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Sample records for british medical response

  1. British Contributions to Medical Libraries Overseas

    PubMed Central

    Clark, Hilda M.

    1965-01-01

    Since the Second World War, Britain has established or rehabilitated medical schools in eight territories for which she has some responsibility, and, through the British Council, she is making medical library services available in many other countries. Official organizations and professional bodies provide abstract and review journals which enable medical men overseas to keep abreast of modern knowledge, while the Library Association Medical Section and the British National Book Centre have established flourishing exchange services, whose facilities are offered to medical libraries abroad. The most pressing need in developing countries at the present time is for professional medical librarians. Opportunities for training in Britain are open to librarians through at least six official sources besides the British Council and World Health Organization, but so far only two trainees have presented themselves on such grants. Less experienced librarians in the developing countries also need the continuing support of their senior colleagues overseas. PMID:14223737

  2. Auditing the British Medical Journal.

    PubMed Central

    Channer, K S

    1994-01-01

    The purpose of this study was to audit the outcome in terms of change in practice of the published research from one volume of the British Medical Journal. All original papers and short reports from one Volume 296 of the British Medical Journal (BMJ) 1988 were read and classified into theoretical only, practical and theoretical and practical. Those papers with any practical message were reviewed by one of a panel of specialists in the subject of the paper to assess if the recommendation made by the paper had become common clinical practice. The results show that most papers originated from teaching centres and research institutes in the UK. Only 8% of main papers and 6% of short reports had a solely practical application, although a further 18% and 22% had practical elements. The majority of the recommendations aimed at changing practice were of relevance to hospital specialists rather than general practitioners (GPs). Of the papers with any practical implications 48% (12% of the total) of main papers and 41% (11% of the total) of short reports were considered to be current practice. The reasons why the papers failed to change practice are discussed. In conclusion, the majority of the original research papers published in the BMJ in 1988 were of a theoretical nature and only about 20% of papers made recommendations for a change in practice. About 50% of the recommendations are now current practice. PMID:7837183

  3. Is the British Army medical grading functional assessment tool effective?

    PubMed

    Mackie, Isobel

    2015-12-01

    Decision Support Aids (DSAs) have been widely used throughout industry and one (known as Table 7) is available to support British Army Medical Officers (MOs) grade soldiers against the Joint Medical Employment Standards. It is unknown how useful this DSA is in practice. An electronic questionnaire was distributed to British Army MOs working within Defence Primary Care facilities enquiring about MOs views on the usefulness of the DSA. Although the response rate was low, informative data were obtained. Between a half and a third of respondents felt that their judgement was affected in the application of the grading system when there were career implications to the grading MOs felt that the DSA allowed subjectivity in the grading. The results of this research suggest that although minor changes to Table 7 may improve service provision, an improvement in training in the application of Table 7 would be of greater benefit to the quality of occupational health service provision in the British Army. PMID:26621810

  4. Medical Refugees and the Modernisation of British Medicine, 1930–1960

    PubMed Central

    Weindling, Paul

    2015-01-01

    Summary This paper reappraises the position of medical refugees in Britain between the 1930s and 1950s. Advocates of reforming British medicine in terms of its knowledge base and social provision emerged as strongly supportive of the medical refugees. By way of contrast, an élite in the British Medical Association attempted to exercise a controlling regime through the Home Office Advisory Committee. The effects of these divisions are gauged by reconstructing the complete spectrum of refugees as a total population. Applying this methodology of population reconstruction provides a corrective to the notion of a cohesive ‘medical establishment’ exercising rigid and discriminatory controls. PMID:26166948

  5. Exercise behaviour and attitudes among fourth-year medical students at the University of British Columbia

    PubMed Central

    Holtz, Kaila A.; Kokotilo, Kristen J.; Fitzgerald, Barbara E.; Frank, Erica

    2013-01-01

    Objective To describe the physical activity (PA) levels and counseling attitudes of Canadian undergraduate medical students. Design Online or paper survey. Setting The University of British Columbia (UBC). Participants Fourth-year medical students at UBC from 2007 to 2010. Main outcome measures Physical activity levels, relationship between exercise behaviour and attitudes toward counseling, and student perception of training in the area of exercise prescription. Results A total of 546 out of 883 students participated in the survey (62% response rate). Sixty-four percent of students met the Canadian Society for Exercise Physiology 2011 recommendations for PA. Attitudes toward healthy living were related to PA levels, but the rate of counseling patients about exercise was not; however, students who engaged in more strenuous PA were more likely to perceive exercise counseling as being highly relevant to future clinical practice (P = .018). Overall, 69% of students perceived exercise counseling to be highly relevant to clinical practice, but 86% thought that their training in this area was less than extensive. Conclusion Fourth-year UBC medical students engage in more strenuous PA than average age-matched Canadians, which affects their attitudes toward perceived future counseling practices. Encouraging more student participation in strenuous PA and encouraging academic training in the area of exercise counseling might be important next steps in preparing future physicians to effectively prescribe exercise to their patients. PMID:23341676

  6. Mountain goat response to hydroelectric exploration in northwestern British Columbia

    SciTech Connect

    Foster, B.R.; Rahs, E.Y.

    1983-03-01

    The behavioral responses of more than 800 mountain goats, comprised of 195 social groups, were recorded during hydroelectric exploration activities (primarily aircraft) in northwestern British Columbia. Four categories of overt response were recorded during case tests, ranging from maintenance activity to severe flight. More than 80 percent (n=667) of the observed goats elicited some form of behavioral stress-response, with 33 percent (n=265) displaying a severe flight response to local rock or plant cover. Multiple regression analysis inferred goat responses to be statistically independent of the time of year, type, and vertical orientation of disturbance and group size. As expected, significant correlations (p less than or equal to 0.05) existed between distance of disturbance, geographic area, cover availability, and degree of awareness. Responses were stimulated primarily by auditory and secondarily by visual cues. Repeated aerial and ground follow-up surveys documented temporary range abandonment and changing observability indices (habitat use and activity patterns) associated with areas of intense exploration activity. The assessed data offer mitigation possibilities and enable formulation of management guidelines to lessen project impacts during future exploration, construction, and operation phases.

  7. Educating the future sonographic workforce: membership survey report from the British Medical Ultrasound Society.

    PubMed

    Parker, P C; Harrison, G

    2015-11-01

    The British Medical Ultrasound Society (BMUS), the Consortium for the Accreditation of Sonographic Education (CASE), education providers and the NHS are working together to review how best to develop education for the future sonographic workforce. There is currently a national vacancy rate of approximately 12% across NHS Trusts. Education course placements are often limited to the number of clinical training places available within departments, resulting in a disparity between vacancies and the numbers of qualified sonographers graduating. Clearly there is a need for education to match the service demand. A term often used as a solution to the workforce problem is 'direct entry' ultrasound education. Anecdotally this term has caused confusion amongst health care professionals and as such the aim of this work was to gain an understanding of the views and opinions of BMUS members and interested professionals about direct entry training and subsequent development of any future training programmes. BMUS undertook an online survey with 286 responses. The survey provided insight into the opinions of ultrasound practitioners and the complexities of developing a relevant educational programme for the future sonographer workforce. The results suggested a number of concerns with direct entry ultrasound programmes, including insufficient training places, lack of health care background knowledge, lack of imaging knowledge and no state registration specific to sonographers. Benefits of direct entry to ultrasound training were perceived to be increasing the number of sonographers trained each year, whilst training people in their first choice profession with skills developed specific to the sonographer role. Support for direct entry ultrasound training was limited to 51% of respondents who would advocate this form of ultrasound training if it led to qualified sonographers with the same skills as sonographers exiting from current CASE accredited programmes. PMID:27433263

  8. Do family physicians know the costs of medical care? Survey in British Columbia.

    PubMed Central

    Allan, G. Michael; Innes, Grant D.

    2004-01-01

    OBJECTIVE: To determine the cost of 46 commonly used investigations and therapies and to assess British Columbia family doctors' awareness of these costs. DESIGN: Mailed survey asking about costs of 23 investigations and 23 therapies relevant to family practice. A random sample of 600 doctors was asked to report their awareness of costs and to estimate costs of the 46 items. SETTING: British Columbia. PARTICIPANTS: Six hundred family physicians. MAIN OUTCOME MEASURES: Estimates within 25% of actual cost were considered correct. Associations between cost awareness and respondents'characteristics (eg, sex, practice location) were sought. Degree of error in estimates was also assessed. RESULTS: Overall, 283 (47.2%) surveys were returned and 259 analyzed. Few respondents estimated costs within 25% of true cost, and estimates were highly variable. Physicians underestimated costs of expensive drugs and laboratory investigations and overestimated costs of inexpensive drugs. Cost awareness did not correlate with sex, practice location, College certification, faculty appointment, or years in practice. CONCLUSION: Family doctors in British Columbia have little awareness of the costs of medical care. PMID:15000338

  9. Keeping the culture alive: the laboratory technician in mid-twentieth-century British medical research

    PubMed Central

    Tansey, E.M.

    2008-01-01

    This paper reports results from a detailed study of the careers of laboratory technicians in British medical research. Technicians and their contributions are very frequently missing from accounts of modern medicine, and this project is an attempt to correct that absence. The present paper focuses almost entirely on the Medical Research Council's National Institute for Medical Research in North London, from the first proposal of such a body in 1913 until the mid 1960s. The principal sources of information have been technical staff themselves, largely as recorded in an extensive series of oral history interviews. These have covered a wide range of issues and provide valuable perspectives about technicians' backgrounds and working lives. PMID:18548906

  10. A Decade of Experience with Medical School Applicants at the University of British Columbia

    PubMed Central

    Anderson, Donald O.; Riches, Eleanor

    1963-01-01

    During the decade 1952-1961, 2060 students applied for admission to the University of B.C. medical school. Only 1664 fulfilled the pre-medical requirements. This cluster of eligible applicants changed in size and characteristics as the medical school grew older; in general, the academic calibre of applicant cohorts improved as mean age fell and length of pre-medical training increased. A decline in the number of British Columbia applicants was to some extent balanced by an increase in other applicants. Forty-three per cent of eligible applicants were accepted by the screening committee. In contrast to the applicant cluster, freshman classes contained a disproportionate number of B.C. residents. Acceptance, however, was strongly correlated with good pre-medical academic performance and all M.C.A.T. scores except those for “Understanding Modern Society”. Unfortunately, one-quarter of all accepted students withdrew before registration and had to be replaced. These observations are interpreted in terms of student recruitment and the efficiency of the screening committee. PMID:14012835

  11. Perceptions of British Columbia residents and their willingness to pay for medication management services provided by pharmacists

    PubMed Central

    Tsao, Nicole W.; Khakban, Amir; Gastonguay, Louise; Li, Kathy; Lynd, Larry D.

    2015-01-01

    Background: Across Canada, pharmacists have expanded their scope of practice by performing medication management (MM) services. However, little is currently known about the opinions and attitudes of patients and the general population toward MM services. Methods: A cross-sectional online survey, including a best-worst scaling task, was designed to understand the general public’s opinions, preferences and willingness-to-pay with respect to MM services in British Columbia. Results: Of 977 individuals contacted, 819 responded to the questionnaire (84% response rate). The mean age was 45 years (standard deviation [SD] 16 years), and 37% were male. Overall, 93% of respondents felt that the medication advice from their pharmacist resulted in improvement in patient outcomes and/or medication use. This was also selected as the “best” attribute of MM, while other preferred attributes of MM included being able to obtain an appointment with the pharmacist on the same day or via walk-in, improved patient-physician relationships and MM sessions able to be completed in 15 minutes with the pharmacist. The average willingness to pay for MM was $24.55 (SD $21.44). Younger males with higher household income and those who had had MM in the past were willing to pay more for MM services out of pocket. Discussion and Conclusion: The accessibility of pharmacists was valued highly by respondents who, overall, were supportive of MM services and recognized the potential of pharmacists’ involvement in drug therapy management to improve patient outcomes and medication use. Alternative models of funding are worth considering for the sustainability of MM service provision. PMID:26445584

  12. [Experiments on living subjects: the vivisection debate in German and British medical weekly journals 1919-1939].

    PubMed

    Lisner, Wiebke

    2009-01-01

    By the end of the 1920s, animal experiments were considered a standardized procedure for testing medical substances and therapies. In the context of the so-called "crisis of medicine", however, some physicians and the wider lay public in Germany and Great Britain criticized animal based research. While British antivivisectionists had little relevance in the 1930s, their German counterparts allied with the National Socialist Party and gained social and political force. The debates within the German and British medical profession about doctors' interventions in that debate, as well as the public perception of doctors will be analysed on the basis of the most important medical weekly journals of the time, that were involved in these debates. PMID:19746883

  13. Response to the Victims of Domestic Violence: Analysis and Implications of the British Experience.

    ERIC Educational Resources Information Center

    Dwyer, Diane C.

    1995-01-01

    Examines problem of domestic violence in Great Britain, which has a stronger feminist movement and a much lower level of stranger-to-stranger violence than does the United States. The prevalence rate of domestic violence is quite similar to that of the United States and the British system has been less progressive in its response. (LKS)

  14. (Re-)reading medical trade catalogs: the uses of professional advertising in British medical practice, 1870-1914.

    PubMed

    Jones, Claire L

    2012-01-01

    This article explores how medical practitioners read, used, and experienced medical trade catalogs in late-nineteenth- and early-twentieth-century Britain. Reader responses to the catalog, a book-like publication promoting medical tools, appliances, and pharmaceuticals, have been chronically understudied, as have professional reading practices within medicine more generally. Yet, evidence suggests that clinicians frequently used the catalog and did so in three main ways: to order medical products, to acquire new information about these products, and to display their own product endorsements and product designs. The seemingly widespread nature of these practices demonstrates an individual and collective professional desire to improve medical practice and highlights the importance of studying professional reading practices in the cultural history of medicine. PMID:23241910

  15. Medical responsibility and thermonuclear war

    SciTech Connect

    Cassel, C.; Jameton, A.

    1982-09-01

    The attention of physicians is being drawn to the issue of nuclear weapons and nuclear war, creating controversy about whether a political concern is appropriate for health care professionals. The use of nuclear weapons would incur human death and injury on a scale both unprecedented and unimaginable, and possibly damage the ecosphere far beyond the weapons' immediate effects. Medical supplies and facilities would be nonexistent; no meaningful medical response would be possible. A physician's responsibility to prevent nuclear war is based on the imperative to prevent a devastating incurable disease that cannot be treated. Such an imperative is consistent with the historic tradition of the social responsibility of health professionals, and can be justified by philosophical argument.

  16. Canadian family doctors’ roles and responsibilities toward outbound medical tourists

    PubMed Central

    Johnston, Rory; Crooks, Valorie A.; Snyder, Jeremy; Dharamsi, Shafik

    2013-01-01

    Abstract Objective To explore how Canadian family doctors understand their roles and responsibilities toward patients who seek health care abroad. Design Six focus groups were held with family doctors across British Columbia to explore their experiences with and perspectives on outbound medical tourism. Focus groups were digitally recorded, transcribed, and subsequently thematically coded to discover common issues and themes across the entire data set. Setting Focus groups were held with family doctors in 6 cities in British Columbia that provided representation from all provincial health authorities and a range of urban contexts. Participants A total of 22 currently practising family doctors participated across the 6 focus groups, with groups ranging in size from 2 to 6 participants (average 4 participants). Methods Thematic analysis of the transcripts identified cross-cutting themes that emerged across the 6 focus groups. Main findings Participants reported that medical tourism threatened patients’ continuity of care. Informational continuity is disrupted before patients go abroad because patients regularly omit family doctors from preoperative planning and upon return home when patients lack complete or translated medical reports. Participants believed that their responsibilities to patients resumed once the patients had returned home from care abroad, but were worried about not being able to provide adequate follow-up care. Participants were also concerned about bearing legal liability toward patients should they be asked to clinically support treatments started abroad. Conclusion Medical tourism poses challenges to Canadian family doctors when trying to reconcile their traditional roles and responsibilities with the novel demands of private out-of-country care pursued by their patients. Guidance from professional bodies regarding physicians’ responsibilities to Canadian medical tourists is currently lacking. Developing these supports would help address

  17. Medical responsibility and air transport.

    PubMed

    Hédouin, V; Lallemand, M; Révuelta, E; Dreszer, M A; Gosset, D

    1998-01-01

    When a medical emergency occurs during a flight operated by a commercial airline, the assistance of a physician-passenger fortuitously present aboard may be requested. This physician becomes bound by both his professional and civil responsibilities. However, in the case of a serious problem, he would usually ignore the question of the jurisprudence of the country where the emergency occurs. In discussing this issue, this paper analyses different situations and risks that the physician may incur and points out various defects in the law not currently covered by existing international conventions. PMID:10396911

  18. Multicenter randomized controlled trial of the management of unresectable malignant mesothelioma proposed by the British Thoracic Society and the British Medical Research Council.

    PubMed

    Girling, David J; Muers, Martin F; Qian, Wendi; Lobban, Dawn

    2002-02-01

    Malignant mesothelioma is almost invariably fatal. The incidence of the disease is rising rapidly in many countries, and there is no generally accepted standard treatment for patients with unresectable disease. According to current British Thoracic Society (BTS) guidelines, patients should be treated with active symptom control (ASC), involving (1) regular follow-up in a specialist clinic; (2) structured assessments of physical, psychological and social problems with appropriate action; (3) rapid involvement of additional specialists; and (4) parallel nursing support. Although many nonrandomized studies have reported tumor responses to anticancer chemotherapy, few have studied palliation and it is not known whether chemotherapy prolongs survival or provides clinically worthwhile palliation with acceptable toxicity when given in addition to ASC. We therefore plan to conduct a multicenter randomized controlled trial comparing (1) ASC alone, (2) ASC plus mitomycin vinblastine and cisplatin (MVP), and (3) ASC plus vinorelbine (N; Navelbine, Pierre Fabre Oncology, Winchester, UK). We chose these chemotherapy regimens because they have been shown in nonrandomized studies to provide good symptom control as recorded by patients. The outcome measures are overall survival, palliation of symptoms, performance status, analgesic usage, toxicity, quality of life, tumor response, and recurrence/progression-free survival. In a preliminary feasibility study, we are assessing the acceptability of the trial design to patients and the suitability of two standard quality-of-life instruments in mesothelioma. Data will help us to decide the final details of the large multicenter trial. PMID:11836674

  19. Yaws, syphilis, sexuality, and the circulation of medical knowledge in the British Caribbean and the Atlantic world.

    PubMed

    Paugh, Katherine

    2014-01-01

    This history of the disease categories "yaws" and "syphilis" explores the interplay between European and African medical cultures in the early modern Atlantic world. The assertion made by both early modern and modern medical authorities, that yaws and syphilis are the same disease, prompts a case study of the history of disease that reflects on a variety of issues in the history of medicine: the use of ideas about contagion to demarcate racial and sexual difference at sites around the British Empire; the contrast between persistently holistic ideas about disease causation in the Black Atlantic and the growth of ontological theories of disease among Europeans and Euro-Americans; and the controversy over the African practice of yaws inoculation, which may once have been an effective treatment but was stamped out by plantation owners who viewed it as a waste of their enslaved laborers' valuable time. PMID:24976161

  20. RISQy Business (Relationships, Incentives, Supports, and Quality): Evolution of the British Columbia Model of Primary Care (Patient-Centered Medical Home)

    PubMed Central

    MacCarthy, Dan; Hollander, Marcus J

    2014-01-01

    In 2002, the British Columbia Ministry of Health and the British Columbia Medical Association (now Doctors of BC) came together to form the British Columbia General Practice Services Committee to bring about transformative change in primary care in British Columbia, Canada. This committee’s approach to primary care was to respond to an operational problem—the decline of family practice in British Columbia—with an operational solution—assist general practitioners to provide better care by introducing new incentive fees into the fee-for-service payment schedule, and by providing additional training to general practitioners. This may be referred to as a “soft power” approach, which can be summarized in the abbreviation RISQ: focus on Relationships; provide Incentives for general practitioners to spend more time with their patients and provide guidelines-based care; Support general practitioners by developing learning modules to improve their practices; and, through the incentive payments and learning modules, provide better Quality care to patients and improved satisfaction to physicians. There are many similarities between the British Columbian approach to primary care and the US patient-centered medical home. PMID:24867550

  1. From medical astrology to medical astronomy: sol-lunar and planetary theories of disease in British medicine, c. 1700-1850.

    PubMed

    Harrison, M

    2000-03-01

    After 1700, astrology lost the respect it once commanded in medical circles. But the belief that the heavens influenced bodily health persisted - even in learned medicine - until well into the nineteenth century. The continuing vitality of these ideas owed much to the new empirical and mechanical outlook of their proponents. Taking their cue from the work of Robert Boyle and Richard Mead, a number of British practitioners amassed statistical evidence which purported to prove the influence of the Moon upon fevers and other diseases. Such ideas flourished in the colonies and in the medical services of the armed forces, but their exponents were not marginal men. Some, like James Lind, were widely respected and drew support for their views from such influential figures as Erasmus Darwin. PMID:11624340

  2. [Nuclear arms and medical responsibility].

    PubMed

    Firket, H

    1999-01-01

    The medical profession would be unable to cope with the millions of simultaneous casualities of a nuclear war. Such a war between developed countries becomes less likely, but new countries equip themselves, with nuclear weapons, using the violation of the Non-Proliferation Treaty by the great powers as an excuse. The danger of nuclear war is spreading with the consequences one can imagine. A world movement, including military experts, political, moral and scientific leaders and representative national medical groups, among them the World Medical Association, press governments to negotiate a comprehensive abolition treaty. The "Académie royale de Médecine de Belgique" joining moral prestige to an authoritative expertise, should take a stand on the problem. PMID:10687249

  3. Response to ‘Discussion: “Streamlined erosional residuals and drumlins in central British Columbia, Canada”’

    NASA Astrophysics Data System (ADS)

    McClenagan, J. Donald

    2014-03-01

    A response is given to 'Discussion: “Streamlined erosional residuals and drumlins in central British Columbia, Canada”'. Emphasis is made that the main purpose of the paper under discussion is to present the recognition of a distinctive landscape pattern in central British Columbia that appears to be an immense anastomosing channel network. A channel network of the magnitude described requires a large magnitude of flowing water to form it. Thus, that recognizable landscape pattern and associated upland landform shapes can be explained as products of water erosion. Such landscape patterns are observed being formed by water today.

  4. Green Consciousness or Dollar Diplomacy? The British Response to the Threat of Ozone Depletion.

    ERIC Educational Resources Information Center

    Maxwell, James H.; Weiner, Sanford L.

    1993-01-01

    Discusses the British role in the regulation of believed ozone-depleting substances such as chlorofluorocarbons. Recounts the history of the British policies during the emergence of the issue from 1974-80; a period of tactical resistance from 1980-87; and a change in policy from 1987-90. (66 references) (MDH)

  5. The Medical School Learning Milieu: A Study of Students' Perceptions of Twenty-Five British and Irish Medical Schools.

    ERIC Educational Resources Information Center

    Wakeford, Richard

    1984-01-01

    A study of medical students' perceptions of their learning environments revealed (1) numerous differences on some dimensions, including vocational vs. scientific orientation, extracurricular involvement, and perceived course intensiveness and (2) only slight differences in administrative flexibility, emphasis on concept vs. fact, and course…

  6. Medical ethics and education for social responsibility.

    PubMed Central

    Roemer, M. I.

    1980-01-01

    The physician, said Henry Sigerist in 1940, has been acquiring an increasingly social role. For centuries, however, codes of medical ethics have concentrated on proper behavior toward individual patients and almost ignored the doctor's responsibilities to society. Major health service reforms have come principally from motivated lay leadership and citizen groups. Private physicians have been largely hostile toward movements to equalize the economic access for people to medical care and improve the supply and distribution of doctors. Medical practice in America and throughout the world has become seriously commercialized. In response, governments have applied various strategies to constrain physicians and induce more socially responsible behavior. But such external pressures should not be necessary if a broad socially oriented code of medical ethics were followed. Health care system changes would be most effective, but medical education could be thoroughly recast to clarify community health problems and policies required to meet them. Sigerist proposed such a new medical curriculum in 1941; if it had been introduced, a social code of medical ethics would not now seem utopian. An international conference might well be convened to consider how physicians should be educated to reach the inspiring goals of the World Health Organization. PMID:7405276

  7. Medical responsibility in the United Arab Emirates.

    PubMed

    Benomran, Fawzi

    2010-05-01

    Medical responsibility in the United Arab Emirates was formerly defined and governed according to Law 7 of 1975 for the practice of medical professions, which had been a part of civil law. The passing of Law 10 of 2008, namely the "Law on Medical Responsibility in UAE", enacted on 16th December 2008 created a new framework to deal with this issue. One of its provisions required medical practitioners to hold insurance policies, so that insurance companies pays damages to the plaintiff (patient) injured as a result of a physicians' negligence. This paper outlines the issue of medical responsibility and medical negligence. The author's translation of the new law into English is included so that its full text is available for the readers, especially expatriate doctors working in the UAE. Where appropriate, a brief comparison between the old law and new laws is also presented. The objective of this paper is to provide medical practitioners with basic information about the subject in general and to this legislation in particular. It is mandatory for doctors to realize inherent risks involved in the course of their practice. A basic knowledge of the law is required to avoid pitfalls and to safeguard oneself against errors arising from ignorance of the duties and rights of the professional person. PMID:20382353

  8. Therapeutic drug monitoring (TDM) of antifungal agents: guidelines from the British Society for Medical Mycology

    PubMed Central

    Ashbee, H. Ruth; Barnes, Rosemary A.; Johnson, Elizabeth M.; Richardson, Malcolm D.; Gorton, Rebecca; Hope, William W.

    2014-01-01

    The burden of human disease related to medically important fungal pathogens is substantial. An improved understanding of antifungal pharmacology and antifungal pharmacokinetics–pharmacodynamics has resulted in therapeutic drug monitoring (TDM) becoming a valuable adjunct to the routine administration of some antifungal agents. TDM may increase the probability of a successful outcome, prevent drug-related toxicity and potentially prevent the emergence of antifungal drug resistance. Much of the evidence that supports TDM is circumstantial. This document reviews the available literature and provides a series of recommendations for TDM of antifungal agents. PMID:24379304

  9. Chromosome 2p shows significant linkage to antihypertensive response in the British Genetics of Hypertension Study.

    PubMed

    Padmanabhan, Sandosh; Wallace, Chris; Munroe, Patricia B; Dobson, Richard; Brown, Morris; Samani, Nilesh; Clayton, David; Farrall, Martin; Webster, John; Lathrop, Mark; Caulfield, Mark; Dominiczak, Anna F; Connell, John M

    2006-03-01

    There is a lack of consistently linked loci influencing blood pressure and hypertension status, and this may be because of genetic or phenotypic heterogeneity. We hypothesize that stratification of subjects by response to antihypertensive drug groups could be used to stringently define subsets that will have reduced genetic and etiologic heterogeneity, by partitioning contrasting mechanisms of hypertension and, thus, enhancing gene finding. We investigated the British Genetics of Hypertension Study population, which is composed of 2142 severely hypertensive white affected sibling pairs. Nonresponse to antihypertensive therapy was defined as an on-treatment blood pressure of >140/90 mm Hg or a difference between prediagnosis and on-treatment blood pressure of <20 mm Hg. Of the nonresponders, there were 89 sibling pairs (AB) who were both on antihypertensive therapy that inhibit the renin-angiotensin system (angiotensin-converting enzyme inhibitors, angiotensin II type-1 receptor blockers, or beta-blockers), and 76 sibling pairs (CD) who were both on drugs that do not (calcium channel blockers or diuretics). Nonparametric linkage analysis carried out using markers from a 10-cM genome scan and additional "grid tightening" markers showed significant linkage in the AB group on chromosome 2p (logarithm of odds=4.84 at 90.68 Kosambi cM) and suggestive linkage for the CD group on chromosome 10q (logarithm of odds=2.83 at 125.96 Kosambi cM). The AB linkage locus attained genomewide significance after simulation using 10,000 replicates (P=0.005). This locus may contain a gene for the salt-sensitive form of hypertension and/or a pharmacogenetic locus affecting drug response. We have demonstrated for the first time identification of a significant locus by partitioning different pathways of hypertension using drug response. PMID:16391175

  10. NASA Medical Response to Human Spacecraft Accidents

    NASA Technical Reports Server (NTRS)

    Patlach, Robert

    2010-01-01

    Manned space flight is risky business. Accidents have occurred and may occur in the future. NASA's manned space flight programs, with all their successes, have had three fatal accidents, one at the launch pad and two in flight. The Apollo fire and the Challenger and Columbia accidents resulted in a loss of seventeen crewmembers. Russia's manned space flight programs have had three fatal accidents, one ground-based and two in flight. These accidents resulted in the loss of five crewmembers. Additionally, manned spacecraft have encountered numerous close calls with potential for disaster. The NASA Johnson Space Center Flight Safety Office has documented more than 70 spacecraft incidents, many of which could have become serious accidents. At the Johnson Space Center (JSC), medical contingency personnel are assigned to a Mishap Investigation Team. The team deploys to the accident site to gather and preserve evidence for the Accident Investigation Board. The JSC Medical Operations Branch has developed a flight surgeon accident response training class to capture the lessons learned from the Columbia accident. This presentation will address the NASA Mishap Investigation Team's medical objectives, planned response, and potential issues that could arise subsequent to a manned spacecraft accident. Educational Objectives are to understand the medical objectives and issues confronting the Mishap Investigation Team medical personnel subsequent to a human space flight accident.

  11. Mass care and the University of British Columbia: A new approach to disaster response.

    PubMed

    Fountain, Reg

    2016-01-01

    In the event of a major earthquake affecting the lower mainland of British Columbia, the University of British Columbia (UBC) would be expected to provide emergency services and support to a population of over 51,000 students, 14,000 faculty and staff and over 10,000 UBC community residents and private companies who live and work on the Point Grey peninsula. This paper will detail how UBC would provide shelter, food, accommodation and support (together known as mass care) to this demographic. PMID:27318287

  12. Framing Higher Education: Questions and Responses in the British Social Attitudes Survey, 1983-2010

    ERIC Educational Resources Information Center

    Mountford-Zimdars, Anna; Jones, Steven; Sullivan, Alice; Heath, Anthony

    2013-01-01

    This article focuses on questions and attitudes towards higher education in the British Social Attitudes (BSA) survey series. First, we analyse the changing BSA questions (1983-2010) in the context of key policy reports. Our results show that changes in the framing of higher education questions correspond with changes in the macro-discourse of…

  13. The Foreign Language Needs of British Business: A CTC Response. CTC Trust Publication Number 3.

    ERIC Educational Resources Information Center

    Hagen, Stephen

    The need for second language training in the United Kingdom for trade and industry is examined, and the role of City Technology Colleges (CTCs) in providing such training is discussed. It is argued that reliance on English is no longer sufficient for trade in the world market, since the most important markets for British goods and services are…

  14. Bearing response-ability: theater, ethics and medical education.

    PubMed

    Rossiter, Kate

    2012-03-01

    This paper addresses a growing concern within the medical humanities community regarding the perceived need for a more empathically-focused medical curricula, and advocates for the use of creative pedagogical forms as a means to attend to issues of suffering and relationality. Drawing from the ethical philosophy of Emmanuel Levinas, I critique the notion of empathy on the basis that it erases difference and disregards otherness. Rather, I propose that the concept of empathy may be usefully replaced with that of ethical responsibility, which suggests a shared sense of humanity outside the boundaries of presumed knowledge of the other. To illustrate this argument, I theorize the importance of theater within medical education. Theater, I argue, may engender ethical responsibility in the Levinasian sense, and thus may allow learners to differently engage with the experience of the suffering other. As such, I examine Margaret Edson's widely used play Wit as a platform for such an ethical encounter to occur. Thus, rather than working to understand the value of theater in medical education in terms of knowledge and skill acquisition, I theorize that its primacy within medical curricula arises from its ethical/relational potential, or potential to engender new forms of inter-human relationality. PMID:22109642

  15. Neutral Caregivers or Military Support? The British Red Cross, the Friends’ Ambulance Unit, and the Problems of Voluntary Medical Aid in Wartime

    PubMed Central

    2015-01-01

    During the First World War the British Red Cross Society (BRCS) served as the coordinating body for voluntary medical aid giving in Britain. Among the many units which came within its purview was the Friends’ Ambulance Unit (FAU), formed by a group of young men whose desire to serve their nation in wartime conflicted with their pacifist principles. Both the BRCS and the FAU were wracked by ideological conflicts in the years which preceded and throughout the war. These struggles over voluntarist identity highlight the contested meanings of service and conscience in wartime. Through a critical examination of the language of official histories and biographies, this article will argue that the war formed a key moment in the relationship between the British state and voluntary medical aid, with the state’s increasing role in the work of such organizations raising questions about the voluntarist principles to which aid organizations laid claim. The struggles that both organizations and individuals within them faced in reconciling the competing pressures that this new relationship created form a legacy of the war which continues to have important implications for the place of medical voluntarism in wartime today. PMID:26213442

  16. Preschooler Study: The Medical, Social and Economic Correlates of Poverty in Preschool Children of British Columbia. A Pilot Study.

    ERIC Educational Resources Information Center

    Tonkin, Roger S.; And Others

    Over 200 families from lower and middle income areas of British Columbia, including a group representing the Indian communities, were studied in this effort to examine poverty as it relates to families, especially to young children. A wide variety of health, social, and economic variables were examined in the hope of developing output criteria for…

  17. A grim contradiction: the practice and consequences of corporate social responsibility by British American Tobacco in Malaysia.

    PubMed

    Barraclough, Simon; Morrow, Martha

    2008-04-01

    In the wake of the World Health Organization Framework Convention on Tobacco Control, corporate social responsibility (CSR) is among the few remaining mechanisms for tobacco corporations publicly to promote their interests. Health advocates may be unaware of the scale, nature and implications of tobacco industry CSR. This investigation aimed to construct a typology of tobacco industry CSR through a case study of the evolution and impact of CSR activities of a particular tobacco corporation in one country - British American Tobacco, Malaysia (BATM), the Malaysian market leader. Methods included searching, compiling and critically appraising publicly available materials from British American Tobacco, BATM, published literature and other sources. The study examined BATM's CSR strategy, the issues which it raises, consequences for tobacco control and potential responses by health advocates. The investigation found that BATM's CSR activities included assistance to tobacco growers, charitable donations, scholarships, involvement in anti-smuggling measures, 'youth smoking prevention' programs and annual Social Reports. BATM has stated that its model is predominantly motivated by social and stakeholder obligations. Its CSR activities have, however, had the additional benefits of contributing to a favourable image, deflecting criticism and establishing a modus vivendi with regulators that assists BATM's continued operations and profitability. It is imperative that health advocates highlight the potential conflicts inherent in such arrangements and develop strategies to address the concerns raised. PMID:18304713

  18. Eliminating child labour in Malawi: a British American Tobacco corporate responsibility project to sidestep tobacco labour exploitation

    PubMed Central

    Otañez, M G; Muggli, M E; Hurt, R D; Glantz, S A

    2006-01-01

    Objectives To examine British American Tobacco and other tobacco industry support of the Eliminating Child Labour in Tobacco Growing Foundation. Design Analyses of internal tobacco industry documents and ethnographic data. Results British American Tobacco co‐founded the Eliminating Child Labour in Tobacco Growing Foundation (ECLT) in October 2000 and launched its pilot project in Malawi. ECLT's initial projects were budgeted at US$2.3 million over four years. Labour unions and leaf dealers, through ECLT funds, have undertook modest efforts such as building schools, planting trees, and constructing shallow wells to address the use of child labour in tobacco farming. In stark contrast, the tobacco companies receive nearly US$40 million over four years in economic benefit through the use of unpaid child labour in Malawi during the same time. BAT's efforts to combat child labour in Malawi through ECLT was developed to support the company's “corporate social responsibility agenda” rather than accepting responsibility for taking meaningful steps to eradicate child labour in the Malawi tobacco sector. Conclusion In Malawi, transnational tobacco companies are using child labour projects to enhance corporate reputations and distract public attention from how they profit from low wages and cheap tobacco. PMID:16728754

  19. Repeatability of Response to Asthma Medications

    PubMed Central

    Wu, Ann; Tantisira, Kelan; Li, Lingling; Schuemann, Brooke; Weiss, Scott

    2010-01-01

    Background Pharmacogenetic studies of drug response in asthma assume that patients respond consistently to a treatment but that treatment response varies across patients, however, no formal studies have demonstrated this. Objective To determine the repeatability of commonly used outcomes for treatment response to asthma medications: bronchodilator response, forced expiratory volume in 1 second (FEV1), and provocative concentration of methacholine producing a 20% decline in FEV1 (PC20). Methods The Childhood Asthma Management Program (CAMP) was a multi-center clinical trial of children randomized to receiving budesonide, nedocromil, or placebo. We determined the intraclass correlation coefficient (ICC) for each outcome over repeated visits over four years in CAMP using mixed effects regression models. We adjusted for the covariates: age, race/ethnicity, height, family income, parental education, and symptom score. We incorporated each outcome for each child as repeated outcome measurements and stratified by treatment group. Results The ICC for bronchodilator response was 0.31 in the budesonide group, 0.35 in the nedocromil group, and 0.40 in the placebo group, after adjusting for covariates. The ICC for FEV1 was 0.71 in the budesonide group, 0.60 in the nedocromil group, and 0.69 in the placebo group, after adjusting for covariates. The ICC for PC20 was 0.67 in the budesonide and placebo groups and 0.73 in the nedocromil group, after adjusting for covariates. Conclusion The within treatment group repeatability of FEV1 and PC20 are high; thus these phenotypes are heritable. FEV1 and PC20 may be better phenotypes than bronchodilator response for studies of treatment response in asthma. PMID:19064281

  20. Comparison of Loss Estimates for Greater Victoria, British Columbia, from Scenario Earthquakes using HAZUS - Implications for Risk, Response and Recovery

    NASA Astrophysics Data System (ADS)

    Zaleski, M. P.; Clague, J. J.

    2012-12-01

    Victoria, British Columbia, lies near the Cascadia subduction zone, where three distinct classes of earthquakes contribute to local seismic risk. The largest-magnitude events are subduction-interface earthquakes, which generate widespread shaking across the Pacific Northwest region from British Columbia to northern California. Interface-earthquake risk is mitigated somewhat by the low frequency of events and the distance from the source to populated areas. The largest contribution to the probabilistic hazard is from strong deep-focus earthquakes within the down-going Juan de Fuca slab. Intraslab quakes are frequent, but attenuation from depth results in smaller ground motions. The highest-loss scenarios are associated with major earthquakes on shallow west- to northwest-trending crustal faults that extend across Puget Sound and the southern Strait of Georgia. These faults are a result of compression in the North American plate associated with oblique subduction of the Juan de Fuca slab beneath southwestern British Columbia and northwestern Washington. Our understanding of frequency-magnitude relations for individual shallow-crustal faults is hampered by a widespread cover of Pleistocene glacial deposits, thus the risk is difficult to estimate. We have prepared shake maps for several scenario earthquakes that take into account local geologic conditions. We compare strong ground motions from local crustal fault sources with Cascadia plate-boundary, intraslab and probabilistic building code ground motions. Hazard maps from scenario events are combined with models of the build environment within the HAZUS platform to generate loss estimates. The results may be used to identify vulnerabilities, focus advance mitigation efforts, and guide response and recovery planning.

  1. Medical Director Responsibilities to the ESRD Network

    PubMed Central

    DeOreo, Peter B.

    2015-01-01

    The 18 regional ESRD Networks are established in legislation and contract with the Centers for Medicare and Medicaid Services to improve the quality and safety of dialysis, maximize patient rehabilitation, encourage collaboration among and between providers toward common quality goals, and improve the reliability and the use of data in pursuit of quality improvement. The Networks are funded by a $0.50 per treatment fee deducted from the reimbursement to dialysis providers, and their deliverables are determined by a statement of work, which is updated in a new contract every 3 years. The Conditions for Coverage require dialysis providers to participate in Network activities, and failure to do so can be the basis for sanctions against the provider. However, the Networks attempt to foster a collegial relationship with dialysis facilities by offering tools, educational activities, and other resources to assist the facilities in meeting the evolving requirements by the Centers for Medicare and Medicaid Services on the basis of national aims and domains for quality improvement in health care that transcend the ESRD program. Because of his/her responsibility for implementing the quality assessment and performance improvement activities in the facility, the medical director has much to gain by actively participating in Network activities, especially those focused on quality, safety, patient grievance, patient engagement, and coordination of care. Membership on Network committees can also foster the professional growth of the medical director through participation in quality improvement activity development and implementation, authorship of articles in peer-reviewed journals, creation of educational tools and presentations, and application of Network-sponsored materials to improve patient outcomes, engagement, and satisfaction in the medical director’s facility. The improvement of care of patients on dialysis will be beneficial to the facility in achieving its goals of

  2. Medical Director Responsibilities to the ESRD Network.

    PubMed

    DeOreo, Peter B; Wish, Jay B

    2015-10-01

    The 18 regional ESRD Networks are established in legislation and contract with the Centers for Medicare and Medicaid Services to improve the quality and safety of dialysis, maximize patient rehabilitation, encourage collaboration among and between providers toward common quality goals, and improve the reliability and the use of data in pursuit of quality improvement. The Networks are funded by a $0.50 per treatment fee deducted from the reimbursement to dialysis providers, and their deliverables are determined by a statement of work, which is updated in a new contract every 3 years. The Conditions for Coverage require dialysis providers to participate in Network activities, and failure to do so can be the basis for sanctions against the provider. However, the Networks attempt to foster a collegial relationship with dialysis facilities by offering tools, educational activities, and other resources to assist the facilities in meeting the evolving requirements by the Centers for Medicare and Medicaid Services on the basis of national aims and domains for quality improvement in health care that transcend the ESRD program. Because of his/her responsibility for implementing the quality assessment and performance improvement activities in the facility, the medical director has much to gain by actively participating in Network activities, especially those focused on quality, safety, patient grievance, patient engagement, and coordination of care. Membership on Network committees can also foster the professional growth of the medical director through participation in quality improvement activity development and implementation, authorship of articles in peer-reviewed journals, creation of educational tools and presentations, and application of Network-sponsored materials to improve patient outcomes, engagement, and satisfaction in the medical director's facility. The improvement of care of patients on dialysis will be beneficial to the facility in achieving its goals of

  3. NASA Medical Response to Human Spacecraft Accidents

    NASA Technical Reports Server (NTRS)

    Patlach, Robert

    2011-01-01

    This slide presentation reviews NASA's role in the response to spacecraft accidents that involve human fatalities or injuries. Particular attention is given to the work of the Mishap Investigation Team (MIT), the first response to the accidents and the interface to the accident investigation board. The MIT does not investigate the accident, but the objective of the MIT is to gather, guard, preserve and document the evidence. The primary medical objectives of the MIT is to receive, analyze, identify, and transport human remains, provide assistance in the recovery effort, and to provide family Casualty Coordinators with latest recovery information. The MIT while it does not determine the cause of the accident, it acts as the fact gathering arm of the Mishap Investigation Board (MIB), which when it is activated may chose to continue to use the MIT as its field investigation resource. The MIT membership and the specific responsibilities and tasks of the flight surgeon is reviewed. The current law establishing the process is also reviewed.

  4. British psychiatry and its discontents

    PubMed Central

    Cooper, Brian

    2010-01-01

    Summary Psychiatry in the UK is currently faced with serious difficulties arising from failure in recruiting British doctors and a high rate of early retirement from the specialty. To diagnose the underlying causes, account must be taken of government policies affecting the NHS in general and mental health services in particular. The latter include an excessive run-down of acute hospital beds, as well as projects aimed at changing the clinical role of psychiatrists and promoting mass treatment of milder mental disorders by non-medical personnel. Psychiatrists have reacted to these developments with anger and dismay, but have as yet reached no consensus with regard to either causal factors or appropriate response. Their uncertainty reflects the need for a firmer grasp of the historical background. Modern British psychiatry was effectively created and moulded as an integral part of the NHS. It flourished as long as the public service framework remained intact, but has suffered a decline since the whole structure began to buckle under the pressure of sustained political assaults. A clearer understanding of this vital connection would help to raise psychiatrists' morale and encourage them to establish common ground with medical colleagues and other healthcare professionals. PMID:20929890

  5. Mobilizing physicians to conduct clinical intervention in tobacco use through a medical-association program: 5 years' experience in British Columbia.

    PubMed Central

    Bass, F

    1996-01-01

    During the last 5 years, a program run by the medical association in British Columbia has recruited 23% of the province's general practitioners (GPs) to take an active, systematic approach to clinical intervention in tobacco use. Another 9% of GPs (considered "semi-active") regularly use the program's educational materials for patients, and another 25% have been trained in intervention or have been given intervention materials or both. If the cessation rate (rate of patients who quit smoking who would not otherwise have done so) was 4% among physicians actively involved in intervention and 2% among physicians considered semi-active, in 1995 an estimated 4700 smokers quit and were followed by their GPs as a result of the program. Another 135,000 smokers received brief counselling from their GPs and were also followed. This article reviews the strategies and methods used in this program to mobilize physicians. Images Fig. 1 PMID:8548704

  6. [Medical professionalism-on social responsibilities viewed from historical perspective].

    PubMed

    Kim, Jang Han

    2015-03-01

    What is medical professionalism and does it matter to the patients? Medical professionals take responsibility for their judgements and the consequences that ensue. Traditionally medical professionalism is defined as a set of values, behaviors, and relationships which support the trust the public has in doctors. The public is well aware that absence of professionalism is harmful to their interests. However, the exercise of medical professionalism is endangered by the political and cultural environment. The values of professionalism have been changed throughout the medical history and the meaning of it was also changed according to social theories. Traditional medical professionalism was based on the virtue of autonomy, self-regulation and competency etc. However, in the new millenium era, the meaning of professionalism has changed under the concept of responsibility which includes the classical virtues. The meaning of professionalism nowadays is only based on the structure and conflicting theories which cannot solve all the issues surrounding professionalism in medical practice. The conditions of medical practice are critical determinants for the future of professionalism. The interaction between doctor and patient is central to the medical care, and medical professionalism has roots in almost every aspect of medical care. I argue that doctors have responsibility to act according to the values which have been determined by the medical profession, history and surrounding society. The new millennium medical professionalism which based on the responsibility could initiate a public dialogue about the role of the doctor in creating a fairer society. PMID:25797380

  7. Complex mass wasting response of drainage basins to forest management in coastal British Columbia

    NASA Astrophysics Data System (ADS)

    Brardinoni, Francesco; Hassan, Marwan A.; Slaymaker, H. Olav

    2003-01-01

    The impacts of logging activities on mass wasting were examined in five watersheds in the coastal mountains of British Columbia. Historical aerial photos were used to document mass wasting events, and their occurrence was related to logging activities in the study basins. Logged and forested areas were compared in terms of mass wasting magnitude and frequency, with reference to site characteristics. The recovery time of the landscape after logging was assessed. Bedrock type and basin physiography had no identifiable effect on mass wasting frequency and magnitude. Mass wasting failure was primarily controlled by slope gradient. Basin vulnerability increased, following clearcutting relative to forested areas, in that mass wasting was initiated on gentler slopes. The volume of sediment produced from logged slopes is of the same order as that from forested areas, which are steeper by as much as 10°. In both logged and forested areas, the size distribution of mass wasting events follows an exponential distribution. However, the variability in mass wasting size in forested areas is much higher than that obtained for logged areas. The recovery time after forest harvesting is over 20 years, which confirms published estimates based on vegetation reestablishment. Continuous disturbance of the basin, however, may extend the recovery time for the whole basin well beyond 20 years.

  8. Media and medical response to the introduction of prescription charging in the National Health Service.

    PubMed

    Koizia, Louis; Zielicka, Zofia

    2009-12-01

    In April 2009 the National Health Service (NHS) prescription charge rose to pounds 7.20 in England, whereas in Wales prescriptions have been free since 2007. This major difference has led to much controversy amongst the public, media and medical profession. This paper tries to identify the response of the media and medical profession to the introduction of prescription charging in the NHS. When established on July 5th 1948 the NHS provided free healthcare including prescriptions to the entire population of Britain. However, following concerns around finance, the Conservative government introduced a one shilling prescription charge in June 1952. Information gathered from newspapers, despite their differing readerships and political affiliations, revealed that the media generally accepted the charge with little opposition. In contrast, large debate and divisions arose amongst the medical profession, with huge volumes of literature being published on the issue. The London based British Medical Association opposed the charge as they felt doctors were not government tax collectors; whereas rural doctors became concerned that the charge would affect the doctor-patient relationship. This paper identifies that the introduction of the prescription charge, not only aroused debate in parliament, but caused a spectrum of views amongst lay and medical circles. PMID:20509505

  9. Hazardous materials. Disaster medical planning and response.

    PubMed

    Levitin, H W; Siegelson, H J

    1996-05-01

    Hazardous materials offer a variety of unique challenges to emergency personnel. These agents have immense economic impact, but when mishandled, they become notorious for turning contained accidents into disasters involving the entire community. During a hazmat accident, the victims often ignore the rules of the disaster plan by seeking out the nearest hospital for medical care, regardless of that institution's capabilities. Health care workers rushing to the aid of contaminated individuals, without taking appropriate precautions (i.e., donning PPE), potentially make themselves victims. Disaster preparedness requires planning, policy, and procedure development, hazard analysis, training, and the availability of personal protective equipment for all responding personnel. Presently, the level of hazmat preparedness varies greatly among different hospitals, EMS and fire services, and disaster response teams. These differences in hazmat preparedness can be linked to a variety of factors (lack of awareness, funding, and support) and controversies (types of PPE and level of training required) which have prevented the establishment of a national hazmat policy for most of these organizations. Despite these difficulties, emergency departments continue to be the primary provider of care to contaminated individuals. As a result, emergency physicians must work with their hospital to implement a hazmat decontamination program in order to appropriately care for these individuals. The appendix to this article presents a list of recommendations for hospital hazmat preparedness. It is modeled after existing CDC and OSHA guidelines. PMID:8635411

  10. Sensitometric responses of selected medical radiographic films.

    PubMed

    Kofler, J M; Gray, J E

    1991-12-01

    Radiographic films produce different densities and contrast when processor changes occur, and the magnitude and rate of change vary with film type. The ability to detect and interpret the clinical importance of film density changes may depend on the method of sensitometry used. The characteristics of several medical radiographic films and various sensitometers were examined under three sensitometric variations and five processing variations. Of all variations used, only exposure with a single-versus a double-sided sensitometer caused a film type to have a marked different response. The results indicate that mismatching the sensitometer spectral output with the spectral sensitivity of the film in most cases does not affect the density changes of the film. The fact that a few films may be sensitive to differences in spectral content of the exposing light and dual- versus single-sided exposure and that only a limited number of film types were tested, however, leads to the prudent conclusion that the exposure conditions for quality control purposes should match clinical exposure conditions as closely as possible. PMID:1947114

  11. Population Aging and the Determinants of Healthcare Expenditures: The Case of Hospital, Medical and Pharmaceutical Care in British Columbia, 1996 to 2006

    PubMed Central

    Cunningham, Colleen

    2011-01-01

    There is a gap between rhetoric and reality concerning healthcare expenditures and population aging: although decades-old research suggests otherwise, there is widespread belief that the sustainability of the healthcare system is under serious threat owing to population aging. To shed new empirical light on this old debate, we used population-based administrative data to quantify recent trends and determinants of expenditure on hospital, medical and pharmaceutical care in British Columbia. We modelled changes in inflation-adjusted expenditure per capita between 1996 and 2006 as a function of two demographic factors (population aging and changes in age-specific mortality rates) and three non-demographic factors (age-specific rates of use of care, quantities of care per user and inflation-adjusted costs per unit of care). We found that population aging contributed less than 1% per year to spending on medical, hospital and pharmaceutical care. Moreover, changes in age-specific mortality rates actually reduced hospital expenditure by —0.3% per year. Based on forecasts through 2036, we found that the future effects of population aging on healthcare spending will continue to be small. We therefore conclude that population aging has exerted, and will continue to exert, only modest pressures on medical, hospital and pharmaceutical costs in Canada. As indicated by the specific non-demographic cost drivers computed in our study, the critical determinants of expenditure on healthcare stem from non-demographic factors over which practitioners, policy makers and patients have discretion. PMID:22851987

  12. [The modern approaches to the principles of medical and surgical casualty estimation. The US and British experience].

    PubMed

    Zhuravlev, V K; Golota, A S; Krassiĭ, A B; Mironov, V G; Parfenov, V D

    2014-01-01

    The current article is dedicated to the principles of medical and surgical casualty estimation elaborated by the medical services of the US and Great Britain Armed Forces on the basis of their experience obtained during Afghanistan and Iraq operations. PMID:24734435

  13. The diets of British schoolchildren. Sub-committee on Nutritional Surveillance. Committee on Medical Aspects of Food Policy.

    PubMed

    1989-01-01

    1. Statistical analysis and interpretation 1.1 This Report deals with the dietary habits of British schoolchildren and the contribution made by school meals in 1983. Since then many Local Education Authorities have introduced active policies to encourage healthy eating, accompanied in the last 4 years by health promotion campaigns, in the light of the publication of the COMA Report on Diet and Cardiovascular Disease in 1984, and other reports on diet and health. 1.2 Data are presented on the food and nutrient intakes of a representative sample of British schoolchildren measured by a 7-day record. Most food and some nutrient intakes were not normally distributed and median values are given in the tables of results. Interpretation and commentary are restricted to findings which achieved statistical significance (p less than 0.05) by parametric analyses. No non-parametric statistical analyses were attempted but data are given in detail in the tables and for those wishing to examine them further, the computer database of the survey is also available through the National Data Archive. Full documentation of the database may be obtained from the Social Survey Division of the Office of Population Censuses and Surveys, (OPCS) London. 2. Foods consumed 2.1 The main sources of dietary energy in the diets of British schoolchildren were bread, chips, milk, biscuits, meat products, cake and puddings. Almost all children in the survey recorded consumption of chips, crisps, cakes and biscuits. Boys recorded more chips consumed than girls along with more milk, breakfast cereals and baked beans; girls recorded more fruit consumed and more girls drank fruit juice than boys. Yogurt, fizzy drinks and sweets were more popular among younger children. Older children recorded consumption of more tea and coffee (para 9.2). 2.2 Scottish primary school children appeared to have a distinctive dietary pattern. They recorded higher median consumption of beef, soups, milk, cheese, sausages

  14. British Columbia

    ERIC Educational Resources Information Center

    Walton, Gerald

    2006-01-01

    The province of British Columbia has a dubious history where support for lesbian, gay, bisexual, and transgendered (LGBT) issues in education is concerned. Most notable is the Surrey School Board's decision in 1997 to ban three picture books for children that depict families with two moms or two dads. The North Vancouver School Board has also…

  15. Role of information technology in disaster medical response.

    PubMed

    Harrison, Jeffrey P; Harrison, Richard A; Smith, Megan

    2008-01-01

    This article addresses the importance of information technology (IT) in support of disaster medical response and provides a framework for the use of IT in response to natural disasters or terrorist activities. The appropriate use of IT enhances the effectiveness of the disaster response system, thereby safeguarding the population and the community infrastructure. This study found that most US hospitals have wireless local area networks (LANs) with disaster medical response capabilities. The data indicate that combined with the wireless LAN, many hospitals have acquired personal digital assistants, tablets, and handheld personal computers, which are important disaster medical response resources. This research shows that the wireless LAN networks and remote input devices are in place to ensure a timely medical response to disasters within many US communities. PMID:19011412

  16. Roles and responsibilities of a medical geneticist.

    PubMed

    Rubinstein, Wendy S

    2008-01-01

    Medical geneticists must generate a differential diagnosis, practice evidence-based medicine, and apply ethical, legal, and social issue (ELSI) principles in the clinical setting. Several clinical scenarios are presented which illustrate dilemmas in the cancer genetics setting. These include the differential diagnosis of breast and gastric cancer, and the predicament posed by the need to practice evidence-based medicine in light of limitations in the medical genetics literature, which may mean recommending prophylactic surgery. Also discussed are three BRCA1/2 genetic testing scenarios which illustrate the difficulty of knowing where to "draw the line", i.e., when to offer testing and what level of testing to pursue. Decision-making about BRCA1/2 gene testing including Ashkenazi Jewish founder mutation testing, comprehensive reflex testing, and expedited testing, is explored. The duty to recontact as standard of care evolves requires that medical geneticists determine how to prospectively set expectations with patients as well as to decide which situations require recontact and to determine how to systematically do so. The case of patient recontact regarding new mutation detection techniques with improved sensitivity, e.g., BART testing which is based on the ability to detect large BRCA1/2 rearrangements, is discussed. General principles are highlighted so that these specific cases can be extrapolated to other genes and hereditary conditions by medical geneticists, genetic counselors, and others practicing in the field of cancer genetics. PMID:17624600

  17. Determining medical fitness to drive: physicians' responsibilities in Canada.

    PubMed Central

    Coopersmith, H G; Korner-Bitensky, N A; Mayo, N E

    1989-01-01

    Current legislation indicates that physicians in Canada have a legal responsibility to know which medical conditions may impede driving ability, to detect these conditions in their patients and to discuss with their patients the implications of these conditions. The requirements to report unfit drivers vary among the provinces, and the interpretations of the law vary among the courts; therefore, physicians' risks of liability are unclear. Physicians may be sued by their patients if they fail to counsel the patients on the dangers of driving associated with certain medications or medical conditions. Physicians may also face legal action by victims of motor vehicle accidents caused by their patients if the court decides that the physicians could have foreseen the danger of their patients' continuing to drive. Physicians' legal responsibilities to report patients with certain medical conditions override their ethical responsibilities to keep patients' medical histories confidential. PMID:2914258

  18. Medical Student Response to a Class Lipid-Screening Project.

    ERIC Educational Resources Information Center

    Lum, Gifford; And Others

    1982-01-01

    Medical students at the State University of New York's Downstate Medical Center initiated and carried out a voluntary project to screen lipids (cholesterol) to identify known coronary risk factors. The incidence of coronary disease factors among these students and the response of students with high cholesterol levels are reported. (Authors/PP)

  19. Field Report: Medical Response to Super Typhoon Haiyan.

    PubMed

    Noone, Michael

    2015-10-01

    This report describes the experience and observations during a humanitarian medical response 10 days after landfall of Typhoon Haiyan in the Leyte Island region of the Philippines. Loss of availability of local health care providers was observed to affect the ability of the local community to provide for immediate, post-event medical relief. PMID:26451783

  20. Chemical and Biological Terrorism: Improvements to Emergency Medical Response.

    ERIC Educational Resources Information Center

    DeGraffenreid, Jeff Gordon

    The challenge facing many emergency medical services (EMS) is the implementation of a comprehensive educational strategy to address emergency responses to terrorism. One such service, Johnson County (Kansas) Medical Action, needed a strategy that would keep paramedics safe and offer the community an effective approach to mitigation. A…

  1. Referrals for neonatal medical care in the United Kingdom over one year. British Association of Perinatal Medicine Working Group.

    PubMed

    1989-01-21

    A survey of referrals for neonatal medical care was conducted by neonatal paediatricians in the United Kingdom from 1 August 1986 to 31 July 1987. It was intended to estimate the unmet need for neonatal medical care and to find out what happens after an attempt to transfer a pregnant woman or a baby has been unsuccessful. A total of 3734 attempts had been made, of which 1646 were for in utero cases and 2088 were for postnatal cases. Nationally, about 9% of attempts to transfer (331) were unsuccessful. In most regions a high proportion of attempts that were eventually successful had taken a considerable amount of time to arrange. It is concluded that despite a twofold increase since 1980 in the number of cots available for neonatal intensive care, arrangements for such provision in the UK are not adequate to meet every request for transfer. No health region in England or country in the UK was able to meet every request immediately, and some regions had great difficulties in arranging even those transfers that had been accepted. Such delays in transfer may lead to appreciable extra morbidity and considerable costs in future. PMID:2493842

  2. Targeting brains, producing responsibilities: the use of neuroscience within British social policy.

    PubMed

    Broer, Tineke; Pickersgill, Martyn

    2015-05-01

    Concepts and findings 'translated' from neuroscientific research are finding their way into UK health and social policy discourse. Critical scholars have begun to analyse how policies tend to 'misuse' the neurosciences and, further, how these discourses produce unwarranted and individualizing effects, rooted in middle-class values and inducing guilt and anxiety. In this article, we extend such work while simultaneously departing from the normative assumptions implied in the concept of 'misuse'. Through a documentary analysis of UK policy reports focused on the early years, adolescence and older adults, we examine how these employ neuroscientific concepts and consequently (re)define responsibility. In the documents analysed, responsibility was produced in three different but intersecting ways: through a focus on optimisation, self-governance, and vulnerability. Our work thereby adds to social scientific examinations of neuroscience in society that show how neurobiological terms and concepts can be used to construct and support a particular imaginary of citizenship and the role of the state. Neuroscience may be leveraged by policy makers in ways that (potentially) reduce the target of their intervention to the soma, but do so in order to expand the outcome of the intervention to include the enhancement of society writ large. By attending as well to more critical engagements with neuroscience in policy documents, our analysis demonstrates the importance of being mindful of the limits to the deployment of a neurobiological idiom within policy settings. Accordingly, we contribute to increased empirical specificity concerning the impacts and translation of neuroscientific knowledge in contemporary society whilst refusing to take for granted the idea that the neurosciences necessarily have a dominant role (to play). PMID:25792340

  3. The Importance of the Medical Record: A Critical Professional Responsibility.

    PubMed

    Ngo, Elizabeth; Patel, Nachiket; Chandrasekaran, Krishnaswamy; Tajik, A Jamil; Paterick, Timothy E

    2016-01-01

    Comprehensive, detailed documentation in the medical record is critical to patient care and to a physician when allegations of negligence arise. Physicians, therefore, would be prudent to have a clear understanding of this documentation. It is important to understand who is responsible for documentation, what is important to document, when to document, and how to document. Additionally, it should be understood who owns the medical record, the significance of the transition to the electronic medical record, problems and pitfalls when using the electronic medical record, and how the Health Information Technology for Economic and Clinical Health Act affects healthcare providers and health information technology. PMID:27249883

  4. Numerical Modelling of Freshwater Flux and Temperature on the Northern British Columbia Coast in support of Marine Oil Spill Response

    NASA Astrophysics Data System (ADS)

    Bourdin, D. R.; Fleming, S. W.; Fortin, V.; Durnford, D. A.

    2014-12-01

    Canada has the longest coastline of any country (>120,000 miles). Canadian response to potential oil spills along its coast is being improved under a high-level federal government strategy, falling under the rubric of the World Class Tanker Safety System (WCTSS). The first component of this strategy focuses on the Kitimat area and its marine approaches on the northern British Columbia (BC) coast. This initiative reflects concerns around both existing ship traffic, and potential increases in tanker traffic associated with the proposed Northern Gateway pipeline. The project includes joint development, between multiple federal departments, of an operational modeling system to predict currents in the coastal ocean. One of Environment Canada's (EC) contributions is the development and implementation of a short-term forecast model of river flows with corresponding stream temperatures. These quantities influence currents in the coastal ocean, which in turn affect oil spill fate and transport. Our platform is based on the Surface Prediction System (SPS), which is essentially a driver for a land surface scheme (LSS) linked to a hydrological routing model, and is related to the earlier MESH platform. LSS's under consideration for use in this mountain rainforest environment are the Canadian Land Surface Scheme (CLASS), and the Soil and Vegetation Simulator (SVS), which is an evolution of the Interactions Soil-Biosphere-Atmosphere (ISBA) model. Runoff and drainage outputs are then routed through the stream network by WATROUTE. The River Basin Model (RBM), a physically-based stream temperature simulator, is also being integrated into SPS to additionally enable water temperature forecasting. The freshwater modelling system will be directly driven by EC's numerical weather prediction (NWP) systems.Preliminary results from this ambitious modeling program are presented, along with recommendations for improvements to physical process representation in the various models employed.

  5. Review on emergency medical response against terrorist attack.

    PubMed

    Wang, De-Wen; Liu, Yao; Jiang, Ming-Min

    2014-01-01

    Terrorism is a global issue and a constant international threat. As a result, anti-terrorism and emergency response strategies are tasks of critical importance that have a direct impact on the national security of every country in the world. This paper reviews new characteristics of international anti-terrorism measures and offers an in-depth reflection on emergency medical response countermeasures; additionally, this paper presents the goals of related research, which include: 1) to present a model of a highly efficient medical response command; 2) to introduce the pre-planning phases of the emergency medical response; 3) to establish a response system capable of handling various types of terror attacks; 4) to promote anti-terrorism awareness to the general public and emphasize its prevention; and 5) to continue basic investigations into emergency medical responses for various types of terrorist attacks (for example, the classifications and characteristics of new injuries, pathophysiology, prevention and treatment of the resultant stress disorders, improved high-efficiency medical response measures and equipment, etc.). PMID:25722867

  6. The lack of integration of clinical audit and the maintenance of medical dominance within British hospital trusts.

    PubMed

    McErlain-Burns, T L; Thomson, R

    1999-08-01

    Concerns have been expressed repeatedly about the effectiveness of clinical audit. Some have argued that this is limited by the lack of integration within day-to-day practice and with other NHS policy initiatives. We aimed to explore what mechanisms were being used to develop annual clinical audit programmes within NHS Trusts, and to describe the influence of other initiatives on this; to understand how such influences are exerted; and to understand the role of key players, in order to inform future programme development. Semi-structured face-to-face interviews were performed with Chairs of Clinical Audit Committees, Clinical Audit Managers and Co-ordinators (N = 15) in the former Yorkshire Region of the NHS in England. Concerns about the development, planning and integration of clinical audit focused upon an almost exclusive medical dominance and upon how audit leadership could be delivered within the context of hospital management structures. The lack of an overall plan for the development of clinical audit in most sites was seen as enabling the doctors' agenda to dominate. Purchasing authorities were recognized as being important, but often with limited influence. Other influences on the audit agenda, such as research and development (R&D) and clinical risk management, were rarely well co-ordinated. These findings concur with previous studies in identifying a wide range of constraints on the progress of audit. Several of these constraints operate within the internal environment, for example the doctors' agenda, and concerns about management involvement. Such constraints require resolution in order to facilitate the integration of audit with other initiatives and to achieve the goals of audit effectively. Clinical effectiveness and clinical governance may offer a means of facilitating this integration. PMID:10461584

  7. Creating a state medical response system for medical disaster management: the North Carolina experience.

    PubMed

    Kearns, Randy D; Skarote, Mary Beth; Peterson, Jeff; Hubble, Michael W; Winslow, James E

    2014-09-01

    The purpose of this work was to examine the creation and evolution of the North Carolina state medical response system (SMRS). During the past 30 years, states and local communities have developed a somewhat incongruent patchwork of medical disaster response systems. Several local or regional programs participated in the National Disaster Medical System; however, aside from the Disaster Medical Assistance Teams, most of these local resources lacked national standards and national direction. The September 11, 2001 terrorist attacks in Washington, DC and New York, and the anthrax-laced letters mailed to prominent individuals in the US media and others (bioterrorism) in the months that followed were tragic, but they served as both a tipping point and a unifying factor to drive preparedness activities on a national level. Each state responded to the September 11, 2001 attacks by escalating planning and preparedness efforts for a medical disaster response. The North Carolina SMRS was created based on the overall national direction and was tailored to meet local needs such as hurricane response. This article reviews the accomplishments to date and examines future aims. From regional medical response teams to specialty programs such as ambulance strike teams, burn surge planning, electronic inventory and tracking systems, and mobile pharmacy resources, the North Carolina SMRS has emerged as a national leader. Each regional coalition, working with state leadership, has developed resources and has used those resources while responding to disasters in North Carolina. The program is an example of how national leadership can work with state and local agencies to develop a comprehensive and effective medical disaster response system. PMID:25188616

  8. Wireless Internet Information System for Medical Response in Disasters (WIISARD)

    PubMed Central

    Lenert, Leslie; Chan, Theodore C.; Griswold, William; Killeen, James; Palmer, Douglas; Kirsh, David; Mishra, Rajesh; Rao, Ramesh

    2006-01-01

    The Wireless Internet Information System for Medical Response in Disasters (WIISARD) explores the use of scalable wireless networks to facilitate medical care at the site of a disaster. The focus of the project is care of victims of industrial accidents or terrorist attacks with traumatic injuries complicated by chemical, biological or radiological contamination. We report on developments of new architectures for mesh networks, RFID tracking and telemetry, mobile collaborative work, and command and control informed by deployments in large-scale exercises with the San Diego Regional Metropolitan Medical Strike Team.

  9. The Canadian Armed Forces medical response to Typhoon Haiyan

    PubMed Central

    Savage, LCol Erin; Christian, Maj Michael D.; Smith, Maj Stephanie; Pannell, Capt Dylan

    2015-01-01

    Background In the setting of international disaster response, an important challenge is determining when it is appropriate to withdraw deployed assets as the acute disaster response transitions to recovery and rebuilding. We describe our experience with real-time data collection during our medical response to Typhoon Haiyan as a means to guide military aid mission parameters. Methods The operational medical headquarters prospectively developed a database for use in this mission. Mobile medical teams (MMTs) were deployed to provide primary care, and the nurse designated to each MMT was responsible for entering and transmitting data daily to the medical headquarters. Data collected included the MMT location, basic patient demographics, the primary reason for the encounter and any treatment provided. These encounters were then classified as disaster, acute or chronic. Results Between Nov. 16 and Dec. 16, 2013, medical care was provided to 6596 local nationals; 238 (3.6%) had disaster-related illness or injury, 4321 (65.5%) had acute postdisaster medical conditions and 2037 (30.9%) sought medical care for chronic conditions. Of the 257 patients with traumatic injuries, 28 (11%) had disaster-related injuries and 214 (83%) had acute injuries that occurred postdisaster. Conclusion The data collected during the mission to the Philippines was compiled with performance metrics from the other Disaster Assistance Response Team components to help advise the Canadian government regarding mission duration. We recommended that data collection continue on all future missions and be modified to provide further information to larger disaster coordination teams, such as the United Nations Office for the Coordination of Humanitarian Affairs. PMID:26100775

  10. British Communicator Occupations.

    ERIC Educational Resources Information Center

    Tunstall, Jeremy

    Occupations and organizations within the British press and broadcasting systems are examined in this paper. Its sections summarize recent British research on media communicators and discuss characteristics of craft unions and other media organizations; the historical development of the British press; the British Broadcasting Corporation (BBC) and…

  11. The educational attributes and responsibilities of effective medical educators.

    PubMed

    Hatem, Charles J; Searle, Nancy S; Gunderman, Richard; Krane, N Kevin; Perkowski, Linda; Schutze, Gordon E; Steinert, Yvonne

    2011-04-01

    Of the many roles that the academic-educator may fulfill, that of teacher is particularly challenging. Building on prior recommendations from the literature, this article identifies the skill set of teachers across the medical education continuum-characteristics of attitude and attributes, knowledge, and pedagogic skills that permit effective teaching to be linked with effective learning and understanding. This examination which characterizes teachers' attitudes, knowledge, and skills serves to reemphasize the centrality of teaching within medical education, provides direction for faculty and institutions alike in the discharge of academic responsibilities, and makes educational accountability clear. This listing of teacher attitudes and responsibilities was vetted in 2009 by medical education leaders from across North America during a national conference on faculty development.A set of recommendations concerning faculty development issues for medical teachers is offered. The recommendations are intended to establish an academic culture in medical education that values and rewards-academically and fiscally-those centrally committed to the role of teacher. The challenges of defining skills, developing and funding programs, and ongoing evaluation must be faced to achieve success in teaching throughout medical education, now and in the future. Faculty members, fellow learners, and patients deserve no less. PMID:21346510

  12. Addressing social responsibility in medical education: the African way.

    PubMed

    Kwizera, Enoch N; Iputo, Jehu E

    2011-01-01

    Indigenous sub-Saharan societies have, over the millennia, lived and socialised within the unwritten 'rules' of the 'Ubuntu' or similar philosophies that emphasises holistic 'humanness', and which is a form of 'social responsibility'. This article looks into some relevant social responsibility aspects of medical education in the South African context, with particular emphasis on how these aspects have been addressed. Apartheid was, by its very nature, incompatible with social responsibility for the majority of South Africans, but one medical school that was a non-complicit product of apartheid succeeded in fulfilling a socially responsible mission. Thus, this article implicitly identifies what South Africa, Africa and the global Health Professions Education community could learn from these trail-blazing experiences. PMID:21774652

  13. MEDIC: An Approach to Student Responsibility in Drug Usage

    ERIC Educational Resources Information Center

    Coppoc, Gordon L.; Stuckey, William J.

    1977-01-01

    The Minimum Essential Drug Information Checklist (MEDIC) was designed at Purdue University in response to a need for more structure in the approach to drug education in veterinary medicine. It covers: therapeutic goal, routes given, dose form, dose interval, duration of therapy, withdrawal time, cost, precautions, reactions, antidote, and therapy…

  14. Continuing Veterinary Medical Education: Responsibilities, Support and Rewards

    ERIC Educational Resources Information Center

    Gage, E. Dean; And Others

    1978-01-01

    The Advanced Studies Committee of the Association of American Veterinary Medical Colleges addresses these questions: What are the responsibilities of the school of veterinary science department in continuing education? How should continuing education be funded? What are the appropriate mechanisms for recognizing or rewarding faculty participation…

  15. Medical errors; causes, consequences, emotional response and resulting behavioral change

    PubMed Central

    Bari, Attia; Khan, Rehan Ahmed; Rathore, Ahsan Waheed

    2016-01-01

    Objective: To determine the causes of medical errors, the emotional and behavioral response of pediatric medicine residents to their medical errors and to determine their behavior change affecting their future training. Methods: One hundred thirty postgraduate residents were included in the study. Residents were asked to complete questionnaire about their errors and responses to their errors in three domains: emotional response, learning behavior and disclosure of the error. The names of the participants were kept confidential. Data was analyzed using SPSS version 20. Results: A total of 130 residents were included. Majority 128(98.5%) of these described some form of error. Serious errors that occurred were 24(19%), 63(48%) minor, 24(19%) near misses,2(2%) never encountered an error and 17(12%) did not mention type of error but mentioned causes and consequences. Only 73(57%) residents disclosed medical errors to their senior physician but disclosure to patient’s family was negligible 15(11%). Fatigue due to long duty hours 85(65%), inadequate experience 66(52%), inadequate supervision 58(48%) and complex case 58(45%) were common causes of medical errors. Negative emotions were common and were significantly associated with lack of knowledge (p=0.001), missing warning signs (p=<0.001), not seeking advice (p=0.003) and procedural complications (p=0.001). Medical errors had significant impact on resident’s behavior; 119(93%) residents became more careful, increased advice seeking from seniors 109(86%) and 109(86%) started paying more attention to details. Intrinsic causes of errors were significantly associated with increased information seeking behavior and vigilance (p=0.003) and (p=0.01) respectively. Conclusion: Medical errors committed by residents have inadequate disclosure to senior physicians and result in negative emotions but there was positive change in their behavior, which resulted in improvement in their future training and patient care. PMID:27375682

  16. Transplant ethics under scrutiny - responsibilities of all medical professionals.

    PubMed

    Trey, Torsten; Caplan, Arthur L; Lavee, Jacob

    2013-02-01

    In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices. PMID:23444249

  17. Transplant ethics under scrutiny – responsibilities of all medical professionals

    PubMed Central

    Trey, Torsten; Caplan, Arthur L.; Lavee, Jacob

    2013-01-01

    In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices. PMID:23444249

  18. Offloading social care responsibilities: recent experiences of local voluntary organisations in a remote urban centre in British Columbia, Canada.

    PubMed

    Hanlon, Neil; Rosenberg, Mark; Clasby, Rachael

    2007-07-01

    Services offered by voluntary organisations are an integral but often overlooked component of health and social care. Of late, there has been a renewed interest in voluntary welfare provision as a viable alternative to state and market. Recent developments in welfare provision in Canada appear to have brought greater social care roles for the voluntary sector at the same time as new and arguably more restrictive funding and accountability mechanisms are being imposed by different arms of the state. To explore these issues more closely, the present paper examines the impressions and experiences of voluntary and formal sector providers of services for senior citizens and people with disabilities in a remote urban centre (population less than 100 000) in the interior of British Columbia, Canada. Two important operational pressures provide the context of the analysis: (1) reform of provincial government funding and regulation of voluntary services; and (2) the restructuring of welfare provision, especially in the areas of health care and social services. The authors found evidence of an escalating incursion of the state into local voluntary sector affairs that needs to be understood in the context of long-standing institutional links between government and 'professional' voluntary welfare provision in British Columbia. The results point to three important directions in contemporary local voluntary provision: (1) an emerging ethos of accountability, efficiency and competition in voluntary provision; (2) increasing pressure to centralise volunteer services; and consequently, (3) the potential erosion of flexibility and personalisation that are seen to characterise the voluntary sector. PMID:17578395

  19. Civilian exposure to toxic agents: emergency medical response.

    PubMed

    Baker, David

    2004-01-01

    Civilian populations are at risk from exposure to toxic materials as a result of accidental or deliberate exposure. In addition to industrial hazards, toxic agents designed for use in warfare now are a potential hazard in everyday life through terrorist action. Civil emergency medical responders should be able to adapt their plans for dealing with casualties from hazardous materials (HazMat) to deal with the new threat. Chemical and biological warfare (CBW) and HazMat agents can be viewed as a continuous spectrum. Each of these hazards is characterized by qualities of toxicity, latency of action, persistency, and transmissibility. The incident and medical responses to release of any agent is determined by these characteristics. Chemical and biological wardare agents usually are classified as weapons of mass destruction, but strictly, they are agents of mass injury. The relationship between mass injury and major loss of life depends very much on the protection, organization, and emergency care provided. Detection of a civil toxic agent release where signs and symptoms in casualties may be the first indicator of exposure is different from the military situation where intelligence information and tuned detection systems generally will be available. It is important that emergency medical care should be given in the context of a specific action plan. Within an organized and protected perimeter, triage and decontamination (if the agent is persistent) can proceed while emergency medical care is provided at the same time. The provision of advanced life support (TOXALS) in this zone by protected and trained medical responders now is technically feasible using specially designed ventilation equipment. Leaving life support until after decontamination may have fatal consequences. Casualties from terrorist attacks also may suffer physical as well as toxic trauma and the medical response also should be capable of dealing with mixed injuries. PMID:15506255

  20. Measuring the social responsiveness of medical schools: setting the standards.

    PubMed

    Peabody, J W

    1999-08-01

    This article calls for medical schools to use a new set of standards to gauge how well they contribute to social welfare. Because medical schools receive public funding and are given the authority to certify that providers are sufficiently trained, they incur an obligation to be socially responsible. In addition to setting and using higher standards, medical schools should call on their credibility and use their scientific expertise to find new policies that promote social welfare. In particular, they should do research on socially oriented policies and participate more actively in debates about health sector reform. Although societies vary and have different values, most countries and peoples probably share the following social objectives: They want to use limited public and private resources rationally to produce the best possible health, they do not want individuals or groups to suffer, and they want to protect people against catastrophic illness and associated financial losses. Although new standards are needed, medical schools should be encouraged to continue producing technically sophisticated providers and conducting high-level basic and clinical research. Available evidence suggests that medical schools can further contribute to the three social objectives noted above by increasing the intensity and relevancy of primary care training, expanding the curriculum beyond its biomedical focus, encouraging research in health services, and assessing the effectiveness of social policy in improving the health of the population. PMID:10495745

  1. The emergency medical response to the Cantara hazardous materials incident.

    PubMed

    Koehler, G A; Van Ness, C

    1993-01-01

    On 14 July 1991, at 2150 h, a train derailment occurred near the Cantara rail curve about six miles above Dunsmuir in Northern California. The derailment spilled approximately 19,000 gallons of metam-sodium into the Sacramento River. When mixed with water, metam-sodium degrades to methylisothiocyanate (MITC) and other gases. The contaminated river water passed the town of Dunsmuir and other occupied areas exposing residents to MITC gas. From 15 July to 20 July (five days), a total of 360 people underwent triage. The majority of patients displayed minor exposure symptoms that did not require hospital care. Mercy Mt. Shasta Hospital, a small rural hospital close to Dunsmuir, received the majority of patients. As of 29 July, 15 days after the incident, Mercy Mt. Shasta Hospital had seen 244 exposed patients in its emergency department, and had admitted five. Three had symptoms that could have been spill-related. Three Regional Poison Control Centers provided medical toxicology advice. Medical management of the emergency medical services (EMS) response to the event was piecemeal and weak. There did not appear to be a medical operations component at local Emergency Operations Centers (EOC). Most health care personnel interviewed complained about inadequate information about the substance and the situation. Local fire service mutual-aid agreements to obtain additional fire service and ambulance personnel worked well. It is important to emphasize that everyone who believed they had been exposed to the chemical underwent triage and received appropriate acute medical care. PMID:10155481

  2. Best of British: British Information Online.

    ERIC Educational Resources Information Center

    Ojala, Marydee

    1988-01-01

    Discusses the importance of British databases and information services to U.S. business searchers and describes several British databases and services. Topics covered include database contents, available search strategies, access from the United States, language differences, and dating problems. A directory of contacts is provided. (six…

  3. British Sign Name Customs

    ERIC Educational Resources Information Center

    Day, Linda; Sutton-Spence, Rachel

    2010-01-01

    Research presented here describes the sign names and the customs of name allocation within the British Deaf community. While some aspects of British Sign Language sign names and British Deaf naming customs differ from those in most Western societies, there are many similarities. There are also similarities with other societies outside the more…

  4. Prevalence and response to antiretroviral therapy of non-B subtypes of HIV in antiretroviral-naive individuals in British Columbia.

    PubMed

    Alexander, Christopher S; Montessori, Valentina; Wynhoven, Brian; Dong, Winnie; Chan, Keith; O'Shaughnessy, Michael V; Mo, Theresa; Piaseczny, Magda; Montaner, Julio S G; Harrigan, P Richard

    2002-03-01

    In North America, the B subtype of the major group (M) of HIV-1 predominates. Phylogenetic analysis of HIV reverse transcriptase and protease sequences isolated from 479 therapy-naive patients, first seeking treatment in British Columbia between June 1997 and August 1998, revealed a prevalence of 4.4% non-B virus. A range of different subtypes was identified, including one subtype A, 11 C, two D, five CRF01_AE, and one sample that could not be reliably subtyped. Baseline CD4 courts were significantly lower in individuals harbouring the non-B subtypes (P = 0.02), but baseline viral loads were similar (P = 0.80). In this study, individuals infected with non-B variants did not have a significantly different virological response to therapy after up to 18 months. PMID:12008785

  5. The medical ethos and social responsibility in clinical medicine.

    PubMed Central

    Francis, C. K.

    2001-01-01

    The medical profession will face many challenges in the new millennium. As medicine looks forward to advances in molecular genetics and the prospect of unprecedented understanding of the causes and cures of human disease, clinicians, scientists and bioethicists may benefit from reflection upon the origins of the medical ethos and its relevance to postmodern medicine. Past distortions of the medical ethos, such as Nazism and the Tuskegee Syphilis Study, as well as more recent experience with the ethical challenges of employer-based market driven managed care, provide important lessons as medicine contemplates the future. Racial and ethnic disparities in health status and access to care serve as a reminders that the racial doctrines that fostered the horrors of the Holocaust and the Tuskegee Syphilis Study have not been completely removed from contemporary thinking. Inequalities in health status based on race and ethnicity, as well as socioeconomic status, attest to the inescapable reality of racism in America. When viewed against a background of historical distortions and disregard for the traditional tenets of the medical ethos, persistent racial and ethnic disparities and health and the prospect of genetic engineering raise the specter of discrimination because of genotype, a postmodern version of "racist medicine" or of a "new eugenics." There is a need to balance medicine's devotion to the wellbeing of the patient and the primacy of the patient-physician relationship against with the need to meet the health care needs of society. The challenge facing the medical profession in the new millennium is to establish an equilibrium between the responsibility to assure quality health care for the individual patient while affecting societal changes to achieve "health for all." PMID:11405593

  6. A Comparative Analysis of the Influence of Surface Mining on Hydrological and Geochemical Response of Selected Headwater Streams in the Elk Valley, British Columbia, Canada.

    NASA Astrophysics Data System (ADS)

    Carey, S. K.; Shatilla, N. J.; Szmudrowska, B.; Rastelli, J.; Wellen, C.

    2014-12-01

    Surface mining is a common method of accessing coal. Blasting of overburden rock allows access to mineable ore. In high-elevation environments, the removed overburden rock is deposited in adjacent valleys as waste rock spoils. As part of a multi-year R&D program examining the influence of surface mining on watershed hydrological and water quality responses in the Elk Valley, British Columbia, this study reports on how surface mining affects streamflow hydrological and geochemical response at four reference and four mine-influenced catchments. The hydrology of this environment is dominated by snowmelt and steep topographic gradients. Flows were attenuated in mine-influenced catchments, with spring freshet delayed and more muted responses to precipitation events observed. Dissolved ions were an order of magnitude greater in mine-influenced streams, with more dilution-based responses to flows compared with chemostatic behavior observed in reference streams. Stable isotope signatures in stream water suggested that in both mine-influenced and reference watersheds, stream water was derived from well mixed groundwater as annual variability of stream isotope signatures was dampened compared with precipitation signatures. However, deflection of stream isotopes in response to precipitation were more apparent in reference watersheds. As a group, mine influenced catchments had a heavier isotope signature than reference watersheds, suggesting an enhanced influence of rainfall on recharge. Transit time distributions indicate existing waste rock spoils increase the average time water takes to move through the catchment.

  7. A small single-nozzle rainfall simulator to measure erosion response on different burn severities in southern British Columbia, Canada

    NASA Astrophysics Data System (ADS)

    Covert, Ashley; Jordan, Peter

    2010-05-01

    To study the effects of wildfire burn severity on runoff generation and soil erosion from high intensity rainfall, we constructed an effective yet simple rainfall simulator that was inexpensive, portable and easily operated by two people on steep, forested slopes in southern British Columbia, Canada. The entire apparatus, including simulator, pumps, hoses, collapsible water bladders and sample bottles, was designed to fit into a single full-sized pick-up truck. The three-legged simulator extended to approximately 3.3 metres above ground on steep slopes and used a single Spraying Systems 1/2HH-30WSQ nozzle which can easily be interchanged for other sized nozzles. Rainfall characteristics were measured using a digital camera which took images of the raindrops against a grid. Median drop size and velocity 5 cm above ground were measured and found to be 3/4 of the size of natural rain drops of that diameter class, and fell 7% faster than terminal velocity. The simulator was used for experiments on runoff and erosion on sites burned in 2007 by two wildfires in southern British Columbia. Simulations were repeated one and two years after the fires. Rainfall was simulated at an average rate of 67 mm hr-1 over a 1 m2 plot for 20 minutes. This rainfall rate is similar to the 100 year return period rainfall intensity for this duration at a nearby weather station. Simulations were conducted on five replicate 1 m2 plots in each experimental unit including high burn severity, moderate burn severity, unburned, and unburned with forest floor removed. During the simulation a sample was collected for 30 seconds every minute, with two additional samples until runoff ceased, resulting in 22 samples per simulation. Runoff, overland flow coefficient, infiltration and sediment yield were compared between treatments. Additional simulations were conducted immediately after a 2009 wildfire to test different mulch treatments. Typical results showed that runoff on plots with high burn

  8. Fly-By medical care: Conceptualizing the global and local social responsibilities of medical tourists and physician voluntourists

    PubMed Central

    2011-01-01

    Background Medical tourism is a global health practice where patients travel abroad to receive health care. Voluntourism is a practice where physicians travel abroad to deliver health care. Both of these practices often entail travel from high income to low and middle income countries and both have been associated with possible negative impacts. In this paper, we explore the social responsibilities of medical tourists and voluntourists to identify commonalities and distinctions that can be used to develop a wider understanding of social responsibility in global health care practices. Discussion Social responsibility is a responsibility to promote the welfare of the communities to which one belongs or with which one interacts. Physicians stress their social responsibility to care for the welfare of their patients and their domestic communities. When physicians choose to travel to another county to provide medical care, this social responsibility is expanded to this new community. Patients too have a social responsibility to use their community's health resources efficiently and to promote the health of their community. When these patients choose to go abroad to receive medical care, this social responsibility applies to the new community as well. While voluntourists and medical tourists both see the scope of their social responsibilities expand by engaging in these global practices, the social responsibilities of physician voluntourists are much better defined than those of medical tourists. Guidelines for engaging in ethical voluntourism and training for voluntourists still need better development, but medical tourism as a practice should follow the lead of voluntourism by developing clearer norms for ethical medical tourism. Summary Much can be learned by examining the social responsibilities of medical tourists and voluntourists when they engage in global health practices. While each group needs better guidance for engaging in responsible forms of these practices

  9. Sexual harassment in the medical profession: legal and ethical responsibilities.

    PubMed

    Mathews, Ben; Bismark, Marie M

    2015-08-17

    Sexual harassment of women in medicine has become a subject of national debate after a senior female surgeon stated that if a woman complained of unwanted advances her career would be jeopardised, and subsequent reports suggest that sexual harassment is a serious problem in the medical profession. Sexual harassment of women in the medical profession by their colleagues presents substantial legal, ethical and cultural questions for the profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and employers face significant legal consequences for sexual harassment in every Australian state and territory, and individual medical practitioners and employers need to understand their legal and ethical rights and responsibilities in this context. An individual offender may be personally liable for criminal offences, and for breaching anti-discrimination legislation, duties owed in civil law, professional standards and codes of conduct. An employer may be liable for breaching anti-discrimination legislation, workplace safety laws, duties owed in contract law, and a duty of care owed to the employee. Employers, professional colleges and associations, and regulators should use this national debate as an opportunity to improve gender equality and professional culture in medicine; individuals and employers have clear legal and ethical obligations to minimise sexual harassment to the greatest extent possible. PMID:26268291

  10. An academic medical center's response to widespread computer failure.

    PubMed

    Genes, Nicholas; Chary, Michael; Chason, Kevin W

    2013-01-01

    As hospitals incorporate information technology (IT), their operations become increasingly vulnerable to technological breakdowns and attacks. Proper emergency management and business continuity planning require an approach to identify, mitigate, and work through IT downtime. Hospitals can prepare for these disasters by reviewing case studies. This case study details the disruption of computer operations at Mount Sinai Medical Center (MSMC), an urban academic teaching hospital. The events, and MSMC's response, are narrated and the impact on hospital operations is analyzed. MSMC's disaster management strategy prevented computer failure from compromising patient care, although walkouts and time-to-disposition in the emergency department (ED) notably increased. This incident highlights the importance of disaster preparedness and mitigation. It also demonstrates the value of using operational data to evaluate hospital responses to disasters. Quantifying normal hospital functions, just as with a patient's vital signs, may help quantitatively evaluate and improve disaster management and business continuity planning. PMID:24352930

  11. Orthopedic medical devices: ethical questions, implant recalls and responsibility.

    PubMed

    Racine, Jennifer

    2013-06-01

    The hip replacement is a surgical procedure to replace the femoral head and acetabulum with prosthetic implants to improve function, increase mobility, and relieve pain caused by damage from disorders such as osteoarthritis and fractures. In recent years, we have seen several recalls of poorly functioning implant systems, most recently, the Johnson and Johnson (J&J) Articular Surface Replacement device. Product recalls are often the results of premature failure of implants requiring additional surgery to exchange the failed device. This raises many questions - technical, medical, regulatory, ethical, and legal - that ultimately put patients at risk, compromise confidence in medicine and regulatory agencies, and important relationships including those between the physician-patient and physician-industry. Where do the responsibilities lie for the patients' suffering, morbidity, and costs of removing the failed device? This article discusses the current recall of the J&J implant, the responsibilities of the manufacturer, surgeons, and the regulatory agency. PMID:23741723

  12. Recurrent hypersomnia: Report of medication-responsive cases

    PubMed Central

    Perin, Bruna V.; Rodrigues, Iorrana; Giasson, Franciele T.B.; Balen, Matheus; Posenato, Naiana; Forcelini, Cassiano M.

    2015-01-01

    Introduction Recurrent hypersomnia (RH) is a rare disorder without established treatment. Methods We report 2 RH medication-responsive cases with typical characteristics of Kleine–Levin syndrome (KLS). Case-reports A 10 y.o. girl and a 14 y.o. boy presented with sudden sleepiness for 3–9 days (every 2–3 weeks). Physical examination, brain images and blood tests were normal. Polysomnographic findings were heterogenous, including disrupted sleep architecture. MSLTs revealed 2–3 SOREMPs and short sleep latency. Carbamazepine rendered girl׳s sleep normalization, while risperidone normalized boy׳s sleep cycles. Conclusions Facing the absence of clinical trials in RH, reports of responsive cases are the available therapeutic evidence. PMID:26483951

  13. Divisions and diversity: the complexities of medical refuge in Britain, 1933-1948.

    PubMed

    Decker, Karola

    2003-01-01

    The experiences of medical refugees who came to the United Kingdom from Nazi Germany and occupied Europe in the 1930s and 1940s reflect the general characteristics of the British response to the refugee crisis. This article analyzes the role of the British medical establishment and its interplay with the government and refugee aid organizations. Processes of decision making and changes of policy are revealed, drawing on the files of the "Aliens Committee" at the archive of the British Medical Association, on the private collection of Yvonne Kapp, former administrative head of the Medical Department of the Central Office for Refugees, and on the medical subseries of the archive of the Society for the Protection of Science and Learning. "Divisions" refer to differing interests and attitudes of the institutions, organizations and individuals involved; "diversity" reflects the response to the various nationalities of medical refugees, mainly German, Austrian, Czech, and Polish. PMID:14657586

  14. Problem Gambling Treatment within the British National Health Service

    ERIC Educational Resources Information Center

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study examines the…

  15. Headwater Stream Temperature Response to Forest Harvesting in Coastal British Columbia, Canada: Influences of Riparian Buffer Width, Channel Morphology and Weather

    NASA Astrophysics Data System (ADS)

    Moore, R.; Gomi, T.; Dhakal, A.

    2003-12-01

    Forest harvesting can influence stream temperature regimes, and the potentially deleterious impacts of higher temperatures on salmonids and other species have generated significant debate. One common approach to protecting streams is to leave a riparian buffer to provide shade. However, little information has been collected on the effectiveness of different buffer widths. We report the results of a 6-year field experiment to evaluate the effects of different riparian buffer widths on stream and riparian ecosystems, including stream temperature response, in headwater streams in coastal British Columbia. The experiment included 13 streams, with at least three being assigned to each of four treatments, including no harvesting (80 yr-old second growth conifer riparian forest), clear-cut harvesting with 10 m and 30 m riparian buffers, and clear-cut harvesting with no buffer. Regression analysis was used to calibrate the pre-harvest data for each treatment stream with one of the control streams, to provide a basis for estimating post-harvest treatment effects. Autoregressive and heteroskedastic errors were included in the regression model, because stream temperature exhibited serial correlation and the error variance increased with stream temperature. Temperature response was substantial in the clearcut treatments with no buffers, with maximum temperatures increasing by up to 8 degrees C. The magnitude of temperature response amongst the no-buffer treatments varied with channel morphology, particularly in relation to bank shading and stream depth. The treatment effect for daily maximum water temperature increased with decreasing flow and increasing maximum air temperature on the current day, and also exhibited significant autocorrelation, indicating that the sequence of daily weather conditions can influence the magnitude of temperature response.

  16. Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

    PubMed Central

    2013-01-01

    , future research implications should include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry. PMID:24314027

  17. Ebola Virus Disease: Ethics and Emergency Medical Response Policy.

    PubMed

    Jecker, Nancy S; Dudzinski, Denise M; Diekema, Douglas S; Tonelli, Mark

    2015-09-01

    Caring for patients affected with Ebola virus disease (EVD) while simultaneously preventing EVD transmission represents a central ethical challenge of the EVD epidemic. To address this challenge, we propose a model policy for resuscitation and emergent procedure policy of patients with EVD and set forth ethical principles that lend support to this policy. The policy and principles we propose bear relevance beyond the EVD epidemic, offering guidance for the care of patients with other highly contagious, virulent, and lethal diseases. The policy establishes (1) a limited code status for patients with confirmed or suspected EVD. Limited code status means that a code blue will not be called for patients with confirmed or suspected EVD at any stage of the disease; however, properly protected providers (those already in full protective equipment) may initiate resuscitative efforts if, in their clinical assessment, these efforts are likely to benefit the patient. The policy also requires that (2) resuscitation not be attempted for patients with advanced EVD, as resuscitation would be medically futile; (3) providers caring for or having contact with patients with confirmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response; (5) patients with EVD and their proxies be involved in care discussions; and (6) care team and provider discretion guide the care of patients with EVD. We discuss ethical issues involving medical futility and the duty to avoid harm and propose a utilitarian-based principle of triage to address resource scarcity in the emergency setting. PMID:25855946

  18. Professional responsibility in maternity care: role of medical audit.

    PubMed

    Bhatt, R V

    1989-09-01

    In 1965, Baroda Medical College initiated a process of medical audit of maternal and perinatal deaths occurring at this institution, and consultation in peripheral medical facilities providing antenatal and obstetric care. By 1984 maternal and perinatal mortality had declined and clinical judgment in maternity care had improved. PMID:2572472

  19. Migrant labour, racism and the British National Health Service.

    PubMed

    Kyriakides, Christopher; Virdee, Satnam

    2003-11-01

    This study explores the dynamics of racism, specifically its generation and reproduction as an ideology, and its role in affecting the reception and occupational location of migrant medical labour in Britain. It is argued that the treatment of 'overseas doctors' in Britain draws on a complex interplay between racism and nationalism underpinned by the historical construction of 'welfarism' as a moral legitimator of 'Britishness'. Through an exploration of internal and external immigration controls introduced with the aim of regulating migrant labour, we demonstrate how British social policy and elite discourses of 'race' combine to construct moral prescriptions of threat such that migrants and British-born 'non-whites' entering the British medical profession are forced to negotiate 'saviour/pariah' ascriptions indicative of discriminatory but contradictory processes specific to the operation of the British National Health Service as a normative institution. PMID:14660122

  20. For British eyes only

    SciTech Connect

    Rothstein, L.

    1993-04-01

    Americans are learning about the history of their own nuclear weapons program from British documents released under the 30-year rule. In January, the British government released papers related to the 1958-61 U.S.-Soviet moratorium on nuclear testing and the resumption of U.S. testing in 1962. According to Solly Zuckerman, chief scientific advisor to the British Defense Ministry at the time, the United Kingdom had not appreciated that the nuclear weapons experts of the U.S. and U.S.S.R. used the two-and-a-half-year moratorium to plan the largest program of tests these countries carried out.

  1. The gene responsible for X-linked cleft palate (CPX) in a British Columbia native kindred is localized between PGK1 and DXYS1.

    PubMed

    Gorski, S M; Adams, K J; Birch, P H; Friedman, J M; Goodfellow, P J

    1992-05-01

    Human craniofacial malformations are a class of common congenital anomalies in which the etiology is heterogeneous and often poorly understood. To better delineate the molecular basis of craniofacial development, we have undertaken a series of experiments directed toward the isolation of a gene involved in human secondary palate formation. DNA marker linkage studies have been performed in a large British Columbia (B.C.) Native family in which cleft palate segregates as an X-linked trait. We have examined 62 family members, including 15 affected males and 8 obligate carrier females. A previous clinical description of the clefting defect in this kindred included submucous cleft palate and bifid or absent uvula. Our recent reevaluation of the family has indicated that ankyloglossia (tongue-tie) is also a feature of X-linked cleft palate in some of the affected males and carrier females. Ankyloglossia has previously been associated with X-linked cleft palate in an Icelandic kindred in which a gene responsible for cleft palate (CPX) was assigned to the Xq21.3-q22 region between DXYS12 and DXS17. For the B.C. kindred reported here, we have mapped the gene responsible for cleft palate and/or ankyloglossia to a more proximal position on the X chromosome. No recombination was observed between B.C. CPX and the DNA marker DXS72 (peak lod score [Zmax] = 7.44 at recombination fraction [theta] = .0) localized to Xq21.1. Recombination was observed between CPX and PGK1 (Zmax = 7.35 at theta = .03) and between CPX and DXYS1 (Zmax = 5.59 at theta = .04). These recombination events localize B.C. CPX between PGK1 and DXYS1 in the Xq13-q21.31 region. PMID:1570839

  2. Two Species with an Unusual Combination of Traits Dominate Responses of British Grasshoppers and Crickets to Environmental Change.

    PubMed

    Beckmann, Björn C; Purse, Bethan V; Roy, David B; Roy, Helen E; Sutton, Peter G; Thomas, Chris D

    2015-01-01

    There are large variations in the responses of species to the environmental changes of recent decades, heightening interest in whether their traits may explain inter-specific differences in range expansions and contractions. Using a long-term distributional dataset, we calculated range changes of grasshoppers and crickets in Britain between the 1980s and the 2000s and assessed whether their traits (resource use, life history, dispersal ability, geographic location) explain relative performance of different species. Our analysis showed large changes in the distributions of some species, and we found a positive relationship between three traits and range change: ranges tended to increase for habitat generalists, species that oviposit in the vegetation above ground, and for those with a southerly distribution. These findings accord well with the nature of environmental changes over this period (climatic warming; reductions in the diversity and increases in the height of vegetation). However, the trait effects applied mainly to just two species, Conocephalus discolor and Metrioptera roeselii, which had shown the greatest range increases. Once they were omitted from the analysis, trait effects were no longer statistically significant. Previous studies on these two species emphasised wing-length dimorphism as the key to their success, resulting in a high phenotypic plasticity of dispersal and evolutionary-ecological feedback at their expanding range margins. This, combined with our results, suggests that an unusual combination of traits have enabled these two species to undertake extremely rapid responses to recent environmental changes. The fact that our results are dominated by two species only became apparent through cautious testing of the results' robustness, not through standard statistical checks. We conclude that trait-based analyses may contribute to the assessment of species responses to environmental change and provide insights into underlying mechanisms, but

  3. Two Species with an Unusual Combination of Traits Dominate Responses of British Grasshoppers and Crickets to Environmental Change

    PubMed Central

    Beckmann, Björn C.; Purse, Bethan V.; Roy, David B.; Roy, Helen E.; Sutton, Peter G.; Thomas, Chris D.

    2015-01-01

    There are large variations in the responses of species to the environmental changes of recent decades, heightening interest in whether their traits may explain inter-specific differences in range expansions and contractions. Using a long-term distributional dataset, we calculated range changes of grasshoppers and crickets in Britain between the 1980s and the 2000s and assessed whether their traits (resource use, life history, dispersal ability, geographic location) explain relative performance of different species. Our analysis showed large changes in the distributions of some species, and we found a positive relationship between three traits and range change: ranges tended to increase for habitat generalists, species that oviposit in the vegetation above ground, and for those with a southerly distribution. These findings accord well with the nature of environmental changes over this period (climatic warming; reductions in the diversity and increases in the height of vegetation). However, the trait effects applied mainly to just two species, Conocephalus discolor and Metrioptera roeselii, which had shown the greatest range increases. Once they were omitted from the analysis, trait effects were no longer statistically significant. Previous studies on these two species emphasised wing-length dimorphism as the key to their success, resulting in a high phenotypic plasticity of dispersal and evolutionary-ecological feedback at their expanding range margins. This, combined with our results, suggests that an unusual combination of traits have enabled these two species to undertake extremely rapid responses to recent environmental changes. The fact that our results are dominated by two species only became apparent through cautious testing of the results’ robustness, not through standard statistical checks. We conclude that trait-based analyses may contribute to the assessment of species responses to environmental change and provide insights into underlying mechanisms

  4. The 2012 derecho: emergency medical services and hospital response.

    PubMed

    Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B

    2014-10-01

    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications. PMID:25231139

  5. No Time for Nostalgia!: Asylum-Making, Medicalized Colonialism in British Columbia (1859-97) and Artistic Praxis for Social Transformation

    ERIC Educational Resources Information Center

    Roman, Leslie G.; Brown, Sheena; Noble, Steven; Wainer, Rafael; Young, Alannah Earl

    2009-01-01

    This article asks: How have disability, indigenous arts and cultural praxis transformed and challenged the historical sociological archival research into relationships among asylum-making, medicalized colonialism and eugenics in the Woodlands School, formerly the Victoria Lunatic Asylum, the Provincial Asylum for the Insane in Victoria, BC 1859-72…

  6. Standards for British Libraries.

    ERIC Educational Resources Information Center

    Vaughan, Anthony

    1982-01-01

    Reviews developments in British library standards since 1971, highlighting types of standards, public libraries, academic libraries (university, polytechnic, college), school libraries, and special libraries (hospital and health sciences, prison, subject specializations). Thirty-nine references are cited. (EJS)

  7. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... responsible for the delivery of patient care and outcomes in the facility. The medical director is accountable to the governing body for the quality of medical care provided to patients. Medical director... admissions, patient care, infection control, and safety are adhered to by all individuals who treat...

  8. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... responsible for the delivery of patient care and outcomes in the facility. The medical director is accountable to the governing body for the quality of medical care provided to patients. Medical director... admissions, patient care, infection control, and safety are adhered to by all individuals who treat...

  9. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... responsible for the delivery of patient care and outcomes in the facility. The medical director is accountable to the governing body for the quality of medical care provided to patients. Medical director... admissions, patient care, infection control, and safety are adhered to by all individuals who treat...

  10. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... responsible for the delivery of patient care and outcomes in the facility. The medical director is accountable to the governing body for the quality of medical care provided to patients. Medical director... admissions, patient care, infection control, and safety are adhered to by all individuals who treat...

  11. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... responsible for the delivery of patient care and outcomes in the facility. The medical director is accountable to the governing body for the quality of medical care provided to patients. Medical director... admissions, patient care, infection control, and safety are adhered to by all individuals who treat...

  12. Responses of a macroinvertebrate community from a pristine, southern British Columbia, Canada, stream to metals in experimental mesocosms

    SciTech Connect

    Richardson, J.S.; Kiffney, P.M.

    2000-03-01

    Metal contamination is one of the most widespread impacts on surface waters. Experimental flumes receiving water and aquatic invertebrates from an undisturbed, forested stream were used to determine the impact of metals in a low-conductivity stream. The experimental flumes were exposed to a gradient of doses maintaining a constant ratio of metals (1995: Cu, Zn, Mn, and Pb; 1996: Cu and Zn) for 6 d. Benthos and emigration were sampled from each of the 16 troughs. The overall densities of benthos declined, but not significantly, as the dose of metals increased. On the basis of the slopes of the concentration-response curve, Baetis, Ameletus, and Paraleptophlebia were the most sensitive taxa present. Other taxa (e.g., Nemouridae and Oligochaeta) were mildly affected by high metal concentrations. Chironomidae showed no significant decrease in densities with increasing dose. Chironomids made up >80% of the benthos and is the primary reason for no significant dose effect on overall densities. No treatment effect was observed on either algal standing crop or bacterial respiration rates. The invertebrate genera most affected by exposure to metals in this study were also absent or rare in nearby urban streams with high metal concentrations.

  13. Moorgate tube train disaster. Part 1-Response of medical services.

    PubMed Central

    1975-01-01

    Experience of the medical staff at a major subterranean accident scene showed that there appeared to be a substantial advantage in using site medical teams that could offer anaesthetic facilities. The need for adequate communication from the accident site to the hospital is emphasized. Images FIG. 1 FIG. 2 PMID:1174871

  14. Medical Response to Radiological Accidents in Latin America and International Assistance.

    PubMed

    Reyes, Eduardo Herrera; Baciu, Florian; Benderitter, Marc; Lataillade, Jean Jacques; Bey, Eric; Trompier, Francois; Tamarat, Radia

    2016-04-01

    This article provides an overview of four radiological accidents in Latin America, and includes a history of the events, the clinical manifestations and health consequences for the exposed individuals, the medical response based on preclinical studies and the role of the International Atomic Energy Agency (IAEA) in coordinating medical response assistance. PMID:27018777

  15. Bach to the future: response to: Extending preimplantation genetic diagnosis: medical and non-medical uses.

    PubMed

    Ashcroft, R

    2003-08-01

    Professor Robertson sketches an elegant framework for policy evaluation and regulation of the use of preimplantation genetic diagnosis for various medical, medical related, and non-medical purposes. In criticism of his position, I argue that the distinction between policy and ethics upon which his argument relies is highly unstable, and the approach taken to ethical evaluation of particular parental interests leaves open many issues which the policy approach would hope to exclude. In conclusion I argue that while his position ultimately fails, the onus is on his critics to come up with a viable and satisfying alternative. PMID:12930853

  16. Psychological symptoms and medical responses in nineteenth-century India.

    PubMed

    Radhika, P; Murthy, Pratima; Sarin, Alok; Jain, Sanjeev

    2015-03-01

    The article documents medical approaches to mental illness in mid- to late-nineteenth-century India through examining the Indian Medical Gazette and other medical accounts. By the late nineteenth century, psychiatry in Europe moved from discussions around asylum-based care to a nuanced and informed debate about the nature of mental symptoms. This included ideas on phrenology and craniometry, biological and psycho-social causes, physical and drug treatments, many of which travelled to India. Simultaneously, indigenous socio-medical ideas were being debated. From the early to the mid-nineteenth century, not much distinction was made between the Western and the native 'mind', and consequently the diagnosis and investigation of mental symptoms did not differ. However, by the late nineteenth century Western medicine considered the 'Western mind' as more civilized and sophisticated than the 'native mind. PMID:25698688

  17. UK national audit against the key performance indicators in the British Association for Sexual Health and HIV Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

    PubMed

    McClean, H; Sullivan, A K; Carne, C A; Warwick, Z; Menon-Johansson, A; Clutterbuck, D

    2012-10-01

    A national audit of practice performance against the key performance indicators in the British Association for Sexual Health and HIV (BASHH) and HIV Medical Foundation for AIDS Sexual Health Standards for the Management of Sexually Transmitted Infections (STIs) was conducted in 2011. Approximately 60% and 8% of level 3 and level 2 services, respectively, participated. Excluding partner notification performance, the five lowest areas of performance for level 3 clinics were the STI/HIV risk assessment, care pathways linking care in level 2 clinics to local level 3 services, HIV test offer to patients with concern about STIs, information governance and receipt of chlamydial test results by clinicians within seven working days (the worst area of performance). The five lowest areas of performance for level 2 clinics were participating in audit, having an audit plan for the management of STIs for 2009-2010, the STI/HIV risk assessment, HIV test offer to patients with concern about STIs and information governance. The results are discussed with regard to the importance of adoption of the standards by commissioners of services because of their relevance to other national quality assurance drivers, and the need for development of a national system of STI management quality assurance measurement and reporting. PMID:23104750

  18. Chlamydial partner notification in the British Association for Sexual Health and HIV (BASHH) 2011 UK national audit against the BASHH Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

    PubMed

    McClean, H; Carne, C A; Sullivan, A K; Radcliffe, K W; Ahmed-Jushuf, I

    2012-10-01

    This paper reports on chlamydial partner notification (PN) performance in the 2011 BASHH national audit against the British Association for Sexual Health and HIV (BASHH) Medical Foundation for AIDS Sexual Health (MedFASH) Sexually Transmitted Infection Management Standards (STIMS). There was wide regional variation in level 3 clinic PN performance against the current standard of index case-reported chlamydial PN, with 43% (regional range 0-80%) of clinics outside London meeting the ≥0.6 contacts seen per index standard, and 85% of clinics (regional range 82-88%) in London meeting the ≥0.4 standard. For level 2 clinics, 39% (regional range 0-100%) of clinics outside London met the ≥0.6 standard, and 43% (regional range 40-50%) of clinics in London met the ≥0.4 standard. Performance for health-care worker (HCW)-verified contact attendance is also reported. New standards for each of these performance measures are proposed for all level 3 clinics: ≥0.6 contacts seen per index case based on index case report, and ≥0.4 contacts seen per index case based on HCW verification, both within four weeks of the first partner notification interview. The results are discussed with regard to the importance of adoption of standards by commissioners of services, relevance to national quality agendas, and the need for development of a national system of PN quality assurance measurement and reporting. PMID:23104751

  19. Where does medical education stand in nurturing the 3Rs in medical students: responsibility, resilience and resolve?

    PubMed

    Eley, Diann S; Stallman, Helen

    2014-10-01

    Over the past decade, the medical education literature has recognized the need to develop a culture that nurtures wellbeing and resilience in students. However, the introduction of or increase in student fees precipitated a shift in higher education policies toward a consumer model of education. Importantly, it has altered the expectations of students and promoted a sense of "entitlement", rather than "striving" for something where success is not guaranteed. This model is consistent with materialism and status, and removed from intrinsic goals that are associated with mental and physical wellbeing. This article challenges medical educators to reconsider the current context of student learning and realign it with the graduate attributes needed to be a competent and responsible medical practitioner by enabling students to develop the 3Rs of resilience, responsibility and resolve. We propose that brave decisions and actions must be made by medical educators to provide students with opportunities to learn independence, self-management, and self-regulation and guarantee their role in helping medical students become resilient and responsible doctors of tomorrow. PMID:25072531

  20. The Limits of Movement Politics: The Case of British Feminism.

    ERIC Educational Resources Information Center

    Stetson, Dorothy M.

    Analysis of the British feminist movement from 1850 to 1975 reveals a constant struggle by feminists for equality in the face of legal and social restrictions and a corresponding lack of response by the British government to movement demands. The political organization of the feminist movement is described in four phases. During the first phase,…

  1. Universities Under Financial Crisis: The Case of British Columbia.

    ERIC Educational Resources Information Center

    Dennison, John D.

    1987-01-01

    The consequences of the 1980-83 economic recession in Canada for the political climate in British Columbia and for the University of British Columbia are discussed. The University's response to budgetary cuts is placed in a provincial and national context, and the implications of reductions in public support for higher education are addressed.…

  2. Improving the Social Responsiveness of Medical Schools: Proceedings of the 1998 Educational Commission for Foreign Medical Graduates/World Health Organization Invitational Conference.

    ERIC Educational Resources Information Center

    Gary, Nancy E., Ed.; Boelen, Charles, Ed.; Gastel, Barbara, Ed.; Ayers, William, Ed.

    1999-01-01

    Proceedings of the conference on improving the social responsiveness of medical schools include papers on the role of medical schools in relation to societal needs, the missions of medical schools (from North American, European, African, and Asian perspectives), measuring social responsiveness (perspective of the United Kingdom, standard-setting,…

  3. "Medicalisation of falling in love": medical students' responses to Thomas Mann's The Black Swan.

    PubMed

    Lahtinen, Aino-Maija; Torppa, Martina

    2007-06-01

    The value of implementing literature in medical education is widely accepted. The initial responses of medical students to Thomas Mann's short story The Black Swan are described and their resources for making sense of the story are presented. Their written responses revealed that the students interpreted the story mainly through a medical framework and were capable of understanding the story's complex and existential issues related to medicine. Evident gaps in the students' interpretations and understanding are discussed and suggestions on using such kinds of intellectual texts in medical teaching are offered. PMID:23674300

  4. Dopaminergic medication impairs feedback-based stimulus-response learning but not response selection in Parkinson's disease

    PubMed Central

    Vo, Andrew; Hiebert, Nole M.; Seergobin, Ken N.; Solcz, Stephanie; Partridge, Allison; MacDonald, Penny A.

    2014-01-01

    Cognitive dysfunction is a feature of Parkinson's Disease (PD). Some cognitive functions are impaired by dopaminergic medications prescribed to address the movement symptoms that typify PD. Learning appears to be the cognitive function most frequently worsened by dopaminergic therapy. However, this result could reflect either impairments in learning (i.e., acquisition of associations among stimuli, responses, and outcomes) or deficits in performance based on learning (e.g., selecting responses). We sought to clarify the specific effects of dopaminergic medication on (a) stimulus-response association learning from outcome feedback and (b) response selection based on learning, in PD. We tested 28 PD patients on and/or off dopaminergic medication along with 32 healthy, age- and education-matched controls. In Session 1, participants learned to associate abstract images with specific key-press responses through trial and error via outcome feedback. In Session 2, participants provided specific responses to abstract images learned in Session 1, without feedback, precluding new feedback-based learning. By separating Sessions 1 and 2 by 24 h, we could distinguish the effect of dopaminergic medication on (a) feedback-based learning and response selection processes in Session 1 as well as on (b) response selection processes when feedback-based learning could not occur in Session 2. Accuracy achieved at the end of Session 1 were comparable across groups. PD patients on medication learned stimulus-response associations more poorly than PD patients off medication and controls. Medication did not influence decision performance in Session 2. We confirm that dopaminergic therapy impairs feedback-based learning in PD, discounting an alternative explanation that warranted consideration. PMID:25324767

  5. The role, responsibilities and status of the clinical medical physicist in AFOMP.

    PubMed

    Ng, K H; Cheung, K Y; Hu, Y M; Inamura, K; Kim, H J; Krisanachinda, A; Leung, J; Pradhan, A S; Round, H; van Doomo, T; Wong, T J; Yi, B Y

    2009-12-01

    This document is the first of a series of policy statements being issued by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP). The document was developed by the AFOMP Professional Development Committee (PDC) and was endorsed for official release by AFOMP Council in 2006. The main purpose of the document was to give guidance to AFOMP member organizations on the role and responsibilities of clinical medical physicists. A definition of clinical medical physicist has also been provided. This document discusses the following topics: professional aspects of education and training; responsibilities of the clinical medical physicist; status and organization of the clinical medical physics service and the need for clinical medical physics service. PMID:20169835

  6. The "RTR" medical response system for nuclear and radiological mass-casualty incidents: a functional TRiage-TReatment-TRansport medical response model.

    PubMed

    Hrdina, Chad M; Coleman, C Norman; Bogucki, Sandy; Bader, Judith L; Hayhurst, Robert E; Forsha, Joseph D; Marcozzi, David; Yeskey, Kevin; Knebel, Ann R

    2009-01-01

    Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IND) or large radiological dispersal device (RDD) requires unique advanced planning due to the potential magnitude of the event, lack of warning, and radiation hazards. In order for medical care and resources to be collocated and matched to the requirements, a [US] Federal interagency medical response-planning group has developed a conceptual approach for responding to such nuclear and radiological incidents. The "RTR" system (comprising Radiation-specific TRiage, TReatment, TRansport sites) is designed to support medical care following a nuclear incident. Its purpose is to characterize, organize, and efficiently deploy appropriate materiel and personnel assets as close as physically possible to various categories of victims while preserving the safety of responders. The RTR system is not a medical triage system for individual patients. After an incident is characterized and safe perimeters are established, RTR sites should be determined in real-time that are based on the extent of destruction, environmental factors, residual radiation, available infrastructure, and transportation routes. Such RTR sites are divided into three types depending on their physical/situational relationship to the incident. The RTR1 sites are near the epicenter with residual radiation and include victims with blast injuries and other major traumatic injuries including radiation exposure; RTR2 sites are situated in relationship to the plume with varying amounts of residual radiation present, with most victims being ambulatory; and RTR3 sites are collection and transport sites with minimal or no radiation present or exposure risk and a victim population with a potential variety of injuries or radiation exposures. Medical Care sites are predetermined sites at which definitive medical care is given to those in immediate need of care. They include local/regional hospitals, medical centers, other

  7. U.S. Policy Responses to Calls for the Medical Use of Cannabis

    PubMed Central

    Hall, Wayne

    2015-01-01

    This paper discusses the evolution of U.S. policy responses to calls to allow patients to use cannabis for medical purposes. It first summarizes the research evidence on the safety and efficacy of cannabinoids for various medical uses. It then outlines the challenges in developing new pharmaceutical cannabinoids that are safe, effective, and acceptable to patients. It briefly describes the strengths and limitations of the different ways in which U.S. states have allowed patients to use cannabis for medical purposes. These include allowing access for research trials only, allowing medical necessity as a defense against prosecution, and allowing commercial medical dispensaries to provide cannabis to approved patients. It argues that liberal definitions of indications for medical cannabis use and the commercialization of medical cannabis supply in California have produced the de facto legalization of recreational cannabis use. PMID:26339208

  8. Prevent and "British Values"

    ERIC Educational Resources Information Center

    Kenny, Alex; Ghale, Baljeet

    2015-01-01

    At the recent National Union of Teachers' conference the role of the Prevent strategy and the introduction of "British Values" in the Office for Standards in Education, Children's Services and Skills framework emerged as key issues for delegates. Two of the speeches made at the conference are presented here.

  9. Evaluating professionalism in medical undergraduates using selected response questions: findings from an item response modelling study

    PubMed Central

    2011-01-01

    Background Professionalism is a difficult construct to define in medical students but aspects of this concept may be important in predicting the risk of postgraduate misconduct. For this reason attempts are being made to evaluate medical students' professionalism. This study investigated the psychometric properties of Selected Response Questions (SRQs) relating to the theme of professional conduct and ethics comparing them with two sets of control items: those testing pure knowledge of anatomy, and; items evaluating the ability to integrate and apply knowledge ("skills"). The performance of students on the SRQs was also compared with two external measures estimating aspects of professionalism in students; peer ratings of professionalism and their Conscientiousness Index, an objective measure of behaviours at medical school. Methods Item Response Theory (IRT) was used to analyse both question and student performance for SRQs relating to knowledge of professionalism, pure anatomy and skills. The relative difficulties, discrimination and 'guessabilities' of each theme of question were compared with each other using Analysis of Variance (ANOVA). Student performance on each topic was compared with the measures of conscientiousness and professionalism using parametric and non-parametric tests as appropriate. A post-hoc analysis of power for the IRT modelling was conducted using a Monte Carlo simulation. Results Professionalism items were less difficult compared to the anatomy and skills SRQs, poorer at discriminating between candidates and more erratically answered when compared to anatomy questions. Moreover professionalism item performance was uncorrelated with the standardised Conscientiousness Index scores (rho = 0.009, p = 0.90). In contrast there were modest but significant correlations between standardised Conscientiousness Index scores and performance at anatomy items (rho = 0.20, p = 0.006) though not skills (rho = .11, p = .1). Likewise, students with high peer

  10. Rapid response: email, immediacy, and medical humanitarianism in Aceh, Indonesia.

    PubMed

    Grayman, Jesse Hession

    2014-11-01

    After more than 20 years of sporadic separatist insurgency, the Free Aceh Movement and the Indonesian government signed an internationally brokered peace agreement in August 2005, just eight months after the Indian Ocean tsunami devastated Aceh's coastal communities. This article presents a medical humanitarian case study based on ethnographic data I collected while working for a large aid agency in post-conflict Aceh from 2005 to 2007. In December 2005, the agency faced the first test of its medical and negotiation capacities to provide psychiatric care to a recently amnestied political prisoner whose erratic behavior upon returning home led to his re-arrest and detention at a district police station. I juxtapose two methodological approaches-an ethnographic content analysis of the agency's email archive and field-based participant-observation-to recount contrasting narrative versions of the event. I use this contrast to illustrate and critique the immediacy of the humanitarian imperative that characterizes the industry. Immediacy is explored as both an urgent moral impulse to assist in a crisis and a form of mediation that seemingly projects neutral and transparent transmission of content. I argue that the sense of immediacy afforded by email enacts and amplifies the humanitarian imperative at the cost of abstracting elite humanitarian actors out of local and moral context. As a result, the management and mediation of this psychiatric case by email produced a bureaucratic model of care that failed to account for complex conditions of chronic political and medical instability on the ground. PMID:24788052

  11. Hurricane Floyd. Response of the Pitt County Medical Community.

    PubMed

    Franklin, J A; Wiese, W; Meredith, J T; Lalikos, J F; Dolezal, J M; Brigham, D; Wooden, W A; Ohl, C

    2000-01-01

    The financial impact of Hurricane Floyd on the medical community is still being tabulated. Initial estimates indicate a $5.8 million loss to UHS in operating revenue. Additional hospital costs include $568,000 for overtime pay, $310,000 for special equipment including helicopters and general supplies, and $1.2 million in "bonus pay" to the hospital's 6000 employees. The ECU School of Medicine suffered losses estimated at $3.6 million, including lost revenue, overtime, and salaries paid when clinics and services were shut down. Most private offices suffered from lost revenues and occasionally from flood damage to property. Hurricane Floyd was the most costly disaster to hit Eastern North Carolina and the Mid-Atlantic United States. The medical community and its patients were severely challenged from the terrible effects of flooding, but the collaborative efforts of a great number of individuals and a spirit of teamwork came together to provide continued health care to the region. It is very likely that the preventive measures enacted both before and after the storm averted illness and injury, and saved lives. Ingenuity, innovation, and optimal use of available resources allowed Pitt County Memorial Hospital and its surrounding medical community to stay in operation. We have learned a great deal from these experiences that will help us plan for future natural disasters. PMID:10647255

  12. [Commitment of drug abusers in Israel: medical or social responsibility?].

    PubMed

    Sigal, M; Gelkopf, M; Ben-Or, H M

    1991-01-01

    In 1977 a new paragraph was added to Israel's penal law allowing rehabilitation of convicted drug abusers by compulsory psychiatric treatment. The commitment was implemented on the basis of a court order. Notwithstanding the doubts of psychiatrists the law permitted the commitment of a significant number of drug abusers to psychiatric wards. The rehabilitation treatment through commitment and some of its negative consequences are described in a study that covers 10 years of activity at the Pardessia Menta Health Center. We present 3 typical profiles of drug abusers who were treated in our center as specified by the law. None needed medical help in physical withdrawal from the drug. All took advantage of the opportunity to spend part of their incarceration time in the hospital instead of in jail. The law was amended in July 1989 and since February 1990 treatment is conducted under the supervision of probation officers and not in a medical institution. The amended law reflects the approach to drug abuse as a social not psychopathological problem, so that social agencies and no medical instances are in charge. PMID:2010135

  13. Exercise Responses in Boys with Attention Deficit/Hyperactivity Disorder: Effects of Stimulant Medication

    ERIC Educational Resources Information Center

    Mahon, Anthony D.; Stephens, Brooke R.; Cole, Andrew S.

    2008-01-01

    Objective: The effect of stimulant medication on exercise responses was studied in 14 boys (10.9 plus or minus 1.1 years) with attention deficit/hyperactivity disorder (ADHD). Method: Exercise, with and without medication, was performed at 25 W, 50 W, and 75 W, followed by a peak exercise test. Result: Submaximal heart rate (HR) was significantly…

  14. Responsive Medical Professionalism: Integrating Education, Practice, and Community in a Market-Driven Era.

    ERIC Educational Resources Information Center

    Frankford, David M.; Konrad, Thomas R.

    1998-01-01

    The traditional response of medical education to challenges from the external environment has been to claim that the medical profession must have autonomy concerning educational mission. However, as social, educational, and economic forces change, more explicit, formal, and systematic linkages between practice institutions and educational…

  15. Measuring social responsiveness of medical schools: a case study from New Mexico.

    PubMed

    Kaufman, A

    1999-08-01

    Medical schools can assess their social responsiveness by gauging the degrees to which the health needs of the populations and communities they serve frame their missions and endeavors in education, service, and research. Beyond considering these traditional academic missions, medical schools can also assess how well they apply their expertise to needed reform of the health care delivery system and to the formation of health policies aimed at improving community health status. This article summarizes the means by which a medical school's social responsiveness can be judged in each of the above areas, and it presents examples of successes and failures in such responsiveness by the University of New Mexico School of Medicine. It concludes with lessons learned that can guide future innovations in social responsiveness of medical schools. PMID:10495746

  16. Utstein-Style Template for Uniform Data Reporting of Acute Medical Response in Disasters

    PubMed Central

    Debacker, Michel; Hubloue, Ives; Dhondt, Erwin; Rockenschaub, Gerald; Rüter, Anders; Codreanu, Tudor; Koenig, Kristi L.; Schultz, Carl; Peleg, Kobi; Halpern, Pinchas; Stratton, Samuel; Della Corte, Francesco; Delooz, Herman; Ingrassia, Pier Luigi; Colombo, Davide; Castrèn, Maaret

    2012-01-01

    Background: In 2003, the Task Force on Quality Control of Disaster Management (WADEM) published guidelines for evaluation and research on health disaster management and recommended the development of a uniform data reporting tool. Standardized and complete reporting of data related to disaster medical response activities will facilitate the interpretation of results, comparisons between medical response systems and quality improvement in the management of disaster victims. Methods: Over a two-year period, a group of 16 experts in the fields of research, education, ethics and operational aspects of disaster medical management from 8 countries carried out a consensus process based on a modified Delphi method and Utstein-style technique. Results: The EMDM Academy Consensus Group produced an Utstein-style template for uniform data reporting of acute disaster medical response, including 15 data elements with indicators, that can be used for both research and quality improvement. Conclusion: It is anticipated that the Utstein-style template will enable better and more accurate completion of reports on disaster medical response and contribute to further scientific evidence and knowledge related to disaster medical management in order to optimize medical response system interventions and to improve outcomes of disaster victims. PMID:23066513

  17. The Ethical Perspective of British and American Preservice Teachers.

    ERIC Educational Resources Information Center

    Deering, Thomas E.

    1998-01-01

    Comparison of responses from 38 U.S. and 27 British preservice teachers on the Ethics Position Questionnaire indicated that both groups had high idealism. U.S. teachers had lower relativism scores. (SK)

  18. The global workforce shortages and the migration of medical professions: the Australian policy response

    PubMed Central

    Smith, Saxon D

    2008-01-01

    Medical migration sees the providers of medical services (in particular medical practitioners) moving from one region or country to another. This creates problems for the provision of public health and medical services and poses challenges for laws in the nation state and for laws in the global community. There exists a global shortage of healthcare professionals. Nation states and health rights movements have been both responsible for, and responsive to, this global community shortage through a variety of health policy, regulation and legislation which directly affects the migration of medical providers. The microcosm responses adopted by individual nation states, such as Australia, to this workforce shortage further impact on the global workforce shortage through active recruitment of overseas-trained healthcare professionals. "Push" and "pull" factors exist which encourage medical migration of healthcare professionals. A nation state's approach to health policy, regulation and legislation dramatically helps to create these "push factors" and "pull factors". A co-ordinated global response is required with individual nation states being cognisant of the impact of their health policy, regulations and legislation on the global community through the medical migration of healthcare professionals. PMID:18507867

  19. Origins of British geriatrics.

    PubMed Central

    Howell, T. H.

    1976-01-01

    We may see from the foregoing account that British physicians have played a major part in the history of geriatric medicine. Other countries have no counterpart to J H Sheldon of Wolverhampton, whose work on the social medicine of old age was so fundamental, or George Adams of Belfast, to whom we owe such a debt of knowledge about cerebrovascular disease in the aged, or to Marjory Warren and the other pioneers mentioned above. Long may this tradition continue. PMID:785477

  20. Speed of Inhibition Predicts Teacher--Rated Medication Response in Boys with Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Scheres, Anouk; Oosterlaan, Jaap; Sergeant, Joseph A.

    2006-01-01

    This study aimed at investigating whether one of the key deficits in Attention Deficit Hyperactivity Disorder (ADHD), slow response inhibition, predicted the response to methylphenidate (MPH) treatment. In order to address this issue, we used Stop Signal Reaction Times (SSRTs) measured at baseline in 20 medication-naive boys with ADHD as…

  1. Prediction of Response to Medication and Cognitive Therapy in the Treatment of Moderate to Severe Depression

    ERIC Educational Resources Information Center

    Fournier, Jay C.; DeRubeis, Robert J.; Shelton, Richard C.; Hollon, Steven D.; Amsterdam, Jay D.; Gallop, Robert

    2009-01-01

    A recent randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate to severely depressed outpatients. In this article, the authors seek to identify the variables that were associated with response across both treatments as well as variables that predicted…

  2. Shadow Bowl 2003: a collaborative exercise in community readiness, agency cooperation, and medical response.

    PubMed

    Balch, David; Taylor, Carl; Rosenthal, David; Bausch, Chris; Warner, Dave; Morris, Ray

    2004-01-01

    This paper describes a model for homeland security, community readiness, and medical response that was applied during an operational exercise around Super Bowl XXXVII. In addition, it describes the products provided by private companies involved in the exercise and how they would have contributed to a medical disaster had one occurred. The purpose of Shadow Bowl was to demonstrate community readiness and medical response to a mass casualty event. The goals of the project were to: (1) provide enhanced public safety using an advanced communication network and sensor grid; (2) develop mass casualty surge capabilities through medical reach-back; and (3) build a collaboration model between civilian, military, public, and private partners. The results of the Shadow Bowl Exercise accentuated the value of new telehealth and disaster medicine tools in treating large numbers of patients when infrastructure overload occurs. PMID:15650528

  3. Medical mitigation model: quantifying the benefits of the public health response to a chemical terrorism attack.

    PubMed

    Good, Kevin; Winkel, David; VonNiederhausern, Michael; Hawkins, Brian; Cox, Jessica; Gooding, Rachel; Whitmire, Mark

    2013-06-01

    The Chemical Terrorism Risk Assessment (CTRA) and Chemical Infrastructure Risk Assessment (CIRA) are programs that estimate the risk of chemical terrorism attacks to help inform and improve the US defense posture against such events. One aspect of these programs is the development and advancement of a Medical Mitigation Model-a mathematical model that simulates the medical response to a chemical terrorism attack and estimates the resulting number of saved or benefited victims. At the foundation of the CTRA/CIRA Medical Mitigation Model is the concept of stock-and-flow modeling; "stocks" are states that individuals progress through during the event, while "flows" permit and govern movement from one stock to another. Using this approach, the model is able to simulate and track individual victims as they progress from exposure to an end state. Some of the considerations in the model include chemical used, type of attack, route and severity of exposure, response-related delays, detailed treatment regimens with efficacy defined as a function of time, medical system capacity, the influx of worried well individuals, and medical countermeasure availability. As will be demonstrated, the output of the CTRA/CIRA Medical Mitigation Model makes it possible to assess the effectiveness of the existing public health response system and develop and examine potential improvement strategies. Such a modeling and analysis capability can be used to inform first-responder actions/training, guide policy decisions, justify resource allocation, and direct knowledge-gap studies. PMID:22744439

  4. Measuring social responsiveness of medical schools: a case study from Thailand.

    PubMed

    Sirisup, N

    1999-08-01

    Thailand has 13 medical schools, one of which is private. Graduates of the 12 government medical schools must provide service in rural areas for three years after graduation. The Chulalongkorn University Faculty of Medicine (Chulalongkorn Medical School) pursues social responsibility in various ways. For example, it has multiple tracks for student admission, includes a curricular track designed to produce doctors for rural areas, has revised curriculum to make it more relevant to social needs, chooses clinical teaching sites with such needs in mind, and works closely with relevant institutions in the government and elsewhere. Until recently, Thai medical schools evaluated their social responsiveness informally. This evaluation has become much more systematic, however, since 1996, when the Ministry of University Affairs issued policies and guidelines for quality assurance in higher education. As a member of the International Working Party for Measuring the Social Accountability of Medical Schools, Chulalongkorn Medical School recently used the social accountability grid to help assess its performance. It found its social responsiveness to be outstanding in the educational domain, fair in the research domain, and good in the service domain. PMID:10495747

  5. Functional Limitations, Medication Support, and Responses to Drug Costs among Medicare Beneficiaries

    PubMed Central

    Whaley, Christopher; Reed, Mary; Hsu, John; Fung, Vicki

    2015-01-01

    Objective Standard Medicare Part D prescription drug benefits include substantial and complex cost-sharing. Many beneficiaries also have functional limitations that could affect self-care capabilities, including managing medications, but also have varying levels of social support to help with these activities. We examined the associations between drug cost responses, functional limitations, and social support. Data Sources and Study Setting We conducted telephone interviews in a stratified random sample of community-dwelling Medicare Advantage beneficiaries (N = 1,201, response rate = 70.0%). Participants reported their functional status (i.e., difficulty with activities of daily living) and social support (i.e., receiving help with medications). Drug cost responses included cost-reducing behaviors, cost-related non-adherence, and financial stress. Study Design We used multivariate logistic regression to assess associations among functional status, help with medications, and drug cost responses, adjusting for patient characteristics. Principal Findings Respondents with multiple limitations who did not receive help with their medications were more likely to report cost-related non-adherence (OR = 3.2, 95% CI: 1.2–8.5) and financial stress (OR = 2.4, 95% CI: 1.3–4.5) compared to subjects with fewer limitations and no help; however, those with multiple limitations and with medication help had similar odds of unfavorable cost responses as those with fewer limitations. Conclusion The majority of beneficiaries with functional limitations did not receive help with medications. Support with medication management for beneficiaries who have functional limitations could improve adherence and outcomes. PMID:26642195

  6. Genetic Predictors of Response to Different Medical Therapies in Acromegaly.

    PubMed

    Ramos-Leví, Ana M; Bernabeu, Ignacio; Sampedro-Núñez, Miguel; Marazuela, Mónica

    2016-01-01

    In the era of predictive medicine, management of diseases is evolving into a more personal and individualized approach, as more data are available regarding clinical, biochemical, radiological, molecular, histopathological, and genetic aspects. In the particular setting of acromegaly, which is a rare, chronic, debilitating, and disfiguring disease, an optimized approach deems even more necessary, especially because of an associated increased morbidity and mortality, the impact on patients' quality of life, and the increased cost of frequently necessary life-long treatments. In this paper, we review the available studies that address potential genetic influences on acromegaly, their role in the outcome, and response to treatments, as well as their contribution to the risk of developing side effects. We focus mainly on pharmacogenetic factors involved during treatment with dopamine agonists, somatostatin analogs, and pegvisomant. Specifically, mutations in dopamine receptors, somatostatin receptors, growth hormone receptors, and metabolic pathways involved in growth hormone action; polymorphisms in the insulin-like growth factor and the insulin-like growth factor binding proteins; and polymorphisms in other genes that may determine differences in the frequency of developing adverse events. PMID:26940388

  7. Medical and radiological aspects of emergency preparedness and response at SevRAO facilities.

    PubMed

    Savkin, M N; Sneve, M K; Grachev, M I; Frolov, G P; Shinkarev, S M; Jaworska, A

    2008-12-01

    Regulatory cooperation between the Norwegian Radiation Protection Authority and the Federal Medical Biological Agency (FMBA) of the Russian Federation has the overall goal of promoting improvements in radiation protection in Northwest Russia. One of the projects in this programme has the objectives to review and improve the existing medical emergency preparedness capabilities at the sites for temporary storage of spent nuclear fuel and radioactive waste. These are operated by SevRAO at Andreeva Bay and in Gremikha village on the Kola Peninsula. The work is also intended to provide a better basis for regulation of emergency response and medical emergency preparedness at similar facilities elsewhere in Russia. The purpose of this paper is to present the main results of that project, implemented by the Burnasyan Federal Medical Biophysical Centre. The first task was an analysis of the regulatory requirements and the current state of preparedness for medical emergency response at the SevRAO facilities. Although Russian regulatory documents are mostly consistent with international recommendations, some distinctions lead to numerical differences in operational intervention criteria under otherwise similar conditions. Radiological threats relating to possible accidents, and related gaps in the regulation of SevRAO facilities, were also identified. As part of the project, a special exercise on emergency medical response on-site at Andreeva Bay was prepared and carried out, and recommendations were proposed after the exercise. Following fruitful dialogue among regulators, designers and operators, special regulatory guidance has been issued by FMBA to account for the specific and unusual features of the SevRAO facilities. Detailed sections relate to the prevention of accidents, and emergency preparedness and response, supplementing the basic Russian regulatory requirements. Overall it is concluded that (a) the provision of medical and sanitary components of emergency

  8. "Time enough! Or not enough time!" An oral history investigation of some British and Australian community nurses' responses to demands for "efficiency" in health care, 1960-2000.

    PubMed

    Hallett, Christine E; Madsen, Wendy; Pateman, Brian; Bradshaw, Julie

    2012-01-01

    Oral history methodology was used to investigate the perspectives of retired British district nurses and Australian domiciliary nurses who had practiced between 1960 and 2000. Interviews yielded insights into the dramatic changes in community nursing practice during the last four decades of the 20th century. Massive changes in health care and government-led drives for greater efficiency meant moving from practice governed by "experiential time" (in which perception of time depends on the quality of experience) to practice governed by "measured time" (in which experience itself is molded by the measurement of time). Nurses recognized that the quality of their working lives and their relationships with families had been altered by the social, cultural, and political changes, including the drive for professional recognition in nursing itself, soaring economic costs of health care and push for deinstitutionalization of care. Community nurses faced several dilemmas as they grappled with the demands for efficiency created by these changes. PMID:22360001

  9. Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review

    PubMed Central

    Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

    2016-01-01

    Objective This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Setting Early prehospital phase of a major incident. Design Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and ‘major incidents’ to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. Results The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. Conclusions HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. Trial registration number CRD42013004473. PMID:26861938

  10. The physician as health advocate: translating the quest for social responsibility into medical education and practice.

    PubMed

    Dharamsi, Shafik; Ho, Anita; Spadafora, Salvatore M; Woollard, Robert

    2011-09-01

    There is a growing demand for educating future physicians to be socially responsible. It is not clear, however, how social responsibility is understood and acted on in medical education and practice, particularly within the context of a growing desire to improve health care through an equitable and sustainable delivery system. The authors conduct a concept analysis, exploring the practical philosophical understanding of social responsibility and its implications for medical education and practice. The aim is to inform curricular development, professional practice, and further research on social responsibility. The particular ways in which social responsibility is interpreted can either enhance or establish limits on how it will appear across the continuum of medical education and practice. A physician's place in society is closely tied to a moral sense of responsibility related to the agreed-on professional characteristics of physicianhood in society, the capacity to carry out that role, and the circumstances under which such professionals are called to account for failing to act appropriately according to that role. The requirement for social responsibility is a moral commitment and duty developed over centuries within societies that advanced the notion of a "profession" and the attendant social contract with society. A curriculum focused on developing social responsibility in future physicians will require pedagogical approaches that are innovative, collaborative, participatory, and transformative. PMID:21785306

  11. Schizotrypanum in British bats.

    PubMed

    Gardner, R A; Molyneux, D H

    1988-08-01

    Two species of Schizotrypanum, T. (S.) dionisii and T. (S.) vespertilionis, were identified from British bats. Laboratory studies on stocks of isolated trypanosomes from 5 species of bat (Pipistrellus pipistrellus, Nyctalus leisleri, N. noctula, Eptesicus serotinus and Myotis brandti) indicated that the predominant species was T. d. dionisii. Collections and dissection of the bat bug Cimex pipistrelli from bat roosts revealed flagellate infection in a total of 12 out of 20 bugs; 7 of these bugs had metacyclic trypanosomes present. C. pipistrelli and the human bed bug, C. lectularius were reared in the laboratory and allowed to feed on wild-caught bats known to be infected with T. d. dionisii. Development occurred in both species of Cimex. Cimex spp. could be used to detect subpatent Schizotrypanum infections by xenodiagnosis. This technique was used to test the parasitological status of bats collected in the wild or reared in captivity. On a single occasion an apparent transmission of T. d. dionisii to an uninfected (by xenodiagnosis) laboratory reared bat was achieved. A stock of Schizotrypanum isolated from a wild-caught C. pipistrelli collected in a N. leisteri roost was identified by DNA buoyant density centrifugation as T. (S.) vespertilionis. A P. pipistrellus known to be infected with T. d. dionisii was found to have cyst-like structures in thoracic skeletal muscle containing amastigotes. The study provided the strongest evidence yet that C. pipistrelli is the vector of Schizotrypanum in British bats. PMID:3174237

  12. How Iranian Medical Trainees Approach their Responsibilities in Clinical Settings; A Grounded Theory Research

    PubMed Central

    Asemani, Omid; Iman, Mohammad Taghi; Moattari, Marzieh; Khayyer, Mohammad; Sharif, Farkhondeh; Tabei, Seyed Ziaaddin

    2015-01-01

    Background: It seems we are now experiencing “responsibility problems” among medical trainees (MTs) and some of those recently graduated from medical schools in Iran. Training responsible professionals have always been one of the main concerns of medical educators. Nevertheless, there is a dearth of research in the literature on “responsibility” especially from the medical education point of view. Therefore, the present study was carried out with the aim of presenting a theoretical based framework for understanding how MTs approach their responsibilities in educational settings. Method: This qualitative study was conducted at Shiraz University of Medical Sciences (SUMS) using the grounded theory methodology. 15 MTs and 10 clinical experts and professional nurses were purposefully chosen as participants. Data was analyzed using the methodology suggested by Corbin and Strauss, 1998. Results: “Try to find acceptance toward expectations”, “try to be committed to meet the expectations” and “try to cope with unacceptable expectations” were three main categories extracted based on the research data. Abstractly, the main objective for using these processes was “to preserve the integrity of student identity” which was the core category of this research too. Moreover, it was also found that practically, “responsibility” is considerably influenced by lots of positive and negative contextual and intervening conditions. Conclusion: “Acceptance” was the most decisive variable highly effective in MTs’ responsibility. Therefore, investigating the “process of acceptance” regarding the involved contextual and intervening conditions might help medical educators correctly identify and effectively control negative factors and reinforce the constructive ones that affect the concept of responsibility in MTs. PMID:26379351

  13. Indians Repulse British With Rocket

    NASA Technical Reports Server (NTRS)

    2004-01-01

    During the early introduction of rockets to Europe, they were used only as weapons. Enemy troops in India repulsed the British with rockets. Later, in Britain, Sir William Congreve developed a rocket that could fire to about 9,000 feet. The British fired Congreve rockets against the United States in the War of 1812.

  14. Responsive medical professionalism: integrating education, practice, and community in a market-driven era.

    PubMed

    Frankford, D M; Konrad, T R

    1998-02-01

    Revolutionary changes in the nature and form of medical practice institutions are likely to reverberate backward into medical education as leaders of the new practice organizations demand that the educational mission be responsive to their needs, and as these demands are increasingly backed by market power. In the face of this pressure, medical education's traditional response--that it should have autonomy in defining its mission--is no longer viable. Instead, more explicit, formal, and systemic linkages between practice and educational institutions are inevitable. The crucial question is whether these linkages will reflect the values of the market, oriented by economic self-interest, or the values of medical professionalism, oriented by the obligation to sacrifice economic self-interest in the service of patients. The authors maintain that the realization of the normative ideal of professionalism in medical education within the emerging market environment requires that a vision be articulated that is distinct from that of either autonomy or the market, and that combined lay-professional institutions be established to integrate--and perhaps merge--education and practice, and to foster responsiveness to lay values and community needs. The authors conclude by briefly describing examples of current efforts in this direction. PMID:9484186

  15. Improving the social responsiveness of medical schools: lessons from the Canadian experience.

    PubMed

    Cappon, P; Watson, D

    1999-08-01

    The recent Canadian experience in promoting social accountability and social responsiveness of medical schools has been one of steady improvement in certain institutions, against a background lacking overall national policy direction. Canada has several distinct advantages in trying to devise means of enhancing social accountability of medical training and health services, including a strong national system of publicly supported and financed health care of high quality, a network of excellent academic medical centers, and well-established accreditation bodies. A review of the literature, complemented by a new survey of Canadian medical schools, confirms that some of the centers, conscious of the need to promote social responsiveness, are developing innovative programs to do so. Future progress toward the goal of social responsiveness of medical schools on a pan-Canadian basis will require a more cohesive approach involving systematic sharing of best practices among academic health centers, effective alliances with other health professionals to promote these objectives, and support by federal and provincial ministries of health. Canadian awareness of an international movement tending to similar objectives would support the efforts of Canadian health professionals engaged in practices of enhanced accountability. PMID:10495748

  16. Nursing and Medical Perceptions of a Hospital Rapid Response System: New Process But Same Old Game?

    PubMed

    Douglas, Clint; Osborne, Sonya; Windsor, Carol; Fox, Robyn; Booker, Catriona; Jones, Lee; Gardner, Glenn

    2016-01-01

    Perhaps no other patient safety intervention depends so acutely on effective interprofessional teamwork for patient survival than the hospital rapid response system. Yet, little is known about nurse-physician relationships when rescuing at-risk patients. This study compared nursing and medical staff perceptions of a mature rapid response system at a large tertiary hospital. Findings indicate that the rapid response system may be failing to address a hierarchical culture and systems-level barriers to early recognition and response to patient deterioration. PMID:26132845

  17. Medical emergency rescue in disaster: the international emergency response to the Haiyan typhoon in Philippines.

    PubMed

    Ling, Feng; Ye, Zhen; Cai, Wenwei; Lu, Ye; Xia, Shichang; Chen, Zhiping; Chen, Enfu; Wang, Xiaofeng; Wang, Zhen; Lv, Huakun; Gong, Zhenyu

    2014-12-01

    Following Typhoon Haiyan, the World Health Organization (WHO) has been supporting the Government of the Philippines in coordinating the incoming relief supplies from more than 30 international humanitarian health organizations. During the 10 days in Abuyong, Philippines, the Chinese medical rescue team consisting of 50 experts specialized in clinical medicine and disease prevention and control action was taken including, medical treatment, environmental disinfection and health education. A total of 1,831 cases and 2,144 outpatients were treated, blood tests, B-ultrasound, electrocardiogram (ECG) and other laboratory examinations were carried out for more than 615 patients; a cumulative 90,000 square meters in external environment were disinfected, and more than 500 health education materials were handed out. Besides, measures of purifying drinking water, and rebuilding the local hospital have also been carried out. The international emergency response to the Haiyan typhoon in Philippines contributed to reconstruct the local disaster health system by the activities from international medical emergency rescue. To improve the capacity of international medical emergency rescue in disaster, the special project of foreign medical emergency rescue should be set in countries' medical emergency rescue, and disaster emergency medical rescue should be reserved as a conventional capacity. PMID:25641183

  18. The Center for Healthy Weight: an academic medical center response to childhood obesity

    PubMed Central

    Robinson, T N; Kemby, K M

    2012-01-01

    Childhood obesity represents a worldwide medical and public health challenge. Academic medical centers cannot avoid the effects of the obesity epidemic, and must adopt strategies for their academic, clinical and public policy responses to childhood obesity. The Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford provides an example and model of one such strategy. The design provides both breadth and depth through six cores: Research, Patient Care, Community Programs, Advocating for Public Policy Change, Training and Professional Education, and the Healthy Hospital Initiative. The Center and its cores are designed to facilitate interdisciplinary collaboration across the university, medical school, children's hospital and surrounding community. The foci of these cores are likely to be relevant to almost any academic medical center's mission and functions. PMID:25089192

  19. National health and medical services response to incidents of chemical and biological terrorism.

    PubMed

    Tucker, J B

    1997-08-01

    In response to the growing threat of terrorism with chemical and biological weapons, the US government has developed a national concept of operations for emergency health and medical services response. This capability was developed and tested for the first time during the Atlanta Olympic Games in the summer of 1996. In the event of a chemical or biological terrorist incident that exceeded local and state-level response capabilities, federal agencies would provide specialized teams and equipment to help manage the consequences of the attack and treat, decontaminate, and evacuate casualties. The US Congress has also established a Domestic Preparedness Program that provides for enhanced training of local first-responders and the formation of metropolitan medical strike teams in major cities around the country. While these national response capabilities are promising, their implementation to date has been problematic and their ultimate effectiveness is uncertain. PMID:9244313

  20. A two-stage approach for medical supplies intermodal transportation in large-scale disaster responses.

    PubMed

    Ruan, Junhu; Wang, Xuping; Shi, Yan

    2014-11-01

    We present a two-stage approach for the "helicopters and vehicles" intermodal transportation of medical supplies in large-scale disaster responses. In the first stage, a fuzzy-based method and its heuristic algorithm are developed to select the locations of temporary distribution centers (TDCs) and assign medial aid points (MAPs) to each TDC. In the second stage, an integer-programming model is developed to determine the delivery routes. Numerical experiments verified the effectiveness of the approach, and observed several findings: (i) More TDCs often increase the efficiency and utility of medical supplies; (ii) It is not definitely true that vehicles should load more and more medical supplies in emergency responses; (iii) The more contrasting the traveling speeds of helicopters and vehicles are, the more advantageous the intermodal transportation is. PMID:25350005

  1. A Two-Stage Approach for Medical Supplies Intermodal Transportation in Large-Scale Disaster Responses

    PubMed Central

    Ruan, Junhu; Wang, Xuping; Shi, Yan

    2014-01-01

    We present a two-stage approach for the “helicopters and vehicles” intermodal transportation of medical supplies in large-scale disaster responses. In the first stage, a fuzzy-based method and its heuristic algorithm are developed to select the locations of temporary distribution centers (TDCs) and assign medial aid points (MAPs) to each TDC. In the second stage, an integer-programming model is developed to determine the delivery routes. Numerical experiments verified the effectiveness of the approach, and observed several findings: (i) More TDCs often increase the efficiency and utility of medical supplies; (ii) It is not definitely true that vehicles should load more and more medical supplies in emergency responses; (iii) The more contrasting the traveling speeds of helicopters and vehicles are, the more advantageous the intermodal transportation is. PMID:25350005

  2. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module I. The Emergency Medical Technician, His Role, Responsibility, and Training.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide is one of fifteen modules designed for use in the training of emergency medical technicians (EMT). Four units are presented: (1) role of the EMT, including the operation of an emerging medical services system; (2) the laws relevant to EMTs functioning in the field; (3) activities and responsibilities of an EMT…

  3. The British National Formulary: Checking, medicines and clinicians.

    PubMed

    Dickson, Jane

    2015-01-01

    The British National Formulary underpins the way medical practice is made safe in the UK. Its move from book to digital product has been identified as welcome but with problematic aspects. This chapter describes and investigates the current use of the formulary in order to examine how a rapid, well-targeted project is designed and executed. PMID:26249183

  4. Abnormal centroparietal ERP response in predominantly medication-naive adolescent boys with ADHD during both response inhibition and execution.

    PubMed

    Gow, Rachel V; Rubia, Katya; Taylor, Eric; Vallée-Tourangeau, Frédéric; Matsudaira, Toshiko; Ibrahimovic, Almira; Sumich, Alexander

    2012-04-01

    Abnormal event-related potential (ERP) responses have been reported in children and adolescents with attention deficit hyperactivity disorder (ADHD) and a medication history compared with in healthy controls during tasks of response control and conflict inhibition. This study reports neurophysiologic correlates of a task dependent on these cognitive functions in a large, predominantly medication naive, group of adolescents with ADHD compared with that in healthy age- and intelligence quotient (IQ)-matched controls using area-under-the-curve (AUC) analysis. Fifty-four adolescents with ADHD and 55 healthy comparisons completed a hybrid conflict and response inhibition Go/NoGo ERP task. The performance data showed that children with ADHD compared with controls had deficits in both the inhibitory measures (higher commission errors) and the Go process of the task (slower reaction times and enhanced omission errors). The ERP data showed significant impairments in brain function in the ADHD relative to the control group for late, endogenous ERPs (N2, P3a, and P3b), whereas no group differences were found for the earlier P200. All findings remained when a minority of children with medication history was excluded. Furthermore, deficits were not specific to the inhibitory processes of the task but were equally observed during the execution functions. Group differences were particularly pronounced over central and centroparietal sites across all time points, presumably reflecting the midline attention system mediated by anterior and posterior cingulate that is important for generic, condition-independent visual-spatial attention and response selection processes. The findings demonstrate that adolescents with ADHD have abnormal ERP responses not only during inhibitory, but also execution-related processes and, furthermore, that these deficits are independent from medication history. PMID:22469685

  5. Toward Diversity-Responsive Medical Education: Taking an Intersectionality-Based Approach to a Curriculum Evaluation

    ERIC Educational Resources Information Center

    Muntinga, M. E.; Krajenbrink, V. Q.; Peerdeman, S. M.; Croiset, G.; Verdonk, P.

    2016-01-01

    Recent years have seen a rise in the efforts to implement diversity topics into medical education, using either a "narrow" or a "broad" definition of culture. These developments urge that outcomes of such efforts are systematically evaluated by mapping the curriculum for diversity-responsive content. This study was aimed at…

  6. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities. 120.113 Section 120.113 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS...

  7. Overcoming Barriers to Eye Care: Patient Response to a Medical Social Worker in a Glaucoma Service.

    PubMed

    Fudemberg, Scott J; Amarasekera, Dilru C; Silverstein, Marlee H; Linder, Kathryn M; Heffner, Paul; Hark, Lisa A; Waisbourd, Michael

    2016-08-01

    This paper investigates the patient response to a medical social worker in a glaucoma clinic. The literature suggests that medical social workers are effective in a variety of health care settings, yet the efficacy of a medical social worker in an adult ophthalmic setting has not been studied. We present the results of a retrospective chart review of 50 patients with glaucoma referred to a medical social worker between January 5, 2015 and June 31, 2015 in an outpatient clinic of an urban eye hospital. Clinical and demographic data, as well as the data from a quality of care questionnaire, were collected for each patient. Patients rated their interaction with the medical social worker as highly positive (mean = 4.75, 5-point Likert scale), and nearly 90 % of patients expressed interest in future contact with the social worker. Additionally, most patients reported that the social worker resolved the issues they were facing (61.1 %), supported them in seeing their ophthalmologist (70.6 %), and helped them to manage their glaucoma (69.7 %). Reported barriers to glaucoma care were emotional distress; cost of office visits and medications; lack of medical insurance; transportation; poor medication adherence; impairment of daily activities; follow-up adherence; and language. As vision loss from glaucoma is irreversible, it is important to detect and treat patients at early stages of the disease. Therefore, it is imperative for patients to regularly visit their eye care providers and adhere to treatment and follow-up recommendations. This study suggests that a medical social worker could play a pivotal role in helping patients with glaucoma overcome barriers to treatment and facilitate disease management. PMID:26860278

  8. Understanding British addiction statistics.

    PubMed

    Johnson, B D

    1975-01-01

    The statistical data issued by the Home Office and Department of Health and Social Security are quite detailed and generally valid measures of hard core addiction in Great Britain (Judson, 1973). Since 1968, the main basis of these high quality British statistics is the routine reports filed by Drug Treatment Centres. The well-trained, experienced staff of these clinics make knowledgeable dicsions about a cleint's addiction, efficiently regulate dosage, and otherwise exert some degree of control over addicts (Judson, 1973; Johnson, 1974). The co-operation of police, courts, prison physicians, and general practitioners is also valuable in collecting data on drug addiction and convictions. Information presented in the tables above indicates that a rising problem of herion addiction between 1962 and 1967 were arrested by the introduction of the treatment clinics in 1968. Further, legally maintained heroin addiction has been reduced by almost one-third since 1968, since many herion addicts have been transferred to injectable methadone. The decline in herion prescribing and the relatively steady number of narcotics addicts has apparently occurred in the face of a continuing, and perhaps increasing, demand for heroin and other opiates. With few exceptions of a minor nature analysis of various tables suggests that the official statistics are internally consistent. There are apparently few "hidden" addicts, since few unknown addicts die of overdoses or are arrested by police (Lewis, 1973), although Blumberg (1974) indicates that some unknown users may exist. In addition, may opitate usersnot officially notified are known by clinic doctors as friends of addicts receiving prescriptions (Judson, 1973; Home Office, 1974). In brief, offical British drug statistics seem to be generally valid and demonstrate that heroin and perhaps methadone addiction has been well contained by the treatment clinics. PMID:1039283

  9. Accidental Deaths Among British Columbia Indians

    PubMed Central

    Schmitt, N.; Hole, L. W.; Barclay, W. S.

    1966-01-01

    A statistical and epidemiological review of British Columbia native Indian and non-Indian mortality revealed that accidents were the leading cause of death among Indians but ranked only fourth among non-Indians. Comparison of accidental death rates by age and sex showed that, without exception, the rates among Indians were considerably higher than the corressponding rates for non-Indians. While the Indians represented some 2% of the total population of British Columbia, they accounted for over 10% of the total accident fatalities, 29% of drownings, and 21% of fatal burns. Socioeconomic, environmental and psychosocial factors and excessive drinking are considered the chief causes responsible for this rather unusual epidemiological phenomenon. This study revealed certain hazardous conditions which are specific to the Indian's present way of life. In the authors' opinion the recognition of these specific hazards is imperative for the planning of effective preventive campaigns. PMID:5902238

  10. Potential cardiac arrest – an observational study of pre-hospital medical response

    PubMed Central

    Zakariassen, Erik; Hunskaar, Steinar

    2016-01-01

    Objectives A previous study showed that Norwegian GPs on call attended around 40% of out-of-hospital medical emergencies. We wanted to investigate the alarms of prehospital medical resources and the doctors' responses in situations of potential cardiac arrests. Design and setting A three-month prospective data collection was undertaken from three emergency medical communication centres, covering a population of 816,000 residents. From all emergency medical events, a sub-group of patients who received resuscitation, or who were later pronounced dead at site, was selected for further analysis. Results 5,105 medical emergencies involving 5,180 patients were included, of which 193 met the inclusion criteria. The GP on call was alarmed in 59 %, and an anaesthesiologist in 43 % of the cases. When alarmed, a GP attended in 84 % and an anaesthesiologist in 87 % of the cases. Among the patients who died, the GP on call was alarmed most frequently. Conclusion Events involving patients in need of resuscitation are rare, but medical response in the form of the attendance of prehospital personnel is significant. Norwegian GPs have a higher call-out rate for patients in severe situations where resuscitation was an option of treatment, compared with other “red-response” situations. Key pointsThis study investigates alarms of and call-outs among GPs and anaesthesiologists on call, in the most acute clinical situations:Medical emergencies involving patients in need of resuscitation were rare.The health care contribution by pre-hospital personnel being called out was significant.Compared with other acute situations, the GP had a higher attendance rate to patients in life-threatening situations. PMID:27092724

  11. A Community-Led Medical Response Effort in the Wake of Hurricane Sandy.

    PubMed

    Kraushar, Matthew L; Rosenberg, Rebecca E

    2015-08-01

    On October 29, 2012, Hurricane Sandy made landfall in the neighborhood of Red Hook in Brooklyn, New York. The massive tidal surge generated by the storm submerged the coastal area, home to a population over 11,000 individuals, including the largest public housing development in Brooklyn. The infrastructure devastation was profound: the storm rendered electricity, heat, water, Internet, and phone services inoperative, whereas local ambulatory medical services including clinics, pharmacies, home health agencies, and other resources were damaged beyond functionality. Lacking these services or lines of communication, medically fragile individuals became isolated from the hospital and 911-emergency systems without a preexisting mechanism to identify or treat them. Medically fragile individuals primarily included those with chronic medical conditions dependent on frequent and consistent monitoring and treatments. In response, the Red Hook community established an ad hoc volunteer medical relief effort in the wake of the storm, filling a major gap that continues to exist in disaster medicine for low-income urban environments. Here we describe this effort, including an analysis of the medically vulnerable in this community, and recommend disaster risk reduction strategies and resilience measures for future disaster events. PMID:26030400

  12. Baseline Antihypertensive Drug Count and Patient Response to Hypertension Medication Management.

    PubMed

    Crowley, Matthew J; Olsen, Maren K; Woolson, Sandra L; King, Heather A; Oddone, Eugene Z; Bosworth, Hayden B

    2016-04-01

    Telemedicine-based medication management improves hypertension control, but has been evaluated primarily in patients with low antihypertensive drug counts. Its impact on patients taking three or more antihypertensive agents is not well-established. To address this evidence gap, the authors conducted an exploratory analysis of an 18-month, 591-patient trial of telemedicine-based hypertension medication management. Using general linear models, the effect of medication management on blood pressure for patients taking two or fewer antihypertensive agents at study baseline vs those taking three or more was compared. While patients taking two or fewer antihypertensive agents had a significant reduction in systolic blood pressure with medication management, those taking three or more had no such response. The between-subgroup effect difference was statistically significant at 6 months (-6.4 mm Hg [95% confidence interval, -12.2 to -0.6]) and near significant at 18 months (-6.0 mm Hg [95% confidence interval, -12.2 to 0.2]). These findings suggest that baseline antihypertensive drug count may impact how patients respond to hypertension medication management and emphasize the need to study management strategies specifically in patients taking three or more antihypertensive medications. PMID:26370918

  13. Client-Centered Advocacy: Every Occupational Therapy Practitioner's Responsibility to Understand Medical Necessity.

    PubMed

    Stover, Alyson D

    2016-01-01

    Occupational therapy practitioners must advocate for clients in multiple ways. The Occupational Therapy Practice Framework: Domain and Process as well as the Occupational Therapy Code of Ethics lend support to advocacy. Recognizing one's responsibility to provide advocacy for clients is different from knowing how to provide that advocacy. One aspect of health care affected by the Patient Protection and Affordable Care Act (ACA) is the definition and implementation of medical necessity. This article outlines some major concepts around medical necessity, particularly in relation to the passage of the ACA, and outlines guidance on how to advocate effectively to meet both individual and community needs. PMID:27548855

  14. Understanding barriers to medication adherence in the hypertensive population by evaluating responses to a telephone survey

    PubMed Central

    Nair, Kavita V; Belletti, Daniel A; Doyle, Joseph J; Allen, Richard R; McQueen, Robert B; Saseen, Joseph J; Vande Griend, Joseph; Patel, Jay V; McQueen, Angela; Jan, Saira

    2011-01-01

    Background: Although hypertension is a major risk factor for cardiovascular disease, adherence to hypertensive medications is low. Previous research identifying factors influencing adherence has focused primarily on broad, population-based approaches. Identifying specific barriers for an individual is more useful in designing meaningful targeted interventions. Using customized telephonic outreach, we examined specific patient-reported barriers influencing hypertensive patients’ nonadherence to medication in order to identify targeted interventions. Methods: A telephone survey of 8692 nonadherent hypertensive patients was conducted. The patient sample comprised health plan members with at least two prescriptions for antihypertensive medications in 2008. The telephone script was based on the “target” drug associated with greatest nonadherence (medication possession ratio [MPR] <80%) during the four-month period preceding the survey. Results: The response rate was 28.2% of the total sample, representing 63.8% of commercial members and 37.2% of Medicare members. Mean age was 63.4 years. Mean MPR was 61.0% for the target drug. Only 58.2% of Medicare respondents and 60.4% of commercial respondents reported “missing a dose of medication”. The primary reason given was “forgetfulness” (61.8% Medicare, 60.8% commercial), followed by “being too busy” (2.7% Medicare, 18.5% commercial) and “other reasons” (21.9% Medicare, 8.1% commercial) including travel, hospitalization/sickness, disruption of daily events, and inability to get to the pharmacy. Prescription copay was a barrier for less than 5% of surveyed patients. Conclusion: Our findings indicate that events interfering with daily routine had a significant impact on adherence. Medication adherence appears to be a patterned behavior established through the creation of a routine and a reminder system for taking the medication. Providers should assess patients’ daily schedules and medication

  15. History of British Space Science

    NASA Astrophysics Data System (ADS)

    Massie, Harrie; Robins, M. O.

    2009-12-01

    1. The scientific background; 2. The technical background; 3. The initiation of the Skylark rocket programme; 4. Post IGY developments; 5. The Ariel programme; 6. The European Space Research Organisation; 7. Commonwealth co-operation in space research; 8. Smaller rockets for scientific purposes - Skua and Petrel; 9. Attitude controlled Skylark rockets; 10. The Trend Committee and the Science Research Council; 11. The transformation of ESRO into ESA; 12. The Space Science Committee for Europe; 13. Scientific studies by British space scientists I; 14. Scientific studies by British space scientists II; 15. The contribution from British space scientists to astronomy; 16. Concluding remarks; Appendices; Annexes.

  16. Differences in maintenance of response upon discontinuation across medication treatments in attention-deficit/hyperactivity disorder.

    PubMed

    Buitelaar, Jan; Asherson, Philip; Soutullo, Cesar; Colla, Michael; Adams, David H; Tanaka, Yoko; Haynes, Virginia S; Escobar, Rodrigo; Upadhyaya, Himanshu

    2015-10-01

    The attention-deficit/hyperactivity disorder (ADHD) treatment literature has been focused on onset-of-effect and short-term effect size, with little exploration of ADHD symptoms upon medication discontinuation. The objective of this narrative review and analysis was to better understand the relapse of ADHD symptoms upon discontinuation of medication treatment in children, adolescents, and adults with ADHD who have responded to medication treatment and to explore differences among different medications in maintaining treatment response. Randomized withdrawal studies of dexmethylphenidate hydrochloride (d-MPH), methylphenidate modified-release (MPH-LA), lisdexamphetamine dimesylate (LDX), guanfacine extended-release (GXR), and atomoxetine (ATX) in both children/adolescents and adults with ADHD were reviewed. The percentage of relapse was significantly higher and the time-to-relapse significantly shorter with placebo compared to active treatment in patients who were previously stable on 5 weeks to 1 year of active treatment, suggesting clinically significant benefit with continued long-term pharmacotherapy. However, percentage of relapse at each time point studied after discontinuing stimulants and GXR appears substantially higher than observed when discontinuing ATX, suggesting longer maintenance of response after discontinuing ATX than after stimulants and GXR. Additionally, slope of relapse percentages over time appears to be more rapid with stimulants or GXR than with ATX. These differences in maintenance of response among ATX, GXR, and stimulants may reflect differences in mechanisms of action and persistence of the medication effect. Alternatively, they may be due to methodological differences, including study design and response/relapse definitions. Continued investigation is needed regarding factors that affect risk of symptom relapse upon discontinuation of pharmacotherapy. PMID:26169574

  17. "Signs of the times": Medicine and nationhood in British India.

    PubMed

    Chakrabarti, Pratik

    2009-01-01

    Medical practice and research in colonial India historically had been an imperial preserve, dominated by the elite members of the Indian Medical Service. This was contested from the 1900s on by the emerging Indian nationalism. This essay studies debates about the establishment of a medical research institution and how actors imposed the political identities of nationalism on British colonial practices of medical science. At the same time, Indian nationalism was also drawing from other emerging ideas around health and social welfare. The Indian nationalists and doctors sought to build the identities of the new nation and its medicine around their own ideas of its geography, people, and welfare. PMID:20027771

  18. Response capabilities of the National Guard: a focus on domestic disaster medical response.

    PubMed

    Bochicchio, Daniel

    2010-01-01

    The National Guard has a 373-year history of responding to the nation's call to duty for service both at home and abroad (The National Guard Bureau Web site: Available at http://www.ngb.army.mil/default. aspx.). The National Guard (NG) is a constitutionally unique organization (United States Constitution, US Government Printing Office Web site: Available at http://www.gpoaccess.gov/constitution/index.html.). Today's Guard conducts domestic disaster response and civilian assistance missions on a daily basis. Yet, the NG's role, mission, and capabilities are not well-known or understood. The National Response Framework (NRF) places significant responsibility on the local and state disaster planners (Department of Homeland Security: National Response Framework. US Department of Homeland Security, Washington, DC, January 2008). The public health professionals are an integral component of the disaster planning community. It is critical that the public health community be knowledgeable of types and capabilities of all the response assets at their disposal. PMID:20349703

  19. Ethics of care in medical tourism: Informal caregivers' narratives of responsibility, vulnerability and mutuality.

    PubMed

    Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy

    2015-09-01

    This study examines the experiences of informal caregivers in medical tourism through an ethics of care lens. We conducted semi-structured interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery, asking questions that dealt with their experiences prior to, during and after travel. Thematic analysis revealed three themes central to an ethics of care: responsibility, vulnerability and mutuality. Ethics of care theorists have highlighted how care has been historically devalued. We posit that medical tourism reproduces dominant narratives about care in a novel care landscape. Informal care goes unaccounted for by the industry, as it occurs in largely private spaces at a geographic distance from the home countries of medical tourists. PMID:26313855

  20. British Association of Clinical Anatomists

    PubMed Central

    1983-01-01

    The Annual General Meeting of the British Association of Clinical Anatomists for 1983 was held at the Royal College of Surgeons of England on 14th January 1983. The following are abstracts of the papers presented. PMID:19310890

  1. Condition Self-Management in Pediatric Spina Bifida: A Longitudinal Investigation of Medical Adherence, Responsibility-Sharing, and Independence Skills

    PubMed Central

    Psihogios, Alexandra M.; Kolbuck, Victoria

    2015-01-01

    Objective This study aimed to evaluate rates of medical adherence, responsibility, and independence skills across late childhood and adolescence in youth with spina bifida (SB) and to explore associations among these disease self-management variables. Method 111 youth with SB, their parents, and a health professional participated at two time points. Informants completed questionnaires regarding medical adherence, responsibility-sharing, and child independence skills. Results Youth gained more responsibility and independence skills across time, although adherence rates did not follow a similar trajectory. Increased child medical responsibility was related to poorer adherence, and father-reported independence skills were associated with increased child responsibility. Conclusions This study highlights medical domains that are the most difficult for families to manage (e.g., skin checks). Although youth appear to gain more autonomy across time, ongoing parental involvement in medical care may be necessary to achieve optimal adherence across adolescence. PMID:26002195

  2. Reinforcement and Stimulant Medication Ameliorate Deficient Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder.

    PubMed

    Rosch, Keri S; Fosco, Whitney D; Pelham, William E; Waxmonsky, James G; Bubnik, Michelle G; Hawk, Larry W

    2016-02-01

    This study examined the degree to which reinforcement, stimulant medication, and their combination impact response inhibition in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Across three studies, participants with ADHD (n = 111, 25 girls) and typically-developing (TD) controls (n = 33, 6 girls) completed a standard version of the stop signal task (SST) and/or a reinforcement-manipulation SST with performance-contingent points. In two of these studies, these tasks were performed under placebo or 0.3 and 0.6 mg/kg methylphenidate (MPH) conditions. Cross-study comparisons were conducted to test hypotheses regarding the separate and combined effects of reinforcement and methylphenidate on response inhibition among children with ADHD relative to TD controls. Baseline response inhibition was worse among children with ADHD compared to controls. MPH produced dose-related improvements in response inhibition in children with ADHD; compared to non-medicated TD controls, 0.3 mg/kg MPH normalized deficient response inhibition, and 0.6 mg/kg MPH resulted in better inhibition in children with ADHD. Reinforcement improved response inhibition to a greater extent for children with ADHD than for TD children, normalizing response inhibition. The combination of MPH and reinforcement improved response inhibition among children with ADHD compared to reinforcement alone and MPH alone, also resulting in normalization of response inhibition despite repeated task exposure. Deficient response inhibition commonly observed in children with ADHD is significantly improved with MPH and/or reinforcement, normalizing inhibition relative to TD children tested under standard conditions. PMID:25985978

  3. Utility and assessment of non-technical skills for rapid response systems and medical emergency teams.

    PubMed

    Chalwin, R P; Flabouris, A

    2013-09-01

    Efforts are ongoing to improve outcomes from cardiac arrest and medical emergencies. A promising quality improvement modality is use of non-technical skills (NTS) that aim to address human factors through improvements in performance of leadership, communication, situational awareness and decision-making. Originating in the airline industry, NTS training has been successfully introduced into anaesthesia, surgery, emergency medicine and other acute medical specialities. Some aspects of NTS have already achieved acceptance for cardiac arrest teams. Leadership skills are emphasised in advanced life support training and have shown favourable results when employed in simulated and clinical resuscitation scenarios. The application of NTS in medical emergency teams as part of a rapid response system attending medical emergencies is less certain; however, observations of simulations have also shown promise. This review highlights the potential benefits of NTS competency for cardiac arrest teams and, more importantly, medical emergency teams because of the diversity of clinical scenarios encountered. Discussion covers methods to assess and refine NTS and NTS training to optimise performance in the clinical environment. Increasing attention should be applied to yielding meaningful patient and organisational outcomes from use of NTS. Similarly, implementation of any training course should receive appropriate scrutiny to refine team and institutional performance. PMID:23611153

  4. Interactive voice response systems for medication identification requests: poison or cure?

    PubMed

    Benson, Blaine E

    2011-11-01

    Interactive voice response systems (IVR) have traditionally been used by banking and credit card industries to rapidly process information requests for their customers. Today IVR technology is being used in clinical medicine to randomize patients in clinical studies, to collect patient data, and to follow-up on recently discharged patients. Use of IVR systems by poison centers is relatively new. This commentary explores the advantages and disadvantages of applying IVR technology to the medication identification requests in poison centers. PMID:22077245

  5. Performance indicators for initial regional medical response to major incidents: a possible quality control tool

    PubMed Central

    2012-01-01

    Background Timely decisions concerning mobilization and allocation of resources and distribution of casualties are crucial in medical management of major incidents. The aim of this study was to evaluate documented initial regional medical responses to major incidents by applying a set of 11 measurable performance indicators for regional medical command and control and test the feasibility of the indicators. Methods Retrospective data were collected from documentation from regional medical command and control at major incidents that occurred in two Swedish County Councils. Each incident was assigned to one of nine different categories and 11 measurable performance indicators for initial regional medical command and control were systematically applied. Two-way analysis of variance with one observation per cell was used for statistical analysis and the post hoc Tukey test was used for pairwise comparisons. Results The set of indicators for regional medical command and control could be applied in 102 of the130 major incidents (78%), but 36 incidents had to be excluded due to incomplete documentation. The indicators were not applicable as a set for 28 incidents (21.5%) due to different characteristics and time frames. Based on the indicators studied in 66 major incidents, the results demonstrate that the regional medical management performed according to the standard in the early phases (1–10 min after alert), but there were weaknesses in the secondary phase (10–30 min after alert). The significantly lowest scores were found for Indicator 8 (formulate general guidelines for response) and Indicator 10 (decide whether or not resources in own organization are adequate). Conclusions Measurable performance indicators for regional medical command and control can be applied to incidents that directly or indirectly involve casualties provided there is sufficient documentation available. Measurable performance indicators can enhance follow- up and be used as a structured

  6. Medical Operations Console Procedure Evaluation: BME Response to Crew Call Down for an Emergency

    NASA Technical Reports Server (NTRS)

    Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis

    2006-01-01

    International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task

  7. Development and validation of a questionnaire to evaluate medical students’ and residents’ responsibility in clinical settings

    PubMed Central

    Asemani, Omid; Iman, Mohammad Taghi; Khayyer, Mohammad; Tabei, Seyed Ziaaddin; Sharif, Farkhondeh; Moattari, Marzieh

    2014-01-01

    There is a shortage of quantitative measures for assessing the concept of responsibility as a fundamental construct in medical education, ethics and professionalism in existing literature. This study aimed to develop an instrument for measuring responsibility in both undergraduate and graduate medical students during clinical training. Instrument content was based on literature review and mainly qualitative data obtained from a published grounded theory research. The draft questionnaire (Persian version) was then validated and revised with regard to face and content validity. The finalized 41-item questionnaire consists of four domains that were identified using factor analysis. Test-retest reliability and internal consistency were also assessed. Test-retest reliability was rather high, ranging between 0.70 and 0.75 for all domains. Cronbach’s alpha coefficients were 0.75 – 0.76 for all domains and 0.90 for the composite scale of the whole questionnaire. Correlations between the four domains of the instrument were also satisfactory (r ≤ 0.47 for most domains). The correlation between each domain and the composite scale was higher than its correlation with other domains (r ≥ 0.79 for most domains). The instrument demonstrated good construct and internal validity, and can be suitable for measuring the concept of responsibility in practice in different groups of undergraduate and graduate medical trainees (MTs). PMID:25512836

  8. Medical response to the Great East Japan Earthquake in Ishinomaki City

    PubMed Central

    2011-01-01

    Problem The Ishinomaki Red Cross Hospital is the only designated disaster hospital in the Ishinomaki Medical Zone, Japan that was undamaged from the Great East Japan Earthquake in March 2011. The tsunami completely destroyed a large part of the Ishinomaki Medical Zone. Context The Ishinomaki Red Cross Hospital was designed with the capability to respond to disasters. An instruction manual for responding to disasters had been developed and was exercised through drills. Action In accordance with the manual, the hospital disaster task force was established. The Ishinomaki Zone Joint Relief Team coordinated medical support from organizations such as physicians associations, dental associations, self-defence forces medical teams, pharmacists associations, the Japanese Red Cross and relief teams from hospitals all over the country. In three days, the joint relief team directly visited all emergency shelters to make an initial assessment and to collect information about the number and state of health of evacuees, provision of food and drinking-water and the availability of electricity, water and sewerage. Outcome Initial assessment revealed that 35 emergency shelters lacked a sufficient food supply and that 100 shelters had unsanitary conditions. The joint relief team provided the Miyagi Prefecture government and the Ishinomaki municipal government with information about emergency shelters that did not have sufficient food supply. As of 30 September, the activities of the joint relief team were completed, and there was no outbreak of communicable diseases in the Ishinomaki Medical Zone. A total of 328 shelters with 46 480 evacuees were managed by the Ishinomaki Zone Joint Relief Team. Discussion Advanced preparation to quickly establish an initial response system, expertise, and decision-making ability and the ability to get things done are required for disaster response management. PMID:23908895

  9. Courses in Physics in Medical Colleges

    ERIC Educational Resources Information Center

    Physics Education, 1975

    1975-01-01

    Provides information concerning programs in medical physics, radiation biology, and radiation physics at eight British medical colleges. Each institution is separately listed, and the provided information typically includes program descriptions, graduate programs, and main branches of research. (MLH)

  10. Medical Rapid Response in Psychiatry: Reasons for Activation and Immediate Outcome.

    PubMed

    Manu, Peter; Loewenstein, Kristy; Girshman, Yankel J; Bhatia, Padam; Barnes, Maira; Whelan, Joseph; Solderitch, Victoria A; Rogozea, Liliana; McManus, Marybeth

    2015-12-01

    Rapid response teams are used to improve the recognition of acute deteriorations in medical and surgical settings. They are activated by abnormal physiological parameters, symptoms or clinical concern, and are believed to decrease hospital mortality rates. We evaluated the reasons for activation and the outcome of rapid response interventions in a 222-bed psychiatric hospital in New York City using data obtained at the time of all activations from January through November, 2012. The primary outcome was the admission rate to a medical or surgical unit for each of the main reasons for activation. The 169 activations were initiated by nursing staff (78.7 %) and psychiatrists (13 %) for acute changes in condition (64.5 %), abnormal physiological parameters (27.2 %) and non-specified concern (8.3 %). The most common reasons for activation were chest pain (14.2 %), fluctuating level of consciousness (9.5 %), hypertension (9.5 %), syncope or fall (8.9 %), hypotension (8.3 %), dyspnea (7.7 %) and seizures (5.9 %). The rapid response team transferred 127 (75.2 %) patients to the Emergency Department and 46 (27.2 %) were admitted to a medical or surgical unit. The admission rates were statistically similar for acute changes in condition, abnormal physiological parameters, and clinicians' concern. In conclusion, a majority of rapid response activations in a self-standing psychiatric hospital were initiated by nursing staff for changes in condition, rather than for policy-specified abnormal physiological parameters. The findings suggest that a rapid response system may empower psychiatric nurses to use their clinical skills to identify patients requiring urgent transfer to a general hospital. PMID:25796608

  11. Genetic studies of DRD4 and clinical response to neuroleptic medications

    SciTech Connect

    Kennedy, J.L.; Petronis, A.; Gao, J.

    1994-09-01

    Clozapine is an atypical antipsychotic drug that, like most other medications, is effective for some people and not for others. This variable response across individuals is likely significantly determined by genetic factors. An important candidate gene to investigate in clozapine response is the dopamine D4 receptor gene (DRD4). The D4 receptor has a higher affinity for clozapine than any of the other dopamine receptors. Furthermore, recent work by our consortium has shown a remarkable level of variability in the part of the gene coding for the third cytoplasmic loop. We have also identified polymorphisms in the upstream 5{prime} putative regulatory region and at two other sites. These polymorphisms were typed in a group of treatment-resistant schizophrenia subjects who were subsequently placed on clozapine (n = 60). In a logistic regression analysis, we compared genotype at the DRD4 polymorphism to response versus non-response to clozapine. Neither the exon-III nor any of the 5{prime} polymorphisms alone significantly predicted response; however, when the information from these polymorphisms was combined, more predictive power was obtained. In a correspondence analysis of the four DRD4 polymorphisms vs. response, we were able to predict 76% of the variance in response. Refinement of the analyses will include assessment of subfactors involved in clinical response phenotype and incorporation of the debrisoquine metabolizing locus (CYP2D6) into the prediction algorithm.

  12. Foreign medical teams: what role can they play in response to a catastrophic disaster in the US?

    PubMed

    Hanfling, Dan; Bouri, Nidhi

    2013-12-01

    Hurricane Katrina demonstrated that a catastrophic event in the continental United States (US) can overwhelm domestic medical response capabilities. The recent focus on response planning for a catastrophic earthquake in the New Madrid Seismic Zone and the detonation of an improvised nuclear device also underscore the need for improved plans. The purpose of this analysis is to identify the potential role of foreign medical teams (FMTs) in providing medical response to a catastrophic event in the US. We reviewed existing policies and frameworks that address medical response to catastrophic events and humanitarian emergencies and assess current response capabilities by a variety of FMTs. While several policies and plans outline the role of the US in providing medical assistance during foreign disasters, further planning is necessary to identify how the US will integrate foreign medical assistance during a domestic catastrophic event. We provide an overview of considerations related to federal roles and responsibilities for managing and integrating FMTs into the overarching domestic medical response to a catastrophic disaster occurring in the continental US. PMID:24112384

  13. Impact of sanctions on procurement of medicine and medical devices in Iran; a technical response.

    PubMed

    Hosseini, Seyed Alireza

    2013-12-01

    Following recent sanctions on foreign trade, financial and banking services, Iran has faced major difficulties for importing medicines (both finished products and pharmaceutical raw materials) and medical devices. Problems with money transfer have made it extremely lengthy in time to import medicine and medical devices and these have negatively affected access to and affordability of medicines. Quality of pharmaceuticals and treatment of patients have also been affected due to changing the sources of imported medicines and raw materials for locally produced pharmaceuticals. Several interventions have been employed during the past few months in Iran to overcome the effects imposed by recent sanctions and drug shortages have been managed to some extent with attempts made by Iran Food and Drug Organization (IRI FDO). As recommended by the experts, a specific Society for Worldwide Interbank Financial Telecommunication line should be allocated for transferring money for medicines and medical devices and certain financial institutions are assigned for this purpose. It is also suggested that defining a white list of Iranian pharmaceuticals and medical device companies together with their foreign counterparts would facilitate this process. It appears that, in a public health prospective, ordinary people and patients are hurt and paying the cost for current sanctions. It remains the responsibility of the public health and international communities to separate public health from politics and to ease the pain of public from sanctions. PMID:24329148

  14. Educating Africans for Inferiority under British Rule: Bo School in Sierra Leone.

    ERIC Educational Resources Information Center

    Corby, Richard A.

    1990-01-01

    Sierra Leone's Bo School was established in 1906 by British colonial officials to educate chiefs' sons for subordinate positions. Nevertheless, the school contributed to creation of the postindependence ruling class. Enrollment, curriculum, student life, responsibilities of British and African teachers, and alumni networks are examined. Contains…

  15. Methods for the analysis of ordinal response data in medical image quality assessment.

    PubMed

    Keeble, Claire; Baxter, Paul D; Gislason-Lee, Amber J; Treadgold, Laura A; Davies, Andrew G

    2016-07-01

    The assessment of image quality in medical imaging often requires observers to rate images for some metric or detectability task. These subjective results are used in optimization, radiation dose reduction or system comparison studies and may be compared to objective measures from a computer vision algorithm performing the same task. One popular scoring approach is to use a Likert scale, then assign consecutive numbers to the categories. The mean of these response values is then taken and used for comparison with the objective or second subjective response. Agreement is often assessed using correlation coefficients. We highlight a number of weaknesses in this common approach, including inappropriate analyses of ordinal data and the inability to properly account for correlations caused by repeated images or observers. We suggest alternative data collection and analysis techniques such as amendments to the scale and multilevel proportional odds models. We detail the suitability of each approach depending upon the data structure and demonstrate each method using a medical imaging example. Whilst others have raised some of these issues, we evaluated the entire study from data collection to analysis, suggested sources for software and further reading, and provided a checklist plus flowchart for use with any ordinal data. We hope that raised awareness of the limitations of the current approaches will encourage greater method consideration and the utilization of a more appropriate analysis. More accurate comparisons between measures in medical imaging will lead to a more robust contribution to the imaging literature and ultimately improved patient care. PMID:26975497

  16. Toward diversity-responsive medical education: taking an intersectionality-based approach to a curriculum evaluation.

    PubMed

    Muntinga, M E; Krajenbrink, V Q E; Peerdeman, S M; Croiset, G; Verdonk, P

    2016-08-01

    Recent years have seen a rise in the efforts to implement diversity topics into medical education, using either a 'narrow' or a 'broad' definition of culture. These developments urge that outcomes of such efforts are systematically evaluated by mapping the curriculum for diversity-responsive content. This study was aimed at using an intersectionality-based approach to define diversity-related learning objectives and to evaluate how biomedical and sociocultural aspects of diversity were integrated into a medical curriculum in the Netherlands. We took a three-phase mixed methods approach. In phase one and two, we defined essential learning objectives based on qualitative interviews with school stakeholders and diversity literature. In phase three, we screened the written curriculum for diversity content (culture, sex/gender and class) and related the results to learning objectives defined in phase two. We identified learning objectives in three areas of education (medical knowledge and skills, patient-physician communication, and reflexivity). Most diversity content pertained to biomedical knowledge and skills. Limited attention was paid to sociocultural issues as determinants of health and healthcare use. Intersections of culture, sex/gender and class remained mostly unaddressed. The curriculum's diversity-responsiveness could be improved by an operationalization of diversity that goes beyond biomedical traits of assumed homogeneous social groups. Future efforts to take an intersectionality-based approach to curriculum evaluations should include categories of difference other than culture, sex/gender and class as separate, equally important patient identities or groups. PMID:26603884

  17. Task force St. Bernard: operational issues and medical management of a National Guard disaster response operation.

    PubMed

    Bonnett, Carl J; Schock, Tony R; McVaney, Kevin E; Colwell, Christopher B; Depass, Christopher

    2007-01-01

    After Hurricane Katrina struck the Gulf Coast of the United States on 29 August 2005, it became obvious that the country was facing an enormous national emergency. With local resources overwhelmed, governors across the US responded by deploying thousands of National Guard soldiers and airmen. The National Guard has responded to domestic disasters due to natural hazards since its inception, but an event with the magnitude of Hurricane Katrina was unprecedented. The deployment of >900 Army National Guard soldiers to St. Bernard Parish, Louisiana in the aftermath of the Hurricane was studied to present some of the operational issues involved with providing medical support for this type of operation. In doing so, the authors attempt to address some of the larger issues of how the National Guard can be incorporated into domestic disaster response efforts. A number of unforeseen issues with regards to medical operations, medical supply, communication, preventive medicine, legal issues, and interactions with civilians were encountered and are reviewed. A better understanding of the National Guard and how it can be utilized more effectively in future disaster response operations can be developed. PMID:18087915

  18. Micro- and Nanotechnologies for Intelligent and Responsive Biomaterial-Based Medical Systems

    PubMed Central

    Caldorera-Moore, Mary; Peppas, Nicholas A.

    2009-01-01

    Advances in medical treatments of a wide variety of pathophysiological conditions require the development of better therapeutic agents, as well as a combination of the required therapeutic agents with device-integrated biomaterials that can serve as sensors and carriers. Combination of micro- and nanofabricated systems with intelligent biomaterials that have the ability to sense and respond is a promising avenue for the development of better diagnostic and therapeutic medical systems. Micro- and nano-electromechanical systems (MEMs and NEMs) are now becoming a family of potentially powerful new technologies for drug delivery, diagnostic tools, and tissue engineering. Improvements in micro- and nano-fabrication technology have enhanced the ability to create better performing therapeutic systems for numerous pathophysiological applications. More importantly, MEMS and NEMS-based tissue regeneration scaffolds, biosensors, and drug delivery devices provide new opportunities to mimic the natural intelligence and response of biological systems. PMID:19758574

  19. An 802.11 wireless blood pulse-oximetry system for medical response to disasters.

    PubMed

    Palmer, Douglas A; Rao, Ramesh; Lenert, Leslie A

    2005-01-01

    In a mass casualty situation, medical personnel at the disaster site and other field treatment settings may need to monitor the vital signs of hundreds of seriously injured patients with minimal staffing. The conditions may be primitive and personnel may have to improvise infrastructure. As part of our research to enhance medical response to disasters with Internet-enabled systems, we have developed a prototype Wireless Blood Pulse Oximeter system for mass casualty events designed to operate in WiFi hotspots. Pulse ox units were designed using low-cost embedded system technologies to operate in integrated or stand alone environments. Units can report data to a command post on the scene or any remote location with Internet access. The entire system is potentially capable of tracking and monitoring several hundred patients. PMID:16779359

  20. Discontinuation of medication overuse in headache patients: recovery of therapeutic responsiveness.

    PubMed

    Zeeberg, P; Olesen, J; Jensen, R

    2006-10-01

    It is generally accepted that ongoing medication overuse nullifies the effect of prophylactic treatment, although few data support this contention. We set out to describe the treatment outcome in patients withdrawn from medication overuse and relate any improvement to a renewed effect of prophylaxis. For patients with probable medication-overuse headache (pMOH), treated and dismissed from the Danish Headache Centre in 2002 and 2003, we assed, from prospective headache diaries, the headache frequency before and after withdrawal of offending drugs and compared these frequencies with the headache frequency at dismissal. Among 1326 patients, 337 had pMOH. Eligible were 175, mean age 49 years, male/female ratio 1 : 2.7. Overall, there was a 46% decrease in headache frequency from the first visit to dismissal (P < 0.0001). Patients with no improvement 2 months after complete drug withdrawal (N = 88) subsequently responded to pharmacological and/or non-pharmacological prophylaxis with a 26% decrease in headache frequency as measured from the end of withdrawal to dismissal (P < 0.0001). At dismissal, 47% were on prophylaxis. Former non-responders to medical prophylaxis had a 49% decrease in headache frequency from first visit to dismissal (P < 0.0001), whereas those who had never received prophylaxis had a 56% reduction (P < 0.0001). This difference was not statistically significant (P = 0.22). Almost all MOH patients benefit from drug withdrawal, either just from the withdrawal or by transformation from therapeutic non-responsiveness to responsiveness. According to the International Classification of Headache Disorders, 2nd edn, the MOH diagnosis requires improvement after drug withdrawal. Our data suggest that these diagnostic criteria are too strict. PMID:16961785

  1. Medical school survival versus social responsibility: finances as a driving force.

    PubMed

    Brandt, E N

    1989-01-01

    Medical educators are an interesting group of people. They thrive on new knowledge. They get excited and enthusiastic, and readily adopt new ways when the evidence is sufficient. Yet, at the same time, they resist with great vehemence change in the way they do their business. Ask how often the curriculum structure is examined. Indeed, the function of most curriculum committees is to ensure that that does not happen. Ask how often the criteria for medical school admission are examined, especially with respect to the knowledge requirements. Ask how often the faculty discusses, or even examines, the expectations of society as they are expressed by alumni, legislators, or members of the public. Ask how often faculties try to determine strategies for dealing with all of these external forces. Are those strategies approached with the same degree of objectivity and data-gathering skills that would be used in examining new therapeutic regimens? Medical educators are talented, creative people. They have a very large appetite for information and great ambition to be as fine academicians as possible. It is those characteristics that have served them well, as students and as responsible academicians. Indeed, the great strength of medical education, in my view, is that medical schools take some very bright people called faculty and some very bright people called students, mix them together for four years, and graduate a group of very smart people who will then spend three years or more mixed up with some very bright and creative people. That is a strength that can-not lost. Will the future allow us to continue that in an equally effective manner? PMID:2734361

  2. Self-reported responsiveness to direct-to-consumer drug advertising and medication use: results of a national survey

    PubMed Central

    2011-01-01

    Background Direct-to-consumer (DTC) marketing of pharmaceuticals is controversial, yet effective. Little is known relating patterns of medication use to patient responsiveness to DTC. Methods We conducted a secondary analysis of data collected in national telephone survey on knowledge of and attitudes toward DTC advertisements. The survey of 1081 U.S. adults (response rate = 65%) was conducted by the Food and Drug Administration (FDA). Responsiveness to DTC was defined as an affirmative response to the item: "Has an advertisement for a prescription drug ever caused you to ask a doctor about a medical condition or illness of your own that you had not talked to a doctor about before?" Patients reported number of prescription and over-the-counter (OTC) medicines taken as well as demographic and personal health information. Results Of 771 respondents who met study criteria, 195 (25%) were responsive to DTC. Only 7% respondents taking no prescription were responsive, whereas 45% of respondents taking 5 or more prescription medications were responsive. This trend remained significant (p trend .0009) even when controlling for age, gender, race, educational attainment, income, self-reported health status, and whether respondents "liked" DTC advertising. There was no relationship between the number of OTC medications taken and the propensity to discuss health-related problems in response to DTC advertisements (p = .4). Conclusion There is a strong cross-sectional relationship between the number of prescription, but not OTC, drugs used and responsiveness to DTC advertising. Although this relationship could be explained by physician compliance with patient requests for medications, it is also plausible that DTC advertisements have a particular appeal to patients prone to taking multiple medications. Outpatients motivated to discuss medical conditions based on their exposure to DTC advertising may require a careful medication history to evaluate for therapeutic duplication or

  3. Self-reported responsiveness to direct-to-consumer drug advertising and medication use: results of a national survey.

    PubMed

    Dieringer, Nicholas J; Kukkamma, Lisa; Somes, Grant W; Shorr, Ronald I

    2011-01-01

    ABSTRACT: BACKGROUND: Direct-to-consumer (DTC) marketing of pharmaceuticals is controversial, yet effective. Little is known relating patterns of medication use to patient responsiveness to DTC. METHODS: We conducted a secondary analysis of data collected in national telephone survey on knowledge of and attitudes toward DTC advertisements. The survey of 1081 U.S. adults (response rate = 65%) was conducted by the Food and Drug Administration (FDA). Responsiveness to DTC was defined as an affirmative response to the item: "Has an advertisement for a prescription drug ever caused you to ask a doctor about a medical condition or illness of your own that you had not talked to a doctor about before?" Patients reported number of prescription and over-the-counter (OTC) medicines taken as well as demographic and personal health information. RESULTS: Of 771 respondents who met study criteria, 195 (25%) were responsive to DTC. Only 7% respondents taking no prescription were responsive, whereas 45% of respondents taking 5 or more prescription medications were responsive. This trend remained significant (p trend .0009) even when controlling for age, gender, race, educational attainment, income, self-reported health status, and whether respondents "liked" DTC advertising. There was no relationship between the number of OTC medications taken and the propensity to discuss health-related problems in response to DTC advertisements (p = .4). CONCLUSION: There is a strong cross-sectional relationship between the number of prescription, but not OTC, drugs used and responsiveness to DTC advertising. Although this relationship could be explained by physician compliance with patient requests for medications, it is also plausible that DTC advertisements have a particular appeal to patients prone to taking multiple medications. Outpatients motivated to discuss medical conditions based on their exposure to DTC advertising may require a careful medication history to evaluate for therapeutic

  4. The Effect of Training on Medical Students' Responses to Geriatric Patient Concerns: Results of a Linguistic Analysis.

    ERIC Educational Resources Information Center

    Robins, Lynne S.; Wolf, Fredric M.

    1989-01-01

    Found that experience-based educational intervention in which medical students interview volunteer nursing home residents significantly changed medical students' responses to two geriatric patient vignettes. Concluded that use of elderly volunteers in practice interviews helped to sensitize students to problems of aging and taught them empathic…

  5. Family experiences with pediatric antiretroviral therapy: responsibilities, barriers, and strategies for remembering medications.

    PubMed

    Marhefka, Stephanie L; Koenig, Linda J; Allison, Susannah; Bachanas, Pamela; Bulterys, Marc; Bettica, Linda; Tepper, Vicki J; Abrams, Elaine J

    2008-08-01

    This study examines the relationship between adherence to pediatric HIV regimens and three family experience factors: (1) regimen responsibility; (2) barriers to adherence; and (3) strategies for remembering to give medications. Caregivers of 127 children ages 2-15 years in the PACTS-HOPE multisite study were interviewed. Seventy-six percent of caregivers reported that their children were adherent (taking > or = 90% of prescribed doses within the prior 6 months). Most caregivers reported taking primary responsibility for medication-related activities (72%-95% across activities); caregivers with primary responsibility for calling to obtain refills (95%) were more likely to have adherent children. More than half of caregivers reported experiencing one or more adherence barriers (59%). Caregivers who reported more barriers were also more likely to report having non-adherent children. Individual barriers associated with nonadherence included forgetting, changes in routine, being too busy, and child refusal. Most reported using one or more memory strategies (86%). Strategy use was not associated with adherence. Using more strategies was associated with a greater likelihood of reporting that forgetting was a barrier. For some families with adherence-related organizational or motivational difficulties, using numerous memory strategies may be insufficient for mastering adherence. More intensive interventions, such as home-based nurse-administered dosing, may be necessary. PMID:18627275

  6. Measuring health status in British patients with rheumatoid arthritis: reliability, validity and responsiveness of the short form 36-item health survey (SF-36).

    PubMed

    Ruta, D A; Hurst, N P; Kind, P; Hunter, M; Stubbings, A

    1998-04-01

    The objective was to assess the performance of the SF-36 health survey (SF-36) in a sample of patients with rheumatoid arthritis (RA) stratified by functional class. The eight SF-36 subscales and the two summary scales (the physical and mental component scales) were assessed for test retest reliability, construct validity and responsiveness to self-reported change in health. In 233 patients with RA, the SF-36 scales were: reliable (intra-class correlation coefficients 0.76-0.93); correlated with American College of Rheumatology (ACR) core disease activity measures [Spearman r = -0.12 (erythrocyte sedimentation rate) to -0.89 (Modified Health Assessment Questionnaire)]; and responsive to improvements in health (standardized response means 0.27-0.9). The distribution of scores on four of the eight subscales (physical function, role limitations physical, role limitations emotional and social function) was clearly non-Gaussian. Very marked floor effects were noted with the physical function scale, and both ceiling and floor effects with the other three subscales. The two SF-36 physical and mental component summary scales are reliable, valid and responsive measures of health status in patients with RA. Six of the eight subscales meet standards required for comparing groups of patients, and the physical function and general health scales may be suitable for monitoring individuals. The two scales measuring role limitations have poor measurement characteristics. The SF-36 pain and physical function scales may be suitable for use as patient self-assessed measures of pain and physical function within the ACR core disease activity set. PMID:9619895

  7. Infectious disease control in the Ionian Islands during the British Protection (1815-1864).

    PubMed

    Tsiamis, Costas; Thalassinou, E; Poulakou-Rebelakou, E; Anogiatis-Pelé, D; Hatzakis, A

    2013-09-01

    This review presents the medical and social role of British military doctors in the formation of the British sanitary campaign in the Ionian Islands during the period 1815-1864. They were the core of a health system based on the old sanitary model of the Venetian Republic, which was the former ruler of the region. The British innovation and reorganisation of the old lazarettos (a quarantine system for maritime travellers), the new marine sanitary procedures, the determination of quarantine duration for major infectious diseases along with the introduction of the vaccination system resulted in a satisfactory defence against epidemics in Greece during the 19th century. The British military physicians applied and established West European medical ideas, as well as the principles of preventive medicine, for the first time in the Greek territory and this is a historical example of a successful sanitary campaign based on the experience of military physicians and their collaboration with civilian physicians. PMID:23720505

  8. Medical planning and response for a nuclear detonation: a practical guide.

    PubMed

    Coleman, C Norman; Adams, Steven; Adrianopoli, Carl; Ansari, Armin; Bader, Judith L; Buddemeier, Brooke; Caro, J Jaime; Casagrande, Rocco; Case, Cullen; Caspary, Kevin; Chang, Arthur S; Chang, H Florence; Chao, Nelson; Cliffer, Kenneth D; Confer, Dennis; Deitchman, Scott; Derenzo, Evan G; Dobbs, Allen; Dodgen, Daniel; Donnelly, Elizabeth H; Gorman, Susan; Grace, Marcy Beth; Hatchett, Richard; Hick, John L; Hrdina, Chad; Jones, Robert; Kane, Elleen; Knebel, Ann; Koerner, John F; Laffan, Alison M; Larson, Leon; Livinski, Alicia; Mackinney, John; Maidment, Bert W; Manning, Ronald; Marinissen, Maria J; Martin, Colleen; Michael, Gretchen; Murrain-Hill, Paula; Nemhauser, Jeffrey B; Norwood, Ann E; Nystrom, Scott; Raheem, Murad; Redlener, Irwin; Sheehan, Kevin; Simon, Steven L; Taylor, Tammy P; Toner, Eric; Wallace, Katherine S; Wieder, Jessica; Weinstock, David M; Wiley, Albert L; Yeskey, Kevin; Miller, Charles W; Whitcomb, Robert C

    2012-12-01

    This article summarizes major points from a newly released guide published online by the Office of the Assistant Secretary for Preparedness and Response (ASPR). The article reviews basic principles about radiation and its measurement, short-term and long-term effects of radiation, and medical countermeasures as well as essential information about how to prepare for and respond to a nuclear detonation. A link is provided to the manual itself, which in turn is heavily referenced for readers who wish to have more detail. PMID:23244500

  9. British privatization--taking capitalism to the people.

    PubMed

    Moore, J

    1992-01-01

    From 1983 to 1986, John Moore served in the Thatcher government in Britain, launching that country's privatization program. In "British Privatization--Taking Capitalism to the People, " he describes the thinking behind privatization, the objections raised against it, and the actual measures taken to implement it. With privatization, corporate performance has improved and the government has been able to focus on regulation, not ownership. But in the end, says Moore, the greatest success of British privatization was that it transformed the public's attitude toward ownership and economic responsibility. PMID:10119711

  10. Determinants of the occupational strategies adopted by British hospital nurses.

    PubMed

    Bellaby, P; Oribabor, P

    1980-01-01

    This paper focuses on the position of the nurse in the division of labor in health care and the occupational strategies British hospital nurses have adopted in response to their changing employement situation. The authors suggest a Marxist framework as an alternative to current approaches to the study of occupational strategy, which tend to focus on the level of distribution relations. An adequate analysis of the situation of hospital nurses, the paper suggests, depends upon locating the occupation within the wider setting of the mode of control and delivery of health care. The central feature of this setting is the dominance of medicine and medical technology, and the main factors shaping it are the activities of individual capitalists involved in the health industry and the State operating within the constraints of capital in general and within the context of class struggle. It is suggested that the characteristic feature of nurses' occupational strategy--the vacillation between professionalism and unionism--can best be understood in relation to the changing mode of control and delivery of health care and nurses' contradictory position within the social relations that constitute that mode. PMID:7372385

  11. Is There a Crisis in British Secondary Schools?

    ERIC Educational Resources Information Center

    Judge, Harry

    1989-01-01

    Advertised as a response to a secondary school's crisis in Great Britain, the Education Reform Act (1988) is actually engineering a crisis by attempting to change the nature of British society and politics. Traditional arrangements are yielding to a more centralized educational finance system, a national curriculum, and increased teacher…

  12. Dual Relationships in Counselling: A Survey of British Columbian Counsellors

    ERIC Educational Resources Information Center

    Nigro, Tracey; Uhlemann, Max R.

    2004-01-01

    The British Columbian Members of the Canadian Counselling Association were surveyed, in order to explore their attitudes and experiences regarding dual relationships. Of 529 deliverable surveys, 206 usable returns yielded a response rate of 39%. The survey instrument collected data regarding respondents' characteristics and ethicality ratings of…

  13. Learning to Be. A Perspective from British Columbia, Canada

    ERIC Educational Resources Information Center

    Halbert, Judy; Kaser, Linda

    2015-01-01

    This article describes how "learning to be", with a specific focus on social-emotional competencies, has become part of the educational mindset--and educational policy--in British Columbia, Canada. The development of a set of learning progressions for social responsibility, an emphasis on social emotional learning in the new curriculum…

  14. Reducing Emergency Medical Service response time via the reallocation of ambulance bases.

    PubMed

    Nogueira, L C; Pinto, L R; Silva, P M S

    2016-03-01

    The demand for highly efficient and effective services and consumer goods is an essential prerequisite for modern organizations. In healthcare, efficiency and effectiveness mean reducing disabilities and maintaining human life. One challenge is guaranteeing rapid Emergency Medical Service (EMS) response. This study analyzes the EMS of Belo Horizonte, Brazil, using two modeling techniques: optimization and simulation. The optimization model locates ambulance bases and allocates ambulances to those bases. A simulation of this proposed configuration is run to analyze the dynamic behavior of the system. The main assumption is that optimizing the ambulance base locations can improve the system response time. Feasible solutions were found and the current system may be improved while considering economic and operational changes. PMID:24744263

  15. ADULT EDUCATION IN BRITISH COLUMBIA.

    ERIC Educational Resources Information Center

    VERNER, COOLIE, ED.

    PREPARED UNDER THE SPECIAL EDITORSHIP OF COOLIE VERNER, THIS JOURNAL ISSUE REVIEWS THE OVERALL DEVELOPMENT OF ADULT EDUCATION IN BRITISH COLUMBIA FROM THE LATE NINETEENTH CENTURY TO THE PRESENT, TRACES THE GROWTH OF UNIVERSITY EXTENSION DURING THE PERIOD 1915-63, DISCUSSES RECENT TRENDS AND ACTIVITIES IN VOCATIONAL AND NONVOCATIONAL PUBLIC SCHOOL…

  16. American English vs. British English

    ERIC Educational Resources Information Center

    Shahheidaripour, Gholamabbass

    1997-01-01

    The present study, using a totally direct method, investigates, within the framework of sociolinguistics and foreign language teaching in Iran, whether teachers of English prefer British or American variety of English language, and whether their preference corresponds to their performance on a related test. Thirty Iranian English language teachers…

  17. Instructor Training on British Railways

    ERIC Educational Resources Information Center

    Gibson, J. D.

    1970-01-01

    The value of instructor training was recognized by British Railways as early as 1950 with the setting up of a training center at Darlington. This article shows the results of this continuous training experience in the benefits to be obtained from re-appraisal techniques and practical work. (Author/EB)

  18. Children's Superstitions: British and Canadian.

    ERIC Educational Resources Information Center

    McLeish, John

    1984-01-01

    A 100-item test covering nine areas of superstitious belief administered with 10 control items to 1,749 Canadian and British children showed younger children and girls were more superstitious than older children and boys. Academically inclined children were less superstitious. Science-based education had little effect. Implications for Canadian…

  19. Tides of the British Seas

    ERIC Educational Resources Information Center

    Sandon, Frank

    1975-01-01

    Examines the gravitational effects and the way that local conditions interact with these effects to produce the tides characteristic of the British seas. Presents some effects of tides including the possibility of harnessing tidal energy and the effect of tidal friction on the use of the earth as a clock. (GS)

  20. British Industrial Libraries Before 1939

    ERIC Educational Resources Information Center

    Marshall, Margaret R.

    1972-01-01

    British industrial firm libraries are traced from their beginnings till 1939, by which date they had spread to many branches of industry and had been recognized as an important part of the industrial and library worlds, thus establishing standard patterns of work. The origins and significance of Aslib are discussed. (27 references) (Author/NH)

  1. Early response to medical treatment of trigeminal neuralgia in a Nigerian population

    PubMed Central

    Omoregie, Osawe Felix; Okoh, Mercy

    2015-01-01

    Background: This study evaluates the clinical profile of patients suffering from trigeminal neuralgia (TN) and correlates the findings with early response of the patients to medical treatment. Patients and Methods: A 4-year prospective study in which patients diagnosed of TN were treated medically and followed up weekly for 8 weeks to determine early treatment outcome, in the University of Benin Teaching Hospital, Benin City, Nigeria. Results: Of the 287 patients seen during the study period, a total of 14 (4.9%) patients were diagnosed of TN. Thirteen (4.5%) of the cases were selected based on compliance to the 8-week follow-up visits, consisting of 8 (61.5%) males and 5 (38.5%) females, giving a ratio of 1.6:1. The mean age of the patients was 50±1.5 years. The mandibular (n = 6, 46.2%) and maxillary (n = 5, 38.5%) divisions of the trigeminal nerve were mostly affected. The lesion was slightly more common on the right side of the face (n = 7, 53.8%) than the left side (n = 6, 46.2%). Talking (n=4, 30.8%) and chewing (n = 3, 23.1%) were the most frequent trigger factors. The patients mostly described the pain as severe, spontaneous, and sharp (n = 5, 38.2%). Most patients became stable on tablets carbamazepine 200 mg 12 hourly, folic acid 5 mg daily, and phenytoin 100 mg daily. Good response was observed in most patients within 2 weeks (n = 6, 46.2%) of medical treatment, especially in patients at the seventh decade of age (n = 3, 23.1%) and those with lesions involving the mandibular division of the trigeminal nerve (n = 3, 23.1%). Conclusion: This study shows early response of TN to medical treatment. We recommend combination therapy of carbamazepine and folic acid in the treatment of patients, especially elderly patients with lesions involving the mandibular division of the trigeminal nerve. PMID:26903693

  2. Incorporating Concomitant Medications into Genome-Wide Analyses for the Study of Complex Disease and Drug Response

    PubMed Central

    Graham, Hillary T.; Rotroff, Daniel M.; Marvel, Skylar W.; Buse, John B.; Havener, Tammy M.; Wilson, Alyson G.; Wagner, Michael J.; Motsinger-Reif, Alison A.; Friedewald, W.T.

    2016-01-01

    Given the high costs of conducting a drug-response trial, researchers are now aiming to use retrospective analyses to conduct genome-wide association studies (GWAS) to identify underlying genetic contributions to drug-response variation. To prevent confounding results from a GWAS to investigate drug response, it is necessary to account for concomitant medications, defined as any medication taken concurrently with the primary medication being investigated. We use data from the Action to Control Cardiovascular Disease (ACCORD) trial in order to implement a novel scoring procedure for incorporating concomitant medication information into a linear regression model in preparation for GWAS. In order to accomplish this, two primary medications were selected: thiazolidinediones and metformin because of the wide-spread use of these medications and large sample sizes available within the ACCORD trial. A third medication, fenofibrate, along with a known confounding medication, statin, were chosen as a proof-of-principle for the scoring procedure. Previous studies have identified SNP rs7412 as being associated with statin response. Here we hypothesize that including the score for statin as a covariate in the GWAS model will correct for confounding of statin and yield a change in association at rs7412. The response of the confounded signal was successfully diminished from p = 3.19 × 10−7 to p = 1.76 × 10−5, by accounting for statin using the scoring procedure presented here. This approach provides the ability for researchers to account for concomitant medications in complex trial designs where monotherapy treatment regimens are not available.

  3. Medical response to a radiologic/nuclear event: integrated plan from the Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services.

    PubMed

    Coleman, C Norman; Hrdina, Chad; Bader, Judith L; Norwood, Ann; Hayhurst, Robert; Forsha, Joseph; Yeskey, Kevin; Knebel, Ann

    2009-02-01

    The end of the Cold War led to a reduced concern for a major nuclear event. However, the current threats from terrorism make a radiologic (dispersal or use of radioactive material) or nuclear (improvised nuclear device) event a possibility. The specter and enormousness of the catastrophe resulting from a state-sponsored nuclear attack and a sense of nihilism about the effectiveness of a response were such that there had been limited civilian medical response planning. Although the consequences of a radiologic dispersal device are substantial, and the detonation of a modest-sized (10 kiloton) improvised nuclear device is catastrophic, it is both possible and imperative that a medical response be planned. To meet this need, the Office of the Assistant Secretary for Preparedness and Response in the Department of Health and Human Services, in collaboration within government and with nongovernment partners, has developed a scientifically based comprehensive planning framework and Web-based "just-in-time" medical response information called Radiation Event Medical Management (available at http://www.remm.nlm.gov). The response plan includes (1) underpinnings from basic radiation biology, (2) tailored medical responses, (3) delivery of medical countermeasures for postevent mitigation and treatment, (4) referral to expert centers for acute treatment, and (5) long-term follow-up. Although continuing to evolve and increase in scope and capacity, current response planning is sufficiently mature that planners and responders should be aware of the basic premises, tools, and resources available. An effective response will require coordination, communication, and cooperation at an unprecedented level. The logic behind and components of this response are presented to allow for active collaboration among emergency planners and responders and federal, state, local, and tribal governments. PMID:18387707

  4. Using environmental and growth characteristics of plants to detect long-term changes in response to atmospheric pollution: some examples from British beechwoods.

    PubMed

    Ling, K A

    2003-07-01

    This study uses the Ellenberg system of plant indicator values, along with Grime et al.'s plant growth strategy values, to investigate the nature of temporal changes in the composition of ground flora in two beechwoods in the Cotswolds region of the UK, currently receiving atmospheric inputs of nitrogen in excess of critical loads. The woods, first surveyed in the early 1960s, were resurveyed in 1998 using the original sampling protocol. Temporal changes in the abundance of individual species at Blackstable West Wood indicate changes in light over time, although decreases in sun species, and both increases and decreases in shade species suggest that this change has been patchy. Analysis of changes in plant community as represented by weighted and unweighted quadrat Ellenberg and CSR scores have yielded more significant results. Blackstable West Wood shows increases in nitrophilic, moist-soil and competitive species accompanied by a decline in stress-tolerant species. In Buckholt Top Wood there has been an increase in sun and moist-soil species, a decrease in competitive species and, when weighted Ellenberg scores are considered, an increase in acid-tolerant species. These changes indicate both the impact of woodland management by selective felling and an underlying influence of enhanced atmospheric deposition especially of nitrogen pollutants. It is concluded that quadrat mean scores are a useful tool especially where few individual species have undergone large temporal changes in abundance. However, lack of correlations between quadrat Ellenberg scores for pH and light on one hand, and their equivalents measured in the field, i.e. soil pH and surrogates for light, such as distance to the nearest tree and tree density, suggest that this approach may not be sensitive enough to pick up small-scale, within site variations. Although harder to interpret, plant strategy scores were found to be a useful additional descriptor, encapsulating a plant's response to a range of

  5. Factors affecting response to medical management in patients of filarial chyluria: A prospective study

    PubMed Central

    Goyal, Neeraj Kumar; Goel, Apul; Sankhwar, Satyanarayan; Singh, Vishwajeet; Ali, Wahid; Natu, S. M.; Singh, Bhupendra Pal; Sinha, Rahul Janak; Dalela, Divakar

    2014-01-01

    Introduction: Filarial chyluria is a common problem in filarial endemic countries. Its management begins with medical therapy but some patients progress to require surgery. The present study aimed to determine factors affecting response to medical management in patients of filarial chyluria. Materials and Methods: This prospective study conducted between August 2008 and November 2012, included conservatively managed patients of chyluria. Demographic profile, clinical presentation, treatment history and urinary triglycerides (TGs) and cholesterol levels at baseline were compared between the responders and non-responders. Apart from the clinical grade of chyluria, hematuria was evaluated as an independent risk factor. Results: Out of the 222 patients (mean age, 37.99 ± 13.29 years, 129 males), 31 patients failed to respond while 35 had a recurrence after initial response; the overall success rate being 70.3% at a mean follow-up of 25 months. No difference was observed in demographics, clinical presentation, presence of hematuria, disease duration and mean urinary TGs loss between responders and non-responders. On multivariate analysis, patients with treatment failure were found to have a higher-grade disease (14.3% Grade-I, 36.6% Grades-II and 60% Grade-III), higher number of pretreatment courses (1.59 ± 1.08 vs. 1.02 ± 0.79) and heavier cholesterol (26.54 ± 23.46 vs. 8.81 ± 8.55 mg/dl) loss at baseline compared with responders (P < 0.05). Conclusion: Conservative management has a success rate in excess of 70%, not affected by the disease chronicity, previous episodes and recurrent nature. However, higher-grade disease, extensive pre-treatment with drugs and higher urinary cholesterol loss at baseline are the predictors of poor response. Hematuria is not an independent poor risk factor for conservative management. PMID:24497677

  6. A brief history of British military experiences with infectious and tropical diseases.

    PubMed

    Bailey, Mark S

    2013-09-01

    Infectious and tropical diseases have been a problem for British expeditionary forces ever since the Crusades. Outbreaks were especially common on Navy ships from the 16th to 18th centuries due to poor living conditions and travel to the tropics. However, since these occurred in small, isolated and controlled environments it meant that naval medical practitioners were able to keep detailed records and develop empirical approaches for their prevention. The first Royal Naval Hospitals were established in response to these diseases and Royal Navy doctors made valuable early contributions towards understanding them. Even larger outbreaks of infectious and tropical diseases occurred in the Army during the Napoleonic, Crimean and Boer Wars and throughout the colonial era, which strongly influenced the formation of the Army Medical Services including provision for teaching and research. The establishment of germ theory led to a golden era of discovery regarding these diseases and British Army doctors made numerous important contributions. Subsequent improvements in prevention, diagnosis and treatment reduced the mortality from infectious and tropical diseases during the World Wars, but they remained a significant problem in the non-European campaigns and also the numerous 'small wars' that followed. Even in the 21st century some of these diseases still cause outbreaks with significant morbidity and impact on deployments, but the military clinical and academic resources to deal with them are now much reduced. Preventive measures such as hygiene, sanitation, infection control, vaccination and chemoprophylaxis are invaluable, but history shows that these can become neglected over time and disrupted or overwhelmed during the early or most intense stages of military operations. This is why military specialists in infectious diseases, tropical medicine, sexual health, medical microbiology and communicable diseases control are still required. PMID:24109135

  7. The Student Response System. A 5-year Mayo Medical School Experience.

    PubMed

    Ludwig, J; Mitchell, M M

    1977-09-01

    The Student Response System is a commercially available electronic communication system applicable to many teaching and testing situations. At rather short intervals during a programmed course, the instructor projects on a screen multiple-choice questions that the student should have learned to answer during one or two previous teaching steps. Correct and incorrect responses are indicated on a panel on the desk of the instructor. If students fail to give the correct answer, the teaching step is repeated. Recurrent incorrect answers indicate that explanations had been inappropriate or that test slides were poorly designed. Thus, the system allows the instructor to monitor his own performance. Students are kept alert and attention spans are prolonged; communication is increased and personal embarrassment is minimized. Only the instructor has access to the individual student's response. Most learning takes place in the classroom rather than during subsequent private study. This system is quite versatile and offers potential uses hitherto untested in medical education at all levels. PMID:70573

  8. Combination of Two Targeted Medications (Bevacizumab Plus Cetuximab) Improve the Therapeutic Response of Pancreatic Carcinoma

    PubMed Central

    Tai, Cheng-Jeng; Huang, Ming-Te; Wu, Chih-Hsiung; Wang, Chien-Kai; Tai, Chen-Jei; Chang, Chun-Chao; Hsieh, Cheng-I.; Chang, Yu-Jia; Wu, Chang-Jer; Kuo, Li-Jen; Wei, Po-Lei; Chen, Ray-Jade; Chiou, Hung-Yi

    2016-01-01

    Abstract The objective of this study is to evaluate the efficacy and safety profiles of the targeted medications, bevacizumab and cetuximab, in combination with cytostatic drugs in patients with locally advanced or metastatic pancreatic cancer. In this retrospective phase 2 study, a total of 59 patients with pancreatic cancer were recruited and received conventional (gemcitabine, cisplatin, and fluorouracil) or targeted regimen (conventional plus bevacizumab and cetuximab for the first cycle) in 2-week intervals for four cycles. The primary end-point for this study was the overall response rate. Secondary end-points were progression-free survival and the safety profiles of the combined therapy. The median time-to-progression and overall survival were 3 and 7 months, respectively, in the conventional treatment group as well as 11 and 13 months, respectively, in the targeted medications treatment group. The most common adverse events in both treatment groups were nausea and vomiting. Moderate (Grade 2) nausea and vomiting were more common in the conventional group than the targeted group but severe (Grade 3) nausea and vomiting were more common in the targeted group. Bevacizumab and cetuximab in combination with gemcitabine, cisplatin, and fluorouracil may help lengthen overall survival up to six months for patients with pancreatic cancer. PMID:27082562

  9. New Zealand needs guidelines for the safe and responsible inclusion of pregnant women in medical research.

    PubMed

    Ballantyne, Angela J

    2016-01-01

    Pregnancy is a crucial window of time that influences long-term population health. As a matter of justice, pregnant woman are entitled to high quality, evidenced-based care. As a matter of population health, we need to better understand foetal development, particularly the impact of lifestyle, stress, chronic conditions and clinical treatment during pregnancy. Pregnancy continues to be dominated by the precautionary principle, advocating for the routine exclusion of pregnant women from medical research, particularly intervention studies, on the grounds of foetal vulnerability. But this stance simply shifts the risk into the community. Due to a lack of evidence-based data, many pregnant women are refused medically important drugs, are subject to dangerous delays in getting drugs, or are prescribed drugs that are thought 'safe', despite evidence of possible teratogenicity. I argue that New Zealand needs to shift to a default position of inclusion of pregnant women in research; and to develop guidelines to facilitate their safe and responsible inclusion. The uniqueness of pregnancy gives rise to specific questions regarding research ethics. These questions warrant focused debate and the answers cannot simply be deduced from the general principles of research ethics we currently have in New Zealand. PMID:27362600

  10. A web-services architecture designed for intermittent connectivity to support medical response to disasters.

    PubMed

    Brown, Steve; Griswold, William; Lenert, Leslie A

    2005-01-01

    To support mobile computing systems for first responders at mass casualty sites, as part of the WIISARD (Wireless Internet Information System for Medical Response in Disasters) project, we have developed a data architecture to gracefully handle an environment with frequent network failure and, multiple writers that also supports rapid dissemination of updates that could be critical to the safety of responders. This is accomplished by allowing for a subset of the overall information available in a disaster scene to be cached locally on a responder's device and locally modified with or without network access. When the network is available, the local subset of the model is automatically synchronized with a server that contains the full model, and conflicts are resolved. When changes from a device are committed, the changes are instantly sent to any connected devices where the local subset would be modified by the changes. PMID:16779191

  11. Student Response to Team-Based Learning and Mixed Gender Teams in an Undergraduate Medical Informatics Course

    PubMed Central

    Masters, Ken

    2012-01-01

    Objectives: Team-based learning (TBL) is increasingly being used in medical and medically-related courses. The aim of this study was to evaluate student responses to a TBL-based course in medical informatics at the Sultan Qaboos University, Oman. Methods: A total of 11 TBL sessions were run during a 14-week semester of the Medical Informatics II course at SQU. An online student evaluation was performed in week 13 of the course. Results: Of the 108 students on the course, 96 (88.9%) of the students responded to the survey. For the most part, the students regarded TBL favourably, and derived great benefit from the TBL sessions. Cultural norms, however, appear to have impacted negatively on the females’ experience of the TBL sessions. Conclusion: TBL’s benefits in the medical informatics course were recognised by the students. In such an environment, however, facilitators will have to bear in mind and continually address cultural issues. PMID:22912928

  12. Assessing the Awareness of Egyptian Medical Students about Responsible Conduct of Research and Research Ethics: Impact of an Educational Campaign.

    PubMed

    El-Shinawi, Mohamed; Mohamed, Karim Osama; Fouad, Yousef Ahmed; Fahmy, Yara Mohamed; Asar, Hadeel Abdulwahed; Khalil, Mohamed Gomaa; Anestidou, Lida; El-Kamary, Samer S; Mohamed, Mona Mostafa

    2016-01-01

    This is a quasi-experimental pre-post assessment study utilizing an anonymous self-administered questionnaire to assess Egyptian medical students' awareness about responsible conduct of research (RCR) and research ethics. Students' were assessed before and after an RCR awareness campaign. Our results showed that most of the pre-campaign respondents were not familiar with the basic principles and terms of RCR. An increase in the awareness about RCR across all discussed topics was noted following the campaign. We concluded that an educational awareness campaign is effective in increasing medical students' awareness about RCR and should be incorporated into current medical school curricula in Egypt. PMID:26647065

  13. Medical Relief Response by Miyako Public Health Center after the Great East Japan Earthquake and Tsunami, 2011.

    PubMed

    Yanagihara, Hiroki

    2016-01-01

    Objectives To improve disaster preparedness, we investigated the response of medical relief activities managed by Iwate Prefectural Miyako Public Health Center during the post-acute phase of the Great East Japan Earthquake and Tsunami on March 11, 2011.Methods The study divided the post-disaster period into three approximate time segments: Period I (time of disaster through late March), Period II (mid-April), and Period III (end of May in Miyako City, early July in Yamada Town). We reviewed records on medical relief activities conducted by medical assistance teams (MATs) in Miyako City and Yamada Town.Results Miyako Public Health Center had organized a meeting to coordinate medical relief activities from Period I to Period III. According to demand for medical services and recovery from the local medical institutions (LMIs) in the affected area, MATs were deployed and active on evacuation centers in each area assigned. The number of patients examined by MATs in Miyako rose to approximately 250 people per day in Period I and decreased to 100 in Period III. However, in Yamada, the number surged to 700 in Period I, fell to 100 in Period II, and decreased to 50 in Period III. This difference could be partly explained as follows. In Miyako, most evacuees had consulted LMIs which restarted medical services after disaster, and the number of LMIs restarted had already reached 29 (94% of the whole) in Period I. In Yamada, most evacuees who had consulted MATs in Period I had almost moved to LMIs restarted in Period II. During the same time, a division of roles and coordination on medical services provision was conducted, such as MATs mainly in charge of primary emergency triage, in response to the number of LMIs restarted which reached 1 (20%) in Period I and 3 (60%) in Period II. Following Period III, more than 80% of patients in Miyako had been a slight illness, such as need for health guidance, and the number of people who underwent emergency medical transport

  14. Evaluation of interactive teaching for undergraduate medical students using a classroom interactive response system in India

    PubMed Central

    Datta, Rakesh; Datta, Karuna; Venkatesh, M.D.

    2015-01-01

    Background The classical didactic lecture has been the cornerstone of the theoretical undergraduate medical education. Their efficacy however reduces due to reduced interaction and short attention span of the students. It is hypothesized that the interactive response pad obviates some of these drawbacks. The aim of this study was to evaluate the effectiveness of an interactive response system by comparing it with conventional classroom teaching. Methods A prospective comparative longitudinal study was conducted on 192 students who were exposed to either conventional or interactive teaching over 20 classes. Pre-test, Post-test and retentions test (post 8–12 weeks) scores were collated and statistically analysed. An independent observer measured number of student interactions in each class. Results Pre-test scores from both groups were similar (p = 0.71). There was significant improvement in both post test scores when compared to pre-test scores in either method (p < 0.001). The interactive post-test score was better than conventional post test score (p < 0.001) by 8–10% (95% CI-difference of means – 8.2%–9.24%–10.3%). The interactive retention test score was better than conventional retention test score (p < 0.001) by 15–18% (95% CI-difference of means – 15.0%–16.64%–18.2%). There were 51 participative events in the interactive group vs 25 in the conventional group. Conclusions The Interactive Response Pad method was efficacious in teaching. Students taught with the interactive method were likely to score 8–10% higher (statistically significant) in the immediate post class time and 15–18% higher (statistically significant) after 8–12 weeks. The number of student–teacher interactions increases when using the interactive response pads. PMID:26285666

  15. Education and Training for Major Incidents Through Medical Response to Major Incidents-MRMI course.

    PubMed

    Samardzic, Josip; Hreckovski, Boris; Hasukic, Ismar

    2015-06-01

    Incidence of major incidents nowadays is in constant growth, especially in last decade. Main goal of all health systems is to minimize and prevent tragic outcomes of major incidents, thus reducing morbidity and mortality and psychological and physical suffering. Lessons learned from Major Incidents throughout the World point out that tragical outcomes could be avoided through adequate preparation and planning. Necessity to plan and to educate to response to Major incident is greater than ever. Finally it is legal obligation that every hospital has plan in case of Major Incident. Effective planning must incorporate: identification of risks, methods of prevention, identification of all recourses, anticipation of errors and detailed protocol of response for each participant. Knowledge and skills needed for Major incident situations must be adopted through interactive training and practical exercise ("learning by doing"). That can be achieved by field exercises and by simulation model. Simulation model has many advantages and enables simultaneous education and training of all participants; scene, transport, hospitals, communication and command which than can be evaluated through objective outcomes. The goal is to train medical staff in real time, on position they are assigned to, with available resources in conditions of Major incident. PMID:26236085

  16. Premorbid functioning in schizophrenia: relation to baseline symptoms, treatment response, and medication side effects.

    PubMed

    Strous, Rael D; Alvir, Jose M J; Robinson, Delbert; Gal, Gilad; Sheitman, Brian; Chakos, Miranda; Lieberman, Jeffrey A

    2004-01-01

    Impaired premorbid functioning prior to the onset of acute psychosis has frequently been noted in schizophrenia. This study examined retrospectively the premorbid status of patients in their first episode of psychosis in order to determine relationships with baseline symptoms, treatment response, and medication side effects. One hundred eleven schizophrenic and schizoaffective patients participating in a large prospective study of first episode schizophrenia were evaluated with the Premorbid Adjustment Scale (PAS). Premorbid functioning in males became progressively worse over time. Deficit state patients exhibited worse premorbid functioning. A third of patients exhibited sustained poor premorbid functioning. At various developmental stages, lower "sociability and withdrawal" scores correlated with increased time to treatment response, more severe negative symptoms, increased drug-induced parkinsonism, and deterioration of premorbid functioning. Various mean PAS scores predicted susceptibility to tardive dyskinesia. Our findings suggest that prior to acute psychosis onset there are certain behavioral precursors reflected in premorbid functioning that may predict subsequent illness manifestations. Measures of premorbid functioning indicate that disease pathogenesis is manifest, albeit more subtly, prior to presentation of first psychotic symptoms. PMID:15279045

  17. Education and Training for Major Incidents Through Medical Response to Major Incidents–MRMI course

    PubMed Central

    Samardzic, Josip; Hreckovski, Boris; Hasukic, Ismar

    2015-01-01

    Incidence of major incidents nowadays is in constant growth, especially in last decade. Main goal of all health systems is to minimize and prevent tragic outcomes of major incidents, thus reducing morbidity and mortality and psychological and physical suffering. Lessons learned from Major Incidents throughout the World point out that tragical outcomes could be avoided through adequate preparation and planning. Necessity to plan and to educate to response to Major incident is greater than ever. Finally it is legal obligation that every hospital has plan in case of Major Incident. Effective planning must incorporate: identification of risks, methods of prevention, identification of all recourses, anticipation of errors and detailed protocol of response for each participant. Knowledge and skills needed for Major incident situations must be adopted through interactive training and practical exercise („learning by doing„). That can be achieved by field exercises and by simulation model. Simulation model has many advantages and enables simultaneous education and training of all participants; scene, transport, hospitals, communication and command which than can be evaluated through objective outcomes. The goal is to train medical staff in real time, on position they are assigned to, with available resources in conditions of Major incident. PMID:26236085

  18. A comparison of responses to alcohol expectancy questionnaire (CEOA) of Indian and Malaysian medical students.

    PubMed

    Ganaraja, B; Ramesh, Bhat M; Kotian, M S

    2010-01-01

    Alcohol addiction is a social problem faced by every country worldwide. Young people are more at risk of this menace. In spite of a clear knowledge and message about the effects of alcohol on individual health and social fabric, it is hard to curb the overuse of this beverage. In the present study, we compared the outcome of a survey using Comprehensive effects of Alcohol (CEOA) in two private Medical institutions in two Asian countries, viz. KMC, Mangalore, India (n=180) and AIMST, Kedah, Malaysia (n=170). The study included both males and female students. The result suggested that the negative reinforcement responses were rated higher in both the study groups. But those who have tasted alcohol before had a higher rating that alcohol may cause positive reinforcement. Both groups of respondents showed similar trend suggesting that the alcohol expectancies are similar in Indian students and Malaysian students. From the results we could conclude that the responses of the two sample groups were comparable to each other. While the male respondents were inclined show higher affinity towards acceptance of alcohol females are very much less so. However, the respondents of both groups appeared to be well aware of the negative aspects of alcohol. Importantly previous exposure to alcohol intake dramatically changed the perception and showed increased inclination towards alcoholism. This study thus provides an important clue to the clinician, counselors and parents regarding the importance of guiding the young people about the alcoholism. PMID:21409864

  19. Response of a hybrid pixel detector (MEDIPIX3) to different radiation sources for medical applications

    SciTech Connect

    Chumacero, E. Miguel; De Celis Alonso, B.; Martínez Hernández, M. I.; Vargas, G.; Moreno Barbosa, E.; Moreno Barbosa, F.

    2014-11-07

    The development in semiconductor CMOS technology has enabled the creation of sensitive detectors for a wide range of ionizing radiation. These devices are suitable for photon counting and can be used in imaging and tomography X-ray diagnostics. The Medipix[1] radiation detection system is a hybrid silicon pixel chip developed for particle tracking applications in High Energy Physics. Its exceptional features (high spatial and energy resolution, embedded ultra fast readout, different operation modes, etc.) make the Medipix an attractive device for applications in medical imaging. In this work the energy characterization of a third-generation Medipix chip (Medipix3) coupled to a silicon sensor is presented. We used different radiation sources (strontium 90, iron 55 and americium 241) to obtain the response curve of the hybrid detector as a function of energy. We also studied the contrast of the Medipix as a measure of pixel noise. Finally we studied the response to fluorescence X rays from different target materials (In, Pd and Cd) for the two data acquisition modes of the chip; single pixel mode and charge summing mode.

  20. Response of a hybrid pixel detector (MEDIPIX3) to different radiation sources for medical applications

    NASA Astrophysics Data System (ADS)

    Chumacero, E. Miguel; De Celis Alonso, B.; Martínez Hernández, M. I.; Vargas, G.; Moreno Barbosa, F.; Moreno Barbosa, E.

    2014-11-01

    The development in semiconductor CMOS technology has enabled the creation of sensitive detectors for a wide range of ionizing radiation. These devices are suitable for photon counting and can be used in imaging and tomography X-ray diagnostics. The Medipix[1] radiation detection system is a hybrid silicon pixel chip developed for particle tracking applications in High Energy Physics. Its exceptional features (high spatial and energy resolution, embedded ultra fast readout, different operation modes, etc.) make the Medipix an attractive device for applications in medical imaging. In this work the energy characterization of a third-generation Medipix chip (Medipix3) coupled to a silicon sensor is presented. We used different radiation sources (strontium 90, iron 55 and americium 241) to obtain the response curve of the hybrid detector as a function of energy. We also studied the contrast of the Medipix as a measure of pixel noise. Finally we studied the response to fluorescence X rays from different target materials (In, Pd and Cd) for the two data acquisition modes of the chip; single pixel mode and charge summing mode.

  1. Checklist of British and Irish Hymenoptera - Platygastroidea

    PubMed Central

    Buhl, Peter N.; Notton, David G.

    2016-01-01

    Abstract Background A revised checklist of the British and Irish Platygastroidea (Platygastridae) substantially updates the previous comprehensive checklist, dating from 1978. Distribution data (i.e. occurrence in England, Scotland, Wales, Ireland and the Isle of Man) is reported where known. New information A total of 381 British and Irish Platygastroidea represents a 47% increase on the number of British and Irish species reported in 1978. PMID:27279762

  2. Audience response technology: Engaging and empowering non-medical prescribing students in pharmacology learning

    PubMed Central

    2010-01-01

    Background Non-medical prescribing (NMP) is a six month course for nurses and certain allied health professionals. It is critical that these students develop a good understanding of pharmacology; however, many students are mature learners with little or no formal biological science knowledge and struggle with the pharmacology component. The implications for patient safety are profound, therefore we encourage students not just to memorise enough pharmacology to pass the exam but to be able to integrate it into clinical practice. Audience response technology (ART), such as the KeePad system (KS) has been shown to promote an active approach to learning and provide instant formative feedback. The aim of this project, therefore, was to incorporate and evaluate the use the KS in promoting pharmacology understanding in NMP students. Methods Questions were incorporated into eight pharmacology lectures, comprising a mix of basic and clinical pharmacology, using TurningPoint software. Student (n = 33) responses to questions were recorded using the KS software and the percentage of students getting the question incorrect and correct was made immediately available in the lecture in graphical form. Survey data collected from these students investigated student perceptions on the use of the system generally and specifically as a learning tool. More in depth discussion of the usefulness of the KS was derived from a focus group comprising 5 students. Results 100% of students enjoyed using the KS and felt it promoted their understanding of key concepts; 92% stated that it helped identify their learning needs and 87% agreed that the technology was useful in promoting integration of concepts. The most prevalent theme within feedback was that of identifying their own learning needs. Analysis of data from the focus group generated similar themes, with the addition of improving teaching. Repeated questioning produced a significant increase (p < 0.05) in student knowledge of specific

  3. Predictors and Moderators of Response to Cognitive Behavioral Therapy and Medication for the Treatment of Binge Eating Disorder

    ERIC Educational Resources Information Center

    Grilo, Carlos M.; Masheb, Robin M.; Crosby, Ross D.

    2012-01-01

    Objective: To examine predictors and moderators of response to cognitive behavioral therapy (CBT) and medication treatments for binge-eating disorder (BED). Method: 108 BED patients in a randomized double-blind placebo-controlled trial testing CBT and fluoxetine treatments were assessed prior, throughout, and posttreatment. Demographic factors,…

  4. Treatment of ADHD with Stimulant Medications: Response to Nissen Perspective in the New England Journal of Medicine

    ERIC Educational Resources Information Center

    Biederman, Joseph; Spencer, Thomas J.; Wilens, Timothy E.; Prince, Jefferson B.; Faraone, Stephen V.

    2006-01-01

    This article is a response to Dr. Steven E. Nissen's comments (Nissen, 2006) about attention deficit/hyperactivity disorder (ADHD) and its treatment with stimulant medications. In this article, the authors refute his arguments and provide accurate information. Here, they answer the questions, such as: (1) Do stimulants increase the risk for sudden…

  5. The governments' doctors: the roles and responsibilities of chief medical officers in the European Union.

    PubMed

    Jakubowski, Elke; Martin-Moreno, José M; McKee, Martin

    2010-12-01

    The regular meetings of the chief medical officers (CMOs) from the European Union's (EU's) 27 Member States provide an important forum to address issues of common interest affecting Europe's populations. Yet there is no universally agreed role for a CMO. This article describes the findings of a study, based on interviews with key informants and documentary analysis that sought to describe their diverse roles. For the purpose of this article, CMOs are defined as those sent by their governments to the regular EU meetings of CMOs. Four broad categories of countries were identified: those whose CMO is the most senior doctor in the health ministry, in some cases with responsibility spanning all of government; where they are head of a division within the health ministry; head of a separate body such as a national board of health; and countries where no single individual can be identified. Although the diversity of health systems means that these roles cannot be harmonised, there is scope to explore what can be learnt from the different approaches. PMID:21413477

  6. Assessment of Biodosimetry Methods for a Mass-Casualty Radiological Incident: Medical Response and Management Considerations

    PubMed Central

    Sullivan, Julie M.; Prasanna, Pataje G. S.; Grace, Marcy B.; Wathen, Lynne; Wallace, Rodney L.; Koerner, John F.; Coleman, C. Norman

    2013-01-01

    Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual’s radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual’s dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a stand-alone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, we reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point. PMID:24162058

  7. The Response of Radiation Portal Monitors to Medical Radionuclides at Border Crossings

    SciTech Connect

    Kouzes, Richard T.; Siciliano, Edward R.

    2006-05-01

    Radio-pharmaceuticals are found at detectable levels in about one in 2600 Americans. Such individuals are thus commonly found at border crossings where equipment exists for radiation detection, and the resulting alarms must be handled by cognizant officials. A total of approximately 14.4 million medical procedures using radionuclides were performed in the U.S. during 2001. Of this total number of procedures during 2001, approximately 14.2 million were diagnostic procedures and 0.2 million were therapeutic procedures. Although there were over 45 different commercially-available products used in over 75 different types of procedures, 17 isotopes comprise the complete set of active ingredients in the commercially available radiopharmaceuticals in the U.S. Of these, 12 are customarily administered to outpatients, and 9 of these produce energetic photons. At 91.5%, the isotope 99mTc is the one most likely administered by an overwhelming margin. This paper reports on various impacts of radiopharmaceuticals observed at border crossings. Calculations were performed to simulate the photon response of portal radiation monitors to these types of sources. It is shown that at any time, about one in 2600 Americans carries a detectable radiation burden. (PIET-43741-TM-326)

  8. 802.11 wireless infrastructure to enhance medical response to disasters.

    PubMed

    Arisoylu, Mustafa; Mishra, Rajesh; Rao, Ramesh; Lenert, Leslie A

    2005-01-01

    802.11 (WiFi) is a well established network communications protocol that has wide applicability in civil infrastructure. This paper describes research that explores the design of 802.11 networks enhanced to support data communications in disaster environments. The focus of these efforts is to create network infrastructure to support operations by Metropolitan Medical Response System (MMRS) units and Federally-sponsored regional teams that respond to mass casualty events caused by a terrorist attack with chemical, biological, nuclear or radiological weapons or by a hazardous materials spill. In this paper, we describe an advanced WiFi-based network architecture designed to meet the needs of MMRS operations. This architecture combines a Wireless Distribution Systems for peer-to-peer multihop connectivity between access points with flexible and shared access to multiple cellular backhauls for robust connectivity to the Internet. The architecture offers a high bandwidth data communications infrastructure that can penetrate into buildings and structures while also supporting commercial off-the-shelf end-user equipment such as PDAs. It is self-configuring and is self-healing in the event of a loss of a portion of the infrastructure. Testing of prototype units is ongoing. PMID:16778990

  9. British African Caribbean Women and Depression

    ERIC Educational Resources Information Center

    Adkison-Bradley, Carla; Maynard, Donna; Johnson, Phillip; Carter, Stephaney

    2009-01-01

    Depression is a common condition among women in the United Kingdom. However, little is known about the context of depression among British African Caribbean women. This article offers a preliminary discussion regarding issues and information pertaining to depression among British African Caribbean women. Characteristics and symptoms of depression…

  10. Providing a Background for British Literature.

    ERIC Educational Resources Information Center

    DeLuca, Diana Macintyre

    One consequence of teaching British literature far away from British shores is the loss of intimacy that comes from a shared culture. American teachers can help bring Britain into their classrooms by requesting audiovisual aids from the various museums and galleries in Britain that are willing to supply material. Among such sources are (1) Walton…