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BACKGROUND: Evaluation is a challenging but necessary part of the development cycle of clinical information systems like the electronic medical records (EMR) system. It is believed that such evaluations should include multiple perspectives, be comparative and employ both qualitative and quantitative methods. Self-administered questionnaires are frequently used as a quantitative evaluation method in medical informatics, but very few validated questionnaires
Background Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. Methods This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Results Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Conclusion Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing.
Background Evaluation is a challenging but necessary part of the development cycle of clinical information systems like the electronic medical records (EMR) system. It is believed that such evaluations should include multiple perspectives, be comparative and employ both qualitative and quantitative methods. Self-administered questionnaires are frequently used as a quantitative evaluation method in medical informatics, but very few validated questionnaires address clinical use of EMR systems. Methods We have developed a task-oriented questionnaire for evaluating EMR systems from the clinician's perspective. The key feature of the questionnaire is a list of 24 general clinical tasks. It is applicable to physicians of most specialties and covers essential parts of their information-oriented work. The task list appears in two separate sections, about EMR use and task performance using the EMR, respectively. By combining these sections, the evaluator may estimate the potential impact of the EMR system on health care delivery. The results may also be compared across time, site or vendor. This paper describes the development, performance and validation of the questionnaire. Its performance is shown in two demonstration studies (n = 219 and 80). Its content is validated in an interview study (n = 10), and its reliability is investigated in a test-retest study (n = 37) and a scaling study (n = 31). Results In the interviews, the physicians found the general clinical tasks in the questionnaire relevant and comprehensible. The tasks were interpreted concordant to their definitions. However, the physicians found questions about tasks not explicitly or only partially supported by the EMR systems difficult to answer. The two demonstration studies provided unambiguous results and low percentages of missing responses. In addition, criterion validity was demonstrated for a majority of task-oriented questions. Their test-retest reliability was generally high, and the non-standard scale was found symmetric and ordinal. Conclusion This questionnaire is relevant for clinical work and EMR systems, provides reliable and interpretable results, and may be used as part of any evaluation effort involving the clinician's perspective of an EMR system.
Background: To assess the student's attitude, perception and feedback on teachinglearning methodology and evaluation methods in pharmacology. Materials and Methods: One hundred and forty second year medical students studying at Smt. Kashibai Navale Medical College, Pune, were selected. They were administered a pre-validated questionnaire containing 22 questions. Suggestions were also asked regarding the qualities of good pharmacology teachers and modification in pharmacology teaching methods. Descriptive statistics were used and results were expressed as percentage. Results: Majority of the students found cardiovascular system (49.25%) as the most interesting topic in pharmacology, whereas most of the students opined that cardiovascular system (60.10%), chemotherapy (54.06%) and central nervous system (44.15%) are going to be the most useful topics in internship. 48.53% students preferred clinical/patient-related pharmacology and 39.13% suggested use of audiovisual-aided lectures. Prescription writing and criticism of prescription were amongst the most useful and interesting in practical pharmacology. Students expressed interest in microteaching and problem-based learning, whereas seminars, demonstrations on manikin and museum studies were mentioned as good adjuvants to routine teaching. Multiple Choice Question (MCQ) practice tests and theory viva at the end of a particular system and periodical written tests were mentioned as effective evaluation methods. Students were found to have lot of interest in gathering information on recent advances in pharmacology and suggested to include new drug information along with prototype drugs in a comparative manner. Conclusion: There is a need of conducting few microteaching sessions and more of clinical-oriented problem-based learning with MCQ-based revisions at the end of each class in the pharmacology teaching at undergraduate level.
Bhosale, Uma A.; Yegnanarayan, Radha; Yadav, Gauri E.
Purpose This paper aims to assess the validity of a questionnaire aimed at assessing how general practitioners (GPs) and specialists rate collaboration. Design\\/methodology\\/approach Primary data were collected in The Netherlands during March to September 2006. A cross-sectional study was conducted among 259 GPs and 232 specialists. Participants were randomly selected from The Netherlands Medical Address Book. Specialists rarely
Annette J. Berendsen; Wim H. G. M. Benneker; Klaas H. Groenier; Jan Schuling; Richard P. T. M. Grol; Betty Meyboom-de Jong
Although evidence of medical student mistreatment has accumulated for more than 20 years, only recently have professional organizations like the Association of American Medical Colleges (AAMC) and the American Medical Association truly acknowledged it as an issue. Since 1991, the AAMC's annual Medical School Graduation Questionnaire (GQ) has included questions about mistreatment. Responses to the GQ have become the major source of evidence of the prevalence and types of mistreatment. This article reviews national mistreatment data, using responses to the GQ from 2000 through 2012; examines how students' experiences have changed over time; and highlights the implications of this information for the broader medical education system. The authors discuss what mistreatment is, including the changing definitions from the GQ; the prevalence, types, and sources of mistreatment; and evidence of students reporting incidents. In addition, they discuss next steps, including better defining mistreatment, specifically public humiliation and belittling, taking into account students' subjective evaluations; understanding and addressing the influence of institutional culture and what institutions can learn from current approaches at other institutions; and developing better systems to report and respond to reports of mistreatment. They conclude with a discussion of how mistreatment currently is conceptualized within the medical education system and the implications of that conceptualization for eradicating mistreatment in the future. PMID:24667505
Mavis, Brian; Sousa, Aron; Lipscomb, Wanda; Rappley, Marsha D
Background Demographic development is accompanied by an increasingly aging society. Concerning medical education, the treatment of older people as well as the scientific research and exploration of ageing aspects in the coming years need to be considered. Aim of the study was to ascertain medical students knowledge, interest, and attitudes regarding older patients and geriatric medicine. Methods Each participant completed a self-designed questionnaire. This questionnaire was based on three validated internationally recognised questionnaires (Facts on Aging Quiz FAQ, Expectations Regarding Aging ERA and the Aging Semantic Differential ASD). The inquiry and survey were performed at the beginning of the summer term in 2012 at the University of Regensburg Medical School. Results A total of n?=?184/253 (72.7%) students participated in this survey. The results of the FAQ 25+ showed that respondents were able to answer an average of M?=?20.4 of 36 questions (56.7%) correctly (Median, Md?=?21; SD ±6.1). The personal attitudes and expectations of ageing averaged M?=?41.2 points on the Likert-scale that ranged from 0 to 100 (Md?=?40.4; SD ±13.7). Respondents attitudes towards the elderly (ASD 24) averaged M?=?3.5 points on the Likert-scale (range 17, Md 3.6, SD ±0.8). Conclusions In our investigation, medical students knowledge of ageing was comparable to previous surveys. Attitudes and expectations of ageing were more positive compared to previous studies. Overall, medical students expect markedly high cognitive capacities towards older people that can actively prevent cognitive impairment. However, medical students personal interest in medicine of ageing and older people seems to be rather slight.
BACKGROUND: The main objective of the present study was to evaluate the agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases. METHODS: Cross-sectional sample of 100 poisoning cases consecutively admitted to the Hospital Pulau Pinang, Malaysia during the period from September 2003 to February 2004 were studied. Data on health and socioeconomic problems were
It has been pointed out that currently, Iwaki City faces an insufficiency of doctors working at hospitals, compared with before. Such an insufficiency became more remarkable after the 2011 Tohoku Earthquake and Fukushima Nuclear Disaster, as about 30,000 people relocated to Iwaki City from the evacuation areas. In this regard, the Iwaki Medical Association conducted a questionnaire survey to investigate the problems of medical cooperation and utilize the data to improve medical cooperation within hospitals and clinics. A total of 159 doctors answered the questionnaires: 64% were community physicians, 36% were doctors working at hospitals, and 42% were physicians. About 60% of the doctors were satisfied with the present medical cooperation. Home health care was performed by 25% of the doctors working at hospitals and 45% of the community physicians. Approximately 80% of the doctors felt the need for additional physicians to perform home health care, although more than half of the doctors answered that they do not perform it. Various problems exist in the context of medical cooperation, but many doctors still hope for its improvement, according to the answers in the questionnaires. Efforts have to be exerted further in order to enhance medical cooperation among the health care team. PMID:24712146
The number of physicians engaged in basic sciences and teaching is sharply decreasing in Japan. To alleviate this shortage, central government has increased the quota of medical students entering the field. This study investigated medical students' interest in basic sciences in efforts to recruit talent. A questionnaire distributed to 501 medical students in years 2 to 6 of Juntendo University School of Medicine inquired about sex, grade, interest in basic sciences, interest in research, career path as a basic science physician, faculties' efforts to encourage students to conduct research, increases in the number of lectures, and practical training sessions on research. Associations between interest in basic sciences and other variables were examined using ?(2) tests. From among the 269 medical students (171 female) who returned the questionnaire (response rate 53.7%), 24.5% of respondents were interested in basic sciences and half of them considered basic sciences as their future career. Obstacles to this career were their original aim to become a clinician and concerns about salary. Medical students who were likely to be interested in basic sciences were fifth- and sixth-year students, were interested in research, considered basic sciences as their future career, considered faculties were making efforts to encourage medical students to conduct research, and wanted more research-related lectures. Improving physicians' salaries in basic sciences is important for securing talent. Moreover, offering continuous opportunities for medical students to experience research and encouraging advanced-year students during and after bedside learning to engage in basic sciences are important for recruiting talent. PMID:23337622
Objectives: The present study examined the psychometric properties of the Chinese Virtues Questionnaire (CVQ). The reliability, factor structure, construct validity, and temporal stability of the inventory were examined. Method: A university student sample ("n" = 878) and a working adult sample ("n" = 153) were recruited.
Duan, Wenjie; Ho, Samuel M. Y.; Bai, Yu; Tang, Xiaoqing
OBJECTIVE--To review current knowledge of the effectiveness of medical audit programmes as a whole and of specific interventions within these programmes, as a means of changing clinical behaviour. CRITERIA FOR INCLUSION AND EXCLUSION OF PUBLISHED REPORTS--Articles listed on Medline from 1985-92 with key words "quality assurance" or "medical audit", and "evaluation" and relevant references from these articles, and from recently published reviews and reports on medical audit, were included. Excluded were simple descriptions of audit activity, replications of previous work, and publication in a language other than English. RESULTS--Evaluation of entire programmes of medical audit is unusual. Most reports concern specific interventions and focus particularly on the scientific and technical aspects of quality. These interventions may be classified by the means through which they attempt to achieve desired changes: patient characteristics; physician characteristics; administrative and organisational structures; and financial incentives. CONCLUSIONS--Knowledge about effective methods of bringing about specific changes in clinical behaviour is rudimentary. Impact is highly dependent on local factors, so generalisation of results to other settings is difficult. More qualitative research is needed to define the local factors which influence results.
The construct validity of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was evaluated by examining its correlation to the Medical Outcomes Study Short Form36 (SF-36). The study sample was 90 patients seen at the upper-extremity clinic of a university-based orthopedic practice. Patients were asked to complete a packet that included the DASH and SF-36 questionnaires. Pearson correlation
Nelson Fong SooHoo; Allen P. McDonald; John Gray Seiler; Gary R. McGillivary
This paper discusses the importance of criteria in the evaluation of a teacher by his students and proposes a method of representing the results of the questionnaire in the form of one weighted average. The following points, emphasized in the construction of the questionnaire, are elaborated: a) the characteristics of a good teacher; b) the
Summary form only given. The role of the medical technology evaluation program in the purchase of medical equipment is threefold: 1) assuring that biomedical equipment facilitates the delivery of quality patient care, 2) assuring that the equipment purchased meets the needs of all users, and 3) establishing hospital standards for biomedical equipment. Medical technology evaluation occurs in two phases. Phase
SUMMARY Computer-aided tools can be built to give support to different usability evaluation techniques, reducing some of their costs. These tools are complementary to existing fully automated ones, which are limited to the evaluation of external attributes. In this work, a generic model for questionnaire-based usability evaluation is described, along with the tool that implements it, which allows for fuzzy
Data from clinical and nonclinical samples ("Ns" = 2,096, 618) were used to evaluate and replicate the measurement structure of the Outcome Questionnaire-45.2. Different measurement models and invariance tests were evaluated and the best psychometric support was found for a shortened measure of two factors: overall maladjustment and
Health care laser systems offer general laser hazards and additional specific concerns unique to the clinical environment. A formal laser hazard evaluation procedure provides an efficient mechanism for identifying potential laser safety hazards. This paper outlines such a medical laser hazard evaluation program and highlights the unique characteristics of medical lasers. PMID:12132727
Edwards, Ben E; Barnes, L K; Gibbs, J B; Nguyen, G B
The aim of this study was to determine the reliability, validity, and sensitivity of the Patient-rated Tennis Elbow Evaluation (PRTEE) Questionnaire in 78 tennis playing subjects who had chronic, unilateral, MRI-confirmed lateral elbow tendinopathy and who concomitantly participated in an outcome study. The PRTEE results were compared with results of the Visual Analog Scale (VAS); the Disabilities of the Arm,
Purpose To develop and psychometrically evaluate the Endometriosis Treatment Satisfaction Questionnaire, a patient-reported assessment\\u000a of satisfaction with endometriosis treatment.\\u000a \\u000a \\u000a \\u000a \\u000a Methods The Endometriosis Treatment Satisfaction Questionnaire was developed based on the results of five focus groups and three iterative\\u000a sets of cognitive interviews along with expert opinion and a review of the literature. The psychometric properties were assessed\\u000a using data collected during a
Linda S. DealValerie; Valerie S. L. Williams; Dana Britt DiBenedetti; Sheri E. Fehnel
Background Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbachs alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbachs alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.
Objectives: To determine what behaviors patients perceive as reflecting a physicians humanistic qualities, to develop an instrument\\u000a for patients to use to assess the humanistic behaviors of their own physicians, and to compare patient assessment of residents\\u000a humanistic behaviors with patient satisfaction and the assessment of attending physicians.\\u000a \\u000a \\u000a Design: Cross-sectional descriptive study, using patient interviews and questionnaires, and evaluations of
Michael J. Weaver; Cathy L. Ow; Debra J. Walker; Ernest F. Degenhardt
Given the rise of prescription stimulant misuse, examination of effect expectancies could prove helpful. The Prescription Stimulant Expectancy Questionnaire (PSEQ) was designed to explore positive and negative prescription stimulant-related expectancies. In 2006, 157 participants nationwide completed an Internet survey of prescription stimulant use, attention-deficit/hyperactivity disorder symptoms, and expectancies. Multiple regressions demonstrate that positive, but not negative expectancies, predicted frequency of use. Recreational and medical users were classified by hierarchical cluster analysis. Recreational users reported fewer positive and negative expectancies than medical users. Implications and limitations are discussed. Future research is warranted on prescription stimulant expectancies and the utility of the PSEQ. PMID:19938932
Despite its high prevalence, nonulcer dyspepsia is still difficult to study, due to the lack of adequate tools to measure significant outcomes. The objective of this study was to develop and validate a symptom-focused, disease-specific questionnaire to evaluate patients with nonulcer dyspepsia. For that, the questionnaire was carefully written following widely accepted terminology, so as to facilitate translation and validation
Guilherme Becker Sander; Luiz Edmundo Mazzoleni; Carlos Fernando Magalhães Francesconi; André Castagna Wortmann; Eduardo André Ott; Alexandro Theil; Vicenzo Da Cruz Piccoli; Ângela Cristiane Da Silva; Leandro Oliveira; Simone Beheregaray; Simone Matioti; Gustavo Somm; José Roberto Goldim
This paper describes a method used to evaluate 48 medical residency programs at one institution. It presents the background rationale, logistics, and results obtained by surveying alumni, in the context of their current practice, for relevant data on the value of their training experience. Surveys were sent for 3 years to all alumni of Cleveland
Background At some medical schools, students can opt to undertake a 1 year intercalated degree, usually a BSc, in addition to their medical course. Over the last few years the numbers of students who have opted to undertake an intercalated degree have been steadily decreasing despite the advantages in securing foundation posts. The aim of this study was to find out why medical students opted not to take an intercalated degree. Methods All 4th and 5th year medical students (n = 343) who had elected not to take an intercalated degree were personally handed a questionnaire. Results 293 completed questionnaires were returned (response rate 85%). The most common reason students opted not to intercalate was because they did not want to have another year of study (69.6%) or incur more debt (51.9%). Only 45 (15.3%) students said they had enough information to inform their decision: reported take up of information provision was poor. Conclusions Our findings indicate that the benefits of intercalating need to be better defined and presented to students in a way that they can make a more informed decision.
This is a further development of a specific questionnaire, the 3-set 4P, to be used for measuring former ICU patients' physical and psychosocial problems after intensive care and the need for follow-up. The aim was to psychometrically test and evaluate the 3-set 4P questionnaire in a larger population. The questionnaire consists of three sets: "physical", "psychosocial" and "follow-up". The questionnaires were sent by mail to all patients with more than 24-hour length of stay on four ICUs in Sweden. Construct validity was measured with exploratory factor analysis with Varimax rotation. This resulted in three factors for the "physical set", five factors for the "psychosocial set" and four factors for the "follow-up set" with strong factor loadings and a total explained variance of 62-77.5%. Thirteen questions in the SF-36 were used for concurrent validity showing Spearman's r(s) 0.3-0.6 in eight questions and less than 0.2 in five. Test-retest was used for stability reliability. In set follow-up the correlation was strong to moderate and in physical and psychosocial sets the correlations were moderate to fair. This may have been because the physical and psychosocial status changed rapidly during the test period. All three sets had good homogeneity. In conclusion, the 3-set 4P showed overall acceptable results, but it has to be further modified in different cultures before being considered a fully operational instrument for use in clinical practice. PMID:22835992
Akerman, Eva; Fridlund, Bengt; Samuelson, Karin; Baigi, Amir; Ersson, Anders
Medical education in Japan has undergone significant reforms. Patient perspective and outcome have been highly valued in curricular reforms. Therefore, we evaluated an undergraduate curriculum particularly on communication skills by comparing outpatient satisfaction before and after the reforms implemented at Saga Medical School. Cross-sectional study was conducted at the General Medicine Clinic of Saga University Hospital in 1999 and 2009. A total of 729 newcomer patients evaluated 159 students; namely, 287 patients evaluated sixth-year medical students (n = 82) in 1999, and in 2009, 442 patients evaluated fifth-year medical students (n = 77). Students interviewed newcomer patients prior to a faculty's clinical examination. After a student-patient encounter, the patient was asked to fill in six-item Patient Satisfaction Questionnaire (PSQ) developed by the American Board of Internal Medicine. Mixed model two-way analysis of variance (ANOVA) with covariant of students' gender was conducted. Effect sizes were calculated to evaluate the amplitude of influence. The average score in 2009 was significantly higher than that in 1999 (3.63 ± 0.62 versus 3.36 ± 0.66; p < 0.001). Since the "encouraging and answering questions" and "clear explanations" were lower than those of the other items (3.24 ± 0.98 and 3.46 ± 0.85), these two items showed the most significant improvements (Phi coefficient = 0.31 and 0.24, p < 0.001). Thus, students' performance has improved since 1999, which may represent the success of curricular reforms at Saga Medical School. We propose that "encouraging and answering questions" and "clear explanations" should be emphasized in interview training. PMID:22075966
We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved
An evaluation was conducted of the diagnostic accuracy and treatment appropriateness of emergency medical technicians (EMTs) in caring for 4,455 consecutive patients during a four and one-half month period. Data on EMT diagnosis and treatment and physicia...
Non-prescribed use of stimulant medication among college students has become a public health concern. Although it has been well-established that outcome expectancies play a prominent role in initiation and maintenance of drinking behaviors it is unknown if and how outcome expectancies influence non-prescribed use of stimulant medication among college students. The aim of this study was to develop a valid and reliable scale that assesses outcome expectancies of non-prescribed use of stimulant medication. A 16-item Stimulant Medication Outcome Expectancy Questionnaire (SMOEQ) was created using qualitative information given by introductory psychology students regarding their expectancies about misusing stimulant medication. An exploratory factor analysis (EFA) identified a three-factor solution: the Academic factor, Recreational factor, and Negative Physiological Effects factor, respectively. A confirmatory factor analysis (CFA) validated the factor structure identified in the EFA and indicated a modest fit of the hypothesized factor structure to the data. Correlation analyses provided support for the internal consistency and construct validity of the SMOEQ. PMID:20356682
Background The need for Complementary and Alternative Medicine (CAM) and holistic approaches in allopathic medical school curricula has been well articulated. Despite increased CAM instruction, feasible and validated instruments for measuring learner outcomes in this content area do not widely exist. In addition, baseline attitudes or beliefs of medical students towards CAM, and the factors that may have formed them, including use of CAM itself, remain unreported. Methods A 10-item measure (CHBQ CAM Health Belief Questionnaire) was constructed and administered to three successive classes of medical students simultaneously with the previously validated 29-item Integrative Medicine Attitude Questionnaire (IMAQ). Both measures were imbedded in a baseline needs assessment questionnaire. Demographic and other data were collected on students' use of CAM modalities and their awareness and use of primary CAM information resources. Analysis of CHBQ items was performed and its reliability and criterion-related validity were established. Results Response rate was 96.5% (272 of 282 students studied). The shorter CHBQ compared favorably with the longer IMAQ in internal consistency reliability. Cronbach's coefficient alpha was 0.75 and 0.83 for the CHBQ and IMAQ respectively. Students showed positive attitudes/beliefs towards CAM and high levels of self-reported CAM use. The majority (73.5%) of students reported using at least one CAM modality, and 54% reported using at least two modalities. Eighty-one percent use the internet as a primary source of information for CAM. Conclusions The CHBQ is a practical, valid and reliable instrument for measuring medical student attitudes/beliefs and has potential utility for measuring the impact of CAM instruction. Medical students showed a high self-reported rate of CAM use and positive attitudes towards CAM. Short, didactic exposure to CAM instruction in the first year of medical school did not additionally impact these already positive attitudes. Unlike the IMAQ, which was intended for use with physicians, the CHBQ is generic in design and content and applicable to a variety of learner types. Evaluation measures must be appropriate for specific CAM instructional outcomes.
The 1987 National Medical Expenditure Survey (NMES), Institutional Population Component Survey is a survey of persons in nursing and personal care homes and facilities for the mentally retarded. The document includes the data collection questionnaires in ...
This article uses the case of designing a new course questionnaire to discuss the issues of validity, reliability and diagnostic power in good questionnaire design. Validity is often not well addressed in course questionnaire design as there are no straightforward tests that can be applied to an individual instrument. The authors propose the
We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions.
Six regional medical associations in Shiga prefecture agreed to cooperate in an investigation of medical care for male gonococcal and chlamydial urethritis. In June 2011, we sent a questionnaire to 372 medical offices in Shiga prefecture, and analyzed replies of respondents. Ten urologists and 175 non-urologists responded to the survey (response rate 49.7%). Among 185 physicians, 52 (10 urologists and 42 nonurologists) have treated male patients with gonococcal and chlamydial urethritis. More than 20% (42/175) of non-urological clinics are involved in the medical management. At initial diagnosis for sexually transmitted male urethritis, all urologists select the nucleic acid amplification method (100%), whereas many non-urologists do not (35%). For the treatment of chlamydial urethritis, non-urologists select levofloxacin (LVFX, 52.8%) rather than azithromycin (AZM, 22.0%), whereas urologists use AZM (78.0%) mostly but do not use LVFX (0%) (p = 0.023). For the treatment of gonococcal urethritis, non-urologists prefer oral new quinolones (53.1%) compared to urologists (25.0%) (p = 0. 74). For cure judgment of gonoccocal and chlamydial urethritis, many non-urologists rely on the improvement of subjective symptoms (50 and 47%), but urologists do not (10 and 0%) (p = 0.022 and 0.026, respectively). As for recognition of the clinical guideline for sexually transmitted disease, most urologists (90%) know it, but few non-urologists (13%) do (p < 0.001). We found that non-urological clinics make a great contribution to the medical treatment for male gonococcal and chlamydial urethritis in Shiga prefecture. It is important to standardize the medical care for sexually transmitted male urethritis by familiarizing non-urological practitioners with the clinical guideline. PMID:24594766
Introduction: Physiological, anthropometrical and thermal perceptual are the most important factors affecting thermoregulation of men and women in workplaces. The purpose of this study was determining the validity of a questionnaire method for assessing women's heat strain in workplaces. Methods: This cross-sectional study was carried out on 96 healthy women. Data were continuously collected over a period of 3 months (July-September) in 2012. Mean ± (SD) of age was found to be 31.5 ± 7.48 years, of height 1.61 ± 0.05 m, of weight 61.55 ± 10.35 kg, and of body mass index 23.52 ± 3.75 kg/m2 in different workplaces. Heart rate and oral temperature were measured by heart rate monitoring and a medical digital thermometer, respectively. Subjects completed a draft questionnaire about the effective factors in the onset of heat strain. After collecting the questionnaires, the data were analyzed by applying Cronbachsa calculation, factor analysis method, Pearson correlation and receiver operator characteristic curves using the SPSS 18 software. Results: The value for Cronbach's ? was found to be 0.68. The factor analysis method on items of draft questionnaire extracted three subscale (16 variables) which they explained 63.6% of the variance. According to the results of receiver operator characteristic curve analysis, the cut-off questionnaire score for separating people with heat strain from people with no heat strain was obtained to be 17. Conclusions: The results of this research indicated that this quantitative questionnaire has an acceptable reliability and validity, and a cut-off point. Therefore it could be used in the preliminary screening of heat strain in women in warm workplaces, when other heat stress evaluation methods are not available.
Dehghan, Habibollah; Habibi, Ehsanollah; Habibi, Peymaneh; Maracy, Mohammad Reza
Aims: Evaluation of the effectiveness of clinical teaching is an important contribution for the quality control of medical teaching. This should be evaluated using a reliable instrument in order to be able to both gauge the status quo and the effects of instruction. In the Stanford Faculty Development Program (SFDP), seven categories have proven to be appropriate: Establishing the Learning Climate, Controlling a Teaching Session, Communication of Goals, Encouraging Understanding and Retention, Evaluation, Feedback and Self-directed Learning. Since 1998, the SFDP26 questionnaire has established itself as an evaluation tool in English speaking countries. To date there is no equivalent German-language questionnaire available which evaluates the overall effectiveness of teaching. Question: Development and theoretical testing of a German-language version of SFDP26 (SFDP26-German), Check the correlation of subscale of SFDPGerman against overall effectiveness of teaching. Methods: 19 anaesthetists (7 female, 12 male) from the University of Lübeck were evaluated at the end of a teaching seminar on emergency medical care using SFDP-German. The sample consisted of 173 medical students (119 female (68.8%) and 54 male (31.2%), mostly from the fifth semester (6.6%) and sixth semester (80.3%). The mean age of the students was 23±3 years. Results: The discriminatory power of all items ranged between good and excellent (rit=0.48-0.75). All subscales displayed good internal consistency (?=0.69-0.92) and significant positive inter-scale correlations (r=0.40-0.70). The subscales and overall effectiveness of teaching showed significant correlation, with the highest correlation for the subscale communication of goals (p< 0.001; r = 0.61). Conclusion: The analysis of SFDP26-German confirms high internal consistency. Future research should investigate the effectiveness of the individual categories on the overall effectiveness of teaching and validate according to external criteria.
Iblher, Peter; Zupanic, Michaela; Hartel, Christoph; Heinze, Hermann; Schmucker, Peter; Fischer, Martin R.
In Switzerland, every physician has the right to report a patient that is potentially unfit to drive to the licensing authority without violating medical confidentiality. Verified information regarding physicians' attitudes concerning this discretionary reporting and the frequency of such reports are not available. In order to answer these questions, 635 resident physicians were sent a questionnaire. The response rate was 52%. On average, the responding physicians--for all specialties--reported 0.31 patients (SD 0.64, 95% CI 0.24-0.38) in the year before the survey and 1.00 patient (SD 1.74, 95% CI 0.81-1.20) in the past 5 years. Seventy-nine percent of the responding physicians indicated knowing the current legal requirements for driving in Switzerland. In applied logistic regression analysis, only two factors correlate significantly with reporting: male sex (odds ratio 5.4) and the specialty "general medicine" (odds ratio 3.4). Ninety-seven percent of the physicians were against abolishing medical discretionary reporting and 29% were in favor of introducing mandatory reporting. The great majority of the questioned physicians supported the discretionary reporting of drivers that are potentially unfit to drive as currently practiced in Switzerland. The importance and the necessity of a regular traffic medicine-related continuing education for medical professionals are shown by the low number of reports per physician. PMID:21534006
Eggert, Sebastian; Thali, Michael J; Pfäffli, Matthias
The aim of this study is to examine the questionnaires used to evaluate teaching performance in higher education institutes and called "Instructor and Course EvaluationQuestionnaires (ICEQ)" in terms of questionnaire preparation techniques and components of curriculum. Obtaining at least one ICEQ belonging to any state and private universities in
Introduction: Media literacy is a 21st century approach to education. It provides a framework to access, analyze, evaluate, and create messages in a variety of forms - from print to video to the Internet. Also, it builds an understanding of the role of media in society as well as essential skills of inquiry and self-expression necessary for citizens of a democracy. The purpose of this research was to determine the rate of media literacy among Isfahan University of Medical Sciences students using Iranian Media Literacy Questionnaire (IMLQ). Materials and Methods: This is a survey research in which the data were collected by a researcher-made questionnaire. Its validity and reliability were confirmed by Library and Information Sciences specialists and Chronbach's alpha (r = 0.89), respectively. Statistical population consisted of all students in Isfahan University of Medical Sciences (7000 cases) and the samples were 364. Sampling method was random stratified sampling. Data were analyzed by descriptive (frequency distribution, mean) and inferential (T-test, ANOVA, and one-sample t-test) statistics through SPSS16 software. Results: The findings showed that the mean level of media literacy among Isfahan University of Medical Sciences students was 3.20 ± 0.558 (higher than average). The highest mean was skill in avoiding confusion and focus on activates such as watching television, listening to radio, reading newspaper, and using internet; and the lowest mean was skill in membership and subscription in useful society networks. The mean of evaluation of media messages dimension was more than others. The lowest mean of dimensions was for selective and purposeful use of media with 2.99 ± 0.761. Comparison between gender, married status, educational degree, and college type and the rate of media literacy among Isfahan University of Medical Sciences students showed no significant difference. Conclusion: The results showed that the rate of media literacy among Isfahan University of Medical Sciences students was higher than average. But students didn't have enough skill in membership and subscription in useful society networks and Skill in tracking news about your favorite artists and musicians. Generally, all students and education practitioners should pay special attention to factors affecting in improving media literacy as a basic capability in using media.
Evaluating interactive question answering (QA) systems with real users can be challenging because traditional evaluation measures based on the relevance of items returned are difficult to employ since relevance judgments can be unstable in multi-user evaluations. The work reported in this paper evaluates, in distinguishing among a set of interactive QA systems, the effectiveness of three questionnaires: a Cognitive Workload Questionnaire (NASA TLX), and Task and System Questionnaires customized to a specific interactive QA application. These Questionnaires were evaluated with four systems, seven analysts, and eight scenarios during a 2-week workshop. Overall, results demonstrate that all three Questionnaires are effective at distinguishing among systems, with the Task Questionnaire being the most sensitive. Results also provide initial support for the validity and reliability of the Questionnaires.
Kelly, Diane; Kantor, Paul B.; Morse, Emile; Scholtz, Jean; Sun, Y.
Background Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP) has been implemented within organisations across a strategic health authority (SHA). The aim of the study was to provide an overview of NMP across one SHA. Methods NMP leads across one SHA were asked to supply the email addresses of NMPs within their organisation. One thousand five hundred and eighty five NMPs were contacted and invited to complete an on-line descriptive questionnaire survey, 883 (55.7%) participants responded. Data was collected between November 2010 and February 2011. Results The majority of NMPs were based in primary care and worked in a team of 2 or more. Nurse independent supplementary prescribers were the largest group (590 or 68.6%) compared to community practitioner prescribers (198 or 22.4%), pharmacist independent supplementary prescribers (35 or 4%), and allied health professionals and optometrist independent and/or supplementary prescribers (8 or 0.9%). Nearly all (over 90%) of nurse independent supplementary prescribers prescribed medicines. Approximately a third of pharmacist independent supplementary prescribers, allied health professionals, and community practitioner prescribers did not prescribe. Clinical governance procedures were largely in place, although fewer procedures were reported by community practitioner prescribers. General practice nurses prescribed the most items. Factors affecting prescribing practice were: employer, the level of experience prior to becoming a non-medical prescriber, existence of governance procedures and support for the prescribing role (p?0.001). Conclusion NMP in this strategic health authority reflects national development of this relatively new role in that the majority of non-medical prescribers were nurses based in primary care, with fewer pharmacist and allied health professional prescribers. This workforce is contributing to medicines management activities in a range of care settings. If non-medical prescibers are to maximise their contribution, robust governance and support from healthcare organisations is essential. The continued use of supplementary prescribing is questionable if maximum efficiency is sought. These are important points that need to be considered by those responsible for developing non-medical prescribing in the United Kingdom and other countries around the world.
Since 2003, the Essential Skills Series training program developed by the Canadian Evaluation Society has been offered to more than 15 groups in the province of Quebec. The evaluations of these workshops were based on the participants' reactions collected by a Participant Feedback Questionnaire. This article describes the process used to assess
Objective To determine if general practitioner rates of antidepressant drug prescribing and referrals to specialist services for depression vary in line with patients scores on depression severity questionnaires.Design Analysis of anonymised medical record data.Setting 38 general practices in three sitesSouthampton, Liverpool, and Norfolk.Data reviewed Records for 2294 patients assessed with severity questionnaires for depression between April 2006 and March 2007
Tony Kendrick; Christopher Dowrick; Anita McBride; Amanda Howe; Pamela Clarke; Sue Maisey; Michael Moore; Peter W Smith
Confirmatory factor analyses were done in an attempt to replicate the factor structure of the Aggression Questionnaire constructed by Buss and Perry (1992) [Journal of Personality and Social Psychology, 63, 452459] in a Dutch sample. The findings indicated that the Buss and Perry 4-factor model provided a poor fit to the full 29-item questionnaire. Although generally confirming the 4-factor structure,
Cor Meesters; Peter Muris; Hans Bosma; Erik Schouten; Sandra Beuving
The purpose of the study was to test the psychometric properties of a culturally sensitive and theory-based instrument: the Breast Health Behavior Questionnaire. This instrument was translated into Spanish and back-translated at a third- to fourth-grade reading level. The pilot group consisted of 70 Hispanic women who attended a class at a local church. Subsequent to pilot testing, another 40 Hispanic women who attended a class at the local health department comprised the study sample. The participants responded to the 15-item questionnaire, which is formatted as a Likert scale. Content validity of the Breast Health Behavior Questionnaire was determined by a panel of experts. A factor analysis of this instrument showed five separate dimensions accounting for 71.82% of the instrument's variance. The three major components of self-regulation theory (schema, coping, and appraisal criteria) were found clustered within the first three dimensions after three items were discarded. The Breast Health Behavior Questionnaire demonstrated an internal consistency reliability coefficient of .7172. The psychometric properties of the Spanish version of this questionnaire warrant further research. The instrument may support a better understanding of the Hispanic woman's practice of breast health behavior. Eventually, the Breast Health Behavior Questionnaire may assist nurses in the formulation of culturally grounded interventions. PMID:11502042
ObjectivesQuestionnaires are used to estimate disease burden. Agreement between questionnaire responses and a criterion standard is important for optimal disease prevalence estimates. We measured the agreement between self-reported disease and medical record diagnosis of disease.
Yuji Okura; Lynn H. Urban; Douglas W. Mahoney; Steven J. Jacobsen; Richard J. Rodeheffer
Public Use Tape 9 from the 1987 National Medical Expenditure Survey (NMES) contains person level data from the Household Survey health status questionnaire and the access to care supplement. The health status questionnaire elicited information on current ...
The purpose of this study was to provide an assessment tool to judge coaching performance that was appropriate for completion by athletes. The questionnaire underwent a variety of developmental stages. In its final form, it contained 36 items. The tool was shown to be a valid, reliable, and standardized questionnaire. It demonstrated discriminability and provoked honest, accurate responding in subjects. The test was capable of providing immediate feedback to coaches seeking information about athletes' perceptions of their coaching performance. Responses on the developed scale were weighted to reflect the desirability of the coaching characteristics of a good coach. The questionnaire provides a total score which can be interpreted by the coach as a measure of how much of an "ideal" coach exists in him/her. PMID:4053263
Background: The physical activity in teaching faculties is an important aspect to maintain good health. This not only prevents the various non - communicable diseases but also has role in secondary prevention of diseases. It is also proven that the growing epidemic of obesity mostly in children is linked to recent decline in physical activity levels both in home, school and working places. Social class is thought to have a bearing on physical activity. On basis of this, the survey was done to assess the physical activity levels in higher social class population i.e. on teaching faculty of Melaka Manipal Medical College, Manipal, Karnataka, India. Materials and Methods: Questionnaire study was implemented in 2010 as the design of this research without any manual intervention. No experiment was conducted in the research. Questions were specific and related to the physical activities in home and also in working environment. Results: The study found that in medical college the lifestyle is restricted mostly to sedentary and moderate work. Most of faculties were using bike and cars to reach there working place and also we found the physical activities in the form of exercise and sports activity were lacking. Discussion: In addition to the importance of a physical activity professional's potential influence on others as a model, engaging in a physically active lifestyle is very important for personal reasons. Achieving and maintaining a health-enhancing level of physical fitness is one of the basic standards for good teaching and maintaining good health. Physical activity in professionals leads to both personal health benefits, and improve job satisfaction. Conclusion: Infrastructure improvements such as sports activity in colleges among faculties, combined with regular exercise provide additional physical activity that would help reduce obesity and non-communicable diseases.
Examined psychometric properties of Adolescent Risk-Taking Questionnaire, using 11- to 18-year-olds. Found that the four-factor risk structure was substantiated via confirmatory factor analysis. One week test-retest and internal consistency indices were sound. Older adolescents and boys perceived less risk and reported more risky behaviors than
This report presents the results of a study that was undertaken to identify student attitudes toward the Pass-Fail (P-F) option at the University of Washington. A questionnaire designed to assess student opinions toward and possible behavioral changes resulting from P-F courses was sent to a random sample of sophomores, juniors and seniors
Washington Univ., Seattle. Educational Assessment Center.
The purpose of this study was to develop a teaching quality assessment questionnaire and assess its reliability by using it with a sample of first-year medical students. Principal components analysis with varimax orthogonal rotation resulted in the development of a 12-item, two-component tool, adequate for use in lectures and small-group sessions.
Gaspar, Maria Filomena; Pinto, Anabela Mota; da Conceicao, Hugo Camilo F.; da Silva, Jose Antonio Pereira
The 1987 National Medical Expenditure Survey (NMES) contains person level data from the Household Survey Health Status Questionnaire and the Access to Care Supplement. The public use data set contains one record each for a total of 30,038 household Survey...
In this paper we describe the development of a standardized computer satisfaction usability questionnaire for use with speakers of the Turkish language, the Turkish Computer System Usability Questionnaire, Short Version (T-CSUQ-SV). This new questionnaire, based on the English-language CSUQ, underwent careful translation and transformation through comprehensive psychometric evaluation. The results of the psychometric evaluation revealed an acceptable level of reliability,
Background Drug abuse is hazardous and known to be prevalent among young adults, warranting efforts to increase awareness about harmful effects and to change attitudes. This study was conducted to assess the perceptions of a group of medical students from Pakistan, a predominantly Muslim country, regarding four drugs namely heroin, charas, benzodiazepines and alcohol. Results In total, 174 self-reported questionnaires were received (87% response rate). The most commonly cited reasons for why some students take these drugs were peer pressure (96%), academic stress (90%) and curiosity (88%). The most commonly cited justifiable reason was to go to sleep (34%). According to 77%, living in the college male hostel predisposed one to using these drugs. Sixty percent of students said that the drugs did not improve exam performance, while 54% said they alleviated stress. Seventy-eight percent said they did not intend to ever take drugs in the future. Females and day-scholars were more willing to discourage a friend who took drugs. Morality (78%), religion (76%) and harmful effects of drugs (57%) were the most common deterrents against drug intake. Five suggestions to decrease drug abuse included better counseling facilities (78%) and more recreational facilities (60%). Conclusion Efforts need to be made to increase student awareness regarding effects and side effects of drugs. Our findings suggest that educating students about the adverse effects as well as the moral and religious implications of drug abuse is more likely to have a positive impact than increased policing. Proper student-counseling facilities and healthier avenues for recreation are also required.
To support developments in genetics education, we constructed the GPGeneQ questionnaire to assess skills required for the\\u000a practice of genetics by general practitioners (GPs). We describe the process of developing and validating this questionnaire\\u000a to provide a detailed guide in the construction for questionnaires in the application of evaluating genetics education. The\\u000a GPGeneQ was developed through a multi-step process with
Anna Flouris; Graeme Hawthorne; MaryAnne Aitken; Clara Gaff; Sylvia A. Metcalfe
As part of a larger effort to assess passenger comfort in aircraft, two questionnaires were administered: one to ground-based respondents; the other to passengers in flight. Respondents indicated the importance of various factors influencing their satisfaction with a trip, the perceived importance of various physical factors in determining their level of comfort, and the ease of time spent performing activities in flight. The in-flight sample also provided a rating of their level of comfort and of their willingness to fly again. Comfort ratings were examined in relation to (1) type of respondent, (2) type of aircraft, (3) characteristics of the passengers, (4) ease of performing activities, and (5) willingness to fly again.
This paper describes recent research in subjective usability measurement at IBM. The focus of the research was the application of psychometric methods to the development and evaluation of questionnaires that measure user satisfaction with system usability. The primary goals of this paper are to (1) discuss the psychometric characteristics of four IBM questionnaires that measure user satisfaction with computer system
The Leeds Sleep EvaluationQuestionnaire comprises ten self-rating 100-mm-line analogue questions concerned with aspects of sleep and early morning behaviour. The questionnaire has been used to monitor subjectively perceived changes in sleep during psychopharmacological investigations involving a variety of psychoactive agents, including sedative-hypnotics, antidepressants, anxiolytics, CNS stimulants, and antihistamines.
A thorough documentation of a patient's medical history is widely recognised as providing good indicators of potential intraoperative and postoperative complications. As preoperative assessment can be time consuming, computer-based information collection systems (ICS) can help free up precious and limited resources, leaving clinicians with more time to fulfil their primary mission of administrating medical care. In addition, medical histories collected
Matt-mouley Bouamrane; Alan L. Rector; Martin Hurrell
Fourth in a series of volumes designed to develop an evaluation design for the Urban Development Action Grant (UDAG) program, this volume consists of a set of data collection instruments to be administered to various public officials, agency staff, and pr...
D. Culp L. Haydon G. Reigeluth N. Rockler J. Tilney
To describe a program to study medication safety in pregnancy, the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). MEPREP is a multi-site collaborative research program developed to enable the conduct of studies of medication use and outcomes in pregnancy. Collaborators include the U.S. Food and Drug Administration and researchers at the HMO Research Network, Kaiser Permanente Northern and Southern California, and Vanderbilt University. Datasets have been created at each site linking healthcare data for women delivering an infant between January 1, 2001 and December 31, 2008 and infants born to these women. Standardized data files include maternal and infant characteristics, medication use, and medical care at 11 health plans within 9 states; birth certificate data were obtained from the state departments of public health. MEPREP currently involves more than 20 medication safety researchers and includes data for 1,221,156 children delivered to 933,917 mothers. Current studies include evaluations of the prevalence and patterns of use of specific medications and a validation study of data elements in the administrative and birth certificate data files. MEPREP can support multiple studies by providing information on a large, ethnically and geographically diverse population. This partnership combines clinical and research expertise and data resources to enable the evaluation of outcomes associated with medication use during pregnancy.
Andrade, Susan E.; Davis, Robert L.; Cheetham, T. Craig; Cooper, William O.; Li, De-Kun; Amini, Thushi; Beaton, Sarah J.; Dublin, Sascha; Hammad, Tarek A.; Pawloski, Pamala A.; Raebel, Marsha A.; Smith, David H.; Staffa, Judy A.; Toh, Sengwee; Dashevsky, Inna; Haffenreffer, Katherine; Lane, Kimberly; Platt, Richard; Scott, Pamela E.
The Reassurance Questionnaire (RQ; Speckens, Spinhoven, Van Hemert, & Bolk, (2000) is a self-report measure designed to assess the extent to which patients feel reassured by their attending physicians. While the original RQ was validated in Dutch, the invariance of the factor structure has not been examined in the English version of the RQ. In the current study, the English
Nicole E. Pugh; Heather D. Hadjistavropoulos; Donald Sharpe
Objectives: This study aimed to determine attitudinal and self reported behavioural variations between medical students in different years to scenarios involving academic misconduct. Design: A cross-sectional study where students were given an anonymous questionnaire that asked about their attitudes to 14 scenarios describing a fictitious student engaging in acts of academic misconduct and asked them to report their own potential behaviour. Setting: Dundee Medical School. Participants: Undergraduate medical students from all five years of the course. Method: Questionnaire survey. Main measurements: Differences in medical students' attitudes to the 14 scenarios and their reported potential behaviour with regards to the scenarios in each of the years. Results: For most of the scenarios there was no significant difference in the response between the years. Significant differences in the responses were found for some of the scenarios across the years, where a larger proportion of year one students regarded the scenario as wrong and would not engage in the behaviour, compared to other years. These scenarios included forging signatures, resubmitting work already completed for another part of the course, and falsifying patient information. Conclusion: Observed differences between the years for some scenarios may reflect a change in students' attitudes and behaviour as they progress though the course. The results may be influenced by the educational experience of the students, both in terms of the learning environment and assessment methods used. These differences may draw attention to the potential but unintentional pressures placed on medical students to engage in academic misconduct. The importance of developing strategies to engender appropriate attitudes and behaviours at the undergraduate level must be recognised.
Background The project to develop a new Japanese Orthopaedic Association (JOA) score rating system for low back disorders, the JOA Back\\u000a Pain EvaluationQuestionnaire (JOABPEQ), is currently in progress. Part 1 of the study selected 25 candidate? items for use\\u000a on the JOABPEQ. The purpose of this current Part 2 of the study was to verify the reliability of the questionnaire.
The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants-30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission. PMID:21409398
Kumar, B Deepak; Kumari, C M Vinaya; Sharada, M S; Mangala, M S
Background: The focus of this review is on methods that are currently being used to evaluate the behavioural effects of medication for individuals with intellectual disabilities. First we describe what has been identified as the ideal criteria for conducting clinical trials and how these criteria may be adapted to do less controlled evaluations.
Objectives To assess the safety culture in an acute medical admissions unit (AMAU) of a teaching hospital in order to benchmark results\\u000a against international data and guide a unit-based, integrated, risk management strategy.\\u000a \\u000a \\u000a \\u000a Methods The safety attitudes questionnaire (SAQ), a validated instrument for the measurement of safety culture was applied to an AMAU.\\u000a All AMAU healthcare staff (n = 92) were surveyed: doctors, nurses,
Background In a previous questionnaire-based survey, we found extensive use of nonsteroidal anti-inflammatory drugs (NSAIDs) in subjects\\u000a with risk factors for serious gastrointestinal complications.\\u000a \\u000a \\u000a \\u000a Aim This study focused on the use of NSAIDs in subjects who reported either (a) pre-existing disorders which would have required\\u000a caution in using NSAIDs (e.g. dyspepsia\\/heartburn or peptic ulcer) or (b) co-medication with drugs having a high
Maria Chiara Silvani; Domenico Motola; Elisabetta Poluzzi; Ambrogio Bottoni; Fabrizio De Ponti; Alberto Vaccheri; Nicola Montanaro
Background Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. Methods Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1st and 3rd years. Diagnostic interviews (MINI) were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. Results 98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. Conclusion Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available.
Physicians play a unique role in the adoption of electronic medical records (EMR) within the healthcare organization. As leaders, they are responsible for setting the standards for this new technology within their sphere of influence while concurrently being required to learn and integrate EMR into their own workflow and process as the recipients
Effective teaching is a concern of all teachers. Therefore, regular teachers' training is emphasized globally. B. P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university situated in eastern region of Nepal has an established Medical Education unit which attempts to improve teaching-learning skills by training faculty members through organizing regular medical education training programs. The aim of the present study was to assess the effectiveness of 3-day training workshop on "Teaching-learning methodology and Evaluation" held in four different medical colleges of Nepal. The workshop was targeted at middle and entry level of health profession teachers who had not been previously exposed to any teacher's training program. The various components, such as teaching-learning principles, writing educational objectives, organizing and sequencing education materials, teaching-learning methods, microteaching and assessment techniques, were incorporated in the workshop. A team of resource persons from BPKIHS were involved in all the four medical institutions. The collection data had two categories of responses: (1) a questionnaire survey of participants at the beginning and end of the workshop to determine their gain in knowledge and (2) a semi-structured questionnaire survey of participants at the end of workshop to evaluate their perception on usefulness of the workshop. The later category had items with three-point likert scale (very useful, useful and not useful) and responses to open-ended questions/ statements to document participants general views. The response was entered into a spreadsheet and analyzed using SPSS. The result showed that all participants (n = 92) improved their scores after attending the workshop (p < 0.001). Majority of respondents expressed that the teaching-learning methods, media, microteaching and evaluation techniques were useful in teaching-learning. The workshop was perceived as an acceptable way of acquiring teaching-learning skills but 39.4% participants expressed that the duration of the workshop was too short. The overall impression about trainers was very positive. Therefore, regular organization of such workshops with addition of new advances in medical education would be highly beneficial to improve teaching learning skill of medical teachers. PMID:18092430
Objective: To compare the pattern, efficacy, and tolerability of self-medicated drugs and to assess the adequacy of their dose in primary dysmenorrhea (PD). Materials and Methods: A survey using a self-developed, validated, objective, and structured questionnaire as a tool was conducted among subjects with PD. Statistical analysis was carried out using Chi-square test and ANOVA with post-hoc Tuckey's test. Results: Out of 641 respondents, 42% were self-medicated. The pattern of drugs used was: Dicyclomine, an unknown drug, mefenamic acid, mefenamic acid + dicyclomine, and metamizole by 35%, 29%, 26%, 9%, and 1% of respondents, respectively. Mefenamic acid + dicyclomine, the combination was the most efficacious in comparison to other drugs in moderate to severe dysmenorrhea. There was better tolerability with mefenamic acid + dicyclomine group compared to other drugs. Sub-therapeutic doses were used by 86% of self-medicating respondents. Conclusions: The prevailing self-medication practices were inappropriate in a substantial proportion of women with inadequate knowledge regarding appropriate drug choice, therapeutic doses, and their associated side effects.
The purpose of this study was to elicit patient feedback regarding the perceived clarity and level of difficulty associated with self-report human immunodeficiency virus (HIV) medication adherence measurement tools. HIV-infected patients from clinics in Shreveport, Louisiana, and Chicago, Illinois, were recruited to participate in four focus group discussions. Three groups consisted of patients with limited literacy skills (
Michael S. Wolf; Charles L. Bennett; Terry C. Davis; Estela Marin; Connie Arnold
Cohort studies of doctors' career choices and career progression since the mid-1970s have shown important changes in the medical workforce, in specialist training, and in employment. Examples of these changes are the increasing proportion of women doctors and of doctors who wish to work part time, the emigration patterns of doctors, and the development of vocational training for general practice. Studies enable the effects of longer term changes to be assessed, and sometimes they inform current debate. PMID:8611884
Lambert, T W; Goldacre, M J; Parkhouse, J; Edwards, C
Background/Aims The aim of this study was to examine the convenience of the quality of life and utility evaluation survey technology (QUEST) questionnaire and the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire as self-assessment diagnostic instrument. Methods This was a two-way crossover study conducted over 6 weeks from September 2010 to November 2010. The subjects were 60 consecutive patients admitted to the Hiratsuka city hospital with a gastrointestinal condition, regardless of the coexistence of heartburn. They were assigned to fill in both the QUEST and FSSG questionnaires in random order. We analyzed the time taken to complete the questionnaires, whether subjects asked any questions as they filled in the questionnaire, and the questionnaire scores. Results Comparison of the QUEST and the FSSG revealed significant differences in the completion time (196.5 vs. 97.5 seconds, respectively; P < 0.0001) and in whether subjects asked any questions (37 vs. 15 subjects, respectively; P < 0.0001). Completion time in QUEST scores of ? 4 was lower than < 4 (170.5 vs. 214.0 seconds, respectively; P = 0.022), and the QUEST score was significantly higher without questions than with question (3 vs. 1 points, respectively; P = 0.025). Conclusions This study revealed that the FSSG questionnaire may be easier for Japanese subjects to complete than the QUEST questionnaire.
Complex administrative procedures have gradually been established for the evaluation of implantable medical devices, resulting in improved patient safety. These procedures include in vitro testing, animal experimentation, clinical premarketing studies, and post-market surveillance. Further improvements are needed, however, including more independent experts and clinical studies, while ensuring that the approval process is neither to slow nor too hasty. PMID:23259342
This study tests a questionnaire method for eliciting process criteria for medical care appraisal. The questionnaire was sent to national samples of family physicians, pediatricians, and pediatricians specializing in infectious diseases asking their opinions about various clinical actions in 125 clinical situations concerning respiratory infection in infants. Five hundred twenty-four (54%) physicians returned completed questionnaires. Questionnaire responses favored the performance of a majority of actions and opposed very few. Opinions concerning individual actions, particularly diagnostic tests and treatments, varied widely depending upon the clinical situation presented. A second questionnaire sent one year later indicated that the opinions expressed in the first questionnaire remained stable over time, especially if the initial opinion favored performance of the action. Comparison of the questionnaire responses and medical records of a group of practitioners demonstrated that only 55% of actions favored in a practitioner's questionnaire appeared in his records. Although the questionnaire method appears to be a feasible, specific, and reliable means of identifying clinical opinion, there remains considerable discordance between opinion as expressed in the questionnaire and recorded clinical practice.
Wagner, E H; Williams, C A; Greenberg, R; Kleinbaum, D; Wolf, S; Ibrahim, M A
Medical establishments play important roles in different activities by using of modern technology to serve the humans and the environment through different departments in the establishment and its firms. Medical wastes are considered as a hazardous waste because they contain toxic materials, infectious, or non-infectious wastes and they are considered as a hazard to millions of patients, health care workers, and visitors. Treatment processes for medical wastes comprise autoclaving, microwaving, chemical disinfection, irradiation, plasma system, and incineration. Incineration is a thermal process, which destroys most of the waste including microorganisms. Combustion process must be under controlled conditions to convert wastes containing hazardous materials into mineral residues and gases. Hospital waste incinerators may emit a number of pollutants depending on the waste being incinerated. These pollutants include particulate matter, acid gases, toxic metals, and toxic organic compounds products of incomplete combustion, e.g., dioxins, furans, and carbon monoxide, as well as sulfur oxides and nitrogen oxides. So, there should be a reduction of emissions of most of these pollutants by air pollution control devices. This study was conducted in 51 medical establishments (ME) in Alexandria. To evaluate its incinerators. It was found that only 31.4% of total ME have their own incinerators to treat their medical waste. Also, the incinerators conditions were poor with incomplete combustion. So, the study recommend handling of all medical wastes of ME in Alexandria by the company which is responsible now for management of domestic solid wastes of the city. PMID:16900615
Labib, Ossama A; Hussein, Ahmed H; El-Shall, Waffaa I; Zakaria, Adel; Mohamed, Mona G
Despite advances in child maltreatment research, accurate measurement of exposure remains a key issue. In this study, we evaluated a short form (CEVQ-SF) of the Childhood Experiences of Violence Questionnaire (CEVQ) in a sample of adolescents involved with child protection services in an urban city in Ontario, Canada. Focusing on the two most
This study describes the processes involved in the development and statistical validation of a primary science curriculum delivery evaluation instrument, the Science Curriculum Implementation Questionnaire (SCIQ), used to identify factors influencing science programme delivery at the classroom and school level. The study begins by exploring the
Clinical observation, systematic research and popular anecdote indicate that, when confronted by death, people change the criteria by which they evaluate their lives. Questionnaires used routinely to assess quality of life in people with poor-prognosis cancer tend to be symptom-based and do not assess factors which become important when confronted by fatal illness, such as the meaning of life and
In this study, the authors report on the validity and reliability of a paper-and-pencil instrument called SET37 used for Student Evaluation of Teaching (SET) in higher education. Using confirmatory factor analysis on 2525 questionnaires, a revalidation of the SET37 shows construct and discriminant validity of the 12 dimensions included in the
The purpose of this pilot study was to develop and evaluate an instrument for measuring Greek elementary physical educators' knowledge of student assessment. A multiple-choice questionnaire comprised of items about concepts, methods, tools, and types of student assessment in physical education was designed and tested. The initial 35-item
Emmanouilidou, Kyriaki; Derri, Vassiliki; Aggelousis, Nicolaos; Vassiliadou, Olga
Introduction: To achieve a valid evaluation of faculty members, it is necessary to develop an inclusive and dynamic system of evaluation addressing all the activities and responsibilities of faculty members. Among these responsibilities, educational activities comprise an important part which needs to be investigated. This study aimed to investigate the current system of evaluating the faculty members educational duties. Methods: In this descriptive cross-sectional study, a checklist for investigating the current evaluation system and was developed confirmed by a focus group. The data for checklist were collected through a researcher-made questionnaire and interview with eight experts of faculty evaluation that worked in different Iranian Medical Universities. For completion of information, the available documents and records were studied. Finally, the current evaluation system of different universities was depicted. Results: The developed checklist had six themes and 123 subthemes. The extracted themes included: Tools, evaluators, processes, appropriateness of faculty field of work with evaluation, feedback status, and university status regarding decisions made based on faculty evaluation results. As for comprehensiveness, all evaluation items except for evaluation and assessment skills and religiosity from personality traits subtheme were fully investigated. The evaluation tools were not enough for different types of education such as clinical education. In six universities, the feedbacks provided were only for making inter/intra department comparison, and no scientific suggestions were included. The results of evaluations were used only for the faculties promotions. Discussion: Suitability between evaluation and performance components is a necessity in every evaluation system. The study showed this does not exist in Iranian Universities. For instance, there was no appropriate tool for the evaluation of clinical education. Also, the results of the faculty evaluation were not used for the improvement of their educational performance.
Background Achieving asthma control is a major challenge in children, otherwise symptoms perception remain poor especially at this age. The aim of this study is to evaluate the relationship between Asthma Control Test (ACTTM), Asthma Therapy Assessment Questionnaire (ATAQTM) and exercise-induced bronchospasm (EIB). Methods We studied 80 asthmatic children. Airways hyperresponsiveness (AHR) was assessed by exercise-induced bronchospasm (Balke Protocol). Asthma control was evaluated using two questionnaires in all subjects: ACT (composed by Childhood-ACT and ACT) and ATAQ. In addition the use of short acting beta 2 agonist agents (SABAs) was assessed for each patient. Non-parametric variables were compared by Chi Square Test. Binomial logistic regression was performed to estimate the two questionnaires Odds Ratio (OR) in finding AHR. Results We have found that ATAQ has a sensitivity and a specificity of 0.72 and 0.45 respectively; instead, ACT has a sensitivity and a specificity of 0.5 and 0.39 respectively in evaluating AHR. Patients with uncontrolled asthma according to ATAQ revealed a significant higher percentage of AHR compared with ACT (72% vs 50%, p < 0.01). Confirming this finding, patients declaring uncontrolled asthma to ATAQ have a significantly higher percentage (34%) of frequent SABAs use than the group with uncontrolled asthma to ACT (21%) (p <0.01). Binomial logistic regression shows how a test revealing uncontrolled asthma is associated with the increasing odds of having AHR according to ATAQ (OR = 3.8, p = 0.05), not to ACT (OR = 0.2, p = 0.1). Conclusions Our results show that ATAQ reflects AHR and asthma control better than ACT. Children with uncontrolled asthma according to ATAQ have higher odds of having AHR and use of rescue medications (SABAs) compared to patients declaring uncontrolled asthma according to ACT. However both questionnaires are not sufficient alone to fully evaluate asthma control in children and it is always necessary to perform functional tests and investigate patients lifestyle, drug use and other important data that a simple questionnaire is not able to point out
This is a two-phase study on attitudes of medical students toward Alcoholics Anonymous. The first phase compares views of addiction faculty to third-year medical students on the importance of spirituality in addiction treatment. We administered a questionnaire to assess attitudes toward spiritual, biological, and psychosocial approaches to addiction treatment. The faculty viewed spirituality as relatively more important in addiction treatment
Lydia Fazzio; Marc Galanter; Helen Dermatis; Petros Levounis
This is a two?phase study on attitudes of medical students toward Alcoholics Anonymous. The first phase compares views of addiction faculty to third?year medical students on the importance of spirituality in addiction treatment. We administered a questionnaire to assess attitudes toward spiritual, biological, and psychosocial approaches to addiction treatment. The faculty viewed spirituality as relatively more important in addiction treatment
Lydia Fazzio; Marc Galanter; Helen Dermatis; Petros Levounis
...management. (a) Medical staff shall...1) Measure and record height and weight; (2) Take and record vital signs... (5) General medicalevaluation; ...indicated. (b) Medical staff shall take and record weight...
Home oxygen therapy (HOT) is a medical treatment for the patients suffering from severe lung diseases. Although walking outdoors is recommended for the patients to maintain physical strength, the patients always have to carry a portable oxygen supplier which is not sufficiently light weight for this purpose. Our ultimate goal is to develop a mobile robot to carry an oxygen tank and follow a patient in an urban outdoor environment. We have proposed a mobile robot with a tether interface to detect the relative position of the foregoing patient. In this paper, we report the questionnaire-based evaluation about the two developed prototypes by the HOT patients. We conduct maneuvering experiments, and then obtained questionnaire-based evaluations from the 20 patients. The results show that the basic following performance is sufficient and the pulling force of the tether is sufficiently small for the patients. Moreover, the patients prefer the small-sized prototype for compactness and light weight to the middle-sized prototype which can carry larger payload. We also obtained detailed requests to improve the robots. Finally the results show the general concept of the robot is favorably received by the patients. PMID:24187296
Developed an instrument to evaluate the performance of educational administrators at a Canadian medical school. After 3 yearly evaluations, 20 administrators and 80 evaluators acknowledged broader input into evaluation, but saw little evaluation-related improved performance. (SLD)
Guyatt, Gordon; Cook, Deborah; King, Derek; Nishikawa, James; Brill-Edwards, Patrick
The recently revised version of the Short-Form McGill Pain Questionnaire (SF-MPQ-2) was created to assess both neuropathic and non-neuropathic pain. The current study extends prior research by testing the reliability and validity of the SF-MPQ-2 in a sample of U.S. veteran patients with a range of chronic pain diagnoses. Participants (N = 186) completed the SF-MPQ-2, a sociodemographic questionnaire, the Structured Clinical Interview for the DSM-IV, and self-report pain and psychiatric measures. Pain diagnoses were extracted from the electronic medical record. The SF-MPQ-2 total and scale scores demonstrated good to excellent internal consistency. Convergent and discriminant validity were supported, and SF-MPQ-2 total and scale scores increased with number of pain diagnoses and pain severity. Confirmatory factor analyses indicated a four-factor model fit the data better than a single-factor model. However, high intercorrelations among the four latent constructs were observed, and a 2nd-order global pain construct also emerged. Overall, the SF-MPQ-2 demonstrated excellent reliability and validity in a sample of U.S. veteran patients with chronic neuropathic and non-neuropathic pain. Future psychometric studies of the SF-MPQ-2 should employ longitudinal data to evaluate the ability of scale scores to uniquely predict clinical and health service outcomes.
Lovejoy, Travis I.; Turk, Dennis C.; Morasco, Benjamin J.
The occurrence of patients with gastrointestinal symptoms attributed either to food allergy or intolerance has significantly increased. Nevertheless, an accurate and detailed case history, a systematic evaluation and the outcomes of specific allergy tests to identify the offending foods, including "in vivo" and "in vitro" allergy tests, are often negative for food allergy and may indicate a lactose intolerance, which is a recurrent condition affecting about 50% of adults. The aims of our study were the following: (1) What is the real incidence of the food hypersensitivity and the primary lactose intolerance in patients with gastrointestinal symptoms, initially referred to allergy or food intolerance? (2) Does lactose intolerance affect the quality of life and compliance to the therapy program? We investigated 262 consecutive patients, 72 men and 190 women. An accurate and detailed history and clinical examination were completed to investigate the offending foods. The evaluation in each patient included: allergy tests, lactose H2 breath test (LHBT) and the HRQoL questionnaire. Five years after the diagnosis of lactose intolerance, a questionnaire on the persistence of gastrointestinal symptoms after lactose ingestion and the diet compliance was distributed. Our results demonstrate an high prevalence of lactose intolerance, more frequent in women; in these patients, bloating and diarrhea are the most reported symptoms. We observe only a significant positive correlation between adverse drug reaction (ADR) and LHBT+ patients, but not an augmented prevalence of food allergy and a negative impact on the HRQoL questionnaire of lactose intolerance. PMID:21614464
Objective. To develop a reliable and valid questionnaire to evaluate satisfaction with maternity care in Sylheti-speaking Bangladeshi women. Design. Two-stage, psychometric study. Firstly, focus groups, in-depth interviews and iterative methods for translation and cultural adaptation were used to develop a Sylheti questionnaire, called the survey of Bangladeshi women's experience of maternity services from an English language questionnaire. Secondly, quantitative psychometric
Medication errors are responsible for a significant number of hospital admissions, and significant morbidity and mortality. Many of these errors result from differences in physicians and patients understanding of medications. Health care providers think in terms of medication name and dose, however patients remember size, shape, and markings of their medications more frequently than the names. The Medication Sketch Artist was developed to be a graphically interfaced medication identification system to aid in physician-patient communication. This pilot study evaluated the softwares ability to identify medications described from memory by volunteers. Out of 25 pills, each described 5 separate times, there were 80 correct identifications, and 9 identifications of the correct medication, but at a different dose. The Medication Sketch Artist shows promise as a tool to determine unknown medications. It could play an important role in reducing medication errors.
Background Health outcomes researchers are increasingly applying Item Response Theory (IRT) methods to questionnaire development, evaluation,\\u000a and refinement efforts.\\u000a \\u000a \\u000a \\u000a Objective To provide a brief overview of IRT, to review some of the critical issues associated with IRT applications, and to demonstrate\\u000a the basic features of IRT with an example.\\u000a \\u000a \\u000a \\u000a Methods Example data come from 6,504 adolescent respondents in the National Longitudinal Study of
As more Spanish speaking immigrants participate in and become the focus of research studies, questions arise about the appropriateness of existing research tools. Questionnaires have often been adapted from English language instruments and tested among college- educated Hispanic-Americans. Little has been written regarding the testing and evaluation of research tools among less educated Latino immigrants. The purpose of this study was to revise and evaluate the appropriateness of a battery of existing Spanish-language questionnaires for a physical activity intervention for immigrant Hispanic women. A three-step process was utilized to evaluate, adapt and test Spanish versions of the Self-Efficacy and Exercise Habits Survey, an abbreviated version of the Hispanic Stress Inventory-Immigrant version and the Latina Values Scale. The revised tools demonstrated acceptable validity and reliability. The adaptations improved the readability of the tools, resulting in a greater response rate, less missing data and fewer extreme responses. Psychometric limitations to the adaptation of Likert scales are discussed.
...UTILIZATION CONTROL Utilization Control: Mental Hospitals Medical, Psychiatric, and...evaluations. (a) Before admission to a mental hospital or before authorization...findings; (3) Medical history; (4) Mental and physical functional capacity;...
Background It is well accepted that medical faculty teaching staff require an understanding of educational theory and pedagogical methods for effective medical teaching. The purpose of this study was to evaluate the effectiveness of a 5-day teaching education program. Methods An open prospective interventional study using quantitative and qualitative instruments was performed, covering all four levels of the Kirkpatrick model: Evaluation of 1) Reaction on a professional and emotional level using standardized questionnaires; 2) Learning applying a multiple choice test; 3) Behavior by self-, peer-, and expert assessment of teaching sessions with semistructured interviews; and 4) Results from student evaluations. Results Our data indicate the success of the educational intervention at all observed levels. 1) Reaction: The participants showed a high acceptance of the instructional content. 2) Learning: There was a significant increase in knowledge (P<0.001) as deduced from a pre-post multiple-choice questionnaire, which was retained at 6 months (P<0.001). 3) Behavior: Peer-, self-, and expert-assessment indicated a transfer of learning into teaching performance. Semistructured interviews reflected a higher level of professionalism in medical teaching by the participants. 4) Results: Teaching performance ratings improved in students evaluations. Conclusions Our results demonstrate the success of a 5-day education program in embedding knowledge and skills to improve performance of medical educators. This multimethodological approach, using both qualitative and quantitative measures, may serve as a model to evaluate effectiveness of comparable interventions in other settings.
Background A mission statement (MS) sets out the long-term goals of an institution and is supposed to be suited for studying learning environments. Yet, hardly any study has tested this issue so far. The aim of the present study was the development and psychometric evaluation of an MS-Questionnaire (MSQ) focusing on explicit competencies. We investigated to what extent the MSQ captures the construct of learning environment and how well a faculty is following - in its perception - a competency orientation in a competency-based curriculum. Methods A questionnaire was derived from the MS teaching (Medical Faculty, Heinrich-Heine University Düsseldorf) which was based on (inter-) nationally accepted goals and recommendations for a competency based medical education. The MSQ was administered together with the Dundee Ready Education Environment Measure (DREEM) to 1119 students and 258 teachers. Cronbachs alpha was used to analyze the internal consistency of the items. Explorative factor analyses were performed to analyze homogeneity of the items within subscales and factorial validity of the MSQ. Item discrimination was assessed by means of part-whole corrected discrimination indices, and convergent validity was analyzed with respect to DREEM. Demographic variations of the respondents were used to analyze the inter-group variations in their responses. Results Students and teachers perceived the MS implementation as moderate and on average, students differed significantly in their perception of the MS. They thought implementation of the MS was less successful than faculty did. Women had a more positive perception of educational climate than their male colleagues and clinical students perceived the implementation of the MS on all dimensions significantly worse than preclinical students. The psychometric properties of the MSQ were very satisfactory: Item discrimination was high. Similarly to DREEM, the MSQ was highly reliable among students (? = 0.92) and teachers (? = 0.93). In both groups, the MSQ correlated highly positively with DREEM (r = 0.79 and 0.80, p < 0.001 each). Factor analyses did not reproduce the three areas of the MS perfectly. The subscales, however, could be identified as such both among teachers and students. Conclusions The perceived implementation of faculty-specific goals can be measured in an institution to some considerable extent by means of a questionnaire developed on the basis of the institutions MS. Our MSQ provides a reliable instrument to measure the learning climate with a strong focus on competencies which are increasingly considered crucial in medical education. The questionnaire thus offers additional information beyond the DREEM. Our site-specific results imply that our own faculty is not yet fully living up to its competency-based MS. In general, the MSQ might prove useful for faculty development to the increasing number of faculties seeking to measure their perceived competency orientation in a competency-based curriculum.
The Prescription Drug Use Questionnaire (PDUQ) is one of several published tools developed to help clinicians better identify the presence of opioid abuse or dependence in patients with chronic pain. This paper introduces a patient version of the PDUQ (PDUQp), a 31-item questionnaire derived from the items of the original tool designed for self-administration, and describes evidence for its validity
Peggy A. Compton; Stephen M. Wu; Beatrix Schieffer; Quynh Pham; Bruce D. Naliboff
The medical investigations completed on the KC-135 during FY 1990 in support of the development of the Health Maintenance Facility and Medical Operations are discussed. The experiments are comprised of engineering evaluations of medical hardware and medical procedures. The investigating teams are made up of both medical and engineering personnel responsible for the development of medical hardware and medical operations. The hardware evaluated includes dental equipment, a coagulation analyzer, selected pharmaceutical aerosol devices, a prototype air/fluid separator, a prototype packaging and stowage system for medical supplies, a microliter metering system, and a workstation for minor surgical procedures. The results of these engineering evaluations will be used in the design of fleet hardware as well as to identify hardware specific training requirements.
Lloyd, Charles W.; Guess, Terrell M.; Whiting, Charles W.; Doarn, Charles R.
Digital watermarking medical images provides security to the images. The purpose of this study was to see whether digitally watermarked images changed clinical diagnoses when assessed by radiologists. We embedded 256 bits watermark to various medical images in the region of non-interest (RONI) and 480K bits in both region of interest (ROI) and RONI. Our results showed that watermarking medical images did not alter clinical diagnoses. In addition, there was no difference in image quality when visually assessed by the medical radiologists. We therefore concluded that digital watermarking medical images were safe in terms of preserving image quality for clinical purposes. PMID:17946306
In a multicenter study, patients of the German statutory insurance were encouraged to deal with their own rehabilitation goals using a questionnaire sent in advance of rehabilitation. How patients and physicians assess the benefits and practicability of this method should, in particular, be examined.In a randomized controlled study a questionnaire, based on the preparation booklet of the DRV Bund, was sent by the German statutory insurance to 2?782 rehabilitation patients (northo=1?406, nonco714, npsy=662). For the intervention group, the questionnaire included, in addition to general information about rehabilita-tion goals, free text fields for the formulation of own goals. Patients were asked to bring the completed questionnaire to the admission interview. At the end of rehabilitation, satisfaction with participation in the goal-setting process and perceived usefulness of information on rehabilita-tion goals were captured. The doctors/psychologists responded to standardized items regarding various aspects of utility and practicability of the questionnaire.34% of the targeted rehabilitation pa-tients brought the completed questionnaire to the admission interview. For most of the rehabilitation patients goal setting is important; 31.4% reported the information obtained to rehabilitation goals to be very, and 62.9% particularly help-ful. For practitioners, the questionnaire is likely to orient rehabilitation patients to rehabilitation goals: they reported that 56.6% of the patients reflected about their goals and that 50% were more familiar with the subject. Physicians rated the handling and integration of the questionnaire into the interview, its format and layout as well as its benefits more positively than the surveyed psychologists. These were more optimistic about the ability of rehabilitation patients to answer the questionnaire (62.5%, physicians 47.2%) and define own goals (77.8%, physicians 41.7%).The applied questionnaire has been well accepted by the majority of rehabilitation patients and practitioners as well as was judged to be practical and useful in important aspects. A comprehensive implementation of the questionnaire proves to be promising, particularly in the context of oncological and orthopedic rehabilitation. To increase the return of the questionnaire, alternative delivery options should be explored in future. Against the background that rehabilitation patients and practitioners of psychosomatic medicine perceived the questionnaire as less helpful, it is also prudent to investigate whether indication-specific implementation strategies would be advantageous. PMID:24323628
The medical investigations completed on the KC-135 during FY 1991 in support of the development of the Health Maintenance Facility and Medical Operations are presented. The experiments consisted of medical and engineering evaluations of medical hardware and procedures and were conducted by medical and engineering personnel. The hardware evaluated included prototypes of a crew medical restraint system and advanced life support pack, a shuttle orbiter medical system, an airway medical accessory kit, a supplementary extended duration orbiter medical kit, and a surgical overhead canopy. The evaluations will be used to design flight hardware and identify hardware-specific training requirements. The following procedures were evaluated: transport of an ill or injured crewmember at man-tended capability, surgical technique in microgravity, transfer of liquids in microgravity, advanced cardiac life support using man-tended capability Health Maintenance Facility hardware, medical transport using a model of the assured crew return vehicle, and evaluation of delivery mechanisms for aerosolized medications in microgravity. The results of these evaluation flights allow for a better understanding of the types of procedures that can be performed in a microgravity environment.
Addresses three issues: (1) how children respond to the medicalevaluation for sexual abuse; (2) how the trauma of the evaluation experienced by some children can be minimized and the benefits maximized; and (3) how children's responses to the medicalevaluation for sexual abuse can be interpreted. (DB)
A critical aspect of air pollution exposure models is the estimation of the air exchange rate (AER) of individual homes, where people spend most of their time. The AER, which is the airflow into and out of a building, is a primary mechanism for entry of outdoor air pollutants and removal of indoor source emissions. The mechanistic Lawrence Berkeley Laboratory (LBL) AER model was linked to a leakage area model to predict AER from questionnaires and meteorology. The LBL model was also extended to include natural ventilation (LBLX). Using literature-reported parameter values, AER predictions from LBL and LBLX models were compared to data from 642 daily AER measurements across 31 detached homes in central North Carolina, with corresponding questionnaires and meteorological observations. Data was collected on seven consecutive days during each of four consecutive seasons. For the individual model-predicted and measured AER, the median absolute difference was 43% (0.17 h?1) and 40% (0.17 h?1) for the LBL and LBLX models, respectively. Additionally, a literature-reported empirical scale factor (SF) AER model was evaluated, which showed a median absolute difference of 50% (0.25 h?1). The capability of the LBL, LBLX, and SF models could help reduce the AER uncertainty in air pollution exposure models used to develop exposure metrics for health studies.
The medicalevaluation of children with suspected sexual abuse includes more than just the physical examination of the child. The importance of taking a detailed medical history from the parents and a history from the child about physical sensations following sexual contact has been emphasized in other articles in the medical literature. The
Purpose: To compare history of 22 different diseases reported during an in-person interview with that reported on a mailed self-administered questionnaire. Methods: 7841 participants of the European Prospective Investigation into Cancer (EPIC)-Potsdam study. The interview at baseline and the questionnaire at follow-up approximately 2 years later included identical questions about whether the participant had ever had a physician diagnosis of
Manuela M. Bergmann; Eric J. Jacobs; Kurt Hoffmann; Heiner Boeing
A pilot program with primary care physicians was established in Clinica Cuauhtémoc y Famosa, focused to evaluate women older than 35 years with climateric symptoms. This program included a survey, a complete gynecological examination with Pap smears, ultrasound pelvic examination and mamography. Also, blood samples were collected for cholesterol, tryglycerides, calcium, phosphorus and alkaline phosphatase. An ECG, bone densitometry of the radius and X-rays of the vertebral column were obtained. This group was formed by 69 women with an age media of 50 years (SD 7.6 years, median 49 years). The survey disclosed that 34/65 women had been hysterectomized, and only 34/64 had received antitetanic immunization in the last 10 years. A preexistent chronic disease occurred in 36/59 women, these were diabetes mellitus, arterial hypertension or degenerative osteoarthritis. Alcohol consumption was recorded in 5/66 women and tabac consumption in 9/66 women, and 32/68 women accepted to be sedentary. Laboratory examinations disclosed hypercholesterolemia in 19/66 women and hypertryglyceridemia in 8/64 women. Osteopenia was detected in 33/60 women. This findings support a systematic plan to provide medical assistance for women in this age, specially if previous epidemiologycal studies have disclosed that coronary disease is the main cause of death for women older than 50 years in this region, that also belongs to the area of highest incidence of diabetes. PMID:8549923
The purpose of this study was to discover safe and effective tasks in medication management for nurses; create a new electronic Medication Administration Record, or eMAR; and formally and informally assess this new eMAR. The samples mean computer experien...
The noise equivalent quanta (NEQ) has been recommended as a measure of physical quality of medical images. Digitised data of medical radiographs in a previous work have been analysed in terms of resolution via the modulation transfer function (MTF) and noise via the noise power spectrum (NPS), but not in terms of NEQ. As the NEQ is currently regarded as
Muhamad Saridan; Wan Hassan; Yusof Munajat; Shamsul Sahibuddin
This is a two-phase study on attitudes of medical students toward Alcoholics Anonymous. The first phase compares views of addiction faculty to third-year medical students on the importance of spirituality in addiction treatment. We administered a questionnaire to assess attitudes toward spiritual, biological, and psychosocial approaches to addiction treatment. The faculty viewed spirituality as relatively more important in addiction treatment than did the students. The second phase was designed to assess whether medical student attitudes toward spiritually based treatments changed over the course of a psychiatry clerkship. At the beginning of the clerkship, students rated a spiritually oriented approach as important in addiction treatment as a biological approach, whereas, at the end of the clerkship, they rated the biological approach as more important. It may be important to educate medical students about the spiritual dimensions of recovery so they can integrate this into their treatment of addiction. PMID:12913366
Computer-administered food frequency questionnaires (FFQs) can address limitations inherent in paper questionnaires by allowing very complex skip patterns, portion size estimation based on food pictures, and real-time error checking. We evaluated a web-based FFQ, the Graphical Food Frequency System (GraFFS). Participants completed the GraFFS, six telephone-administered 24-hour dietary recalls over the next 12 weeks, followed by a second GraFFS. Participants were 40 men and 34 women, aged 18 to 69 years, living in the Columbus, OH, area. Intakes of energy, macronutrients, and 17 micronutrients/food components were estimated from the GraFFS and the mean of all recalls. Bias (second GraFFS minus recalls) was -9%, -5%, +4%, and -4% for energy and percentages of energy from fat, carbohydrate, and protein, respectively. De-attenuated, energy-adjusted correlations (intermethod reliability) between the recalls and the second GraFFS for fat, carbohydrate, protein, and alcohol were 0.82, 0.79, 0.67, and 0.90, respectively; for micronutrients/food components the median was 0.61 and ranged from 0.40 for zinc to 0.92 for beta carotene. The correlations between the two administrations of the GraFFS (test-retest reliability) for fat, carbohydrate, protein, and alcohol were 0.60, 0.63, 0.73, and 0.87, respectively; among micronutrients/food components the median was 0.67 and ranged from 0.49 for vitamin B-12 to 0.82 for fiber. The measurement characteristics of the GraFFS were at least as good as those reported for most paper FFQs, and its high intermethod reliability suggests that further development of computer-administered FFQs is warranted. PMID:24462267
Kristal, Alan R; Kolar, Ann S; Fisher, James L; Plascak, Jesse J; Stumbo, Phyllis J; Weiss, Rick; Paskett, Electra D
BackgroundMillions of Americans search the Internet for health-related information; however, the readability and comprehensiveness of consumer medication information (CMI) on the Internet has not been widely studied.
Karissa Y. Kim; Anne Metzger; Patricia R. Wigle; Pearl J. Choe
Questionnaires were sent out to the staffs (13 physicians, 52 nurses and 5 medical engineers) of the ICU/CCU at the University of Tokyo Hospital, to evaluate pharmaceutical services by analyzing problems in the services offered. Four components of pharmaceutical services were evaluated: inventory control of drugs, check of drug usage and doses, mixing of injections, and offering drug information. Almost all responses from medical staffs evaluated pharmaceutical services overall as "good". The high response rate (96%) from the nursing staff was attributed to the fact that they were familiar with the pharmacist's role with drug inventory, and mixing injections, when nursing was not available for these tasks. Although 50% of physicians rated the pharmaceutical services of providing drug information as "good", this value was lower than responses on other items of the questionnaires, which suggests some dissatisfaction. The occurrences of drug information obtained by passive offering (121 subjects) was 4 times as common as drug information obtained by active offering (30 subjects). From this finding, and comments on the questionnaires from physicians, it suggests that physicians require more drug information for dosage regimens, and prefer the drug information to be provided more actively. Further, an important comment from physicians and nurses was that the services of pharmacists are not available on all shifts/all days of the week to provide consultation for drug information and mixing of injections. Although having a pharmacist available daily around the clock is desirable and ideal to the medical team, the number of pharmacists under the present system cannot support this. As a solution, we think that it is crucial that pharmacists educate medical staff when they are present to in order to optimize therapy and patient care over time. PMID:15118240
The development of age appropriate paediatric formulations, particularly those suitable for young children, presents challenges with only limited knowledge available on the acceptability of different medicines and how this affects medication adherence. This publication describes studies conducted at Alder Hey Children's Hospital, Liverpool, UK with the aim of determining which factors relating to dose form and organoleptic properties of a medicinal product influence medication adherence in chronically ill children. The research was conducted in two phases comprising 70 chronically ill children aged between 3 and 11 years, 70 primary caregivers, and 33 hospital clinical and technical staff. Phase one, the CHIMP study (children's medication preferences), investigated children's preferences in terms of the organoleptic properties of medicines, and factors which influence these preferences and medication adherence. The data generated in the CHIMP study was used to construct a Medication Adherence Prediction Tool (MedAPT), in the form of a questionnaire, which was the subject of a second study (MedAPT), to qualify the prediction tool, in which adherence predictions derived from children and primary caregiver's questionnaire response data were statistically evaluated against adherence measurement generated from pharmacy medication refill data. The developed MedAPT questionnaire correctly predicted medication adherence/non-adherence in 79.4% of children. It is envisaged that, following further confirmation of the MedAPT as a prediction tool, this may be used in clinical practice as a predictor of adherence, and as a means of focussing resources and interventions to address non-adherence. PMID:24797763
Objective: To evaluate the impact of sex reassignment surgery on the defense mechanisms of 32 transsexual patients at two different points in time using the Defensive Style Questionnaire. Method: The Defensive Style Questionnaire was applied to 32 patients upon their admission to the Gender Identity Disorder Program, and 12 months after they had undergone sex reassignment surgery. Results: There were
Maria Inês Lobato; Walter José Koff; Tiago Crestana; Camila Chaves; Jaqueline Salvador; Analídia Rodolpho Petry; Esalba Silveira; Alexandre Annes Henriques; Fábio Cervo; Eduardo Siam Böhme; Raffael Massuda
Objectives: To determine (1) the proportion of responses to an open-ended question related to patient satisfaction that could be categorized into 1 or more of 9 previously developed domains of out- patient care and (2) whether any other important aspects of care could be identified by adding the open-ended question to a satisfaction questionnaire. Study Design: A 3-month observational study
Bruce D. Bialor; Joseph L. Musial; Graciela E. Rojas; Mark J. Fagan
Objective: Evaluatemedical students communication and professionalism skills from the perspective of the ambulatory patient and later compare these skills in their first year of residency. Methods: Students in third year neurology clerkship clinics see patients alone followed by a revisit with an attending neurologist. The patient is then asked to complete a voluntary, anonymous, Likert scale questionnaire rating the student on friendliness, listening to the patient, respecting the patient, using understandable language, and grooming. For students who had completed 1?year of residency these professionalism ratings were compared with those from their residency director. Results: Seven hundred forty-two questionnaires for 165 clerkship students from 2007 to 2009 were analyzed. Eighty-three percent of forms were returned with an average of 5 per student. In 64% of questionnaires, patients rated students very good in all five categories; in 35% patients selected either very good or good ratings; and <1% rated any student fair. No students were rated poor or very poor. Sixty-two percent of patients wrote complimentary comments about the students. From the Class of 2008, 52% of students received better than their peers professionalism ratings from their PGY1 residency directors and only one student was rated below their peers. Conclusion: This questionnaire allowed patient perceptions of their students communication/professionalism skills to be evaluated in a systematic manner. Residency director ratings of professionalism of the same students at the end of their first year of residency confirms continued professional behavior.
Davis, Larry E.; King, Molly K.; Wayne, Sharon J.; Kalishman, Summers G.
Context: Jichi Medical School (JMS) is the first and only medical school in Japan that was founded exclusively to graduate/prepare rural doctors. Purpose: To evaluate the long-term effect of JMS on the nationwide distribution of doctors. Methods: Data from the Japanese population census of 1995 and from the Japanese physician census of 1994 were
The article intends to analyze the software safety problems in high-risk medical devices based on the investigation of software R & D Quality control procedures in Shanghai medical device manufacturing enterprises. The idea of improving the software pre-market safety evaluation method in China is also explored through the way of comparing those in U.S. and Europe. PMID:21179714
A variety of direct and indirect methods have been used to evaluate written medication information; however, no published research has validated assessment tools or presented direct consumer assessment of patient information leaflets (PILs) provided in US community pharmacy (CP). We report on two new instruments: the medication information design assessment scale (MIDAS), an indirect measure of design quality administered by
Comorbid depression and medical illness is associated with a number of adverse health outcomes such as lower medication adherence and higher rates of subsequent mortality. Reliable and valid psychological measures capable of detecting a range of depressive symptoms found in medical settings are needed. The Cardiac Depression Visual Analogue Scale (CDVAS) is a recently developed, brief six-item measure originally designed to assess the range and severity of depressive symptoms within a cardiac population. The current study aimed to further investigate the psychometric properties of the CDVAS in a general and medical sample. The sample consisted of 117 participants, whose mean age was 40.0 years (SD = 19.0, range 18-84). Participants completed the CDVAS, the Cardiac Depression Scale (CDS), the Depression Anxiety Stress Scales (DASS) and a demographic and health questionnaire. The CDVAS was found to have adequate internal reliability (? = .76), strong concurrent validity with the CDS (r = .89) and the depression sub-scale of the DASS (r = .70), strong discriminant validity and strong predictive validity. The principal components analysis revealed that the CDVAS measured only one component, providing further support for the construct validity of the scale. Results of the current study indicate that the CDVAS is a short, simple, valid and reliable measure of depressive symptoms suitable for use in a general and medical sample. PMID:23534347
Activities during the reporting period include test and evaluation of nuclear powered pacemakers; test, evaluation, and design of transcutaneous transformers to supply power for implanted blood pumps; and two exploratory projects aimed toward developing p...
This study aimed to develop and validate a de novo food frequency questionnaire for self-defined vegans in the United States. Diet histories from pilot samples of vegans and a modified Block Method using seven selected nutrients of concern in vegan diet patterns, were employed to generate the questionnaire food list. Food frequency responses of 100 vegans from 19 different U.S. states were obtained via completed mailed questionnaires and compared to multiple telephone-conducted diet recall interviews. Computerized diet analyses were performed. Correlation coefficients, t-tests, rank, cross-tabulations, and probability tests were used to validate and compare intake estimates and dietary reference intake (DRI) assessment trends between the two methods. A 369-item vegan-specific questionnaire was developed with 252 listed food frequency items. Calorie-adjusted correlation coefficients ranged from r = 0.374 to 0.600 (p < 0.001) for all analyzed nutrients except calcium. Estimates, ranks, trends and higher-level participant percentile placements for Vitamin B12 were similar with both methods. Questionnaire intakes were higher than recalls for most other nutrients. Both methods demonstrated similar trends in DRI adequacy assessment (e.g., significantly inadequate vitamin D intake among vegans). This vegan-specific questionnaire can be a useful assessment tool for health screening initiatives in U.S. vegan communities.
Dyett, Patricia; Rajaram, Sujatha; Haddad, Ella H.; Sabate, Joan
This study aimed to develop and validate a de novo food frequency questionnaire for self-defined vegans in the United States. Diet histories from pilot samples of vegans and a modified 'Block Method' using seven selected nutrients of concern in vegan diet patterns, were employed to generate the questionnaire food list. Food frequency responses of 100 vegans from 19 different U.S. states were obtained via completed mailed questionnaires and compared to multiple telephone-conducted diet recall interviews. Computerized diet analyses were performed. Correlation coefficients, t-tests, rank, cross-tabulations, and probability tests were used to validate and compare intake estimates and dietary reference intake (DRI) assessment trends between the two methods. A 369-item vegan-specific questionnaire was developed with 252 listed food frequency items. Calorie-adjusted correlation coefficients ranged from r = 0.374 to 0.600 (p < 0.001) for all analyzed nutrients except calcium. Estimates, ranks, trends and higher-level participant percentile placements for Vitamin B12 were similar with both methods. Questionnaire intakes were higher than recalls for most other nutrients. Both methods demonstrated similar trends in DRI adequacy assessment (e.g., significantly inadequate vitamin D intake among vegans). This vegan-specific questionnaire can be a useful assessment tool for health screening initiatives in U.S. vegan communities. PMID:25006856
Dyett, Patricia; Rajaram, Sujatha; Haddad, Ella H; Sabate, Joan
The Behavioral Inhibition Questionnaire (BIQ) is a parent-rating scale for measuring temperamental characteristics referring to shyness, fearfulness, and withdrawal in young, preschool children. The present study evaluated the psychometric properties of the BIQ in a Dutch community sample of children with a broad age range. For this purpose, the
All 15 subscales of the Motivated Strategies for Learning Questionnaire (Pintrich, Smith, Garcia, & McKeachie, 1993) were administered to 352 undergraduate students taking Introductory Psychology. Their scores were evaluated with respect to incremental validity (in addition to ACT scores) they provided for predicting course grades. Results
Burlison, Jonathan D.; Murphy, Chanda S.; Dwyer, William O.
The article describes and discusses the use of focus groups and questionnaires to evaluate educational printed material for high school level art teachers prior to publication. The material consisted of "The Notebook of the Investigative Teacher," created by the Instituto Itau Cultural to help teachers develop critical skills in discussing
Almeida, Adriana Mortara; Martins, Maria Helena Pires
\\u000a Objective To summarize the psychometric properties of the PHQ2 and PHQ9 as screening instruments for depression.\\u000a \\u000a \\u000a \\u000a Interventions We identified 17 validation studies conducted in primary care; medical outpatients; and specialist medical services (cardiology,\\u000a gynecology, stroke, dermatology, head injury, and otolaryngology). Electronic databases from 1994 to February 2007 (MEDLINE,\\u000a PsycLIT, EMBASE, CINAHL, Cochrane registers) plus study reference lists have been used for this
Simon Gilbody; David Richards; Stephen Brealey; Catherine Hewitt
Without robust and credible evidence for the benefits in health outcomes of non-medical prescribing, widespread implementation will be challenging. Our aim is to develop a consistent evaluation framework that could be applied to non-medical prescribing research. An informal collaboration was initiated in 2008 by a group of pharmacists from Australia and New Zealand to assist in information sharing, pilot design, methodologies and evaluation for pharmacist prescribing. Different pilots used different models, methodologies and evaluation. It was agreed that the development of a consistent evaluation framework to be applied to future research on non-medical prescribing was required. The framework would help to align the outcomes of different research pilots and enable the comparison of endpoints to determine the effectiveness of a non-medical prescribing intervention. PMID:22624646
Hale, Andrew R; Stowasser, Danielle A; Coombes, Ian D; Stokes, Julie; Nissen, Lisa
...Revised Medical Criteria for Evaluating Mental Disorders AGENCY: Social Security Administration...other aspects of the proposed listings for mental disorders that we receive during this...aspect of our proposed rules to revise our mental disorders listings: Definitions we...
Increasing numbers of medical practitioners and medical students are using online social and business-related networking websites such as Facebook, Doc2doc and LinkedIn. These rapidly evolving and growing social media have potential to promote public health by providing powerful instruments for communication and education. However, evidence is emerging from studies, legal cases, and media reports that the use of these new technologies is creating several ethical problems for medical practitioners as well as medical students. Improper online activities may harm not only individual reputations and careers, but also the medical profession as a whole, for example by breach of patient confidentiality, defamation of colleagues and employers, undisclosed conflict of interests that bias the medical practitioner's medical advice, posting of advice/information without an evidence base, and infringement of copyright. We developed a self-evaluation checklist for medical practitioners using social media. The checklist addresses three key elements in the use of social media: personal information and accessibility, connections, and postings. It contains questions specifically formulated to evaluate a medical practitioner's social media profile, to prevent unintended, improper online activities and to promote professional online behaviour. PMID:23099596
Visser, Benjamin J; Huiskes, Florian; Korevaar, Daniel A
OBJECTIVE: To develop a reliable, valid measure of patient satisfaction with out of hours care suitable for large scale service evaluation. DESIGN: Focus group meetings and semistructured interviews with patients to identify issues of importance to patients and possible questionnaire items; interviews and two pilot studies to test and identify new questionnaire items; modification or removal of items to eliminate ambiguity and reduce non-response and skewed responses; questionnaire survey of out of hours care. SETTING: Greater Manchester and Leicester. SUBJECTS: 11 general practice patients participated in the focus groups and 28 in the semistructured interviews; 41 in the preliminary interviews; 41 and 378 in the postal pilots; and 1466 in the survey of out of hours care. RESULTS: A 32 item questionnaire was developed. Component analysis indicated seven scales (satisfaction with communication and management, doctor's attitude, continuity of care, delay until visit, access to out of hours care, initial contact person, telephone advice) related to overall satisfaction and containing issues identified as important to patients. Levels of reliability were satisfactory, Cronbach's alpha correlation coefficient exceeding 0.60 for all scales. CONCLUSION: A reliable, valid measure of patient satisfaction has been developed, suitable for large scale evaluation of out of hours care.
McKinley, R. K.; Manku-Scott, T.; Hastings, A. M.; French, D. P.; Baker, R.
Purpose The aim of this study was to examine if package inserts (PIs) supplied with prescribed and over-the-counter medications in Saudi Arabia contain information relevant for the safe and appropriate use of these medications. Methods Sixty PIs for prescription-only medications (n = 37) and over-the-counter medications (n = 23) were evaluated against a set of safety criteria compiled from the literature. Results Analyzed PIs were defective in many aspects. Particularly of concern were unclear dosage instructions, lack of measures to be taken when an administrative error was made, inappropriate presentation of side effects, and lack of measures to be taken if serious side effects occurred. Conclusion This study indicated that information relevant to the safe and appropriate use of medications was not uniformly mentioned in the PIs analyzed. To avoid medication errors due to deficits in the current PIs, we recommend improvement in the existing PIs based on best practice for information content and design.
Many current health status instruments either are too long to use in many acquired immune deficiency syndrome (AIDS) clinical trials or omit important concepts. In this study, human immunodeficiency virus (HIV)-relevant items developed for the Medical Outcomes Study (MOS) from subscales for cognitive function, energy\\/fatigue, health distress, and a single quality of life item were added to a portion of
Albert W. Wu; Haya R. Rubin; William C. Mathews; Ware John E. Jr; Lucy T. Brysk; William D. Hardy; Samuel A. Bozzette; Stephen A. Spector; Douglas D. Richman
This work presents the development of a framework to make available a free, online, multipurpose and multimodality medical image database for software and algorithm evaluation. We have implemented a distributed architecture for medical image database, including authoring, storage, and repository for documents and image processing software. The system aims to offer a complete test bed and a set of resources including software, link to scientific papers, gold standards, reference images and post-processed images, enabling medical image processing community (scientists, physicians, students and industrials) to be more aware of evaluation issues. Our focus of development was on convenience and easy of use of a generic system adaptable to different contexts.
This paper is an extended example of transactional evaluation; extended to show not only that the narrow purpose of a particular evaluation can be a means to further ends, but also to document the developmental character of process in a dynamic setting. The primary purpose of the study was to determine what preceptors or advisory teachers
Background Evaluation is an integral part of medical education. Despite a wide use of various evaluation tools, little is known about student perceptions regarding the purpose and desired consequences of evaluation. Such knowledge is important to facilitate interpretation of evaluation results. The aims of this study were to elicit student views on the purpose of evaluation, indicators of teaching quality, evaluation tools and possible consequences drawn from evaluation data. Methods This qualitative study involved 17 undergraduate medical students in Years 3 and 4 participating in 3 focus group interviews. Content analysis was conducted by two different researchers. Results Evaluation was viewed as a means to facilitate improvements within medical education. Teaching quality was believed to be dependent on content, process, teacher and student characteristics as well as learning outcome, with an emphasis on the latter. Students preferred online evaluations over paper-and-pencil forms and suggested circulating results among all faculty and students. Students strongly favoured the allocation of rewards and incentives for good teaching to individual teachers. Conclusions In addition to assessing structural aspects of teaching, evaluation tools need to adequately address learning outcome. The use of reliable and valid evaluation methods is a prerequisite for resource allocation to individual teachers based on evaluation results.
This study is a part of a larger project Nr. NJ 6139-3 funded by the Grant Agency of the Czech Ministry of Health. The aim of the paper was to analyse the response rate using standard statistical methods and the Geographical Information System (GIS); to indicate differences in the response by sex, age, education, and employment; to determine the breakpoint for the collection of questionnaires according to which we can estimate the total response rate; to indicate whether the study sample was representative enough to generalize the project results. The additional aim of the paper was to collect those background literary sources dealing with the response rate as a methodological paradigm. The statistical and GIS analysis were based on comparison of the total population data (Census 2001), the study sample and the sample of the completed questionnaires data in the 23 districts of the city of Ostrava. The information from the data collection was derived from the date of receipt for each questionnaire. The literature sources were obtained from the Internet--in total 228 papers from the period since 1986 to the present have been checked. The main results of this study are: the GIS analysis was confirmed in all stages by standard statistical methods--it can therefore be used as a valid tool for quick orientation in data and for the comparison of a study sample with the general population; we did not find significant differences in the course of the collection of the questionnaires between sex, age, education, and the employment of respondents; it can be seen that the breakpoint according to which we can estimate the total response rate, is the 10th day after the questionnaires are distributed by post (75% of the questionnaires collected); our sample is representative enough from the geographical point of view. More detailed information about the whole project and results already published or presented are available on the following web site: www.zuova.cz/projekty/ses/php. PMID:12884550
This article examines the concept of disability adopted by the most important cash transfer program targeting the disabled population in Brazil, the Continuous Cash Benefit (Benefício de Prestação Continuada--BPC). The study compares the eligibility criteria established by law and the criteria used by medical examiners in the beneficiary selection process. The data are from a sample survey of 16% of the medical examiners working in the program. The questionnaire aims to assess the instructions, forms, and procedures for selecting disabled beneficiaries. The results show a discrepancy between the formal program criteria and actual practice by the examiners, suggesting an expanded concept of disability aimed at including beneficiaries with genetic, chronic, and severe infectious diseases. PMID:17952251
The economic evaluation of medical technology has evolved as a key element in supporting health budget allocation decisions. Among suppliers of innovation, the medical device industry is one of the most dynamic fields of medical progress with thousands of new products marketed every year. Accordingly, the broad variety of technologies covered by the umbrella term 'medical devices' have come under increasing scrutiny regarding their cost effectiveness. In the process, a number of device-specific factors have become apparent, each of which can complicate a thorough economic evaluation and limit its informative value. Some of these factors relate to specific characteristics of device functioning. Examples of such factors include the fact that most technologies require, or form part of, a procedure and that many devices have multiple indications or purposes. Others in turn reflect external conditions and are more general in character, such as the regulatory framework that a medical device manufacturer faces prior to market approval and the structure of the medical device industry. Drawing on the available literature, these complicating factors and their practical implications are discussed and used as a basis to elaborate on the emerging challenges for the economic evaluation of medical devices. PMID:23329383
A modified version of Caplan's Job Stress Questionnaire (JSQ) was administered to 169 male and 56 female entrepreneurs. Entrepreneurs were found to have higher levels of stress associated with workload than with role ambiguity and underutilization of skills. Compared to scores reported previously for various occupational categories, the entrepreneurs scored significantly higher than did white collar, blue collar, and professional
Julie Aitken Harris; Robert Saltstone; Maryann Fraboni
Background By means of the ICONAS project, the Healthcare Agency of an Italian Region developed, and used a standardised questionnaire to quantify the organisational climate. The aims of the project were (a) to investigate whether the healthcare institutions were interested in measuring climate, (b) to estimate the range of applicability and reliability of the instrument, (c) to analyse the dimensions of climate among healthcare personnel, (d) to assess the differences among employees with different contractual positions. Methods The anonymous questionnaire containing 50 items, each with a scale from 1 to 10, was offered to the healthcare organisations, to be compiled during ad hoc meetings. The data were sent to the central project coordinator. The differences between highly specialised staff (mostly physicians) and other employees were assessed after descriptive statistical analysis of the single items. Both Principal Component Analysis and Factor Analysis were used. Results Ten healthcare organisations agreed to partecipate. The questionnaire was completed by 8691 employees out of 13202. The mean value of organisational climate was 4.79 (range 110). There were significant differences among single items and between the 2 groups of employees. Multivariate methods showed: (a) one principal component explained > 40% of the variance, (b) 7 factors summarised the data. Conclusion Italian healthcare institutions are interested in assessing organisational phenomena, especially after the reforms of the nineties. The instrument was found to be applicable and suitable for measuring organisational climate. Administration of the questionnaire leads to an acceptable response rate. Climate can be discribed by means of 7 underlying dimensions.
BACKGROUND: Negative experiences of first childbirth increase risks for maternal postpartum depression and may negatively affect mothers' attitudes toward future pregnancies and choice of delivery method. Postpartum questionnaires assessing mothers' childbirth experiences are needed to aid in identifying mothers in need of support and counselling and in isolating areas of labour and birth management and care potentially in need of
Anna Dencker; Charles Taft; Liselotte Bergqvist; Håkan Lilja; Marie Berg
Perceived self-efficacy (SE) for eating fruit and vegetables (FV) is a key variable mediating FV change in interventions. This study applies item response modeling (IRM) to a fruit, juice and vegetable self-efficacy questionnaire (FVSEQ) previously validated with classical test theory (CTT) procedures. The 24-item (five-point Likert scale) FVSEQ
Two studies addressed the psychometric properties of the Self-Efficacy Questionnaire for Children (SEQ-C) when used in studies with American youths. A sample of 697 middle and high school students completed the SEQ-C along with measures of life satisfaction and psychopathology. Exploratory factor analysis procedures supported the existence of
A study undertaken to evaluate the impact of the experimental introduction of copayment requirements on health care use, provider services, and cost savings to the Medi-Cal program is documented. Data on which the evaluation is based were obtained from tw...
Due to organ shortage and difficulties for availability of cadaveric donors, living donor transplantation is an important choice for having allograft. Live donor surgery is elective and easier to organize prior to starting dialysis thereby permitting preemptive transplantation as compared to cadaveric transplantation. Because of superior results with living kidney transplantation, efforts including the usage of Medically complex living donors are made to increase the availability of organs for donation. The term Complex living donor is probably preferred for all suboptimal donors where decision-making is a problem due to lack of sound medical data or consensus guidelines. Donors with advanced age, obesity, asymptomatic microhematuria, proteinuria, hypertension, renal stone disease, history of malignancy and with chronic viral infections consist of this complex living donors. This medical complex living donors requires careful evaluation for future renal risk. In this review we would like to present the major issues in the evaluation process of medically complex living kidney donor.
Asthma is one of the most common chronic diseases in women of reproductive age, occurring in up to 8 % of pregnancies. The objective of this study is to assess the prevalence of asthma medication use during pregnancy in a large diverse cohort. We identified women aged 15-45 years who delivered a live born infant between 2001 and 2007 across 11 U.S. health plans within the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). Using health plans' administrative and claims data, and birth certificate data, we identified deliveries for which women filled asthma medications from 90 days before pregnancy through delivery. Prevalence (%) was calculated for asthma diagnosis and medication dispensing. There were 586,276 infants from 575,632 eligible deliveries in the MEPREP cohort. Asthma prevalence among mothers was 6.7 %, increasing from 5.5 % in 2001 to 7.8 % in 2007. A total of 9.7 % (n = 55,914) of women were dispensed asthma medications during pregnancy. The overall prevalence of maintenance-only medication, rescue-only medication, and combined maintenance and rescue medication was 0.6, 6.7, and 2.4 % respectively. The prevalence of maintenance-only use doubled during the study period from 0.4 to 0.8 %, while rescue-only use decreased from 7.4 to 5.8 %. In this large population-based pregnancy cohort, the prevalence of asthma diagnoses increased over time. The dispensing of maintenance-only medication increased over time, while rescue-only medication dispensing decreased over time. PMID:23108737
Background Asthma is one of the most common chronic diseases in women of reproductive age, occurring in up to 8% of pregnancies. Objective Assess the prevalence of asthma medication use during pregnancy in a large diverse cohort. Methods We identified women aged 15 to 45 years who delivered a live born infant between 2001 and 2007 across 11 U.S. health plans within the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP). Using health plans administrative and claims data, and birth certificate data, we identified deliveries for which women filled asthma medications from 90 days before pregnancy through delivery. Prevalence (%) was calculated for asthma diagnosis and medication dispensing. Results There were 586,276 infants from 575,632 eligible deliveries in the MEPREP cohort. Asthma prevalence among mothers was 6.7%, increasing from 5.5% in 2001 to 7.8% in 2007. A total of 9.7% (n=55,914) of women were dispensed asthma medications during pregnancy. The overall prevalence of maintenance-only medication, rescue-only medication, and combined maintenance and rescue medication was 0.6%, 6.7%, and 2.4% respectively. The prevalence of maintenance-only use doubled during the study period from 0.4% to 0.8%, while rescue-only use decreased from 7.4% to 5.8%. Conclusions In this large population-based pregnancy cohort, the prevalence of asthma diagnoses increased over time. The dispensing of maintenance-only medication increased over time, while rescue-only medication dispensing decreased over time.
Hansen, Craig; Joski, Peter; Freiman, Heather C.; Andrade, Susan; Toh, Sengwee; Dublin, Sascha; Cheetham, T. Craig; Cooper, William O.; Pawloski, Pamala A.; Li, De-Kun; Beaton, Sarah J.; Scott, Pamela E.; Hammad, Tarek; Davis, Robert
Seven on-campus continuing medical education programs offered during the 1971-72 academic year were evaluated. A multiple-choice examination was taken by the participants before each course; the same examination was administered immediately after the course was completed, and a third examination was taken three to five months later. It was found that for each course there was a significant increase in knowledge at both post-testing periods. A questionnaire developed for the purpose of determining the effectiveness of the courses was also administered at the time of the third test, and exhibited reasonable degrees of reliability and validity. A large proportion of the participants indicated the content of their courses was relevant and necessary, and was being used in their medical practice. It was concluded that the effectiveness of these programs justified their continuation.
The purpose of this study was to develop a questionnaire to investigate volleyball coaches' orientations toward the coaching process. The study was preceded by four developmental stages in order to improve user understanding, validate the content, and refine the psychometric properties of the instrument. Participants for the reliability and validity study were 334 Spanish volleyball team coaches, 86.5% men and 13.2% women. The following 6 factors emerged from the exploratory factor analysis: team-work orientation, technological orientation, innovative orientation, dialogue orientation, directive orientation, and social climate orientation. Statistical results indicated that the instrument produced reliable and valid scores in all the obtained factors (a> .70), showing that this questionnaire is a useful tool to examine coaches' orientations towards coaching. PMID:17959129
Aim: To evaluate the eating behaviour in normal-weight, overweight, and obese women seeking participation in a diet-based programme of weight reduction or achievement of ideal body weight. Methods: Thirty-seven obese, 42 overweight, and 14 normal-weight subjects, seen at an Italian university outpatient clinic, were asked to complete the Stunkard and Messick three-factor eating questionnaire (TFEQ). The TFEQ is designed to
Background Worldwide, herbs and spices are much used food flavourings. However, little data exist regarding actual dietary intake of\\u000a culinary herbs and spices. We developed a food frequency questionnaire (FFQ) for the assessment of habitual diet the preceding\\u000a year, with focus on phytochemical rich food, including herbs and spices. The aim of the present study was to evaluate the\\u000a intakes of
The undisputed increase of the relevance of mental work load is confronted with a lack of qualified or at least well documented measuring instruments covering all important aspects. The COPSOQ (Copenhagen Psychosocial Questionnaire), a comprehensive instrument for the assessment of psychosocial factors at work, was tested in a partly modified version in a large German sample (N = 2561 employees). The aims of the study were the detailed investigation of the psychometric measurement properties, and based on these results, the development of an abbreviated version of the instrument. The analysis of objectivity, acceptance, practicability, sensitivity and content validity of the questionnaire as a whole did not show any problematic results with some limitations regarding the length of the questionnaire. The assessment of the reliability, generalisability, construct validity, criterion validity and diagnostic power of the single scales showed medium to good measuring qualities for the majority of the scales (i.e. Cronbachs alpha mostly >0.7). In addition, the psychometric properties were very similar to those in the Danish COPSOQ-study. Considering all aspects of the measurement quality, a shortened version of the instrument was created. It attempts to combine measuring qualities as high as possible with a number of questions as low as possible. The German COPSOQ questionnaire is a free screening-instrument for the recording of psychosocial work load and strain for all enterprises and organisations interested. The next step is the construction of a "job exposure matrix" for psychosocial factors at work, that means a central database with work load profiles and reference values for as many occupational groups as possible.
Nubling, Matthias; Stossel, Ulrich; Hasselhorn, Hans-Martin; Michaelis, Martina; Hofmann, Friedrich
ObjectiveGiven the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area.DesignThe authors performed a needs assessment, content and technology planning, implementation, and student evaluation.MeasurementsThe needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions.ResultsThe needs assessment indicated much interest in
William R Hersh; Katherine Junium; Mark Mailhot; Patricia Tidmarsh
Background Implementation of evidence-based practice (EBP) is regarded as core competence to improve healthcare quality. In the current study, we investigated the EBP of six groups of professionals: physicians, nurses, pharmacists, physical therapists, technicians, and other allied healthcare personnel. Methods A structured questionnaire survey of regional hospitals throughout Taiwan was conducted by post in 2011. Questionnaires were mailed to all healthcare workers of 11 randomly selected hospitals. Linear and logistic regression models were used to examine predictors for implementing EBP. Results In total, 6,160 returned questionnaires, including 645 from physicians, 4,206 from nurses, 430 from pharmacists, 179 from physical therapists, 537 from technicians, and 163 from other allied healthcare professionals, were valid for the analysis. Physicians and pharmacists were more aware of EBP than were the other professional groups (p?0.001). Positive attitudes toward and beliefs in EBP were significantly lower among nurses than in the other groups (p?0.001). Physicians had more sufficient knowledge and skills of EBP than did the other professionals (p?0.001); in addition, they implemented EBP for clinical decision-making more often and perceived fewer personal barriers to EBP (p?0.001). Multivariate logistic regression analyses showed that EBP implementation was associated with the following characteristics of participants: EBP training, having a faculty position, academic degree, one's profession, and perceptions (beliefs, attitudes, knowledge, skills and barriers). Conclusions This study depicts various levels of EBP implementation among medical, nursing, pharmacological, and allied healthcare personnel. There were significant differences in their implementation of EBP. We observed that certain factors were associated with EBP implementation, including personal backgrounds and perceptions toward EBP. The data suggest that strategies for enhancing EBP implementation should differ for various groups of professionals.
Background The aim of this study is to validate the questionnaire ECOS-16 (Assessment of health related quality of life in osteoporosis) for the evaluation of health related quality of life (HRQoL) in post-menopausal women with osteoporosis. Methods An observational, prospective and multi-centre study was carried out among post-menopausal women with osteoporosis in primary care centres and hospital outpatient clinics. All patients attended 2 visits: at baseline and at 6 months. In addition, the subgroup of outpatients attended another visit a month after the baseline to assess the test-retest reliability. The psychometric properties of the questionnaire were evaluated in terms of feasibility, validity (content validity and construct validity) and internal consistency in baseline, and in terms of test-retest reliability and responsiveness to change in visit at month and visit at 6 months, respectively. In all visits, ECOS-16, EUROQoL-5D (EQ-5D) and four 7-point items about health status (general health status, back pain, limitation in daily activities and emotional status) were administered, whereas only outpatients were given MINI-OQLQ (Mini Osteoporosis Quality of Life Questionnaire), besides all clinical variables; and sociodemographic variables at baseline. Results 316 women were consecutively included, 212 from primary care centres and 104 from hospital outpatient clinics. Feasibility: 94.3% of patients answered all items of the questionnaire. The mean administration time was 12.3 minutes. Validity: factor analysis suggested that the questionnaire was unidimensional. In the multivariate analysis, patients with vertebral fractures, co-morbidity and a lower education level showed to have worse HRQoL. Moderate to high correlations were found between the ECOS-16 score and the other health status questionnaires (0.470.82). Reliability: internal consistency (Cronbach's ?) was 0.92 and test-retest reliability (ICC) was 0.80. Responsiveness to change: ECOS-16 scores increased according to change perceived by the patient, as well as the effect size (ranges between 1.35 to 0.43), the greater the perception of change in patients' general health status, the greater the changes in patients' scores. The Minimal Clinically Important Difference (MCID) suggested a change of 0.5 points in the ECOS-16 score, representing the least improvement in general health status due to their osteoporosis: "slightly better". Conclusion ECOS-16 has been proven preliminarily to have good psychometric properties, so that it can be potentially a useful tool to evaluate HRQoL of post-menopausal women with osteoporosis in research and routine clinical practice.
The potential of computer based tools to assist physicians in medical decision making, was envisaged five decades ago. Apart from factors like usability, integration with work-flow and natural language processing, lack of decision accuracy of the tools has hindered their utility. Hence, research to develop accurate algorithms for medical decision support tools, is required. Pioneering research in last two decades, has demonstrated the utility of fuzzy set theory for medical domain. Recently, Wagholikar and Deshpande proposed a fuzzy relation based method (FR) for medical diagnosis. In their case studies for heart and infectious diseases, the FR method was found to be better than naive bayes (NB). However, the datasets in their studies were small and included only categorical symptoms. Hence, more evaluative studies are required for drawing general conclusions. In the present paper, we compare the classification performance of FR with NB, for a variety of medical datasets. Our results indicate that the FR method is useful for classification problems in the medical domain, and that FR is marginally better than NB. However, the performance of FR is significantly better for datasets having high proportion of unknown attribute values. Such datasets occur in problems involving linguistic information, where FR can be particularly useful. Our empirical study will benefit medical researchers in the choice of algorithms for decision support tools. PMID:20703722
BACKGROUND: In the past only physiological and clinical outcomes have been used to assess the effect of asthma interventions and the effect of the intervention on the lives of the patients has not been determined. The objective of this study was to assess health related impairment of quality of life in adult asthmatic patients and to develop a questionnaire for measuring quality of life in clinical trials in asthma. METHODS: Impairment of quality of life in adults with asthma was evaluated from structured interviews in which patients were asked to identify the parts of their daily lives affected by asthma. On the basis of these results, an asthma quality of life questionnaire was developed in an interviewer and self administered form and tested for comprehension and acceptability. A total of 150 adults with asthma and with a wide range of airway hyperresponsiveness were enrolled from previous clinical trials, local asthma clinics, and notices in the media. RESULTS: Areas of quality of life impairment included symptoms classically associated with asthma, responses to environmental stimuli, the need to avoid these stimuli, limitation of activities, and emotional dysfunction. Areas of impairment were similar across strata of airway hyperresponsiveness, age, and treatment requirements and between sexes, thus allowing a single questionnaire suitable for all adults with asthma to be developed. The questionnaire contains 32 items and takes 5-10 minutes to administer; in the pretesting it was shown to be acceptable to a wide range of patients. CONCLUSIONS: The questionnaire includes areas of quality of life impairment that are important to adult asthmatic patients. It has been designed to be responsive to within subject change and therefore may be used as a measure of outcome in clinical trials in asthma.
Juniper, E F; Guyatt, G H; Epstein, R S; Ferrie, P J; Jaeschke, R; Hiller, T K
We surveyed carbon fiber reinforced plastic orthoses (carbon orthoses) and their associated occupational and medical problems based on a questionnaire sent to 310 companies which were members of the Japan Orthotics and Prosthetics Association. Of all the companies, 232 responded: 77 of the 232 companies dealt with ready-made carbon orthoses, 52 dealt with fabricated custom-made orthoses, and 155 did not dealt with carbon orthoses. Although the total number of custom-made carbon ortheses in Japan was 829/ 5 years, there was a difference by region, and one company fabricated only 12 (per 5 years) custom-made carbon orthoses on average. The advantages of the carbon orthosis were the fact that it was "light weight", "well-fitted", had a "good appearance", and "excellent durability", while the disadvantages were that it was "expensive", "high cost of production", of "black color", and required a "longer time for completion", and "higher fabrication techniques". From the standpoint of industrial medicine, "scattering of fine fragments of carbon fibers", "itching on the skin" and "health hazards" were indicated in companies that manufacture the orthosis. In order to make the carbon orthosis more popular, it is necessary to develop a new carbon material that is easier to fabricate at a lower cost, to improve the fabrication technique, and to resolve the occupational and medical problems. PMID:21913380
Objective: Given the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area. Design: The authors performed a needs assessment, content and technology planning, implementation, and student evaluation. Measurements: The needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions. Results: The needs assessment indicated much interest in a medical informatics distance learning program, with electronic medical records and outcome research the subject areas of most interest. The courses were implemented by means of streaming audio plus slides for lectures and threaded discussion boards for student interaction. Students were assessed by multiple-choice tests, a term paper, and a take-home final examination. In their course evaluations, student expressed strong satisfaction with the teaching modalities, course content, and system performance. Although not assessed experimentally, the performance of distance learning students was superior to that of on-campus students. Conclusion: Medical informatics education can be successfully implemented by means of distance learning technologies, with favorable student satisfaction and demonstrated learning. A graduate certificate program is now being implemented.
Hersh, William R.; Junium, Katherine; Mailhot, Mark; Tidmarsh, Patricia
An evaluation was conducted of the diagnostic accuracy and treatment appropriateness of emergency medical technicians (EMTs) in caring for 4,455 consecutive patients during a four-and-one-half month period. Data on EMT diagnosis and treatment and physician diagnosis were collected, and EMT data validated by observers. There were fifty-eight
This article suggests that quality assessment in the UK has been largely set apart from learning and teaching and reports on a pilot project at the Hull York Medical School which attempted to integrate students' evaluation of their clinical placements into the curriculum. It outlines the operational demands of this integrated method and compares
Aim: To evaluate the activity and impact of a Medical Emergency Team (MET) one year after implementation. Setting and population: A 700-bed District General Hospital (DGH) in Southeast England with approximately 53,500 adult admissions per annum. The population studied included all adult admissions receiving intervention by the MET during a 12-month period between 1 October 2000 and 30 September 2001.
Gary Kenward; Nicolas Castle; Timothy Hodgetts; Loua Shaikh
This paper describes the evaluation of an online training course in Neonatal Medicine, which involved medical practitioners from across Europe. The paper focuses on the findings from an analysis of the online discussion groups. The project aimed to develop an online course for practitioners and included the development of four modules. Delivery was achieved using hybrid technology via distribution of
This article describes a psychotropic PRN Evaluative Tool developed by interprofessional clinicians to address inconsistent reporting and assessment of the effectiveness of PRN medications used for people who are developmentally disabled. Fifty-nine participants (37 males, 22 females), ages 16 to 60 years, were included in the review, all
Silk, Larry; Watt, Jackie; Pilon, Nancy; Draper, Chad
Results are presented of a project undertaken to evaluate the success of the MED-WISE Programs systems approach in effecting medication compliance in the elderly. The project had three objectives: (1) to improve the patient-physician relationship, (2) to ...
Society has demanded reform in medical resident work scheduling; consequently, hospitals are implementing changes having organizational, clinical, financial, social, emotional, and educational consequences for physician training and patient care. We report the use of simulation modeling as an approach to evaluate the outcomes of alternative designs prior to implementation. Mobile resources such as physicians with complex job descriptions and patients
Robert S. Dittus; Robert W. Klein; David J. DeBrota; Mark A. Dame; John F. Fitzgerald
Objective: Simulations of doctor-patient interactions have become a popular method for the training of medical skills, primarily communication skills. A new questionnaire for the measurement of students satisfaction with medical courses using this technique is presented, the Student Evaluation Scale for Medical Courses with Simulations of the Doctor-Patient Interaction (SES-Sim). Method: A set of items focusing on the course quality and the core elements of simulations was created and presented to 220 medical students who had been trained with this method. Results: Based on factor-analyses 18 items were selected for the final version of the scale, which represent five dimensions: learning success, actors, premises, tutors and students. The five dimensions are all significantly correlated with a 1-item-measure of the general satisfaction with the course. Conclusion: The SES-Sim enables tutors to assess in an economic way whether the course has met the students needs and what can be done better.
Neumann, Eva; Obliers, Rainer; Schiessl, Christine; Stosch, Christoph; Albus, Christian
OBJECTIVE To conduct a cross-cultural adaptation of the Foot Health Status Questionnaire into Brazilian-Portuguese and to assess its measurement properties. INTRODUCTION This instrument is an outcome measure with 10 domains with scores ranging from 0100, worst to best, respectively. The translated instrument will improve the examinations and foot care of rheumatoid arthritis patients. METHODS The questions were translated, back-translated, evaluated by a multidisciplinary committee and pre-tested (n = 40 rheumatoid arthritis subjects). The new version was submitted to a field test (n = 65) to evaluate measurement properties such as test-retest reliability, internal consistency and construct validity. The Health Assessment Questionnaire, Numeric Rating Scale for foot pain and Sharp/van der Heijde scores for foot X-rays were used to test the construct validity. RESULTS The cross-cultural adaptation was completed with minor wording adaptations from the original instrument. The evaluation of measurement properties showed high reliability with low variation coefficients between interviews. The ?-Cronbach coefficients varied from 0.468 to 0.855, while correlation to the Health Assessment Questionnaire and Numeric Rating Scale was statistically significant for five out of eight domains. DISCUSSION Intra- and inter-observer correlations showed high reliability. Internal consistency coefficients were high for all domains, revealing higher values for less subjective domains. As for construct validity, each domain revealed correlations with a specific group of parameters according to what the domains intended to measure. CONCLUSION The FHSQ was cross-culturally adapted, generating a reliable, consistent, and valid instrument that is useful for evaluating foot health in patients with rheumatoid arthritis.
Ferreira, Ana F. B.; Laurindo, Ieda M. M.; Rodrigues, Priscilla T.; Ferraz, Marcos Bosi; Kowalski, Sergio C.; Tanaka, Clarice
Introduction HIV/AIDS, the most important health problem in Africa, is the leading cause of death on the continent. Ignorance on HIV/AIDS status will hamper treatment and prevention. To investigate the level of HIV/AIDS knowledge among men in a rural area, we performed a questionnaire study on HIV/AIDS knowledge in men living in Banga Bakundu, a rural village in Cameroon. Methods Forty-eight men, aged 17-66 years, were interviewed. They were divided in 2 groups: ?29 years, being those young enough to be able to have knowledge about HIV/AIDS at the time of their first sexual contact, and those > 29 years who weren't. A semi-structured clinical interview was performed to obtain information about socio-demographic characteristics, sexual activity, knowledge about HIV/AIDS and its prevention. Results There is an overall good HIV/AIDS knowledge and what should be done about it. Men with a higher level of education and more HIV/AIDS knowledge seem to take less preventive measures. The differentiation per age group showed that age influenced the data on knowledge and behaviour. Conclusion Our data are consistent with other studies. Remarkable is the difference in HIV/AIDS knowledge between the 2 age groups, and the relation between HIV/AIDS knowledge and sexual habits and prevention. Sufficient HIV/AIDS knowledge did not lead to significant changes in sexual behaviour. The questionnaire showed to provide sufficient information and was easy to use. Further research should be performed.
Background and objectiveThe chronic respiratory questionnaire (CRQ), the St. Georges Respiratory Questionnaire (SGRQ), and the feeling thermometer (FT) evaluate change in health-related quality of life (HRQL) in patients with chronic airflow limitation (CAL). Although the interpretability, and in particular the minimal important difference (MID) in score changes, is well established for the CRQ, this is not the case for the
Holger J Schünemann; Lauren Griffith; Roman Jaeschke; Roger Goldstein; David Stubbing; Gordon H Guyatt
Background Mobile learning (ML) is an emerging educational method with success dependent on many factors including the ML device, physical infrastructure and user characteristics. At Gippsland Medical School (GMS), students are given a laptop at the commencement of their four-year degree. We evaluated the educational impact of the ML program from students' perspectives. Methods Questionnaires and individual interviews explored students' experiences of ML. All students were invited to complete questionnaires. Convenience sampling was used for interviews. Quantitative data was entered to SPSS 17.0 and descriptive statistics computed. Free text comments from questionnaires and transcriptions of interviews were thematically analysed. Results Fifty students completed the questionnaire (response rate 88%). Six students participated in interviews. More than half the students owned a laptop prior to commencing studies, would recommend the laptop and took the laptop to GMS daily. Modal daily use of laptops was four hours. Most frequent use was for access to the internet and email while the most frequently used applications were Microsoft Word and PowerPoint. Students appreciated the laptops for several reasons. The reduced financial burden was valued. Students were largely satisfied with the laptop specifications. Design elements of teaching spaces limited functionality. Although students valued aspects of the virtual learning environment (VLE), they also made many suggestions for improvement. Conclusions Students reported many educational benefits from school provision of laptops. In particular, the quick and easy access to electronic educational resources as and when they were needed. Improved design of physical facilities would enhance laptop use together with a more logical layout of the VLE, new computer-based resources and activities promoting interaction.
Background. Acne vulgaris is a common skin disease that can adversely affect the quality of life of patients. Objective. The aim of this study was to determine the quality of life in patients with acne vulgaris. Methods. This study was carried out on 70 patients with acne vulgaris (28 males, 42 females). All the patients filled out two Persian versions of questionnaires: short form 36 (SF-36) and Dermatology Life Quality Index (DLQI). The obtained data were analyzed by using SPSS software (version 17). Results. The scores for physical functioning, social functioning, and bodily pain domains in patients were over 70%, but the scores for role physical, general health, vitality, role emotional, and mental health in patients were under 70%. Scores on the DLQI in patients with acne vulgaris ranged from 0 to 22 (mean ± SD, 8.18 ± 4.83). After comparing mean score of DLQI with respect to gender and age, it was found that the difference between the two groups was not statistically significant. Conclusion. Acne vulgaris has a significant effect on the quality of life. There was not any significant gender or age related difference in QOL.
ObjectiveA number of practice guidelines and recommendations call for an assessment of childhood abuse history among adult medical patients. The cultural sensitivity of screening instruments, however, has not been examined. High rates of childhood abuse history have been reported among adults who abuse substances. The objective of this study was to investigate the measurement invariance of the Childhood Trauma QuestionnaireShort
Brett D. Thombs; Charles Lewis; David P. Bernstein; Martha A. Medrano; John P. Hatch
The emotions and attitudes of mothers towards their infants are crucial for the child's well-being and development. Some mothers experience a delay in the onset of maternal affection after childbirth and occasionally a longer lasting failure to bond will ensue. Little is known about the precise prevalence of these difficulties, how they relate to maternal mental health, how they develop over time and what their biological and psychosocial correlates are. In research studies the mother-infant relationship has traditionally been assessed using observational methods but these are time consuming and not suited for screening in clinical practice. Two self-rating instruments have recently been developed to assess maternal bonding. Both can be used in large samples of recently delivered mothers including those suspected to be at high risk of bonding disorders. In this study, the psychometric properties of the 8-item Mother-to-Infant Bonding Scale (MIB) and the 25-item screening questionnaire for mother-infant bonding disorders, namely the Postpartum Bonding Questionnaire (PBQ), were examined in a sample of first-time mothers in order to establish their reliability and validity. Ninety-six women completed the MIB, PBQ and the Kennerley Blues Scale on day 2-4 postpartum. Both bonding instruments demonstrated acceptable reliability and reasonable validity, with the exception of the PBQ subscale of risk of abuse. PMID:17607505
Despite the enormous development in medical ultrasound (US) imaging over the last decades, penetration depth with satisfying image quality is often a problem in clinical practice. Coded excitation, used for years in radar techniques to increase signal-to-noise ratio (SNR), has recently been introduced in medical US scanning. In the present study, coded excitation using frequency-modulated US signals is implemented and evaluated in vivo.A total of nine male volunteers were scanned in three different abdominal locations, using both conventional pulsed and coded excitation. A modified scanner (B-K Medical model 3535) with transmitter and receiver boards developed in our group and a mechanical 4 MHz transducer were used. The system acquired coded and conventional US image frames interleaved, yielding identical acquisitions with the two techniques. Cine-loop sequences were evaluated by three experienced sonographers estimating penetration depth and scoring image quality of both conventional and coded imaging. The results showed a significant (p < 0.001) increase in penetration depth around 2 cm. Image quality was significantly (p < 0.001) better using codes at full usable depth and slightly, but also significantly (p < 0.05), better above depths, where the effect of coded excitation was noticeable to the sonographers. We conclude that the higher SNR offered by coded excitation gives improved image quality and provides increased penetration in medical US imaging. This increased SNR can, alternatively, be used to allow imaging at higher frequencies and thereby increase spatial resolution without any loss of penetration. PMID:12837505
Pedersen, Morten H; Misaridis, Thanassis X; Jensen, Jørgen A
Background Although cervical cancer is ??the second most common tumor among Brazilian women, studies that evaluate the quality of life of these women are still scarce. This situation is explained by the lack of specific and validated tools for this purpose in Portuguese (Brazil). The aim of this study was to evaluate the psychometric properties of the Portuguese version of the FACT-CX (Functional Assessment of Cancer Therapy-Cervix) questionnaire in a population of Brazilian women with cervical cancer. Methods The psychometric properties of the FACT-CX questionnaire were tested in a sample of 100 women diagnosed with cervical cancer who were previously treated in the Barretos Cancer Hospital. We analyzed the internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient - ICC), confirmatory factor analysis, convergent validity (correlation with the SF-36 questionnaire), and discriminant validity by disease stage and two questions related to self-perception of health was also performed. Results The scales had Cronbach´s alpha coefficients ranging from 0.61 to 0.80. However, three scales did not have a statistically significant coefficient greater than 0.70. The ICC ranged from 0.68 to 0.82 and all considered satisfactory. Factor analysis did not generate consistent components. The FACT-G and FACT-CX total scores had good internal consistency and reproducibility, and also correlated well with the General Health and Vitality scales of the SF-36. However, only two FACT-CX scales had a significant correlation with SF-36. Discriminant analysis showed that FACT-CX failed to discriminate groups according to clinical stage but was able to divide the women according to the self-perception of health. Conclusion FATC-CX total score had good internal consistency, reproducibility and discriminant validity. In addition, it correlated well with General Health and Vitality scales of SF-36. However, three scales had questionable internal consistency and only two had significant correlation with SF-36.
Fregnani, Cristiane Menezes Sirna; Fregnani, Jose Humberto Tavares Guerreiro; Dias de Oliveira Latorre, Maria do Rosario; de Almeida, Ana Maria
Human errors in medical device use account for a large portion of medical errors. Most of these errors are due to inappropriate designs for user interactions, rather than mechanical failures. Evaluating and predicting patient safety in medical device use ...
J. Zhang V. L. Patel T. R. Johnson P. Chung J. P. Turley
Background The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on whole-system redesign, and not just isolated parts of medical practices. Methods Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. Results A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. Conclusions Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures.
Crabtree, Benjamin F.; Chase, Sabrina M.; Wise, Christopher G.; Schiff, Gordon D.; Schmidt, Laura A.; Goyzueta, Jeanette R.; Malouin, Rebecca A.; Payne, Susan M. C.; Quinn, Michael T.; Nutting, Paul A.; Miller, William L.; Jaen, Carlos Roberto
Background The aim of this study was to test the ability of the Chinese version of the Mood Disorder Questionnaire (MDQ) to identify Bipolar Disorders (BD) in patients diagnosed with Major Depressive Disorder (MDD) or Unipolar Disorder (UD) in the clinical setting. Methods 1,487 being treated for MDD or UD at 12 mental health centers across China, completed the MDQ and subsequently examined by the Mini International Neuropsychiatric Interview (MINI). Receiver Operating Characteristic(ROC) curves were used to determine the ability of the MDQ to differentiate between BD (BD, BD-I and BD-II) and MDD or UD and patients with BD-I from patients with BD-II. Results Of the 1,487 patients, 309 (20.8%) satisfied the DSM-IV criteria for BD: 118 (7.9%) for BD-I and 191 (12.8%) for BD-II. When only part one of the MDQ was used, the best cutoff was 7 between BD and UD (sensitivity 0.66, specificity 0.88, positive predictive value 0.59, negative predictive value 0.91), 6 between BD-II and UD, and 10 between BD-I and BD-II. If all three parts of the MDQ were used, the MDQ could not distinguish between BD and UD at a cutoff of 7 (or 6), and the sensitivity was only 0.22 (or 0.24). Conclusion The Chinese version of the MDQ had good psychometric features in screening bipolar disorders from depressive patients with mood disorders when part two and part three of the MDQ were ignored.
Although the 36-Item Short-Form General Health Survey (SF-36) has been utilized to assess quality of life (QoL) in cross-sectional\\u000a studies, no longitudinal studies have evaluated this instrument in stone formers. Hence, we evaluated the performance of the\\u000a SF-36 over time in a group of stone formers. From January to May 2007, the SF-36 was administered by independent interviewers\\u000a to 155
Chester J. Donnally; Amit Gupta; Karim Bensalah; Altug Tuncel; Jay Raman; Margaret S. Pearle; Yair Lotan
A "medical home" provides accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care. This study implemented and evaluated the pilot phase of a pediatric practice-directed medical home quality improvement (QI) project focused on improving primary care for children and youth with special health care needs (CYSHCN). Six practices received training, QI team development and facilitation, and receipt of mini-grants for QI projects. Practice-level and parent-level evaluations were obtained at pre-intervention and post-intervention. The intervention was well-received. Many areas of improvement were found on practice-level evaluations, especially family-centered care and QI activities. Poor response rates limited the interpretation of family-level outcomes; 26% completed baseline outcome evaluations, and 64% of initial respondents completed them post-intervention. Practice education and implementation of QI teams to plan individualized strategies for the practice are feasible ways to seek to improve outcomes for CYSHCN. Modifications of evaluation strategies are needed to enhance response rates for family-level evaluations. PMID:19515943
Rankin, Kristin M; Cooper, Andrew; Sanabria, Kathleen; Binns, Helen J; Onufer, Charles
Applying different institutional addresses in the scientific production of a same university has underestimated the scientific\\u000a production of Iranian universities and consequently lowered their position in the international academic rankings for a long\\u000a time. The present study evaluated the scientific production of Iranian medical universities according to their institutional\\u000a addresses registered in the papers indexed by Science Citation Index Expanded
Farzaneh Aminpour; Payam Kabiri; Mohammad Ali Boroumand; Abbas Ali Keshtkar; Seyed Shamsoddin Hejazi
BACKGROUND: Changes in self-concept are an important potential outcome for many interventions for people with long-term conditions. This study sought to identify and evaluate outcome questionnaires suitable for quantifying changes in self-concept in people with long-term conditions, in the context of treatment with acupuncture and Chinese medicine. METHODS: A literature search was followed by an evaluation of three questionnaires: The
This module provides a strategy for determining whether a written questionnaire is an appropriate means of gathering data to meet the goals of an evaluation. The authors define which conditions are suitable for using questionnaires.
Alcohol expectancies are important in the mediation and prediction of alcohol use. Expectancies for the effects of other drugs, although less well delineated, appear equally important. Therefore, development and validation of expectancy measures for drugs other than alcohol is necessary for evaluating the importance of these constructs. We examined the factor structure, reliability, and validity of the Marijuana Effect Expectancy
Gregory A. Aarons; Sandra A. Browna; Eric Sticed; Michael T. Coee
In many countries, there has been a development towards the inclusion of students with special educational needs in regular education. Over the past decade, this has resulted in an increased interest in attitudes towards this educational change of those directly involved. This current study aims at the development, psychometric evaluation, and
de Boer, Anke; Timmerman, Marieke; Pijl, Sip Jan; Minnaert, Alexander
Body checking is considered an expression of an excessive preoccupation with appearance. The first aim of this study was to evaluate the psychometric properties of a Brazilian Portuguese version of the Body Checking Questionnaire (BCQ). Additionally, we wanted to examine the questionnaires associations with body avoidance behaviour, body mass index, dietary habits, and the intensity, frequency, and length of physical exercise. Finally, we also examined the differences between the total BCQ score and the individual BCQ factor scores. Differences between active and sedentary persons and between non-dieters and those on weight-loss diets were also analyzed. For the psychometric study, 546 female public university students from four different courses were surveyed. Two minor samples of university students and eating disorders women were also recruited. In the second part of the study, 403 women were recruited from weight-loss programs, gyms, and a university. All participants were verbally invited to participate in the research and voluntarily took part. Confirmatory factor analysis showed a good fit to the original model of the Brazilian BCQ that retained all 23 items. Satisfactory evidence of construct validity and internal consistency were also generated through analysis of factor loadings, t-values, Cronbachs alpha, and construct reliability tests. The results also showed associations among body checking and body avoidance, body satisfaction, social anxiety, body mass index, and the frequency and intensity of physical exercise. Significant differences were found between non-dieters and weight-loss dieters for all BCQ factors and the total BCQ score. For physically active and sedentary persons, a significant difference was only observed for idiosyncratic checking behaviour. In conclusion, the BCQ appears to be a valid and reliable scale for Brazilian research, and the associations and differences found in this study suggest that women at gyms and especially in weight-loss programs should be targeted for future body checking studies.
Campana, Angela Nogueira Neves Betanho; Swami, Viren; Onodera, Carolina Mie Kawagosi; da Silva, Dirceu; Tavares, Maria da Consolacao Gomes Cunha Fernandes
From the perspective of academic medical centers (AMCs), community engagement is a collaborative process of working toward mutually defined goals to improve the community's health, and involves partnerships between AMCs, individuals, and entities representing the surrounding community. AMCs increasingly recognize the importance of community engagement, and recent programs such as Prevention Research Centers and Clinical and Translational Science Awards have highlighted community engagement activities. However, there is no standard or accepted metric for evaluating AMCs' performance and impact of community engagement activities.In this article, the authors present a framework for evaluating AMCs' community engagement activities. The framework includes broad goals and specific activities within each goal, wherein goals and activities are evaluated using a health services research framework consisting of structure, process, and outcome criteria. To illustrate how to use this community engagement evaluation framework, the authors present specific community engagement goals and activities of the University of Rochester Medical Center to (1) improve the health of the community served by the AMC; (2) increase the AMC's capacity for community engagement; and (3) increase generalizable knowledge and practices in community engagement and public health.Using a structure-process-outcomes framework, a multidisciplinary team should regularly evaluate an AMC's community engagement program with the purpose of measurably improving the performance of the AMC and the health of its surrounding community. PMID:24556768
Szilagyi, Peter G; Shone, Laura P; Dozier, Ann M; Newton, Gail L; Green, Theresa; Bennett, Nancy M
Introduction Effective behavior change counseling is an important component of the optimal care of patients, yet only a minority of medical schools currently include such training in their curriculum. Aim To design and evaluate a formal curriculum to teach medical students the principles of motivational interviewing (MI) that will improve knowledge, skills, and confidence in the area of counseling patients for health behavior change. Participants Fifty-three 3rd year medical students at the University of California, San Diego. Program Description A 4-week curriculum consisting of four 2-h sessions, in a small group format (812 students). Educational strategies included a combination of short didactics, video demonstrations, small group role plays, and interactive exercises. Program Evaluation Students completed identical pre- and post-assessments, consisting of a questionnaire measuring confidence and knowledge, and a performance assessment using the Video Assessment of Simulated Encounters-Revised (VASE-R) tool. Knowledge improved significantly (pre-mean: 7.04, post-mean: 11.54; P?0.001), as did skill development (pre-mean: 7.02, post-mean: 9.47; P?0.001). Student satisfaction with behavior change counseling training improved from 3.6 to 8.1 (P?0.001). Students were significantly more confident (P?0.001) in their abilities to assess a patients readiness for change and counsel the patient on behavior change after the course. Discussion Participation in a focused curriculum on the use of motivational interviewing techniques significantly improved 3rd year medical students knowledge, confidence, and skills in the area of behavior change counseling. These gains may help students succeed in promoting good health habits in their future patients.
The occurrence of patients with gastrointestinal symptoms attributed either to food allergy or intolerance has significantly\\u000a increased. Nevertheless, an accurate and detailed case history, a systematic evaluation and the outcomes of specific allergy\\u000a tests to identify the offending foods, including in vivo and in vitro allergy tests, are often negative for food allergy\\u000a and may indicate a lactose intolerance, which
Attitudes and beliefs towards psychotropic medication were evaluated among psychiatric outpatients, patients receiving buprenorphine treatment for substance abuse, and a group who reported never having used psychotropic medications (non-users). The Drug Attitude Inventory scale and the Beliefs about Medicines Questionnaire General were used to assess attitudes and beliefs of 49 participants. Non-users exhibited more negative attitudes and beliefs toward psychotropic medication than both psychiatric groups. PMID:22662401
Fife, Stephanie A; Ketzenberger, Kay E; Olson, James N
...ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Medical Care Evaluation Studies Â§ 456...selecting and conducting medical care evaluation studies in the mental hospital; (2) Documents for each studyâ (i) Its...
Background: Educational evaluation is a process which deals with data collection and assessment of academic activities progress. In this research, educational evaluation of Dentistry School of Tehran University of Medical Sciences, which trains students in undergraduate and residency courses, was studied. Methods: This descriptive study was done with a model of educational evaluation in ten steps and 13 fields including purposes and mission objectives, management and organization, academic board members, students, human resources and support, educational, research, health and treatment spaces, educational, diagnostic, research and laboratory tools, educational, research, health and treatment programs and courses, process of teaching and learning, evaluation and assessment, alumni, and patients satisfaction. Data were collected using observation, interviews, questionnaires, and checklists. Results: Results of the study were mainly qualitative and in some cases quantitative, based on defined optimal situation. The total mean of qualitative results of educational evaluation of dentistry school in all 13 fields was 55.98% which is relatively desirable. In the case of quantitative ones, results of some fields such as treatment quality of patients and education and learning of the students were relatively desirable (61.32% and 60.16% respectively). Conclusion: According to the results, educational goals and missions, educational and research facilities and spaces which were identified as the weakest areas need to be considered and paid more serious attention.
Circadian rhythms, cyclic fluctuations in many physiological and psychological functions, are thought to influence adjustment to shiftwork. A widely acknowledged individual difference in circadian rhythms, commonly called morningness, indicates preferences associated with morning or evening activities. Various self-report instruments have been developed to measure morningness, although little measurement data have been published for these scales. Because morningness scales are being used to select workers for night shiftwork, psychometric evaluations of these scales are needed. Psychometric assessments of undergraduate responses (N = 501) on three widely used scales indicate internal (interitem) measurement deficiencies in all three. Therefore, a 13-item scale was developed that distills the best items from two of these scales. Relationships between the new composite scale and external criteria are comparable with or stronger than similar relationships between the published scales and external criteria. PMID:2793773
Background Consumer and patient participation proved to be an effective approach for medical pictogram design, but it can be costly and time-consuming. We proposed and evaluated an inexpensive approach that crowdsourced the pictogram evaluation task to Amazon Mechanical Turk (MTurk) workers, who are usually referred to as the turkers. Objective To answer two research questions: (1) Is the turkers collective effort effective for identifying design problems in medical pictograms? and (2) Do the turkers demographic characteristics affect their performance in medical pictogram comprehension? Methods We designed a Web-based survey (open-ended tests) to ask 100 US turkers to type in their guesses of the meaning of 20 US pharmacopeial pictograms. Two judges independently coded the turkers guesses into four categories: correct, partially correct, wrong, and completely wrong. The comprehensibility of a pictogram was measured by the percentage of correct guesses, with each partially correct guess counted as 0.5 correct. We then conducted a content analysis on the turkers interpretations to identify misunderstandings and assess whether the misunderstandings were common. We also conducted a statistical analysis to examine the relationship between turkers demographic characteristics and their pictogram comprehension performance. Results The survey was completed within 3 days of our posting the task to the MTurk, and the collected data are publicly available in the multimedia appendix for download. The comprehensibility for the 20 tested pictograms ranged from 45% to 98%, with an average of 72.5%. The comprehensibility scores of 10 pictograms were strongly correlated to the scores of the same pictograms reported in another study that used oral responsebased open-ended testing with local people. The turkers misinterpretations shared common errors that exposed design problems in the pictograms. Participant performance was positively correlated with their educational level. Conclusions The results confirmed that crowdsourcing can be used as an effective and inexpensive approach for participatory evaluation of medical pictograms. Through Web-based open-ended testing, the crowd can effectively identify problems in pictogram designs. The results also confirmed that education has a significant effect on the comprehension of medical pictograms. Since low-literate people are underrepresented in the turker population, further investigation is needed to examine to what extent turkers misunderstandings overlap with those elicited from low-literate people.
Abstract Conclusion: Nasal resistance and the OSA-18 score were useful for evaluating surgical treatments. The sleep disturbance score may also be useful for predicting the severity of obstructive sleep apnea (OSA) in children. Objective: We evaluated the effect of surgery on children with OSA using polysomnography (PSG) parameters, nasal resistance, and the OSA-18 questionnaire, and also investigated the cut-off OSA-18 score to screen for pediatric OSA. Methods: This was a retrospective study in which PSG parameters and nasal resistance were measured using a rhinomanometer and the OSA-18 score was obtained from the OSA-18 questionnaire before and after surgery in 45 children with OSA. Results: The mean age of the 45 patients was 5.7 ± 2.0 years. The mean value of the obstructive apnea hypopnea index (O-AHI) improved from 16.2 ± 14.3/h before surgery to 1.1 ± 1.7/h after surgery, the mean nasal resistance improved from 0.44 ± 0.19 to 0.32 ± 0.10 Pa/cm(3)/s, and the mean OSA-18 score improved from 61.1 ± 13.7 to 30.4 ± 5.8, and all these improvements were significant. The O-AHI value was lower than 1/h after surgery in 64.4% of patients (29/45). The O-AHI value was significantly correlated with the sleep disturbance score (r = 0.352, p = 0.018). When the cut-off OSA-18 score for screening was set at 40, sensitivity was 100%. PMID:24847948
During the last 20 years, safety evaluation of medical devices has evolved from screening assays to the pharmaceutical model of preclinical testing. Biocompatibility testing guidelines for medical devices are published in the International Organization for Standardization (ISO) document 109931: Biological evaluation of medical devicesPart 1: Evaluation and testing. These guidelines are recognized by most national regulatory bodies and supplement, but
Background Instruments have been developed to assess professional views of the quality of care but have rarely been tested for responsiveness to change. The objective of this study was to test the responsiveness of the General Practitioner Experiences Questionnaire (GPEQ) for the measurement of Community Mental Health Centres in Norway. Methods National surveys were conducted in Norway in 2006 (n = 2,415) and 2008 (n = 2,209) to measure general practitioners' evaluation of community mental health centres. GPs evaluated the centres by means of a postal questionnaire, consisting of questions focused on centre quality and cooperation with GPs. As part of the national surveys 75 GPs in 2006 and 66 GPs in 2008 evaluated Hamar community mental health centre. Between the surveys, several quality improvement initiatives were implemented which were directed at cooperation with and guidance for GPs in Stange municipality, one of eight municipalities in Hamar centre catchment area. The main outcome measures were changes in GPEQ scores from 2006 to 2008 for GPs evaluating Hamar community mental health centre from Stange municipality, and changes in scores for GPs in the other seven municipalities and nationally which were assessed for statistical significance. Results GPs in Stange municipality rated Hamar community mental health centre significantly better on the guidance scale in 2008 than in 2006; on a 0-100 scale where 100 represents the best possible experiences the score was 26.5 in 2006 and 58.3 in 2008 (p < 0.001). Apart from one item about workforce situation, none of the other scales and items showed significant changes. The control group from the other seven municipalities gave significantly poorer rating for the emergency situation scale, the workforce situation scale and seven items in 2008 than in 2006. The national results showed small differences between 2006 and 2008, even though several scales and items were significantly different. A question about changes in centre performance over the last 2-3 years showed that 82% of GPs from Stange municipality reported that Hamar community mental health centre had improved, compared to only 36% from the other seven municipalities and 40% nationally which was statistically significant. Conclusions Following the implementation of an initiative designed to enhance service quality, the GPEQ identified expected changes in the guidance scale for the intervention group, indicating that the instrument is responsive to change. The worsening of services for GPs in the control group evaluating Hamar centre warrants further study.
Background Mobile phones with operating systems and capable of running applications (smartphones) are increasingly being used in clinical settings. Medical calculating applications are popular mhealth apps for smartphones. These include, for example, apps that calculate the severity or likelihood of disease-based clinical scoring systems, such as determining the severity of liver disease, the likelihood of having a pulmonary embolism, and risk stratification in acute coronary syndrome. However, the accuracy of these apps has not been assessed. Objective The objective of this study was to evaluate the accuracy of smartphone-based medical calculation apps. Methods A broad search on Google Play, BlackBerry World, and the iTunes App Store was conducted to find medical calculation apps for smartphones. The list of apps was narrowed down based on inclusion and exclusion criteria focusing on functions thought to be relevant by a panel of general internists (number of functions =13). Ten case values were inputted for each function and were compared to manual calculations. For each case, the correct answer was assigned a score of 1. A score for the 10 cases was calculated based on the accuracy of the results for each function on each app. Results We tested 14 apps and 13 functions for each app if that function was available. We conducted 10 cases for each function for a total of 1240 tests. Most functions tested on the apps were accurate in their results with an overall accuracy of 98.6% (17 errors in 1240 tests). In all, 6 of 14 (43%) apps had 100% accuracy. Although 11 of 13 (85%) functions had perfect accuracy, there were issues with 2 functions: the Child-Pugh scores and Model for End-Stage Liver Disease (MELD) scores on 8 apps. Approximately half of the errors were clinically significant resulting in a significant change in prognosis (8/17, 47%). Conclusions The results suggest that most medical calculating apps provide accurate and reliable results. The free apps that were 100% accurate and contained the most functions desired by internists were CliniCalc, Calculate by QxMD, and Medscape. When using medical calculating apps, the answers will likely be accurate; however, it is important to be careful when calculating MELD scores or Child-Pugh scores on some apps. Despite the few errors found, greater scrutiny is warranted to ensure full accuracy of smartphone medical calculator apps.
Objective To develop and psychometrically evaluate an audio digitised tool for assessment of comprehension of informed consent among low-literacy Gambian research participants. Setting We conducted this study in the Gambia where a high illiteracy rate and absence of standardised writing formats of local languages pose major challenges for research participants to comprehend consent information. We developed a 34-item questionnaire to assess participants comprehension of key elements of informed consent. The questionnaire was face validated and content validated by experienced researchers. To bypass the challenge of a lack of standardised writing formats, we audiorecorded the questionnaire in three major Gambian languages: Mandinka, Wolof and Fula. The questionnaire was further developed into an audio computer-assisted interview format. Participants The digitised questionnaire was administered to 250 participants enrolled in two clinical trials in the urban and rural areas of the Gambia. One week after first administration, the questionnaire was readministered to half of the participants who were randomly selected. Participants were eligible if enrolled in the parent trials and could speak any of the three major Gambian languages. Outcome measure The primary outcome measure was reliability and validity of the questionnaire. Results Item reduction by factor analysis showed that 21 of the question items have strong factor loadings. These were retained along with five other items which were fundamental components of informed consent. The 26-item questionnaire has high internal consistency with a Cronbach's ? of 0.730.79 and an intraclass correlation coefficient of 0.94 (95% CI 0.923 to 0.954). Hypotheses testing also showed that the questionnaire has a positive correlation with a similar questionnaire and discriminates between participants with and without education. Conclusions We have developed a reliable and valid measure of comprehension of informed consent information for the Gambian context, which might be easily adapted to similar settings. This is a major step towards engendering comprehension of informed consent information among low-literacy participants.
Afolabi, Muhammed O; Bojang, Kalifa; D'Alessandro, Umberto; Ota, Martin O C; Imoukhuede, Egeruan B; Ravinetto, Raffaella; Larson, Heidi J; McGrath, Nuala; Chandramohan, Daniel
Objectives To first, validate in English hospitals the internal structure of the Patient Evaluation of Emotional Care during Hospitalisation (PEECH) survey tool which was developed in Australia and, second, to examine how it may deepen the understanding of patient experience through comparison with results from the Picker Patient Experience Questionnaire (PPE-15). Design A 48-item survey questionnaire comprising both PEECH and PPE-15 was fielded. We performed exploratory factor analysis and then confirmatory factor analysis using a number of established fit indices. The external validity of the PEECH factor scores was compared across four participating services and at the patient level, factor scores were correlated with the PPE-15. Setting Four hospital services (an Emergency Admissions Unit; a maternity service; a Medicine for the Elderly department and a Haemato-oncology service) that contrasted in terms of the reported patient experience performance. Participants Selection of these acute service settings was based on achieving variation of the following factors: teaching hospital/district general hospital, urban/rural locality and high-performing/low-performing organisations (using results of annual national staff and patient surveys). A total of 423 surveys were completed by patients (26% response rate). Results A different internal structure to the PEECH instrument emerged in English hospitals. However, both the existing and new factor models were similar in terms of fit. The correlations between the new PEECH factors and the PPE-15 were all in the expected direction, but two of the new factors (personal interactions and feeling valued) were more strongly associated with the PPE-15 than the remaining two factors (feeling informed and treated as an individual). Conclusions PEECH can help to build an understanding of complex interpersonal aspects of quality of care, alongside the more transactional and functional aspects typically captured by PPE-15. Further testing of the combined instrument should be undertaken in a wider range of healthcare settings.
Background The changes in the organization of mental health care services have made the role of the family even more important in caring for patients with mental disorders. Caring may have serious consequences for family caregivers, with a great impact on the quality of family life. This study reports on the translation, cultural adaptation, and validation of the Involvement EvaluationQuestionnaire-European Union (IEQ-EU) into the Greek language. Methods Caregivers of patients with major mental disorders were interviewed to test a modified version of the IEQ-EU questionnaire. Psychometric measurements included reliability coefficients, exploratory factor analysis and confirmatory analysis by linear structural relations. To measure the concurrent validity we used the Nottingham Health Profile (NHP). Results Most caregivers were female (83%), mainly mothers living with the patient (80%), with quite a high level of burden. The Greek version of the IEQ-EU (G-IEQ-EU) demonstrated a good reliability with high internal consistency (? = 0.88), Guttman split-half correlation of 0.71, high test-retest reliability (ICC = 0.82) and good concurrent validity with the NHP. A four-factor structure was confirmed for the G-IEQ-EU, slightly different from the original IEQ. The confirmatory factor analysis demonstrated that the four-factor model offered modest fit to our data. Conclusions The G-IEQ-EU is a reasonably valid and reliable tool for use in both clinical and research contexts in order to assess the burden of caregivers of patients with mental disorders.
Whether developing questions for questionnaires or interviews or focus groups, there are certain guidelines that help to ensure that respondents provide information that is useful and can later be analyzed. This resource offers advice on developing questions for interviews or focus groups. It contains basics conducting the interviews, providing directions to respondents as well as guidelines for composing the content and wording of the questionnaire. This resource is aimed for use in workshops/conferences and is intended for novice evaluators.
The aim of the study was to develop and preliminarily validate a self-completed questionnaire that could help in the assessment\\u000a of families before and during psycho-educational interventions. The questionnaire was developed according to the cognitive-behavioural\\u000a psycho-educational model. From an initial 38-item version of the questionnaire, a final shorter 24-item version was derived.\\u000a The validation study of the final version was
Rita Roncone; Monica Mazza; Donatella Ussorio; Rocco Pollice; Ian R. H. Falloon; Pierluigi Morosini; Massimo Casacchia
Four studies evaluate the new Self Description Questionnaire II short-form (SDQII-S) that measures 11 dimensions of adolescent self-concept based on responses to 51 of the original 102 SDQII items and demonstrate new statistical strategies to operationalize guidelines for short-form evaluation proposed by G. T. Smith, D. M. McCarthy, and K. G.
Marsh, Herbert W.; Ellis, Louise A.; Parada, Roberto H.; Richards, Garry; Heubeck, Bernd G.
Decentralized models of medical education, particularly for preparing primary care specialists, are increasing in importance as medical educators become aware of the need for medical students and residents to receive part of their clinical training away from the academic medical center in real practice settings. (Editor/PG)
Medical Simulation is becoming more and more important training mode for hospitals. How to evaluate training effects is an interesting topic in a medical simulation training center. This paper tries to introduce a framework of Medical Simulation Education and Evaluation System (MSEES). After identifying its problems, an improved MSEES for supporting SaaS is given. The improved MSEES is rule-based. By
BACKGROUND: In medical education, feedback from students is helpful in course evaluation. However, the impact of medical students' feedback on long-term course development is seldom reported. In this project we studied the correspondence between medical students' descriptive evaluations and key features of course development over five years. METHODS: Qualitative content analysis was used. The context was consultation skills courses in
High speed networking is a crucial ingredient in medical information systems. ATM (Asynchronous Transfer Mode) and FDDI (Fiber Distributed Data Interface) networking have overcome their high costs and it is now possible to deploy these technologies widely. However, the impact of these networks on the performance of medical information systems is not well documented. Structured experiments are required to evaluate networking in complex systems of hardware and software. A test system designed to simulate an image delivery and display system using Ethernet, FDDI and ATM networking was established. Bottlenecks in this system related to networking protocols and hardware, as well as operating system and disk operations were identified and examined. Special attention was given to the DICOM (Digital Imaging and Communications in Medicine) protocol layered on TCP/IP (Transmission Control Protocol/Internet Protocol). Although the test ATM network was rated at 155 Mbps at the physical layer, observed maximum throughputs using TCP with optimized parameters were 79 Mbps for memory to memory transfers and 50 Mbps for disk to memory transfers. The default parameters yielded much lower throughputs with rates of 28 Mbps for memory to memory transfers. When the DICOM protocol was layered on top of TCP, a performance degradation of 10% to 78% of the optimal TCP rate was observed, depending on the type of image study being transferred (CR, CT, or MR). These initial data indicate the performance of a medical information system can be limited by a series of factors. Image data types have performance characteristics based on their image and study size. Appropriate selection and tuning of higher level protocols also makes a substantial contribution to system performance. Once network bandwidth exceeds ethernet speeds, disk operations are rate limiting factors in image retrieval.
OBJECTIVE: To validate an adaptation of a short questionnaire measuring behaviour related to selecting low fat diets. The questionnaire was adapted for telephone use in a low income, low education population. DESIGN: The factorial structure of the 38 item adaptation was studied in a population based random sample of 1432 adults. Seven day test-retest reliability was measured in a convenience
In the model medical curriculum HannibaL at Hannover Medical School (MHH, Hannover, Germany), communication skills in taking case histories and disclosing diagnoses (breaking bad news) are assessed through an objective structured clinical examination (OSCE). This is part of the examinations which at the MHH represent the equivalent to the First Part of the Medical Examinations. The second year doctor-patient communication course preparing for these examinations was evaluated during the 2009/10 academic year. Using questionnaires specific to the learning objectives, learning needs were assessed, pre-post comparisons of self-assessed competencies were performed and key teaching methods were evaluated (5-point Likert scales, 5=fully agree). At T0 (start of the course) 267 students participated (response rate: 93.7%), of which 180 filled out the T1 questionnaire during the last session of the course (67.4%). Within-subject analyses of variance and paired t-tests were conducted. The highest learning needs were found for the to show how-items regarding history taking and disclosing diagnoses (M=4.4). The T1-T0 comparisons showed the greatest improvements for history taking (to know how: mean difference = +1.7, to show how: +1.8, p<.0001 as with all tests) and the to know how-item regarding the disclosure of diagnoses (+1.6), followed by the to show how-items on disclosing a diagnosis (+1.4), shared decision making (+1.2), self-assessing ones own strengths/weaknesses (+1.0) and confidently approaching new patients (+0.7). Students with T0 values of 1 or 2 on the respective scales improved on average by 2.2 points across all items, students with the value of 3 by 1.1, and from 4 or 5 by 0.1. Methodically, the use of simulated patients was rated the most helpful (M=4.8, 87% with the scale value 5). This doctor-patient communication course is associated with substantial improvements regarding all key learning objectives. Regarding methods, the deployed simulated patients (2-4 per 10-student-course group in 3 of the 7 course sessions, respectively) were rated the most helpful. The present evaluation calls for both further development of the doctor-patient communication curriculum at the MHH and joint activities across medical schools, which are discussed at the end of the paper.
von Lengerke, Thomas; Kursch, Angelika; Lange, Karin
Background Significant changes in medical education have occurred in recent decades because of new challenges in the health sector and new learning theories and practices. This might have contributed to the decision of medical schools throughout the world to adopt community-based learning activities. The community-based learning approach has been promoted and supported by the World Health Organization and has emerged as an efficient learning strategy. The aim of the present paper is to describe the characteristics of a community immersion clerkship for third-year undergraduate medical students, its evolution over 15 years, and an evaluation of its outcomes. Methods A review of the literature and consensus meetings with a multidisciplinary group of health professionals were used to define learning objectives and an educational approach when developing the program. Evaluation of the program addressed students perception, achievement of learning objectives, interactions between students and the community, and educational innovations over the years. Results The program and the main learning objectives were defined by consensus meetings among teaching staff and community health workers, which strengthened the community immersion clerkship. Satisfaction, as monitored by a self-administered questionnaire in successive cohorts of students, showed a mean of 4.4 on a five-point scale. Students also mentioned community immersion clerkship as a unique community experience. The learning objectives were reached by a vast majority of students. Behavior evaluation was not assessed per se, but specific testimonies show that students have been marked by their community experience. The evaluation also assessed outcomes such as educational innovations (eg, students teaching other students), new developments in the curriculum (eg, partnership with the University of Applied Health Sciences), and interaction between students and the community (eg, student development of a website for a community health institution). Conclusion The community immersion clerkship trains future doctors to respond to the health problems of individuals in their complexity, and strengthens their ability to work with the community.
Chastonay, P; Zesiger, V; Klohn, A; Soguel, L; Mpinga, E K; Vu, NV; Bernheim, L
Background Point-of-care electronic medical records (EMRs) are a key tool to manage chronic illness. Several EMRs have been developed for use in treating HIV and tuberculosis, but their applicability to primary care, technical requirements and clinical functionalities are largely unknown. Objectives This study aimed to address the needs of clinicians from resource-limited settings without reliable internet access who are considering adopting an open-source EMR. Study eligibility criteria Open-source point-of-care EMRs suitable for use in areas without reliable internet access. Study appraisal and synthesis methods The authors conducted a comprehensive search of all open-source EMRs suitable for sites without reliable internet access. The authors surveyed clinician users and technical implementers from a single site and technical developers of each software product. The authors evaluated availability, cost and technical requirements. Results The hardware and software for all six systems is easily available, but they vary considerably in proprietary components, installation requirements and customisability. Limitations This study relied solely on self-report from informants who developed and who actively use the included products. Conclusions and implications of key findings Clinical functionalities vary greatly among the systems, and none of the systems yet meet minimum requirements for effective implementation in a primary care resource-limited setting. The safe prescribing of medications is a particular concern with current tools. The dearth of fully functional EMR systems indicates a need for a greater emphasis by global funding agencies to move beyond disease-specific EMR systems and develop a universal open-source health informatics platform.
We evaluated methods for comparing the effects of dextroamphetamine (Dexedrine), thioridazine (Mellaril), and contingency management in the control of severe behavior problems. A reversal design was used in which medications were systematically titrated and assessed in unstructured as well as structured settings with three clients. Subsequently, behavioral procedures including timeout, differential reinforcement of other behavior, and visual screening, were used in a multiple-baseline design across settings. The assessment and design methods were useful in comparing the interventions. Dextroamphetamine decreased inappropriate behaviors and improved academic behaviors in one client, but no reliable effects were observed in the other two clients. Thioridazine was variable across clients, settings, behaviors, and dosages. Contingency management produced consistent decreases in inappropriate behaviors and small improvements in academic performance.
Little is known about how other than cancer pain related issues are represented in medical education. A standardised questionnaire was mailed to all medical students who graduated from the five Finnish medical schools in 2001. A total of 387 students received the questionnaire and 41% responded. The students had to evaluate the quantity and the quality of pain teaching. The
Objective: The evaluation of medical research performance is a key prerequisite for the systematic advancement of medical faculties, research foci, academic departments, and individual scientists careers. However, it is often based on vaguely defined aims and questionable methods and can thereby lead to unwanted regulatory effects. The current paper aims at defining the position of German academic medicine toward the aims, methods, and consequences of its evaluation. Methods: During the Berlin Forum of the Association of the Scientific Medical Societies in Germany (AWMF) held on 18 October 2013, international experts presented data on methods for evaluatingmedical research performance. Subsequent discussions among representatives of relevant scientific organizations and within three ad-hoc writing groups led to a first draft of this article. Further discussions within the AWMF Committee for Evaluation of Performance in Research and Teaching and the AWMF Executive Board resulted in the final consented version presented here. Results: The AWMF recommends modifications to the current system of evaluatingmedical research performance. Evaluations should follow clearly defined and communicated aims and consist of both summative and formative components. Informed peer reviews are valuable but feasible in longer time intervals only. They can be complemented by objective indicators. However, the Journal Impact Factor is not an appropriate measure for evaluating individual publications or their authors. The scientific impact rather requires multidimensional evaluation. Indicators of potential relevance in this context may include, e.g., normalized citation rates of scientific publications, other forms of reception by the scientific community and the public, and activities in scientific organizations, research synthesis and science communication. In addition, differentiated recommendations are made for evaluating the acquisition of third-party funds and the promotion of junior scientists. Conclusions: With the explicit recommendations presented in the current position paper, the AWMF suggests enhancements to the practice of evaluatingmedical research performance by faculties, ministries and research funding organizations.
The report addresses the legislative and regulatory framework and criteria for the definition of orphan status, diseases that could be managed by medical food products, the adequacy of current incentives for the development of orphan medical foods, barrie...
...applied by the Coast Guard in making medical fitness determinations for issuance of merchant...applied by the Coast Guard in making medical fitness determinations for issuance of merchant...the ultimate determination of medical fitness rests with the Coast Guard,...
Background Physical inactivity is a major cardiovascular risk factor. Recently, we showed that non-exercise activity thermogenesis (NEAT) assessed by the self-reported questionnaire is favorably associated with metabolic risks in patients with type 2 diabetes. The purpose of the present study was to examine the validity of the questionnaire by comparing with objectively measured daily physical activity (PA) by using the triaxial accelerometer. Methods Daily physical activity level (PAL) of 51 participants (24 men and 27 women) with type 2 diabetes was measured by the triaxial accelerometer. At the same time, we evaluated their NEAT score using our original questionnaire modified from a compendium of physical activities. Results The NEAT score was significantly and positively correlated with PAL measured by the triaxial accelerometer (r?=?0.604, P?0.001). PAL was also significantly and positively correlated with both the locomotive NEAT score and the non-locomotive NEAT score (r?=?0.444, P?=?0.001 and r?=?0.526, P?0.001, respectively). Conclusions The NEAT score measured by the self-reported questionnaire was highly correlated with PAL measured by the triaxial accelerometer. Our original NEAT questionnaire may be useful for evaluation of daily PAL in clinical practices.
Podcasting has become a popular means of transferring knowledge in higher education through making lecture contents available to students at their convenience. Accessing courses on media players provides students with enhanced learning opportunities. Development of teaching methods able to cope with ever-changing nature of medicine is crucial to train the millennium students. Pharmacology education in Tehran University of Medical Sciences has been based on lectures so far; our aim was to implement a pilot study to evaluate the advantages and disadvantages of offering the course contents as podcasts as well as evaluating whether such program can be feasible in our educational program. 46% of students downloaded the podcast according to our download center. 48% favored usage of both internet and DVD-ROM concurrently. Overall 96% of students perceived that podcasting had a positive impact on their learning in pharmacology course. Our results indicate that most of attendants proposed the positive yields of podcasting despite low usage of it, mainly as a pre-class preparing tool. PMID:23456586
ObjectiveThis paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions.
Richard H. Osborne; Gerald R. Elsworth; Kathryn Whitfield
The authors evaluated the utility of the Multidimensional Body-Self Relations Questionnaire (MBSRQ; Brown, Cash, & Mikulka, 1990) and the Appearance Schemas Inventory-Revised (ASI-R; Cash, Melnyk, & Hrabosky, 2004) by administering the instruments to Hispanic female college students. Results indicated that the means of the MBSRQ and the ASI-R
This paper provides the results of two studies designed to evaluate a newly constructed self-report instrument, the Sexual Abuse Questionnaire (SAQ). The SAQ was designed as a brief screening device to aid in the identification of a childhood sexual abuse history. A unique feature of the SAQ is the inclusion of a number of non-face valid questions derived from clinical
Timothy G. Lock; Donald J. Levis; Patricia A. Rourke
Two studies describe the development of a comprehensive, vignette-based measure of social information processing (SIP) particularly relevant for children with internalizing problems. Study 1 (N = 219 3rd-6th graders) describes the creation of the Children's Evaluation of Everyday Social Encounters Questionnaire (ChEESE-Q) and evidence for its
Bell, Debora J.; Luebbe, Aaron M.; Swenson, Lance P.; Allwood, Maureen A.
The manner in which health care workers (HCWs) interact with HIV\\/AIDS patients and drug users during their work clearly influences the sustainability of harm reduction programs. To evaluate the professional attitudes of HCWs, we designed a questionnaire with four constructs discrimination, acceptance of HIV\\/AIDS patients, acceptance of drug users, and fear and tested its reliability and validity. Ten
An essential goal of evaluation is to foster learning. Across the medical education spectrum, evaluation of clinical performance is dominated by subjective feedback to learners based on observation by expert supervisors. Research in non-medical settings has suggested that participants' perceptions of evaluation processes exert considerable
The expansion of biomedical knowledge and the pursuit of more meaningful learning have led to world-wide evidence-based innovative changes in medical education and curricula. The recent emphasis on problem-based learning (PBL) and student-centred learning environments are, however, not being implemented in Nigerian medical schools. Traditional
Anyaehie, U. S. B.; Nwobodo, E.; Oze, G.; Nwagha, U. I.; Orizu, I.; Okeke, T.; Anyanwu, G. E.
Human errors in medical device use account for a large portion of medical errors. Most of these errors are due to inappropriate designs for user interactions, rather than mechanical failures. Evaluating and predicting patient safety in medical device use is critical for developing interventions to reduce such errors either by redesigning the devices or, if redesign is not an option,
Jiajie Zhang; Vimla L. Patel; Todd R. Johnson; Philip Chung; James P. Turley
The Skylab program established the opportunity for the first time to perform extensive medical experimentation on man in a long-term zero-g environment. This experimentation involved metabolic studies, cardiovascular systems, nutrition and mineral balance, hematology, vestibular function, and many other related investigations. This report presents an overview of the significant results of the medical experiments performed during the program and a summary of the medical observations gathered by the team of life scientists.
Objective: To survey the self-perceived capability of medically oriented child maltreatment teams in the US to provide mental health referrals and services when needed and to evaluate children with special health care needs (CSHCN). Methods: Mailed questionnaire with 5 items related to mental health, 12 items on services for CSHCN, and 28 items on
Montoya, Louise A.; Giardino, Angelo P.; Leventhal, John M.
The University of Minnesota medical student wiki (UMMedWiki) allows students to collaboratively edit classroom notes to support medical education. Since 2007, UMMedWiki has grown to include 1,591 articles that have collectively received 1.2 million pageviews. Although small-scale wikis have become increasingly important, little is known about their dynamics compared to large wikis, such as Wikipedia. To better understand UMMedWiki's management and its potential reproducibility at other medical schools, we used an edit log with 28,000 entries to evaluate the behavior of its student editors. The development of tools to survey UMMedwiki allows for quality comparisons that improve both the wiki and the curriculum itself. We completed a content survey by comparing the UMMedWiki with two types of rubric data: TIME, a medical education taxonomy consisting of 1500 terms and national epidemiological data on 2,100 diseases. PMID:22195202
A statistical measure of user satisfaction among medical school faculty members was undertaken which found that such libraries tend to develop techniques of storage, retrieval, and dissemination of medical information without benefit of current research into the real needs of faculties and researchers. (Author/MLW)
Medical school admissions committees are expected to select physicians with specific attributes such as intelligence, altruism, dutifulness, and compassion. Besides basing these attributes on the best professional judgment of the physicians and medical school faculty, there has been little quantitative research to determine the psychological
While some published research indicates a fairly high frequency of Intravenous (IV) medication errors associated with the use of smart infusion pumps, the generalizability of these results are uncertain. Additionally, the lack of a standardized methodology for measuring these errors is an issue. In this study we iteratively developed a web-based data collection tool to capture IV medication errors using a participatory design approach with interdisciplinary experts. Using the developed tool, a prevalence study was then conducted in an academic medical center. The results showed that the tool was easy to use and effectively captured all IV medication errors. Through the prevalence study, violation errors of hospital policy were found that could potentially place patients at risk, but no critical errors known to contribute to patient harm were noted.
Ohashi, Kumiko; Dykes, Patricia; McIntosh, Kathleen; Buckley, Elizabeth; Wien, Matt; Bates, David W.
This article describes a study of Nigerian medical students' perceptions of traditional didactic lectures and their overall learning environment. The results confirm declining interest in didactic lectures and practical sessions with preferences for peer-tutored discussion classes, which were considered more interactive and interesting. This study recommends more emphasis on student-centered learning with alternatives to passive lecture formats and repetitive cookbook practical sessions. The institutionalization of student feedback processes in Nigerian medical schools is also highly recommended.
Self-concept scales from the Australian Self Description Questionnaire II (SDQII) were included in the National Education Longitudinal Study of 1988 (NELS:88). Mean differences based on 17,544 U.S. responses and the Australian normative sample were small. Results support construct validity of SDQII responses in NELS:88 data. (SLD)
We developed three ethnic food frequency questionnaires (FFQs) to characterize the diets of South Asian, Chinese, and European immigrants. FFQs were developed from foods reported in the diet records and recalls of 29 South Asians, 25 Chinese, and 20 Europeans participating in a pilot study from 19951996 in Hamilton, Ontario, Canada. The FFQ and a seven-day diet record were then
Linda E. Kelemen; Sonia S. Anand; Vladimir Vuksan; Qilong Yi; Koon K. Teo; Sudarshan Devanesen; Salim Yusuf
The authors describe the development and validation of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y), a child-report measure of psychological inflexibility engendered by high levels of cognitive fusion and experiential avoidance. Consistent with the theory underlying acceptance and commitment therapy (ACT), items converged into a
Temperament is a developmentally important construct, hierarchically comprised of several lower-order dimensions subsumed under effortful control, negative affectivity, and surgency. The Children's Behavior Questionnaire-Very Short Form (CBQ-VSF) was developed as a brief measure of the higher-order factors of temperament to aid researchers in
Allan, Nicholas P.; Lonigan, Christopher J.; Wilson, Shauna B.
Background In the UK, chronic disease, including chronic kidney disease (CKD) is largely managed in primary care. We developed a tool to assess practitioner confidence and knowledge in managing CKD compared to other chronic diseases. This questionnaire was part of a cluster randomised quality improvement interventions in chronic kidney disease (QICKD; ISRCTN56023731). Methods The questionnaire was developed by family physicians, primary care nurses, academics and renal specialists. We conducted three focus groups (n?=?7, 6, and 8) to refine the questionnaire using groups of general practitioners, practice nurses and trainees in general practice. We used paper based versions to develop the questionnaire and online surveys to test it. Practitioners in a group of volunteer, trial practices received the questionnaire twice. We measured its reliability using Cohens Kappa (K). Results The practitioners in the focus groups reached a consensus as to the key elements to include in the instrument. We achieved a 73.1% (n?=?57/78) initial response rate for our questionnaire; of these 57, 54 completed the questionnaire a second time. Family physicians made up the largest single group of respondents (47.4%, n?=?27). Initial response showed more female (64.9%, n?=?37) than male (35.1%, n?=?20) respondents. The reliability results from retesting showed that there was moderate agreement (k?>?0.4) on all questions; with many showing substantial agreement (k?>?0.6). There was substantial agreement in the questions about loop diuretics (k?=?0.608, CI 0.432-0.784, p?0.001), confidence in managing hypertension (k?=?0.628, 95%CI 0.452-0.804, p?0.001), diastolic blood pressure treatment thresholds in CKD (k?=?0.608, 95%CI 0.436-0.780, p?0.001) and the rate of decline of eGFR that would prompt referral (k?=?0.764, 95%CI 0.603-0.925, p?0.001). Conclusion The QICKD-CCQ is a reliable instrument for measuring confidence and knowledge among primary care practitioners on CKD management in the context of UK primary care.
The National University of Ireland in Galway established a Master in Science (MSc.) program in medical physics in 2002. The course was designed to be 90 ECTS(1) credits and of one calendar year duration. From the outset the MSc. was designed to be part of an overall medical physics training program. MSc. programs are now widely used as part of the training and education of medical physicists. There is however paucity of data on the effectiveness of such courses and the purpose of the study reported here is to provide information on one particular MSc. course in medical physics. This is relevant to medical physicists who are involved in the development and running of medical physics training programs. The study used as methodology the Kirkpatrick levels of professional training. It was conducted through an online survey, both from students who graduated from the course and from students who were in the process of completing the course. The survey proved to be an effective way to determine attributes of modules such as learning outcomes, knowledge imparted, quality of teaching materials and others. The survey proved to be remarkably able to demonstrate interventions in the individual course modules. Although the course was shown to be effective in the imparting of the knowledge required to become a qualified medical physicist several areas for improvement were identified. These are mainly in the areas of increased practical experience and in course delivery. PMID:24309504
It was only 30 years ago that the medical community began to develop an increased awareness of child sexual abuse, and the role of the medical provider in the evaluation of sexually abused children has evolved significantly. As clinicians worldwide develop a greater understanding of the impact of the sexual abuse evaluation on the child, the roles of the physician
Background While practice-level or team accreditation is not new to primary care in the UK and there are organisational indicators in the Quality and Outcomes Framework (QOF) organisational domain, there is no universal system of accreditation of the quality of organisational aspects of care in the UK. Aim To describe the development, content and piloting of version 1 of the Primary Medical Care Provider Accreditation (PMCPA) scheme, which includes 112 separate criteria across six domains: health inequalities and health promotion; provider management; premises, records, equipment, and medicines management; provider teams; learning organisation; and patient experience/involvement, and to present the results from the pilot service evaluation focusing on the achievement of the 30 core criteria and feedback from practice staff. Design of study Observational service evaluation using evidence uploaded onto an extranet system in support of 30 core summative pilot PMCPA accreditation criteria. Setting Thirty-six nationally representative practices across England, between June and December 2008. Method Study population: interviews with GPs, practice managers, nurses and other relevant staff from the participating practices were conducted, audiotaped, transcribed, and analysed using a thematic approach. For each practice, the number of core criteria that had received either agoodorsatisfactoryrating from a RCGP-trained assessment team, was counted and expressed as a percentage. Results Thirty-two practices completed the scheme, with nine practices passing 100% of core criteria (range: 27100%). There were no statistical differences in achievement between practices of different sizes and in different localities. Practice feedback highlighted seven key issues: (1) overall view of PMCPA; (2) the role of accreditation; (3) different motivations for taking part; (4) practice managers dominated the workload associated with implementing the scheme; (5) facilitators for implementation; (6) patient benefit relevance of PMCPA to quality improvement; (7) recommendations for improving the scheme. Conclusion Version 1 of PMCPA has been piloted as a primary care accreditation scheme and shown to be relevant to different types of practice. The scheme is undergoing revision in accordance with the findings from the pilot and ongoing consultation.
Campbell, Stephen M; Chauhan, Umesh; Lester, Helen
This paper highlights the development and testing of the Infant Movement Motivation Questionnaire (IMMQ), an instrument designed to evaluate qualities of infant characteristics that relate specifically to early motor development. The measurement development process included three phases: item generation, pilot testing and evaluation of acceptability and feasibility for parents and exploratory factor analysis. The resultant 27-item questionnaire is designed for completion by parents and contains four factors including Activity, Exploration, Motivation and Adaptability. Overall, the internal consistency of the IMMQ is 0.89 (Cronbach's alpha), with test-retest reliability measured at 0.92 (ICC, with 95% CI 0.83-0.96). Further work could be done to strengthen the individual factors; however it is adequate for use in its full form. The IMMQ can be used for clinical or research purposes, as well as an educational tool for parents. PMID:24861943
ObjectiveThe causes of low back pain in China and Western countries are extremely different. We attempted to analyze the risk factors of low back pain in urban and rural patients under the dual economy with the simplified Chinese version of Roland-Morris disability questionnaire (SC-RMDQ) to demonstrate that SC-RMDQ could evaluate patients with low back pain arising from different causes.MethodsRoland-Morris disability
Honglei Yi; Xinran Ji; Xianzhao Wei; Ziqiang Chen; Xinhui Wang; Xiaodong Zhu; Wei Zhang; Jiayu Chen; Diqing Zhang; Ming Li
Two studies describe the development of a comprehensive, vignette-based measure of social information processing (SIP) particularly relevant for children with internalizing problems. Study 1 (N = 219 3rd6th graders) describes the creation of the Children's Evaluation of Everyday Social Encounters Questionnaire (ChEESE-Q) and evidence for its reliability and validity, including internal structure and relation of SIP variables to depressive and anxious symptoms.
Debora J. Bell; Aaron M. Luebbe; Lance P. Swenson; Maureen A. Allwood
Scuba diving has become a popular recreational sport throughout the world. Although it is not a competitive sport, a certain level of physical fitness is recommended because of the physical characteristics of the underwater environment. Immersion alone will increase cardiac preload leading to a rise in both cardiac output and blood pressure, counteracted by increased diuresis. Increased oxygen partial pressure and cold exposure during scuba diving will additionally increase afterload by vasoconstrictive effects and may induce bradyarryhthmias in combination with breathholds. Volumes of gas in the body cavities will be affected by changing pressure, and inert gas components of the breathing-gas mixture will dissolve in body tissues and blood with increasing alveolar inert-gas partial pressure. During decompression, a free gas phase may form in supersaturated tissues, resulting in the generation of inert gas microbubbles that are eliminated by venous return to the lungs under normal circumstances. It has been reported that more air bubbles were detected in divers when dives were performed in the open sea rather than in hyperbaric chambers. Both dry and wet dives are associated with hyperoxia, increased density of breathing gas, and decompression stress, with possible formation of venous bubbles and enhancement of the inflammatory cascade. However, open-water dives are also associated with immersion, the mechanical load of the breathing apparatus, a high level of physical activity, and exposure to a cold environment. Immersion in cold water results in breathing colder and denser gas and may also, by inducing peripheral cutaneous vasoconstriction in conjunction with the immersion effect, potentiate central pooling of blood more than in dry dives. Water immersion-induced changes in haemodynamic, neuroendocrine and autonomic activities have been reviewed previously. Cardiovascular conditions may have an impact on these physiological changes, increasing the risk of suffering adverse events from scuba diving. Systemic hypertension may be aggravated by underwater exercise and immersion. Metabolic disorders are also of concern, since obesity is associated with both higher bubble grades in Doppler ultrasound detection after scuba dives when compared to normal subjects and with an increased risk of decompression illness. Thus, the diver's cardiovascular status is important in the assessment of fitness to dive, and some cardiovascular conditions, such as symptomatic coronary artery disease and heart rhythm disorders, should preclude scuba diving. Any history of cardiac disease or abnormalities detected during routine physical examination should prompt further evaluation and specialist referral. Recreational scuba diving is usually performed without accurate medical examination. In 2003, the only countries requiring pre-diving medical examination were France, the UK and Australia (no longer the case in Australia), while it is still required for commercial diving. Swimming in rough water and strong currents can induce fatigue, anxiety or panic in divers. A question of fundamental importance is: what is a level of physical fitness needed to deal with the reasonable, expected and unexpected demands of a recreational dive? The paper by Buzzacott et al investigates this topic, confirming previous research that the mean aerobic need is about 7 METs (metabolic equivalents). Nonetheless, we know that a US Navy diver must swim at least at 1.3 knots, which means 13 METs and a recreational scuba diver usually swims at 0.5 knots (5 METs) but during an emergency he could reach up to 1.0 knot (10 METs). Moreover, we have to take into account that an expert scuba diver has a better exercise efficiency compared to the non-expert, so these conclusions appear reasonable. Many unresolved questions remain open: for example, the reliability of the value of MET. A recent paper reported that the mean rate of resting oxygen consumption (VO?) in a sample of healthy men was 3.21 mL·kg?¹·min?¹, significantly lower than the standard resting MET value o
Objective To evaluate reproductive health education which is essential to the prevention of sexual risk behavior and its associated adverse outcomes of unwanted pregnancy, AIDS and other sexually transmitted disease in adolescents. Little is known about youth educational needs about reproductive health in Iran. The aim of this study is evaluation of female youth educational needs about reproductive health in non-medical universities in the city of Qom, north central of Iran. Materials and methods The study was descriptive-analytical type conducted in nine non-medical universities (400 students). A questionnaire was constructed to meet the purpose of the study based on similar studies of knowledge and attitude in different countries, yet it was modified according to Iranian culture and social norms. Results The findings showed that a majority of participants have moderate knowledge about all components of reproductive health. Approximately, one - third of the participants reported difficulties to discuss about sexual health with mothers. The most of the participants believed insufficient female youth reproductive health services and low knowledge about reproductive health were the main barriers for female youth reproductive health aims. Conclusion The participants in this study are representatives of an important subgroup in Iran in order to evaluate female youth reproductive health educational needs. The study identified many misconception and negative attitude that need to be addressed. A health education program through parents, peers, mass media campaign and more comprehensive family planning curriculum in universities are recommended to overcome misconception and spread awareness.
In the face of a growing number of natural disasters and the increasing costs associated with them, Europe and Greece in particular, have devoted significant efforts and resources in natural hazards mitigation during the last decades. Despite the significant legislative efforts (e.g. 1998/22/EC, 2001/792/EC, 2007/60/EC Directives, 3013/2002 Act) and even though a number of steps has been taken towards improving civil protection, recent catastrophic events have illustrated the weaknesses of current approaches. In particular, in Greece, events such as the 1999 Athens earthquake, the 2007 and 2009 wildfires have shown the inadequacy of prevention and mitigation practices. Given the enhanced civil protection responsibilities, given by the Greek national law (Acts 3013/2002, 3852/2010) to local authorities in Greece, this work analyses and evaluates the existing structure and current management framework under which local authorities function and examines their risk mitigation practices. We conducted the largest questionnaire survey regarding Civil Protections issues, among the municipalities of Greece. To this aim, this work used a innovative online tool to assess current framework. Therefore, a network connecting civil protection departments of municipalities was developed, based on an Internet platform that acted also as a communication tool. Overall, we had feedback either online or offline from 125 municipalities across the country (representing more than one/third of the total municipalities of Greece). Through this network, municipal civil protection officials completed surveys designed to obtain and quantify information on several aspects of civil protection practices and infrastructure. In particular, the examined factors included: (i) personnel and equipment, (ii) inter-agency cooperation, (iii) training, (iv) compliance with existing regulations and (v) persistent problems encountered by civil protection departments, that prevent the effectiveness of current practices. Responses showed that civil protection personnel lack adequate training and expertise, many are overstretched with several duties, while several prevention actions are carried out by seasonal or voluntary staff. Approximately half of the heads of civil protection offices do not hold a university degree, only 27% have a relevant scientific background (geoscientists or engineers) and more than half of them are elected members and not permanent staff, implying that no continuity is secured. Inter-agency cooperation is shown to be poor and organizational learning from international practices not adequate. Half of the municipalities report that the authorization processes are too slow so that prevention actions particularly regarding forest fires are severely delayed. Existing regulations are not followed by a significant portion of municipalities since 19% have not established a civil protection office and 23% have not compiled an action plan yet. Existing action plans lack important information, present no spatial data and are predominantly catalogues and tables of information regarding authorised personnel and equipment. Overall, underfunding, poor coordination of the different actors involved, lack of training and understaffing, lack of proper equipment and several other issues are held responsible by officials for preventing effectiveness of current practices. Finally, the EU emergency number 112 is widely unknown (87%). This work was held under the LIFE+ project "Local Authorities Alliance for Forest Fire Prevention - LIFE08/ENV/GR/000553" which is implemented with the contribution of the LIFE financial instrument of the European Community.
An essential goal of evaluation is to foster learning. Across the medical education spectrum, evaluation of clinical performance\\u000a is dominated by subjective feedback to learners based on observation by expert supervisors. Research in non-medical settings\\u000a has suggested that participants perceptions of evaluation processes exert considerable influence over whether the feedback\\u000a they receive actually facilitates learning, but similar research on perceptions
Outpatient nursing services expend a vast amount of time for manual documentation and management of patient basic claims data. Context-driven acquisition of sensor data, documentation of observations and their automated processing can reduce this time, while availability of documented information increases. Usage of wireless sensors is a major element of long-term measurement of medical data. Currently a technical experienced nurse,
Development of the STARPAHC telemedicine system is documented. Using STARPAHC assessment results and monitoring experience, on board and ground based flight medical system monitoring requirements and operational procedures were developed for use with the Space Transportation System during OFT and mature operation phases of the shuttle.
Barriers to medical students receiving nutrition education exist and use of multimedia programs has been suggested as one solution. However, evaluation strategies to determine the effectiveness of this approach are lacking. The experience of 140 medical students using a nutrition multimedia program and the strategies used to assess student attitudes toward this independent learning strategy are reported. Their performance in
Kathryn M. Kolasa; Ann C. Jobe; Maria Clay; Janice Daugherty
The effectiveness of using nonmedical personnel to evaluatemedical students' performance on medical history-taking and physical examination was studied at Mercer University School of Medicine. Advantages in using nonphysician observers were that they were more available, economical, and attentive. (MLW)
The atypical antipsychotic medication risperidone was evaluated using a double-blind, placebo-controlled design to treat destructive behavior in two males (ages 6 and 24) with autism. Destructive behavior during the demand condition was significantly reduced during the medication phases, whereas it continued to occur to obtain tangible items and
Crosland, Kimberly A.; Zarcone, Jennifer R.; Lindauer, Steven E.; Valdovinos, Maria G.; Zarcone, Troy J.; Hellings, Jessica A.; Schroeder, Stephen R.
To help determine the role that test instrument formats play in evaluation, two parallel examinations were given to 227 second-year medical students. The tests were based on information presented in a medical case history. One required students to generate their own problem lists (the generate group); the other required the students to select
Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer
As compared with terrestrial circuits, communication satellites possess superior characteristics such as wide area coverage, broadcasting functions, high capacity, and resistance to disasters. Utilizing the narrow band channel (64 kbps) of the stationary communication satellite JCSAT1 located at an altitude of 36,000 km above the equator, we investigated satelliterelayed dynamic medical images transmitted by video signals, using hepatic ultrasonography as a model. We conclude that the "variable playing speed transmission scheme" proposed by us is effective for the transmission of dynamic images in the narrow band channel. This promises to permit diverse utilization and applications for purposes such as the transmission of other types of ultrasonic images as well as remotely directed medical diagnosis and treatment. PMID:8916265
The administration of medicines to patients with dysphagia presents substantial challenges to patient safety. Within stroke services, where up to half of patients may experience dysphagia, ensuring safe medication management is particularly challenging. This article describes how best practice within one stroke unit is being achieved by means of a knowledge-to-action service improvement project, ongoing education and training, and the input of a specialist dysphagia practitioner. PMID:23905260
A conceptual design of a passively safe reactor facility for boron neutron capture therapy has been previously described. The medical therapy reactor (MTR) has a maximum power level of 10 MW(thermal) and utilizes 45 wt% uranium in UZrH, 20 wt% Â²Â³âµU enriched hydride fuel matrix with 1 wt% erbium, which is a burnable poison and provides prompt negative reactivity feedback.
Background Complaints of Arm Neck and Shoulder (CANS) represent a wide range of complaints, which can differ in severity from mild, periodic symptoms to severe, chronic and debilitating conditions. They are thought to be associated with both physical and psychosocial risk factors. The measurement and identification of the various risk factors for these complaints is an important step towards recognizing (a) high risk subgroups that are relevant in profiling CANS; and (b) also for developing targeted and effective intervention plans for treatment. The purpose of the present study was to investigate the prevalence of CANS in a Dutch population of computer workers and to develop a questionnaire aimed at measuring workplace physical and psychosocial risk factors for the presence of these complaints. Methods To examine potential workplace risk factors for the presence of CANS, the Maastricht Upper Extremity Questionnaire (MUEQ), a structured questionnaire, was developed and tested among 264 computer office workers of a branch office of the national social security institution in the Netherlands. The MUEQ holds 95 items covering demographic characteristics, in addition to seven main domains assessing potential risk factors with regard to (1) work station, (2) posture during work, (3) quality of break time, (4) job demands, (5) job control, and (6) social support. The MUEQ further contained some additional questions about the quality of the work environment and the presence of complaints in the neck, shoulder, upper and lower arm, elbow, hand and wrist. The prevalence rates of CANS in the past year were computed. Further, we investigated the psychometric properties of the MUEQ (i.e. factor structure and reliability). Results The one-year prevalence rate of CANS indicated that 54% of the respondents reported at least one complaint in the arm, neck and/or shoulder. The highest prevalence rates were found for neck and shoulder symptoms (33% and 31% respectively), followed by hand and upper arm complaints (11% to 12%) and elbow, lower arm and wrist complaints (6% to 7%). The psychometric properties of the MUEQ were assessed using exploratory factor analysis which resulted in the identification of 12 factors. The calculation of internal consistency and cross validation provided evidence of reliability and lack of redundancy of items. Conclusion Neck and shoulder complaints are more frequently reported among Dutch computer workers than arm, elbow and hand complaints. The results further indicate that the MUEQ has satisfactory reliability and internal consistency when used to document CANS among computer workers in the Netherlands.
Eltayeb, Shahla; Staal, J Bart; Kennes, Janneke; Lamberts, Petra HG; de Bie, Rob A
Questionnaire is a general and indispensable method frequently and widely used in many academic, engineering, medical, commercial, and political survey research activities to obtain systematic data and information. Ubiquitous questionnaire, i.e., to provide users with E-questionnaire services anytime and anywhere such that one can use E-questionnaire servers without even thinking about them, is an ideal ubiquitous service in service-oriented computing.
The purpose was to examine, jointly, cockpit automation and social processes. Automation was varied by the choice of two radically different versions of the DC-9 series aircraft, the traditional DC-9-30, and the glass cockpit derivative, the MD-88. Airline pilot volunteers flew a mission in the simulator for these aircraft. Results show that the performance differences between the crews of the two aircraft were generally small, but where there were differences, they favored the DC-9. There were no criteria on which the MD-88 crews performed better than the DC-9 crews. Furthermore, DC-9 crews rated their own workload as lower than did the MD-88 pilots. There were no significant differences between the two aircraft types with respect to the severity of errors committed during the Line-Oriented Flight Training (LOFT) flight. The attitude questionnaires provided some interesting insights, but failed to distinguish between DC-9 and MD-88 crews.
Wiener, Earl L.; Chidester, Thomas R.; Kanki, Barbara G.; Palmer, Everett A.; Curry, Renwick E.; Gregorich, Steven E.
An evaluation program for fourth-year electives at Wright State University School of Medicine is described. Although individual electives were assessed, the evaluation program allows generalizations across electives by identifying strengths and weaknesses commonly found in the electives that were evaluated. (MLW)
In response to a request from the respiratory therapist educator of HCA Wesley Medical Center in Wichita, Kansas, an evaluation was conducted of the effectiveness of revised procedures for administering ribavirin (36791045) via hood. The containment syste...
This is a preliminary report to evaluate the validity and reliability of the Workload Management System (WMS) for Nursing. The system is currently being used as the basis for nurse staffing decisions within the Navy Medical Department. This report present...
The Corometrics Medical Systems Neonatal Monitor, Model 506, was tested for environmental and electromagnetic interference/compatibility in the UH-60A helicopter under the U.S. Army Program for Testing and Evaluation of Equipment for Aeromedical Operation...
This paper describes an evaluation methodology designed for the IMSA (Interactive Multimedia System for Auto-medication) system. IMSA stands in the multidisciplinary field of medical informatics and aims at providing a health care Internet tool for the general public. As far as a medical information system is patient-oriented, issues in understanding content and of human - computer interface usability are key factors to achieve success. The team developing IMSA concentrated part of its work on designing an evaluation methodology to ensure that the system is user-friendly and responds in a way that can be easily understood by the general public. This methodology is built on a three-tier architecture with the user, the evaluator and a set of medical case descriptions. The testing protocol is based on a user trying to run scenarios related to mild clinical signs on the IMSA prototype under the passive presence of an evaluator. PMID:12851053
...HINT) or the Hearing in Noise Test--Children (HINT-C) should we consider when we evaluate hearing loss treated with cochlear implantation? Should we provide examples of medical reasons for a discrepancy between the speech reception threshold...
Reports the results of an evaluation of Distance Interactive Learning in Obstetrics and Gynecology (DIALOG) which is an electronic program for continuing education. Presents 10 golden rules for designing software for medical practitioners. (Contains 26 references.) (Author/YDS)
In March 2000, the National Institute for Occupational Safety and Health (NIOSH) received a request from the Service Employees International Union (SEIU) local 1997 to conduct a health hazard evaluation (HHE) at Riverside County Regional Medical Center in...
One (A.I) of the authors has developed BDIM (Before-Discharge Intervention Method) for the purpose of making alcoholics aware of their drinking problems. 153 patients were treated by BDIM. After the practiced BDIM, the patients underwent a 52 month observational period. 82 patients (53.6%) continued with either treatment as outpatient or inpatients, or attendance of a self-help group. We administered these 82 patients our questionnaire that asked for their assessment about the therapeutic effects of BDIM. 76 patients (49.7%) completed our questionnaire. Regarding the impression of family members' letters in BDIM, 70 patients (92.1% of 76) answered that the letter have had a positive impression on them. 52 patients (68.4% of 76) answered that they have had very strong or strong impressions. The numbers of patients who have [very strong or strong] impression are significantly more in the abstinence group than in the drinking group. Also, we asked patients about which messages of spouses, daughters and sons in BDIM gave the strongest impression to these patients. The result showed that their daughter gave the strongest impression to many patients. We believe that their children, especially the patients' daughter's messages, have therapeutic effects as impact messages even though alcoholics have cognitive or memory disorder. Patients positively assessed that BDIM strengthened motivation for treatment or attendance of self-help group meetings, for abstinence and for the consequence to their lives. Many patients assessed that BDIM has effect on awareness of their drinking problems. But the ratio of positive answers about motivation of awareness of drinking problem is smaller than the ratio of positive answers about other questions. As a result, we surmised that BDIM will have the effect of empowerment, including the effect of awareness. PMID:17037344
OBJECTIVE--To develop and evaluate a short (10 item) simple measure of outcome mainly for use with patients with mild to moderate head injuries. DESIGN--Two studies on patients at three and six months after injury, comparing different methods of administration (two raters and postal questionnaire), and comparing ratings with other assessments. SUBJECTS--Forty three patients seen three months after injury and 46 seen six months after injury; both groups had head injuries covering a range of severity from minor to severe. MAIN OUTCOME MEASURES--Differences between ratings in different groups of patients (Mann-Whitney U test); differences in ratings used different methods of administration (Wilcoxon signed rank test); and correlation between ratings from the same patient (Spearman r). RESULTS--The sum total ratings were consistent between raters and between methods (postal questionnaire v face to face interview) with no evidence of selective bias between rates or methods. Ratings on individual items were also reasonably consistent. The sum total rating varied as anticipated between groups divided by clinical judgement of recovery and patient assessment of recovery, and related as expected to the extent of post-concussion symptomatology. The 10 items included covered the most important problem areas reported by patients. CONCLUSION--The Rivermead head injury follow up questionnaire (RHFUQ) is a short, simple, adequately reliable, and valid measure of outcome, across the entire range of severity, but particularly after mild to moderate head injury.
Introduction: Physicians increasingly earn continuing medical education (CME) credits through on-line courses, but there have been few rigorous evaluations to determine their effects. The present study explores the feasibility of implementing standardized evaluation templates and tests them to evaluate 30 on-line CME courses. Methods: A time
Although many individuals applying for political asylum allege maltreatment and sometimes torture in their countries of origin,\\u000a the utility of medicalevaluations in asylum adjudication has not been documented. This study compares the asylum grant rate\\u000a among US asylum seekers who received medicalevaluations from Physicians for Human Rights (PHR), with rates among asylum seekers\\u000a who did not receive PHR
Stuart L. Lustig; Sarah Kureshi; Kevin L. Delucchi; Vincent Iacopino; Samantha C. Morse
Ever since Taiwan's National Health Insurance implemented the diagnosis-related groups payment system in January 2010, hospital income has declined. Therefore, to meet their medical waste disposal needs, hospitals seek suppliers that provide high-quality services at a low cost. The enactment of the Waste Disposal Act in 1974 had facilitated some improvement in the management of waste disposal. However, since the implementation of the National Health Insurance program, the amount of medical waste from disposable medical products has been increasing. Further, of all the hazardous waste types, the amount of infectious medical waste has increased at the fastest rate. This is because of the increase in the number of items considered as infectious waste by the Environmental Protection Administration. The present study used two important findings from previous studies to determine the critical evaluation criteria for selecting infectious medical waste disposal firms. It employed the fuzzy analytic hierarchy process to set the objective weights of the evaluation criteria and select the optimal infectious medical waste disposal firm through calculation and sorting. The aim was to propose a method of evaluation with which medical and health care institutions could objectively and systematically choose appropriate infectious medical waste disposal firms.
Ho, Chao Chung, E-mail: firstname.lastname@example.org [Department of Industrial Management, National Taiwan University of Science and Technology, Taipei, Taiwan (China)
The economic evaluation of medical products and services is increasingly prioritised by healthcare decision makers and plays a key role in informing funding allocation decisions. It is well known that there are a number of methodological difficulties in the health technology assessment of medical devices, particularly in the provision of efficacy evidence. By contrasting devices with pharmaceuticals, the way in which the differing systems of innovation mould the UK's industry landscape is described and substantiated with market statistics. In recognition of the challenges faced by industry, as well as the growing need for cost-effective allocation of National Health Service (NHS) resources, the National Institute for Health and Care Excellence (NICE) led the development of the Medical Technologies Evaluation Programme (MTEP), which launched in 2009/2010. The review of the UK's medical devices market supports the programme's three principal aims: to simplify access to evaluation, speed up the process, and increase evaluative capacity for devices within NICE. However, an analysis of the output of MTEP's first 3 years suggests that it has some way to go to meet each of these aims. PMID:24934924
Although a vast literature has indicated that stimulant medications are effective for reducing inappropriate behavior in children with attention deficit hyperactivity disorder (ADHD), the effects of stimulant medication on ancillary behaviors (e.g., play) have yet to be investigated with the same rigor. We used a reinforcer assessment procedure to evaluate the effects of medication on the play and social behavior of 5 preschool children who had been diagnosed with ADHD. Conditions included (a) social reinforcement (i.e., playing with friends), (b) alone play, and (c) quiet time (i.e., resting). Results indicated that 1 of the 5 participants selected fewer social reinforcers and more nonsocial reinforcers (alone play or quiet time) while on medication. The findings indicate that the reinforcer assessment procedure may be a viable way to evaluatemedication effects on an ongoing basis and to inform treatment decisions. PMID:18468289
Larue, Robert H; Northup, John; Baumeister, Alan A; Hawkins, Mike F; Seale, Lauren; Williams, Tara; Ridgway, Andrea
Purpose: Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy. Methods and Materials: An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at (www.oncolink.org)) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy. Results: Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief. Conclusions: Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.
Simone, Charles B. [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA (United States); Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD (United States)], E-mail: email@example.com; Vapiwala, Neha; Hampshire, Margaret K.; Metz, James M. [Department of Radiation Oncology, Hospital of University of Pennsylvania, Philadelphia, PA (United States)
This report presents an evaluation of the TRIPAD system at Keesler AFB. The evaluation focuses on the system objectives which were established as part of the system development process. The results were based on data collected before and after the system ...
Our aim was to validate a 16-item food intake questionnaire (16-FIQ) and create an easy to use method to estimate patients nutrient intake in primary health care. Participants (52 men, 25 women) completed a 7-day food record and a 16-FIQ. Food and nutrient intakes were calculated and compared using Spearman correlation. Further, nutrient intakes were compared using kappa-statistics and exact and opposite agreement of intake tertiles. The results indicated that the 16-FIQ reliably categorized individuals according to their nutrient intakes. Methods to estimate nutrient intake based on the answers given in 16-FIQ were created. In linear regression models nutrient intake estimates from the food records were used as the dependent variables and sum variables derived from the 16-FIQ were used as the independent variables. Valid regression models were created for the energy proportion of fat, saturated fat, and sucrose and the amount of fibre (g), vitamin C (mg), iron (mg), and vitamin D (?g) intake. The 16-FIQ is a valid method for estimating nutrient intakes in group level. In addition, the 16-FIQ could be a useful tool to facilitate identification of people in need of dietary counselling and to monitor the effect of counselling in primary health care.
This report summarizes the work done on the contract NAG9-567, which was activated at the New Jersey Medical School-UMDNJ in April 1992 and carried on during the 1992-93 year to the present 1993-94 year which was terminated in May 1994. The initial examination stage was completed of an interactive program for the recording of physical and physiologic injury information obtained from examination of an injured person, who might be an astronaut sustaining traumatic injury, due to a burn or physical trauma, either in space or in an earth bound training environment. In this report three aspects will be discussed: 1) a description of the system of diagnostic examination graphics, 2) a description of the organization of the therapeutic advisory systems with a demonstration of two specific modules, and 3) a brief technical description of the organization of the programming system carried out on a UNIX based work station using a WINDOWS environment.
Future medical ion beam applications for cancer therapy which are based on scanning technology will require advanced beam diagnostics equipment. For a precise analysis of beam parameters we want to resolve time structures in the range of microseconds to nanoseconds. A prototype of an advanced beam monitor was developed by the University of Applied Sciences Wiener Neustadt and its research subsidiary Fotec in co-operation with CERN RD42, Ohio State University and the Joef Stefan Institute in Ljubljana. The detector is based on polycrystalline Chemical Vapor Deposition (pCVD) diamond substrates and is equipped with readout electronics up to 2 GHz analog bandwidth. In this paper we present the design of the pCVD-detector system and results of tests performed in various particle accelerator based facilities. Measurements performed in clinical high energy photon beams agreed within 1.2% with results obtained by standard ionization chambers.
Sexual abuse is a form of abuse. Children often have difficulty making the story and behavioral disorders are a common mode of revelation. Aggression of less than 3days is a medical and forensic emergency. The examination should include a general physical examination and pelvic examination for traumatic injuries. Samples are oriented depending on the context, the type of attack and delay. In most cases, the examination is normal, which does not exclude the reality of sexual assault. Prescription of levonorgestrel and anti-HIV combination therapy should be discussed, as well as prevention of seroconversion to hepatitis B. The indication for hospitalization is assessed on a case-by-case basis. PMID:24612562
Comprehensive evaluation methods are generally used to assess the population data. When we need to estimate the sample data in special situations, the impacts brought by the sampling error should be considered. Due to lack of the accurate measurement for the sensitivity and stability in the comprehensive evaluation methods, sampling errors usually cannot be estimated in the sampling research. Monte Carlo simulation was used in this article to solve the probability of the ordering results, and the matlab programs were presented. Based on the simulated results, we change the conventional "absolute conclusion" of comprehensive evaluation methods to "probability results" for the sample data, and put forward a new sorting and ranking method for the results of comprehensive evaluation. PMID:24820283
Internet-based surveys are still relatively new, and researchers are just beginning to articulate best practices for questionnaire design. Online questionnaire design has generally been guided by the principles applying to other self-administered instruments, such as paper-based questionnaires. Web-based questionnaires, however, have the potential
This comprehensive guide leads the user step-by-step through questionnaire creation. Topics include preliminary considerations, writing the questionnaire items, issues that may come up when giving the questionnaire, statistical considerations, and references for further reading. This resource is intended for novice and professional evaluators.
On March 30, 1983, the National Union of Hospital and Health Care Employees requested a health hazard evaluation at the respiratory therapy section (RTS) of the Hospital of Medical College of Pennsylvania (MCP) to evaluate the possibility of an abnormal n...
Objective: Physicians typically receive little continuing medical education (CME) about their role in workplace injury management as well as on workplace injuries and disease. Although new technologies may help educate physicians in these areas, careful evaluation is required, given the understudied nature of these interventions. The objective of this study is to evaluate two promising new technologies to deliver CME
Harry Karlinsky; Celina Dunn; Bill Clifford; Jim Atkins; George Pachev; Ken Cunningham; Peter Fenrich; Yassaman Bayani
...0960-AG21 New Medical Criteria for Evaluating Language and Speech Disorders AGENCY: Social...whether to propose new rules for evaluating language and speech disorders. The new rules would apply to disability claims involving language and speech disorders in adults and...
Safety assessment of medical devices includes sterilization and biological evaluation or biocompatibility testing. Sterilization by ETO gas is critised for their carcinogenic potency or even banned. Mutual acceptance of biological evaluation test results is promoted by a laboratory accreditation and qualification program.
The purpose of this study was to evaluate the potential for online continuing medical education (CME) seminars to improve quality of care. Primary care physicians (113) participated in a randomized controlled trial to evaluate an online CME series. Physicians were randomized to view either a seminar about type 2 diabetes or a seminar about systolic heart failure. Following the seminar,
Christine M. Weston; Christopher N. Sciamanna; David B. Nash
Objectives: To investigate why sexual abuse was sus- pected and what physical findings were present among children referred for the evaluation of sexual abuse with- out a verbal disclosure or witnessed abuse, and to deter- mine if the reasons for requesting medicalevaluation var- ied by referral source. Design: Prospective descriptive study. Setting\\/Patients: Two groups of consecutive chil- dren referred
Ridge-like structures in digital images may be extracted by convolving the images with deriva- tives of Gaussians. The choice of the convolution operator and of the parameters involved defines a specific ridge image. In this paper, various ridge measures related to isophote curvature are con- structed, reviewed, and evaluated with respect to their usability in CT\\/MRI matching of human brain
J. B. Antoine Maintz; Petra A. Van Den Elsen; Max A. Viergever
Results from an alumni survey for the School of Education and Related Professional Studies of Rowan College (New Jersey) were analyzed and evaluated. The survey had been developed as a result of a previous educational practicum. Research questions were how well the School had prepared its graduates, which program goals and objectives the graduates
As part of a broader study aimed at evaluating perceived alliance with service providers and level of satisfaction with services received, 103 monolingual Spanish speaking Hispanic women were interviewed. Participants were receiving ongoing behavioral health treatment at three different community service provider sites located in the greater New
Bedregal, Luis E.; Paris, Manuel Jr.; Anez, Luis M.; Shahar, Golan; Davidson, Larry
Objective:To study the reliability and validity of using medical school faculty in the evaluation of the interviewing skills of medical\\u000a students.\\u000a \\u000a Design:All second-year University of North Carolina medical students (n=159) were observed interviewing standardized patients for\\u000a 5 minutes by one of eight experienced clinical faculty. Interview quality was assessed by a faculty checklist covering questioning\\u000a style, facilitative behaviors, and specific
Background: Because practice-based learning and improvement (PBLI) is a core competency for residents, the fundamentals of PBLI should be developed in medical school.Purpose: Evaluate the effects of a PBLI module for 1st-year students at Dartmouth Medical School in 200405.Methods: Design. Randomized two-group trial (early and late intervention). Intervention. One half of students received the standard curriculumreviewing studentpatientpreceptor reports with their
Greg Ogrinc; Alan West; M. Scottie Eliassen; Stephen Liuw; Jennifer Schiffman; Nan Cochran
Miscarriage treated surgically and medically were compared in a randomised controlled trial evaluating pain and bleeding. Surgery is associated with less pain (P < 0.03) and vaginal bleeding (duration and severity, P = 0.001) than medical treatment, fewer daily hospital attendances (2.5 compared with three, P = 0.04) but a greater drop in haemoglobin concentration (difference, 1 g\\/dl; CI95% =
Nick Johnson; Mike Priestnall; Thelma Marsay; Paul Ballard; Joan Watters
Background The internet is increasingly being used worldwide in imparting medical education and improving its delivery. It has become\\u000a an important tool for healthcare professionals training but the data on its use by medical students in developing countries\\u000a is lacking with no study on the subject from Pakistan. This study was, therefore, carried out with an aim to evaluate the\\u000a pattern
Nauman A Jadoon; Muhammad F Zahid; Hafiz Mansoorulhaq; Sami Ullah; Bilal A Jadoon; Ali Raza; Mansoor Hussain; Rehan Yaqoob; Mohammad A Shahzad
The pre-travel medicalevaluation of elderly patients and patients with chronic illness requires special assessment and advice. Screening and special precautions are reviewed for traveling patients with respiratory disease, cardiac disease, sinusitis, diabetes mellitus, HIV infection, and other chronic medical conditions. Current guidelines for empiric therapy and prophylaxis of travelers' diarrhea are reviewed, with emphasis on concerns in geriatric or chronically ill travelers. Special considerations such as potential drug-drug interactions and insurance coverage are also discussed.
Background Professionalism is a difficult construct to define in medical students but aspects of this concept may be important in predicting\\u000a the risk of postgraduate misconduct. For this reason attempts are being made to evaluatemedical students' professionalism.\\u000a This study investigated the psychometric properties of Selected Response Questions (SRQs) relating to the theme of professional\\u000a conduct and ethics comparing them with
Histology stands as a major discipline in the life science curricula, and the practice of teaching it is based on theoretical didactic strategies along with practical training. Traditionally, students achieve practical competence in this subject by learning optical microscopy. Today, students can use newer information and communication technologies in the study of digital microscopic images. A virtual microscopy program was recently introduced at Ghent University. Since little empirical evidence is available concerning the impact of virtual microscopy (VM) versus optical microscopy (OM) on the acquisition of histology knowledge, this study was set up in the Faculty of Medicine and Health Sciences. A pretest-post test and cross-over design was adopted. In the first phase, the experiment yielded two groups in a total population of 199 students, Group 1 performing the practical sessions with OM versus Group 2 performing the same sessions with VM. In the second phase, the research subjects switched conditions. The prior knowledge level of all research subjects was assessed with a pretest. Knowledge acquisition was measured with a post test after each phase (T1 and T2). Analysis of covariance was carried out to study the differential gain in knowledge at T1 and T2, considering the possible differences in prior knowledge at the start of the study. The results pointed to non-significant differences at T1 and at T2. This supports the assumption that the acquisition of the histology knowledge is independent of the microscopy representation mode (VM versus OM) of the learning material. The conclusion that VM is equivalent to OM offers new directions in view of ongoing innovations in medical education technology. PMID:23463716
Extravasations are common manifestations of iatrogenic injury that occur in patients requiring intravenous delivery of known vesicants. These injuries can contribute substantially to patient morbidity, cost of therapy, and length of stay. Many different mechanisms are behind the tissue damage during extravasation injuries. In general, extravasations consist of four different subtypes of tissue injury: vasoconstriction, osmotic, pH related, and cytotoxic. Recognition of high-risk patients, appropriate cannulation technique, and monitoring of higher risk materials remain the standard of care for the prevention of extravasation injury. Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Topical vasodilators and intradermal terbutaline may provide relief. Intradermal hyaluronidase has been effective for hyperosmotic extravasations, although its use largely depends on the risk of tissue injury and the severity of extravasation. Among the hyperosmotic agents, calcium extravasation is distinctive because it may present as an acute tissue injury or may possess delayed clinical manifestations. Extravasation of acidic or basic materials can produce significant tissue damage. Phenytoin is the prototypical basic drug that causes a clinical manifestation known as purple glove syndrome (PGS). This syndrome is largely managed through preventive and conservative treatment measures. Promethazine is acidic and can cause a devastating extravasation, particularly if administered inadvertently through the arteriolar route. Systemic heparin therapy remains the accepted treatment option for intraarteriolar administration of promethazine. Overall, the evidence for managing extravasations due to noncytotoxic medications is nonexistent or limited to case reports. More research is needed to improve knowledge of patient risk, prompt recognition of the extravasation, and time course for tissue injury, and to develop prevention and treatment strategies for extravasation injuries. PMID:24420913
Reynolds, Paul M; MacLaren, Robert; Mueller, Scott W; Fish, Douglas N; Kiser, Tyree H
Objectives To (1) evaluate educational needs of clinical students at Al-Quds University Medical School in the West Bank; (2) address these needs where possible using synchronous distance learning, with clinicians in Oxford providing case-based tutorials to undergraduates in the West Bank via an online platform (WizIQ) and (3) assess the impact of this education. Design Review of online OxPal Medlink database for tutorials held between March 2012 and April 2013. Needs assessment and evaluation of student and tutor experiences through online questionnaires, focus groups and semi-structured interviews. Setting Oxford University Hospitals, Oxford, UK, and Al-Quds University Medical School, Abu Dies, Palestine. Participants Doctors at Oxford University Hospitals and fourth-, fifth- and sixth-year medical students and faculty members at Al-Quds Medical School. Main outcome measures Number of tutorials, student participation, student-rated satisfaction and qualitative feedback from tutors and students. Results Students demonstrated strong theoretical knowledge but struggled to apply this in presentation-based scenarios. Between March 2012 and April 2013, 90 tutorials were delivered to 60 students. Feedback: >95% respondents rated tutorials as Excellent or Good and Very or Fairly relevant to their future practice in Palestine. Students reported the programme had modified their approach to patients but requested better synchronization with concurrent attachments and clarification of learning outcomes. Conclusions OxPal Medlink is a novel, web-based distance-learning partnership designed to overcome some of the challenges to local medical education in the occupied Palestinian territories. Evaluation of the first year indicates teaching is relevant to local practice and of high quality. This approach may have the potential to strengthen local capacity for medical education.
Ali, Mohammad A; Ali, Adam M; Patel, Ishita; MacGregor, Thomas; Shankar, Sushma; Cahill, Thomas J; Finlayson, Alexander ET; Mahmud, Imran
Ankylosing spondylitis quality of life (ASQoL) is an instrument for assessing quality of life (QoL). The aims of this study were to assess the reliability of Persian version of ASQoL questionnaire and evaluation of QoL status and related factors in ankylosing spondylitis (AS). One hundred and sixty-three Iranian patients with AS who fulfilled modified New York criteria were enrolled. Patients were evaluated using questionnaires including demographic and clinical variables, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), fatigue, Bath AS Metrology Index, pain and ASQoL. Reliability and validity of Persian version of ASQoL were evaluated by test-re-test agreement, internal consistency and correlation with specific scales. Relationship of parameters with ASQoL was analyzed by multiple regression. Age, disease duration and ASQoL score (mean ± SD) were 37.74 ± 9.88, 14.49 ± 8.47 and 8.02 ± 5.28 years, respectively. Test-re-test reproducibility for ASQoL was good as assessed by intra-class correlation coefficient (ICC: 0.97, P < 0.001). Internal consistency was high (Cronbach's alpha: 0.91). Convergent validity was confirmed by correlation of ASQoL score with specific scales (BASFI, r = 0.74, BASDAI, r = 0.6, fatigue, r = 0.56, depression, r = 0.24, intermalleolar distance, r = -0.44 and educational level, r = -0.37). Persian version of ASQoL is a valid and reliable scale to assess QoL in AS. Function, fatigue, mood, hip mobility and education are the factors which should be noted to achieve the best QoL. PMID:24170319
Background Physical activity promotes health and longevity. Further elaboration of the role of physical activity for human health in epidemiological studies on large samples requires accurate methods that are easy to use, cheap, and possible to repeat. The use of telecommunication technologies such as cell phones is highly interesting in this respect. In an earlier report, we showed that physical activity level (PAL) assessed using a cell phone procedure agreed well with corresponding estimates obtained using the doubly labeled water method. However, our earlier study indicated high within-subject variation in relation to between-subject variations in PAL using cell phones, but we could not assess if this was a true variation of PAL or an artifact of the cell phone technique. Objective Our objective was to compare within- and between-subject variations in PAL by means of cell phones with corresponding estimates using an accelerometer. In addition, we compared the agreement of daily PAL values obtained using the cell phone questionnaire with corresponding data obtained using an accelerometer. Methods PAL was measured both with the cell phone questionnaire and with a triaxial accelerometer daily during a 2-week study period in 21 healthy Swedish women (20 to 45 years of age and BMI from 17.7 kg/m2 to 33.6 kg/m2). The results were evaluated by fitting linear mixed effect models and descriptive statistics and graphs. Results With the accelerometer, 57% (95% confidence interval [CI] 40%-66%) of the variation was within subjects, while with the cell phone, within-subject variation was 76% (95% CI 59%-83%). The day-to-day variations in PAL observed using the cell phone questions agreed well with the corresponding accelerometer results. Conclusions Both the cell phone questionnaire and the accelerometer showed high within-subject variations. Furthermore, day-to-day variations in PAL within subjects assessed using the cell phone agreed well with corresponding accelerometer values. Consequently, our cell phone questionnaire is a promising tool for assessing levels of physical activity. The tool may be useful for large-scale prospective studies.
Background To assess validation and reliability of the Persian version of the short-form 8-item Parkinsons disease questionnaire (PDQ-8) and to compare its psychometric properties with that of the long-form questionnaire (PDQ-39) in order to evaluate the health-related quality of life (HRQoL) in patients with Parkinsons disease (PD). Methods This cross-sectional study was conducted on 114 non-demented idiopathic PD (IPD) patients consecutively recruited from an outpatient referral movement disorder clinic. Patients were interviewed to fill in the Persian version of PDQ-39 and PDQ-8 questionnaires and clinical examination was performed to measure disease severity indices. Results The Cronbachs alpha coefficient of the entire PDQ-8 was 0.740 (95% CI: 0.661-0.806). Replacement of PDQ-8 items with other questions with the highest internal consistency within each dimension of the original PDQ-39 did not improve Cronbachs alpha coefficient [0.723 (95% CI: 0.639-0.794)]. The scores from both PDQ-8 and PDQ-39 had significant correlation with the Hoehn & Yahr (rPDQ-8?=?0.376, rPDQ-39?=?0.442), and Schwab & England (rPDQ-8?=?-0.503, rPDQ-39?=?-0.598) disease severity scales and disease duration (rPDQ-8?=?0.342, rPDQ-39?=?0.396). Conclusions Persian version of the short-form PDQ (PDQ-8) was shown to be a valid and reliable instrument to assess disease-specific HRQoL in a PD population when used independently. Although the PDQ-8 items were not necessarily those with the highest internal consistency in the components of PDQ-39, they entirely showed proper psychometric properties especially in mental and behavioral aspects. PDQ-8 is a practical and informative instrument in daily clinical practice where clinicians are in shortage of time and when a validated self-reported brief questionnaire is of value.
The Medical Information System (MIS) at the Los Alamos Scientific Laboratory automates the acquisition, storage, and retrieval of medical information concerning the nine thousand project-connected personnel. The MIS incorporates an on-line, interactive medical history questionnaire, mark sense form processing, and automated coronary risk assesment in the medicalevaluation process. Also, MIS has created the ability for long-term study and comparison of employee health as well as made the physician's time more effective.
Evaluation of research activity is extremely important but remains a complex domain. There's no standardized methods and evaluation is often based on the scientific publications. It is easy to identify, for a researcher, all the publications realized over a given period of time. At the level of an important establishment like an University Hospital, with about 500 researchers, this sort of inventory is very difficult to realize: we have to list the researchers, to list their publications, to determine the quality of articles produced, to store retrieved data and to calculate summary statistics. We have developed a full-Web prototype, using free software which, for a given researchers' list, interrogates the Pubmed server, downloads the found references and stores them in a local database. They are then enriched with local data which allow the realization of more or less complex analyses, the automatic production of reports, or keyword search. This tool is very easy to use, allowing for immediate analysis of publications of a researcher or a research team. This tool will allow to identify those active teams to be maintained or emergent teams to be supported. It will also allow to compare candidate profiles for appointments to research posts. PMID:14664073
The objective of this paper is to present results and recommendations from the Austrian e-Medikation pilot project. e-Medikation comprises a national medication list of all prescribed and dispensed medications as well as central medication checks. Evaluation was based on log-file analysis and survey of all participants (physicians, pharmacists, patients). During the evaluation period, 97 physicians, 58 pharmacies and more than 5.000 patients, participated. All user groups found that e-Medikation has the potential to improve patient safety, but that software quality and system architecture is not yet suitable for routine use. The evaluation resulted in 34 recommendations for further development and roll out of e-Medikation in Austria. Most of these recommendations have already been included in the recently passed law concerning the upcoming Austrian electronic health record system called "ELGA". PMID:23920574
In the present study, we evaluated the antiemetic effect of aprepitant in combination with 5-hydroxytryptophan(5-HT3) receptor antagonist and dexamethasone for chemotherapy-induced emesis and nausea in lung cancer patients treated with carboplatin-based systemic chemotherapy using the Functional Living Index-Emesis, an emesis- and nausea-specific quality of life(QOL)questionnaire. Patients experiencing emesis and/or nausea during and/or after previous courses of carboplatin-based chemotherapy received aprepitant in the following treatment cycle with the same anti-cancer agent. Emesis- and nausea-specific QOL aspects were significantly improved with the addition of aprepitant to the existing regimen containing dexamethasone and 5-HT3 receptor antagonist. Our result suggests that combined antiemetic treatment with aprepitant, dexamethasone, and 5-HT3 receptor antagonist is more effective in lung cancer patients receiving carboplatin-based systemic chemotherapy than dexamethasone and 5-HT3 receptor antagonist alone. PMID:24743279
Background The h-index is a commonly used metric for evaluating the publication performance of researchers. However, in a multidisciplinary field such as medical informatics, interpreting the h-index is a challenge because researchers tend to have diverse home disciplines, ranging from clinical areas to computer science, basic science, and the social sciences, each with different publication performance profiles. Objective To construct a reference standard for interpreting the h-index of medical informatics researchers based on the performance of their peers. Methods Using a sample of authors with articles published over the 5-year period 20062011 in the 2 top journals in medical informatics (as determined by impact factor), we computed their h-index using the Scopus database. Percentiles were computed to create a 6-level benchmark, similar in scheme to one used by the US National Science Foundation, and a 10-level benchmark. Results The 2 benchmarks can be used to place medical informatics researchers in an ordered category based on the performance of their peers. A validation exercise mapped the benchmark levels to the ranks of medical informatics academic faculty in the United States. The 10-level benchmark tracked academic rank better (with no ties) and is therefore more suitable for practical use. Conclusions Our 10-level benchmark provides an objective basis to evaluate and compare the publication performance of medical informatics researchers with that of their peers using the h-index.
In this issue, Brenner and colleagues report a correlation between the frequency of negative comments in the "dean's letter" and future problems during a psychiatry residency program. Their study makes an important contribution to the body of literature on factors that predict professionalism-related performance issues during residency and suggests the importance of dependable data that can be used to predict and hopefully intervene early in the training of future physicians across all specialties. As we think about the implications of this study, important issues involving the standardization of medical student performance evaluations (MSPEs) and the assessment of professionalism are raised. Despite the Association of American Medical Colleges' 2002 guidelines for MSPEs, subsequent studies have revealed that considerable inconsistencies among the evaluations still remain. To enhance the accuracy and usefulness of the MSPEs in predicting "problem residents," improved standardization is necessary. Moreover, Brenner's findings call for the development of more vigorous assessment of professionalism in undergraduate medical education, as well as more accurate reporting of these assessments to residency programs. Longitudinal assessment of professionalism with robust tools allows for the identification and possible remediation of students early in their undergraduate training. Insofar as unprofessional behavior in medical school is predictive not only of problems during residency but also of later disciplinary action against the practicing physician by state medical boards, it is the obligation of the medical school to the residency program and to society to identify and report these behaviors. PMID:20592502
During the survey, respondents are asked to provide qualitative answers (well, adequate, needs improvement) on how well material control and accountability (MC&A) functions are being performed. These responses can be used to develop failure probabilities for basic events performed during routine operation of the MC&A systems. The failure frequencies for individual events may be used to estimate total system effectiveness using a fault tree in a probabilistic risk analysis (PRA). Numeric risk values are required for the PRA fault tree calculations that are performed to evaluate system effectiveness. So, the performance ratings in the questionnaire must be converted to relative risk values for all of the basic MC&A tasks performed in the facility. If a specific material protection, control, and accountability (MPC&A) task is being performed at the 'perfect' level, the task is considered to have a near zero risk of failure. If the task is performed at a less than perfect level, the deficiency in performance represents some risk of failure for the event. As the degree of deficiency in performance increases, the risk of failure increases. If a task that should be performed is not being performed, that task is in a state of failure. The failure probabilities of all basic events contribute to the total system risk. Conversion of questionnaire MPC&A system performance data to numeric values is a separate function from the process of completing the questionnaire. When specific questions in the questionnaire are answered, the focus is on correctly assessing and reporting, in an adjectival manner, the actual performance of the related MC&A function. Prior to conversion, consideration should not be given to the numeric value that will be assigned during the conversion process. In the conversion process, adjectival responses to questions on system performance are quantified based on a log normal scale typically used in human error analysis (see A.D. Swain and H.E. Guttmann, 'Handbook of Human Reliability Analysis with Emphasis on Nuclear Power Plant Applications,' NUREG/CR-1278). This conversion produces the basic event risk of failure values required for the fault tree calculations. The fault tree is a deductive logic structure that corresponds to the operational nuclear MC&A system at a nuclear facility. The conventional Delphi process is a time-honored approach commonly used in the risk assessment field to extract numerical values for the failure rates of actions or activities when statistically significant data is absent.
Powell, Danny H [ORNL] [ORNL; Elwood Jr, Robert H [ORNL] [ORNL
Introduction: Education is basically one of the Universities and faculties leading missions and duties; its promoted quality will also lead to an elevated educational quality in the University. Teacher assessment can be mentioned as essential for the success of the quality promotion process. This article deals with the designing and evaluation of a teaching quality evaluation form for teachers, from the Lorestan University of Medical Science students point of view. Methods: A two-stage, cross-sectional study was conducted on 290 Lorestan University of Medical Science students. First, evaluation priorities were extracted using the Delphi technique in the fifth section, including teaching skills, communication skills, principles of training, and skills assessment. In the second stage, as the priority and importance of each item was evaluated in the fourth Lickert option, sampling was done in few stages. The study instrument was a questionnaire, which included six areas. The first part of the questionnaire was made up of the demographic characteristics and the second part included five evaluation areas that were obtained from the student. The collected data were analyzed using statistical software SPSS-16 and chi-square test, Kruskal-Wallis test. Results: In the areas of teaching skills, mastery of the course, individual characteristics, self-confidence, communication skills, intimate relationship with students, educational principles, rules respecting the beginning and end time of class, skill assessment, and an accurate comprehensive examination at the end of the semester by the students, were chosen as the most important factors. There were significant differences in the majority of expressed comments between the genders and academic status (P < 0.05). Conclusion: Students can properly diagnose the essential factors in teachers evaluation, but in item prioritizing they may be partly affected by some factors such as gender, academic status, semester, and academic course.
Nasal polyposis (NP) has a great impact on quality of life (QOL) and its management involves a combination of medical therapy and surgery. To the authors' knowledge, no publication has extensively examined NP after optimal medical treatment based on subjective evaluations. The aim of this prospective study was designed to evaluate the QOL in NP patients after (1) a short course of oral steroids, (2) initial 3-month course of macrolide, and (3) long-term treatment with intranasal steroids. A total of 55 patients with grades I and II NP were consecutively treated with oral prednisolone at 25 mg in a single dose for 2 weeks, macrolide at 250 mg daily for the first 3 months, and long-term intranasal steroids. Patients were followed up and evaluated at baseline and 3, 6, and 12 months for QOL measure. At baseline, patients with grade I and grade II NP showed significantly worse QOL scores on all Rhinosinusitis Disability Index domains, particularly for physical function (4.59 ± 1.41) and were significantly higher in social function (3.16 ± 1.17). At 3, 6, and 12 months of treatment, patients showed a significant improvement in all impaired QOL domains compared with baseline after optimal medical therapy (p < 0.05). These results suggest that the optimal medical treatment to improve QOL incorporates medical polypectomy with a short course of oral steroids in addition to macrolide and this can be maintained by long-term intranasal steroid therapy.
A significant number of asylum seekers who largely survived torture live in the United States. Asylum seekers have complex social and medical problems with significant barriers to health care access. When evaluating and providing care for survivors, health providers face important challenges regarding medical ethics and professional codes. We review ethical concerns in regard to accountability, the patient-physician relationship, and moral responsibilities to offer health care irrespective of patient legal status; competing professional responsibility toward society and the judiciary system; concerns about the consistency of asylum seekers' claims; ethical concerns surrounding involving trainees and researching within the evaluation setting; and the implication of broader societal views towards rights and social justice. We discuss contributing factors, including inadequate and insufficient provider training, varying and inadequate institutional commitment, asylum seekers' significant medical and social problems, and the broader health and social system issues. We review existing resources to address these concerns and offer suggestions. PMID:23767428
The questionnaire is the instrument used for recording performance data on the nuclear material protection, control, and accountability (MPC&A) system at a nuclear facility. The performance information provides a basis for evaluating the effectiveness of the MPC&A system. The goal for the questionnaire is to provide an accurate representation of the performance of the MPC&A system as it currently exists in the facility. Performance grades for all basic MPC&A functions should realistically reflect the actual level of performance at the time the survey is conducted. The questionnaire was developed after testing and benchmarking the material control and accountability (MC&A) system effectiveness tool (MSET) in the United States. The benchmarking exercise at the Idaho National Laboratory (INL) proved extremely valuable for improving the content and quality of the early versions of the questionnaire. Members of the INL benchmark team identified many areas of the questionnaire where questions should be clarified and areas where additional questions should be incorporated. The questionnaire addresses all elements of the MC&A system. Specific parts pertain to the foundation for the facility's overall MPC&A system, and other parts pertain to the specific functions of the operational MPC&A system. The questionnaire includes performance metrics for each of the basic functions or tasks performed in the operational MPC&A system. All of those basic functions or tasks are represented as basic events in the MPC&A fault tree. Performance metrics are to be used during completion of the questionnaire to report what is actually being done in relation to what should be done in the performance of MPC&A functions.
Powell, Danny H [ORNL] [ORNL; Elwood Jr, Robert H [ORNL] [ORNL
Context: People capacity maturity model (PCMM) is one of the models which focus on improving organizational human capabilities. Aims: The aim of this model's application is to increase people ability to attract, develop, motivate, organize and retain the talents needed to organizational continuous improvement. Settings and Design: In this study, we used the PCMM for investigation of organizational maturity level in medical record departments of governmental hospitals and determination strengths and weaknesses of their staff capabilities. Materials and Methods: This is an applied research and cross sectional study in which data were collected by questionnaires to investigation of PCMM model needs in medical record staff of governmental hospitals at Isfahan, Iran. We used the questionnaire which has been extracted from PCMM model and approved its reliability with Cronbach's Alpha 0.96. Statistical Analysis Used: Data collected by the questionnaire was analyzed based on the research objectives using SPSS software and in accordance with research questions descriptive statistics were used. Results: Our findings showed that the mean score of medical record practitioners, skill and capability in governmental hospitals was 35 (62.5%) from maximum 56 (100%). There is no significant relevance between organizational maturity and medical record practitioners, attributes. Conclusions: Applying PCMM model is caused increasing staff and manager attention in identifying the weaknesses in the current activities and practices, so it will result in improvement and developing processes.
Yarmohammadian, Mohammad H.; Tavakoli, Nahid; Shams, Assadollah; Hatampour, Farzaneh
A survey of American medical school preventive medicine curricula found more emphasis on teaching and evaluation of students in areas of clinical preventive services and quantitative methods and less emphasis on community services and health services organization and delivery. Written tests and unstructured observation were the most common methods
Garr, David R.; Lackland, Daniel T.; Wilson, Diane B.
Vagus nerve stimulation (VNS) constitutes an adjunctive, modern management of medically intractable seizures, especially when surgery is inadvisable. Objective: To evaluate the long-term results as regards efficacy, safety and tolerability of VNS in epileptic subjects, with focal and\\/or generalised seizures, refractory to old and new AEDs, without indication for resective surgery. Patients: 51 epileptic subjects (30 males, 21 females), aged
Paolo Tanganelli; Sergio Ferrero; Patrizio Colotto; Giovanni Regesta
An analysis of the evaluation instruments of clinical clerkships from 54 medical schools was made. Instruments were classified as to purpose, format, and skills measured. Thirty-nine schools used a modified Likert format; a few schools also had a check list of adjectives or short answer questions. Nearly all instruments had some space for general
History-taking and physical examination techniques specific to clinical evaluation of the pediatric patient can be taught to medical students through a combination of audiovisual materials and limited bedside teaching. This combination of instruction was found to be as effective as and more efficient than a preceptor-type model. (Author/MLW)
A study examined the extent to which current medical-student evaluation assesses noncognitive clinical skills and behaviors needed by graduates, including small-group conferences, case-based discussion, library research, lifelong learning, reasoned thinking, interpersonal skills, and logical/sequenced history taking and physical examinations.
Image segmentation is the partition of an image into a set of nonoverlapping regions whose union is the entire image. The image is decomposed into meaningful parts which are uniform with respect to certain characteristics, such as gray level or texture. In this paper, we propose a methodology for evaluatingmedical image segmentation algorithms wherein the only information available is
Brown Medical School developed a comprehensive curriculum in which enriched aging content increased from 22 to 80 hours in preclerkship courses and was also added for clerkships, residencies, and nongeriatrician physicians. Innovative evaluation strategies are also described. Highlights include "treasure hunts" in the anatomy laboratory, a
Besdine, Richard W.; Shield, Renee R.; McNicoll, Lynn; Campbell, Susan E.; Wetle, Terrie
The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment (SBIRT) methods for alcohol and substance use problems. This paper describes the training program and provides initial evaluation after the
Bray, James H.; Kowalchuk, Alicia; Waters, Vicki; Laufman, Larry; Shilling, Elizabeth H.
A study to determine the feasibility of creating and administering computer-based problem-solving examinations for evaluating second-year medical students in immunology and to determine how students would perform on these tests relative to their performances on concurrently administered objective and essay examinations is described. (Author/MLW)
:Objective. To evaluate the implementation of a health literacy intervention to improve medication adherence among patients in an inner-city health system. Methods. Interviews with pharmacists and focus groups with pharmacy patients were conducted one month and six months after beginning the intervention. Patients and pharmacists described their experiences with the intervention, consisting of an automated telephone call reminder system, an
Sarah C. Blake; Karen McMorris; Kara L. Jacobson; Julie A. Gazmararian; Sunil Kripalani
Objective. To evaluate the implementation of a health literacy intervention to improve medication adherence among patients in an inner-city health system. Methods. Interviews with pharmacists and focus groups with pharmacy patients were conducted one month and six months after beginning the intervention. Patients and pharmacists described their experiences with the intervention, consisting of an automated telephone call reminder system, an
MA Karen McMorris Kara L. Sarah C. Blake; MSc Sunil Kripalani
A medical school at a Southeastern university implemented a tobacco free policy to promote a healthy environment for its employees, patients, and visitors. Eighteen months post policy implementation, undergraduate students in the Department of Health Education and Promotion evaluated the satisfaction, awareness, and perceived
Decker, Jesse; Ronay, Ashley; Telfer, Megan; Becker, Craig M.; Cremeens, Jennifer; Swinker, Marian
Cognitive deficits have been associated with several chronic medical conditions, but the additive effects of multiple conditions on cognition have less studied. Six hundred ninety-two community dwelling older adults were enrolled through their primary care physicians and evaluated for medical burden and cognition. Medical burden was assessed by self-report questionnaire. Cognition was assessed with the Repeatable Battery for the Assessment
Kevin Duff; James W. Mold; Michelle M. Roberts; Sherry L. McKay
Background Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact. As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE. Methods A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students). Results The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4?±?6.3 vs. 43.4?±?8.9; p?0.01). The only independent variables that were significantly predictive of the score in a linear regression analysis were gender and the condition of medical or osteopathic student. The EFS mean score also showed a significant difference between the osteopathic and medical students (30.76?±?2.9 vs. 27.85?±?4.3; p?0.01). Factor analysis of the new questionnaire identified three factors (appropriateness and usefulness, sexual implications and passive role) accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearsons r coefficient?=?0.61). Reliability was expressed in terms of Cronbachs alpha coefficient, which equals 0.86. Conclusions These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional understanding and future interprofessional education.
In 1998, the American Physiological Society (APS) and the Association of Chairs of Departments of Physiology (ACDP) began collaboration on a project to develop a set of physiology learning objectives for medical students. Over the next 2 years, more than 50 physiologists collaborated in the development a comprehensive draft containing its 695 learning objectives. Faculty in 31 medical schools in the United States, Canada, and Puerto Rico evaluated these objectives. On the basis of this evaluation, the ACDP recommended deleting 13 of them. The final project, containing 682 objectives, was approved in December 2000 by the ACDP and published on the APS website http://www.the-aps.org/education/MedPhysObj/medcor.htm. The identification of the "content" of medical physiology instruction provides the APS and the ACDP with a tool to introduce emerging topics, such as the physiology of aging and gender differences, at a national level. The medical physiology learning objectives project provides a guide for directing current and future medical physiology instruction in the United States.
PhD Robert G. Carroll (East Carolina State University Department of Physiology)
Background The SEGUE (Set the stage, Elicit information, Give information, Understand the patient's perspective, and End the encounter) Framework is a checklist-style rating scale to facilitate the teaching and assessment of communication skills in medical learners. It has been used for over 15 years, and it is recommended in the Accreditation Council for Graduate Medical Education toolbox of assessment methods for resident training. When it was developed, its ability to provide objective scoring was a substantial improvement over global ratings. Methods In this article we describe the strengths and weaknesses of the SEGUE Framework. We highlight one residency program's experience with using the SEGUE Framework to evaluate residents' communication skills. Specifically, we cite previous studies and describe our own analysis of resident interviewing performance that demonstrates how the SEGUE Framework did not distinguish between different levels of interviewing skill level in our sample. Results Two case examples illustrate how the SEGUE Framework is not an ideal instrument to measure either the quality or the process of medical interviews. Conclusion Therefore, we propose a new method of contextualized assessment that builds on the SEGUE Framework. Our system evaluates discrete interviewing behaviors within the context of an ambulatory medical interview. We describe our interview structure, as well as a new instrument (the Wy-Mii, pronounced why me), to assess both communication and interpersonal skills. We expect that our new method of contextualized assessment will better differentiate between beginning and advanced levels of medical interviewing skills for residents.
Skillings, Jared Lyon; Porcerelli, John H.; Markova, Tsveti
New display technologies enable the usage of 3D-visualization in a medical context. Even though user performance seems to be enhanced with respect to 2D thanks to the addition of recreated depth cues, human factors, and more particularly visual comfort and visual fatigue can still be a bridle to the widespread use of these systems. This study aimed at evaluating and comparing two different 3D visualization systems (a market stereoscopic display, and a state-of-the-art multi-view display) in terms of quality of experience (QoE), in the context of interactive medical visualization. An adapted methodology was designed in order to subjectively evaluate the experience of users. 14 medical doctors and 15 medical students took part in the experiment. After solving different tasks using the 3D reconstruction of a phantom object, they were asked to judge their quality of the experience, according to specific features. They were also asked to give their opinion about the influence of 3D-systems on their work conditions. Results suggest that medical doctors are opened to 3D-visualization techniques and are confident concerning their beneficial influence on their work. However, visual comfort and visual fatigue are still an issue of 3D-displays. Results obtained with the multi-view display suggest that the use of continuous horizontal parallax might be the future response to these current limitations.
This study was carried out to evaluate home-generated medical waste in Mauritius. A questionnaire survey was undertaken among a random sample population in 250 houses in the nine districts of the island. Results of this study showed an overwhelmingly large proportion of medical waste arising from the domestic environment joins the common municipal solid waste stream and ends in landfills.
Background With increased governmental interest in value assessment of technologies and where medical device manufacturers are finding it increasingly necessary to become more familiar with economic evaluation methods, the study sought to explore the levels of health economics knowledge within small and medium-sized enterprises (SMEs) and to scope strategies they employ to demonstrate the value of their products to purchasers. Methods A short questionnaire was completed by participants attending one of five workshops on product development in the medical device sector that took place in England between 2007 and 2011. From all responses obtained, a large proportion of participants were based in SMEs (N?=?43), and these responses were used for the analysis. Statistical analysis using non-parametric tests was performed on questions with approximately interval scales. Qualitative data from participant responses were analysed to reveal emerging themes. Results The questionnaire results revealed that 60% of SME participants (mostly company directors or managers, including product or project managers) rated themselves as having low or no knowledge of health economics prior to the workshops but the rest professed at least medium knowledge. Clinical trials and cost analyses or cost-effectiveness studies were the most highly cited means by which SMEs aim to demonstrate value of products to purchasers. Purchasers were perceived to place most importance on factors of safety, expert opinion, cost-effectiveness and price. However many companies did not utilise formal decision-making tools to prioritise these factors. There was no significant dependence of the use of decision-making tools in general with respect to professed knowledge of health economics methods. SMEs did not state a preference for any particular aspect of potential value when deciding whether to develop a product. A majority of SMEs stated they would use a health economics tool. Research and development teams or marketing and sales departments would most likely use one. Conclusion This study points to the need for further research into the education requirements of SMEs in the area of Health Technology Assessment (HTA) and also for investigation into how SMEs engage with existing HTA processes as required by assessors such as NICE.
Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS Crewmembers to more speedily and accurately respond to medical situations on the ISS.
Four studies evaluate the new Self Description Questionnaire II short-form (SDQII-S) that measures 11 dimensions of adolescent self-concept based on responses to 51 of the original 102 SDQII items and demonstrate new statistical strategies to operationalize guidelines for short-form evaluation proposed by G. T. Smith, D. M. McCarthy, and K. G. Anderson (2000). Multiple-group confirmatory factor analyses revealed that the factor structure based on responses to 51 items by a new cross-validation group (n=9,134) was invariant with the factor structures based on responses to the same 51 items and to all 102 items by the original normative archive group (n = 9,187). Reliabilities for the 11 SDQII-S factors were nearly the same and consistently high (.80 to .89) for both groups. Multitrait-multimethod analyses support the internal validity of responses over time. Gender and age effects on the 11 SDQII-S factors were invariant across the archive and cross-validation groups. PMID:15769230
Marsh, Herbert W; Ellis, Louise A; Parada, Roberto H; Richards, Garry; Heubeck, Bernd G
Introduction Effective behavior change counseling is an important component of the optimal care of patients, yet only a minority of medical\\u000a schools currently include such training in their curriculum.\\u000a \\u000a \\u000a \\u000a Aim To design and evaluate a formal curriculum to teach medical students the principles of motivational interviewing (MI) that\\u000a will improve knowledge, skills, and confidence in the area of counseling patients for health
Canada has a noteworthy reputation for high quality health care. Nonetheless, street youth are one of our most vulnerable yet underserved populations. Consequently, a medical and dental clinic was created in downtown Ottawa, Ontario to respond to their needs. The purpose of this study is to describe a process evaluation of the clinic during its first year of operation with a focus on program fidelity, dose, reach, and satisfaction. A mixed methods approach was used involving interviews with providers, focus groups with street youth, analysis of Electronic Medical Record (EMR) data, and supplemental information such as document reviews. The evaluation identified areas that were working well along with challenges to program implementation. Areas of concerns and possible solutions were presented to the management team that then helped to plan and make improvements to the clinic. Our evaluation design and working relationship with clinic management promoted the integration of real-time evidence into program improvements. PMID:23692920
Veterinary cordon fences are used in Southern Africa to separate wildlife from domestic animals in order to prevent transmission of infectious diseases. Such fences are a control method recognized by the World Organization for Animal Health (OIE) for establishing disease-free zones in beef exporting countries. However, few studies have evaluated the ecological impact of these physical barriers or their effectiveness at a multispecies level. We examined the permeability of one such barrier, along 357 km of the western and southern boundary of the Kruger National Park (KNP) during 2007. Information was gathered using a semi-structured questionnaire implemented among 32 teams of fence maintenance workers. Data were analyzed to identify (a) the main causes of fence damage, (b) the seasonality, location and duration of fence repairs, (c) high permeability areas for elephant (Loxodonta africana), kudu (Tragelaphus strepsiceros), impala (Aepyceros melampus), buffalo (Syncerus caffer) and warthog (Phacochoerus africanus), and (d) the influence of fence electrification, rivers and elephant damage on the frequency of observation of wildlife species outside the KNP estimated during the year. Human and elephant damage were the most common reasons for fence repairs. Elephant and buffalo were the most and least common large mammal species reported observed outside the KNP (1076 and 162 reports/year), respectively. Cattle incursions into the KNP were also reported in 44% of the fence sections. Electrification of the fence was an important factor explaining differences in estimated wildlife species observations outside the KNP during the year. Correlations between estimations of observed species suggested that fence gaps created by elephants might be used by the other wildlife species. Estimated annual counts of kudu, impala and buffalo, but not warthog, were found to correlate with elephant observations. Negative binomial regression models were developed to explore the relationships between observed estimations of different wildlife species outside the KNP the fence, electrification of fence sections and the presence of watercourses, suggesting that kudu, impala and buffalo could use elephant induced fence damage to leave the KNP. The questionnaire was able to evaluate fence integrity and identify sections where integrity was sub-optimal for separating wildlife from domestic livestock species. If combined with more quantitative methods and applied on a routine basis, it could provide an efficient and cost-effective method for monitoring the effectiveness of physical barriers to contain wildlife within protected areas such as is the case with veterinary cordon fences in Southern Africa. PMID:21536336
Jori, F; Brahmbhatt, D; Fosgate, G T; Thompson, P N; Budke, C; Ward, M P; Ferguson, K; Gummow, B
An experimental model of teaching/learning involving the formulation, execution and presentation of results of a research project has been developed and introduced as part of a Basic Pharmacology course for medical students at the University of the Basque Country (UPV/EHU). The perceptions of the students who participated in the experimental model were evaluated and compared with those who participated in a traditional model of practical activity. An 18-point questionnaireevaluated students' perceptions of aspects of the course itself (such as its duration and organization), personal response characteristics (such as entertainment, interest and effort required) and the current and future utility of the activities which had been carried out. A randomized, double-controlled and double-blind study compared experimental (n = 110) and control groups (n = 63). Students pertaining to the experimental group reported deeper satisfaction and greater participation in the activity. They evaluated more positively the utility of the educational activity for their future profession and more frequently considered that they had acquired useful skills or attitudes. Members of the experimental group recognized that they had invested more time and effort than those of the control group. No differences related to organization, support received and attitudes of teachers were observed between groups. In conclusion, a transitional intervention from traditional models towards PBL-based medical education was favourably evaluated by the participants. The activity was received with deeper satisfaction when compared with a traditional model of practical activity in Pharmacology. PMID:16147771
Tamayo, Gonzalo; Santibañez, Miguel; Javier Meana, J
The rise in popularity of smartphones and tablets has sparked substantial interest among healthcare providers. Increasing number of medical schools have launched curricula targeted for mobile tablets. A mobile tablet that facilitates clinical documentation can enhance the mobility of residents and physicians by eliminating the need to be tethered to a workstation. Considering the popularity of Apples iPad, a clinical
Conventional gas-compensated medication reservoirs used for implantable infusion devices require perfect sealing of the gas chamber, because the gases used are generally toxic. In addition, the physical properties of selected gas critically affect the performance of infusion devices and hydraulic performance of the infusion device can be affected by the amount of medication discharged.?In this study, we suggest a new medication reservoir that adopts a cerebrospinal fluid (CSF)-compensating mechanism, such that when a medication is released from the reservoir by a mechanical actuator, native CSF enters into the reservoir to minimize the build-up of pressure drop. We evaluated in vitro performance and conducted in vivo feasibility tests by using an intrathecal infusion device developed at the Korean National Cancer Center. Experimental results showed that the proposed CSF-compensated infusion pump was essentially less affected by ambient temperature or pressure conditions compared to the gas-compensated infusion pump. Moreover, it showed moderate implant feasibility and operating stability during an animal experiment performed for 12 days. We believe that the proposed volume-compensating mechanism could be applied in various medical fields that use implantable devices. PMID:23504815
Nam, Kyoung Won; Choi, Seong Wook; Kim, In Young; Kim, Kwang Gi; Jo, Yung Ho; Kim, Dae Hyun
Background: Nonadherence with medication is a major factor that influences acute psychiatric hospital readmission. Pharmacists can positively influence rapid psychiatric readmission due to nonadherence by counseling patients and providing filled prescriptions on discharge. Objective: This study is a retrospective evaluation of a pharmacist-driven discharge medication service for hospitalized psychiatric patients. Measured outcomes include a comparison of rapid readmissions pre and post implementation. Rapid readmissions between the concurrent study group and excluded group were also compared. Methods: From October 2010 to November 2011, home-destined subjects being discharged from the hospitals behavioral health unit were provided filled psychiatric prescriptions for self-administration upon discharge, coupled with medication counseling. A series of statistical comparisons were made between the 2 prior years' overall rapid readmissions. This was subsequently compared with the overall rapid readmission rate during the study year. The study groups rapid readmissions were then compared to the overall rapid readmission rate of the study year as well as to the concurrent excluded group. Results: Thirty-day hospital readmissions were found to be significantly decreased in studied subjects compared to total rapid readmissions during the previous year (P = .004) and to the excluded group (P = .020). Conclusion: Immediate availability of prescriptions upon discharge, coupled with development of therapeutic alliances with patients, removes some of the barriers to patient medication adherence in the discharged, acute psychiatric patient. The program provided positive outcomes with regard to decreased frequent, rapid readmission to the acute care psychiatric unit due to medication nonadherence.
INTRODUCTION Tuberculosis (TB), a disease caused by the bacteria Mycobacterium tuberculosis (M. tuberculosis), is spread from person to person through the air. TB usually infects the lungs, but it can also infect other body parts such as the brain, kidneys, or spine. People who are infected by the bacteria but who do not exhibit symptoms have latent TB infection. It is estimated that one-third of the world's population has latent TB infection, and approximately 5%-10% of those infected will develop TB disease within their lifetimes.(() (-) ()) In July 2011, the National Institute for Occupational Safety and Health (NIOSH) received a health hazard evaluation request from management representatives at a medical center in Arizona concerning exposure of employees to M. tuberculosis. They asked for our assistance in evaluating the infection control and occupational health practices related to TB. At the time of our visit, the medical center included an inpatient hospital with 73 beds and adjacent outpatient facility, and the center had approximately 1000 employees. One nurse, the infection control practitioner, was responsible for all infection control and occupational health activities at the medical center. The medical center's TB policy required annual tuberculin skin testing (TST) of all employees with face-to-face patient contact, which included the majority of employees. PMID:24499024
Objectives To evaluate the feasibility of providing regular, live, text-based teaching to medical students and junior doctors in Somaliland using a dedicated case-based medical education website (www.MedicineAfrica.com). Design Review of MedicineAfrica database for details of teaching sessions held in Somaliland from December 2008-October 2010 and evaluation of user experiences through focus groups. Setting King's College Hospital, London, UK and Ahmoud University, Borama, Somaliland. Participants Final year medical students, newly graduated interns and second year interns at Ahmoud University, Borama, Somaliland. Main outcome measures Qualitative and quantitative user rating of online case-based tutorials in the context of pre-existing educational opportunities available to them. Results Regular online teaching sessions are received enthusiastically by students and junior doctors and are reported to improve their clinical practice. Conclusions Despite technological limitations in Somaliland, a live text-based teaching service can be delivered effectively and streamlined with local curricula. This represents an alternative to traditional static teaching methodologies currently used in international medical education.
To provide easy retrieval, integration and evaluation of multimodal cardiology images and data in a web browser environment, distributed application technologies and java programming were used to implement a client-server architecture based on software agents. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. The client side is a Java applet running in a web browser and providing a friendly medical user interface to perform queries on patient and medical test dat and integrate and visualize properly the various query results. A set of tools based on Java Advanced Imaging API enables to process and analyze the retrieved cardiology images, and quantify their features in different regions of interest. The platform-independence Java technology makes the developed prototype easy to be managed in a centralized form and provided in each site where an intranet or internet connection can be located. Giving the healthcare providers effective tools for querying, visualizing and evaluating comprehensively cardiology medical images and records in all locations where they can need them- i.e. emergency, operating theaters, ward, or even outpatient clinics- the developed prototype represents an important aid in providing more efficient diagnoses and medical treatments.
Mental imagery can improve motor performance in stroke populations when combined with physical therapy. Valid and reliable instruments to evaluate the imagery ability of stroke survivors are needed to maximize the benefits of mental imagery therapy. The purposes of this study were to: examine and compare the test-retest intra-rate reliability of the Movement Imagery Questionnaire-Revised, Second Edition (MIQ-RS) in stroke survivors and able-bodied controls, examine internal consistency of the visual and kinesthetic items of the MIQ-RS, determine if the MIQ-RS includes both the visual and kinesthetic dimensions of mental imagery, correlate impairment and motor imagery scores, and investigate the criterion validity of the MIQ-RS in stroke survivors by comparing the results to the KVIQ-10. Test-retest analysis indicated good levels of reliability (ICC range: .83-.99) and internal consistency (Cronbach ?: .95-.98) of the visual and kinesthetic subscales in both groups. The two-factor structure of the MIQ-RS was supported by factor analysis, with the visual and kinesthetic components accounting for 88.6% and 83.4% of the total variance in the able-bodied and stroke groups, respectively. The MIQ-RS is a valid and reliable instrument in the stroke population examined and able-bodied populations and therefore useful as an outcome measure for motor imagery ability. PMID:22474504
Butler, Andrew J; Cazeaux, Jennifer; Fidler, Anna; Jansen, Jessica; Lefkove, Nehama; Gregg, Melanie; Hall, Craig; Easley, Kirk A; Shenvi, Neeta; Wolf, Steven L
This study aimed to evaluate the quality of sperm morphology evaluation skills of 16 technologists who are responsible for semen analyses in their institution. The 1-day workshop was held at the Centre for Research in Reproductive Health in Sagamu, Nigeria. Participants were requested to complete a questionnaire that provided information regarding their experience and training as technologists in their institution. The workshop consisted of 4 sections, namely (i) pre-training test, (ii) lectures on morphometric characteristics and details of normal and abnormal sperm (iii) a laboratory-based hands-on, post training test and (iv) a consensus training session. The findings of the questionnaire indicated that none of the participants had any previous formal training and that all participants had very little knowledge about the morphological appearance of normal spermatozoa. These findings were supported by the results obtained during the pre-training session that showed a mean percentage difference of 24% between the reference and participant's values. These somewhat alarming results highlight the need for training facilities for technologists who work in the clinical diagnostic field of reproductive science. PMID:17982953
Background In Switzerland, nurses are allowed to prescribe and administer morphine in emergency situations without a doctor. Still, nurses and other health professionals are often reluctant to prescribe and administer morphine for pain management in patients. No valid French-speaking instrument is available in Switzerland to assess the attitudes of nurses and other health professionals towards the prescription and administration of morphine. In this study, we evaluated the psychometric properties of the French version of the questionnaire Attitudes towards morphine use. Methods The instrument was derived from an Italian version. Forward and back translations of the questionnaire were performed. Item analysis and construct validity were assessed between April and December 2010 in a cross sectional study including five Swiss hospitals in a sample of 588 health professionals (533 nurses, mean age 38.3?±?10.2 years). Thirty subjects participated in test-retest reliability. Results The time to complete the instrument ranged between 12 and 15 minutes and neither floor nor ceiling effect were found. The initial 24-item instrument showed an intraclass correlation (ICC) of 0.69 (95% CI: 0.64 to 0.73, P?0.001), and a Cronbachs ? of 0.700. Factor analysis led to a six-component solution explaining 52.4% of the total variance. After excluding five items, the shortened version showed an ICC of 0.74 (95% CI, 0.70 to 0.77, P?0.001) and a Cronbachs ? of 0.741. Factor analysis led to a five-component solution explaining 54.3% of the total variance. The five components were named risk of addiction/dependence; operational reasons for not using morphine; risk of escalation; other (non-dependence) risks and external (non-operational) reasons. In test-retest, the shortened instrument showed an ICC of 0.797 (95% CI, 0.630 to 0.911, P?0.001) and a Cronbachs ? of 0.797. Conclusions The 19-item shortened instrument assessing attitudes towards the prescription and administration of morphine showed adequate content and construct validity.
Whether there are differences between countries in the validity of self-reported diet in relation to BMI, as evaluated using recovery biomarkers, is not well understood. We aimed to evaluate BMI-related reporting errors on 24 h dietary recalls (24-HDR) and on dietary questionnaires (DQ) using biomarkers for protein and K intake and whether the BMI effect differs between six European countries. Between 1995 and 1999, 1086 men and women participating in the European Prospective Investigation into Cancer and Nutrition completed a single 24-HDR, a DQ and one 24 h urine collection. In regression analysis, controlling for age, sex, education and country, each unit (1 kg/m²) increase in BMI predicted an approximately 1·7 and 1·3 % increase in protein under-reporting on 24-HDR and DQ, respectively (both P < 0·0001). Exclusion of individuals who probably misreported energy intake attenuated BMI-related bias on both instruments. The BMI effect on protein under-reporting did not differ for men and women and neither between countries on both instruments as tested by interaction (all P>0·15). In women, but not in men, the DQ yielded higher mean intakes of protein that were closer to the biomarker-based measurements across BMI groups when compared with 24-HDR. Results for K were similar to those of protein, although BMI-related under-reporting of K was of a smaller magnitude, suggesting differential misreporting of foods. Under-reporting of protein and K appears to be predicted by BMI, but this effect may be driven by 'low-energy reporters'. The BMI effect on under-reporting seems to be the same across countries. PMID:21791145
Freisling, Heinz; van Bakel, Marit M E; Biessy, Carine; May, Anne M; Byrnes, Graham; Norat, Teresa; Rinaldi, Sabina; Santucci de Magistris, Maria; Grioni, Sara; Bueno-de-Mesquita, H Bas; Ocké, Marga C; Kaaks, Rudolf; Teucher, Birgit; Vergnaud, Anne-Claire; Romaguera, Dora; Sacerdote, Carlotta; Palli, Domenico; Crowe, Francesca L; Tumino, Rosario; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie-Christine; Khaw, Kay-Tee; Wareham, Nicholas J; Trichopoulou, Antonia; Naska, Androniki; Orfanos, Philippos; Boeing, Heiner; Illner, Anne-Kathrin; Riboli, Elio; Peeters, Petra H; Slimani, Nadia
The idea of in-situ visualization for surgical procedures has been widely discussed in the community. While the tracking technology offers nowadays a sufficient accuracy and visualization devices have been developed that fit seamlessly into the operational workflow [1, 3], one crucial problem remains, which has been discussed already in the first paper on medical augmented reality. Even though the data is presented at the correct place, the physician often perceives the spatial position of the visualization to be closer or further because of virtual/real overlay. This paper describes and evaluates novel visualization techniques that are designed to overcome misleading depth perception of trivially superimposed virtual images on the real view. We have invited 20 surgeons to evaluate seven different visualization techniques using a head mounted display (HMD). The evaluation has been divided into two parts. In the first part, the depth perception of each kind of visualization is evaluated quantitatively. In the second part, the visualizations are evaluated qualitatively in regard to user friendliness and intuitiveness. This evaluation with a relevant number of surgeons using a state-of-the-art system is meant to guide future research and development on medical augmented reality. PMID:17354911
Australia's fabled Royal Flying Doctor Service recently undertook a soul-searching evaluation of its structure, operations and goals. Although there are no plans to stop providing emergency medical services to the residents of the outback, the service may refocus efforts on health promotion and prevention, since 75% of its work involves nonemergency care. Cost efficiency, the key phrase for health care around the globe, will be another goal. Images p746-a p747-a p748-a
Objective: To study the reliability of a peer-approved checklist for scoring anesthesia case reports prepared by 5th-year medical students. Methods: A report checklist was created by a tutor in the Department of Anesthesia, Khon Kaen University, comprising: 4 items on pre-anesthetic evaluation; 4 on pre-anesthetic preparation; 8 on intra-operative management; and, 5 on postoperative care. The checklist was pre-approved by
In this paper we discuss and evaluate a method for automatic text illustration, applied to answers to medical questions. Our method for selecting illustrations is based on the idea that similarities between the answers and picture-related text (the pictures caption or the section\\/paragraph that includes the picture) can be used as evidence that the picture would be appropriate to illustrate
Wauter Bosma; M. Theune; C. M. J. van Hooijdonk; E. Krahmer; F. Maes
BACKGROUND:Patient education is an essential element to quality health care, both in the physical health andmental health care arenas. Providers use written materials as tools to educate, but benefits are dependent on learners reading and comprehension abilities. OBJECTIVE:The purpose of this descriptive study was to evaluate adequacy of reading level and readability of psychotropic medication patient handouts.STUDYDESIGN:Reading level and readability
Objective: To describe the components of a function-based prospective payment model for inpatient medical rehabilitation that parallels diagnosis-related groups (DRGs) to evaluate this model in relation to stakeholder objectives, and to detail the components of a quality of care incentive program that, when combined with this payment model, creates an incentive for providers to maximize functional outcomes.Data Sources: This article
Outcome questionnaires are increasingly used in the current medical practice. Patient reported outcomes serve as an essential and perhaps more relevant means for assessing patients response to treatment than clinical measures alone. Many of the procedures performed in plastic surgery are associated with aesthetic outcomes, therefore it is pertinent to thoroughly understand the patients perspective of achieved results. Surgeons need to possess the knowledge and skills about outcomes assessments and understand how to apply them to improve quality of care delivered based on evidence. This paper discusses the appropriate use of outcome questionnaires to rigorously evaluate treatment methods based on patient satisfaction and the outcome measurement instruments frequently used in plastic surgery.
Objectives: To evaluate Multiple Choice and Short Essay Question items in Basic Medical Sciences by determining item writing flaws (IWFs) of MCQs along with cognitive level of each item in both methods. Methods: This analytical study evaluated the quality of the assessment tools used for the first batch in a newly established medical college in Karachi, Pakistan. First and sixth module assessment tools in Biochemistry during 2009-2010 were analyzed. Cognitive level of MCQs and SEQs, were noted and MCQ item writing flaws were also evaluated. Results: A total of 36 SEQs and 150 MCQs of four items were analyzed. The cognitive level of 83.33% of SEQs was at recall level while remaining 16.67% were assessing interpretation of data. Seventy six percent of the MCQs were at recall level while remaining 24% were at the interpretation. Regarding IWFs, 69 IWFs were found in 150 MCQs. The commonest among them were implausible distracters (30.43%), unfocused stem (27.54%) and unnecessary information in the stem (24.64%). Conclusion: There is a need to review the quality including the content of assessment tools. A structured faculty development program is recommended for developing improved assessment tools that align with learning outcomes and measure competency of medical students.
The process of keeping up-to-date the medical knowledge stored in relational databases is of paramount importance. Since quality and reliability of medical knowledge are essential, in many cases physicians' proposals of updates must undergo experts' evaluation before possibly becoming effective. However, until now no theoretical framework has been provided in order to cope with this phenomenon in a principled and non-ad hoc way. Indeed, such a framework is important not only in the medical domain, but in all Wikipedia-like contexts in which evaluation of update proposals is required. In this paper we propose GPVM (General Proposal Vetting Model), a general model to cope with update proposal?evaluation in relational databases. GPVM extends the current theory of temporal relational databases and, in particular, BCDM - Bitemporal Conceptual Data Model - "consensus" model, providing a new data model, new operations to propose and accept?reject updates, and new algebraic operators to query proposals. The properties of GPVM are also studied. In particular, GPVM is a consistent extension of BCDM and it is reducible to it. These properties ensure consistency with most relational temporal database frameworks, facilitating implementation on top of current frameworks and interoperability with previous approaches. PMID:23380684
Anselma, Luca; Bottrighi, Alessio; Montani, Stefania; Terenziani, Paolo
Background: To create a checklist of the tasks that a pharmacist must perform during medication order review in the hospital setting and to evaluate the utility of and pharmacists satisfaction with the checklist. Methods: An evidence-based checklist for medication order review was developed, with items related to order urgency, verification of patients identity, therapeutic review, and actionable items. Pharmacists were educated about the checklist, and it was made available at 2 community hospitals in an urban setting. Pharmacists completed a nonvalidated satisfaction survey and participated in focus groups or interviews within 3 months after implementation of the checklist. Qualitative descriptive theory was used to identify themes within the data. Near-miss occurrence reports for the 3 months before and after implementation of the checklist were quantified. Results: Of 16 pharmacists who were involved in the implementation phase, 14 participated in focus groups or an interview, and 11 responded to the survey. All respondents felt that the primary role of the checklist was for training. They felt that the checklist could be useful when reviewing high-alert or unfamiliar medications or therapy for patients with complex medications. The checklist was most helpful when it was used as a reminder, on an as-needed basis. Nine (82%) of the 11 survey respondents indicated that the checklist standardized the process of medication order review, the same number felt that it prevented accidental omission of critical checks, and 8 (73%) felt that it improved patient safety. Education was necessary to reinforce the purpose of the checklist and its self-check nature. There was no difference in the number of near misses in the pharmacy between the 3-month periods before and after implementation of the checklist. Conclusion: Pharmacists participating in the study felt that a checklist for medication order review had a role in training new pharmacists and standardizing processes.
Meyer, Lindsay D; Raymond, Colette B; Rodrigue, Christine M J
Safe reprocessing of medical devices through cleaning, disinfection, and sterilization is essential for the prevention of health care associated infections (HAI) and to guarantee patient safety. Several studies detected residual contamination and even severe infections of patients, despite carrying out reprocessing. To develop appropriate solutions, the existing situation in Germany and selected European countries was analyzed. Additionally, in 27 medical practitioners offices and 14 hospitals, the true practice of reprocessing was analyzed using a questionnaire, a checklist, and inspection on site. A structured analysis of potential alternatives to the internal reprocessing was conducted within the German and European context. The results indicate that the conditions for the execution of the reprocessing process in the analyzed health facilities in southern Hesse (Germany) do not satisfy legal requirements. The detected deficiencies were consistent with other reports from Germany and Europe. The analysis gave insight into several reasons for the detected deficiencies. The three main reasons were the high costs for proper implementation, the subjective value assigned to the reprocessing unit in health care facilities, and deficits in monitoring by the health authority. Throughout the European Union, a similar regulatory framework for the performance of the reprocessing process exists, while the environment, structures of the health systems and administrative supervision vary significantly. The German states as well as selected European countries are currently discussing the challenges of increased quality-assured execution of the reprocessing process. For instance, the same supervisory system for hospitals and medical practitioners should be established at an equal standard. Alternatives such as the use of single-use medical devices, outsourcing the decontamination processes, or the cooperation of health facilities may be considered. This paper also discusses economic and ecological aspects. Finally, different options are recommended to ensure the exclusive use of reliable medical devices for surgical procedures that guarantee an adequate standard of patient safety within economic constraints.
Safe reprocessing of medical devices through cleaning, disinfection, and sterilization is essential for the prevention of health care associated infections (HAI) and to guarantee patient safety. Several studies detected residual contamination and even severe infections of patients, despite carrying out reprocessing. To develop appropriate solutions, the existing situation in Germany and selected European countries was analyzed. Additionally, in 27 medical practitioners' offices and 14 hospitals, the true practice of reprocessing was analyzed using a questionnaire, a checklist, and inspection on site. A structured analysis of potential alternatives to the internal reprocessing was conducted within the German and European context. The results indicate that the conditions for the execution of the reprocessing process in the analyzed health facilities in southern Hesse (Germany) do not satisfy legal requirements. The detected deficiencies were consistent with other reports from Germany and Europe. The analysis gave insight into several reasons for the detected deficiencies. The three main reasons were the high costs for proper implementation, the subjective value assigned to the reprocessing unit in health care facilities, and deficits in monitoring by the health authority. Throughout the European Union, a similar regulatory framework for the performance of the reprocessing process exists, while the environment, structures of the health systems and administrative supervision vary significantly. The German states as well as selected European countries are currently discussing the challenges of increased quality-assured execution of the reprocessing process. For instance, the same supervisory system for hospitals and medical practitioners should be established at an equal standard. Alternatives such as the use of single-use medical devices, outsourcing the decontamination processes, or the cooperation of health facilities may be considered. This paper also discusses economic and ecological aspects. Finally, different options are recommended to ensure the exclusive use of reliable medical devices for surgical procedures that guarantee an adequate standard of patient safety within economic constraints. PMID:24327946
This short document guides the user through the stages of creating and implementing an effective questionnaire. The types of questions and how they should be worded are addressed, and many good examples of the different types of questions that could go into a questionnaire are presented. This resource is intended for novice evaluators.
New and modern image modalities generate digital images and increase the amount of data in a hospital. Without data compression techniques the practical use of many applications like teleradiology is not usable. A typical CT-series is about 25-50 MB. Many non-standardized lossy data compression techniques have been developed for the clinical environment. This paper describes qualitative and quantitative evaluation of three standardized compression methods, JPEG, MPEG, and H.261 for clinical cases. The evaluation shows that JPEG and MPEG can actually still compete with special non-standardized medical image compression methods and the compressed images can be decompressed with very little effort.
Khademi, Mojdeh; von Gehlen, Sandra; Jensch, Peter F.
OBJECTIVE: To evaluate fourth-year medical students abilities to obtain informed consent or refusal for HIV testing through a performance-based\\u000a evaluation method.\\u000a \\u000a \\u000a DESIGN: Student competence was assessed in a standardized patient interaction in which the student obtained informed consent or refusal\\u000a for HIV testing. A previously validated 16-item checklist was completed by the standardized patient. A subset was independently\\u000a reviewed and
Laura Weiss Roberts; Cynthia Geppert; Teresita McCarty; S. Scott Obenshain
In 1996, California was the first state to pass a Compassionate Use Act allowing for the legal use of marijuana for medical purposes. Here we review several current policy and land use environmental interventions designed to limit problems related to the influx of medical marijuana dispensaries across California cities. Then we discuss the special challenges, solutions, and techniques used for studying the effects of these place-based policies. Finally, we present some of the advanced spatial analytic techniques that can be used to evaluate the effectiveness of environmental interventions, such as those related to reducing problems associated with the proliferation of medical marijuana dispensaries. Further, using data from a premise survey of all the dispensaries in Sacramento, this study will examine what characteristics and practices of these dispensaries are related to crime within varying distances from the dispensaries (e.g., 100, 250, 500, and 1,000 feet). We find that some security measures, such as security cameras and having a door man outside, implemented by medical marijuana dispensary owners might be effective at reducing crime within the immediate vicinity of the dispensaries. PMID:22821130
Freisthler, Bridget; Kepple, Nancy J; Sims, Revel; Martin, Scott E
Aims To develop and evaluate for the National Prescribing Service (NPS) a web-based interactive prescribing curriculum for Australian senior medical students based on the World Health Organizations Guide to Good Prescribing. Methods Teachers of prescribing from all Australian medical schools in 2000 wrote 12 case-based modules which were converted to on-line format. Objective evidence was provided for selecting first-line medicines from available alternatives by comparing efficacy, safety, convenience and cost. The curriculum was made available to final year students in 2001 and was evaluated by measuring use from web statistics and by semistructured interviews with 15 teachers (2003) and on-line surveys of 363 students over 2003 and 2004. Results By 2004 the curriculum was used by nine of 11 possible medical schools. Uptake increased each year from 2001 and all 12 modules were accessed consistently. Student access was significantly (P < 0.001) greater when prescribing was an assessable part of their course. Teachers evaluations were uniformly supportive and the curriculum is seen as a valuable resource. Student responses came from a small proportion of those with password access but were also supportive. Over half of student respondents had created their own evidence-based formulary. Conclusions A collaborative venture initiated by the NPS with Australian medical schools has been successfully implemented in most courses. Teachers find the resource of high quality. Student respondents find the curriculum valuable in developing their own prescribing skills. It is best delivered by self-directed study followed by tutorial discussion of prescribing decisions.
In this AMEE Guide, we consider the design and development of self-administered surveys, commonly called questionnaires. Questionnaires are widely employed in medical education research. Unfortunately, the processes used to develop such questionnaires vary in quality and lack consistent, rigorous standards. Consequently, the quality of the questionnaires used in medical education research is highly variable. To address this problem, this AMEE Guide presents a systematic, seven-step process for designing high-quality questionnaires, with particular emphasis on developing survey scales. These seven steps do not address all aspects of survey design, nor do they represent the only way to develop a high-quality questionnaire. Instead, these steps synthesize multiple survey design techniques and organize them into a cohesive process for questionnaire developers of all levels. Addressing each of these steps systematically will improve the probabilities that survey designers will accurately measure what they intend to measure.
La Rochelle, Jeffrey S.; Dezee, Kent J.; Gehlbach, Hunter
Background: Medication errors are prevalent in the hospital settings. To ensure the patient safety and provide better health services, medication errors should be curbed. India is still lacking the regulatory system for the control of medication errors. Therefore, a stringent regulatory set up should be established to reduce medication errors. Awareness among the health-care professionals regarding medication errors may be the major factor in the establishment of successful regulatory system. In Indian context, no study has been reported about the awareness of medication errors. Therefore, this study assessed the awareness of the health-care professionals representing North, East and West regions of India about medication errors. These health-care professionals also included the students who were in the final phase of professional courses related to health management. Materials and Methods: A questionnaire comprising of 17 questions pertaining to different aspects of medication errors was prepared. Questionnaire was distributed to 456 health-care professionals of various institutes of North, East and West India. Respondents of the questionnaire were restricted to one sitting for answering the entire questionnaire and they were not allowed to consult with anyone for the purpose of answering the questions. Data was compiled and analyzed. Results: It has been found that 18.45%, 39.48%, 14.16%, 27.9% of respondents were having excellent, good, average, poor knowledge respectively regarding the fundamentals of medication error. Knowledge regarding reporting medication errors was excellent in 56.65%, good in 22.53%, average in 09.23% and poor in 11.59% of respondents. Conclusion: The outcome of this study may be of great help in drafting the regulatory policies to curb the problem of medication errors.
Content-based image retrieval is starting to become an increasingly important factor in medical imaging research and image management systems. Several retrieval systems and methodologies exist and are used in a large variety of applications from automatic labelling of images to diagnostic aid and image classification. Still, it is very hard to compare the performance of these systems as the used databases often contain copyrighted or private images and are thus not interchangeable between research groups, also for patient privacy. Most of the currently used databases for evaluating systems are also fairly small which is partly due to the high cost in obtaining a gold standard or ground truth that is necessary for evaluation. Several large image databases, though without a gold standard, start to be available publicly, for example by the NIH (National Institutes for Health). This article describes the creation of a large medical image database that is used in a teaching file containing more than 8,700 varied medical images. The images are anonymised and can be exchanged free of charge and copyright. Ground truth (a gold standard) has been obtained for a set of 26 images being selected as query topics for content-based query by image example. To reduce the time for the generation of ground truth, pooling methods well known from the text or information retrieval field have been used. Such a database is a good starting point for comparing the current image retrieval systems and to measure the retrieval quality, especially within the context of teaching files, image case databases and the support of teaching. For a comparison of retrieval systems for diagnostic aid, specialised image databases, including the diagnosis and a case description will need to be made available, as well, including gold standards for a proper system evaluation. A first evaluation event for image retrieval is foreseen at the 2004 CLEF conference (Cross Language Evaluation Forum) to compare text-and content-based access mechanism to images. PMID:15294308
Müller, Henning; Rosset, Antoine; Vallée, Jean-Paul; Terrier, François; Geissbuhler, Antoine
Objective To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process. Materials and methods Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis. Results The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations. Discussion Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention. Conclusion The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective.
Tarride, Jean-Eric; Goeree, Ron; Lokker, Cynthia; McKibbon, K Ann
Although many machine-translation programs are currently available, few evaluation methods of such translation exist for any given application area. It is difficult to evaluate machine-translation systems objectively because the quality of a translation depends on the combination of three factors: the translation program, the dictionary, and the original document. In this study, we developed a quantitative evaluation method for assessing machine translation, which evaluates these three factors separately. We applied this method to the translation of English to Japanese for medical literature and the method proved to be a good indicator for further system improvement. Using this method we also discovered other important points for machine translation, such as the examination of target documents for the construction of a better application dictionary. PMID:1943792
Self-efficacy, a known predictor of a wide range of health behaviors, has not been investigated in studies of adherence to antihypertensive medications. A medication adherence self-efficacy scale was developed and evaluated in ambulatory hypertensive African-American patients in two sequential phases. For the item-generation phase, open-ended interviews with 106 patients were used to elicit their experiences with taking antihypertensive medications. Using
Gbenga Ogedegbe; Carol A Mancuso; John P Allegrante; Mary E Charlson
...packet, including USAFA Form 149, Precandidate Questionnaire, with a request for the applicant to provide academic, athletic, leadership, and medical information. (b) The Academy evaluates the precandidate information and provides an analysis to...
Background:There is no disease-specific instrument to describe health-related quality of life (HRQoL) in Indian patients with asthma. However, an abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref), a generic Hindi HRQoL measure, has been developed and validated in India.Aims:To evaluate the WHOQOL-Bref in adult patients with asthma and to test possible modifications to the instrument to improve its psychometric adequacy.Methods:Sixty-seven patients with asthma completed the WHOQOL-Bref. Rasch analysis was used to explore the psychometric performance of the four domains (physical, psychological, social relationships and environment) of the scale. Overall fit of data to model expectations, appropriate category ordering, presence of differential item functioning, individual item fit and targeting of item difficulty to patient ability were explored for each domain. Item deletion and rescoring were applied to misfitting items to improve overall performance.Results:The overall fit of the WHOQOL-Bref data was adequate. Item 3 (pain prevents doing work) displayed a large positive fit residual value (indicating violation of unidimensionality), resulting in poor construct validity for the physical domain. No item exhibited differential item functioning. Ten items had disordered thresholds. The WHOQOL-Bref was modified by dropping item 3 and rescoring category structures of 16 items. The modified scale had good construct validity for all domains, ordered thresholds for all items and good targeting of items to persons.Conclusions:The WHOQOL-Bref performed inadequately in describing HRQoL in the asthma patients studied. However, when modified by Rasch analysis, the scale proved better than the original scale. PMID:24921608
Clinical symptoms of 32 stutterers--schoolchildren of 14-year average age were evaluated according to the questionnaire containing 45 complaints of tetanic syndrome. We found headache, fatigue, anxiety, paresthesias and hypothermia of limbs in 30 per cent of this group. More than 80 per cent of the patients had positive Chvostek sign and 60 per cent had positive ischemic and hyperventilation tests. PMID:1838877
Created by interlocking economies, a global language, the informatics revolution and rapid travel, globalization has penetrated all aspects of human life including science, environment, public health and medicine. Physicians are now members of a global community. The global physician should possess universal core essential competences required for medical practice throughout the world. The Institute for International Medical Education (IIME), created by the China Medical Board (CMB) of New York, has developed the " global minimal essential requirements" (GMER) that define the knowledge, skills, professional behavior and ethics that all physicians must have regardless of where they received their general medical education and training. The IIME initiated a pilot project in China in October, 2003, to evaluate the graduates of the 7- or 8-year track program of eight leading medical schools, including Medical School of Sun Yat-sen University. The results of GMER evaluation indicated strengths and areas for improvement of our school in relation to international standards, which greatly re-invigorate our enthusiasm on medical curriculum reform on the new 8-year track program in Medical School of Sun Yat-sen University. The modifications of our medical curriculum for the new 8-year track program based on the results of GMER evaluation are discussed in this paper. PMID:18236259
Background Many medical situations necessitate a stressful period of waiting for potentially threatening test results. The medical waiting period is often associated with negative anticipatory anxiety and rumination about the outcome of treatment. Few evidence-based self-help coping interventions are available to assist individuals manage these periods. Theory and research suggest that positive reappraisal coping strategies may be particularly useful for this type of unpredictable and uncontrollable stressful context. The objective of this study is to investigate the effects of a Positive Reappraisal Coping Intervention (PRCI) on psychological well-being of women waiting for the outcome of their fertility treatment cycle. Methods/Design In a three-armed randomized controlled trial, the effectiveness of the PRCI will be tested. Consecutive patients undergoing in vitro fertilisation in a Dutch university hospital and meeting selection criteria will be invited to participate. Those who agree will be randomized to one of three experimental groups (N=372). The PRCI Intervention group will receive the intervention that comprises an explanatory leaflet and the 10 statements designed to promote positive reappraisal coping, to be read at least once in the morning, once in the evening. To capture the general impact of PRCI on psychological wellbeing patients will complete questionnaires before the waiting period (pre-intervention), on day ten of the 14-day waiting period (intervention) and six weeks after the start of the waiting period (post-intervention). To capture the specific effects of the PRCI during the waiting period, patients will also be asked to monitor daily their emotions and reactions during the 14-day waiting period. The primary outcome is general anxiety, measured by the Hospital Anxiety and Depression Scale. Secondary outcomes are positive and negative emotions during the waiting period, depression, quality of life, coping and treatment outcome. During recruitment for the RCT it was decided to add a fourth non-randomized group, a PRCI Control group that received the PRCI and completed the questionnaires but did not complete daily monitoring. Discussion Positive reappraisal is one of the few ways of coping that has been shown to be associated with increased wellbeing during unpredictable and uncontrollable situations like medical waiting periods. A simple evidence based self-help intervention could facilitate coping during this common medical situation. This RCT study will evaluate the value of a self-help coping intervention designed for medical waiting periods in women undergoing fertility treatment. Trial registration The study is registered at the Clinical Tials.gov (NCT01701011).
A comprehensive functional assessment requires thorough and careful inquiry, which is difficult to accomplish in most busy\\u000a clinical practices. This paper examines the reliability and validity of the Functional Status Questionnaire (FSQ), a brief,\\u000a standardized, self-administered questionnaire designed to provide a comprehensive and feasible assessment of physical, psychological,\\u000a social and role function in ambulatory patients. The FSQ can be completed
Alan M. Jette; Allyson R. Davies; Paul D. Cleary; David R. Calkins; Lisa V. Rubenstein; Arlene Fink; Jacqueline Kosecoff; Roy T. Young; Robert H. Brook; Thomas L. Delbanco
Although there are a number of medical schools in the Caribbean islands, very few reports have come out so far in the literature regarding the efficacy of small-group teaching. The introduction of small-group teaching in the gross anatomy laboratory one and a half years ago at St. Matthew's University (SMU) on Grand Cayman appears to have had a significant positive impact on the academic achievement of students in anatomy. This study surveyed the responses of the students to the small-group learning method in gross anatomy at SMU using a structured questionnaire. The results show that our students prefer this small-group learning method over a completely self-directed method in the gross anatomy lab because the study materials were carefully chosen and the study objectives were demonstrated by the resource person. However, teacher-centered teaching was deliberately avoided by fostering problem-solving skills in the anatomy lab sessions. Another aim of the small-group teaching at SMU was to develop the interpersonal and communication skills of the students, which are important in their later education and career.
Background The fifth i2b2/VA Workshop on Natural Language Processing Challenges for Clinical Records conducted a systematic review on resolution of noun phrase coreference in medical records. Informatics for Integrating Biology and the Bedside (i2b2) and the Veterans Affair (VA) Consortium for Healthcare Informatics Research (CHIR) partnered to organize the coreference challenge. They provided the research community with two corpora of medical records for the development and evaluation of the coreference resolution systems. These corpora contained various record types (ie, discharge summaries, pathology reports) from multiple institutions. Methods The coreference challenge provided the community with two annotated ground truth corpora and evaluated systems on coreference resolution in two ways: first, it evaluated systems for their ability to identify mentions of concepts and to link together those mentions. Second, it evaluated the ability of the systems to link together ground truth mentions that refer to the same entity. Twenty teams representing 29 organizations and nine countries participated in the coreference challenge. Results The teams' system submissions showed that machine-learning and rule-based approaches worked best when augmented with external knowledge sources and coreference clues extracted from document structure. The systems performed better in coreference resolution when provided with ground truth mentions. Overall, the systems struggled in solving coreference resolution for cases that required domain knowledge.
Objective We describe a novel, crowdsourcing method for generating a knowledge base of problemmedication pairs that takes advantage of manually asserted links between medications and problems. Methods Through iterative review, we developed metrics to estimate the appropriateness of manually entered problemmedication links for inclusion in a knowledge base that can be used to infer previously unasserted links between problems and medications. Results Clinicians manually linked 231?223 medications (55.30% of prescribed medications) to problems within the electronic health record, generating 41?203 distinct problemmedication pairs, although not all were accurate. We developed methods to evaluate the accuracy of the pairs, and after limiting the pairs to those meeting an estimated 95% appropriateness threshold, 11?166 pairs remained. The pairs in the knowledge base accounted for 183?127 total links asserted (76.47% of all links). Retrospective application of the knowledge base linked 68?316 medications not previously linked by a clinician to an indicated problem (36.53% of unlinked medications). Expert review of the combined knowledge base, including inferred and manually linked problemmedication pairs, found a sensitivity of 65.8% and a specificity of 97.9%. Conclusion Crowdsourcing is an effective, inexpensive method for generating a knowledge base of problemmedication pairs that is automatically mapped to local terminologies, up-to-date, and reflective of local prescribing practices and trends.
Wright, Adam; Laxmisan, Archana; Ottosen, Madelene J; McCoy, Jacob A; Butten, David; Sittig, Dean F
Objectives: This article explores ethical and practical issues associated with the Liaison Committee on Medical Education (LCME) provision that states health professionals who provide psychiatric/psychological care to medical students must have no involvement in the academic evaluation or promotion of students receiving those services. Method: The
Kavan, Michael G.; Malin, Paula Jo; Wilson, Daniel R.
The purpose of this research is to build a test for the evaluation of the knowledge needed by medical students before entering clinical courses in medical school. The criterion for this was provided by teachers in both the pre-clinical and clinical subjects. The Pilot instrument consisted of 335 items that covered 8 sections. Each one of these
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 completion and/or navigation, in particular the execution of the Surgeon call sequence. Debrief comments were used to analyze unclear procedural steps and to discern any discrepancies between the procedure and generally accepted BME actions. The sequence followed by BME participants differed considerably from the sequence intended by the procedure. Common deviations included the call sequence used to contact Surgeon, the content of BME and crew interaction and the gathering of pertinent console resources. Differing perceptions of task priority and imprecise language seem to have caused multiple deviations from the procedure s intended sequence. The study generated 40 recommendations for the procedure, of which 34 are being implemented. These recommendations address improving the clarity of the instructions, identifying training considerations, expediting Surgeon contact, improving cues for anticipated flight control team communication and identifying missing console tools.
Medical devices are many and various, ranging from tongue spatulas to implantable or invasive devices and imaging machines; their lifetimes are short, between 18 months and 5 years, due to incessant incremental innovation; and they are operator-dependent: in general, the clinical user performs a fitting procedure (hip implant or pacemaker), a therapeutic procedure using a non-implantable invasive device (arrhythmic site ablation probe, angioplasty balloon, extension spondyloplasty system, etc.) or follow-up of an active implanted device (long-term follow-up of an implanted cardiac defibrillator or of a deep brain stimulator in Parkinson's patients). A round-table held during the XXVIII(th) Giens Workshops meeting focused on the methodology of scientific evaluation of medical devices and the associated procedures with a view to their pricing and financing by the French National Health Insurance system. The working hypothesis was that the available data-set was sufficient for and compatible with scientific evaluation with clinical benefit. Post-registration studies, although contributing to the continuity of assessment, were not dealt with. Moreover, the focus was restricted to devices used in health establishments, where the association between devices and technical medical procedures is optimally representative. An update of the multiple regulatory protocols governing medical devices and procedures is provided. Issues more specifically related to procedures as such, to non-implantable devices and to innovative devices are then dealt with, and the proposals and discussion points raised at the round-table for each of these three areas are presented. PMID:23981256
With the continuous incorporation of health technologies, hospital risk management should be implemented to systemize the monitoring of adverse effects, performing actions to control and eliminate their damage. As part of these actions, Technovigilance is active in the procedures of acquisition, use and quality control of health products and equipment. This study aimed to construct and validate an instrument to evaluatemedical-hospital products. This is a quantitative, exploratory, longitudinal and methodological development study, based on the Six Sigma quality management model, which has as its principle basis the component stages of the DMAIC Cycle. For data collection and content validation, the Delphi technique was used with professionals from the Brazilian Sentinel Hospital Network. It was concluded that the instrument developed permitted the evaluation of the product, differentiating between the results of the tested brands, in line with the initial study goal of qualifying the evaluations performed. PMID:21120414
Kuwabara, Cleuza Catsue Takeda; Evora, Yolanda Dora Martinez; de Oliveira, Márcio Mattos Borges
Mental health problems are underrecognized in medical settings, leading to inadequate treatment. The present paper describes the development of the Health Dynamics Inventory (HDI), a brief, self-report questionnaire developed to evaluate mental health functioning. The HDI was written to evaluate the three aspects of mental disorders as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM): (1) the
Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDUs). In particular, Human Immunodeficiency Virus (HIV) and hepatitis C Virus (HCV) have become endemic in many settings and bacterial and viral infections, such as endocarditis and cellulitis, have become extremely common among this population. In an effort to reduce these public health concerns and the public order problems associated with public injection drug use, in September 2003, Vancouver, Canada opened a pilot medically supervised safer injecting facility (SIF), where IDUs can inject pre-obtained illicit drugs under the supervision of medical staff. The SIF was granted a legal exemption to operate on the condition that its impacts be rigorously evaluated. In order to ensure that the evaluation is appropriately open to scrutiny among the public health community, the present article was prepared to outline the methodology for evaluating the SIF and report on some preliminary observations. The evaluation is primarily structured around a prospective cohort of SIF users, that will examine risk behavior, blood-borne infection transmission, overdose, and health service use. These analyses will be augmented with process data from within the SIF, as well as survey's of local residents and qualitative interviews with users, staff, and key stakeholders, and standardised evaluations of public order changes. Preliminary observations suggest that the site has been successful in attracting IDUs into its programs and in turn helped to reduce public drug use. However, each of the indicators described above is the subject of a rigorous scientific evaluation that is attempting to quantify the overall impacts of the site and identify both benefits and potentially harmful consequences and it will take several years before the SIF's impacts can be appropriately examined.
Wood, Evan; Kerr, Thomas; Lloyd-Smith, Elisa; Buchner, Chris; Marsh, David C; Montaner, Julio SG; Tyndall, Mark W
Objective: To design a Health-related Quality of Life (HRQoL) instrument for HIV-infected people in the era of highly active antiretroviral\\u000a therapy (HAART). Methods: The self-administered questionnaire was developed by an Italian network including researchers, physicians, people living\\u000a with HIV, national institutions and community-based organizations (CBO) through several steps: (1) review of existing HRQoL\\u000a literature and questionnaires for HIV-infected people; (2)
R. Bucciardini; R. Murri; M. Guarinieri; F. Starace; M. Martini; A. Vatrella; L. Cafaro; M. Fantoni; R. Grisetti; A. dArminio Monforte; V. Fragola; R. Arcieri; C. Del Borgo; A. Tramarin; M. Massella; D. Lorenzetti; S. Vella
In response to a request made by the Director of the Operating Room of the West Virginia University Medical Center School of Medicine, personnel of the National Institute for Occupational Safety and Health (NIOSH) performed environmental evaluations to de...
On March 24, 2003, the National Institute for Occupational Safety and Health (NIOSH) received a request from the New York State Nurses Association (NYSNA) to conduct a health hazard evaluation (HHE) at Interfaith Medical Center (IMC) in Brooklyn, New York...
In May 1980, the National Institute for Occupational Safety and Health (NIOSH) received a request from an authorized representative of employees at the Lincoln Medical and Mental Health Center, Bronx, New York. The request asked NIOSH to evaluate potentia...
Radiological imaging is gaining relevance in the acquisition of competencies in clinical anatomy. The aim of this study was to evaluate the perceptions of medical students on teaching/learning of imaging anatomy as an integrated part of anatomical education. A questionnaire was designed to evaluate the perceptions of second-year students
Machado, Jorge Americo Dinis; Barbosa, Joselina Maria Pinto; Ferreira, Maria Amelia Duarte
Objectives Subjective questionnaires are informative in understanding the difficulties faced by patients with hearing loss. Our intent was to establish and validate a new questionnaire that encompasses situations emphasizing binaural hearing. The Spatial Hearing Questionnaire is a self-report assessment tool utilizing eight subscales representing questions pertaining to the perception of male, female, and childrens voices, music in quiet, source localization, understanding speech in quiet, and understanding speech in noise. Design The Spatial Hearing Questionnaire, composed of 24 items, is scored from 0100. It was administered to 142 subjects using one or two cochlear implants. Speech perception and localization abilities were measured, and the Speech, Spatial and Other Qualities (SSQ) questionnaire was completed to evaluate validity of the questionnaire. Psychometric tests were done to test the reliability and factor structure of the Spatial Hearing Questionnaire. Results Results showed high internal consistency reliability (Cronbachs ? = 0.98) and good construct validity (correlations between the Spatial Hearing Questionnaire and other test measures, including the SSQ, were significant). A preliminary factor analysis revealed scores loaded on three factors, representing the following conditions: localization, speech in noise and music in quiet, and speech in quiet, explaining 64.9, 13.0, and 5.3% of the variance, respectively. Most of the questionnaire items (12/24) loaded onto the first factor which represents the subscale related to source localization. Mean scores on the Spatial Hearing Questionnaire were higher for subjects with bilateral cochlear implants over subjects with a unilateral cochlear implant, consistent with other research and supporting construct validity. Conclusions The Spatial Hearing Questionnaire is a reliable and valid questionnaire which can be completed independently by most patients in about 10 minutes. It is likely to be a valuable tool for clinicians and researchers to measure spatial hearing abilities.
BackgroundTools for the evaluation, improvement and promotion of the teaching excellence of faculty remain elusive in residency settings. This study investigates (i) the reliability and validity of the data yielded by using two new instruments for evaluating the teaching qualities of medical faculty, (ii) the instruments' potential for differentiating between faculty, and (iii) the number of residents' evaluations needed per
Onyebuchi A. Arah; Joost B. L. Hoekstra; Albert P. Bos; Kiki M. J. M. H. Lombarts; Tanya Horsley
Background Infertility has potentially inappropriate effects on quality of life in infertile couples. Various general and specific questionnaires have been structured for assessing different aspects of quality of life in infertile men, women, or couples. The present systematic review was designed to assess these questionnaires and also identify different factors affecting infertile couples based on the aforesaid questionnaires. Methods The research strategy involved general and specific terms in relation to couples's infertility and their quality of life. A review was done for studies published from 1982 to 2012 that were indexed in Medline, ISI Web of Science and Scopus as well as abstract books on this subject. We also corresponded with the authors of the references in related studies for introducing more resources and references. Results In all reviewed studies, different aspects of the quality of life in couples were evaluated including sexual, psychological, social, communicational, environmental, occupational, medical, as well as economical ones. In total, after initial screening of all studies, 10 general and 2 specific questionnaires were retrieved. Although no meta-analysis was found in the review, infertility had a negative effect on quality of life in couples. Conclusion This study revealed that some general questionnaires such as SF-36 and WHO-QOL were mostly used for assessing quality of life in infertile couples and some specific questionnaires such as FERTI-QoL and Fertility Problem Inventory were rarely used. Thus, it seems that the evaluation of quality of life in infertile couples needs valid instruments for measurement.
The intake of prescribed medication presents a challenge, in particular for elderly people and in cases where a variety of medications have to be taken in accordance to a complex schedule. To support patients with this task, an mHealth-concept was developed and evaluated in the course of a clinical trial. The system used a multimodal user interface concept, i.e. both RFID tags and barcodes to identify and document the intake of medications. Results of the clinical study with 20 patients indicate that the multimodal mHealth concept utilizing barcode and RFID tags enabled easy-to-use medication management. Although further clinical evaluation is needed to assess whether such a tool can also enhance adherence, the system shows the potential for targeting the problem of medication management with mHealth methods. PMID:24111423
The first development phase of a multi-modality Picture Archiving and Communications System (PACS) has been completed at the Veterans Affairs Medical Center West Los Angeles. This initial phase involved the development of an ultrasound mini-PACS system using a commercially available PACS product line (IMPAXTM) from AGFA Division of Miles Inc. The PACS provides acquisition, archival, display, and network printing capabilities.
Duerinckx, Andre J.; Hagan, Girish T.; Wanchoo, Vishal; Grant, Edward G.
Background Informatics tools may help support hypertension management. Objective To design, implement and evaluate a web-based system for patient anti-hypertensive medication self-titration. Methods Study stages included: six focus groups (50 patients) to identify barriers/facilitators to patient medication self-titration, software design informed by qualitative analysis of focus group responses and a six-month single-arm pilot study (20 patients) to assess implementation feasibility. Results Focus groups emphasised patient need to feel confident that their own primary care providers were directly involved and approved of the titration protocol. Physicians required 3.3 ± 2.8 minutes/patient to create individualised six-step medication pathways for once-monthly blood pressure evaluations. Pilot participants (mean age of 51.5 ± 11 years, 45% women, mean baseline blood pressure 139/84 ± 12.2/7.5 mmHg) had 5 medication increases, 2 non-adherence self-reports, 52 months not requiring medication changes, 24 skipped months and 17 months with no evaluations due to technical issues. Four pilot patients dropped out before study completion. From baseline to study completion, blood pressure decreased among the 16 patients remaining in the study (8.0/4.7 mmHg, p = 0.03 for both systolic and diastolic pressures). Conclusions Lessons learned included the benefit of qualitative patient analysis prior to system development and the feasibility of physicians designing individual treatment pathways. Any potential clinical benefits were offset by technical problems, the tendency for patients to skip their monthly self-evaluations and drop outs. To be more widely adopted such systems must effectively generalise to a wider range of patients and be integrated into clinical workflow.
Grant, Richard W; Pandiscio, Jennifer C; Pajolek, Hannah; Woulfe, Alyssa; Pelletier, Alexandra; Kvedar, Joseph; Park, Elyse R