998-12-31

    Transfusion-associated graft-versus-host disease (TA-GVHD) is a usually complication of transfusion of blood component containing T lymphocytes what recently has also involved immunocompetent patient. Gamma irradiation of cellular blood components has been the mainstay against TA-GVHD, nevertheless there is little information in the literature about current transfusion medicine practices regarding gamma irradiation of blood products. This work presents an overview of the Brazilian reality and suggests policies to optimize TA-GVHD prevention. (Author)

  19. Restrictive versus liberal transfusion strategy for red blood cell transfusion

    DEFF Research Database (Denmark)

    Holst, Lars B; Petersen, Marie W; Haase, Nicolai

    2015-01-01

    OBJECTIVE: To compare the benefit and harm of restrictive versus liberal transfusion strategies to guide red blood cell transfusions. DESIGN: Systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. DATA SOURCES: Cochrane central register of controlled...... trials, SilverPlatter Medline (1950 to date), SilverPlatter Embase (1980 to date), and Science Citation Index Expanded (1900 to present). Reference lists of identified trials and other systematic reviews were assessed, and authors and experts in transfusion were contacted to identify additional trials....... TRIAL SELECTION: Published and unpublished randomised clinical trials that evaluated a restrictive compared with a liberal transfusion strategy in adults or children, irrespective of language, blinding procedure, publication status, or sample size. DATA EXTRACTION: Two authors independently screened...

  20. Structured Communication: Teaching Delivery of Difficult News with Simulated Resuscitations in an Emergency Medicine Clerkship

    Science.gov (United States)

    Lamba, Sangeeta; Nagurka, Roxanne; Offin, Michael; Scott, Sandra R.

    2015-01-01

    Introduction The objective is to describe the implementation and outcomes of a structured communication module used to supplement case-based simulated resuscitation training in an emergency medicine (EM) clerkship. Methods We supplemented two case-based simulated resuscitation scenarios (cardiac arrest and blunt trauma) with role-play in order to teach medical students how to deliver news of death and poor prognosis to family of the critically ill or injured simulated patient. Quantitative outcomes were assessed with pre and post-clerkship surveys. Secondarily, students completed a written self-reflection (things that went well and why; things that did not go well and why) to further explore learner experiences with communication around resuscitation. Qualitative analysis identified themes from written self-reflections. Results A total of 120 medical students completed the pre and post-clerkship surveys. Majority of respondents reported that they had witnessed or role-played the delivery of difficult news, but only few had real-life experience of delivering news of death (20/120, 17%) and poor prognosis (34/120, 29%). This communication module led to statistically significant increased scores for comfort, confidence, and knowledge with communicating difficult news of death and poor prognosis. Pre-post scores increased for those agreeing with statements (somewhat/very much) for delivery of news of poor prognosis: comfort 69% to 81%, confidence 66% to 81% and knowledge 76% to 90% as well as for statements regarding delivery of news of death: comfort 52% to 68%, confidence 57% to 76% and knowledge 76% to 90%. Respondents report that patient resuscitations (simulated and/or real) generated a variety of strong emotional responses such as anxiety, stress, grief and feelings of loss and failure. Conclusion A structured communication module supplements simulated resuscitation training in an EM clerkship and leads to a self-reported increase in knowledge, comfort, and

  1. A Pedagogical Boomerang: From Hans Mauksch to Medicine to the Teaching and Learning of Sociology

    Science.gov (United States)

    Weiss, Gregory L.

    2007-01-01

    Even in its formative stages the scholarship of teaching and learning (SoTL) is drawing the attention and interest of scholars across academic disciplines and across types of educational institutions. Many sociologists are reflecting on how to shape scholarly efforts on teaching and learning within our discipline. This paper recounts the guidance…

  2. Transfusion as an Inflammation Hit: Knowns and Unknowns

    Science.gov (United States)

    Garraud, Olivier; Tariket, S.; Sut, C.; Haddad, A.; Aloui, C.; Chakroun, T.; Laradi, S.; Cognasse, F.

    2016-01-01

    Transfusion of blood cell components is frequent in the therapeutic arsenal; it is globally safe or even very safe. At present, residual clinical manifestations are principally inflammatory in nature. If some rare clinical hazards manifest as acute inflammation symptoms of various origin, most of them linked with conflicting and undesirable biological material accompanying the therapeutic component (infectious pathogen, pathogenic antibody, unwanted antigen, or allergen), the general feature is subtler and less visible, and essentially consists of alloimmunization or febrile non-hemolytic transfusion reaction. The present essay aims to present updates in hematology and immunology that help understand how, when, and why subclinical inflammation underlies alloimmunization and circumstances characteristic of red blood cells and – even more frequently – platelets that contribute inflammatory mediators. Modern transfusion medicine makes sustained efforts to limit such inflammatory hazards; efforts can be successful only if one has a clear view of each element’s role. PMID:27965664

  3. Opportunities for teaching and studying medicine in medieval Portugal before the foundation of the University of Lisbon (1290).

    Science.gov (United States)

    McCleery, I

    2000-01-01

    This paper discusses where Portuguese physicians studied medicine. The careers of two thirteenth-century physicians, Petrus Hispanus and Giles of Santarem, indicate that the Portuguese travelled abroad to study in Montpellier or Paris. But it is also possible that there were opportunities for study in Portugal itself. Particularly significant in this respect is the tradition of medical teaching associated with the Augustinian house of Santa Cruz in Coimbra and the reference to medical texts found in Coimbra archives. From these sources it can be shown that there was a suitable environment for medical study in medieval Portugal, encouraging able students to further their medical interests elsewhere.

  4. Marrow transfusions into normal recipients

    International Nuclear Information System (INIS)

    Brecher, G.

    1983-01-01

    During the past several years we have explored the transfusion of bone marrow into normal nonirradiated mice. While transfused marrow proliferates readily in irradiated animals, only minimal proliferation takes place in nonirradiated recipients. It has generally been assumed that this was due to the lack of available proliferative sites in recipients with normal marrow. Last year we were able to report that the transfusion of 200 million bone marrow cells (about 2/3 of the total complement of marrow cells of a normal mouse) resulted in 20% to 25% of the recipient's marrow being replaced by donor marrow. Thus we can now study the behavior of animals that have been transfused (donor) and endogenous (recipient) marrow cells, although none of the tissues of either donor or recipient have been irradiated. With these animals we hope to investigate the nature of the peculiar phenomenon of serial exhaustion of marrow, also referred to as the limited self-replicability of stem cells

  5. Transfusion related acute lung injury

    Directory of Open Access Journals (Sweden)

    Sharma Ratti

    2009-10-01

    Full Text Available Transfusion related acute lung injury (TRALI is an uncommon but potentially fatal adverse reaction to transfusion of plasma containing blood components. We describe a case of 10-year-old male child with aplastic anemia, platelet count of 7800/΅l, B positive blood group who developed fever (39.2΀C, difficulty in breathing and cyanosis within 2 hrs after transfusion of a random platelet concentrate. Despite the best resuscitative efforts, the child died within next 24 hrs. The present case highlights the fact that TRALI should be kept as a differential diagnosis in all patients developing acute respiratory discomfort within 6 hrs of transfusion. Without a ′gold standard′ the diagnosis of TRALI relies on a high index of suspicion and on excluding other types of transfusion reactions. Notification to transfusion services is crucial to ensure that a proper investigation is carried out and at-risk donor and recipients can be identified, and risk reduction measures can be adopted.

  6. Transfusion reactions in pediatric compared with adult patients: a look at rate, reaction type, and associated products.

    Science.gov (United States)

    Oakley, Fredrick D; Woods, Marcella; Arnold, Shanna; Young, Pampee P

    2015-03-01

    The majority of reports on transfusion reactions address adult patients. Less is known about the types, incidence, and other clinical details of transfusion reactions in pediatric populations. Furthermore, to our knowledge, there have been no previous reports directly comparing these aspects between adults and pediatric patient populations to assess if there are differences. Between the period of January 1, 2011, and February 1, 2013, all reported adult and pediatric transfusion reactions at Vanderbilt University Medical Center (VUMC) were evaluated by transfusion medicine clinical service. The information was subsequently shared with the hemovigilance database. Data provided to hemovigilance included age, sex, blood product associated with the reaction, severity of the reaction, and the type of transfusion reactions. These were collated with hospital and blood bank information system-acquired data on overall admission and product transfusion. A total of 133,671 transfusions were performed at VUMC during the study period including 20,179 platelet (PLT) transfusions, 31,605 plasma transfusions, 79,933 red blood cell (RBC) transfusions, and 2154 cryoprecipitate transfusions. Over the same period, 108 pediatric and 277 adult transfusion reactions were recorded. This corresponds to an incidence of 6.2 reactions per 1000 transfusions within the pediatric (age reactions per 1000 transfusions within the adult population. In both adult and pediatric populations, transfusion reactions were most commonly associated with PLT, followed by RBC, and then plasma transfusions. Within the pediatric population, subset analysis identified multiple differences when compared to the adult population, including an increased incidence of allergic transfusion reactions (2.7/1000 vs. 1.1/1000, p reactions (1.9/1000 vs. 0.47/1000, p reactions (0.29/1000 vs. 0.078/1000, p reaction incidence was the same between sexes in adults, in pediatric patients, reactions were more common in male

  7. Management of Radioactive Spills in Nuclear Medicine; Teaching and Assessing with Objectively Structured Assessment of Technical Skills

    International Nuclear Information System (INIS)

    Hussain, Riffat Parveen

    2015-01-01

    Routine work in nuclear medicine requires the careful elution of radioactivity and its subsequent, storage and handling. Though all effort is maintained to prevent any “spill” of this radioactivity, accidents are bound to happen. The response to this spill is a methodically worked out a plan that is written and adopted as a “standard operating procedure.” This protocol is taught to all involved in the area of working as a mock drill/apprenticeship model. No formal evaluation of learning is in place except for the mock drills. The objectively structured assessment of technical skills (OSATS) is a variation on the Objective Structured Clinical Examination, which is a form of workplace based assessment. The OSATS is cited in the Accreditation Council of Graduate Medical Education evaluation toolbox on the website as the most desirable evaluation tool for the patient care topics. It is the objective of this paper is to introduce the “OSATS” for teaching, and assessment of the learning, of the protocol for the management of radioactive spill. As a review of the literature on the subject failed to reveal any such teaching protocol/material/document for this important technical skill, we hope that it may act as a landmark for the development of teaching and assessment of other technical skills also

  8. Perceived changes in behavior and values after a red blood cell transfusion

    Directory of Open Access Journals (Sweden)

    Broccolo M

    2017-12-01

    Full Text Available Marianna Broccolo,1 Nicolas Favez,2 Oliver Karam3,4 1School of Medicine, 2Clinical Psychology Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, 3Pediatric Intensive Care Unit, Geneva University Hospital, Geneva, Switzerland; 4Division of Pediatric Critical Care Medicine, Children’s Hospital of Richmond at VCU, Richmond, VA, USA Background: Several studies have evaluated perceived changes in patients’ behavior after an organ transplant, especially a heart transplant. Although blood transfusions are much more frequent and have many connotations, derived from religious values, mass culture, or personal ideas, there is no study of the perception the patients have of changes in their behavior and values after a transfusion. This study’s objective was to assess perceived changes in behavior and values after a red blood cell transfusion.Materials and methods: Exploratory study through semistructured interviews with seven adults transfused after orthopedic surgery.Results: Blood had strong symbolic values for all subjects. Each of the seven participants mentioned positive characteristics that they would like to receive from the donor. Six subjects out of the seven acknowledged the possibility that transfusions might induce changes in behavior or values. Three subjects clearly stated that they would refuse to receive blood from a criminal for fear that some negative characteristic may be transmitted to them. Furthermore, three subjects acknowledged that their transfusion might have changed their own behavior or values.Discussion: This study shows that patients might feel that transfusions could modify their behavior or values and that certain personality traits of the donor could be transmitted. Further research in a larger population is warranted to evaluate the incidence of a perceived changed in behavior or values after a blood transfusion, which would then lead to changes in the way information is provided to

  9. Monitoring of Adverse Drug Reactions Associated with Antihypertensive Medicines at a University Teaching Hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    Fowad Khurshid

    2012-09-01

    Full Text Available Aim To monitor the adverse drug reactions (ADRs caused by antihypertensive medicines prescribed in a university teaching hospital.Methods:he present work was an open, non-comparative, observational study conducted on hypertensive patients attending the Medicine OPD of Majeedia Hospital, Jamia Hamdard, New Delhi, India by conducting patient interviews and recording the data on ADR monitoring form as recommended by Central Drugs Standard Control Organization (CDSCO, Government of India.Results:A total of 21 adverse drug reactions were observed in 192 hypertensive patients. Incidence of adverse drug reactions was found to be higher in patients more than 40 years in age, and females experienced more ADRs (n = 14, 7.29 % than males, 7 (3.64 %. Combination therapy was associated with more number of adverse drug reactions (66.7 % as against monotherapy (33.3 %. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n = 7, followed by diuretics (n = 5, and beta- blockers (n = 4. Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 7, followed by torasemide (n = 3. Adverse drug reactions associated with central nervous system were found to be the most frequent (42.8 % followed by musculo-skeletal complaints (23.8 % and gastro-intestinal disorders (14.3 %. Conclusions:The present pharmacovigilance study represents the adverse drug reaction profile of the antihypertensive medicines prescribed in our university teaching hospital. The above findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions.

  10. Risk factors for blood transfusion in patients undergoing high-order Cesarean delivery.

    Science.gov (United States)

    Spiegelman, Jessica; Mourad, Mirella; Melka, Stephanie; Gupta, Simi; Lam-Rachlin, Jennifer; Rebarber, Andrei; Saltzman, Daniel H; Fox, Nathan S

    2017-11-01

    The objective was to identify risk factors associated with blood transfusion in patients undergoing high-order Cesarean delivery (CD). This was a retrospective cohort study of patients undergoing third or more CD by a single maternal-fetal medicine practice between 2005 and 2016. We compared risk factors between women who did and did not receive a red blood cell transfusion during the operation or before discharge. Repeat analysis was performed after excluding women with placenta previa. A total of 514 patients were included, 18 of whom (3.5%; 95% confidence interval [CI], 2.2%-5.5%) received a blood transfusion. Placenta previa was the most significant risk factor for transfusion (61.1% of patients who received a transfusion vs. 1% of patients who did not; p blood transfusion. After women who had placenta previa were excluded, the incidence of blood transfusion was seven of 498 (1.4%; 95% CI, 0.7%-2.9%). Risk factors significantly associated with blood transfusion in the absence of previa were prophylactic anticoagulation during pregnancy and having labored. The incidence of transfusion in patients with no placenta previa, no anticoagulation, and no labor was 0.7% (95% CI, 0.3%-2.1%). Placenta previa was the most predictive risk factor for transfusion with a positive predictive value of 68.8% and a negative predictive value of 98.4%. In patients undergoing a third or more CD, only placenta previa, prophylactic anticoagulation during pregnancy, and having labored are independently associated with requiring a blood transfusion. These data can be used to guide physician ordering of prepared blood products preoperatively. © 2017 AABB.

  11. A ‘How-To-Guide’ for teaching and assessing Collaborator Role competencies in family medicine residency and health professional training programs

    OpenAIRE

    Newton, Christie; Kopansky-Giles, Deborah; Eyre, Alison; Balkou, Steve

    2017-01-01

    Introduction: Collaborative practice competencies are essential for safe, effective practice in today’s health care system. Providing learners with formal teaching and assessment opportunities is a requirement for accreditation in medicine and other health professional programs.  However, identifying and assessing a trainee’s ability to competently collaborate in practice across educational contexts remains challenging. Further, without common assessment tools for collaborative practice teach...

  12. Decreasing the critical value of hemoglobin required for physician notification reduces the rate of blood transfusions

    Directory of Open Access Journals (Sweden)

    Larson EA

    2016-06-01

    Full Text Available Eric A Larson,1 Paul A Thompson,1,2 Zachary K Anderson,3 Keith A Anderson,4 Roxana A Lupu,1 Vicki Tigner,5 Wendell W Hoffman6,7 1Department of Internal Medicine, 2Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, 3Department of Internal Medicine, Fairview Health Services, Edina, MN, 4Department of Laboratory Medicine, Sanford School of Medicine, University of South Dakota, 5Medical Staff Services, 6Department of Infectious Disease, Sanford Health, Sanford USD Medical Center, 7Department of Infectious Disease, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USAAbstract: Red blood cell transfusions have been cited as one of the most overused therapeutic interventions in the USA. Excessively aggressive transfusion practices may be driven by mandatory physician notification of critical hemoglobin values that do not generally require transfusion. We examined the effect of decreasing the critical value of hemoglobin from 8 to 7 g/dL at our institution. Along with this change, mandatory provider notification for readings between 7 and 8 g/dL was rescinded. Transfusion rates were compared retrospectively during paired 5-month periods for patients presenting in three key hemoglobin ranges (6.00–6.99, 7.00–7.99, and 8.00–8.99 g/dL. A change in transfusion practices was hypothesized in the 7–8 g/dL range, which was no longer labeled critical and for which mandated physician calls were rescinded. Transfusion rates showed a statistically significant 8% decrease (P≤0.0001 during the 5-month period post change in our transfusion practices. This decrease in the 7.00–7.99 g/dL range was significantly greater than the 2% decrease observed in either the 6–6.99 g/dL (P=0.0017 or 8–8.99 g/dL (P≤0.0001 range. Cost savings of up to $700,000/year were extrapolated from our results showing 491 fewer units of red blood cells transfused during the 5-month post change. These cost

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

    Science.gov (United States)

    Bryan, Charles S; Longo, Lawrence D

    2013-01-01

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

  14. BET 2: Poor evidence on whether teaching cognitive debiasing, or cognitive forcing strategies, lead to a reduction in errors attributable to cognition in emergency medicine students or doctors.

    Science.gov (United States)

    Oliver, Govind; Oliver, Gopal; Body, Rick

    2017-08-01

    A short review was carried out to see if teaching cognitive forcing strategies reduces cognitive error in the practice of emergency medicine. Two relevant papers were found using the described search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. There is currently little evidence that teaching cognitive forcing strategies reduces cognitive error in the practice of emergency medicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. How do we reduce plasma transfusion in Rhode Island?

    Science.gov (United States)

    Nixon, Christian P; Tavares, Maria F; Sweeney, Joseph D

    2017-08-01

    Plasma transfusions are given to patients with coagulopathy, either prophylactically, before an invasive procedure; or therapeutically, in the presence of active bleeding; and as an exchange fluid in therapeutic plasma exchange for disorders such as thrombotic thrombocytopenic purpura. There is consensus that many prophylactic plasma transfusions are non-efficacious, and the misdiagnosis of thrombotic thrombocytopenic purpura results in unnecessary therapeutic plasma exchange. Beginning in 2001, programs to reduce plasma transfusion in the three major teaching hospitals in Rhode Island were initiated. The programs evolved through the establishment of guidelines, education for key prescribers of plasma, screening of plasma prescriptions, and engagement of individual prescribing physicians for out-of-guidelines prescriptions with modification or cancellation. Establishment of an in-house ADAMTS13 (ADAM metallopeptidase with thrombospondin type 1, motif 13) assay in 2013 was used to prevent therapeutic plasma exchange in patients with non-thrombotic thrombocytopenic purpura microangiopathy. Transfusion service data were gathered at the hospital level regarding blood component use, hospital data for discharges, inpatient mortality, and mean case-mix index, and, at the state level, for units of plasma shipped from the community blood center to in-state hospitals. Between 2006 and 2016, a reduction in plasma use from 11,805 to 2677 units (a 77% decrease) was observed in the three hospitals and was mirrored in the state as a whole. This decline was not associated with any increase in red blood cell transfusion. Inpatient mortality either declined or was unchanged. An active program focused on education and interdiction can achieve a large decrease in plasma transfusions without evidence of patient harm. © 2017 AABB.

  16. A pharmacy student's role as a teaching assistant in an undergraduate medicinal chemistry course - Implementation, evaluation, and unexpected opportunities for educational outreach.

    Science.gov (United States)

    DellaVecchia, Matthew J; Claudio, Alyssa M; Fairclough, Jamie L

    2017-11-01

    To describe 1) a pharmacy student's teaching assistant (TA) role in an undergraduate medicinal chemistry course, 2) an active learning module co-developed by the TA and instructor, and 3) the unexpected opportunities for pharmacy educational outreach that resulted from this collaboration. Medicinal Chemistry (CHM3413) is an undergraduate course offered each fall at Palm Beach Atlantic University (PBA). As a TA for CHM3413, a pharmacy student from the Gregory School of Pharmacy (GSOP) at PBA co-developed and implemented an active learning module emphasizing foundational medicinal chemistry concepts as they pertain to performance enhancing drugs (PEDs). Surveys assessed undergraduate students' perceived knowledge of medicinal chemistry concepts, PEDs, and TA involvement. Students' (total n = 60, three fall semesters) perceived confidence in knowledge of medicinal chemistry concepts and PEDs increased significantly (p medicinal chemistry course. An advanced pharmacy practice experience elective in sports pharmacy (based on Ambrose's model) begins Fall 2017. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Non-transfusion-dependent thalassemias

    Science.gov (United States)

    Musallam, Khaled M.; Rivella, Stefano; Vichinsky, Elliott; Rachmilewitz, Eliezer A.

    2013-01-01

    Non-transfusion-dependent thalassemias include a variety of phenotypes that, unlike patients with beta (β)-thalassemia major, do not require regular transfusion therapy for survival. The most commonly investigated forms are β-thalassemia intermedia, hemoglobin E/β-thalassemia, and α-thalassemia intermedia (hemoglobin H disease). However, transfusion-independence in such patients is not without side effects. Ineffective erythropoiesis and peripheral hemolysis, the hallmarks of disease process, lead to a variety of subsequent pathophysiologies including iron overload and hypercoagulability that ultimately lead to a number of serious clinical morbidities. Thus, prompt and accurate diagnosis of non-transfusion-dependent thalassemia is essential to ensure early intervention. Although several management options are currently available, the need to develop more novel therapeutics is justified by recent advances in our understanding of the mechanisms of disease. Such efforts require wide international collaboration, especially since non-transfusion-dependent thalassemias are no longer bound to low- and middle-income countries but have spread to large multiethnic cities in Europe and the Americas due to continued migration. PMID:23729725

  18. Transfusion-related adverse reactions: From institutional hemovigilance effort to National Hemovigilance program

    Directory of Open Access Journals (Sweden)

    Rahul Vasudev

    2016-01-01

    Full Text Available Aims: In this study we have evaluated the various adverse reactions related to transfusion occurring in our institution as a pilot institutional effort toward a hemovigilance program. This study will also help in understanding the problems faced by blood banks/Transfusion Medicine departments in implementing an effective hemovigilance program. Materials and Methods: All the adverse reactions related to transfusion of whole blood and its components in various clinical specialties were studied for a period of 1 year. Any transfusion-related adverse event was worked up in accordance with guidelines laid down by the Directorate General of Health Services (DGHS and departmental standard operating procedures. Results: During the study period from November 1, 2011 to October 31, 2012, 45812 components were issued [30939 WB/PRBC; 12704 fresh frozen plasma (FFP; 2169 platelets]. Risk estimation per 1000 units of red cells (WB/PRBC transfused was estimated to be: 0.8 for febrile nonhemolytic transfusion reaction (FNHTR, 0.7 for allergic reaction, 0.19 for acute hemolytic transfusion reaction (AcHTR, 0.002 for anaphylactoid reactions, 0.1 for bacterial sepsis, and 0.06 for hypervolemia and hypocalcemia. 0.09 is the risk for delayed transfusion reaction and 0.03 is the risk for transfusion-related acute lung injury (TRALI. Risk estimate per 1,000 units of platelets transfused was estimated to be 1.38 for FNHTR, 1.18 for allergic reaction, and 1 in case of bacterial sepsis. Risk estimation per 1,000 units of FFP was estimated to be 0.15 for FNHTR and 0.2 for allergic reactions. Conclusions: Factors such as clerical checks at various levels, improvement in blood storage conditions outside blood banks, leukodepletion, better inventory management, careful donor screening, bedside monitoring of transfusion, and documentation of adverse events may decrease transfusion-related adverse events. Better coordination between transfusion specialists and various clinical

  19. Basic Geriatrics Knowledge Among Internal Medicine Trainees in a Teaching Hospital in Saudi Arabia.

    Science.gov (United States)

    Al-Aama, Tareef

    2016-06-01

    To assess the basic knowledge of medical trainees, in the absence of a structured geriatrics curriculum, around a variety of geriatric medicine components that are considered essential for the care of the rapidly increasing elderly population. Eighty-three trainees at different levels of training in internal medicine were asked about a variety of common geriatric conditions. Those included: delirium, falls, geriatric syndromes, pain, cognitive impairment, and medications. The trainees' knowledge about common geriatric condition was overall poor. The most pronounced deficits included: the lack of familiarity in diagnosing geriatric syndromes (63 %) or managing them (67 %), the underestimation of the prevalence of delirium (49 %), and the tendency to undertreat pain (64 %). Poor familiarity with polypharmacy and its impact, as well as inappropriate prescription practices in the elderly were also observed. In the absence of a structured geriatric medicine curriculum, internal medicine trainees' knowledge about important geriatric conditions is poor, even if their internal medicine knowledge is overall adequate. This would translate into suboptimal care for this vulnerable and rapidly expanding segment of the population.

  20. Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center.

    Science.gov (United States)

    Ahn, James; Golden, Andrew; Bryant, Alyssa; Babcock, Christine

    2016-03-01

    In the face of declining bedside teaching and increasing emergency department (ED) crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs) in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR. TRs were present in the ED from 12 pm-10 pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief "chalk talks," instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs), residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care. Survey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance. The presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare.

  1. [DIFFERENCE IN THE PREVALENCE OF BURNOUT SYNDROME IN PRECLINICAL AND CLINICAL TEACHING DOCTORS OF MOSTAR SCHOOL OF MEDICINE].

    Science.gov (United States)

    Vukojevič, Mladenka; Antunovič, Andelka; Petrov, Božo

    2015-01-01

    The aim of this study was to determine the difference in the prevalence of burnout syndrome in preclinical and clinical teaching doctors of Mostar School of Medicine in the academic year 2011/2012. Special attention was also focused on finding out the possible difference between the syndrome incidence that was correlated to gender and years of service. The main hypothesis was that the probability of burnout syndrome incidence was higher in the group of female clinical teaching doctors having more years of service. The study involved 62 people with high academic education employed at Mostar School of Medicine who were surveyed during a randomly selected consecutive 3-month period (February to May) of the academic year 2011/2012. The data were prospectively collected through a standardized questionnaire survey. The studied parameters were gender, years of work experience and the engagement in preclinical or clinical departments of the Medical School. The survey showed that 43 out of 62 (69.4%) respondents did not suffer the burnout syndrome, while moderate syndrome was recodred in 19 (30.6%) of them. No person had serious symptoms of the syndrome. The difference between the respondents who suffered the syndrome and those who did not was not statistically significant (P=0.002). Considering the gender of respondents, statistically significant differences were not confirmed (P=0.444). Considering the years of service, the highest incidence of the syndrome was found in people with more work experience (in the group of 21-25 years), but the difference between the groups was not statistically significant (P=0.271). Observing the work in preclinical and clinical departments, because of the limited number of patients we could not confirm the hypothesis. The syndrome had affected 13 (21%) clinical teaching doctors and 6 (9,7%) preclinical doctors, while the differenece between them was not statistically significant (P=0.054). Considering the results of this research, it has

  2. The construction of power in family medicine bedside teaching: a video observation study.

    Science.gov (United States)

    Rees, Charlotte E; Ajjawi, Rola; Monrouxe, Lynn V

    2013-02-01

    Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student

  3. The death penalty in Catholic teaching and medicine: intersections and places for dialogue.

    Science.gov (United States)

    Norko, Michael A

    2008-01-01

    Current debate on the death penalty in public and professional spheres is seen as divisive in nature, disallowing the possibility of common agreement. The history of views of the death penalty within the Catholic Church illustrates centuries of tensions and ambiguities as well as a current posture that manages to hold these tensions while advocating a strong position. That history of church views itself contains allusions to and intersections with medicine. There is something tangible to be gained in understanding religious views on the death penalty, in the debates both within medicine and in the public sphere. An argument is made for sufficient overlap of contemporary purpose between the goals of church and medicine to warrant further dialogue in enhanced and deliberative democratic processes.

  4. The Lost Art of Whole Blood Transfusion in Austere Environments

    Science.gov (United States)

    2015-04-01

    Norway; 2Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway; 3Department of Anesthesia and Intensive Care...intravenously or intraosseously will increase the CO and hence the BP because the circulation is constricted severely with low circulating blood volume...lactate monitor). & Establish an intravenous or intraosseous route. For intraosseous route, sternal access is preferred. & The initial fluid of choice is

  5. [Economic environment and blood transfusion].

    Science.gov (United States)

    Durand-Zaleski, I

    2015-08-01

    The increasing pressure on healthcare resources affects blood donation and transfusion. We attempted a survey of the efficiency of different strategies, actual or proposed to improve the management of blood products. We found an important disconnect between the cost effectiveness ratio of strategies and their uptake by policy makers. In other words, the least efficient strategies are those which increase transfusion safety by increasing the number of biological markers and are those preferred by health authorities in developed countries. Other more efficient strategies are more slowly implemented and included a systematic use of transfusion guidelines, reducing blood losses or increasing pre operative blood levels in elective surgeries. Copyright © 2015. Published by Elsevier SAS.

  6. Transfusão de sangue em terapia intensiva: um estudo epidemiológico observacional Blood transfusion in intensive care: an epidemiological observational study

    Directory of Open Access Journals (Sweden)

    José Rodolfo Rocco

    2006-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A transfusão de concentrado de hemácias (CHA é muito freqüente no centro de tratamento intensivo (CTI, mas as conseqüências da anemia nos pacientes gravemente enfermos ainda são obscuras. Os objetivos desse estudo foram avaliar a freqüência, as indicações, os limiares transfusionais e o prognóstico dos pacientes criticamente enfermos que receberam CHA. MÉTODO: Estudo prospectivo de coorte realizado no CTI médico-cirúrgico de um Hospital Universitário durante 16 meses. Foram coletados dados demográficos, clínicos e os relacionados a transfusão de CHA. Regressão logística binária foi utilizada após as análises univariadas. RESULTADOS: Dos 698 pacientes internados, 244 (35% foram transfundidos com CHA. Os pacientes clínicos e em pós-operatório de urgência foram mais transfundidos. Os limiares transfusionais foram: hematócrito = 22,8% ± 4,5% e hemoglobina = 7,9 ± 1,4 g/dL. Os pacientes transfundidos receberam em média 4,4 ± 3,7 CHA e apresentaram maior letalidade no CTI (39,8% versus 13,2%; p 5 unidades e escore SAPS II. CONCLUSÕES: A transfusão de CHA é freqüente no CTI, particularmente nos pacientes internados por problemas clínicos e após cirurgias de emergência, com internação prolongada, em VM e com cirrose hepática. O limiar transfusional observado foi mais baixo que aquele assinalado pela literatura. A transfusão de CHA foi associada com maior letalidade.BACKGROUND AND OBJECTIVES: Packed red blood cell (PRBC transfusion is frequent in intensive care unit (ICU. However, the consequences of anemia in ICU patients are poorly understood. Our aim was to evaluate the prevalence, indications, pre-transfusion hematocrit and hemoglobin levels, and outcomes of ICU patients transfused with PRBC. METHODS: Prospective cohort study conducted at a medical-surgical ICU of a teaching hospital during a 16-month period. Patients' demographic, clinical, laboratory and transfusion-related data

  7. Hardwiring patient blood management: harnessing information technology to optimize transfusion practice.

    Science.gov (United States)

    Dunbar, Nancy M; Szczepiorkowski, Zbigniew M

    2014-11-01

    This review will describe recent applications of computerized provider order entry (CPOE) with clinical decision support systems (CDSS) in transfusion medicine and other novel ways information technology is being applied to support patient blood management (PBM) efforts. CPOE with CDSS can be used to encourage appropriate transfusion practices as part of an institutional PBM program. The impact of CPOE with CDSS is enhanced when the laboratory information system (LIS) can be linked to the electronic medical record (EMR) to enable adaptive alerts that query transfusion orders against current laboratory and/or clinical data to ensure provider ordering practice is consistent with institutional guidelines. Additional current applications of healthcare information technology to transfusion medicine include creation of electronic reports to support order auditing, assessment of blood product utilization and compliance monitoring. Application of healthcare information technology to transfusion medicine will expand, as more institutions embrace PBM and utilize their EMR and LIS to 'hardwire' appropriate transfusion practice. The impact of implementation of CPOE with CDSS is variable and influenced by multiple factors including existing practice patterns, provider receptiveness and system configuration.

  8. Transfusion-Associated Microchimerism in Combat Casualties

    National Research Council Canada - National Science Library

    Dunne, James R; Lee, Tzong-Hae; Burns, Christopher; Cardo, Lisa J; Curry, Kathleen; Busch, Michael P

    2007-01-01

    ...) in civilian trauma patients receiving allogenic red blood cell (RBC) transfusions. We explored the incidence of TA-MC in combat casualties receiving FrWB compared with patients receiving standard stored RBC transfusions. Methods...

  9. Transfusion transmissible viral infections among potential blood ...

    African Journals Online (AJOL)

    effective approach for prevention and control of transfusion-transmissible infections (TTIs). Also, it has been documented that sub-standard test kits are mostly used in resource limited settings for transfusion related diagnosis. However, the role of ...

  10. Bacteriological Controls at Czechoslovakia Blood Transfusion Centers

    National Research Council Canada - National Science Library

    Jezkova, Zdenka

    1961-01-01

    .... Bacterial contamination may come about: 1. Through incorrect preparation of the transfusion material, such as the withdrawal equipment,transfusion flasks, reservative solution, and, particularly, through inadequate sterilization; 2...

  11. Teaching wound care to family medicine residents on a wound care service

    Directory of Open Access Journals (Sweden)

    Little SH

    2013-08-01

    Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

  12. Structurally Based Therapeutic Evaluation: A Therapeutic and Practical Approach to Teaching Medicinal Chemistry.

    Science.gov (United States)

    Alsharif, Naser Z.; And Others

    1997-01-01

    Explains structurally based therapeutic evaluation of drugs, which uses seven therapeutic criteria in translating chemical and structural knowledge into therapeutic decision making in pharmaceutical care. In a Creighton University (Nebraska) medicinal chemistry course, students apply the approach to solve patient-related therapeutic problems in…

  13. Strategies for Teaching Evidence-Based Management: What Management Educators Can Learn from Medicine

    Science.gov (United States)

    Wright, April L.; Middleton, Stuart; Greenfield, Geoffrey; Williams, Julian; Brazil, Victoria

    2016-01-01

    Evidence-based management (EBMgt) is a growing literature stream in management education which contends that management decision making should be informed by the best available scientific evidence (Rousseau, 2006). Encouraged by the success of evidence-based practice in the field of medicine, advocates of EBMgt have increasingly called for…

  14. Critical Emergency Medicine Procedural Skills: A Comparative Study of Methods for Teaching and Assessment.

    Science.gov (United States)

    Chapman, Dane M.; And Others

    Three critical procedural skills in emergency medicine were evaluated using three assessment modalities--written, computer, and animal model. The effects of computer practice and previous procedure experience on skill competence were also examined in an experimental sequential assessment design. Subjects were six medical students, six residents,…

  15. Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

    Science.gov (United States)

    Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

    2013-01-01

    Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine…

  16. Transfusion complications:Estimate of the residual risk of transfusion ...

    African Journals Online (AJOL)

    Background: Sub-Saharan Africa remains the epicenter of the human immunodeficiency virus (HIV) pan- demic. However, there is a lack of multicenter data on the risk of transfusion-transmitted HIV from blood centers in sub-Saharan Africa. Study design and methods: The incidence of HIV infections in the blood donations ...

  17. E-film - an interactive clinical teaching tool for nuclear medicine

    International Nuclear Information System (INIS)

    Zohar, T.; VanEvery, B.

    2002-01-01

    Full text: With the advent of technology the old fashioned film library used by our Nuclear Medicine staff has been updated and remodelled from 'hard copy learning' with film and light boxes to 'soft-copy learning' using standard PC hardware and software. The new model 'e-film' is a web browser based image viewer written in HTML. It incorporates interesting case studies with interactive questions and answers based on pathology. The easy-to-use design involves selecting a Nuclear Medicine scan e g bone scan, and then the pathology of interest e g osteomyelitis. Each pathology selected has a normal and a number of abnormal cases, which can be viewed as static planar and dynamic images or as movies. The text displayed with each case study is a question with an answer that can be revealed when ready. A general learning tip pertaining to the scan type or particular pathology can also be revealed on request. Many of the case studies incorporate images from other modalities such as CT or MRI for comparison with the Nuclear Medicine images. Pre- and post- treatment scans can also be viewed to assess outcome 'e film' allows staff to search in a specific area of Nuclear Medicine and then test themselves on their understanding of the scan and relevant pathologies. Standard web browsers on PC's allow department-wide user accessibility of e-film via an intranet configuration. In summary, e-film is a convenient, time efficient way of learning with the potential of unlimited data expansion. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  18. Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center

    Directory of Open Access Journals (Sweden)

    James Ahn, MD

    2016-03-01

    Full Text Available Introduction: In the face of declining bedside teaching and increasing emergency department (ED crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR. Methods: TRs were present in the ED from 12pm-10pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief “chalk talks,” instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs, residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care. Results: Survey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance. Conclusion: The presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare.

  19. Student-Opinion Questionnaires on Teacher Performance. An Institutional Strategy for the Evaluation of Teaching Medicine

    Directory of Open Access Journals (Sweden)

    Adrián Martínez González

    2010-05-01

    Full Text Available As a way of showing the usefulness of employing questionnaires for evaluating teaching performance by means of students’ opinion of various aspects of institutional assessment, this article presents the results of applying the Student-Opinion Questionnaire on Teacher Performance (COED for the Spanish initials in first and second-year subjects taught during Semester 2007-2008 II, in the Medical School of the National Autonomous University of Mexico (UNAM. Analyzed were a total of 20,136 questionnaires, of which were evaluated 919 teachers/groups. Teaching activities are systematically evaluated as better in the second-year courses. In general, “Attitude toward students”, “Punctuality”, and “Compliance with the administrative aspects of the courses” (management are assessed as best, while “Teaching methods” and “Use of other support materials and activities” need improvement. The results show that this type of questionnaire, as well as offering feedback on the performance of teachers as individuals, permits the comparison of their performance by materials and levels, as well as basing proposals for research and improvement. In this sense, the questionnaires should form part of the instruments used for every program of institutional evaluation.

  20. Transfusion data: from collection to reflection

    NARCIS (Netherlands)

    van Hoeven, L.R.

    2017-01-01

    Blood transfusion is an important medical treatment for many and diverse patients groups, saving lives but sometimes also causing adverse transfusion reactions in transfusion recipients. For this reason blood use should ideally be as low as possible. The fact that significant differences exist in

  1. Proposed Formulae for Determining Blood Transfusion ...

    African Journals Online (AJOL)

    Background: Blood replacement remains a crucial component of the treatment of severe anaemia irrespective of the cause. The transfusion of an adequate amount of blood is important to prevent under- or over-transfusion. Existing formulae used for the calculation of blood transfusion requirements, while being useful, still ...

  2. Best practices for transfusion for patients with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Ted Wun

    2010-01-01

    Full Text Available The beta-globin gene mutation in sickle cell anemia results in anemia and repeated bouts of vascular occlusion. The cumulative effect of these vasocclusive events is progressive damage to many organs including the kidneys, lungs, and brain. The transfusion of red blood cells (RBC can ameliorate many of these complications, but can be associated with both acute and chronic complications, including iron overload. The objective of the Best Practices in Transfusion Medicine for Patients with Sickle Cell Disease (SCD Conference was to review the available published evidence and clinical experience surrounding the use of RBC transfusions for sickle cell disease by a panel of experts. The expert panel developed explicit clinical guidelines for the use of RBC in SCD patients. The panel also made recommendations for further research.  A set of guidelines were produced for dissemination to pertinent stakeholders. If implemented, these clinical pathways have the potential to optimize the use of red blood cell transfusions in SCD.

  3. Impact of Transfusion on Cancer Growth and Outcome

    Directory of Open Access Journals (Sweden)

    Hadi A. Goubran

    2016-01-01

    Full Text Available For many years, transfusion of allogeneic red blood cells, platelet concentrates, and plasma units has been part of the standard therapeutic arsenal used along the surgical and nonsurgical treatment of patients with malignancies. Although the benefits of these blood products are not a matter of debate in specific pathological conditions associated with life-threatening low blood cell counts or bleeding, increasing clinical evidence is nevertheless suggesting that deliberate transfusion of these blood components may actually lead to negative clinical outcomes by affecting patient's immune defense, stimulating tumor growth, tethering, and dissemination. Rigorous preclinical and clinical studies are needed to dimension the clinical relevance, benefits, and risks of transfusion of blood components in cancer patients and understand the amplitude of problems. There is also a need to consider validating preparation methods of blood components for so far ignored biological markers, such as microparticles and biological response modifiers. Meanwhile, blood component transfusions should be regarded as a personalized medicine, taking into careful consideration the status and specificities of the patient, rather than as a routine hospital procedure.

  4. Comparative analysis of autologous blood transfusion and allogeneic blood transfusion in surgical patients

    OpenAIRE

    Long, Miao-Yun; Liu, Zhong-Han; Zhu, Jian-Guang

    2014-01-01

    Objective: To investigate application effects of autologous blood transfusion and allogeneic blood transfusion in surgically treated patients receiving spine surgery, abdomen surgery and ectopic pregnancy surgery. Methods: 130 patients who would undergo selective operations were divided into autologous transfusion group and allogeneic transfusion group. Both groups received the same anesthesia, and there was no significant difference in transfusion volume or fluid infusion volume. Results: Th...

  5. Students’ perception of teaching-learning methods in Community Medicine at a Government Medical College in Rajasthan

    Directory of Open Access Journals (Sweden)

    Rupa Sharma

    2017-06-01

    Full Text Available Background: Knowledge of Community Medicine plays a pivot role in effective delivery of health care services. Effective Teaching-Learning (T-L of a class of 150-200 students is a challenge. Research is needed to identify methods suitable to the needs of the students. Students’ perspective is an important diagnostic feedback tool in this context. Aims & Objectives: To know the students’ preferences and perceptions regarding current T-L methods and their felt need for modification in the T-L approach. Material & Methods: Responses were collected from students pursuing internship regarding their preferences and perception on a pretested, validated semi structured questionnaire, most of the responses were collected on a Likert type five point scale. The data was analyzed by calculating percentage, mean and Standard Deviation (SD. Result: Majority (66.2% felt a need for modification in T-L Approach and 74% of these opined that it will improve their performance in assessments. Presentation of content was voted as most important component for effective T-L (mean 3.9± 1.39. Desirable modifications was more time allotment to integrated modular T-L (51% and field visits (26%. Conclusion: A judicious combination of Power point presentations with Modular T-L sessions and Field visits can be a more effective T-L approach in Community Medicine from the students’ perspective.

  6. Blood transfusion and hepatitis viruses

    African Journals Online (AJOL)

    virus in blood donors: investigation of type-specific differences in serologic reactivity and rate of alanine aminotransferase abnormalities. Transfusion 1993;. 33: 7-13. 45. McFarlane IG, Smith HM, Johnson PJ, Bray GP, Vergani 0, Williams R. Hepatitis. C virus antibodies in chronic active hepatitis: pathogenetic factor or false-.

  7. Education scholarship in emergency medicine part 1: innovating and improving teaching and learning.

    Science.gov (United States)

    Sherbino, Jonathan; Van Melle, Elaine; Bandiera, Glen; McEwen, Jill; Leblanc, Constance; Bhanji, Farhan; Frank, Jason R; Regehr, Glenn; Snell, Linda

    2014-05-01

    As emergency medicine (EM) education evolves, a more advanced understanding of education scholarship is required. This article is the first in a series of three articles that reports the recommendations of the 2013 education scholarship consensus conference of the Academic Section of the Canadian Association of Emergency Physicians. Adopting the Canadian Association for Medical Education's definition, education scholarship (including both research and innovation) is defined. A rationale for why education scholarship should be a priority for EM is discussed.

  8. Pharmacovigilance study of Ayurvedic medicine in Ayurvedic Teaching Hospital: A prospective survey study.

    Science.gov (United States)

    Ajanal, Manjunath N; Nayak, Shradda U; Kadam, Avinash P; Prasad, B S

    2015-01-01

    Though Ayurveda is practiced in the Indian subcontinent since centuries, there is a paucity of systematic documentation related to the occurrence of adverse drug reactions (ADR) and other issues regarding the safety of Ayurveda medicines. To monitor and analyze the pattern and frequency of ADR to Ayurvedic medicines in an Ayurvedic hospital setup. In this prospective study, ADR monitoring was done in KLE Ayurveda Secondary Care Hospital, Belgaum, Karnataka, India by spontaneous and intensive monitoring technique for a span of 1-year (June 2010 to May 2011). Data pertaining to patient demography, drug and reaction characteristics, organ system involved and reaction outcomes were collected and evaluated. The reaction severity and predisposing factors were also assessed. In a span of one year, 84 adverse drug events were reported out of which 52 confirmed as ADR. The overall incidence of ADR in the patient population was 1.14%, out of which 23 (44.23%) were related to Panchakarma (detoxification process), 13 (25.00%) related to the herbal formulations and 06 (11.53%) were of Rasa Aushadhi (mineral or herbo-mineral formulations). The commonly affected organ systems were gastrointestinal system 24 (46.15%) and skin 15 (28.84%). The majority of the reactions were moderate 30 (57.69%) to mild 20 (38.46%) in severity. Most patients recovered from the incidence. The present work has documented the incidence and characteristic of ADR to Ayurvedic medicine in a typical Ayurveda hospital setup. This will help in developing various strategies for boosting pharmacovigilance in Ayurveda, thereby ensuring safer use of Ayurveda medicines.

  9. A student-led process to enhance the learning and teaching of teamwork skills in medicine.

    Science.gov (United States)

    Balasooriya, Chinthaka; Olupeliyawa, Asela; Iqbal, Maha; Lawley, Claire; Cohn, Amanda; Ma, David; Luu, Queenie

    2013-01-01

    The development of teamwork skills is a critical aspect of modern medical education. This paper reports on a project that aimed to identify student perceptions of teamwork-focused learning activities and generate student recommendations for the development of effective educational strategies. The project utilized a unique method, which drew on the skills of student research assistants (RAs) to explore the views of their peers. Using structured interview guides, the RAs interviewed their colleagues to clarify their perceptions of the effectiveness of current methods of teamwork teaching and to explore ideas for more effective methods. The RAs shared their deidentified findings with each other, identified preliminary themes, and developed a number of recommendations which were finalized through consultation with faculty. The key themes that emerged focused on the need to clarify the relevance of teamwork skills to clinical practice, reward individual contributions to group process, facilitate feedback and reflection on teamwork skills, and systematically utilize clinical experiences to support experiential learning of teamwork. Based on these findings, a number of recommendations for stage appropriate teamwork learning and assessment activities were developed. Key among these were recommendations to set up a peer-mentoring system for students, suggestions for more authentic teamwork assessment methods, and strategies to utilize the clinical learning environment in developing teamwork skills. The student-led research process enabled identification of issues that may not have been otherwise revealed by students, facilitated a better understanding of teamwork teaching and developed ownership of the curriculum among students. The project enabled the development of recommendations for designing learning, teaching, and assessment methods that were likely to be more effective from a student perspective.

  10. Effective Communication Barriers in Clinical Teaching among Malaysian Medical Students in Zagazig Faculty of Medicine (Egypt).

    Science.gov (United States)

    Abass, Marwa Ahmed; Said, Nagwa Samy; Zahed, Eman Salah El; Hussein, Wafaa Fawzy; Hamid, Omaima Ibrahim Abdel

    2015-12-01

    effective communication in a clinical environment plays a vital role in patient assessment and treatment. The aim of this study was to understand the experiences of Malaysian medical students concerning communication barriers during clinical practice. The goal was to provide answers for three important research questions, i.e., 1) Are communication barriers an impediment to Malaysian students during clinical teaching? 2) What is the nature of the language barriers that the students encounter? and 3) What are the best ways of reducing these barriers during clinical teaching? The qualitative method was used to conduct the research, and open-ended questionnaires were used to collect the data. The study was conducted on 95 fourth-, fifth-, and sixth-year students, 80% of whom completed the study. Medical students from Malaysia who have limited knowledge of the Arabic language experience some difficulties in communicating with staff members, patients, and nurses during their clinical practices. Successful orientation of students to the language used in the clinical environment will help the students overcome the communication barriers they encounter during their clinical practices.

  11. [Students of today, physicians of tomorrow. Educational priorities for innovative teaching methods in medicine].

    Science.gov (United States)

    Guicciardi, Stefano; Riforgiato, Chiara; Leopardi, Eleonora

    2015-02-01

    In the past three years there has been increasing debate regarding the educational system of physicians in Italy, mainly due to the implementation of radical changes in the selection and admission criteria to medical courses. From the students' point of view, it is possible to identify different educational challenges to be faced in order to develop a more adequate learning system.First of all, it is necessary to elaborate an accurate planning of the physicians based on the needs of the Italian Healthcare System with a proportionate regulation of access to medical and specialty courses. Secondly, there is the strong need to update the traditional curricula based on a biological reductionist perspective with innovative and integrated courses that could teach new essential topics in a radically changed and globalized world, such as global health or medical ethics. Thirdly, it is crucial to introduce innovative teaching methods that could help students improve and evaluate their practical skills and participate actively in their own education, developing the attitudes and competences needed in their future profession.

  12. Epidemiological considerations for the use of databases in transfusion research: a Scandinavian perspective.

    Science.gov (United States)

    Edgren, Gustaf; Hjalgrim, Henrik

    2010-11-01

    At current safety levels, with adverse events from transfusions being relatively rare, further progress in risk reductions will require large-scale investigations. Thus, truly prospective studies may prove unfeasible and other alternatives deserve consideration. In this review, we will try to give an overview of recent and historical developments in the use of blood donation and transfusion databases in research. In addition, we will go over important methodological issues. There are at least three nationwide or near-nationwide donation/transfusion databases with the possibility for long-term follow-up of donors and recipients. During the past few years, a large number of reports have been published utilizing such data sources to investigate transfusion-associated risks. In addition, numerous clinics systematically collect and use such data on a smaller scale. Combining systematically recorded donation and transfusion data with long-term health follow-up opens up exciting opportunities for transfusion medicine research. However, the correct analysis of such data requires close attention to methodological issues, especially including the indication for transfusion and reverse causality.

  13. The earlier the better: An evaluation of changes to teaching year 1 Nuclear Medicine

    International Nuclear Information System (INIS)

    Adams, E.J.; Kilburn-Watt, E.; Cowell, S.F.

    1998-01-01

    Full text: Changes were made to the content and mode of delivery of the Year 1 Nuclear Medicine degree program at The University of Sydney in 1996. Changes included increased study of skeletal, respiratory and cardiac Nuclear Medicine and the use of problem based learning to increase independent learning and clinical reasoning skills. Learning outcomes were qualitatively assessed to determine the educational value of the changes. The project aimed to evaluate whether changes made to the Year 1 program in 1996 raised clinical abilities of students entering their first clinical placement in Year 2. Retrospective surveys were conducted on both the 1995 and 1996 Year 1 students after completion of their first Year 2 clinical placement. Surveys were designed to assess the students perception of how well Year 1 had prepared them for both understanding and application of content studied in Year 1. Clinical Supervisors who assessed both cohorts of students were surveyed to determine if 1996 students presented with any appreciable difference in understanding and application to areas studied in Year 1. Results of the student survey indicated the 1996 students were more positive than the 1995 students about their clinical readiness. Clinical Supervisor survey results showed a positive response to the level of understanding and application of skills by the 1996 students. In conclusion, the 1996 Year 1 students were perceived to have a higher level of clinical abilities at the commencement of their Year 2 clinical placement. This result demonstrated worthwhile learning outcomes for the changes to content and mode of delivery in the Year 1 Nuclear Medicine degree program

  14. Prediction of Packed Cell Volume after Whole Blood Transfusion in Small Ruminants and South American Camelids: 80 Cases (2006-2016).

    Science.gov (United States)

    Luethy, D; Stefanovski, D; Salber, R; Sweeney, R W

    2017-11-01

    Calculation of desired whole blood transfusion volume relies on an estimate of an animal's circulating blood volume, generally accepted to be 0.08 L/kg or 8% of the animal's body weight in kilograms. To use packed cell volume before and after whole blood transfusion to evaluate the accuracy of a commonly used equation to predict packed cell volume after transfusion in small ruminants and South American camelids; to determine the nature and frequency of adverse transfusion reactions in small ruminants and camelids after whole blood transfusion. Fifty-eight small ruminants and 22 alpacas that received whole blood transfusions for anemia. Retrospective case series; medical record review for small ruminants and camelids that received whole blood transfusions during hospitalization. Mean volume of distribution of blood as a fraction of body weight in sheep (0.075 L/kg, 7.5% BW) and goats (0.076 L/kg, 7.6% BW) differed significantly (P blood volume (volume of distribution of blood) is adequate for calculation of transfusion volumes; however, use of the species-specific circulating blood volume can improve calculation of transfusion volume to predict and achieve desired packed cell volume. The incidence of transfusion reactions in small ruminants and camelids is low. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  15. Blood transfusion practice in the UK and Ireland: a survey of palliative care physicians.

    Science.gov (United States)

    Neoh, Karen; Stanworth, Simon; Bennett, Michael I

    2018-03-23

    Red cell (blood) transfusions are used in palliative care to manage patients with symptomatic anaemia or when patients have lost blood. We aimed to understand current blood transfusion practice among palliative medicine doctors and compare this with National Institute for Health and Care Excellence (NICE) guidance. NICE guidance advocates more restrictive transfusion practice but is based on clinical trials in non-palliative care contexts; the extent to which these findings should be applied to palliative care remains unclear. Four clinical vignettes of common clinical palliative care scenarios were developed. Members of the Association for Palliative Medicine were invited to complete the survey. Results were compared with acceptable responses based on current NICE recommendations and analysed to determine the influence of respondents' gender, experience or work setting. 27% of 1070 members responded. Overall, ideal or acceptable responses were selected by less than half of doctors to all four vignettes. Doctors were more liberal in prescribing blood transfusions than NICE guidance would advocate. Senior doctors were less likely to choose an acceptable response than junior colleagues. Palliative care practice is varied and not consistent with a restrictive blood transfusion policy. More recently trained doctors follow less liberal practices than senior colleagues. More direct evidence of benefits and harms of blood transfusion is needed in palliative care to inform practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Improving transfusion practice in transfusion dependent thalassaemia patients

    Directory of Open Access Journals (Sweden)

    Chathupa Wickremaarachchi

    2017-10-01

    Full Text Available The aim of this study was to improve current transfusion practice in transfusiondependent thalassaemia patients by determining whether safe transition from triplewashed red cells (TWRC to leucodepleted red cells (LDRC, increasing transfusion rates, reducing the use of frusemide and creating uniform practice across patients is possible. In patients receiving regular transfusions (50, triple-washed red blood cells were changed to LDRC, transfusion rates were increased to 5 mL/kg/h (in line with the Cooley’s Foundation guidelines to a maximum of 300 mL/h and frusemide was ceased. Medical review occurred at completion of the transfusion. Of the 20 patients on TWRC, 18 were transitioned to leucodepleted red cells (90%. Recurrent allergic reactions in 2 patients required re-institution of TWRC. 7 of the 8 patients on regular frusemide ceased this practice with no documented transfusion-related fluid overload. One patient refused. Of the eligible 50 patients, 20 patients (40% were increased to the maximum transfusion rate of 300 mLs/h; 6 (12% increased rate but refused to go to the maximum; 9 (18% refused a change in practice and 15 (30% were already at the maximum rate. There was only one documented transfusion reaction (palpitations however this patient was able to tolerate a higher transfusion rate on subsequent transfusions. Thalassemia patients on TWRC were safely transitioned to LDRC. Transfusion rates were safely increased, with a calculated reduction in day-stay bed time of 17.45 h per month. This confirms a guideline of 5 mL/kg/h for transfusion-dependant thalassaemia patients with preserved cardiac function is well tolerated and may be translated to other centres worldwide.   本研究的目的是通过确定是否有可能进行从三洗红细胞(TWRC)到去白细胞红细胞(LDRC)的安全过渡,提高输血速率,减少速尿的使用,并在患者中实施统一规则,从而改进输血依赖型地中海贫血患者中

  17. Anemia of prematurity: time for a change in transfusion management?

    OpenAIRE

    Khodabux, Chantal Muriel

    2013-01-01

    In this thesis we investigated clinical effects of allogeneic red blood cell (RBC) transfusions in premature infants, different transfusion volumes in relation to neonatal outcome in premature infants and the use of autologous cord blood (CB) as an alternative for allogeneic transfusions. Despite the use of a national transfusion guideline, we observed significant differences concerning the total amount of administered transfusions. A liberal transfusion strategy and a higher transfusion volu...

  18. Clinical Holistic Medicine: Teaching Orgasm for Females with Chronic Anorgasmia using the Betty Dodson Method

    Science.gov (United States)

    Struck, Pia; Ventegodt, Søren

    2008-01-01

    The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis) through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM). The patients received 3 × 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP) and complementary medicine (CAM bodywork, manual sexology similar to the “sexological examination”). The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years) with chronic anorgasmia (for 12 years on average) who were participating in the “orgasm course for anorgasmic women”; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93%) had an orgasm during therapy, witnessed by the therapist, and 35 patients (7%) did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient. PMID:18836654

  19. Clinical Holistic Medicine: Teaching Orgasm for Females with Chronic Anorgasmia using the Betty Dodson Method

    Directory of Open Access Journals (Sweden)

    Pia Struck

    2008-01-01

    Full Text Available The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM. The patients received 3 × 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP and complementary medicine (CAM bodywork, manual sexology similar to the “sexological examination”. The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years with chronic anorgasmia (for 12 years on average who were participating in the “orgasm course for anorgasmic women”; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93% had an orgasm during therapy, witnessed by the therapist, and 35 patients (7% did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.

  20. [Evolutionary medicine: an introduction. Evolutionary biology, a missing element in medical teaching].

    Science.gov (United States)

    Swynghedauw, Bernard

    2009-05-01

    The aim of this brief review article is to help to reconcile medicine with evolutionary biology, a subject that should be taught in medical school. Evolutionary medicine takes the view that contemporary ills are related to an incompatibility between the environment in which humans currently live and their genomes, which have been shaped by diferent environmental conditions during biological evolution. Human activity has recently induced acute environmental modifications that have profoundly changed the medical landscape. Evolutionary biology is an irreversible, ongoing and discontinuous process characterized by periods of stasis followed by accelerations. Evolutionary biology is determined by genetic mutations, which are selected either by Darwinian selective pressure or randomly by genetic drift. Most medical events result from a genome/environment conflict. Some may be purely genetic, as in monogenic diseases, and others purely environmental, such as traffic accidents. Nevertheless, in most common diseases the clinical landscape is determined by the conflict between these two factors, the genetic elements of which are gradually being unraveled Three examples are examined in depth:--The medical consequences of the greenhouse effect. The absence of excess mortality during recent heat waves suggests that the main determinant of mortality in the 2003 heatwave was heatstroke and old age. The projected long-term effects of global warming call for research on thermolysis, a forgotten branch of physiology.--The hygiene hypothesis postulates that the exponential rise in autoimmune and allergic diseases is linked to lesser exposure to infectious agents, possibly involving counter-regulatory factors such as IL-10.--The recent rise in the incidence of obesity and type 2 diabetes in rich countries can be considered to result from a conflict between a calorie-rich environment and gene variants that control appetite. These variants are currently being identified by genome

  1. Clinical holistic medicine: teaching orgasm for females with chronic anorgasmia using the Betty Dodson method.

    Science.gov (United States)

    Struck, Pia; Ventegodt, Søren

    2008-09-21

    The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis) through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM). The patients received 3 "e 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP) and complementary medicine (CAM bodywork, manual sexology similar to the inverted exclamation mark section signsexological examination inverted exclamation mark ). The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years) with chronic anorgasmia (for 12 years on average) who were participating in the inverted exclamation mark section signorgasm course for anorgasmic women inverted exclamation mark ; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93%) had an orgasm during therapy, witnessed by the therapist, and 35 patients (7%) did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.

  2. Attitude, belief and knowledge about blood donation and transfusion in saudi population

    International Nuclear Information System (INIS)

    Drees, A.M.A.

    2008-01-01

    Blood donation and transfusion are remarkably safe medical procedures. However, attitudes, beliefs and level of knowledge associated with blood donation and transfusion may affect such procedures. Therefore, the aim of this study was to determine the attitude, belief and knowledge about blood donation and transfusion in Saudi Population. The present study was conducted in the Department of Physiology, College of Medicine, King Saud University Hospitals, Riyadh, Saudi Arabia. A well structured Arabic questionnaire was used to asses the attitude, belief and knowledge regarding blood donation and transfusion. The sample consisted of 335 male (55%) and 274 female (45%); the majority of the sample (65.84%) were non-donors. These non-donors (78.98%) were between the ages of 15-30 years. The 88.5% of the people who participated in the study believed that blood donation was not harmful, 20% of them stated that they would refuse blood transfusion even if they were in need because of the risk of acquiring infectious disease. 84.5% preferred direct donation, (49%) of the sample stated that they would accept blood donation only from relatives, 55.1% believed that blood transfusion was safe. However, 11.6% claimed to have acquired infectious disease after blood transfusion, 58% female in addition to 11.34% male preferred to receive blood from female donor and 69.5% did not know if the blood banks were in need of blood or not and 17.4% believed that all surgical procedures require blood transfusion. Different fears, mistrust in hospital and lack of information may serve as an important issue to be addressed when developing donors recruitment programs or campaigns to clear misconceptions about blood donation. In addition, public should know that numerous screening measures are implemented to ensure that blood donation is safe for the donor and that transfusion of the donated blood is safe for the recipient. (author)

  3. Institutional authorisation and accreditation of Transfusion Services and Blood Donation Sites: results of a national survey

    Science.gov (United States)

    Liumbruno, Giancarlo Maria; Panetta, Valentina; Bonini, Rosaria; Chianese, Rosa; Fiorin, Francesco; Lupi, Maria Antonietta; Tomasini, Ivana; Grazzini, Giuliano

    2011-01-01

    Introduction The aim of the survey described in this article was to determine decisional and strategic factors useful for redefining minimum structural, technological and organisational requisites for transfusion structures, as well as for the production of guidelines for accreditation of transfusion structures by the National Blood Centre. Materials and methods A structured questionnaire containing 65 questions was sent to all Transfusion Services in Italy. The questions covered: management of the quality system, accreditation, conformity with professional standards, structural and technological requisites, as well as potential to supply transfusion medicine-related health care services. All the questionnaires returned underwent statistical analysis. Results Replies were received from 64.7% of the Transfusion Services. Thirty-nine percent of these had an ISO 9001 certificate, with marked differences according to geographical location; location-related differences were also present for responses to other questions and were confirmed by multivariate statistical analysis. Over half of the Transfusion Services (53.6%) had blood donation sites run by donor associations. The statistical analysis revealed only one statistically significant difference between these donation sites: those connected to certified Transfusion Services were more likely themselves to have ISO 9001 certification than those connected to services who did not have such certification. Conclusions The data collected in this survey are representative of the Italian national transfusion system. A re-definition of the authorisation and accreditation requisites for transfusion activities must take into account European and national legislation when determining these requisites in order to facilitate their effective applicability, promote their efficient fulfilment and enhance the development of homogeneous and transparent quality systems. PMID:21839026

  4. Transfusion practice and knowledge in Mozambique

    Science.gov (United States)

    Hartford, Emily; Muanantatha, Olegario; Valigy, Valigy Ismael; Salimo, Sara; Ziman, Alyssa; DeUgarte, Daniel A.

    2016-01-01

    BACKGROUND In Mozambique, there is a limited supply of blood and elevated risks for transmission of infections. Prior studies have documented that many transfusions in Mozambique are potentially avoidable. Transfusion training workshops with a survey and exam were held for providers to understand their perceptions and to improve knowledge and clinical practice. STUDY DESIGN AND METHODS Health care providers completed a survey and a knowledge assessment. The Wilcoxon signed rank test was utilized to compare the relative importance of each factor in the survey, and pre- and posttraining exam scores were compared using Fisher’s exact test. RESULTS A total of 216 health care providers participated; the majority worked in a referral hospital (74%) and reported transfusing blood at least once per week (56%). Most acknowledged the limited blood supply and transfusion risks. Providers rated low hemoglobin (Hb) levels and pallor as significantly important indications for transfusion (p transfuse with age under 5 years when compared to other ages (p transfusion practice were increased reliability of the blood supply, education about transfusion indications, and assessment of perfusion. Before training, the majority of participants identified an incorrect Hb threshold for preoperative or critically ill patients. Overall exam scores improved from a mean of 58% to 74% (p blood transfusions. Preoperative patients, the critically ill, and children appear to be at highest risk for receiving an avoidable blood transfusion. These results will help guide planning for future provider training. PMID:25648912

  5. Complementary and alternative medicine use among elderly patients living with chronic diseases in a teaching hospital in Ethiopia.

    Science.gov (United States)

    Ayele, Asnakew Achaw; Tegegn, Henok Getachew; Haile, Kaleab Taye; Belachew, Sewunet Admasu; Mersha, Amanual Getnet; Erku, Daniel Asfaw

    2017-12-01

    The use of complementary and alternative medicine (CAM) among patients with chronic diseases has grown rapidly worldwide. Yet, little has been known about CAM use by elderly patients with chronic diseases in Ethiopia. This study aimed at assessing the prevalence and reasons for CAM utilization among elderly patients living with chronic diseases in Ethiopia. An institution-based quantitative cross-sectional survey was conducted among elderly patients with chronic disease attending outpatient ambulatory clinics of University of Gondar referral and teaching hospital (UoGRTH). An interviewer-administered and semi-structured questionnaire were utilized to collect the data. Of the total respondents, 240 (74%) reported the use of CAM, with herbal medicine and spiritual healing being the most commonly utilized CAM modalities (50.4% and 40.8% respectively). Dissatisfaction with conventional therapy (40.8%) and belief in the effectiveness of CAM (30.8%) are the most commonly cited reasons for the use of CAM therapies. Rural residency, higher educational status, higher average monthly income and presence of co-morbidity were positively associated with the use of CAM. This survey revealed a higher rate of CAM use among elderly patients with chronic diseases, along with a very low rate of disclosing their use to their health care providers. Special attention should be given for these patient population due to the potentially harmful interaction of different herbal remedies with the prescribed medications, thereby predisposing the patient to untoward adverse effects and compromised overall health outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. [Teaching Bioethics to Students of Medicine with Problem-Based Learning (PBL)].

    Science.gov (United States)

    Bosch-Barrera, Joaquim; Briceño García, Hugo C; Capella, Dolors; De Castro Vila, Carmen; Farrés, Ramón; Quintanas, Anna; Ramis, Josep; Roca, Rosa; Brunet, Joan

    2015-01-01

    We present the experience of the introduction of the subject of bioethics in a medical school in order to give to the 73 students of 5th degree skills to handle ethical conflicts in their practice. The main teaching method used was problem-based learning (PBL). Skills objectives are described. The course was structured with a theoretical seminar (2 hours of duration), a workshop (2 hours of duration), 4 cases of PBL (24 hours of duration in total) and a role playing workshop (2 hours of duration). The seminar was aimed at the acquisition of theoretical knowledge. The PBL cases provided critical appraisal, obtaining knowledge, and application. The Role Playing set out for the practical demonstration of skills acquired in a simulated environment. A continuous assessment of students was performed throughout their practice on the PBL cases (40% of the final score) and also a final evaluation of the course was carried out via exam (60% of the final score). Students completed a course and faculty evaluation anonymously, which came out with positive results (median score of 8.5/10).

  7. [Follow-up of a diploma course graduates in the teaching of medicine].

    Science.gov (United States)

    Ponce de León-Castañeda, Ma Eugenia; Ruíz-Alcocer, Ma del Carmen; Lozano-Sánchez, J Rogelio

    2004-01-01

    Certification in Medical Education; Strategy for Educational Formation. Origins and Follow-Up. This study is a review of the problem of educational formation in terms of an international context, and determinant factors of this need are analyzed, barriers or limitations that have prevented such a formation are highlighted, and some development proposals for educational training are offered. It is also a description of the actions that the Facultad de Medicina (Medical School) of the Universidad Nacional Autónoma de México (National Autonomous University of Mexico) implemented from 1965 to 1996 to promote educational training. In 1997, the Diplomado en Enseñanza de la Medicina began as a new possibility for educational training. The first certification course ran in 1997, and there have been 18 courses to date, eight the Medical School and 10 at external institutions. In 1999, a follow-up questionnaire was answered by physicians trained under the certification program. Results showed that training received in the certification course had a positive effect on teaching skills of physicians who attended it, thus establishing the program as a good option for medical teachers.

  8. Medicine as It Should Be: Teaching Team and Teamwork during a Palliative Care Clerkship.

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    Head, Barbara A; Furman, Christian Davis; Lally, Andrew M; Leake, Kimberly; Pfeifer, Mark

    2018-05-01

    Interprofessional Education (IPE) is an important component of medical education. Rotations with palliative care interdisciplinary teams (IDTs) provide an optimal environment for IPE and teaching teamwork skills. Our objective was to assess the learning of senior medical students during a palliative care rotation. A constant comparison method based on grounded theory was used in this qualitative study. Senior medical students completed a semi-structured reflective writing exercise after a required one-week palliative care clerkship. Sixty randomly selected reflective writings were analyzed. The reflective writings were analyzed to evaluate the student's experiences. Dominant themes identified were related to teams and teamwork. Eight specific themes were identified: value of IDT for team members; value of IDT for patient/family; importance of each team member; reliance on other team members; roles of team members; how teams work; team communication; and interdisciplinary assessment and care planning. Students described exposure to novel experiences and planned to incorporate newly learned behaviors in their future practice. By participating in palliative care IDTs, medical students consistently learned about teamwork within healthcare. Additionally, they learned the importance of such teamwork to patients and the team itself. Rotations with palliative care IDTs have a significant role to play in IPE and preparing medical students to practice on teams.

  9. Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria

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    Anarado Agnes N

    2007-09-01

    Full Text Available Abstract Background The use of Complementary and Alternative Medicine (CAM by cancer patients is very common and varies between populations. The referenced English literature has no local study from Africa on this subject. This study was conducted to define the prevalence, pattern of use, and factors influencing the use of CAM by cancer patients at the University of Nigeria Teaching Hospital Enugu (UNTH-E, Nigeria Method Face-to-face interviews using semi-structured questionnaire were used to determine the use of CAM by cancer patients. All consenting cancer patients were interviewed as they presented at the core surgical units of the UNTH- E, from June 2003 to September 2005. Results 160 patients were interviewed; 68 (42.5% were males and 94 (57.5% were females. Ages ranged from 13–86 years. Breast, urogenital system, gastrointestinal system, and soft tissue cancers predominated. One hundred and four patients (65.0% have used CAM at some time during their current cancer illness; 56 (35.0% patients have not used any form of CAM. There were more females than males among the non-CAM users. The use of CAM was not affected by age, marital status, level of education, religious affiliation, or socioeconomic status. The most frequently used CAMs were herbs (51.9%, faith/prayer healing (49.4%, aloe vera (23.1%, Forever Living Products (16.3%, medicinal tea (14.4%, and Blackstone (12.5%. Over 23% of those who used CAM were satisfied, but 68.3% were disappointed. Most users (67.3% did not see any benefit from the CAM, but 25% could describe some specific benefits. More than 21% of users reported various unwanted effects. While 86.5% of CAM users will use orthodox medicine instead of CAM in the future, 9.6% will use the two together to help each other. Most users (79.8% will not repeat CAM or recommend its use for cancer. The majority of patients (55.8% did not mention their use of CAM to their doctors – mostly because the doctor did not ask

  10. Asynchronous web-based learning, a practical method to enhance teaching in emergency medicine.

    Science.gov (United States)

    Pourmand, Ali; Lucas, Raymond; Nouraie, Mehdi

    2013-03-01

    Abstract Objective: To compare medical knowledge acquisition among emergency medicine (EM) residents who attend weekly core content lectures with those absent but asynchronously viewing the same lectures in a Web-based electronic platform. During the study period all EM residents attending or absent from weekly educational conferences were given a quiz on the covered material. During Phase 1, absentees were not given supplemental educational content for missed lectures. During Phase 2, absentees were sent a link to an online multimedia module containing an audiovisual recording of the actual missed lecture with presentation slides. Scores between attendees and absentees during both phases were compared using a repeated-measures analysis to evaluate the effect of the supplemental online module on knowledge acquisition. Thirty-nine EM residents (equally distributed in postgraduate years 1-4) were studied during a 15-week period. Overall and after adjusting for sex and postgraduate year level, both lecture attendance (b=27; 95% confidence interval, 22-32; pcontent lectures. The percentage of curriculum delivery by asynchronous learning that may be used to achieve overall terminal learning objectives in medical knowledge acquisition requires further study.

  11. Caesarean delivery-related blood transfusion: correlates in a tertiary hospital in Southwest Nigeria.

    Science.gov (United States)

    Akinlusi, Fatimat M; Rabiu, Kabiru A; Durojaiye, Idayat A; Adewunmi, Adeniyi A; Ottun, Tawaqualit A; Oshodi, Yusuf A

    2018-01-10

    Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011. A comparison was made between 188 women who underwent blood transfusion and 718 who did not. Data were obtained on a daily basis by investigators from patients, clinical notes and referral letters using structured pre-tested data collecting form. Socio-demographic characteristics; antenatal, perioperative and intraoperative details; blood loss; transfusion; and puerperal observations were recorded. EPI-Info statistical software version 3.5.3 was used for multivariable analysis to determine independent risk factors for blood transfusion. Of the 2134 deliveries during the study period, 906 (42.5%) had caesarean deliveries and of which 188 (20.8%) were transfused. The modal unit of blood transfused was 3 pints (41.3%). The most common indication for caesarean section was cephalo-pelvic disproportion (25.7%).The independent risk factors for blood transfusion at caesarean section were second stage Caesarean Section (aOR = 76.14, 95% CI = 1.25-4622.06, p = 0.04), placenta previa (aOR = 32.57, 95% CI = 2.22-476.26, p = 0.01), placental abruption (aOR = 25.35, 95% CI = 3.06-211.02, p blood transfusion (aOR = 0.24, 95% CI = 0.09-0.61, p = 0.0024). The overall risk of blood transfusion in cesarean delivery is high. Paturients with the second stage Caesarean section, placenta previa, abruptio placentae and

  12. Educational Needs Assessment Highlights Several Areas of Emphasis in Teaching Evidence-Based Medicine Skills to Physician Assistant Students.

    Science.gov (United States)

    Kuntz, Susan; Ali, Syed Haris; Hahn, Emily

    2016-08-03

    An assessment of educational needs is essential for curricular reform in medical education. Using the conceptual framework of needs assessment, this study aimed to determine which content should be emphasized in teaching evidence-based medicine (EBM) skills to physician assistant (PA) students. Key content areas were identified from the published literature and objectives for previous courses. A questionnaire-type needs assessment instrument was created and given to a graduating class of PA students (n = 21) at the University of North Dakota. The response format had two 5-option scales, one to assess current skill levels and the other to assess ideal skill levels. Means for each category were calculated, and a mean difference analysis was performed. An average mean difference of 0.5 was noted in 3 domains (information retrieval skills, writing skills, and overall gains), and a mean difference of 0.7 was noted in one domain (statistical skills). Items with a mean difference of ≥ 0.7 were identified for prioritization for curricular reform. Open-ended input from respondents substantiated the need for greater emphasis on these content areas. Several content areas related to EBM skills can be identified and prioritized through a systematically conducted educational needs assessment. This method can be used to identify discrepancies between the existing and ideal states of affairs in PA education.

  13. Menopause and work--the experience of middle-aged female teaching staff in an Egyptian governmental faculty of medicine.

    Science.gov (United States)

    Hammam, Rehab A M; Abbas, Reem A; Hunter, Myra S

    2012-03-01

    There is a global trend of increasing numbers of older women in the workforce. However, limited information is available regarding the relationship between the menopause transition and work, especially in developing countries. The objectives of this study were to investigate the relationship between experience of the menopause transition and work and to examine the factors affecting how women cope, including the extent to which women disclosed their menopausal status. Using a cross-sectional single group design, 131 middle-aged female medical teaching staff working in Zagazig Faculty of Medicine completed questionnaires and semi-structured interviews. Participants, particularly those who were postmenopausal, reported high average scores on depressed mood, memory/concentration, sleep problems, vasomotor symptoms, and sexual behavior subscales of the Women's Health Questionnaire (WHQ). Women reported that poor working environment and work policies and conditions, functioning as sources of work stress, aggravated their menopausal symptoms. Disclosure of their menopausal status was uncommon; limited time and socio-cultural barriers were the most commonly reported reasons for non-disclosure. It could be concluded that the menopause transition is an important occupational health issue especially for women in developing countries. Implementing health promotion programs, improving working environment and work policies, and raising awareness of menopause are recommended to help women to cope with the menopause transition and to maintain well-being and productivity at work. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Challenges in Translation: Lessons from Using Business Pedagogy to Teach Leadership in Undergraduate Medicine.

    Science.gov (United States)

    Cadieux, Dani C; Lingard, Lorelei; Kwiatkowski, Daniela; Van Deven, Teresa; Bryant, Murray; Tithecott, Gary

    2017-01-01

    Leadership is increasingly recognized as a core physician competency required for quality patient care, continual system improvement, and optimal healthcare team performance. Consequently, integration of leadership into medical school curriculum is becoming a priority. This raises the question of the appropriate context, timing, and pedagogy for conveying this competency to medical students. Our program introduced a 1-week leadership course grounded in business pedagogy to Year 1 medical students. The curriculum centred on four themes: (a) Understanding Change, (b) Effective Teamwork, (c) Leading in Patient Safety, and (d) Leadership in Action. Post-curriculum qualitative student feedback was analyzed for insight into student satisfaction and attitude towards the leadership course content. The Undergraduate Medical Education program of the Schulich School of Medicine & Dentistry, Western University, is delivered over 4 years across 2 campuses in London and Windsor, Ontario, Canada. Course structure moved from traditional passive lectures to established business pedagogy, which involves active engagement in modules, case-based discussions, insights from guest speakers, and personal reflection. A student-led survey evaluated student opinion regarding the leadership course content. Students valued career development reading materials and insights from guest speakers working in healthcare teams. Students did not relate to messages from speakers in senior healthcare leadership positions. Course scheduling late in the second semester was viewed negatively. Overall student opinion suggested that the 1-week course was suboptimal for establishing leadership principles and translated business pedagogy was ineffective in this context. Leadership curriculum in Undergraduate Medical Education should be grounded in a healthcare context relevant to the student's stage of training. Student engagement may be better supported if leadership is framed as a competency throughout their

  15. [Fetomaternal transfusion and diagnosis of gestational choriocarcinoma].

    Science.gov (United States)

    Emin, L; Izard, A; Schiavone, S; Kermanach, P; Deramecourt, M; Duclusaud, A; Gertych, W; Girard, S

    2015-03-01

    Choriocarcinoma is a rare but agressive malignant trophoblastic neoplasm. Fetomaternal transfusion can be the first sign of choriocarcinoma. We describe two cases of gestational choriocarinoma whose first manifestation was a fetomaternal transfusion. Fetomaternal transfusion is a rare demonstration of choriocarcinoma but its diagnosis must lead to a placenta examination with specific research of choriocarcinoma. The more the therapeutic care is precise, the better is the forecast. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Clinical Practice Guidelines From the AABB: Red Blood Cell Transfusion Thresholds and Storage.

    Science.gov (United States)

    Carson, Jeffrey L; Guyatt, Gordon; Heddle, Nancy M; Grossman, Brenda J; Cohn, Claudia S; Fung, Mark K; Gernsheimer, Terry; Holcomb, John B; Kaplan, Lewis J; Katz, Louis M; Peterson, Nikki; Ramsey, Glenn; Rao, Sunil V; Roback, John D; Shander, Aryeh; Tobian, Aaron A R

    2016-11-15

    is 10 g/dL (strong recommendation, moderate quality evidence). A restrictive RBC transfusion threshold of 8 g/dL is recommended for patients undergoing orthopedic surgery, cardiac surgery, and those with preexisting cardiovascular disease (strong recommendation, moderate quality evidence). The restrictive transfusion threshold of 7 g/dL is likely comparable with 8 g/dL, but RCT evidence is not available for all patient categories. These recommendations do not apply to patients with acute coronary syndrome, severe thrombocytopenia (patients treated for hematological or oncological reasons who are at risk of bleeding), and chronic transfusion-dependent anemia (not recommended due to insufficient evidence). Recommendation 2: patients, including neonates, should receive RBC units selected at any point within their licensed dating period (standard issue) rather than limiting patients to transfusion of only fresh (storage length: transfusion medicine has significantly advanced the science in recent years and provides high-quality evidence to inform guidelines. A restrictive transfusion threshold is safe in most clinical settings and the current blood banking practices of using standard-issue blood should be continued.

  17. Teaching Emotional Intelligence: A Control Group Study of a Brief Educational Intervention for Emergency Medicine Residents

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    Diane L. Gorgas

    2015-11-01

    Full Text Available Introduction: Emotional Intelligence (EI is defined as an ability to perceive another’s emotional state combined with an ability to modify one’s own. Physicians with this ability are at a distinct advantage, both in fostering teams and in making sound decisions. Studies have shown that higher physician EI’s are associated with lower incidence of burn-out, longer careers, more positive patient-physician interactions, increased empathy, and improved communication skills. We explored the potential for EI to be learned as a skill (as opposed to being an innate ability through a brief educational intervention with emergency medicine (EM residents. Methods: This study was conducted at a large urban EM residency program. Residents were randomized to either EI intervention or control groups. The intervention was a two-hour session focused on improving the skill of social perspective taking (SPT, a skill related to social awareness. Due to time limitations, we used a 10-item sample of the Hay 360 Emotional Competence Inventory to measure EI at three time points for the training group: before (pre and after (post training, and at six-months post training (follow up; and at two time points for the control group: pre- and follow up. The preliminary analysis was a four-way analysis of variance with one repeated measure: Group x Gender x Program Year over Time. We also completed post-hoc tests. Results: Thirty-three EM residents participated in the study (33 of 36, 92%, 19 in the EI intervention group and 14 in the control group. We found a significant interaction effect between Group and Time (p<0.05. Post-hoc tests revealed a significant increase in EI scores from Time 1 to 3 for the EI intervention group (62.6% to 74.2%, but no statistical change was observed for the controls (66.8% to 66.1%, p=0.77. We observed no main effects involving gender or level of training. Conclusion: Our brief EI training showed a delayed but statistically significant

  18. Teaching of evidence-based medicine to medical students in Mexico: a randomized controlled trial

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    Sánchez-Mendiola Melchor

    2012-11-01

    Full Text Available Abstract Background Evidence-Based Medicine (EBM is an important competency for the healthcare professional. Experimental evidence of EBM educational interventions from rigorous research studies is limited. The main objective of this study was to assess EBM learning (knowledge, attitudes and self-reported skills in undergraduate medical students with a randomized controlled trial. Methods The educational intervention was a one-semester EBM course in the 5th year of a public medical school in Mexico. The study design was an experimental parallel group randomized controlled trial for the main outcome measures in the 5th year class (M5 EBM vs. M5 non-EBM groups, and quasi-experimental with static-groups comparisons for the 4th year (M4, not yet exposed and 6th year (M6, exposed 6 months to a year earlier groups. EBM attitudes, knowledge and self-reported skills were measured using Taylor’s questionnaire and a summative exam which comprised of a 100-item multiple-choice question (MCQ test. Results 289 Medical students were assessed: M5 EBM=48, M5 non-EBM=47, M4=87, and M6=107. There was a higher reported use of the Cochrane Library and secondary journals in the intervention group (M5 vs. M5 non-EBM. Critical appraisal skills and attitude scores were higher in the intervention group (M5 and in the group of students exposed to EBM instruction during the previous year (M6. The knowledge level was higher after the intervention in the M5 EBM group compared to the M5 non-EBM group (pd=0.88 with Taylor's instrument and 3.54 with the 100-item MCQ test. M6 Students that received the intervention in the previous year had a knowledge score higher than the M4 and M5 non-EBM groups, but lower than the M5 EBM group. Conclusions Formal medical student training in EBM produced higher scores in attitudes, knowledge and self-reported critical appraisal skills compared with a randomized control group. Data from the concurrent groups add validity evidence to the

  19. Red Blood Cell Transfusions in Greece: Results of a Survey of Red Blood Cell Use in 2013

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    Serena Valsami

    2017-03-01

    Full Text Available Objective: Greece is ranked as the second highest consumer of blood components in Europe. For an effective transfusion system and in order to reduce variability of transfusion practice by implementing evidence-based transfusion guidelines it is necessary to study and monitor blood management strategies. Our study was conducted in order to evaluate the use of red blood cell units (RBC-U in nationwide scale mapping parameters that contribute to their proper management in Greece. Materials and Methods: The survey was conducted by the Working Committee of Transfusion Medicine&Apheresis of the Hellenic Society of Hematology from January to December 2013. The collected data included the number, ABO/D blood group, patients’ department, and storage age of RBC-U transfused. Results: The number of RBC-U evaluated was 103,702 (17.77% out of 583,457 RBC-U transfused in Greece in 2013. RBC-U transfused by hospital department (mean percentage was as follows: Surgery 29.34%, Internal Medicine 29.48%, Oncology/Hematology 14.65%, Thalassemia 8.87%, Intensive Care Unit 6.55%, Nephrology 1.78%, Obstetrics/Gynecology 1.46%, Neonatal&Pediatric 0.31%, Private Hospitals 8.57%. RBC-U distribution according to ABO/D blood group was: A: 39.02%, B: 12.41%, AB: 5.16%, O: 43.41%, D+: 87.99%, D-: 12.01%. The majority of RBC-U (62.46% was transfused in the first 15 days of storage, 25.24% at 16 to 28 days, and 12.28% at 29-42 days. Conclusion: Despite a high intercenter variability in RBC transfusions, surgical and internal medicine patients were the most common groups of patients transfused with an increasing rate for internal medicine patients. The majority of RBC-U were transfused within the first 15 days of storage, which is possibly the consequence of blood supply insufficiency leading to the direct use of fresh blood. Benchmarking transfusion activity may help to decrease the inappropriate use of blood products, reduce the cost of care, and optimize the use of the

  20. Blood transfusion knowledge of surgical residents: is an educational intervention effective?

    Science.gov (United States)

    Champion, Caitlin; Saidenberg, Elianna; Lampron, Jacinthe; Pugh, Debra

    2017-04-01

    Evidence-based transfusion education for surgical residents is crucial to improving practice. A pilot study was undertaken to assess the effectiveness of an education module for improving transfusion knowledge among surgical residents. Modules were developed and delivered by experts in surgery and transfusion medicine. They were delivered to residents in their first 2 years of training (Surgical Foundations), and to General Surgery residents across all years of training. Premodule and postmodule and retention knowledge assessments were used to assess efficacy. Median assessment scores for each group were compared using a two-sample Wilcoxon rank-sum analysis. Chi-square tests were used to compare each group's correct response rates for each question across the three tests. Median assessment scores of residents in the Surgical Foundations program improved from a mean of 60% premodule to 80% postmodule and remained at 80% in the retention assessment (p transfusion dose, preoperative blood management, management of reactions, and informed consent (p Transfusion knowledge of surgical residents was improved by a collaborative educational initiative. This could serve as a model for other training programs to improve resident knowledge of evidence-based transfusion practices. The efficacy of such interventions in changing practice remains untested. © 2017 AABB.

  1. Strengthening medical education in haematology and blood transfusion: postgraduate programmes in Tanzania.

    Science.gov (United States)

    Makani, Julie; Lyimo, Magdalena; Magesa, Pius; Roberts, David J

    2017-06-01

    Haematology and blood transfusion, as a clinical and laboratory discipline, has a far-reaching impact on healthcare both through direct patient care as well as provision of laboratory and transfusion services. Improvement of haematology and blood transfusion may therefore be significant in achieving advances in health in Africa. In 2005, Tanzania had one of the lowest distributions of doctors in the world, estimated at 2·3 doctors per 100 000 of population, with only one haematologist, a medical doctor with postgraduate medical education in haematology and blood transfusion. Here, we describe the establishment and impact of a postgraduate programme centred on Master of Medicine and Master of Science programmes to build the capacity of postgraduate training in haematology and blood transfusion. The programme was delivered through Muhimbili University of Health and Allied Sciences (MUHAS) with partnership from visiting medical and laboratory staff from the UK and complemented by short-term visits of trainees from Tanzania to Haematology Departments in the UK. The programme had a significant impact on the development of human resources in haematology and blood transfusion, successfully training 17 specialists with a significant influence on delivery of health services and research. This experience shows how a self-sustaining, specialist medical education programme can be developed at low cost within Lower and Middle Income Countries (LMICs) to rapidly enhance delivery of capacity to provide specialist services. © 2017 John Wiley & Sons Ltd.

  2. Best practices in the differential diagnosis and reporting of acute transfusion reactions

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    Hillis CM

    2016-01-01

    Full Text Available Christopher M Hillis,1–3,* Andrew W Shih,1,3,* Nancy M Heddle1,3,4 1Department of Medicine, 2Department of Oncology, 3McMaster Transfusion Research Program, McMaster University, Hamilton, 4Centre for Innovation, Canadian Blood Services, Ottawa, ON, Canada  *These authors contributed equally to this work Abstract: An acute transfusion reaction (ATR is any reaction to blood, blood components, or plasma derivatives that occurs within 24 hours of a transfusion. The frequencies of ATRs and the associated symptoms, reported by the sentinel sites of the Ontario Transfusion Transmitted Injuries Surveillance System from 2008 to 2012, illustrate an overlap in presenting symptoms. Despite this complexity, the differential diagnosis of an ATR can be determined by considering predominant signs or symptoms, such as fever, dyspnea, rash, and/or hypotension, as these signs and symptoms guide further investigations and management. Reporting of ATRs locally and to hemovigilance systems enhances the safety of the blood supply. Challenges to the development of an international transfusion reaction reporting system are discussed, including the issue of jurisdiction and issues of standardization for definitions, investigations, and reporting requirements. This review discusses a symptom-guided approach to the differential diagnosis of ATRs, the evolution of hemovigilance systems, an overview of the current Canadian system, and proposes a best practice model for hemovigilance based on a World Health Organization patient safety framework. Keywords: blood transfusion, blood components, hemovigilance

  3. D-day on board a tank landing ship: meat, cheese and blood transfusion.

    Science.gov (United States)

    Demetriades, A K; Gavalas, M C; Ryan, J

    2008-03-01

    Tank Landing Ships were used as evacuation station hospitals during D-Day of World War Two. This historical vignette describes how difficulties were overcome in blood transfusion and trauma surgery aboard these ships. Their place in the evacuation chain is discussed in relation to previous experiences in military medicine.

  4. Twin-twin transfusion syndrome - diagnosis and prognosis

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    Hajrić-Egić Amira

    2003-01-01

    . Overall mortality rate was 71%(20/28. Up to 28th weeks mortality rate was 100% and after 28th weeks mortality rate was 20%(2/10.9 cases had "stuck" twin phenomenon. The differences in the Doppler indexes from twin-twin transfusion syndrome cases significantly exceeded those without this syndrome. This difference seemed to predict the risk of twin-twin transfusion syndrome, but the number of cases is too small for general conclusions. Treatment regimens for twin-twin transfusion syndrome have included bed rest, tocolytic agents and serial amniocenthesis for decompression in some cases.Neither serial amniocenthesis nor tocolytic agents use were associated with an improved survival rate in our study. Twin-twin transfusion syndrome can be diagnosed early in second trimester of pregnancy,but the survival rate remains low with the current methods of treatment. Survival was related to gestational age at delivery and birth weight. Twin-twin transfusion syndrome diagnosed before 28th weeks of gestation represents one of the most lethal conditions in perinatal medicine today.

  5. Indications and organisational methods for autologous blood transfusion procedures in Italy: results of a national survey.

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    Catalano, Liviana; Campolongo, Alessandra; Caponera, Maurizio; Berzuini, Alessandra; Bontadini, Andrea; Furlò, Giuseppe; Pasqualetti, Patrizio; Liumbruno, Giancarlo M

    2014-10-01

    Pre-operative donation of autologous blood is a practice that is now being abandoned. Alternative methods of transfusing autologous blood, other than predeposited blood, do however play a role in limiting the need for transfusion of allogeneic blood. This survey of autologous blood transfusion practices, promoted by the Italian Society of Transfusion Medicine and Immunohaematology more than 2 years after the publication of national recommendations on the subject, was intended to acquire information on the indications for predeposit in Italy and on some organisational aspects of the alternative techniques of autotransfusion. A structured questionnaire consisting of 22 questions on the indications and organisational methods of autologous blood transfusion was made available on a web platform from 15 January to 15 March, 2013. The 232 Transfusion Services in Italy were invited by e-mail to complete the online survey. Of the 232 transfusion structures contacted, 160 (69%) responded to the survey, with the response rate decreasing from the North towards the South and the Islands. The use of predeposit has decreased considerably in Italy and about 50% of the units collected are discarded because of lack of use. Alternative techniques (acute isovolaemic haemodilution and peri-operative blood salvage) are used at different frequencies across the country. The data collected in this survey can be considered representative of national practice; they show that the already very limited indications for predeposit autologous blood transfusion must be adhered to even more scrupulously, also to avoid the notable waste of resources due to unused units.Users of alternative autotransfusion techniques must be involved in order to gain a full picture of the degree of use of such techniques; multidisciplinary agreement on the indications for their use is essential in order for these indications to have an effective role in "patient blood management" programmes.

  6. Transfusion in Haemoglobinopathies: Review and recommendations for local blood banks and transfusion services in Oman

    Directory of Open Access Journals (Sweden)

    Arwa Z. Al-Riyami

    2018-04-01

    Full Text Available Sickle cell disease and homozygous β-thalassaemia are common haemoglobinopathies in Oman, with many implications for local healthcare services. The transfusions of such patients take place in many hospitals throughout the country. Indications for blood transfusions require local recommendations and guidelines to ensure standardised levels of care. This article summarises existing transfusion guidelines for this group of patients and provides recommendations for blood banks and transfusion services in Oman. This information is especially pertinent to medical professionals and policy-makers developing required services for the standardised transfusion support of these patients.

  7. [Ethics and transfusion--seminar report].

    Science.gov (United States)

    Hervé, C; Tissot, J-D; Bouësseau, M-C; Pottier, R; Monsellier, M; Garraud, O; Hermine, O; Sannié, T; Cazenave, J-P; Cabaud, J-J; Lefrère, J-J

    2014-05-01

    This paper brings together the abstracts and proceedings of a seminar held on the topic of "ethics and transfusion", October 15, 2013 at the National Institute of Blood Transfusion, Paris. Copyright © 2014. Published by Elsevier SAS.

  8. Why an alternative to blood transfusion?

    Science.gov (United States)

    Shander, Aryeh; Goodnough, Lawrence Tim

    2009-04-01

    Allogeneic blood transfusions have been associated with several risks and complications and with worse outcomes in a substantial number of patient populations and clinical scenarios. Allogeneic blood is costly and difficult to procure, transport, and store. Global and local shortages are imminent. Alternatives to transfusion provide many advantages, and their use is likely to improve outcomes as safer and more effective agents are developed.

  9. Platelet transfusion therapy: from 1973 to 2005.

    NARCIS (Netherlands)

    Brand, A.; Novotny, V.M.J.; Tomson, B.

    2006-01-01

    Platelet transfusions are indispensable for supportive care of patients with hematological diseases. We describe the developments in platelet products for transfusion since the 1970s, when, in particular, support for patients with allo-antibodies against human leukocyte antigens was a laborious

  10. Reducing transfusion requirements in liver transplantation.

    Science.gov (United States)

    Donohue, Ciara I; Mallett, Susan V

    2015-12-24

    Liver transplantation (LT) was historically associated with massive blood loss and transfusion. Over the past two decades transfusion requirements have reduced dramatically and increasingly transfusion-free transplantation is a reality. Both bleeding and transfusion are associated with adverse outcomes in LT. Minimising bleeding and reducing unnecessary transfusions are therefore key goals in the perioperative period. As the understanding of the causes of bleeding has evolved so too have techniques to minimize or reduce the impact of blood loss. Surgical "piggyback" techniques, anaesthetic low central venous pressure and haemodilution strategies and the use of autologous cell salvage, point of care monitoring and targeted correction of coagulopathy, particularly through use of factor concentrates, have all contributed to declining reliance on allogenic blood products. Pre-emptive management of preoperative anaemia and adoption of more restrictive transfusion thresholds is increasingly common as patient blood management (PBM) gains momentum. Despite progress, increasing use of marginal grafts and transplantation of sicker recipients will continue to present new challenges in bleeding and transfusion management. Variation in practice across different centres and within the literature demonstrates the current lack of clear transfusion guidance. In this article we summarise the causes and predictors of bleeding and present the evidence for a variety of PBM strategies in LT.

  11. Transmission of Neurodegenerative Disorders Through Blood Transfusion

    DEFF Research Database (Denmark)

    Edgren, Gustaf; Hjalgrim, Henrik; Rostgaard, Klaus

    2016-01-01

    BACKGROUND: The aggregation of misfolded proteins in the brain occurs in several neurodegenerative disorders. Aberrant protein aggregation is inducible in rodents and primates by intracerebral inoculation. Possible transfusion transmission of neurodegenerative diseases has important public health...... implications. OBJECTIVE: To investigate possible transfusion transmission of neurodegenerative disorders. DESIGN: Retrospective cohort study. SETTING: Nationwide registers of transfusions in Sweden and Denmark. PARTICIPANTS: 1 465 845 patients who received transfusions between 1968 and 2012. MEASUREMENTS.......9% received a transfusion from a donor diagnosed with one of the studied neurodegenerative diseases. No evidence of transmission of any of these diseases was found, regardless of approach. The hazard ratio for dementia in recipients of blood from donors with dementia versus recipients of blood from healthy...

  12. Blood platelet kinetics and platelet transfusion.

    Science.gov (United States)

    Aster, Richard H

    2013-11-01

    The discovery of citrate anticoagulant in the 1920s and the development of plastic packs for blood collection in the 1960s laid the groundwork for platelet transfusion therapy on a scale not previously possible. A major limitation, however, was the finding that platelet concentrates prepared from blood anticoagulated with citrate were unsuitable for transfusion because of platelet clumping. We found that this could be prevented by simply reducing the pH of platelet-rich plasma to about 6.5 prior to centrifugation. We used this approach to characterize platelet kinetics and sites of platelet sequestration in normal and pathologic states and to define the influence of variables such as anticoagulant and ABO incompatibility on post-transfusion platelet recovery. The "acidification" approach enabled much wider use of platelet transfusion therapy until alternative means of producing concentrates suitable for transfusion became available.

  13. Infection after injury: association with blood transfusion.

    Science.gov (United States)

    Rosemurgy, A S; Hart, M B; Murphy, C G; Albrink, M H; Piazza, A; Leparc, G F; Harris, R E

    1992-02-01

    This study was undertaken to evaluate the association between red blood cell transfusions and infections in an easily stratified, homogenous group of injured adults. All received their initial transfusions upon arrival to the emergency department. Over 5 years, 390 uncross-matched trauma patients received type "O" red blood cells (RBCs) during initial resuscitation. One hundred fifty-four (39%) died within 7 days because of injuries sustained: 236 (61%) survived at least 7 days. Of these 236, clear differences could be seen between those receiving 6 or fewer or 7 or more units of RBCs. When adjusted for age, sex, and severity of injury (Champion Trauma Score, Injury Severity Score, TRISS), the risk of infection was higher in those receiving 7 or more units of RBCs. Similarly, risk of infection was related to units of RBCs transfused in a dose-related fashion. Blood transfusions should be avoided, if possible. Arbitrary "trigger points" for transfusions should be abandoned.

  14. Production of teaching materials of nuclear medicine for use in career of Imagenologia Diagnostica y Terapeutica of the Escuela de Tecnologias de Salud of the Universidad de Costa Rica

    International Nuclear Information System (INIS)

    Aguilar Blanco, Luis Alberto; Bertarioni Alfaro, Carol; Elizondo Vargas, David; Gutierrez Villareal, Raul E.; Quesada Silva, Fernando

    2008-01-01

    One of the main obstacles in the career of Imagenologia Diagnostica y Terapeutica of the Escuela de Tecnologias de Salud of the Universidad de Costa Rica has been access to bibliographic material of reference in Spanish. The topics most relevant of nuclear medicine of interest to imaging specialist and other disciplines as: medicine, physics, pharmacy and nursing, have been identified for the purpose of having a bibliographic body; experts have reviewed the selection in each subject. Topics of interest were identified and grouped into five specific teaching areas: 1. Radiation protection, 2. Quality Control of Nuclear Medicine Instruments, 3. Radiopharmacy, 4. Planar Nuclear Medicine, 5. Nuclear Medicine SPECT and PET. (author) [es

  15. Experience-based teaching of acute medicine for extra motivated medical students and young physicians – 4th Emergency Medicine Course and 6th AKUTNĚ.CZ Congress

    Directory of Open Access Journals (Sweden)

    Petr Štourač

    2014-12-01

    Full Text Available Faculty of Medicine of the Masaryk University (MU, and especially its departments focusing on acute medicine, make an active effort to find and to support extra motivated students by organising courses and congresses with simulation-based learning sessions for them. 4th Emergency Medicine Course (EMC and 6th AKUTNĚ.CZ Congress were organised during 2014. EMC was held during a weekend in mid-April for 80 medical students. The congress was held on 22nd November 2014. A group of more than 700 enthusiastic professionals including physicians, nursing staff and medical students interested in acute medicine met again in Brno at the University Campus Bohunice. We also report the evaluation of effectiveness of different types of sessions, as well as its influence on practical skills and the fixation of memory footprint. The website AKUTNĚ.CZ (www.akutne.cz is freely accessible, and anyone can find and watch all the videos and presentations there.

  16. Teaching and training programmes in nuclear medicine for medical and paramedical personnel at the Radiation Medicine Centre, Bhabha Atomic Research Centre

    International Nuclear Information System (INIS)

    Sharma, S.M.; Raikar, U.R.

    1986-01-01

    Prior to 1976, the Radiation Medicine Centre had conducted 12 short courses of five weeks' duration on medical uses of radioisotopes. A total of 162 medical and scientific personnel attended the courses from various parts of India. Owing to the rapid advances made in nuclear medicine these courses were becoming inadequate, and in 1973 the Centre introduced one-year full time training courses for doctors and science graduates, peparing them for examinations for the Diploma in Radiation Medicine (DRM) and the Diploma in Medical Radioisotope Techniques (DMRIT) of the University of Bombay. By March 1984, 64 doctors and 53 technologists had obtained the DRM and DMRIT. A recent survey indicated that 70% of the DRM physicians and 68% of the DMRIT technologists are employed in nuclear medicine departments. Besides the formal one-year training courses, the Centre has conducted advanced courses of two weeks' duration on scintigraphy and thyroid function tests. The Radiation Medicine Centre has been the regional reference centre in nuclear medicine for the World Health Organization and International Atomic Energy Agency for more than ten years. The Centre has trained sponsored personnel from other countries of the region. The Centre has also organized seven symposia, workshops and seminars, four of them in collaboration with WHO and one with the IAEA. (author)

  17. Students' perception of an integrated approach of teaching entire sequence of medicinal chemistry, pharmacology, and pharmacotherapeutics courses in PharmD curriculum.

    Science.gov (United States)

    Islam, Mohammed A; Schweiger, Teresa A

    2015-04-01

    To develop an integrated approach of teaching medicinal chemistry, pharmacology, and pharmacotherapeutics and to evaluate students' perceptions of integration as they progress through the PharmD curriculum. Instructors from each discipline jointly mapped the course contents and sequenced the course delivery based on organ systems/disease states. Medicinal chemistry and pharmacology contents were integrated and aligned with respective pharmacotherapeutics contents to deliver throughout second and third year of the curriculum. In addition to classroom lectures, active learning strategies such as recitation, case studies, online-discussion boards, open book quizzes, and writing patient progress notes were incorporated to enhance student learning. Student learning was assessed by examination scores, patient progress notes, and writing assignments. The impact of course integration was evaluated by a Web-based survey. One hundred and sixty-nine students completed the survey. Students exhibited positive attitude toward the integrated approach of teaching medicinal chemistry, pharmacology, and therapeutics. The P3 and P4 students better appreciated the benefits of integration compared to P2 students (P < .05). Students perceived the course integration as an effective way of learning. This study supports course improvement and the viability of expanding the concept of integration to other courses in the curriculum. © The Author(s) 2014.

  18. Triggers of blood transfusion in percutaneous nephrolithotomy

    International Nuclear Information System (INIS)

    Zehri, A.K.; Biyabani, S.R.; Siddiqui, K.M.; Memon, A.

    2011-01-01

    To determine the triggers of blood transfusion in patients undergoing percutaneous nephrolithotomy (PCNL). The percutaneous surgery database was retrospectively reviewed to identify patients with postoperative haemorrhage and need for blood transfusion. Blood loss was estimated by the postoperative drop in haemoglobin factored by the quantity of any blood transfusion. Various patients and procedure-related factors were assessed for association with total blood loss or blood transfusion requirement using stepwise univariate, forward multivariate regression analysis. A total of 326 procedures were performed in 316 patients. Two hundred and thirty two procedures were included in the study. There were 167 males and 65 females. The mean age was 41+14 years. The mean haemoglobin drop was 1.68 +1.3 gm/dL. The overall blood transfusion rate was 14.2%. Stepwise multivariate regression analysis showed that female gender (p = 0.003), staghorn stone (p = 0.023), stone fragmentation with ultrasound (p = 0.054) and chronic renal failure (p = 0.001) were significantly predictive of the need for blood transfusion. Chronic renal failure, female gender, presence of staghorn calculi and stone fragmentation using ultrasonic device were predictive of blood transfusion in this cohort of patients. (author)

  19. Transfusion regimens in thalassemia intermedia

    Directory of Open Access Journals (Sweden)

    Z. Karakas

    2011-12-01

    Full Text Available Thalassemia intermedia (TI is a heterogeneous disease, in terms of both clinical manifestations and underlying molecular defects. Some TI patients are asymptomatic until adult life, whereas others are symptomatic from early childhood. In contrast with patients with Thalassemia major (TM, the severity of anemia is less and the patients do not require transfusions during at least the first few years of life. Many patients with TI, especially older ones, have been exposed to the multiple long-term effects of chronic anemia and tissue hypoxia and their compensatory reactions, including enhanced erythropoiesis and increased iron absorption. Bone marrow expansion and extramedullary hematopoiesis lead to bone deformities and liver and spleen enlargement. Therapeutic strategies in TI are not clear and different criteria are used to decide the initiation of transfusion and chelation therapy, modulation of fetal hemoglobin production, and hematopoietic stem cell transplantation on an individual basis. The clinical picture of well-treated TM patients with regular transfusionchelation therapy is better from TI patients who have not received adequate transfusion therapy. There is a significant role of early blood transfusion to prevent and treat complications commonly associated with TI, such as extramedullary erythropoiesis and bone deformities, autoimmune hemolytic anemia, leg ulcers, gallstones, pseudoxantoma elasticum, hyperuricosuria, gout and pulmonary hypertension, which are rarely seen in thalassemia major. Nowadays, indications of transfusion in patients with TI are chronic anemia (Hb < 7 g/dL, bone deformities, growth failure, extramedullary erythropoiesis, heart failure, pregnancy and preparation for surgical procedures. Conclusion: Adequate (regular or tailored transfusion therapy is an important treatment modality for increasing the quality of life in patients with thalassemia intermedia during childhood. 就临床表象和潜在的分子缺

  20. [Approach to Evidence-based Medicine Exercises Using Flipped Teaching: Introductory Education for Clinical Practice for 4th-Year Pharmacy Students].

    Science.gov (United States)

    Onda, Mitsuko; Takagaki, Nobumasa

    2018-01-01

     Osaka University of Pharmaceutical Sciences has included an evidence-based medicine (EBM) exercise in the introductory education for clinical practice for 4th-year pharmacy students since 2015. The purpose of this exercise is to learn the process of practice and basic concepts of EBM, especially to cultivate the practical ability to solve patients' problems and answer their questions. Additionally, in 2016, we have attempted flipped teaching. The students are instructed to review the basic knowledge necessary for active learning in this exercise by watching video teaching materials and to bring reports summarizing the contents on the flipped teaching days. The program includes short lectures [overview of EBM, document retrieval, randomized controlled trials (RCTs), and systematic review], exercises [patient, intervention, comparison, outcome (PICO) structuring, critical appraisal of papers in small groups with tutors], and presentations. The program includes: step 1, PICO structuring based on scenarios; step 2, critical appraisal of English-language papers on RCTs using evaluation worksheets; and step 3, reviewing the results of the PICO exercise with patients. The results of the review are shared among groups through general discussion. In this symposium, I discuss students' attitudes, the effectiveness of small group discussions using flipped teaching, and future challenges to be addressed in this program.

  1. Teaching medicine and allied disciplines in the 21st century--lessons from Ireland on the continuing need for reform

    International Nuclear Information System (INIS)

    McMahon, Tim

    2005-01-01

    This article identifies the imperatives behind the need to move away from teaching based on the transmission of a lot of facts to teaching that enables students to become lifelong learners. It reminds us that the over-riding goal is an education process that maximizes the ability of teachers to teach well and of students to learn effectively. It argues that the necessary reform process can only be successful if the three components of an education programme--the curriculum, teaching strategies and assessment--are reformed simultaneously to ensure that each is designed to produce more effective teaching and learning. It points to the literature that tells us what we know about factors affecting student behaviour and, in particular, notes the crucial factor of student perception of the requirement of the assessment regime. It recommends that Biggs' model of constructive alignment is used as the organizing principle of continuing reform

  2. [Blood transfusion, an investigation on its brief history].

    Science.gov (United States)

    Wang, B; Peng, X

    2000-07-01

    Transfusion has developed as a practical clinical technique. Its development has experienced from ignorance to science and from cruelty to civilization for hundreds of year. Transfusion has made great contribution for saving lives and expanding operation coverage. To understand the history of transfusion, we can have reference to promote again the development of transfusion technique.

  3. Blood Donation and Transfusion: A Primer for Health Educators.

    Science.gov (United States)

    Felts, W. Michael; Glascoff, Mary A.

    1991-01-01

    Presents a primer for health educators about blood donation and transfusion, examining the nature of human blood, the background of blood transfusion, blood donation criteria, risks related to homologous blood transfusion, directed blood donation, potential alternatives to homologous transfusion, and resources for education on the subject. (SM)

  4. Residents’ and preceptors’ perceptions of the use of the iPad for clinical teaching in a family medicine residency program

    Science.gov (United States)

    2014-01-01

    Background As Family Medicine programs across Canada are transitioning into a competency-based curriculum, medical students and clinical teachers are increasingly incorporating tablet computers in their work and educational activities. The purpose of this pilot study was to identify how preceptors and residents use tablet computers to implement and adopt a new family medicine curriculum and to evaluate how they access applications (apps) through their tablet in an effort to support and enhance effective teaching and learning. Methods Residents and preceptors (n = 25) from the Family Medicine program working at the Pembroke Regional Hospital in Ontario, Canada, were given iPads and training on how to use the device in clinical teaching and learning activities and how to access the online curriculum. Data regarding the use and perceived contribution of the iPads were collected through surveys and focus groups. This mixed methods research used analysis of survey responses to support the selection of questions for focus groups. Results Reported results were categorized into: curriculum and assessment; ease of use; portability; apps and resources; and perceptions about the use of the iPad in teaching/learning setting. Most participants agreed on the importance of accessing curriculum resources through the iPad but recognized that these required enhancements to facilitate use. The iPad was considered to be more useful for activities involving output of information than for input. Participants’ responses regarding the ease of use of mobile technology were heterogeneous due to the diversity of computer proficiency across users. Residents had a slightly more favorable opinion regarding the iPad’s contribution to teaching/learning compared to preceptors. Conclusions iPad’s interface should be fully enhanced to allow easy access to online curriculum and its built-in resources. The differences in computer proficiency level among users should be reduced by sharing

  5. Residents' and preceptors' perceptions of the use of the iPad for clinical teaching in a family medicine residency program.

    Science.gov (United States)

    Archibald, Douglas; Macdonald, Colla J; Plante, Judith; Hogue, Rebecca J; Fiallos, Javier

    2014-08-20

    As Family Medicine programs across Canada are transitioning into a competency-based curriculum, medical students and clinical teachers are increasingly incorporating tablet computers in their work and educational activities. The purpose of this pilot study was to identify how preceptors and residents use tablet computers to implement and adopt a new family medicine curriculum and to evaluate how they access applications (apps) through their tablet in an effort to support and enhance effective teaching and learning. Residents and preceptors (n = 25) from the Family Medicine program working at the Pembroke Regional Hospital in Ontario, Canada, were given iPads and training on how to use the device in clinical teaching and learning activities and how to access the online curriculum. Data regarding the use and perceived contribution of the iPads were collected through surveys and focus groups. This mixed methods research used analysis of survey responses to support the selection of questions for focus groups. Reported results were categorized into: curriculum and assessment; ease of use; portability; apps and resources; and perceptions about the use of the iPad in teaching/learning setting. Most participants agreed on the importance of accessing curriculum resources through the iPad but recognized that these required enhancements to facilitate use. The iPad was considered to be more useful for activities involving output of information than for input. Participants' responses regarding the ease of use of mobile technology were heterogeneous due to the diversity of computer proficiency across users. Residents had a slightly more favorable opinion regarding the iPad's contribution to teaching/learning compared to preceptors. iPad's interface should be fully enhanced to allow easy access to online curriculum and its built-in resources. The differences in computer proficiency level among users should be reduced by sharing knowledge through workshops led by more skillful i

  6. A Systematic Review and Meta-Analysis of the Clinical Appropriateness of Blood Transfusion in China.

    Science.gov (United States)

    Zhu, Changtai; Gao, Yulu; Li, Zhiqiang; Li, Qinyun; Gao, Zongshuai; Liao, Yanqiu; Deng, Zhifeng

    2015-12-01

    The issue of the clinical appropriateness of blood transfusion has become a focus of transfusion medicine worldwide. In China, irrational uses of blood have often been reported in recent years. However, to date there lacks a systematic review of the rational uses of blood. This study aimed to determine the clinical appropriateness of blood transfusion in China. We searched PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, WanFang Database, and Chinese BioMedical Literature Database, and the retrieval cut-off date was June 31, 2015. SPSS 17.0 and MetaAnalyst 3.13 were employed as the statistics tools in this review. A pooled rate of clinical inappropriateness of transfusion was analyzed by DerSimonian-Laird method. In this study, a total of 39 observational studies were included, which related to 75,132 cases of blood transfusion. According to the meta-analysis results, the overall incidence of clinical inappropriateness of transfusion in China was estimated to be 37.3% (95% confidence interval [CI] [32.1, 42.8]). The subgroup analyses revealed that the pooled rates of clinical inappropriateness of transfusion of plasma, red blood cells (RBCs), cryoprecipitate, and platelets were 56.3% (95% CI [45.8, 66.2]), 30.9% (95% CI [27.1, 35.0]), 25.2% (95% CI [13.2, 42.7]), and 14.1% (95% CI [8.8, 21.9]), respectively. However, the pooled incidence of inappropriateness of transfusion in operative departments was 47.5% (95% CI [36.8, 58.3]), which was significantly higher than that in nonoperative departments, 25.8% (95% CI [18.7, 34.4], P  0.05). In conclusion, China has suffered from a disadvantage in the clinical appropriateness of blood transfusion, especially in plasma and RBC use. In future, comprehensive measures should be implemented in order to improve the clinical appropriateness of blood transfusion.

  7. Transfusion-associated circulatory overload (TACO: prevention, management, and patient outcomes

    Directory of Open Access Journals (Sweden)

    Roubinian NH

    2015-04-01

    Full Text Available Nareg H Roubinian,1,2 Edward L Murphy1–3 1Blood Systems Research Institute, 2Department of Laboratory Medicine, 3Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA Abstract: Transfusion-associated circulatory overload (TACO is acute pulmonary edema associated with left atrial hypertension or volume overload occurring within 6 hours following a blood transfusion. Recognized by physicians as a common complication of blood transfusion, its incidence has been difficult to measure because active surveillance is required to counteract underreporting; active surveillance indicates overall incidence rates as high as 1% per transfused patient. Recent clinical and translational research has focused on the development of electronic alert systems to measure TACO incidence and provide alerts to physicians regarding patients at high risk. Translational research regarding the utility of biomarkers such as brain natriuretic protein (BNP or N-terminal pro-BNP (NT-proBNP as diagnostic tools for TACO has been only moderately successful, but the search for other biomarkers continues. Prevention strategies can be developed based upon evidence derived from both observational studies and might include: using documented risk factors to highlight patients at risk, preferably using real-time analysis of electronic medical records; implementation of modified transfusion strategies to minimize the volume and infusion rate of blood products; consideration of prophylactic diuretic therapy; and heightened diagnostic awareness combined with rapid implementation of treatment. Randomized clinical trials will be required to test such strategies before they are widely implemented. Finally, the occurrence of TACO ought to be considered as a potentially avoidable medical complication that could be used to benchmark transfusion and critical care practice across hospitals. Keywords: blood transfusion, pulmonary edema, risk

  8. Case-based studies in teaching medicinal chemistry in PharmD curriculum: Perspectives of students, faculty, and pharmacists from academia.

    Science.gov (United States)

    Das, Joydip; Fernandez, Julianna; Shah, Dhara; Williams, Louis; Zagaar, Munder

    Pharmacy practice has evolved tremendously over the years to meet the demands of the growing healthcare system. Foundational sciences like, medicinal chemistry can enhance the critical-thinking and therapeutic decision-making skills of today's professional pharmacists. The importance of medicinal chemistry for the doctor of pharmacy (PharmD) curriculum has been discussed from the perspectives of medicinal chemistry and practicing clinical faculty whose focused practices vary from infectious diseases to geriatrics. An Institutional Review Board (IRB)-approved perception survey and a year-end course evaluation were given to the second and third professional year students. Eighty-eight percent of the participating second-year students and 92% of the participating third-year students thought that the introduction of case studies in the medicinal chemistry curriculum enhanced their learning and appreciation for the subject. The Pharmacy Curriculum Outcomes Assessment (PCOA) exams, given at the University of Houston College of Pharmacy during the years of 2013-2015, were briefly discussed. Since the requirement to administer the PCOA went into effect in early 2016, the authors felt that not enough time existed to establish meaningful controls to conduct a correlation study with the student perspective survey results obtained and PCOA data provided in 2015. This study, therefore, highlights the importance of integrated approaches to pharmacy teaching at the University of Houston. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. El modelo experimental en la enseñanza de la medicina en el v semestre The Experimental Teaching Model in the 5th Semester of Medicine

    Directory of Open Access Journals (Sweden)

    María Elena de la Uz Herrera

    2007-09-01

    Full Text Available Se realizó un análisis de los resultados del proceso docente-educativo en la asignatura Propedéutica Clínica y Semiología Médica del V Semestre de la Carrera de Medicina en los estudiantes del Modelo Experimental de Enseñanza, en el actual curso académico. La muestra estuvo constituida por los estudiantes que integran el grupo experimental de enseñanza, insertados en el Proyecto Policlínico Universitario (PPU. Los resultados académicos fueron satisfactorios, con un comportamiento similar a los restantes modelos de enseñanza. La valoración del proceso docente educativo fue considerada de Buena por la mayoría de los estudiantes (60,5 y el 92.1 %de ellos evaluaron positivamenteel papel desempeñado por los profesores integrales (tutores durante este proceso. Se plantearon dificultades con la calidad de algunos medios de enseñanza (Tele clases, así como falta de tiempo para la auto- preparación de los profesores integrales. No obstante, la aplicación de este nuevo modelo revoluciona la enseñanza actual por la introducción de nuevas Formas de Organización de la Enseñanza (FOE, la enseñanza tutorial y el uso de Tecnologías de la Información Científico Técnica (TIC´s, prometiendo un futuro esperanzador hacia la excelencia en la formación médica y profesional que demanda la sociedad contemporánea.The results of the teaching - educative process of Clinical Propedeutics and Medical Semiology in the 5th Semester of Medicine in students of the Teaching Experimental Model in the present academic year were analyzed, the academic results were similarly satisfactory to those of the other teaching models. The assessment of the educative teaching process was considered good by most of the students (60,5 and 92,5% of them evaluated positively the role played by the Comprehensive Professors (Tutors during this process. The difficulties found with the quality of some teaching aids (classes by TV as well as the short time for the

  10. Blood doping: the flip side of transfusion and transfusion alternatives.

    Science.gov (United States)

    Cacic, Daniel Limi; Hervig, Tor; Seghatchian, Jerard

    2013-08-01

    Blood doping in sports has been a hot topic of present. Longitudinal follow up of hematological parameters in different endurance sports, during the 1990s and early 2000s, has provided considerable suspicions about extensive blood manipulation, with performance enhancing effects. Recent doping revelations in the media also prove that blood doping is not an anticipated myth but it is, in fact, real. Erythropoiesis stimulating agents and autologous blood transfusions are used in synergy with substantial effect on the maximum oxygen uptake and delivery to muscles. Whilst both methods of blood manipulation represent a potential health hazard, in the context of an elevated hematocrit, nevertheless despite a number of suspicious deaths amongst athletes, this has not yet been fully documented. A reliable test for detection of recombinant human erythropoietin was implemented in 2000, but this is probably circumvented by microdose regimens. The Athlete's Biological Passport represents the progeny of the idea of an indirect approach based on long term monitoring of hematological parameters, thus making it possible to detect autologous blood doping and erythropoietin use after the substance is excreted. Nevertheless with advances in anti-doping measures it is possible that the levels of excretion of substances used can be masked. Clearly more sensitive and specific diagnostic tools and research/development in these areas of major concern are warranted, which, combined with changes in the athlete's attitude, will help in reaching the vision of fair play. Copyright © 2013. Published by Elsevier Ltd.

  11. Effect of Blood Transfusions on the Outcome of Very Low Body Weight Preterm Infants under Two Different Transfusion Criteria

    Directory of Open Access Journals (Sweden)

    Hsiu-Lin Chen

    2009-06-01

    Conclusion: Both criteria of PRBC transfusion had similar clinical outcomes, although liberal transfusion resulted in a greater amount of blood transfused and a low reticulocyte count at 30 days of age. We suggest restrictive criteria for minimizing the overall amount of transfusion to less than 30 mL may be a better way of preventing CLD in VLBW infants.

  12. PROGRESS IN BLOOD TRANSFUSION SERVICES IN KENYA ...

    African Journals Online (AJOL)

    2009-12-02

    Dec 2, 2009 ... Background: Provision of safe and adequate supplies of blood is dependent on a well organised blood ... effective legislative policies governing operations of blood transfusion .... policy and push for semi autonomy. (iv) Put up ...

  13. Blood transfusion practices in obstetric anaesthesia

    Directory of Open Access Journals (Sweden)

    Ashok Jadon

    2014-01-01

    Full Text Available Blood transfusion is an essential component of emergency obstetric care and appropriate blood transfusion significantly reduces maternal mortality. Obstetric haemorrhage, especially postpartum haemorrhage, remains one of the major causes of massive haemorrhage and a prime cause of maternal mortality. Blood loss and assessment of its correct requirement are difficult in pregnancy due to physiological changes and comorbid conditions. Many guidelines have been used to assess the requirement and transfusion of blood and its components. Infrastructural, economic, social and religious constraints in blood banking and donation are key issues to formulate practice guidelines. Available current guidelines for transfusion are mostly from the developed world; however, they can be used by developing countries keeping available resources in perspective.

  14. Transfusion syndromes in monochorionic multiplets: An overview

    African Journals Online (AJOL)

    come for attention to be focused on an area of gemellology, feto‑fetal transfusion syndromes in multiplets, in order ... These health hazards, all causes of very high perinatal ..... of monochorionic twin pregnancy complicated with selective fetal.

  15. Examination of Traditional Medicine and Herbal Pharmacology and the Implications for Teaching and Education: A Ghanaian Case Study

    Science.gov (United States)

    Asabere-Ameyaw, Akwasi; Sefa Dei, George J.; Raheem, Kolawole

    2009-01-01

    This article presents the preliminary findings of a pilot study of the practice, uses, and effectiveness of traditional medicine in Ghana. Based on in-depth interviews with local key practitioners and users of traditional medicine, the article points to some of the educational significance of local cultural knowledge on the environment and the…

  16. Red blood cell transfusion in neurosurgery.

    Science.gov (United States)

    Linsler, Stefan; Ketter, Ralf; Eichler, Hermann; Schwerdtfeger, Karsten; Steudel, Wolf-Ingo; Oertel, Joachim

    2012-07-01

    The necessity of red blood cell (RBC) transfusions in neurosurgical procedures is under debate. Although detailed recommendations exist for many other surgical disciplines, there are very limited data on the probability of transfusions during neurosurgical procedures. Three-thousand and twenty-six consecutive adult patients undergoing neurosurgical procedures at Saarland University Hospital from December 2006 to June 2008 were retrospectively analyzed for administration of RBCs. The patients were grouped into 11 main diagnostic categories for analysis. The transfusion probability and cross-match to transfusion ratio (C/T ratio) were calculated. Overall, the transfusion probability for neurosurgical procedures was 1.7 % (52/3,026). The probability was 6.5 % for acute subdural hematoma (7/108), 6.2 % for spinal tumors (5/80), 4.6 % for intracerebral hemorrhage (ICH, 4/98), 2.8 % for abscess (3/108), 2.4 % for traumatic brain injury (4/162), 2.3 % for cerebral ischemia (1/44), 1.9 % for subarachnoid hemorrhage (SAH) /aneurysms (4/206), 1.4 % for brain tumors (10/718), 0.8 % for hydrocephalus (2/196), 0.4 % for degenerative diseases of the spine (5/1290), including 3.6 % (3/82) for posterior lumbar interbody fusion (PLIF) and 0 % for epidural hematoma (0/15). The transfusion probabilities for clipping and coiling of SAH were 2.9 % (2/68) and 1.7 % (2/120) respectively. The probability of blood transfusion during neurosurgical procedures is well below the 10 % level which is generally defined as the limit for preoperative appropriation of RBCs. Patients with spinal tumors, acute subdural hematomas or ICH, i.e., patients undergoing large decompressive procedures of bone or soft tissue, had a higher probability of transfusion.

  17. Pre- and Post-Transfusion Alloimmunization in Dogs Characterized by 2 Antiglobulin-Enhanced Cross-match Tests.

    Science.gov (United States)

    Goy-Thollot, I; Giger, U; Boisvineau, C; Perrin, R; Guidetti, M; Chaprier, B; Barthélemy, A; Pouzot-Nevoret, C; Canard, B

    2017-09-01

    When dogs are transfused, blood compatibility testing varies widely but may include dog erythrocyte antigen (DEA) 1 typing and rarely cross-matching. Prospective study to examine naturally occurring alloantibodies against red blood cells (RBCs) and alloimmunization by transfusion using 2 antiglobulin-enhanced cross-match tests. Eighty client-owned anemic, 72 donor, and 7 control dogs. All dogs were typed for DEA 1 and some also for DEA 4 and DEA 7. Major cross-match tests with canine antiglobulin-enhanced immunochromatographic strip and gel columns were performed 26-129 days post-transfusion (median, 39 days); some dogs had an additional early evaluation 11-22 days post-transfusion (median, 16 days). Plasma from alloimmunized recipients was cross-matched against RBCs from 34 donor and control dogs. The 2 cross-match methods gave entirely concordant results. All 126 pretransfusion cross-match results for the 80 anemic recipients were compatible, but 54 dogs died or were lost to follow up. Among the 26 recipients with follow-up, 1 dog accidently received DEA 1-mismatched blood and became cross-match-incompatible post-transfusion. Eleven of the 25 DEA 1-matched recipients (44%) became incompatible against other RBC antigens. No naturally occurring anti-DEA 7 alloantibodies were detected in DEA 7- dogs. The antiglobulin-enhanced immunochromatographic strip cross-match and laboratory gel column techniques identified no naturally occurring alloantibodies against RBC antigens, but a high degree of post-transfusion alloimmunization in dogs. Cross-matching is warranted in any dog that has been previously transfused independent of initial DEA 1 typing and cross-matching results before the first transfusion event. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  18. Risk factors for blood transfusion after shoulder arthroplasty.

    Science.gov (United States)

    Padegimas, E M; Clyde, C T; Zmistowski, B M; Restrepo, C; Williams, G R; Namdari, S

    2016-02-01

    Currently, there is little information about the need for peri-operative blood transfusion in patients undergoing shoulder arthroplasty. The purpose of this study was to identify the rate of transfusion and its predisposing factors, and to establish a blood conservation strategy. We identified all patients who had undergone shoulder arthroplasty at our hospital between 1 January 2011 and 31 December 2013. The rate of transfusion was determined from the patient's records. While there were exceptions, patients typically underwent transfusion if they had a level of haemoglobin of transfusion. High- and low-risk cohorts for transfusion were identified from a receiver operating characteristic (ROC) curve. Of 1174 shoulder arthroplasties performed on 1081 patients, 53 cases (4.5%) required transfusion post-operatively. Predictors of blood transfusion were a lower pre-operative haematocrit (p transfusion. In total 48 of the 436 (11%) shoulder arthroplasties with a pre-operative haematocrit transfusion compared with five of the 738 (0.70%) shoulder arthroplasties with a haematocrit above this level. We found that transfusion was needed less frequently than previously described for shoulder arthroplasty. Patients with a pre-operative haematocrit blood transfusion, while those with a haematocrit above this level are unlikely to require transfusion. The rate of transfusion after shoulder arthroplasty is under 5%, and those with a pre-operative haematocrit greater than or equal to 39.6% have a very low likelihood (transfusion. ©2016 The British Editorial Society of Bone & Joint Surgery.

  19. Preoperative blood transfusions for sickle cell disease

    Science.gov (United States)

    Estcourt, Lise J; Fortin, Patricia M; Trivella, Marialena; Hopewell, Sally

    2016-01-01

    Background Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Surgical interventions are more common in people with sickle cell disease, and occur at much younger ages than in the general population. Blood transfusions are frequently used prior to surgery and several regimens are used but there is no consensus over the best method or the necessity of transfusion in specific surgical cases. This is an update of a Cochrane review first published in 2001. Objectives To determine whether there is evidence that preoperative blood transfusion in people with sickle cell disease undergoing elective or emergency surgery reduces mortality and perioperative or sickle cell-related serious adverse events. To compare the effectiveness of different transfusion regimens (aggressive or conservative) if preoperative transfusions are indicated in people with sickle cell disease. Search methods We searched for relevant trials in The Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 23 March 2016. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register: 18 January 2016. Selection criteria All randomised controlled trials and quasi-randomised controlled trials comparing preoperative blood transfusion regimens to different regimens or no transfusion in people with sickle cell disease undergoing elective or emergency surgery. There was no restriction by outcomes examined, language or publication status. Data collection and analysis Two authors independently assessed trial eligibility and the risk of bias and extracted data. Main results Three trials with 990 participants were eligible for inclusion in the review. There were no

  20. Do autologous blood transfusion systems reduce allogeneic blood transfusion in total knee arthroplasty?

    Science.gov (United States)

    Pawaskar, Aditya; Salunke, Abhijeet Ashok; Kekatpure, Aashay; Chen, Yongsheng; Nambi, G I; Tan, Junhao; Sonawane, Dhiraj; Pathak, Subodhkumar

    2017-09-01

    To study whether autologus blood transfusion systems reduce the requirement of allogneic blood transfusion in patients undergoing total knee arthroplasty. A comprehensive search of the published literature with PubMed, Scopus and Science direct database was performed. The following search terms were used: (total knee replacement) OR (total knee arthroplasty) OR (TKA) AND (blood transfusion) OR (autologous transfusion) OR (autologous transfusion system). Using search syntax, a total of 748 search results were obtained (79 from PubMed, 586 from Science direct and 83 from Scopus). Twenty-one randomized control trials were included for this meta-analysis. The allogenic transfusion rate in autologus blood transfusion (study) group was significantly lower than the control group (28.4 and 53.5 %, respectively) (p value 0.0001, Relative risk: 0.5). The median units of allogenic blood transfused in study control group and control group were 0.1 (0.1-3.0) and 1.3 (0.3-2.6), respectively. The median hospital stay in study group was 9 (6.7-15.6) days and control group was 8.7 (6.6-16.7) days. The median cost incurred for blood transfusion per patient in study and control groups was 175 (85.7-260) and 254.7 (235-300) euros, respectively. This meta-analysis demonstrates that the use of auto-transfusion systems is a cost-effective method to reduce the need for and quantity of allogenic transfusion in elective total knee arthroplasty. Level I.

  1. Does a one-day workshop improve clinical faculty's comfort and behaviour in practising and teaching evidence-based medicine? A Canadian mixed methods study.

    Science.gov (United States)

    Allen, David; Abourbih, Jacques; Maar, Marion; Boesch, Lisa; Goertzen, James; Cervin, Catherine

    2017-07-13

    The purpose of this study was to determine the impact of a 1-day evidence-based medicine (EBM) workshop on physician attitudes and behaviours around teaching and practicing EBM. A mixed methods study using a before/after cohort. A medical school delivering continuing professional development to 1250 clinical faculty over a large geographic area in Canada. 105 physician clinical faculty members. A 1-day workshop presented at 11 different sites over an 18-month period focusing on EBM skills for teaching and clinical practice. (1) A quantitative survey administered immediately before and after the workshop, and 3-6 months later, to assess the hypothesis that comfort with teaching and practising EBM can be improved.(2) A qualitative survey of the expectations for, and impact of the workshop on, participant behaviours and attitudes using a combination of pre, post and 3 to 6-month follow-up questionnaires, and telephone interviews completed 10-14 months after the workshop. Physician comfort with their EBM clinical skills improved on average by 0.93 points on a 5-point Likert scale, and comfort with EBM teaching skills by 0.97 points (p values 0.001). Most of this improvement was sustained 3-6 months later. Three to fourteen months after the workshop, half of responding participants reported that they were using the Population Intervention Comparator Outcome (PICO) methodology of question framing for teaching, clinical practice or both. Comfort in teaching and practicing EBM can be improved by a 1-day workshop, with most of this improvement sustained 3-6 months later. PICO question framing can be learnt at a 1-day workshop, and is associated with a self-reported change in clinical and teaching practice 3-14 months later. This represents both level 2 (attitudes) and level 3 (behaviours) change using the Kirkpatrick model of evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

  2. Leukocytes and transfusion related adverse events: the effects of leuko-reduction process in the prevention of adverse reactions resulted from the transfusion of blood components: review article

    Directory of Open Access Journals (Sweden)

    Ehteramolsadat Hosseini

    2017-05-01

    Full Text Available Blood transfusion is commonly implemented to manage life and health-threatening conditions on a rapid and short-term basis. Over the years, ongoing technical advances have dramatically improved transfusion medicine to provide more safety and effectiveness. However, transfusion is still complicated with different adverse events that mainly induced by the presence of allogeneic leukocytes in the blood products. Several lines of evidence have shown that leukocytes in blood components are involved in the induction of febrile nonhemolytic transfusion reactions (FNHTRs, HLA alloimmunization and platelet refractoriness as well as the increased risk of the infectious diseases transmitted by leukotropic viruses including cytomegalovirus (CMV, human T-lymphotropic virus (HTLV-I/II and Epstein-Barr virus (EBV. During current decades, introducing various leuko-reduction techniques have shown to be associated with less transfusion related adverse events and improved clinical outcomes. The lower incidence and severity of febrile transfusion reactions; reduced risk of transfusion related transmission of CMV or other leukocyte-associated infections, lowered incidence of alloimmune platelet refractoriness in addition to reducing risk of mortality and morbidity in patients are considered as clinical benefits of leuko-reduced products. Currently, by the use of 3rd and 4th generation of filters, the highest levels of leukoreduction in blood components have been achieved. Filtration techniques have also the advantages of being performed shortly after preparation of components (pre-storage or post-storage even at the patient’s bedside. However, it seems that pre-storage depletion of leukocytes provides better protection than post-storage techniques due to the elimination of leukocyte-derived cytokines effects which are increasingly released during storage. Particularly in platelet products, the earlier depletion of leukocyte also favors less platelet

  3. Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare

    Science.gov (United States)

    Park, Jason A.; Safer, Joshua D.

    2018-01-01

    Abstract Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported “high” comfort increased from 45% (9/20) to 80% (16/20) (p=0.04), and students who reported “high” knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) (ptransgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals. PMID:29344576

  4. Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare.

    Science.gov (United States)

    Park, Jason A; Safer, Joshua D

    2018-01-01

    Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported "high" comfort increased from 45% (9/20) to 80% (16/20) ( p =0.04), and students who reported "high" knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) ( p <0.001 ) . Conclusion: Although integrating evidence-based, transgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals.

  5. A three-year study of the impact of instructor attitude, enthusiasm, and teaching style on student learning in a medicinal chemistry course.

    Science.gov (United States)

    Alsharif, Naser Z; Qi, Yongyue

    2014-09-15

    To determine the effect of instructor attitude, enthusiasm, and teaching style on learning for distance and campus pharmacy students. Over a 3-year period, distance and campus students enrolled in the spring semester of a medicinal chemistry course were asked to complete a survey instrument with questions related to instructor attitude, enthusiasm, and teaching style, as well as items to measure student intrinsic motivation and vitality. More positive responses were observed among distance students and older students. Gender did not impact student perspectives on 25 of the 26 survey questions. Student-related items were significantly correlated with instructor-related items. Also, student-related items and second-year cumulative grade point average were predictive of students' final course grades. Instructor enthusiasm demonstrated the highest correlation with student intrinsic motivation and vitality. While this study addresses the importance of content mastery and instructional methodologies, it focuses on issues related to instructor attitude, instructor enthusiasm, and teaching style, which all play a critical role in the learning process. Thus, instructors have a responsibility to evaluate, reevaluate, and analyze the above factors to address any related issues that impact the learning process, including their influence on professional students' intrinsic motivation and vitality, and ability to meet educational outcomes.

  6. The effect of contextual factors on results of teaching evaluation in College of Medicine, Tehran University of Medical Sciences (2003

    Directory of Open Access Journals (Sweden)

    Meshkani Z

    2004-10-01

    Full Text Available Background: The use of students rating in order to improve faculty teaching has increased during last 25 years, and some universities rate all faculties teaching by students. Purpose: To study the influence of some instructor contextual variables in evaluating faculty teaching such as, gender, age, rank, teaching experience and status of employment of faculty. Methods: The available data from evaluation of 3 semesters (2001, 2002, and 2003 for 91 faculty members of medical basic sciences were analyzed as the dependent variables, the instrument for this study was self administered Likert's type questionnaire which administered in the last session of teaching. The effect of variable like gender, rank, teaching experiences, employment status are examined on evaluation score of faculty .The statistical t-test, Leven's and Pearson correlation were used to analyses the data. Results: Of all participant 67% were men. 5.6%of them aged less than 35, 52.2% of subjects were between 35-50years old and 42.2%were older than 50. Of all faculties 16.6% were full professor, 23.4% associate and 56%were assistant professor.4% of the faculty were instructor. There was no statistical significant association between the mean score and variances of evaluation scores Conclusion: The finding of this study showed there were no statistically differences between the dependent and independents variables. However the weak negative correlation was found between age and teaching experience. It means young and less experienced faculty gets better score in student rating KEYWORDS: FACULTY EVALUATION, STUDENT'S SURVEY

  7. Blood transfusion : Transfusion-related acute lung injury: back to basics

    NARCIS (Netherlands)

    Peters, A.L.

    2017-01-01

    Transfusion-related acute lung injury (TRALI) is a life-threatening disease affecting the lungs. TRALI can develop within 6 hours after transfusion and almost all patients with TRALI require mechanical ventilation at the intensive care department. Nevertheless up to 40% of patients do not recover

  8. Ways to develop the prophylaxis of post-transfusion hemolytic complications

    Directory of Open Access Journals (Sweden)

    B. B. Bahovadinov

    2015-01-01

    Full Text Available Post-transfusion hemolytic complications (РНС remain аn urgent рrоblem in medical practice despite the improvement of selecting methods of compatible blood transfusion for patients. The numbеr of РНС remains still high (1 in 6 000 - 29 000 transfusions. Aim: to analyze cases of РНС registered in health care facilities (HCF in the Republic of Tajikistan. Method of investigation. Retrospective analysis of materials of national аnd regional committees оп investigation of РНС cases, histories fro hospital archives. During the period 1989-2014 in health facilities were registered 86 cases of РНС approximately 850 000 doses of red bооd cell transfusions containing blооd components, or 1 in 9418 doses of red blood cell-containing blood components. РНС reasons were: incompatibility of АВО blооd group system - 32 (37,3 %, antigen D of blооd group Rhesus factor system - 34 (39,53 %, according to minor blood group antigens of Rhesus factor and Kell blood group system (С, с, Е, е, К - 16 (18,6 %. In 4 cases (4,6 % the cases of РНС were hemolytic transfusions of erythrocyte-containing bags as а result of improper storage in domestic refrigeration without control of temperature storage. Causes of development 78 out of 86 РНС (90,69 % were HCF doctors' mistakes, 8 (9,31 % - mistakes of health personnel of health facilities departments of blood transfusion аnd regional blооd centers. Reducing the frequency of PHC is impossible without training physicians оn transfusion medicine, introduction of modern methods of phenotyping erythrocyte antigens of recipients and donors оn major transfusion significant blood group antigens the АВО system by direct and cross-over methods, Rhesus (С, с, Е, е, Kell (К of patients requiring multiple transfusions, as well as to girls and women of childbearing age.

  9. Blood work. Canadian nursing and blood transfusion, 1942-1990.

    Science.gov (United States)

    Toman, C

    2001-01-01

    The extension of blood transfusion to civilian populations was contingent on the availability of a nursing workforce capable of taking on increasingly responsible roles. Nurses assumed a variety of roles as they incorporated blood work into patient care and, in the process, enabled, embodied, and engendered it as nurses' and women's work. Initially, the student workforce facilitated transfusion through roles that were congruent with nursing's domestic roots. Later, it constrained the expansion of blood work because of its perpetually novice nature. Delegation constituted one strategy by which a limited number of persons could become experienced and autonomous in a particular role. As long as the skill remained limited, nurses shared its associated power and status, which differentiated them within the work culture. A few women were able to shape blood work to their advantage, using their expertise either as job security or as a bargaining point to negotiate better working conditions. However, when the skill was routinized and dispersed among many nurses, it became dirty work. The examination of one specific technology that shifted from medicine into nursing contributes insights to current issues of expanded roles and delegated skills. Nurses need to question seriously what is gained and lost as they take on and let go of technologies. They need to consider what kinds of knowledge will be needed and how best to develop it. Finally, they need to reflect how changes might complicate care giving and nurses' work.

  10. Red blood cell transfusion in septic shock

    DEFF Research Database (Denmark)

    Rosland, Ragnhild G; Hagen, Marte U; Haase, Nicolai

    2014-01-01

    Sepsis-related Organ Failure Assessment (SOFA) scores (days 1 and 5), more days in shock (5 (3-10) vs. 2 (2-4), p = 0.0001), more days in ICU (10 (4-19) vs. 4 (2-8), p = 0.0001) and higher 90-day mortality (66 vs. 43%, p = 0.001). The latter association was lost after adjustment for admission category....../dl and independent of shock day and bleeding. Patients with cardiovascular disease were transfused at higher haemoglobin levels. Transfused patients had higher Simplified Acute Physiology Score (SAPS) II (56 (45-69) vs. 48 (37-61), p = 0.0005), more bleeding episodes, lower haemoglobin levels days 1 to 5, higher...... and SAPS II and SOFA-score on day 1. CONCLUSIONS: The decision to transfuse patients with septic shock was likely affected by disease severity and bleeding, but haemoglobin level was the only measure that consistently differed between transfused and non-transfused patients....

  11. Transfusion and blood donation in comic strips.

    Science.gov (United States)

    Lefrère, Jean-Jacques; Danic, Bruno

    2013-07-01

    The representation of blood transfusion and donation of blood in the comic strip has never been studied. The comic strip, which is a relatively recent art, emerged in the 19th century before becoming a mass medium during the 20th century. We have sought, by calling on collectors and using the resources of Internet, comic strips devoted, wholly or in part, to the themes of transfusion and blood donation. We present some of them here in chronologic order, indicating the title, country of origin, year of publication, and names of authors. The theme of the superhero using transfusion to transmit his virtues or his powers is repeated throughout the 20th century in North American comic strips. More recently, comic strips have been conceived from the outset with a promotional aim. They perpetuate positive images and are directed toward a young readership, wielding humor to reduce the fear of venipuncture. Few comic strips denounce the abuse of the commercialization of products derived from the human body. The image of transfusion and blood donation given by the comic strips is not to be underestimated because their readership is primarily children, some of whom will become blood donors. Furthermore, if some readers are transfused during their lives, the impact of a memory more or less conscious of these childhood readings may resurface, both in hopes and in fears. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Annals of African Medicine

    African Journals Online (AJOL)

    The Annals of African Medicine is published by the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria and the Annals of African Medicine Society. The Journal is intended to serve as a medium for the publication of research findings in the broad field of Medicine in Africa and other developing countries, and ...

  13. Teaching science throughout the six-year medical curriculum: Two-year experience from the University of Split School of Medicine, Split, Croatia

    Directory of Open Access Journals (Sweden)

    Ana Marušić

    2014-05-01

    Full Text Available Objective. The aim of this article is to present the introduction of a mandatory, vertically integrated course in research methodology into medical curriculum. At the School of Medicine in Split (Croatia we organized this course in 2010, with the total of 270 hours in the 6-year curriculum. In the first year (50 hours students learned basic principles of scientific method, structure of scientific article, basic statistical concepts, data analysis, interpretation and presentation. In the second year (25 hours students applied the knowledge from the first year in real examples of research data to answer a research hypothesis and present the results and conclusions. Students were guided through the process of making a hypothesis, analyzing data, interpreting them, constructing tables and figures, and writing a short research report. At the end of the course they formally presented the results to other students and course teachers, using PowerPoint slides. The third year (25 hours was devoted to mastering concepts and basic skills of evidencebased medicine (EBM. The course in the fourth year (25 hours was integrated with the clinical courses (internal medicine, neurology, and psychiatry and structured as a “journal club”. In the fifth year (25 hours, the teaching was devoted to developing a research plan for the graduation thesis that the students had to conduct during the sixth year. The sixth year (120 hours was devoted to the execution of research planned in the fifth year, including data collection, data analysis, interpretation, and thesis writing and defense. Conclusion. The new course succeeded in increasing students’ knowledge and skills for critical thinking and EBM, and prepared them for life-long learning in medicine.

  14. Recommendations for teaching upon sensitive topics in forensic and legal medicine in the context of medical education pedagogy.

    Science.gov (United States)

    Kennedy, Kieran M; Scriver, Stacey

    2016-11-01

    Undergraduate medical curricula typically include forensic and legal medicine topics that are of a highly sensitive nature. Examples include suicide, child abuse, domestic and sexual violence. It is likely that some students will have direct or indirect experience of these issues which are prevalent in society. Those students are vulnerable to vicarious harm from partaking in their medical education. Even students with no direct or indirect experience of these issues may be vulnerable to vicarious trauma, particularly students who are especially empathetic to cases presented. Despite these risks, instruction relating to these topics is necessary to ensure the competencies of graduating doctors to respond appropriately to cases they encounter during their professional careers. However, risk can be minimised by a well-designed and thoughtfully delivered educational programme. We provide recommendations for the successful inclusion of sensitive forensic and legal medicine topics in undergraduate medical curricula. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  15. Diagnosis of Beta-thalassaemia major in previously transfused patients

    International Nuclear Information System (INIS)

    Ahmed, S.; Rehman, Z.; Karamat, K.A.

    2003-01-01

    Objective: The study was conducted to evaluate the effects of blood transfusion(s) on the haematological picture of beta-thalassaemia major. Results: Out of the 280 patients 109 (39%) had received one or more blood transfusions (cases). The remaining 171 patients who did not receive any transfusion served as controls. The mean MCV, MCH and Hb-F in cases were significantly higher than in the controls (p 4 transfusions (17%) (p=0.016). In the occasionally transfused patients Hb-F level was directly related to the time since last transfusion. In 44/109 (40%) transfused patients (Hb-F>30%) the diagnosis of thalassaemia was not difficult. In 54/109 (50%) patients (Hb-:5-30%) the diagnosis was aided by parent's study, while PCR for thalassaemia mutation was required in 11/109 (10%) patients (Hb-F <5%). Conclusion: In most transfused patients of thalassaemia major MCV and MCH were significantly higher while Hb-F was lower than in the un-transfused patients. There was a linear correlation between Hb-F level and time since last transfusion in the occasionally transfused patients. However, the reduction in Hb-F level was more marked and sustained in multipally transfused patients. Parent's study and PCR are useful aids in establishing the correct diagnosis in these patients. (author)

  16. Quality indicators for the hospital transfusion chain : A national survey conducted in 100 dutch hospitals

    NARCIS (Netherlands)

    Zijlker-Jansen, Pauline Y.; Janssen, M. P.; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.

    2015-01-01

    Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion

  17. [Blood transfusion and supply chain management safety].

    Science.gov (United States)

    Quaranta, Jean-François; Caldani, Cyril; Cabaud, Jean-Jacques; Chavarin, Patricia; Rochette-Eribon, Sandrine

    2015-02-01

    The level of safety attained in blood transfusion now makes this a discipline better managed care activities. This was achieved both by scientific advances and policy decisions regulating and supervising the activity, as well as by the quality system, which we recall that affects the entire organizational structure, responsibilities, procedures, processes and resources in place to achieve quality management. So, an effective quality system provides a framework within which activities are established, performed in a quality-focused way and continuously monitored to improve outcomes. This system quality has to irrigate all the actors of the transfusion, just as much the establishments of blood transfusion than the health establishments. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Transfusion strategy for acute upper gastrointestinal bleeding.

    Science.gov (United States)

    Handel, James; Lang, Eddy

    2015-09-01

    Clinical question Does a hemoglobin transfusion threshold of 70 g/L yield better patient outcomes than a threshold of 90 g/L in patients with acute upper gastrointestinal bleeding? Article chosen Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013;368(1):11-21. Study objectives The authors of this study measured mortality, from any cause, within the first 45 days, in patients with acute upper gastrointestinal bleeding, who were managed with a hemoglobin threshold for red cell transfusion of either 70 g/L or 90 g/L. The secondary outcome measures included rate of further bleeding and rate of adverse events.

  19. Impact of Blood Transfusions on Survival of Locally Advanced Cervical Cancer Patients Undergoing Neoadjuvant Chemotherapy Plus Radical Surgery.

    Science.gov (United States)

    Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Lopez, Carlos; Indini, Alice; Leone Roberti Maggiore, Umberto; Sabatucci, Ilaria; Lorusso, Domenica; Raspagliesi, Francesco

    2017-03-01

    Transfusions represent one of the main progresses of modern medicine. However, accumulating evidence supports that transfusions correlate with worse survival outcomes in patients affected by solid cancers. In the present study, we aimed to investigate the effects of perioperative blood transfusion in locally advanced cervical cancer. Data of consecutive patients affected by locally advanced cervical cancer scheduled to undergo neoadjuvant chemotherapy plus radical surgery were retrospectively searched to test the impact of perioperative transfusions on survival outcomes. Five-year survival outcomes were evaluated using Kaplan-Meier and Cox models. The study included 275 patients. Overall, 170 (62%) patients had blood transfusion. Via univariate analysis, we observed that transfusion correlated with an increased risk of developing recurrence (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.09-4.40; P = 0.02). Other factors associated with 5-year disease-free survival were noncomplete clinical response after neoadjuvant chemotherapy (HR, 2.99; 95% CI, 0.92-9.63; P = 0.06) and pathological (P = 0.03) response at neoadjuvant chemotherapy as well as parametrial (P = 0.004), vaginal (P < 0.001), and lymph node (P = 0.002) involvements. However, via multivariate analysis, only vaginal (HR, 3.07; 95% CI, 1.20-7.85; P = 0.01) and lymph node involvements (HR, 2.4; 95% CI, 1.00-6.06; P = 0.05) correlate with worse disease-free survival. No association with worse outcomes was observed for patients undergoing blood transfusion (HR, 2.71; 95% CI, 0.91-8.03; P = 0.07). Looking at factors influencing overall survival, we observed that lymph node status (P = 0.01) and vaginal involvement (P = 0.06) were independently associated with survival. The role of blood transfusions in increasing the risk of developing recurrence in LAAC patients treated by neoadjuvant chemotherapy plus radical surgery remains unclear; further prospective studies are warranted.

  20. LITERACY AND FOREIGN LANGUAGE TEACHING AS KEY FACTORS FOR SOCIO-ECONOMIC ADAPTATION OF STUDENTS’ POPULATION - CHARACTERISTICS OF LITERACY AMONG DIFFERENT DEPARTMENTS AT THE FACULTY OF MEDICINE

    Directory of Open Access Journals (Sweden)

    Boris Djindjic

    2007-01-01

    skills were the highest at the Department of Medicine, slightly lower at Dentistry and Pharmacy Department and the lowest at the Department of Nursing.Social and communication competence requires not only good knowledge of the mother tongue but of foreign language as well. A major responsibility of teachers at all grade levels is to teach the language and communication skills needed for academic success, career and social mobility.

  1. The practice of reporting transfusion-related acute lung injury: a national survey among clinical and preclinical disciplines.

    Science.gov (United States)

    Vlaar, Alexander P J; Wortel, Kim; Binnekade, Jan M; van Oers, Marinus H J; Beckers, Erik; Gajic, Ognjen; Schultz, Marcus J; Juffermans, Nicole P

    2010-02-01

    Transfusion-related acute lung injury (TRALI) is hypothesized to be a "two-hit" entity, in which an inflammatory condition (e.g., sepsis) predisposes to TRALI. TRALI is a clinical diagnosis. Disciplines involved in managing TRALI may differ in decision-making on the reporting of TRALI. A survey was conducted among critical care physicians, hematologists, hemovigilance workers, and transfusion medicine physicians, using case vignettes and a questionnaire. The vignettes varied in patient- and blood product-related factors that may influence the decision to report a TRALI case. Multiple linear regression analysis was performed. A positive beta-coefficient is in favor of reporting. Ninety-two questionnaires were returned (response rate, 68%). For all disciplines, preferences in favor of reporting TRALI were onset of symptoms within 1 hour (beta = 0.4), after transfusion of a single unit of FFP (beta = 0.5), and in the absence of acute lung injury before transfusion (beta = 1.3). An admission diagnosis of sepsis was a negative preference (beta = -0.3). Massive transfusion (6 RBC plus 4 FFP units) was a negative preference for transfusion medicine physicians (beta = -0.3), but a positive preference for the other disciplines. The questionnaire revealed that massive transfusion and the age of blood products were considered relatively more important reasons to report TRALI by critical care physicians compared to the other disciplines (p reporting of a suspected TRALI case. Disciplines involved in managing TRALI differ in decision-making of reporting TRALI, which may contribute to variance in incidence.

  2. Prevalence of potential drug–drug interactions among internal medicine ward in University of Gondar Teaching Hospital, Ethiopia

    Directory of Open Access Journals (Sweden)

    Akshaya Srikanth Bhagavathula

    2014-05-01

    Conclusion: We have recorded a high rate of prevalence of potential DDI in the internal medicine ward of UOG hospital and a high number of clinically significant DDIs which the most prevalent DDI were of moderate severity. Careful selection of drugs and active pharmaceutical care is encouraged in order to avoid negative consequences of these interactions.

  3. Blood platelet kinetics and platelet transfusion

    OpenAIRE

    Aster, Richard H.

    2013-01-01

    The discovery of citrate anticoagulant in the 1920s and the development of plastic packs for blood collection in the 1960s laid the groundwork for platelet transfusion therapy on a scale not previously possible. A major limitation, however, was the finding that platelet concentrates prepared from blood anticoagulated with citrate were unsuitable for transfusion because of platelet clumping. We found that this could be prevented by simply reducing the pH of platelet-rich plasma to about 6.5 pr...

  4. Cancer incidence in blood transfusion recipients

    DEFF Research Database (Denmark)

    Hjalgrim, Henrik; Edgren, Gustaf; Rostgaard, Klaus

    2007-01-01

    of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. RESULTS: During 5,652,918 person-years of follow-up, 80,990 cancers occurred......, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. CONCLUSIONS: The marked increase in cancer risk shortly after a blood transfusion may...

  5. One-year period prevalence of blood transfusion

    DEFF Research Database (Denmark)

    Madsen, J T; Kimper-Karl, M L; Sprogøe, U

    2010-01-01

    was 9.2/1000 citizens. Most of the transfused patients had a main diagnosis of neoplasm (22% of recipients), diseases of the circulatory system (15%), the digestive system (15%), injuries (13%) and diseases of the blood (8%). Age standardization reversed the relation between sex specific 1-YPPRs......Transfusion practice is reported to differ considerably between countries. Comparisons often rely on transfusion rates, incidence - or prevalence rates. In this paper, the one-year period prevalence rate (1-YPPR) of transfusion of red cells (RBC) is presented. Transfusion data, demographic data...... and patient data were retrospectively combined to calculate sex and diagnosis specific and age standardized 1-YPPR s of RBC transfusion for the complete population in a Danish county. During the calendar year of 2006, 4427 patients received RBC transfusion in Funen County. The crude 1-YPPR of RBC transfusion...

  6. Association of blood transfusion with increased mortality in myocardial infarction

    DEFF Research Database (Denmark)

    Chatterjee, Saurav; Wetterslev, Jørn; Sharma, Abhishek

    2013-01-01

    The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists.......The benefit of blood transfusion in patients with myocardial infarction is controversial, and a possibility of harm exists....

  7. Reappraising the concept of massive transfusion in trauma

    DEFF Research Database (Denmark)

    Stanworth, Simon J; Morris, Timothy P; Gaarder, Christine

    2010-01-01

    ABSTRACT : INTRODUCTION : The massive-transfusion concept was introduced to recognize the dilutional complications resulting from large volumes of packed red blood cells (PRBCs). Definitions of massive transfusion vary and lack supporting clinical evidence. Damage-control resuscitation regimens o...

  8. Several aspects of some techniques avoiding homologous blood transfusions

    NARCIS (Netherlands)

    E.C.S.M. van Woerkens (Liesbeth)

    1998-01-01

    textabstractThe use of homologous blood products during anesthesia and surgery is not without risks. Complications due to homologous blood transfusions include transfusion reactions, isosensitization, transmission of infections (including HIV, hepatitis, CMV) and immunosuppression (resuiting in

  9. Back to the basic sciences: an innovative approach to teaching senior medical students how best to integrate basic science and clinical medicine.

    Science.gov (United States)

    Spencer, Abby L; Brosenitsch, Teresa; Levine, Arthur S; Kanter, Steven L

    2008-07-01

    Abraham Flexner persuaded the medical establishment of his time that teaching the sciences, from basic to clinical, should be a critical component of the medical student curriculum, thus giving rise to the "preclinical curriculum." However, students' retention of basic science material after the preclinical years is generally poor. The authors believe that revisiting the basic sciences in the fourth year can enhance understanding of clinical medicine and further students' understanding of how the two fields integrate. With this in mind, a return to the basic sciences during the fourth year of medical school may be highly beneficial. The purpose of this article is to (1) discuss efforts to integrate basic science into the clinical years of medical student education throughout the United States and Canada, and (2) describe the highly developed fourth-year basic science integration program at the University of Pittsburgh School of Medicine. In their critical review of medical school curricula of 126 U.S. and 17 Canadian medical schools, the authors found that only 19% of U.S. medical schools and 24% of Canadian medical schools require basic science courses or experiences during the clinical years, a minor increase compared with 1985. Curricular methods ranged from simple lectures to integrated case studies with hands-on laboratory experience. The authors hope to advance the national discussion about the need to more fully integrate basic science teaching throughout all four years of the medical student curriculum by placing a curricular innovation in the context of similar efforts by other U.S. and Canadian medical schools.

  10. [The analysis of language competence and students' needs in teaching English for medical purposes to students of medicine, dentistry and health care].

    Science.gov (United States)

    Marković, Vuk; Marosan, Zoran

    2011-01-01

    The paper deals with the analysis of the language competence of the students of Medicine, Dentistry and Health Care at the Medical School of Novi Sad University at the level of their basic language skills of general English and English for Medical Purposes. It also presents the analysis of students' needs of these skills within the field of teaching English for Medical Purposes. The aim of the study was to determine the level of students' language skills, knowledge of general and medical vocabulary and of academic writing in English and to determine which of the skills have the greatest priority in teaching English for Medical Purposes. The students were given a questionnaire and were asked to grade their language skills and knowledge of general and medical vocabulary and of academic writing on the scale from one to five. For the same skills, the students had to determine the level of priority in teaching English for Medical Purposes. The results were given for each of the groups of students evaluated, and the average grade was calculated for all the skills. The students' needs in terms of the priority of the evaluated skills were also presented in the same manner. Analysis Students' skills were analyzed according to the average grade acquired through the students' self-evaluation. The distinction was made between the general language skills and the knowledge of medical vocabulary and academic writing. The analysis of needs was conducted with the same distinction in mind. The study groups were analyzed separately and the general common conclusions for all the groups were made. For a successful program of English for Medical Purposes, it is necessary to conduct "the level of general language competence" test and to test the students' needs beforehand. The difference in the level of knowledge between different study groups points to a need of a student oriented teaching program. The analysis of needs shows the importance of all language skills which have to be

  11. Situational analysis of teaching and learning of medicine and nursing students at Makerere University College of Health Sciences

    Directory of Open Access Journals (Sweden)

    Kiguli Juliet

    2011-03-01

    Full Text Available Abstract Background Makerere University College of Health Sciences (MakCHS in Uganda is undergoing a major reform to become a more influential force in society. It is important that its medicine and nursing graduates are equipped to best address the priority health needs of the Ugandan population, as outlined in the government’s Health Sector Strategic Plan (HSSP. The assessment identifies critical gaps in the core competencies of the MakCHS medicine and nursing and ways to overcome them in order to achieve HSSP goals. Methods Documents from the Uganda Ministry of Health were reviewed, and medicine and nursing curricula were analyzed. Nineteen key informant interviews (KII and seven focus group discussions (FGD with stakeholders were conducted. The data were manually analyzed for emerging themes and sub-themes. The study team subsequently used the checklists to create matrices summarizing the findings from the KIIs, FGDs, and curricula analysis. Validation of findings was done by triangulating information from the different data collection methods. Results The core competencies that medicine and nursing students are expected to achieve by the end of their education were outlined for both programs. The curricula are in the process of reform towards competency-based education, and on the surface, are well aligned with the strategic needs of the country. But implementation is inadequate, and can be changed: • Learning objectives need to be more applicable to achieving competencies. • Learning experiences need to be more relevant for competencies and setting in which students will work after graduation (i.e. not just clinical care in a tertiary care facility. • Student evaluation needs to be better designed for assessing these competencies. Conclusion MakCHS has made a significant attempt to produce relevant, competent nursing and medicine graduates to meet the community needs. Ways to make them more effective though deliberate efforts to

  12. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion.

    Science.gov (United States)

    Carson, Jeffrey L; Carless, Paul A; Hebert, Paul C

    2012-04-18

    Most clinical practice guidelines recommend restrictive red cell transfusion practices, with the goal of minimising exposure to allogeneic blood. The purpose of this review is to compare clinical outcomes in patients randomised to restrictive versus liberal transfusion thresholds (triggers). To examine the evidence for the effect of transfusion thresholds on the use of allogeneic and/or autologous red cell transfusion, and the evidence for any effect on clinical outcomes. We identified trials by searching; The Cochrane Injuries Group Specialised Register (searched 01 Feb 2011), Cochrane Central Register of Controlled Trials 2011, issue 1 (The Cochrane Library), MEDLINE (Ovid) 1948 to January Week 3 2011, EMBASE (Ovid) 1980 to 2011 (Week 04), ISI Web of Science: Science Citation Index Expanded (1970 to Feb 2011), ISI Web of Science: Conference Proceedings Citation Index- Science (1990 to Feb 2011). We checked reference lists of other published reviews and relevant papers to identify any additional trials. Controlled trials in which patients were randomised to an intervention group or to a control group. Trials were included where intervention groups were assigned on the basis of a clear transfusion 'trigger', described as a haemoglobin (Hb) or haematocrit (Hct) level below which a red blood cell (RBC) transfusion was to be administered. Risk ratios of requiring allogeneic blood transfusion, transfused blood volumes and other clinical outcomes were pooled across trials, using a random effects model. Data extraction and assessment of the risk of bias was performed by two people. Nineteen trials involving a total of 6264 patients were identified, and were similar enough that the results could be combined. Restrictive transfusion strategies reduced the risk of receiving a RBC transfusion by 39% (RR 0.61, 95% CI 0.52 to 0.72). This equates to an average absolute risk reduction (ARR) of 34% (95% CI 24% to 45%). The volume of RBCs transfused was reduced on average by 1

  13. Student′s preference of various audiovisual aids used in teaching pre- and para-clinical areas of medicine

    Directory of Open Access Journals (Sweden)

    Navatha Vangala

    2015-01-01

    Full Text Available Introduction: The formal lecture is among the oldest teaching methods that have been widely used in medical education. Delivering a lecture is made easy and better by use of audiovisual aids (AV aids such as blackboard or whiteboard, an overhead projector, and PowerPoint presentation (PPT. Objective: To know the students preference of various AV aids and their use in medical education with an aim to improve their use in didactic lectures. Materials and Methods: The study was carried out among 230 undergraduate medical students of first and second M.B.B.S studying at Malla Reddy Medical College for Women, Hyderabad, Telangana, India during the month of November 2014. Students were asked to answer a questionnaire on the use of AV aids for various aspects of learning. Results: This study indicates that students preferred PPT, the most for a didactic lecture, for better perception of diagrams and flowcharts. Ninety-five percent of the students (first and second M.B.B.S were stimulated for further reading if they attended a lecture augmented by the use of visual aids. Teacher with good teaching skills and AV aids (58% was preferred most than a teacher with only good teaching skills (42%. Conclusion: Our study demonstrates that lecture delivered using PPT was more appreciated and preferred by the students. Furthermore, teachers with a proper lesson plan, good interactive and communicating skills are needed for an effective presentation of lecture.

  14. Influence of the wording of evaluation items on outcome-based evaluation results for large-group teaching in anatomy, biochemistry and legal medicine.

    Science.gov (United States)

    Anders, Sven; Pyka, Katharina; Mueller, Tjark; von Streinbuechel, Nicole; Raupach, Tobias

    2016-11-01

    Student learning outcome is an important dimension of teaching quality in undergraduate medical education. Measuring an increase in knowledge during teaching requires repetitive objective testing which is usually not feasible. As an alternative, student learning outcome can be calculated from student self-ratings. Comparative self-assessment (CSA) gain reflects the performance difference before and after teaching, adjusted for initial knowledge. It has been shown to be a valid proxy measure of actual learning outcome derived from objective tests. However, student self-ratings are prone to a number of confounding factors. In the context of outcome-based evaluation, the wording of self-rating items is crucial to the validity of evaluation results. This randomized trial assessed whether including qualifiers in these statements impacts on student ratings and CSA gain. First-year medical students self-rated their initial (then-test) and final (post-test) knowledge for lectures in anatomy, biochemistry and legal medicine, respectively, and 659 questionnaires were retrieved. Six-point scales were used for self-ratings with 1 being the most positive option. Qualifier use did not affect then-test ratings but was associated with slightly less favorable post-test ratings. Consecutively, mean CSA gain was smaller for items containing qualifiers than for items lacking qualifiers (50.6±15.0% vs. 56.3±14.6%, p=0.079). The effect was more pronounced (Cohen's d=0.82) for items related to anatomy. In order to increase fairness of outcome-based evaluation and increase the comparability of CSA gain data across subjects, medical educators should agree on a consistent approach (qualifiers for all items or no qualifiers at all) when drafting self-rating statements for outcome-based evaluation. Copyright © 2016 Elsevier GmbH. All rights reserved.

  15. Blood Transfusion Strategies in Patients Undergoing Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    Hyoung Soo Kim

    2017-02-01

    Full Text Available Extracorporeal membrane oxygenation (ECMO is frequently associated with bleeding and coagulopathy complications, which may lead to the need for transfusion of multiple blood products. However, blood transfusions are known to increase morbidity and mortality, as well as hospital cost, in critically ill patients. In current practice, patients on ECMO receive a transfusion, on average, of 1-5 packed red blood cells (RBCs/day, with platelet transfusion accounting for the largest portion of transfusion volume. Generally, adult patients require more transfusions than neonates or children, and patients receiving venovenous ECMO for respiratory failure tend to need smaller transfusion volumes compared to those receiving venoarterial ECMO for cardiac failure. Observation studies have reported that a higher transfusion volume was associated with increased mortality. To date, the evidence for transfusion in patients undergoing ECMO is limited; most knowledge on transfusion strategies was extrapolated from studies in critically ill patients. However, current data support a restrictive blood transfusion strategy for ECMO patients, and a low transfusion trigger seems to be safe and reasonable.

  16. Blood Discards in a Nigerian Transfusion Service Centre: The ...

    African Journals Online (AJOL)

    Background: Blood discards have not attracted much attention in transfusion practice in Nigeria, where pre-donation screening is the practice in most health facilities with its attendant deferral of donors reactive to transfusion transmissible infections. The National Blood Transfusion Service of Nigeria lays emphasis on ...

  17. Transfusion associated hepatitis B virus infection among sickle cell ...

    African Journals Online (AJOL)

    Background: Transfusion of blood products is a recognised way of transmitting infections particularly viruses. The extent to which blood transfusion contributes to hepatitis B virus (HBV) infections in transfused patients with sickle cell anaemia (SCA) has been found to be 20% in Lagos, Nigeria. Mamman in Zaria however ...

  18. Blood Transfusion In Surgical Children: The Advantages And Hazards

    African Journals Online (AJOL)

    The increasing opposition to blood transfusion makes the management of surgical children who require blood very challenging. This retrospective study reviews records of blood transfusion so as to determine the advantages and hazards in surgical children. The advantages and hazards of blood transfusion in surgical ...

  19. Survey of facilities for appropriate training in blood transfusion

    African Journals Online (AJOL)

    2018-06-01

    Jun 1, 2018 ... Objective. To survey training facilities for blood transfusion in Anglophone West. Africa for ... to provide workforce for blood transfusion establishments. However, ... A standard blood service is a multi-disciplinary organization in which .... and good manufacturing practices in the blood transfusion laboratory.

  20. Clinical and immunological aspects of pretransplant blood transfusions

    NARCIS (Netherlands)

    Waanders, Marloes Maria

    2009-01-01

    Blood transfusions can lead to immunization or tolerance in the recipient. The latter is characterized by an improved transplant outcome after pretransplant blood transfusions. First observations of improved kidney graft outcome after blood transfusion date 35 years back, however no exclusive

  1. Red blood cell transfusion during septic shock in the ICU

    DEFF Research Database (Denmark)

    Perner, A; Smith, S H; Carlsen, S

    2012-01-01

    Transfusion of red blood cells (RBCs) remains controversial in patients with septic shock, but current practice is unknown. Our aim was to evaluate RBC transfusion practice in septic shock in the intensive care unit (ICU), and patient characteristics and outcome associated with RBC transfusion....

  2. Anemia of prematurity : time for a change in transfusion management?

    NARCIS (Netherlands)

    Khodabux, Chantal Muriel

    2013-01-01

    In this thesis we investigated clinical effects of allogeneic red blood cell (RBC) transfusions in premature infants, different transfusion volumes in relation to neonatal outcome in premature infants and the use of autologous cord blood (CB) as an alternative for allogeneic transfusions. Despite

  3. Hepatitis C and blood transfusion among children attending the ...

    African Journals Online (AJOL)

    EB

    2013-06-02

    Jun 2, 2013 ... Background: Hepatitis C virus (HCV) accounts for 90% of post-transfusion hepatitis. In Uganda, there has been limited research ... Of these, 159 (65%) had a history of blood transfusion. Among the transfused, five patients were .... 6.4 computer software package. Analysis was done using SPSS Version 11,.

  4. Ex-vivo expansion of red blood cells: how real for transfusion in humans?

    Science.gov (United States)

    Migliaccio, Anna Rita; Masselli, Elena; Varricchio, Lilian; Whitsett, Carolyn

    2012-03-01

    Blood transfusion is indispensable for modern medicine. In developed countries, the blood supply is adequate and safe but blood for alloimmunized patients is often unavailable. Concerns are increasing that donations may become inadequate in the future as the population ages prompting a search for alternative transfusion products. Improvements in culture conditions and proof-of-principle studies in animal models have suggested that ex-vivo expanded red cells may represent such a product. Compared to other cell therapies transfusion poses the unique challenge of requiring great cell doses (2.5×10(12) cells vs 10(7) cells). Although production of such cell numbers is theoretically possible, current technologies generate red cells in numbers sufficient only for safety studies. It is conceived that by the time these studies will be completed, technical barriers to mass cell production will have been eliminated making transfusion with ex-vivo generated red cells a reality. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Red blood cell alloimmunization after blood transfusion

    NARCIS (Netherlands)

    Schonewille, Henk

    2008-01-01

    Current pretransfusion policy requires the patients’ serum to be tested for the presence of irregular red blood cell antibodies. In case of an antibody, red blood cells lacking the corresponding antigen are transfused after an antiglobulin crossmatch. The aim of the studies in this thesis is

  6. Prevalence of exchange blood transfusion in severe ...

    African Journals Online (AJOL)

    Background: Exchange blood transfusion (EBT) is carried out for the treatment of conditions presenting with severe hyperbilirubinaemia and anaemia, such as ABO incompatibility, sepsis, prematurity and birth trauma among others. While it is fast being abandoned as treatment modality for severe neonatal jaundice in the ...

  7. Utilization Management in the Blood Transfusion Service

    Science.gov (United States)

    Peña, Jeremy Ryan Andrew; Dzik, Walter “Sunny”

    2015-01-01

    The scope of activity of the Blood Transfusion Service (BTS) makes it unique among the clinical laboratories. The combination of therapeutic and diagnostic roles necessitates a multi-faceted approach to utilization management in the BTS. We present our experience in utilization management in large academic medical center. PMID:24080431

  8. Autologous blood transfusion during emergency trauma operations.

    Science.gov (United States)

    Brown, Carlos V R; Foulkrod, Kelli H; Sadler, Holli T; Richards, E Kalem; Biggan, Dennis P; Czysz, Clea; Manuel, Tony

    2010-07-01

    Intraoperative cell salvage (CS) of shed blood during emergency surgical procedures provides an effective and cost-efficient resuscitation alternative to allogeneic blood transfusion, which is associated with increased morbidity and mortality in trauma patients. Retrospective matched cohort study. Level I trauma center. All adult trauma patients who underwent an emergency operation and received CS as part of their intraoperative resuscitation. The CS group was matched to a no-CS group for age, sex, Injury Severity Score, mechanism of injury, and operation performed. Amount and cost of allogeneic transfusion of packed red blood cells and plasma. The 47 patients in the CS group were similar to the 47 in the no-CS group for all matched variables. Patients in the CS group received an average of 819 mL of autologous CS blood. The CS group received fewer intraoperative (2 vs 4 U; P = .002) and total (4 vs 8 U; P blood cells. The CS group also received fewer total units of plasma (3 vs 5 U; P = .03). The cost of blood product transfusion (including the total cost of CS) was less in the CS group ($1616 vs $2584 per patient; P = .004). Intraoperative CS provides an effective and cost-efficient resuscitation strategy as an alternative to allogeneic blood transfusion in trauma patients undergoing emergency operative procedures.

  9. Autologous Blood Transfusion for Postpartum Hemorrhage.

    Science.gov (United States)

    Greenawalt, Julia A; Zernell, Denise

    Postpartum hemorrhage (PPH) is a leading contributor to maternal morbidity and mortality in the United States and globally. Although the rate of PPH is generally decreasing nationally, severity of PPH appears to be increasing, potentially related to the various comorbidities associated with women of childbearing age. There is increasing evidence of risks associated with allogeneic blood transfusion, which has historically been the classic therapeutic approach for treatment to PPH. Pregnant women are particularly susceptible to the implications of sensitization to red cell antigens, a common sequela to allogenic blood transfusion. Autologous blood transfusion eliminates the potential of communicable disease transmission as well as the conceivable threat of a blood transfusion reaction. Recent technological advances allow cell salvage coupled with the use of a leukocyte filter to be used as an alternative approach for improving the outcome for women experiencing a PPH. Modest changes in standard operating procedure and continued training in use and application of cell salvaged blood may assist in minimizing negative outcomes from PPH. Salvaged blood has been demonstrated to be at least equal and often superior to banked blood. We discuss nursing implications for application of this technology for women with PPH. Continued research is warranted to evaluate the impact that application of cell salvage with filtration has on the patient experiencing a PPH.

  10. Intraoperative transfusion threshold and tissue oxygenation

    DEFF Research Database (Denmark)

    Nielsen, K; Dahl, B; Johansson, P I

    2012-01-01

    Transfusion with allogeneic red blood cells (RBCs) may be needed to maintain oxygen delivery during major surgery, but the appropriate haemoglobin (Hb) concentration threshold has not been well established. We hypothesised that a higher level of Hb would be associated with improved subcutaneous...... oxygen tension during major spinal surgery....

  11. 1. Transfusion Transmissible Infections among Voluntary Blood ...

    African Journals Online (AJOL)

    Esem

    ABSTRACT. Background: HIV1&2, HBsAg, anti-HCV and syphilis antibody are mandatory disease marker tests of Transfusion Transmissible Infections (TTIs) conducted on every donated unit of blood in Zambia. Blood is donated by first time voluntary donors and repeat/regular donors ofages between 16 and 65 years.

  12. Platelet transfusion therapy in sub-Saharan Africa: bacterial contamination, recipient characteristics and acute transfusion reactions

    Science.gov (United States)

    Hume, Heather A.; Ddungu, Henry; Angom, Racheal; Baluku, Hannington; Kajumbula, Henry; Kyeyune-Byabazaire, Dorothy; Orem, Jackson; Ramirez-Arcos, Sandra; Tobian, Aaron A.R.

    2017-01-01

    Background Little data are available on bacterial contamination (BC) of platelet units or acute transfusion reactions to platelet transfusions (PT) in sub-Saharan Africa (SSA). Methods This prospective observational study evaluated the rate of BC of whole blood derived platelet units (WB-PU), the utility of performing Gram stains (GS) to prevent septic reactions, characteristics of patients receiving PT and the rate of acute reactions associated with PT at the Uganda Cancer Institute in Kampala, Uganda. An aliquot of each WB-PU studied was taken to perform GS and culture using the Bactec™ 9120 instrument. Study participants were monitored for reactions. Results 337 WB-PU were evaluated for BC, of which 323 units were transfused in 151 transfusion episodes to 50 patients. The frequency of BC ranged from 0.3%–2.1% (according to criteria used to define BC). The GS had high specificity (99.1%), but low sensitivity to detect units with BC. The median platelet count prior to PT was 10,900 (IQR 6,000–18,900) cells/μL. 78% of PT were given to patients with no bleeding. Acute reactions occurred in 11 transfusion episodes, involving 13 WB-PU, for a rate of 7.3% (95%CI=3.7–12.7%) per transfusion episode. All recipients of units with positive bacterial cultures were receiving antibiotics at the time of transfusion; none experienced a reaction. Conclusions The rate of BC observed in this study is lower than previously reported in SSA, but still remains a safety issue. As GS appears to be an ineffective screening tool, alternate methods should be explored to prevent transfusing bacterially-contaminated platelets in SSA. PMID:27079627

  13. Cost of allogeneic and autologous blood transfusion in Canada. Canadian Cost of Transfusion Study Group.

    OpenAIRE

    Tretiak, R; Laupacis, A; Rivière, M; McKerracher, K; Souêtre, E

    1996-01-01

    OBJECTIVE: To determine the cost, from a societal perspective, of blood transfusion in Canada. STUDY DESIGN: Cost-structure analysis. SETTING: Data were collected from eight hospitals and from six blood centres operated by the Canadian Red Cross Society in four provinces. OUTCOME MEASURES: Costs associated with four stages of transfusion-- collection, production, distribution and delivery--in 1933 were assessed. Costs were divided into the following categories; personnel, purchases, external ...

  14. Serial haematology results in transfused and non-transfused dogs naturally infected with Babesia rossi

    Directory of Open Access Journals (Sweden)

    E. Scheepers

    2011-04-01

    Full Text Available This prospective longitudinal study investigated the progression of haematological changes in 32 transfused and 54 non-transfused dogs naturally infected with Babesia rossi over the 1st 6 days following diagnosis and treatment. The effect of patient age on the results of complete blood counts was determined. Haematology data were analysed at presentation and at 24 hours, 3 days and 6 days after presentation. Dogs were treated with diminazene aceturate at diagnosis and a blood transfusion was given if deemed clinically required. Mildly to moderately regenerative normocytic normochromic anaemia was observed in all dogs throughout the study period. Transfused dogs more often had an inflammatory leukogram at presentation and at 24 hours, than dogs that were not transfused. In dogs with a left shift, a concurrent normal or decreased segmented neutrophil count was found more commonly than neutrophilia. Severe thrombocytopenia that resolved within a week was common. Blood transfusion alleviated the anaemia, but had no significant effect on white blood cell or platelet responses. Blood cell responses were not significantly influenced by age. In conclusion, the red blood cell and white blood cell responses were less than expected in dogs with babesiosis, given the degree of anaemia and inflammation present. The magnitude of thrombocytopenia and rapid return of the platelet count to normal suggested a possible immune-mediated mechanism for the thrombocytopenia.

  15. The risk of transfusion-transmitted viral infections at the Gabonese National Blood Transfusion Centre

    Science.gov (United States)

    Rerambiah, Leonard Kounegnigan; Rerambiah, Laurence Essola; Bengone, Calixte; Djoba Siawaya, Joel F.

    2014-01-01

    Background Blood transfusions carry the risk of transmitting blood-borne infections. In contrast to the situation in the developed world, there is a limited number of studies examining this problem in sub-Saharan Africa. In this study we aimed to calculate the risks of acquiring human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection from units of blood issued by the Gabonese Blood Transfusion Centre between 2009 and 2011. Materials and methods All the donations were tested for infectious diseases and the seroconversion incidence rates of HIV, HBV and HCV were calculated. The residual risk of transfusion-associated transmission for each virus was calculated by multiplying the seroconversion rates by the window period expressed in fractions of a year. Results The risks of becoming infected with HIV, HCV, and HBV in subjects receiving units of blood from the Gabonese Blood Transfusion Centre were 64.7, 207.94 and 534.53 per million donations, respectively. Conclusions This study, which is the first to quantify the true risks of transfusion-transmitted infections in Gabon, reveals and confirms the need to reinforce preventative and screening strategies to improve transfusion safety in sub-Saharan Africa. PMID:24333085

  16. Indications and Effects of Plasma Transfusions in Critically Ill Children

    DEFF Research Database (Denmark)

    Karam, Oliver; Demaret, Pierre; Shefler, Alison

    2015-01-01

    indications for plasma transfusion were critical bleeding in 22.3%, minor bleeding in 21.2%, planned surgery or procedure in 11.7%, and high risk of postoperative bleeding in 10.6%. No bleeding or planned procedures were reported in 34.1%. Before plasma transfusion, the median international normalized ratio......-third of transfused patients were not bleeding and had no planned procedure. In addition, in most patients, coagulation tests are not sensitive to increases in coagulation factors resulting from plasma transfusion. Studies assessing appropriate plasma transfusion strategies are urgently needed....

  17. [Effectiveness of teaching gerontology and geriatrics in students of the 1st Faculty of Medicine, Charles University in Prague].

    Science.gov (United States)

    Mádlová, P; Neuwirth, J; Topinková, E

    2006-01-01

    Increasing number of seniors in the society requires more university-degree educated professionals--health care professionals, social care workers and managers with basic exposure to and knowledge of gerontology and geriatrics. The aim of our paper was to evaluate the effectiveness of undergraduate training of gerontology and geriatrics among students of the 1st Faculty of Medicine, Charles University in Prague. To get information about knowledge of medical students and students of ergotherapy and physiotherapy and about their attitudes towards senior citizens we conducted a survey using two anonymous questionnaires prepared in our department and piloted earlier. The survey ran during the academic year 2004/2005. Students completed identical questionnaires twice, first time before the start of the clinical rotation and second time after the training end (n=134). Evaluation of knowledge and attitudes confirmed that one to two weeks clinical rotation at Department of Geriatrics was effective and increased knowledge of students in the topic trained. The percentage of correct answers in all three evaluated training programmes increased after the completion of the clinical rotation and reached 83% and more. From 134 participating students, 54.5 % appreciated life experience and wisdom of seniors they met, 98.4 % of students were satisfied with the training programme and 67.2 % of students reported that after training they changed their attitude towards senior population. Our survey confirmed that clinical training in geriatric medicine at 1st Faculty of Medicine, Charles University in Prague, prepared in agreement with current European recommendations is sufficiently effective and well accepted by the students. Therefore we recommend introduction of formal geriatric training for students in all medical faculties in the Czech Republic.

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

    Science.gov (United States)

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

    2012-01-01

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

  19. All Clinically-Relevant Blood Components Transmit Prion Disease following a Single Blood Transfusion: A Sheep Model of vCJD

    Science.gov (United States)

    de Wolf, Christopher; Tan, Boon Chin; Smith, Antony; Groschup, Martin H.; Hunter, Nora; Hornsey, Valerie S.; MacGregor, Ian R.; Prowse, Christopher V.; Turner, Marc; Manson, Jean C.

    2011-01-01

    Variant CJD (vCJD) is an incurable, infectious human disease, likely arising from the consumption of BSE-contaminated meat products. Whilst the epidemic appears to be waning, there is much concern that vCJD infection may be perpetuated in humans by the transfusion of contaminated blood products. Since 2004, several cases of transfusion-associated vCJD transmission have been reported and linked to blood collected from pre-clinically affected donors. Using an animal model in which the disease manifested resembles that of humans affected with vCJD, we examined which blood components used in human medicine are likely to pose the greatest risk of transmitting vCJD via transfusion. We collected two full units of blood from BSE-infected donor animals during the pre-clinical phase of infection. Using methods employed by transfusion services we prepared red cell concentrates, plasma and platelets units (including leucoreduced equivalents). Following transfusion, we showed that all components contain sufficient levels of infectivity to cause disease following only a single transfusion and also that leucoreduction did not prevent disease transmission. These data suggest that all blood components are vectors for prion disease transmission, and highlight the importance of multiple control measures to minimise the risk of human to human transmission of vCJD by blood transfusion. PMID:21858015

  20. Effect of blood transfusions on canine renal allograft survival

    International Nuclear Information System (INIS)

    van der Linden, C.J.; Buurman, W.A.; Vegt, P.A.; Greep, J.M.; Jeekel, J.

    1982-01-01

    In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Furthermore, no improvement in graft survival has been found after a peroperative transfusion of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion or irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted

  1. Transfusion practice in hip arthroplasty - a nationwide study

    DEFF Research Database (Denmark)

    Jans, Øivind; Kehlet, H; Hussain, Zubair Butt

    2011-01-01

    ) in Denmark. Materials and Methods We performed a retrospective cohort study of all patients undergoing THA or RTHA in Denmark in 2008. Primary outcomes were intercentre variation in red blood cell (RBC) transfusion rates and the timing of transfusion related to surgery. Results Six thousand nine hundred......Background and Objectives The optimal transfusion strategy in hip arthroplasty remains controversial despite existing guidelines. The aim of this study was to evaluate the transfusion practice in patients undergoing primary total hip arthroplasty (THA) or revision total hip arthroplasty (RTHA...... thirty-two THA patients and 1132 RTHA patients were included for analysis of which 1674 (24%) THA and 689 (61%) RTHA patients received RBC transfusion. Of these, 47% of THA and 73% of RTHA patients received transfusion on the day of surgery. Transfusion rates between centres varied from 7 to 71...

  2. The new Scandinavian Donations and Transfusions database (SCANDAT2)

    DEFF Research Database (Denmark)

    Edgren, Gustaf; Rostgaard, Klaus; Vasan, Senthil K

    2015-01-01

    : It is possible to create a binational, nationwide database with almost 50 years of follow-up of blood donors and transfused patients for a range of health outcomes. We aim to use this database for further studies of donor health, transfusion-associated risks, and transfusion-transmitted disease....... AND METHODS: We have previously created the anonymized Scandinavian Donations and Transfusions (SCANDAT) database, containing data on blood donors, blood transfusions, and transfused patients, with complete follow-up of donors and patients for a range of health outcomes. Here we describe the re......-creation of SCANDAT with updated, identifiable data. We collected computerized data on blood donations and transfusions from blood banks covering all of Sweden and Denmark. After data cleaning, two structurally identical databases were created and the entire database was linked with nationwide health outcomes...

  3. Research training in integrative medicine: how can we make teaching and learning in research methods more sustainable and engaging?

    Science.gov (United States)

    Witt, Claudia M; Withers, Shelly Rafferty

    2013-01-01

    The aim of this project was to identify strategies for increasing learner engagement and knowledge retention in clinical research training of complementary and integrative medicine (CIM) practitioners, and to offer a conceptual framework to address clinical research training for CIM practitioners. In a featured large-group discussion (15min presentation and 30min discussion), two questions (strategies that are recommended to overcome these barriers; relevant aspects for a framework for building sustainable knowledge) were put to the audience. The sample consisted of 43 participants at the International Congress of Educators in Complementary and Alternative Medicine, in Washington, DC, in October 2012. The featured discussion was moderated and detailed notes were taken. Notes were synthesized and discussed by both authors until consensus was reached. Based on the results from the featured discussion session and a focused literature search, a framework for building sustainable knowledge and skills in clinical research for CIM practitioners was developed. Participants' responses to the questions of engagement and sustainability included curricular structures, pedagogical strategies for instruction, the use of digital tools to extend the learning experience, the necessity to ground instruction firmly in the medical literature of the field, and the relevance of mentoring. Key considerations for building sustainable knowledge in clinical research for CIM practitioners are as follows: (1) prioritizing clinical research training, (2) issues of curriculum and pedagogy, (3) technology/digital tools, (4) administrative challenges, (5) supporting the formation of communities of practice, and (6) cultural perspectives of CIM practitioners. © 2013 Elsevier Inc. All rights reserved.

  4. Mapping the Teaching of Laboratory Animal Science and Medicine in the European Union and European Free Trade Area.

    Science.gov (United States)

    Iatridou, Despoina; Nagy, Zsuzsanna; De Briyne, Nancy; Saunders, Jimmy; Bravo, Ana

    2018-06-13

    Developing a common market and allowing free movement of goods, services, and people is one of the main objectives of the European Union (EU) and the European Free Trade Area. In the field of scientific research, Directive 2010/63/EU on the protection of animals used for scientific purposes aims to improve the welfare of laboratory animals by following the principle of the 3Rs (replacement, reduction, and refinement). Each breeder, supplier, and user must appoint a designated veterinarian to advise on the well-being and treatment of the animals. In our report we investigate how the undergraduate veterinary curriculum prepares future veterinarians for the role of designated veterinarian, by analyzing data from 77 European veterinary education establishments. Over 80% of them provide training in laboratory animal science and medicine in their curriculum. All countries in the EU and the European Free Trade Area, having national veterinary schools, include such training in the curriculum of at least one of their establishments. Laboratory animal science and medicine courses can be obligatory or elective and are often part of more than one subject in the veterinary curricula. Post-graduate courses or programs are available at more than 50% of those veterinary schools. Most authorities in the European region consider graduate veterinarians ready to seek the role as designated veterinarian immediately after graduation.

  5. Vermittlung von Naturheilverfahren in der Veterinärmedizin mittels E-Learning [Teaching methods of alternative therapy in veterinary medicine via e-learning

    Directory of Open Access Journals (Sweden)

    Fidelak, Christian

    2008-11-01

    Full Text Available [english] The Free University’s Veterinary Clinic of Reproduction in the Department of Veterinary Medicine, Berlin, has been offering courses on alternative and complementary veterinary medicine to its students for several years. Due to time constraints and shortages in teaching staff, it has not been possible to satisfy student demand for instruction in these areas. To provide more detailed information as well as more opportunities for discussion and practica, subject area courses were modified in two steps. Initially, blended learning was implemented to include e-learning and in-class formats of instruction. Subsequently, an entire block of courses offered were transferred to e-learning format. Students may now voluntarily register for the e-learning course entitled “Introduction of alternative and complementary veterinary medicine” via the Internet and learn the basic principles of homoeopathy, herbal medicine, acupuncture and other alternative methods in veterinary medicine. After passing this basic course, blended learning courses enable advanced students to learn more about fundamentals of methods in greater detail as well as to perform practica with animal subjects. The evaluation of these courses showed that students rated e-learning to be a reasonable addendum to in-class instruction. More than two thirds of the students recommended an increased integration of e-learning into veterinary education. [german] Die Tierklinik für Fortpflanzung in Berlin bietet den Studierenden der Veterinärmedizin seit einigen Semestern Wahlpflichtkurse zu den Naturheilverfahren an. Der enormen Nachfrage seitens der Studierenden standen personelle und zeitliche Begrenzungen des Lehrpersonals gegenüber. Um den Interessenten dennoch umfangreiche Informationen zu bieten sowie Freiräume für Diskussionen und praktische Übungen zu schaffen, wurde das Ausbildungsangebot in zwei Projektphasen ausgebaut. Zunächst wurde dabei die Methode des Blended

  6. [Current legal questions in relation to autologous blood transfusion and legally controlled blood donation in Germany].

    Science.gov (United States)

    Biermann, E

    1994-11-01

    If a patient suffers any damage from treatment, the persons involved in transfusion medicine might be made liable according to civil and penal law for violations against the standards prescribed by the codes of performance and ethics of the individual professions. In order to avoid organisational liability, criteria for adequate patient care must be created which regulate facilities and equipment as well as staff. The typical hazards encountered in interdisciplinary cooperation between specialists of various branches of medicine must be counteracted by a constructive division of tasks and responsibilities. The participating physicians are moreover liable within the scope of the German law forbidding so-called 'unlawful interference with the possession of another' in the case of failure to obtain legally binding consent--usually resulting from inadequacies in informing the patient. The landmark decision by the German Federal Court of Justice on instructing patients about the risks of and alternatives to blood transfusions forces all those involved to take the consequences with regard to instructing patients about the risk of transfusions and concerning the implementation of techniques for sparing and replacing allogenic blood.

  7. Blood Transfusions in Dogs and Cats Receiving Hemodialysis: 230 Cases (June 1997-September 2012).

    Science.gov (United States)

    Langston, C; Cook, A; Eatroff, A; Mitelberg, E; Chalhoub, S

    2017-03-01

    Multiple factors exist that contribute to anemia in dogs and cats receiving hemodialysis, can necessitate transfusion. To describe blood product usage in dogs and cats with acute and chronic kidney disease that were treated with intermittent hemodialysis to determine risk factors associated with the requirement for blood product transfusion. 83 cats and 147 dogs undergoing renal replacement therapy at the Animal Medical Center for acute or chronic kidney disease. Retrospective medical record review of all dogs and cats receiving renal replacement therapy for kidney disease, from June 1997 through September 2012. Blood products (whole blood, packed RBCs, or stromal-free hemoglobin) were administered to 87% of cats and 32% of dogs. The number of dialysis treatments was associated with the requirement for transfusion in cats (adjusted OR 2.21, 95% CI 1.13, 4.32), but not in dogs (adjusted OR 0.98, 95% CI 0.95, 1.03). Administration of a blood product was associated with a higher likelihood of death in dogs (OR 3.198, 95% CI 1.352, 7.565; P = .0098), but not in cats (OR 1.527, 95% CI 0.5404, 4.317, P = .2). Veterinary hospitals with a hemodialysis unit should have reliable and rapid access to safe blood products in order to meet the needs of dogs and cats receiving dialysis. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  8. Outcomes of Protocol-Driven Care of Critically Ill Severely Anemic Patients for Whom Blood Transfusion Is Not an Option.

    Science.gov (United States)

    Shander, Aryeh; Javidroozi, Mazyar; Gianatiempo, Carmine; Gandhi, Nisha; Lui, John; Califano, Frank; Kaufman, Margit; Naqvi, Sajjad; Syed, Faraz; Aregbeyen, Oshuare

    2016-06-01

    To compare the outcomes of severely anemic critically ill patients for whom transfusion is not an option ("bloodless" patients) with transfused patients. Cohort study with propensity score matching. ICU of a referral center. One hundred seventy-eight bloodless and 441 transfused consecutive severely anemic, critically ill patients, admitted between May 1996 and April 2011, and having at least one hemoglobin level less than or equal to 8 g/dL within 24 hours of ICU admission. Patients with diagnosis of brain injury, acute myocardial infarction, or status postcardiac surgery were excluded. Allogeneic RBC transfusion during ICU stay. Primary outcome was in-hospital mortality. Other outcomes were ICU mortality, readmission to ICU, new electrocardiographic or cardiac enzyme changes suggestive of cardiac ischemia or injury, and new positive blood culture result. Transfused patients were older, had higher hemoglobin level at admission, and had higher Acute Physiology and Chronic Health Evaluation II score. Hospital mortality rates were 24.7% in bloodless and 24.5% in transfused patients (odds ratio, 1.01; 95% CI, 0.68-1.52; p = 0.95). Adjusted odds ratio of hospital mortality was 1.52 (95% CI, 0.95-2.43; p = 0.08). No significant difference in ICU readmission or positive blood culture results was observed. Analysis of propensity score-matched cohorts provided similar results. Overall risk of mortality in severely anemic critically ill bloodless patients appeared to be comparable with transfused patients, albeit the latter group had older age and higher Acute Physiology and Chronic Health Evaluation II score. Use of a protocol to manage anemia in these patients in a center with established patient blood management and bloodless medicine and surgery programs is feasible and likely to contribute to improved outcome, whereas more studies are needed to better delineate the impact of such programs.

  9. Electronic remote blood issue: a combination of remote blood issue with a system for end-to-end electronic control of transfusion to provide a "total solution" for a safe and timely hospital blood transfusion service.

    Science.gov (United States)

    Staves, Julie; Davies, Amanda; Kay, Jonathan; Pearson, Oliver; Johnson, Tony; Murphy, Michael F

    2008-03-01

    The rapid provision of red cell (RBC) units to patients needing blood urgently is an issue of major importance in transfusion medicine. The development of electronic issue (sometimes termed "electronic crossmatch") has facilitated rapid provision of RBC units by avoidance of the serologic crossmatch in eligible patients. A further development is the issue of blood under electronic control at blood refrigerator remote from the blood bank. This study evaluated a system for electronic remote blood issue (ERBI) developed as an enhancement of a system for end-to-end electronic control of hospital transfusion. Practice was evaluated before and after its introduction in cardiac surgery. Before the implementation of ERBI, the median time to deliver urgently required RBC units to the patient was 24 minutes. After its implementation, RBC units were obtained from the nearby blood refrigerator in a median time of 59 seconds (range, 30 sec to 2 min). The study also found that unused requests were reduced significantly from 42 to 20 percent, the number of RBC units issued reduced by 52 percent, the number of issued units that were transfused increased from 40 to 62 percent, and there was a significant reduction in the workload of both blood bank and clinical staff. This study evaluated a combination of remote blood issue with an end-to-end electronically controlled hospital transfusion process, ERBI. ERBI reduced the time to make blood available for surgical patients and improved the efficiency of hospital transfusion.

  10. Identification errors in the blood transfusion laboratory: a still relevant issue for patient safety.

    Science.gov (United States)

    Lippi, Giuseppe; Plebani, Mario

    2011-04-01

    Remarkable technological advances and increased awareness have both contributed to decrease substantially the uncertainty of the analytical phase, so that the manually intensive preanalytical activities currently represent the leading sources of errors in laboratory and transfusion medicine. Among preanalytical errors, misidentification and mistransfusion are still regarded as a considerable problem, posing serious risks for patient health and carrying huge expenses for the healthcare system. As such, a reliable policy of risk management should be readily implemented, developing through a multifaceted approach to prevent or limit the adverse outcomes related to transfusion reactions from blood incompatibility. This strategy encompasses root cause analysis, compliance with accreditation requirements, strict adherence to standard operating procedures, guidelines and recommendations for specimen collection, use of positive identification devices, rejection of potentially misidentified specimens, informatics data entry, query host communication, automated systems for patient identification and sample labeling and an adequate and safe environment. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Patient safety challenges in a case study hospital--of relevance for transfusion processes?

    Science.gov (United States)

    Aase, Karina; Høyland, Sindre; Olsen, Espen; Wiig, Siri; Nilsen, Stein Tore

    2008-10-01

    The paper reports results from a research project with the objective of studying patient safety, and relates the finding to safety issues within transfusion medicine. The background is an increased focus on undesired events related to diagnosis, medication, and patient treatment in general in the healthcare sector. The study is designed as a case study within a regional Norwegian hospital conducting specialised health care services. The study includes multiple methods such as interviews, document analysis, analysis of error reports, and a questionnaire survey. Results show that the challenges for improved patient safety, based on employees' perceptions, are hospital management support, reporting of accidents/incidents, and collaboration across hospital units. Several of these generic safety challenges are also found to be of relevance for a hospital's transfusion service. Positive patient safety factors are identified as teamwork within hospital units, a non-punitive response to errors, and unit manager's actions promoting safety.

  12. Blood transfusion: patient identification and empowerment.

    Science.gov (United States)

    Stout, Lynn; Joseph, Sundari

    Positive patient identification is pivotal to several steps of the transfusion process; it is integral to ensuring that the correct blood is given to the correct patient. If patient misidentification occurs, this has potentially fatal consequences for patients. Historically patient involvement in healthcare has focused on clinical decision making, where the patient, having been provided with medical information, is encouraged to become involved in the decisions related to their individualised treatment. This article explores the aspects of patient contribution to patient safety relating to positive patient identification in transfusion. When involving patients in their care, however, clinicians must recognise the diversity of patients and the capacity of the patient to be involved. It must not be assumed that all patients will be willing or indeed able to participate. Additionally, clinicians' attitudes to patient involvement in patient safety can determine whether cultural change is successful.

  13. Detrimental effects of perioperative blood transfusion

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen

    1995-01-01

    Evidence suggests that perioperative allogeneic blood transfusion increases the risk of infectious complications after major surgery and of cancer recurrence after curative operation. This has been attributed to immunosuppression. Several authors have suggested that filtered whole blood and/or red...... cell concentrate, or leucocyte- and buffy coat-reduced red cells in artificial medium or their own plasma, may reduce postoperative immunosuppression. It was also anticipated that the use of autologous blood might minimize the risk of perioperative transfusion, but studies have unexpectedly shown...... similar postoperative infectious complications and cancer recurrence and/or survival rates in patients receiving autologous blood donated before operation and those receiving allogeneic blood. Future studies should identify common risk factors associated with blood storage....

  14. Use and toxicity of traditional and complementary medicine among patients seeking care at an emergency department of a teaching hospital in Malaysia.

    Science.gov (United States)

    Jatau, Abubakar Ibrahim; Aung, Myat Moe Thwe; Kamauzaman, Tuan Hairulnizam Tuan; Ab Rahman, Ab Fatah

    2018-05-01

    Traditional and Complementary Medicines (TCM) are widely used worldwide, and many of them have the potential to cause toxicity, interaction with conventional medications and non-adherence to prescribed medications due to patients' preference for the TCM use. However, information regarding their use among patients seeking care at emergency departments (ED) of a healthcare facility is limited. The study aimed to evaluate the TCM use among patients attending the ED of a teaching hospital in Malaysia. A sub-analysis of data from a prevalence study of medication-related visits among patients at the ED of Hospital Universiti Sains Malaysia was conducted. The study took place over a period of six weeks from December 2014 to January 2015 involving 434 eligible patients. Data on demography, conventional medication, and TCM uses were collected from patient interview and the medical folders. Among this cohort, 66 patients (15.2%, 95%CI 12.0, 19.0) reported concurrent TCM use. Sixteen (24.2%) of the TCM users were using more than one (1) type of TCM, and 17 (25.8%) came to the ED for medication-related reasons. Traditional Malay Medicine (TMM) was the most frequently used TCM by the patients. Five patients (7.6%) sought treatment at the ED for medical problems related to use of TCM. Patients seeking medical care at the ED may be currently using TCM. ED-physicians should be aware of these therapies and should always ask patients about the TCM use. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Results of a protocol of transfusion threshold and surgical technique on transfusion requirements in burn patients.

    Science.gov (United States)

    O'Mara, Michael S; Hayetian, Fernando; Slater, Harvey; Goldfarb, I William; Tolchin, Eric; Caushaj, Philip F

    2005-08-01

    Blood loss and high rates of transfusion in burn centers remains an area of ongoing concern. Blood use brings the risk of infection, adverse reaction, and immunosuppression. A protocol to reduce blood loss and blood use was implemented. Analysis included 3-year periods before and after institution of the protocol. All patients were transfused for a hemoglobin below 8.0 gm/dL. Operations per admission did not change during the two time periods (0.78 in each). Overall units transfused per operation decreased from 1.56+/-0.06 to 1.25+/-0.14 units after instituting the protocol (pburns of less than 20% surface area, declining from 386 to 46 units after protocol institution, from 0.37 to 0.04 units per admission, and from 0.79 to 0.08 units per operation in this group of smallest burns. There was no change noted in the larger burns. This study suggests that a defined protocol of hemostasis, technique, and transfusion trigger should be implemented in the process of burn excision and grafting. This will help especially those patients with the smallest burns, essentially eliminating transfusion need in that group.

  16. Autologous Blood Transfusion in Sports: Emerging Biomarkers.

    Science.gov (United States)

    Salamin, Olivier; De Angelis, Sara; Tissot, Jean-Daniel; Saugy, Martial; Leuenberger, Nicolas

    2016-07-01

    Despite being prohibited by the World Anti-Doping Agency, blood doping through erythropoietin injection or blood transfusion is frequently used by athletes to increase oxygen delivery to muscles and enhance performance. In contrast with allogeneic blood transfusion and erythropoietic stimulants, there is presently no direct method of detection for autologous blood transfusion (ABT) doping. Blood reinfusion is currently monitored with individual follow-up of hematological variables via the athlete biological passport, which requires further improvement. Microdosage is undetectable, and suspicious profiles in athletes are often attributed to exposure to altitude, heat stress, or illness. Additional indirect biomarkers may increase the sensitivity and specificity of the longitudinal approach. The emergence of "-omics" strategies provides new opportunities to discover biomarkers for the indirect detection of ABT. With the development of direct quantitative methods, transcriptomics based on microRNA or messenger RNA expression is a promising approach. Because blood donation and blood reinfusion alter iron metabolism, quantification of proteins involved in metal metabolism, such as hepcidin, may be applied in an "ironomics" strategy to improve the detection of ABT. As red blood cell (RBC) storage triggers changes in membrane proteins, proteomic methods have the potential to identify the presence of stored RBCs in blood. Alternatively, urine matrix can be used for the quantification of the plasticizer di(2-ethyhexyl)phthalate and its metabolites that originate from blood storage bags, suggesting recent blood transfusion, and have an important degree of sensitivity and specificity. This review proposes that various indirect biomarkers should be applied in combination with mathematical approaches for longitudinal monitoring aimed at improving ABT detection. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Blood transfusion before radiation for malignancies

    International Nuclear Information System (INIS)

    Hunt, T.K.

    1989-01-01

    This editorial discusses the situation of administering blood to patients prior to radiotherapy in an attempt to increase tissue/tumor oxygen tension. The author believes that since the rate at which tumor cells consume oxygen is highly variable, the aim of achieving high cellular oxygen tension may be met better by maintaining a high blood perfusion rate. Blood volume can be maintained without relying on transfusion, and safer alternatives are available

  18. [Hemorrhagic syndrome after transfusion of incompatible blood].

    Science.gov (United States)

    Fedorova, Z D; Bsryshev, B A; Khanin, A Z; Chuslov, A G

    1979-11-01

    The patients were observed by a reanimation-hematological team of the Leningrad emergency service. It has been established that the hemorrhagic syndrome is the main one deterimining the unity of pathogenesis and clinical picture of the hemotransfusional complication. Phase character of the changes in the homeostasis system during the transfusion of incompatible blood was noted. The express diagnosis of the disorders and a scheme of the sequence of administration of hemostatic drugs are proposed. Mortality among such patients was reduced.

  19. Effect of blood transfusions on canine renal allograft survival

    International Nuclear Information System (INIS)

    Van Der Linden, C.J.; Buurman, W.A.; Vegt, P.A.; Greep, J.M.; Jeekel, J.

    1982-01-01

    In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Futhermore, no improvement in graft survival has been found after a peroperative transfuson of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion of irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted

  20. Potential Harm of Prophylactic Platelet Transfusion in Adult Dengue Patients.

    Science.gov (United States)

    Lee, Tau-Hong; Wong, Joshua G X; Leo, Yee-Sin; Thein, Tun-Linn; Ng, Ee-Ling; Lee, Linda K; Lye, David C

    2016-03-01

    Thrombocytopenia is a hallmark of dengue infection, and bleeding is a dreaded complication of dengue fever. Prophylactic platelet transfusion has been used to prevent bleeding in the management of dengue fever, although the evidence for its benefit is lacking. In adult dengue patients with platelet count Tan Tock Seng Hospital from January 2005 to December 2008. Baseline characteristics and clinical outcomes were compared between the non-transfused vs. transfused groups. Outcomes studied were clinical bleeding, platelet increment, hospital length of stay, intensive care unit admission and death. Of the 788 patients included, 486 received prophylactic platelet transfusion. There was no significant difference in the presence of clinical bleeding in the two groups (18.2% in non-transfused group vs. 23.5% in transfused group; P = 0.08). Patients in the transfused group took a median of 1 day longer than the non-transfused group to increase their platelet count to 50,000/mm3 or more (3 days vs. 2 days, P hospital stay in the non-transfused group was 5 days vs. 6 days in the transfused group (P50,000/mm3 and increasing length of hospitalization.

  1. The challenges of cross-cultural research and teaching in family medicine: How can professional networks help?

    Directory of Open Access Journals (Sweden)

    Amanda Caroline Howe

    2016-05-01

    Full Text Available Modern medical training emphasizes the value of understanding the patient’s ideas, concerns and expectations, and the use of their personal perspective to assist communication, diagnosis, and uptake of all appropriate health and treatment options. This requires doctors to be ‘culturally sensitive’, which “… involves an awareness and acceptance of cultural differences, self-awareness, knowledge of a patient’s culture, and adaptation of skills”. Yet most of us work in one country, and often one community, for much of our professional careers. Those who enter into academic pursuits will similarly be constrained by our own backgrounds and experiences, even though universities and medical schools often attract a multicultural membership. We therefore rely on our professional training and networks to extend our scope and understanding of how cultural issues impact upon our research and its relevance to our discipline and curricula. This article uses a reflexive narrative approach to examine the role and value of international networks through the lens of one individual and one organisation. It explores the extent to which such networks assist cross cultural sensitivity, using examples from its networks, and how these can (and have impacted on greater cross-culturalism in our teaching and research outputs.

  2. TELEMED – Teaching Legal Medicine: Neukonzeption der Lehre im Fach Rechtsmedizin an der Universität des Saarlandes

    Directory of Open Access Journals (Sweden)

    Feiser, Judith

    2009-02-01

    Full Text Available Das Fach Rechtsmedizin ist Bestandteil der klinischen Lehre des Medizinstudiums. Im Zuge der Neuorientierung der medizinischen Ausbildung durch die Einführung der neuen ärztlichen Approbationsordnung wurde die Lehre am Institut für Rechtsmedizin der Universität des Saarlandes umstrukturiert. Dazu wurde das Lehrkonzept „TELEMED- Teaching Legal Medicine“ entwickelt, bestehend aus eLearning und Kleingruppenunterricht. Im Besonderen wurde bei der Gestaltung des neuen Lehrkonzeptes Wert darauf gelegt, die Lehre praxisbezogen zu gestalten. Aus diesem Anlass wurde am Ende des Wintersemesters (WS 2007/08 eine Evaluation mittels Fragebogen durchgeführt. An der Evaluation nahmen insgesamt 84 Studierende teil. Da das neue Lehrkonzept erstmals im WS 2007/08 Anwendung fand, konnte nicht mit früheren Semestern verglichen werden. Jedoch zeigten die Ergebnisse der Evaluation im Gesamten eine hohe Akzeptanz und positive Einschätzung des Konzeptes bei den Studierenden. Ferner ließ sich feststellen, dass die Verwendung von eLearning im Fach Rechtsmedizin einen großen Beitrag zur Umsetzung der praxisorientierten Lehre liefert.

  3. Autoimmune hemolytic anemia: transfusion challenges and solutions

    Directory of Open Access Journals (Sweden)

    Barros MM

    2017-03-01

    Full Text Available Melca M O Barros, Dante M Langhi Jr, José O Bordin Department of Clinical and Experimental Oncology, Universidade Federal de São Paulo, São Paulo, Brazil Abstract: Autoimmune hemolytic anemia (AIHA is defined as the increased destruction of red blood cells (RBCs in the presence of anti-RBC autoantibodies and/or complement. Classification of AIHA is based on the optimal auto-RBC antibody reactivity temperatures and includes warm, cold-reactive, mixed AIHA, and drug-induced AIHA subtypes. AIHA is a rare disease, and recommendations for transfusion are based mainly on results from retrospective data and relatively small cohort studies, including heterogeneous patient samples or single case reports. In this article, we will review the challenges and solutions to safely transfuse AIHA patients. We will reflect on the indication for transfusion in AIHA and the difficulty in the accomplishment of immunohematological procedures for the selection of the safest and most compatible RBC units. Keywords: hemolytic anemia, RBC autoantibodies, autoimmunity, hemolysis, direct ­antiglobulin test

  4. Plasma fractionation, a useful means to improve national transfusion system and blood safety: Iran experience.

    Science.gov (United States)

    Cheraghali, A M; Abolghasemi, H

    2009-03-01

    In 1974, the government of Iran established Iranian Blood Transfusion Organization (IBTO) as national and centralized transfusion system. Since then donations of blood may not be remunerated and therapy with blood and its components are free of charges for all Iranian patients. Donations are meticulously screened through interviewing donors and lab testing the donations using serological methods. Currently, Iranian donors donate 1735 00 units of blood annually (donation index: 25/1000 population). Implementation of a highly efficient donor selection programme, including donors interview, establishment of confidential unit exclusion programme and laboratory screening of donated bloods by IBTO have led to seroprevalence rates of 0.41%, 0.12% and 0.004% for HBV, HCV and HIV in donated bloods respectively. Since 2004, IBTO has initiated a programme to enter into a contract fractionation agreement for the surplus of recovered plasma produced in its blood collecting centres. Although IBTO has used this project as a mean to improve national transfusion system through upgrading its quality assurance systems, IBTO fractionation project has played a major role in improving availability of plasma-derived medicines in Iran. During 2006-2007, this project furnished the Iran market with 44% and 14% of its needs to the intravenous immunoglobulin and albumin, respectively. Iranian experience showed that contract fractionation of plasma in countries with organized centralized transfusion system, which lack national plasma fractionation facility, in addition to substantial saving on national health resource and enhancing availability of plasma-derived medicines, could serve as a useful means to improve national blood safety profile.

  5. What California sea lions exposed to domoic acid might teach us about autism: lessons for predictive and preventive medicine.

    Science.gov (United States)

    Lahvis, Garet Paul

    2017-09-01

    Autism spectrum disorder (ASD) shares many biological and behavioral similarities with the deleterious effects of domoic acid (DA) exposure. DA is produced by marine algae and most commonly by species of Pseudo-nitzschia . Humans and marine mammals can be exposed to DA when they consume whole fish or shellfish. The mammalian fetus is highly sensitive to the deleterious effects of DA exposure. Both ASD and exposures to toxic levels of DA feature repetitive behaviors, challenges with social interaction, and seizures. They can also share a commonality in brain anatomy and function, particularly the balance between excitatory and inhibitory mechanisms. The current article is relevant to predictive, preventive, and personalized medicine for three reasons. First, shellfish consumption may be a risk factor for ASD and the regulatory limit for DA should be adjusted to prevent this possibility. Human contributions to increased algal production of DA in coastal waters should be identified and reduced. Second, evaluations of sentinel species wild and free-roaming in the environment, though typically outside the purview of biomedical research, should be much more fully employed to gain insights to risk factors for human disease. To better identify and prevent disease, biomedical researchers should study wild populations. Third, studies of DA exposure highlight the possibility that glutamate additives to processed foods may also have deleterious impacts on human brain development and behavior.

  6. Trainer-to-student ratios for teaching psychomotor skills in health care fields, as applied to osteopathic manipulative medicine.

    Science.gov (United States)

    Snider, Karen T; Seffinger, Michael A; Ferrill, Heather P; Gish, Eric E

    2012-04-01

    The hallmark of osteopathic medical education is the inclusion of hands-on instruction in osteopathic manipulative medicine (OMM), which includes palpatory diagnosis and osteopathic manipulative treatment (OMT). This OMM training typically involves a primary instructor presenting theory and techniques with step-by-step demonstrations to a large group of first- and second-year osteopathic medical students. Additional instructors, referred to as table trainers, assist the primary instructor by supervising the students as they practice the presented techniques. To the authors' knowledge, there is no currently accepted standard for a table trainer-to-student ratio in OMM skills laboratories within osteopathic medical schools in the United States. However, through a Google Web search and PubMed literature review, the authors identified published trainer-to-student ratios used in other health care skills training curricula. Psychomotor skills training courses in health care fields typically have a table trainer-to-student ratio of 1 trainer to 8 or fewer students. On the basis of these findings and psychomotor skills learning theory, the authors conclude that this ratio is likely sufficient for OMM skills training.

  7. Prevalence and associated factors of herbal medicine use among pregnant women on antenatal care follow-up at University of Gondar referral and teaching hospital, Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Mekuria, Abebe Basazn; Erku, Daniel Asfaw; Gebresillassie, Begashaw Melaku; Birru, Eshetie Melese; Tizazu, Balem; Ahmedin, Alima

    2017-02-01

    Improving maternal and child health is one of the public health priorities in several African countries including Ethiopia. However, research on herbal medicine use during pregnancy is scarce in Ethiopia. The present study aimed at assessing the prevalence and correlates of herbal medicine use among pregnant women on antenatal care (ANC) follow-up at Gondar university referral hospital, Ethiopia METHODS: An institutional-based cross sectional study was conducted on 364 pregnant women attending ANC clinic from March to May 2016 at University of Gondar referral and teaching hospital, northwest Ethiopia. Data on socio-demography, pregnancy related information as well as herbal medicine use was collected through an interviewer-administered questionnaire. Descriptive statistics, univariate and multivariate logistic regression analysis were performed to determine prevalence and associated factors of herbal medicine use. From 364 respondents, 48.6% used herbal medicine during current pregnancy. ginger (40.7%) and garlic (19%) were the two most commonly used herbs in pregnancy. Common cold (66%) and inflammation (31.6%) were the most common reasons for herbal use. Majority of herbal medicine users (89.8%) had not consulted their doctors about their herbal medicine use. Rural residency (Adjusted odds ratio (AOR): 3.15, Confidence interval (CI): 1.17-6.14), illiteracy (AOR: 4.05, CI: 2.47-6.62) and average monthly income less than 100 USD (AOR: 3.08CI: 1.221-7.77) were found to be strong predictors of herbal medicine use. The use of herbal medicine during pregnancy is a common practice and associated with residency, level of education and average monthly income. From the stand point of high prevalence and low disclosure rate, the health care providers should often consult pregnant women regarding herbal medicine use.

  8. Berlin in Motion: Interprofessional teaching and learning for students in the fields of medicine, occupational therapy, physiotherapy and nursing (INTER-M-E-P-P).

    Science.gov (United States)

    Bohrer, Annerose; Heinze, Cornelia; Höppner, Heidi; Behrend, Ronja; Czakert, Judith; Hitzblech, Tanja; Kaufmann, Ina; Maaz, Asja; Räbiger, Jutta; Peters, Harm

    2016-01-01

    The Berlin project "Interprofessional teaching and learning in medicine, occupational therapy, physiotherapy and nursing" (INTER-M-E-P-P) pursues the goal of developing and testing interprofessional courses in an exemplary manner, and then implement these into their regular study programs. Under the direction of a steering committee of the participating institutions, professions and status groups, interprofessional courses were designed, carried out and evaluated. Specific to this project are the participation of students in the steering committee, and the accompanying of external supervision. The evaluation integrates the perspectives of all project participants, and combines quantitative and qualitative methods. INTER-M-E-P-P established cooperative structures between the participating universities and programs. Three courses were designed, taught and evaluated in an interprofessional manner. The various curricula, organizational patterns and locations of the study paths led to a great need for resources in regard to planning and implementation. This process can be made difficult by any stereotypes or preconceptions inherent to those doing the planning; however, under external supervision, the individual professional viewpoints can still be broadened and enriched. A sustainable implementation of interprofessional education into the curricula of health science study programs is currently complicated by barriers such as different geographical locations and differing university regulations concerning study and testing. Implementation will require long-term support at the university as well as at political levels.

  9. Evaluation of electronic discussion groups as a teaching/learning strategy in an evidence-based medicine course: a pilot study.

    Science.gov (United States)

    Kamin, C; Glicken, A; Hall, M; Quarantillo, B; Merenstein, G

    2001-01-01

    As course directors, we wished to incorporate small group learning into our Evidence-based Medicine course for students to get feedback on the development of a well constructed, researchable clinical question. Scheduling of these groups was problematic. We sought to evaluate computer-mediated communication as an alternative to face-to-face small groups. Students were randomly assigned to either face-to-face small groups or asynchronous, electronic, small groups. Final examination scores were analyzed with an analysis of variance to determine if there were differences in student performance based on group type. Student survey items were analyzed using Fisher's Exact test to determine if there were differences in student attitudes based on group type. There were no significant differences found in overall student performance. Significant differences in student attitudes were found to exist with respect to: (1) participation in discussions, with face-to-face groups reporting greater participation; (2) putting more thought into comments, with electronic groups reporting more thought put into comments; and (3) difficulty relating to other students in the class, with electronic groups reporting more difficulty. We found electronic discussion groups (computer-mediated communication) to be a viable teaching/learning strategy with no adverse effects on student performance or attitudes.

  10. The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals.

    Science.gov (United States)

    Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

    2013-01-01

    Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. To describe the effects of different communication interventions and their problems. Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.

  11. Blood transfusion indications in neurosurgical patients: A systematic review.

    Science.gov (United States)

    Bagwe, Shefali; Chung, Lawrance K; Lagman, Carlito; Voth, Brittany L; Barnette, Natalie E; Elhajjmoussa, Lekaa; Yang, Isaac

    2017-04-01

    Neurosurgical procedures can be complicated by significant blood losses that have the potential to decrease tissue perfusion to critical brain tissue. Red blood cell transfusion is used in a variety of capacities both inside, and outside, of the operating room to prevent untoward neurologic damage. However, evidence-based guidelines concerning thresholds and indications for transfusion in neurosurgery remain limited. Consequently, transfusion practices in neurosurgical patients are highly variable and based on institutional experiences. Recently, a paradigm shift has occurred in neurocritical intensive care units, whereby restrictive transfusion is increasingly favored over liberal transfusion but the ideal strategy remains in clinical equipoise. The authors of this study perform a systematic review of the literature with the objective of capturing the changing landscape of blood transfusion indications in neurosurgical patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Quantifying risk of transfusion in children undergoing spine surgery.

    Science.gov (United States)

    Vitale, Michael G; Levy, Douglas E; Park, Maxwell C; Choi, Hyunok; Choe, Julie C; Roye, David P

    2002-01-01

    The risks and costs of transfusion are a great concern in the area of pediatric spine surgery, because it is a blood-intensive procedure with a high risk for transfusion. Therefore, determining the predictors of transfusion in this patient population is an important first step and has the potential to improve upon the current approaches to reducing transfusion rates. In this study, we reveal several predictors of transfusion in a pediatric patient population undergoing spine surgery. In turn, we present a general rule of thumb ("rule of two's") for gauging transfusion risk, thus enhancing the surgeon's approach to avoiding transfusion in certain clinical scenarios. This study was conducted to determine the main factors of transfusion in a population of pediatric patients undergoing scoliosis surgery. The goal was to present an algorithm for quantifying the true risk of transfusion for various patient groups that would highlight patients "at high risk" for transfusion. This is especially important in light of the various risks associated with undergoing a transfusion, as well as the costs involved in maintaining and disposing of exogenous blood materials. This is a retrospective review of a group of children who underwent scoliosis surgery between 1988 and 1995 at an academic institution. A total of 290 patients were analyzed in this study, of which 63 were transfused and 227 were not. No outcomes measures were used in this study. A retrospective review of 290 patients presenting to our institution for scoliosis surgery was conducted, with a focus on socioclinical data related to transfusion risk. Univariate analysis and logistic regression were used to quantify the determinants of transfusion risk. Univariate analysis identified many factors that were associated with the risk of transfusion. However, it is clear that several of these factors are dependent on each other, obscuring the true issues driving transfusion need. We used multivariate analysis to control for

  13. Risk Factors for Blood Transfusion With Primary Posterior Lumbar Fusion.

    Science.gov (United States)

    Basques, Bryce A; Anandasivam, Nidharshan S; Webb, Matthew L; Samuel, Andre M; Lukasiewicz, Adam M; Bohl, Daniel D; Grauer, Jonathan N

    2015-11-01

    Retrospective cohort study. To identify factors associated with blood transfusion for primary posterior lumbar fusion surgery, and to identify associations between blood transfusion and other postoperative complications. Blood transfusion is a relatively common occurrence for patients undergoing primary posterior lumbar fusion. There is limited information available describing which patients are at increased risk for blood transfusion, and the relationship between blood transfusion and short-term postoperative outcomes is poorly characterized. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients undergoing primary posterior lumbar fusion from 2011 to 2013. Multivariate analysis was used to find associations between patient characteristics and blood transfusion, along with associations between blood transfusion and postoperative outcomes. Out of 4223 patients, 704 (16.7%) had a blood transfusion. Age 60 to 69 (relative risk [RR] 1.6), age greater than equal to 70 (RR 1.7), American Society of Anesthesiologists class greater than equal to 3 (RR 1.1), female sex (RR 1.1), pulmonary disease (RR 1.2), preoperative hematocrit less than 36.0 (RR 2.0), operative time greater than equal to 310 minutes (RR 2.9), 2 levels (RR 1.6), and 3 or more levels (RR 2.1) were independently associated with blood transfusion. Interbody fusion (RR 0.9) was associated with decreased rates of blood transfusion. Receiving a blood transfusion was significantly associated with any complication (RR 1.7), sepsis (RR 2.6), return to the operating room (RR 1.7), deep surgical site infection (RR 2.6), and pulmonary embolism (RR 5.1). Blood transfusion was also associated with an increase in postoperative length of stay of 1.4 days (P risk factors for these occurrences were characterized. Strategies to minimize blood loss might be considered in these patients to avoid the associated complications. 3.

  14. Maimonides? Appreciation for Medicine

    OpenAIRE

    Gesundheit, Benjamin

    2011-01-01

    Moses Maimonides, the illustrious medieval rabbi and philosopher, dedicated the last decade of his life primarily to medicine. His strong interest in medicine was an integral component of his religious-philosophical teachings and world view. In this paper various sources from his rabbinic writings are presented that explain Maimonides’ motivation regarding and deep appreciation for medicine: (A) The physician fulfills the basic biblical obligation to return lost objects to their owner, for wi...

  15. Hydroxyurea for reducing blood transfusion in non-transfusion dependent beta thalassaemias.

    Science.gov (United States)

    Foong, Wai Cheng; Ho, Jacqueline J; Loh, C Khai; Viprakasit, Vip

    2016-10-18

    Non-transfusion dependent beta thalassaemia is a subset of inherited haemoglobin disorders characterised by reduced production of the beta globin chain of the haemoglobin molecule leading to anaemia of varying severity. Although blood transfusion is not a necessity for survival, it is required when episodes of chronic anaemia occur. This chronic anaemia can impair growth and affect quality of life. People with non-transfusion dependent beta thalassaemia suffer from iron overload due to their body's increased capability of absorbing iron from food sources. Iron overload becomes more pronounced in those requiring blood transfusion. People with a higher foetal haemoglobin level have been found to require fewer blood transfusions. Hydroxyurea has been used to increase foetal haemoglobin level; however, its efficacy in reducing transfusion, chronic anaemia complications and its safety need to be established. To assess the effectiveness, safety and appropriate dose regimen of hydroxyurea in people with non-transfusion dependent beta thalassaemia (haemoglobin E combined with beta thalassaemia and beta thalassaemia intermedia). We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of relevant journals. We also searched ongoing trials registries and the reference lists of relevant articles and reviews.Date of last search: 30 April 2016. Randomised or quasi-randomised controlled trials of hydroxyurea in people with non-transfusion dependent beta thalassaemia comparing hydroxyurea with placebo or standard treatment or comparing different doses of hydroxyurea. Two authors independently applied the inclusion criteria in order to select trials for inclusion. Both authors assessed the risk of bias of trials and extracted the data. A third author verified these assessments. No trials comparing hydroxyurea with placebo or standard care were found. However, we included

  16. Predicting blood transfusion in patients undergoing minimally invasive oesophagectomy.

    Science.gov (United States)

    Schneider, Crispin; Boddy, Alex P; Fukuta, Junaid; Groom, William D; Streets, Christopher G

    2014-12-01

    To evaluate predictors of allogenic blood transfusion requirements in patients undergoing minimal invasive oesophagectomy at a tertiary high volume centre for oesophago-gastric surgery. Retrospective analysis of all patients undergoing minimal access oesophagectomy in our department between January 2010 and December 2011. Patients were divided into two groups depending on whether they required a blood transfusion at any time during their index admission. Factors that have been shown to influence perioperative blood transfusion requirements in major surgery were included in the analysis. Binary logistic regression analysis was performed to determine the impact of patient and perioperative characteristics on transfusion requirements during the index admission. A total of 80 patients underwent minimal access oesophagectomy, of which 61 patients had a laparoscopic assisted oesophagectomy and 19 patients had a minimal invasive oesophagectomy. Perioperative blood transfusion was required in 28 patients at any time during hospital admission. On binary logistic regression analysis, a lower preoperative haemoglobin concentration (p blood transfusion requirements. It has been reported that requirement for blood transfusion can affect long-term outcomes in oesophageal cancer resection. Two factors which could be addressed preoperatively; haemoglobin concentration and type of oesophageal resection, may be valuable in predicting blood transfusions in patients undergoing minimally invasive oesophagectomy. Our analysis revealed that preoperative haemoglobin concentration, occurrence of significant complications and type of minimal access oesophagectomy predicted blood transfusion requirements in the patient population examined. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Reappraising the concept of massive transfusion in trauma

    DEFF Research Database (Denmark)

    Stanworth, Simon J; Morris, Timothy P; Gaarder, Christine

    2010-01-01

    ABSTRACT : INTRODUCTION : The massive-transfusion concept was introduced to recognize the dilutional complications resulting from large volumes of packed red blood cells (PRBCs). Definitions of massive transfusion vary and lack supporting clinical evidence. Damage-control resuscitation regimens...... of modern trauma care are targeted to the early correction of acute traumatic coagulopathy. The aim of this study was to identify a clinically relevant definition of trauma massive transfusion based on clinical outcomes. We also examined whether the concept was useful in that early prediction of massive...... transfusion as a concept in trauma has limited utility, and emphasis should be placed on identifying patients with massive hemorrhage and acute traumatic coagulopathy....

  18. Desmopressin use for minimising perioperative blood transfusion

    Science.gov (United States)

    Desborough, Michael J; Oakland, Kathryn; Brierley, Charlotte; Bennett, Sean; Doree, Carolyn; Trivella, Marialena; Hopewell, Sally; Stanworth, Simon J; Estcourt, Lise J

    2017-01-01

    Background Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed. Objectives To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have inherited bleeding disorders. Search methods We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (2017, issue 3) in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (from 1937), the Transfusion Evidence Library (from 1980), and ongoing trial databases (all searches to 3 April 2017). Selection criteria We included randomised controlled trials comparing DDAVP to placebo or an active comparator (e.g. tranexamic acid, aprotinin) before, during, or immediately after surgery or after invasive procedures in adults or children. Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results We identified 65 completed trials (3874 participants) and four ongoing trials. Of the 65 completed trials, 39 focused on adult cardiac surgery, three on paediatric cardiac surgery, 12 on orthopaedic surgery, two on plastic surgery, and two on vascular surgery; seven studies were conducted in surgery for other conditions. These trials were conducted between 1986 and 2016, and 11 were funded by pharmaceutical companies or by a party with a commercial interest in the outcome of the trial. The GRADE quality of evidence was very low to moderate across all outcomes. No trial reported quality of life. DDAVP versus placebo or no treatment Trial results showed considerable heterogeneity between surgical settings for total volume of red cells transfused (low

  19. The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital

    Science.gov (United States)

    2007-10-01

    therapy resuscitation, and exacer- bated by hemorrhagic shock, metabolic acidosis, hypother- mia, hyperfibrinolysis, hypocalcemia , and anemia.11,14–19...outcome studies examining the effect of blood product transfusion ratios for trauma patients requiring massive transfusion. Most deaths (80% to 85%) that...calculation of apheresis platelet units transfused, though FWB has previously been shown to be as effective as 10 units of platelet concentrate.33 The

  20. Transfusion Practices Committee of a public blood bank network in Minas Gerais, Brazil.

    Science.gov (United States)

    de Carvalho, Ricardo Vilas Freire; Brener, Stela; Ferreira, Angela Melgaço; do Valle, Marcele Cunha Ribeiro; Moraes-Souza, Helio

    2012-01-01

    This study aimed to verify the performance of blood transfusion committees in transfusion services linked to the public blood bank network of the state of Minas Gerais. A cross-sectional observational study was conducted between 2007 and 2008 using questionnaires and proficiency tests to evaluate the reporting and investigation of transfusion reactions comparing transfusion services with and without transfusion committees in the public transfusion services of the state of Minas Gerais. Nineteen of Hemominas own transfusion services and 207 that contracted the services of the foundation located in 178 municipalities were visited between 2007 and 2008. Established transfusion committees were present in 63.4% of the services visited. Transfusion incidents were reported by 53 (36.8%) transfusion services with transfusion committees and by eight (9.6%) without transfusion committees (p < 0.001) with 543 (97.5%) and 14 (2.5%) notifications, respectively. Of the reported transfusion incidents, 40 (75.5%) transfusion services with transfusion committees and only two (25%) of those without